code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries APC,00701,Sr89 strontium ,,,4146.34,4146.34,2 APC,00702,"Inj, human-lans, per i.u ",,,1.73,1.73,2 APC,00703,Inj daxibotulinumtoxina-la ,,,3.07,3.07,2 APC,00704,"Inj, aflibercept hd, 1 mg ",,,298.68,298.68,2 APC,00705,Inj avacincaptad pegol 0.1 ,,,103.2,103.2,2 APC,00706,Inj talquetamab-tgvs 0.25 ,,,76.72,76.72,2 APC,00707,"Cantharidin top, applicato ",,,695.21,695.21,2 APC,00708,"Inj, elranatamab-bcmm, 1 m ",,,192.48,192.48,2 APC,00709,Flortaucipir inj 1 millicu ,,,371.0,371.0,2 APC,00710,Inj velmanase alfa-tycv 1 ,,,479.19,479.19,2 APC,00711,"Inj, artesunate, 1mg ",,,51.83,51.83,2 APC,00713,Inj roctavian ml 2x10^13vc ,,,12553.71,12553.71,2 APC,00714,Inj delandistrogene mox ro ,,,3316897.0,3316897.0,2 APC,00715,Pegunigalsidase alfa-iwxj ,,,225.66,225.66,2 APC,00716,"Vyjuvek 5x10^9pfu/ml, 0.1 ",,,1032.44,1032.44,2 APC,00717,"Instill adstiladrin, tx do ",,,64331.61,64331.61,2 APC,00719,Inj cyclophos frindovyx 5 ,,,8.92,8.92,2 APC,00720,"Inj glofitamab gxbm, 2.5 m ",,,2864.68,2864.68,2 APC,00721,Inj rozanolixizum-noli 1 m ,,,23.59,23.59,2 APC,00723,Inj efgart-alfa 2mg hya-qv ,,,34.26,34.26,2 APC,00725,Inj secukinumab intrav 1mg ,,,18.23,18.23,2 APC,00726,Dexrazoxane HCl injection ,,,41.44,41.44,2 APC,00727,"Inj, adzynma, 10 iu ",,,36.21,36.21,2 APC,00728,"Inj, mirikizumab-mrkz, 1 m ",,,32.66,32.66,2 APC,00729,"Inj, motixafortide, 0.25 m ",,,26.48,26.48,2 APC,00730,Inj melphalan (hepzato) 1 ,,,801.48,801.48,2 APC,00731,Sargramostim injection ,,,62.47,62.47,2 APC,00732,"Inj, brixadi, 7 days or le ",,,430.58,430.58,2 APC,00733,"Inj brixadi, more than 7 d ",,,1722.31,1722.31,2 APC,00734,"Inj, levothyroxine, freska ",,,6.84,6.84,2 APC,00736,Amphotericin b liposome in ,,,19.84,19.84,2 APC,00737,"Inj, cipaglucosidase, 5 mg ",,,96.3,96.3,2 APC,00738,Rasburicase ,,,387.45,387.45,2 APC,00739,"Inj, rykindo, 0.5 mg ",,,13.03,13.03,2 APC,00740,Inj hydroxocobalamin iv 25 ,,,5.35,5.35,2 APC,00741,Inj cyclophos dr reddys 5 ,,,0.5,0.5,2 APC,00743,"Inj, cyclophosphamide, nos ",,,0.57,0.57,2 APC,00744,Inst tauro 1.35mg/hep 100u ,,,4.21,4.21,2 APC,00745,"Inj, toripalimab-tpzi, 1 m ",,,40.89,40.89,2 APC,00746,"Inj, betibeglogene autotem ",,,2930260.0,2930260.0,2 APC,00747,"Inj, zolbetuximab-clzb, 2 ",,,33.92,33.92,2 APC,00748,"Inj, lovotibeglogene autot ",,,3235304.0,3235304.0,2 APC,00749,Inj travoprost intra impl ,,,196.75,196.75,2 APC,00750,"Inj, nithiodote, 3mg / 125 ",,,2.17,2.17,2 APC,00752,Dactinomycin injection ,,,307.41,307.41,2 APC,00755,Oral methotrexate (jylamvo ,,,16.47,16.47,2 APC,00756,Oral methotrexate (xatmep) ,,,22.91,22.91,2 APC,00757,"Docetaxel (docivyx), 1 mg ",,,45.51,45.51,2 APC,00759,"Naltrexone, depot form ",,,4.53,4.53,2 APC,00760,Tc-99m graphite crucible ,,,328.6,328.6,2 APC,00761,"Inj, focinvez, 1mg ",,,2.46,2.46,2 APC,00763,"Inj, bupivacaine liposome ",,,1.45,1.45,2 APC,00764,Ketorolac tromethamine inj ,,,0.29,0.29,2 APC,00765,"Inj, donanemab-azbt, 2 mg ",,,4.17,4.17,2 APC,00767,"Inj, nogapendekin pmln 1 m ",,,94.31,94.31,2 APC,00768,"Inj, tarlatamab-dlle, 1 mg ",,,1612.42,1612.42,2 APC,00770,In111 oxyquinoline ,,,831.46,831.46,2 APC,00771,In111 pentetate ,,,745.62,745.62,2 APC,00772,"Inj, pegulicianine, 1 mg ",,,37.51,37.51,2 APC,00774,Tc99m bicisate ,,,775.52,775.52,2 APC,00776,Technetium tc-99m auto wbc ,,,934.13,934.13,2 APC,00777,Indium in-111 auto wbc ,,,1103.19,1103.19,2 APC,00778,"Inj, vasopressin (baxter) ",,,1.75,1.75,2 APC,00779,Indium in-111 pentetreotid ,,,2000.94,2000.94,2 APC,00780,Iodine i-123 iobenguane ,,,2317.5,2317.5,2 APC,00781,Iodine i-123 ioflupane ,,,1387.74,1387.74,2 APC,00782,"Inj, pemrydi rtu, 10 mg ",,,67.94,67.94,2 APC,00784,"Inj, tyenne, 1 mg ",,,4.06,4.06,2 APC,00785,"Inj, cyclophosphamd, sando ",,,3.44,3.44,2 APC,00786,"Inj, tofidence, 1 mg ",,,5.01,5.01,2 APC,00798,"Inj, sezaby, 1 mg ",,,1.12,1.12,2 APC,00800,Leuprolide acetate ,,,1841.26,1841.26,2 APC,00802,Etoposide oral 50 mg ,,,88.06,88.06,2 APC,00804,"Capecitabine, oral, 50 mg ",,,0.08,0.08,2 APC,00805,"Hiv prep, inj, cabotegravi ",,,7.17,7.17,2 APC,00806,"Hiv prep, ftc/tdf 200/300m ",,,0.45,0.45,2 APC,00807,Aldesleukin injection ,,,3338.87,3338.87,2 APC,00808,"Hiv prep, ftc/taf 200/25mg ",,,70.23,70.23,2 APC,00811,"Inj, nyposi 1 mcg ",,,1.03,1.03,2 APC,00812,Carmustine injection ,,,240.01,240.01,2 APC,00813,"Injection, imetelstat, 1 m ",,,59.53,59.53,2 APC,00814,"Inj, magtrace per study do ",,,1254.0,1254.0,2 APC,00815,"Inj, palonosetron (posfrea ",,,55.23,55.23,2 APC,00816,"Inj, tislelizumab-jsgr ",,,58.17,58.17,2 APC,00818,"Inj, crovalimab-akkz, 10 m ",,,551.51,551.51,2 APC,00819,"Inj, alyglo, 500 mg ",,,121.54,121.54,2 APC,00821,Indigotindisulfonate sod 1 ,,,9.3,9.3,2 APC,00822,"Inj, romiplostim 1 microgr ",,,11.62,11.62,2 APC,00824,"Inj, exagamglogene autotem ",,,2300907.0,2300907.0,2 APC,00825,Nelarabine injection ,,,65.41,65.41,2 APC,00827,Floxuridine injection ,,,4396.49,4396.49,2 APC,00831,Obecbtge autol up to 400 m ,,,278250.0,278250.0,2 APC,00835,"Datopotamab deruxtecan, 1 ",,,52.5,52.5,2 APC,00837,"Inj, treosulfan, 50 mg ",,,32.33,32.33,2 APC,00839,Inj axatilimab-csfr 0.1 mg ,,,56.46,56.46,2 APC,00840,Inj melpha hydroch nos 50 ,,,104.9,104.9,2 APC,00841,"Inj, docetaxel (beizray) 1 ",,,46.81,46.81,2 APC,00842,"Inj, melphalan (apotex) 1 ",,,64.78,64.78,2 APC,00843,Pegaspargase injection ,,,29663.96,29663.96,2 APC,00844,Pentostatin injection ,,,2697.99,2697.99,2 APC,00845,"Inj, atidarsagene autotemc ",,,4505000.0,4505000.0,2 APC,00846,"Inj, eculizumab-aeeb, 2 mg ",,,41.17,41.17,2 APC,00847,Inj thiotepa nos 1 mg ,,,4.93,4.93,2 APC,00848,Inj nivolumab 2 mg hyaluro ,,,28.14,28.14,2 APC,00852,"Inj, eculizumab-aagh, 2 mg ",,,31.78,31.78,2 APC,00853,Inj zenocutuzumab-zbco 1 m ,,,33.86,33.86,2 APC,00854,In111 capromab ,,,1730.29,1730.29,2 APC,00855,"Inj ustekinumab-stba, 1 mg ",,,3.08,3.08,2 APC,00858,Inj cladribine per 1 mg ,,,8.19,8.19,2 APC,00859,"Inj ustekinumab-aekn, 1 mg ",,,10.53,10.53,2 APC,00860,"I131 iodobenguate, dx ",,,953.01,953.01,2 APC,00861,"I125 serum albumin, dx ",,,469.06,469.06,2 APC,00862,Cr51 chromate ,,,1917.96,1917.96,2 APC,00863,"I125 iothalamate, dx ",,,649.64,649.64,2 APC,00864,Mitoxantrone hydrochl ,,,29.7,29.7,2 APC,00865,"Inj, hercessi, 10 mg ",,,32.46,32.46,2 APC,00866,"Inj, sod thiosulfate (hope ",,,0.84,0.84,2 APC,00869,"Inj ustekinumab-kfce, 1 mg ",,,3.29,3.29,2 APC,00870,Inj. calaspargase pegol-mk ,,,85.79,85.79,2 APC,00871,Inj pemetrexed (bluepoint) ,,,10.6,10.6,2 APC,00872,"Inj. denosumab-bbdz, 1 mg ",,,27.66,27.66,2 APC,00874,Synvisc or synvisc-one ,,,6.02,6.02,2 APC,00875,Euflexxa inj per dose ,,,98.14,98.14,2 APC,00876,Gallium gozellix 1 millicu ,,,1171.3,1171.3,2 APC,00877,Orthovisc inj per dose ,,,100.33,100.33,2 APC,00878,Aztreonam/avibactam 10 mg ,,,1.77,1.77,2 APC,00879,Inj ceftobipole medocarl 3 ,,,1.1,1.1,2 APC,00880,"Hiv prep, inj, lenacapavir ",,,16.08,16.08,2 APC,00881,"Hiv prep, oral lenacapavir ",,,620.91,620.91,2 APC,00882,Inj glucagon (gvoke) 0.01 ,,,1.8,1.8,2 APC,00883,"Inj, ethacrynate sod, 1 mg ",,,12.42,12.42,2 APC,00884,"Inj, fosdenopterin, 0.1mg ",,,17.74,17.74,2 APC,00885,"Inj, isoniazid, 1 mg ",,,0.3,0.3,2 APC,00886,Inj. remestemcel-l-rknd/ t ,,,203659.8,203659.8,2 APC,00887,Azathioprine parenteral ,,,254.76,254.76,2 APC,00888,"Inj. concizumab-mtci, 0.5 ",,,86.16,86.16,2 APC,00889,Injection fitusiran 0.04 m ,,,131.2,131.2,2 APC,00890,Lymphocyte immune globulin ,,,5548.96,5548.96,2 APC,00891,"Inj, denosumab-bmwo, 1 mg ",,,25.98,25.98,2 APC,00892,"Inj, denosumab-bnht, 1 mg ",,,28.82,28.82,2 APC,00893,"Inj, nipocalimab-aahu, 3 m ",,,32.57,32.57,2 APC,00894,Telisotuzumab vedotin-tllv ,,,146.06,146.06,2 APC,00895,Inj ustekinumab-aauz 1 mg ,,,13.15,13.15,2 APC,00896,"Inj, carboprost, 0.1 mg ",,,16.37,16.37,2 APC,00897,"Revakinagene, per implant ",,,261579.7,261579.7,2 APC,00898,Inj meloxicam (azurity) 1m ,,,1.06,1.06,2 APC,00900,"Inj, liothyronine, 1 mcg ",,,40.13,40.13,2 APC,00901,Alpha 1 proteinase inhibit ,,,5.13,5.13,2 APC,00902,"Injection,onabotulinumtoxi ",,,6.51,6.51,2 APC,00903,Cytomegalovirus imm IV /vi ,,,1858.82,1858.82,2 APC,00904,Testosterone pellet 75 mg ,,,72.8,72.8,2 APC,00905,"Inj, posaconazole, 1 mg ",,,0.34,0.34,2 APC,00906,Inj elivaldogene autotemec ,,,3180000.0,3180000.0,2 APC,00907,"Inj, cyclophos (baxter) 5m ",,,4.39,4.39,2 APC,00908,Topi adm prad zami per tre ,,,3285783.0,3285783.0,2 APC,00909,Inj gemcitabin (avyxa) 200 ,,,400.33,400.33,2 APC,00911,"Inj pozelimab-bbfg, 1 mg ",,,91.73,91.73,2 APC,00912,"Inj, wezlana, iv, 1 mg ",,,2.35,2.35,2 APC,00913,Mitomycin intravesical ins ,,,274.34,274.34,2 APC,00914,Ustekinumab-ttwe iv inj 1 ,,,8.55,8.55,2 APC,00915,"Inj cosibelimab-ipdl, 2 mg ",,,22.27,22.27,2 APC,00916,Inj linvoseltamab-gcpt 1 m ,,,99.31,99.31,2 APC,00917,"Inj, carboplatin (avyxa) ",,,5.2,5.2,2 APC,00918,"Inj, jobevne, 10 mg ",,,82.24,82.24,2 APC,00920,Tc99m succimer ,,,659.93,659.93,2 APC,00921,"Inj, tyruko, 1 mg ",,,24.49,24.49,2 APC,00922,Inj onase abepar-brve trea ,,,2664228.0,2664228.0,2 APC,00923,Inj yimmugo 100 mg ,,,24.14,24.14,2 APC,00924,Inj zopapogene per ther do ,,,121900.0,121900.0,2 APC,00925,Factor viii ,,,1.25,1.25,2 APC,00926,Gemcitabine intravesical s ,,,72984.24,72984.24,2 APC,00927,Factor viii recombinant ,,,1.58,1.58,2 APC,00928,Factor ix complex ,,,1.75,1.75,2 APC,00929,Anti-inhibitor ,,,2.45,2.45,2 APC,00930,Pembrolizumab 1mg berahyal ,,,31.94,31.94,2 APC,00931,Factor IX non-recombinant ,,,1.4,1.4,2 APC,00932,Factor ix recombinant nos ,,,1.86,1.86,2 APC,00933,"Suzetrigine, orl, 1mg ",,,0.31,0.31,2 APC,00934,"Inj, denosumab-nxxp, 1 mg ",,,15.66,15.66,2 APC,00935,"Inj. ferumoxytol, 1 mg ",,,0.4,0.4,2 APC,00936,"Inj, leucovorin cal (avyxa ",,,2.58,2.58,2 APC,00937,Inj fosfomycin disodium 20 ,,,0.63,0.63,2 APC,00938,"Narsoplimab-wuug, 1 mg ",,,102.46,102.46,2 APC,00939,"Inj, qivigy, 100mg ",,,29.59,29.59,2 APC,00940,Inj depemokimab-ulaa 1 mg ,,,267.8,267.8,2 APC,00941,Riboflavin epioxa/hd<=2ml ,,,40427.5,40427.5,2 APC,00942,Inj amivantamab 5mg hyalur ,,,40.74,40.74,2 APC,00943,Octagam injection ,,,47.06,47.06,2 APC,00944,Gammagard liquid/erc inj ,,,49.3,49.3,2 APC,00946,Hepagam b im injection ,,,65.61,65.61,2 APC,00947,Flebogamma injection ,,,90.74,90.74,2 APC,00948,Gamunex-C/Gammaked ,,,49.01,49.01,2 APC,00949,"Inj, denosumab-qbde, 1 mg ",,,4.12,4.12,2 APC,00950,"Inj, tocilizumab-anoh, 1 m ",,,4.69,4.69,2 APC,00951,"Inj, denosumab-kyqq, 1 mg ",,,14.0,14.0,2 APC,00952,"Inj ustekinumab-srlf, 1 mg ",,,11.55,11.55,2 APC,00953,Ibuprofen injection ,,,3.25,3.25,2 APC,00957,Inj belantamab mafodot blm ,,,36.25,36.25,2 APC,00961,"Albumin (human),5%, 50ml ",,,10.62,10.62,2 APC,00963,"Albumin (human), 5%, 250 m ",,,53.08,53.08,2 APC,00964,"Albumin (human), 25%, 20 m ",,,21.33,21.33,2 APC,00965,"Albumin (human), 25%, 50ml ",,,53.32,53.32,2 APC,01064,"I131 iodide cap, rx ",,,24.07,24.07,2 APC,01138,"Hepagam b intravenous, inj ",,,65.61,65.61,2 APC,01139,Protein c concentrate ,,,15.07,15.07,2 APC,01142,Supprelin LA implant ,,,37491.97,37491.97,2 APC,01150,"I131 iodide sol, rx ",,,20.77,20.77,2 APC,01168,"Inj, temsirolimus ",,,32.68,32.68,2 APC,01178,Busulfan injection ,,,1.03,1.03,2 APC,01203,Verteporfin injection ,,,11.37,11.37,2 APC,01207,"Octreotide injection, depo ",,,208.09,208.09,2 APC,01213,Antihemophilic viii/vwf co ,,,1.27,1.27,2 APC,01214,Inj IVIG privigen 500 mg ,,,51.22,51.22,2 APC,01232,Mitomycin injection ,,,34.11,34.11,2 APC,01235,Valrubicin injection ,,,1247.05,1247.05,2 APC,01237,Inj iron dextran ,,,18.99,18.99,2 APC,01238,Topotecan oral ,,,125.33,125.33,2 APC,01253,Triamcinolone a inj prs-fr ,,,19.19,19.19,2 APC,01263,Antithrombin iii injection ,,,4.17,4.17,2 APC,01268,Xyntha inj ,,,1.37,1.37,2 APC,01274,Edetate calcium disodium i ,,,6189.49,6189.49,2 APC,01281,Bevacizumab injection ,,,1.87,1.87,2 APC,01289,AbobotulinumtoxinA ,,,8.95,8.95,2 APC,01295,Sm 153 lexidronam ,,,3159.8,3159.8,2 APC,01296,Degarelix injection ,,,4.48,4.48,2 APC,01297,"Ferumoxytol, non-esrd ",,,0.37,0.37,2 APC,01311,Canakinumab injection ,,,156.54,156.54,2 APC,01312,Hizentra injection ,,,14.88,14.88,2 APC,01327,Imiglucerase injection ,,,43.33,43.33,2 APC,01340,"Collagenase, clost hist in ",,,78.3,78.3,2 APC,01352,Wilate injection ,,,1.33,1.33,2 APC,01353,Belimumab injection ,,,58.3,58.3,2 APC,01413,Lumizyme injection ,,,211.13,211.13,2 APC,01415,Glassia injection ,,,5.58,5.58,2 APC,01416,Factor xiii anti-hem facto ,,,11.23,11.23,2 APC,01417,Gel-one ,,,533.59,533.59,2 APC,01420,Aflibercept injection ,,,743.61,743.61,2 APC,01421,Imported lipodox inj ,,,293.74,293.74,2 APC,01426,Eribulin mesylate injectio ,,,59.98,59.98,2 APC,01441,Dom nonHEU Tc99m add-on/do ,,,10.0,10.0,2 APC,01446,Visualization adjunct ,,,10.87,10.87,2 APC,01458,Phentolaine mesylate inj ,,,288.63,288.63,2 APC,01464,Factor viii (porcine) ,,,5.46,5.46,2 APC,01467,Factor ix recombinan rixub ,,,1.72,1.72,2 APC,01468,"Inj, abilify maintena, 1 m ",,,7.46,7.46,2 APC,01469,Inj filgrastim excl biosim ,,,1.01,1.01,2 APC,01471,"Injection, Pertuzumab, 1 m ",,,17.2,17.2,2 APC,01474,Certolizumab pegol inj 1mg ,,,3.44,3.44,2 APC,01475,Golimumab for iv use 1mg ,,,11.04,11.04,2 APC,01476,Obinutuzumab inj ,,,84.46,84.46,2 APC,01478,Inj human fibrinogen con n ,,,1.49,1.49,2 APC,01480,"Elosulfase alfa, injection ",,,319.52,319.52,2 APC,01482,"Darbepoetin alfa, esrd use ",,,2.92,2.92,2 APC,01485,"Ferumoxytol, esrd use ",,,0.37,0.37,2 APC,01486,Factor ix fc fusion recomb ,,,3.71,3.71,2 APC,01488,"Injection, ramucirumab ",,,76.56,76.56,2 APC,01489,Inj vedolizumab iv 1 mg ,,,21.62,21.62,2 APC,01490,Inj pembrolizumab ,,,60.65,60.65,2 APC,01491,New Technology - Level 1A ,,,4.92,4.92,2 APC,01492,New Technology - Level 1B ,,,15.24,15.24,2 APC,01493,New Technology - Level 1C ,,,25.07,25.07,2 APC,01494,New Technology - Level 1D ,,,34.91,34.91,2 APC,01495,New Technology - Level 1E ,,,44.74,44.74,2 APC,01496,New Technology - Level 1A ,,,4.92,4.92,2 APC,01497,New Technology - Level 1B ,,,15.24,15.24,2 APC,01498,New Technology - Level 1C ,,,25.07,25.07,2 APC,01499,New Technology - Level 1D ,,,34.91,34.91,2 APC,01500,New Technology - Level 1E ,,,44.74,44.74,2 APC,01502,New Technology - Level 2 ( ,,,74.24,74.24,2 APC,01503,New Technology - Level 3 ( ,,,147.98,147.98,2 APC,01504,New Technology - Level 4 ( ,,,246.31,246.31,2 APC,01505,New Technology - Level 5 ( ,,,344.63,344.63,2 APC,01506,New Technology - Level 6 ( ,,,442.96,442.96,2 APC,01507,New Technology - Level 7 ( ,,,541.28,541.28,2 APC,01508,New Technology - Level 8 ( ,,,639.61,639.61,2 APC,01509,New Technology - Level 9 ( ,,,737.94,737.94,2 APC,01510,New Technology - Level 10 ,,,836.26,836.26,2 APC,01511,New Technology - Level 11 ,,,934.59,934.59,2 APC,01512,New Technology - Level 12 ,,,1032.91,1032.91,2 APC,01513,New Technology - Level 13 ,,,1131.24,1131.24,2 APC,01514,New Technology - Level 14 ,,,1229.57,1229.57,2 APC,01515,New Technology - Level 15 ,,,1327.89,1327.89,2 APC,01516,New Technology - Level 16 ,,,1426.22,1426.22,2 APC,01517,New Technology - Level 17 ,,,1524.55,1524.55,2 APC,01518,New Technology - Level 18 ,,,1622.87,1622.87,2 APC,01519,New Technology - Level 19 ,,,1721.2,1721.2,2 APC,01520,New Technology - Level 20 ,,,1819.52,1819.52,2 APC,01521,New Technology - Level 21 ,,,1917.85,1917.85,2 APC,01522,New Technology - Level 22 ,,,2212.83,2212.83,2 APC,01523,New Technology - Level 23 ,,,2704.46,2704.46,2 APC,01524,New Technology - Level 24 ,,,3196.09,3196.09,2 APC,01525,New Technology - Level 25 ,,,3687.72,3687.72,2 APC,01526,New Technology - Level 26 ,,,4179.35,4179.35,2 APC,01527,New Technology - Level 27 ,,,4670.98,4670.98,2 APC,01528,New Technology - Level 28 ,,,5162.61,5162.61,2 APC,01529,New Technology - Level 29 ,,,5654.24,5654.24,2 APC,01530,New Technology - Level 30 ,,,6145.87,6145.87,2 APC,01531,New Technology - Level 31 ,,,6637.5,6637.5,2 APC,01532,New Technology - Level 32 ,,,7129.13,7129.13,2 APC,01533,New Technology - Level 33 ,,,7620.76,7620.76,2 APC,01534,New Technology - Level 34 ,,,8112.39,8112.39,2 APC,01535,New Technology - Level 35 ,,,8604.02,8604.02,2 APC,01536,New Technology - Level 36 ,,,9095.65,9095.65,2 APC,01537,New Technology - Level 37 ,,,9587.28,9587.28,2 APC,01539,New Technology - Level 2 ( ,,,74.24,74.24,2 APC,01540,New Technology - Level 3 ( ,,,147.98,147.98,2 APC,01541,New Technology - Level 4 ( ,,,246.31,246.31,2 APC,01542,New Technology - Level 5 ( ,,,344.63,344.63,2 APC,01543,New Technology - Level 6 ( ,,,442.96,442.96,2 APC,01544,New Technology - Level 7 ( ,,,541.28,541.28,2 APC,01545,New Technology - Level 8 ( ,,,639.61,639.61,2 APC,01546,New Technology - Level 9 ( ,,,737.94,737.94,2 APC,01547,New Technology - Level 10 ,,,836.26,836.26,2 APC,01548,New Technology - Level 11 ,,,934.59,934.59,2 APC,01549,New Technology - Level 12 ,,,1032.91,1032.91,2 APC,01550,New Technology - Level 13 ,,,1131.24,1131.24,2 APC,01551,New Technology - Level 14 ,,,1229.57,1229.57,2 APC,01552,New Technology - Level 15 ,,,1327.89,1327.89,2 APC,01553,New Technology - Level 16 ,,,1426.22,1426.22,2 APC,01554,New Technology - Level 17 ,,,1524.55,1524.55,2 APC,01555,New Technology - Level 18 ,,,1622.87,1622.87,2 APC,01556,New Technology - Level 19 ,,,1721.2,1721.2,2 APC,01557,New Technology - Level 20 ,,,1819.52,1819.52,2 APC,01558,New Technology - Level 21 ,,,1917.85,1917.85,2 APC,01559,New Technology - Level 22 ,,,2212.83,2212.83,2 APC,01560,New Technology - Level 23 ,,,2704.46,2704.46,2 APC,01561,New Technology - Level 24 ,,,3196.09,3196.09,2 APC,01562,New Technology - Level 25 ,,,3687.72,3687.72,2 APC,01563,New Technology - Level 26 ,,,4179.35,4179.35,2 APC,01564,New Technology - Level 27 ,,,4670.98,4670.98,2 APC,01565,New Technology - Level 28 ,,,5162.61,5162.61,2 APC,01566,New Technology - Level 29 ,,,5654.24,5654.24,2 APC,01567,New Technology - Level 30 ,,,6145.87,6145.87,2 APC,01568,New Technology - Level 31 ,,,6637.5,6637.5,2 APC,01569,New Technology - Level 32 ,,,7129.13,7129.13,2 APC,01570,New Technology - Level 33 ,,,7620.76,7620.76,2 APC,01571,New Technology - Level 34 ,,,8112.39,8112.39,2 APC,01572,New Technology - Level 35 ,,,8604.02,8604.02,2 APC,01573,New Technology - Level 36 ,,,9095.65,9095.65,2 APC,01574,New Technology - Level 37 ,,,9587.28,9587.28,2 APC,01575,New Technology - Level 38 ,,,12291.24,12291.24,2 APC,01576,New Technology - Level 39 ,,,17207.54,17207.54,2 APC,01577,New Technology - Level 40 ,,,22123.84,22123.84,2 APC,01578,New Technology - Level 41 ,,,27040.14,27040.14,2 APC,01579,New Technology - Level 42 ,,,34414.59,34414.59,2 APC,01580,New Technology - Level 43 ,,,44247.19,44247.19,2 APC,01581,New Technology - Level 44 ,,,54079.79,54079.79,2 APC,01582,New Technology - Level 45 ,,,63912.39,63912.39,2 APC,01583,New Technology - Level 46 ,,,73744.99,73744.99,2 APC,01584,New Technology - Level 47 ,,,83577.59,83577.59,2 APC,01585,New Technology - Level 48 ,,,93410.2,93410.2,2 APC,01589,New Technology - Level 38 ,,,12291.24,12291.24,2 APC,01590,New Technology - Level 39 ,,,17207.54,17207.54,2 APC,01591,New Technology - Level 40 ,,,22123.84,22123.84,2 APC,01592,New Technology - Level 41 ,,,27040.14,27040.14,2 APC,01593,New Technology - Level 42 ,,,34414.59,34414.59,2 APC,01594,New Technology - Level 43 ,,,44247.19,44247.19,2 APC,01595,New Technology - Level 44 ,,,54079.79,54079.79,2 APC,01596,New Technology - Level 45 ,,,63912.39,63912.39,2 APC,01597,New Technology - Level 46 ,,,73744.99,73744.99,2 APC,01598,New Technology - Level 47 ,,,83577.59,83577.59,2 APC,01599,New Technology - Level 48 ,,,93410.2,93410.2,2 APC,01609,"Rho(D) immune globulin h, ",,,35.79,35.79,2 APC,01613,Trastuzumab injection ,,,70.24,70.24,2 APC,01630,"Hep b ig, im ",,,136.95,136.95,2 APC,01643,"Y90 ibritumomab, rx ",,,56824.55,56824.55,2 APC,01656,Factor viii fc fusion reco ,,,2.58,2.58,2 APC,01658,"Injection, belinostat, 10m ",,,54.45,54.45,2 APC,01660,"Injection, oritavancin ",,,29.73,29.73,2 APC,01662,Inj tedizolid phosphate ,,,2.08,2.08,2 APC,01664,Florbetapir f18 ,,,1795.08,1795.08,2 APC,01670,Tetanus immune globulin in ,,,595.02,595.02,2 APC,01675,P32 na phosphate ,,,278.24,278.24,2 APC,01683,Basiliximab ,,,4905.05,4905.05,2 APC,01685,"Darbepoetin alfa, non-esrd ",,,2.92,2.92,2 APC,01686,"Epoetin alfa, non-esrd ",,,6.88,6.88,2 APC,01687,Digoxin immune fab (ovine) ,,,5293.2,5293.2,2 APC,01688,Ethanolamine oleate ,,,547.27,547.27,2 APC,01689,Fomepizole ,,,6.18,6.18,2 APC,01690,Hemin ,,,35.82,35.82,2 APC,01694,Ziconotide injection ,,,10.61,10.61,2 APC,01696,Palifermin injection ,,,38.69,38.69,2 APC,01700,Inj secretin synthetic hum ,,,43.0,43.0,2 APC,01701,Treprostinil injection ,,,54.74,54.74,2 APC,01704,"Humate-P, inj ",,,1.53,1.53,2 APC,01705,Factor viia recomb novosev ,,,2.77,2.77,2 APC,01710,Clofarabine injection ,,,16.25,16.25,2 APC,01712,Paclitaxel protein bound ,,,6.59,6.59,2 APC,01744,Zidovudine ,,,1.51,1.51,2 APC,01745,Radium ra223 dichloride th ,,,181.55,181.55,2 APC,01746,Factor xiii recomb a-subun ,,,19.11,19.11,2 APC,01747,Monovisc inj per dose ,,,565.27,565.27,2 APC,01748,Inj tbo filgrastim 1 micro ,,,0.24,0.24,2 APC,01809,"Injection, alemtuzumab ",,,2544.94,2544.94,2 APC,01822,"Injection, zarxio ",,,0.35,0.35,2 APC,01823,"Injection, dalbavancin ",,,11.29,11.29,2 APC,01824,Ceftaroline fosamil inj ,,,4.39,4.39,2 APC,01825,Ceftazidime and avibactam ,,,109.77,109.77,2 APC,01826,Hyqvia 100mg immuneglobuli ,,,18.35,18.35,2 APC,01827,Factor viii recomb obizur ,,,3.24,3.24,2 APC,01829,Penicillin g benzathine in ,,,32.59,32.59,2 APC,01832,Dimethyl sulfoxide 50% 50 ,,,748.88,748.88,2 APC,01844,Factor viii pegylated reco ,,,2.12,2.12,2 APC,01846,Factor viii nuwiq recomb 1 ,,,1.22,1.22,2 APC,01847,"Injection, inflectra ",,,27.71,27.71,2 APC,01848,Artiss fibrin sealant ,,,145.67,145.67,2 APC,01850,Gamma globulin 1 cc inj ,,,48.87,48.87,2 APC,01851,Gamma globulin > 10 cc inj ,,,162.52,162.52,2 APC,01853,Minocycline hydrochloride ,,,2.73,2.73,2 APC,01854,Pentobarbital sodium inj ,,,19.3,19.3,2 APC,01856,Factor viii recomb novoeig ,,,1.44,1.44,2 APC,01857,"Inj, factor x, (human), 1i ",,,9.95,9.95,2 APC,01859,Argatroban nonesrd use 1mg ,,,0.86,0.86,2 APC,01861,"Inj., bendeka 1 mg ",,,12.53,12.53,2 APC,01862,Gelsyn-3 injection 0.1 mg ,,,0.58,0.58,2 APC,01901,New Technology - Level 49 ,,,105700.9,105700.9,2 APC,01902,New Technology - Level 49 ,,,105700.9,105700.9,2 APC,01903,New Technology - Level 50 ,,,120449.8,120449.8,2 APC,01904,New Technology - Level 50 ,,,120449.8,120449.8,2 APC,01905,New Technology - Level 51 ,,,135198.7,135198.7,2 APC,01906,New Technology - Level 51 ,,,135198.7,135198.7,2 APC,01907,New Technology - Level 52 ,,,149947.6,149947.6,2 APC,01908,New Technology - Level 52 ,,,149947.6,149947.6,2 APC,02062,"Inj zanidatamab-hrii, 2 mg ",,,25.66,25.66,2 APC,02064,"Inj marstacim-hncq, 0.5 mg ",,,51.19,51.19,2 APC,02065,"Flurpiridaz f18, diag, 1 m ",,,530.0,530.0,2 APC,02066,Inj bortezomib boruzu 0.1 ,,,24.75,24.75,2 APC,02067,Afamitresgene autoleucel ,,,800341.6,800341.6,2 APC,02068,"Inj, aflibercept-ayyh, 1 m ",,,803.25,803.25,2 APC,02069,"Inj, testosterone, azmiro ",,,1.3,1.3,2 APC,02070,"Inj, eculizumab, 2 mg ",,,44.2,44.2,2 APC,02071,Inj ocrelizumab 1mg hya-oc ,,,48.06,48.06,2 APC,02072,"Inj, erzofri, 1 mg ",,,15.87,15.87,2 APC,02073,Inj atezolizumb 5mg hya-tq ,,,32.55,32.55,2 APC,02075,Inj acetaminoph 10mg/ibu 3 ,,,0.09,0.09,2 APC,02076,"Inj, pemetrexed dipotassiu ",,,73.67,73.67,2 APC,02616,"Brachytx, non-str,Yttrium- ",,,17771.01,17771.01,2 APC,02632,Iodine I-125 sodium iodide ,,,396.32,396.32,2 APC,02634,"Brachytx, non-str, HA, I-1 ",,,174.06,174.06,2 APC,02635,"Brachytx, non-str, HA, P-1 ",,,106.75,106.75,2 APC,02636,"Brachy linear, non-str,P-1 ",,,89.4,89.4,2 APC,02638,"Brachytx, stranded, I-125 ",,,35.26,35.26,2 APC,02639,"Brachytx, non-stranded,I-1 ",,,36.64,36.64,2 APC,02640,"Brachytx, stranded, P-103 ",,,88.26,88.26,2 APC,02641,"Brachytx, non-stranded,P-1 ",,,64.48,64.48,2 APC,02642,"Brachytx, stranded, C-131 ",,,119.11,119.11,2 APC,02643,"Brachytx, non-stranded,C-1 ",,,99.8,99.8,2 APC,02645,"Brachytx, non-str, Gold-19 ",,,513.57,513.57,2 APC,02646,"Brachytx, non-str, HDR Ir- ",,,357.49,357.49,2 APC,02647,"Brachytx, NS, Non-HDRIr-19 ",,,908.7,908.7,2 APC,02648,"Brachytx planar, p-103 ",,,4.69,4.69,2 APC,02698,"Brachytx, stranded, NOS ",,,35.26,35.26,2 APC,02699,"Brachytx, non-stranded, NO ",,,36.64,36.64,2 APC,02731,"Immune globulin, powder ",,,80.96,80.96,2 APC,04017,Radiation tx delivery lvl ,,,78.16,78.16,2 APC,04018,Radiation tx delivery lvl ,,,312.32,312.32,2 APC,04019,Radiation tx delivery lvl ,,,384.91,384.91,2 APC,05012,Clinic Visits and Related ,,,133.74,133.74,2 APC,05021,Level 1 Type A ED Visits ,,,84.71,84.71,2 APC,05022,Level 2 Type A ED Visits ,,,154.24,154.24,2 APC,05023,Level 3 Type A ED Visits ,,,274.22,274.22,2 APC,05024,Level 4 Type A ED Visits ,,,419.16,419.16,2 APC,05025,Level 5 Type A ED Visits ,,,598.24,598.24,2 APC,05031,Level 1 Type B ED Visits ,,,74.67,74.67,2 APC,05032,Level 2 Type B ED Visits ,,,93.31,93.31,2 APC,05033,Level 3 Type B ED Visits ,,,172.67,172.67,2 APC,05034,Level 4 Type B ED Visits ,,,265.51,265.51,2 APC,05035,Level 5 Type B ED Visits ,,,412.6,412.6,2 APC,05041,Critical Care ,,,829.79,829.79,2 APC,05045,Trauma Response with Criti ,,,1338.98,1338.98,2 APC,05051,Level 1 Skin Procedures ,,,201.55,201.55,2 APC,05052,Level 2 Skin Procedures ,,,408.37,408.37,2 APC,05053,Level 3 Skin Procedures ,,,742.44,742.44,2 APC,05054,Level 4 Skin Procedures ,,,2072.68,2072.68,2 APC,05055,Level 5 Skin Procedures ,,,3559.87,3559.87,2 APC,05061,Hyperbaric Oxygen ,,,138.24,138.24,2 APC,05071,Level 1 Excision/ Biopsy/ ,,,711.36,711.36,2 APC,05072,Level 2 Excision/ Biopsy/ ,,,1659.12,1659.12,2 APC,05073,Level 3 Excision/ Biopsy/ ,,,2917.95,2917.95,2 APC,05091,Level 1 Breast/Lymphatic S ,,,3933.28,3933.28,2 APC,05092,Level 2 Breast/Lymphatic S ,,,6670.43,6670.43,2 APC,05093,Level 3 Breast/Lymphatic S ,,,8210.63,8210.63,2 APC,05094,Level 4 Breast/Lymphatic S ,,,13843.75,13843.75,2 APC,05101,Level 1 Strapping and Cast ,,,163.24,163.24,2 APC,05102,Level 2 Strapping and Cast ,,,280.97,280.97,2 APC,05111,Level 1 Musculoskeletal Pr ,,,247.79,247.79,2 APC,05112,Level 2 Musculoskeletal Pr ,,,1615.32,1615.32,2 APC,05113,Level 3 Musculoskeletal Pr ,,,3286.91,3286.91,2 APC,05114,Level 4 Musculoskeletal Pr ,,,7289.28,7289.28,2 APC,05115,Level 5 Musculoskeletal Pr ,,,12897.19,12897.19,2 APC,05116,Level 6 Musculoskeletal Pr ,,,17613.72,17613.72,2 APC,05117,Level 7 Musculoskeletal Pr ,,,27257.67,27257.67,2 APC,05151,Level 1 Airway Endoscopy ,,,200.52,200.52,2 APC,05152,Level 2 Airway Endoscopy ,,,392.9,392.9,2 APC,05153,Level 3 Airway Endoscopy ,,,1788.01,1788.01,2 APC,05154,Level 4 Airway Endoscopy ,,,3745.34,3745.34,2 APC,05155,Level 5 Airway Endoscopy ,,,7089.62,7089.62,2 APC,05161,Level 1 ENT Procedures ,,,237.93,237.93,2 APC,05162,Level 2 ENT Procedures ,,,541.79,541.79,2 APC,05163,Level 3 ENT Procedures ,,,1558.65,1558.65,2 APC,05164,Level 4 ENT Procedures ,,,3330.57,3330.57,2 APC,05165,Level 5 ENT Procedures ,,,5946.81,5946.81,2 APC,05166,Cochlear Implant Procedure ,,,33122.37,33122.37,2 APC,05181,Level 1 Vascular Procedure ,,,630.16,630.16,2 APC,05182,Level 2 Vascular Procedure ,,,1581.33,1581.33,2 APC,05183,Level 3 Vascular Procedure ,,,3171.87,3171.87,2 APC,05184,Level 4 Vascular Procedure ,,,5589.84,5589.84,2 APC,05191,Level 1 Endovascular Proce ,,,3256.7,3256.7,2 APC,05192,Level 2 Endovascular Proce ,,,5717.5,5717.5,2 APC,05193,Level 3 Endovascular Proce ,,,11596.79,11596.79,2 APC,05194,Level 4 Endovascular Proce ,,,18415.17,18415.17,2 APC,05200,Implantation Wireless PA P ,,,28814.06,28814.06,2 APC,05211,Level 1 Electrophysiologic ,,,1223.09,1223.09,2 APC,05212,Level 2 Electrophysiologic ,,,7835.21,7835.21,2 APC,05213,Level 3 Electrophysiologic ,,,26256.96,26256.96,2 APC,05221,Level 1 Pacemaker and Simi ,,,3753.99,3753.99,2 APC,05222,Level 2 Pacemaker and Simi ,,,8313.1,8313.1,2 APC,05223,Level 3 Pacemaker and Simi ,,,10499.62,10499.62,2 APC,05224,Level 4 Pacemaker and Simi ,,,19349.46,19349.46,2 APC,05231,Level 1 ICD and Similar Pr ,,,22344.94,22344.94,2 APC,05232,Level 2 ICD and Similar Pr ,,,31531.9,31531.9,2 APC,05241,Level 1 Blood Product Exch ,,,443.18,443.18,2 APC,05242,Level 2 Blood Product Exch ,,,1564.52,1564.52,2 APC,05243,Level 3 Blood Product Exch ,,,4375.35,4375.35,2 APC,05244,Level 4 Blood Product Exch ,,,63187.75,63187.75,2 APC,05301,Level 1 Upper GI Procedure ,,,911.12,911.12,2 APC,05302,Level 2 Upper GI Procedure ,,,1927.65,1927.65,2 APC,05303,Level 3 Upper GI Procedure ,,,3873.04,3873.04,2 APC,05311,Level 1 Lower GI Procedure ,,,934.2,934.2,2 APC,05312,Level 2 Lower GI Procedure ,,,1202.09,1202.09,2 APC,05313,Level 3 Lower GI Procedure ,,,2788.31,2788.31,2 APC,05331,Complex GI Procedures ,,,6098.56,6098.56,2 APC,05341,Level 1 Abdominal/Peritone ,,,3596.72,3596.72,2 APC,05342,Level 2 Abdominal/Peritone ,,,6503.32,6503.32,2 APC,05361,Level 1 Laparoscopy and Re ,,,6073.08,6073.08,2 APC,05362,Level 2 Laparoscopy and Re ,,,10678.27,10678.27,2 APC,05371,Level 1 Urology and Relate ,,,250.99,250.99,2 APC,05372,Level 2 Urology and Relate ,,,700.47,700.47,2 APC,05373,Level 3 Urology and Relate ,,,2099.91,2099.91,2 APC,05374,Level 4 Urology and Relate ,,,3541.04,3541.04,2 APC,05375,Level 5 Urology and Relate ,,,5386.23,5386.23,2 APC,05376,Level 6 Urology and Relate ,,,9509.6,9509.6,2 APC,05377,Level 7 Urology and Relate ,,,13253.58,13253.58,2 APC,05378,Level 8 Urology and Relate ,,,20820.57,20820.57,2 APC,05401,Dialysis ,,,689.44,689.44,2 APC,05411,Level 1 Gynecologic Proced ,,,203.09,203.09,2 APC,05412,Level 2 Gynecologic Proced ,,,306.12,306.12,2 APC,05413,Level 3 Gynecologic Proced ,,,925.25,925.25,2 APC,05414,Level 4 Gynecologic Proced ,,,3251.88,3251.88,2 APC,05415,Level 5 Gynecologic Proced ,,,5025.24,5025.24,2 APC,05416,Level 6 Gynecologic Proced ,,,7449.23,7449.23,2 APC,05431,Level 1 Nerve Procedures ,,,1961.62,1961.62,2 APC,05432,Level 2 Nerve Procedures ,,,3431.72,3431.72,2 APC,05433,Level 3 Nerve Procedures ,,,8815.84,8815.84,2 APC,05441,Level 1 Nerve Injections ,,,308.35,308.35,2 APC,05442,Level 2 Nerve Injections ,,,709.1,709.1,2 APC,05443,Level 3 Nerve Injections ,,,888.5,888.5,2 APC,05461,Level 1 Neurostimulator an ,,,3512.04,3512.04,2 APC,05462,Level 2 Neurostimulator an ,,,6402.03,6402.03,2 APC,05463,Level 3 Neurostimulator an ,,,11193.47,11193.47,2 APC,05464,Level 4 Neurostimulator an ,,,19488.52,19488.52,2 APC,05465,Level 5 Neurostimulator an ,,,30998.31,30998.31,2 APC,05471,Implantation of Drug Infus ,,,18105.99,18105.99,2 APC,05481,Laser Eye Procedures ,,,552.5,552.5,2 APC,05491,Level 1 Intraocular Proced ,,,2318.34,2318.34,2 APC,05492,Level 2 Intraocular Proced ,,,4152.26,4152.26,2 APC,05493,Level 3 Intraocular Proced ,,,5345.55,5345.55,2 APC,05494,Level 4 Intraocular Proced ,,,14572.21,14572.21,2 APC,05495,Level 5 Intraocular Proced ,,,14016.54,14016.54,2 APC,05496,Level 6 Intraocular Proced ,,,16535.84,16535.84,2 APC,05501,"Level 1 Extraocular, Repai ",,,318.85,318.85,2 APC,05502,"Level 2 Extraocular, Repai ",,,1001.42,1001.42,2 APC,05503,"Level 3 Extraocular, Repai ",,,2388.32,2388.32,2 APC,05504,"Level 4 Extraocular, Repai ",,,3949.31,3949.31,2 APC,05521,Level 1 Imaging without Co ,,,87.42,87.42,2 APC,05522,Level 2 Imaging without Co ,,,105.02,105.02,2 APC,05523,Level 3 Imaging without Co ,,,239.69,239.69,2 APC,05524,Level 4 Imaging without Co ,,,548.9,548.9,2 APC,05571,Level 1 Imaging with Contr ,,,176.2,176.2,2 APC,05572,Level 2 Imaging with Contr ,,,350.46,350.46,2 APC,05573,Level 3 Imaging with Contr ,,,787.49,787.49,2 APC,05591,Level 1 Nuclear Medicine a ,,,401.59,401.59,2 APC,05592,Level 2 Nuclear Medicine a ,,,545.44,545.44,2 APC,05593,Level 3 Nuclear Medicine a ,,,1300.55,1300.55,2 APC,05594,Level 4 Nuclear Medicine a ,,,1436.46,1436.46,2 APC,05611,Level 1 Therapeutic Radiat ,,,135.02,135.02,2 APC,05612,Level 2 Therapeutic Radiat ,,,376.14,376.14,2 APC,05613,Level 3 Therapeutic Radiat ,,,1390.44,1390.44,2 APC,05621,Level 1 Radiation Therapy ,,,102.5,102.5,2 APC,05622,Level 2 Radiation Therapy ,,,387.45,387.45,2 APC,05623,Level 3 Radiation Therapy ,,,555.06,555.06,2 APC,05624,Level 4 Radiation Therapy ,,,699.65,699.65,2 APC,05625,Level 5 Radiation Therapy ,,,1255.44,1255.44,2 APC,05626,Level 6 Radiation Therapy ,,,1796.2,1796.2,2 APC,05627,Level 7 Radiation Therapy ,,,7398.85,7398.85,2 APC,05661,Therapeutic Nuclear Medici ,,,234.4,234.4,2 APC,05671,Level 1 Pathology ,,,52.35,52.35,2 APC,05672,Level 2 Pathology ,,,171.15,171.15,2 APC,05673,Level 3 Pathology ,,,360.08,360.08,2 APC,05674,Level 4 Pathology ,,,809.35,809.35,2 APC,05691,Level 1 Drug Administratio ,,,47.04,47.04,2 APC,05692,Level 2 Drug Administratio ,,,72.33,72.33,2 APC,05693,Level 3 Drug Administratio ,,,213.67,213.67,2 APC,05694,Level 4 Drug Administratio ,,,331.81,331.81,2 APC,05721,Level 1 Diagnostic Tests a ,,,129.26,129.26,2 APC,05722,Level 2 Diagnostic Tests a ,,,216.91,216.91,2 APC,05723,Level 3 Diagnostic Tests a ,,,374.86,374.86,2 APC,05724,Level 4 Diagnostic Tests a ,,,862.65,862.65,2 APC,05731,Level 1 Minor Procedures ,,,29.06,29.06,2 APC,05732,Level 2 Minor Procedures ,,,37.52,37.52,2 APC,05733,Level 3 Minor Procedures ,,,59.26,59.26,2 APC,05734,Level 4 Minor Procedures ,,,133.65,133.65,2 APC,05735,Level 5 Minor Procedures ,,,448.76,448.76,2 APC,05741,Level 1 Electronic Analysi ,,,37.49,37.49,2 APC,05742,Level 2 Electronic Analysi ,,,95.5,95.5,2 APC,05743,Level 3 Electronic Analysi ,,,308.54,308.54,2 APC,05771,Cardiac Rehabilitation ,,,129.5,129.5,2 APC,05781,Resuscitation and Cardiove ,,,663.96,663.96,2 APC,05791,Pulmonary Treatment ,,,219.97,219.97,2 APC,05801,Ventilation Initiation and ,,,620.6,620.6,2 APC,05811,Manipulation Therapy ,,,21.69,21.69,2 APC,05821,Level 1 Health and Behavio ,,,37.64,37.64,2 APC,05822,Level 2 Health and Behavio ,,,102.05,102.05,2 APC,05823,Level 3 Health and Behavio ,,,178.3,178.3,2 APC,05851,Intensive Outpatient (3 se ,,,125.6,125.6,2 APC,05852,Intensive Outpatient (4 or ,,,164.58,164.58,2 APC,05853,Partial Hospitalization (3 ,,,125.6,125.6,2 APC,05854,Partial Hospitalization (4 ,,,164.58,164.58,2 APC,05861,Intensive Outpatient (3 se ,,,314.03,314.03,2 APC,05862,Intensive Outpatient (4 or ,,,411.45,411.45,2 APC,05863,Partial Hospitalization (3 ,,,314.03,314.03,2 APC,05864,Partial Hospitalization (4 ,,,411.45,411.45,2 APC,05871,Dental Procedures ,,,649.43,649.43,2 APC,05881,Ancillary Outpatient Servi ,,,13990.69,13990.69,2 APC,06000,PMA Skin Substitute Produc ,,,125.01,125.01,2 APC,06001,510K Skin Substitute Produ ,,,125.01,125.01,2 APC,06002,HCT/P Skin Substitute Prod ,,,125.01,125.01,2 APC,07043,Infliximab not biosimil 10 ,,,31.48,31.48,2 APC,07046,Doxorubicin inj 10mg ,,,116.61,116.61,2 APC,07048,Alteplase recombinant ,,,98.59,98.59,2 APC,07308,Aminolevulinic acid hcl to ,,,389.28,389.28,2 APC,08004,Ultrasound Composite ,,,295.54,295.54,2 APC,08005,CT and CTA without Contras ,,,222.29,222.29,2 APC,08006,CT and CTA with Contrast C ,,,431.55,431.55,2 APC,08007,MRI and MRA without Contra ,,,528.85,528.85,2 APC,08008,MRI and MRA with Contrast ,,,852.57,852.57,2 APC,08010,Mental Health Services Com ,,,411.45,411.45,2 APC,08011,Comprehensive Observation ,,,2627.42,2627.42,2 APC,09002,Tenecteplase injection ,,,217.42,217.42,2 APC,09003,Rsv mab im 50mg ,,,436.75,436.75,2 APC,09004,"Injection, inclisiran, 1 m ",,,12.9,12.9,2 APC,09006,Tacrolimus injection ,,,268.18,268.18,2 APC,09007,Inj cutaquig 100 mg ,,,14.03,14.03,2 APC,09008,"Inj tezepelumab-ekko, 1mg ",,,17.92,17.92,2 APC,09009,"Inj, vutrisiran, 1 mg ",,,5012.6,5012.6,2 APC,09010,Inj efgartigimod 2mg ,,,32.55,32.55,2 APC,09013,Inj risankizumab-rzaaÂ1 m ,,,14.53,14.53,2 APC,09014,"Inj., cerliponase alfa 1 m ",,,123.38,123.38,2 APC,09016,"Inj., triptorelin xr 3.75 ",,,3819.93,3819.93,2 APC,09017,"Inj. byooviz, 0.1 mg ",,,240.97,240.97,2 APC,09018,"Inj, rimabotulinumtoxinB ",,,13.29,13.29,2 APC,09020,Argatroban nonesrd (accord ,,,1.81,1.81,2 APC,09025,"Inj glucagon hcl, freseniu ",,,129.28,129.28,2 APC,09026,"Inj, bortezomib, dr. reddy ",,,3.46,3.46,2 APC,09027,"Inj, bortezomib freseniusk ",,,6.97,6.97,2 APC,09028,Inj inotuzumab ozogam 0.1 ,,,2873.1,2873.1,2 APC,09029,"Inj., guselkumab, 1 mg ",,,66.92,66.92,2 APC,09031,"Inj, etelcalcetide, 0.1 mg ",,,2.47,2.47,2 APC,09032,Baclofen 10 MG injection ,,,186.11,186.11,2 APC,09033,Cidofovir injection ,,,535.74,535.74,2 APC,09034,"Inj cuvitru, 100 mg ",,,18.15,18.15,2 APC,09035,Axicabtagene ciloleucel ca ,,,562500.9,562500.9,2 APC,09036,"Injection, renflexis ",,,26.61,26.61,2 APC,09038,Inj estrogen conjugate ,,,401.5,401.5,2 APC,09042,Glucagon hydrochloride ,,,117.33,117.33,2 APC,09043,"Inj, afstyla, 1 i.u. ",,,1.62,1.62,2 APC,09044,Ibutilide fumarate injecti ,,,175.89,175.89,2 APC,09045,Idursulfase injection ,,,570.04,570.04,2 APC,09046,"Inj., fibryga, 1 mg ",,,1.23,1.23,2 APC,09048,"Inj, alymsys, 10 mg ",,,79.94,79.94,2 APC,09050,"Leuprolide inj, camcevi, 1 ",,,42.06,42.06,2 APC,09051,"Inj, lanreotide, (cipla) 1 ",,,20.33,20.33,2 APC,09052,Fluciclovine f-18 ,,,322.27,322.27,2 APC,09053,Fluorodopa f-18 diag per m ,,,855.55,855.55,2 APC,09054,Lutetium lu 177 vipivotide ,,,267.32,267.32,2 APC,09055,Gallium locametz 1 millicu ,,,362.5,362.5,2 APC,09056,Gallium ga-68 ,,,49.63,49.63,2 APC,09057,Inj nivol relatlimab 3mg/1 ,,,205.51,205.51,2 APC,09059,Vonvendi inj 1 iu vwf:rco ,,,1.81,1.81,2 APC,09063,Rh ig minidose im ,,,80.0,80.0,2 APC,09067,Lutetium lu 177 dotatat th ,,,350.21,350.21,2 APC,09068,Smallpox&monkeypox vac 0.5 ,,,0.01,0.01,2 APC,09070,Inj luxturna 1 billion vec ,,,3069.64,3069.64,2 APC,09071,Capsaicin 8% patch ,,,3.51,3.51,2 APC,09073,Buprenorph xr 100 mg or le ,,,2068.16,2068.16,2 APC,09075,"Inj, kovaltry, 1 i.u. ",,,1.59,1.59,2 APC,09078,Testosterone undecanoate 1 ,,,2.15,2.15,2 APC,09079,"Genvisc 850, inj, 1mg ",,,3.81,3.81,2 APC,09087,"Inj, clevidipine, 1 mg ",,,2.84,2.84,2 APC,09088,Peng benzathine/procaine i ,,,19.52,19.52,2 APC,09094,Radiesse injection ,,,343.34,343.34,2 APC,09095,"Inj, sculptra, 0.5mg ",,,2.12,2.12,2 APC,09097,Inj retacrit non-esrd use ,,,7.97,7.97,2 APC,09099,"Inj fosnetupitant, palonos ",,,503.85,503.85,2 APC,09101,Vaccinia vrs vac 0.3 ml pe ,,,0.01,0.01,2 APC,09102,"Inj, fulvestrant (teva) ",,,41.67,41.67,2 APC,09103,"Inj, fulvestrant (freseniu ",,,27.11,27.11,2 APC,09104,Antithymocyte globuln rabb ,,,1057.79,1057.79,2 APC,09105,Inj pemetrexed (teva) 10mg ,,,10.99,10.99,2 APC,09108,Thyrotropin injection ,,,2158.66,2158.66,2 APC,09109,"Inj, elahere, 1 mg ",,,71.99,71.99,2 APC,09110,"Inj, tremelimumab-actl, 1 ",,,146.89,146.89,2 APC,09111,Inj teclistamab cqyv 0.5 m ,,,35.32,35.32,2 APC,09112,Inj teplizumab mzwv 5 mcg ,,,39.22,39.22,2 APC,09113,Inj olipudase alfa-rpcp 1m ,,,404.95,404.95,2 APC,09114,Inj eflapegrastim-xnst 0.1 ,,,38.56,38.56,2 APC,09115,"Inj, spesolimab-sbzo, 1 mg ",,,65.73,65.73,2 APC,09117,"Inj, cimerli, 0.1 mg ",,,82.53,82.53,2 APC,09118,"Inj, fylnetra, 0.5 mg ",,,105.11,105.11,2 APC,09119,"Inj, pedmark, 100 mg ",,,96.78,96.78,2 APC,09122,Triptorelin pamoate ,,,466.37,466.37,2 APC,09123,"Inj pemetrexed, hospira 10 ",,,2.94,2.94,2 APC,09125,"Risperidone, long acting ",,,11.11,11.11,2 APC,09126,Natalizumab injection ,,,24.41,24.41,2 APC,09127,Inj pemetrexed (accord) 10 ,,,9.74,9.74,2 APC,09129,"Inj, stimufend, 0.5 mg ",,,143.67,143.67,2 APC,09130,"Inj, imm glob bivigam, 500 ",,,81.24,81.24,2 APC,09131,"Inj, Ado-trastuzumab Emt 1 ",,,43.63,43.63,2 APC,09132,Prothrombin complex kcentr ,,,2.01,2.01,2 APC,09133,"Rabies ig, im/sc ",,,281.19,281.19,2 APC,09134,"Rabies ig, heat treated ",,,352.44,352.44,2 APC,09135,"Varicella-zoster ig, im ",,,2497.73,2497.73,2 APC,09136,Inj leu acet lutr dpt 7.5 ,,,687.29,687.29,2 APC,09138,"Inj, hemgenix, per tx dose ",,,3691450.0,3691450.0,2 APC,09139,"Rabies vaccine, im ",,,331.98,331.98,2 APC,09140,"Rabies vaccine, id ",,,236.86,236.86,2 APC,09141,Inj onase abepar-xioi trea ,,,2680038.0,2680038.0,2 APC,09142,FecalÂmicrobiota jslm 1 m ,,,65.6,65.6,2 APC,09144,"Inj, panzyga, 500 mg ",,,71.35,71.35,2 APC,09145,"Inj, invega hafyera/trinza ",,,13.26,13.26,2 APC,09146,"Inj, ixinity, 1 i.u. ",,,1.94,1.94,2 APC,09149,"Inj ublituximab-xiiy, 1 mg ",,,72.24,72.24,2 APC,09150,"Inj mosunetuzumab-axgb, 1 ",,,674.5,674.5,2 APC,09154,"Inj, vivimusta, 1 mg ",,,29.91,29.91,2 APC,09155,Inj lenacapavir (hiv tx) 1 ,,,22.94,22.94,2 APC,09157,"Lecanemab-irmb, for iv inj ",,,1.32,1.32,2 APC,09158,"Inj, pegcetacoplan, 1mg ",,,148.94,148.94,2 APC,09159,"Inj, vegzelma, 10 mg ",,,23.65,23.65,2 APC,09166,"Inj, fosaprepitant (teva) ",,,0.04,0.04,2 APC,09171,Factor ix idelvion inj ,,,5.51,5.51,2 APC,09173,"Injection, fulphila ",,,67.02,67.02,2 APC,09174,"Inj, durolane 1 mg ",,,6.24,6.24,2 APC,09178,"Inj., meropenem, vaborbact ",,,2.22,2.22,2 APC,09179,"Inj., aristada initio, 1 m ",,,3.46,3.46,2 APC,09180,"Inj., patisiran, 0.1 mg ",,,101.03,101.03,2 APC,09181,"Inj., perseris, 0.5 mg ",,,12.2,12.2,2 APC,09182,"Inj mogamulizumab-kpkc, 1 ",,,258.54,258.54,2 APC,09183,"Inj., plazomicin, 5 mg ",,,3.52,3.52,2 APC,09186,"Inj., rituximab, 10 mg ",,,73.28,73.28,2 APC,09187,"Injection, burosumab-twza ",,,513.37,513.37,2 APC,09189,"Inj., ibalizumab-uiyk, 10 ",,,79.51,79.51,2 APC,09190,"Inj., vestronidase alfa-vj ",,,291.54,291.54,2 APC,09193,Nivestym ,,,0.32,0.32,2 APC,09194,Tisagenlecleucel car-pos t ,,,611693.2,611693.2,2 APC,09195,"Injection, udenyca 0.5 mg ",,,149.13,149.13,2 APC,09196,"Inj, trivisc 1 mg ",,,3.04,3.04,2 APC,09198,"Inj andexxa, 10 mg ",,,131.16,131.16,2 APC,09199,"Injection, caplacizumab-yh ",,,839.17,839.17,2 APC,09200,"Inj, remdesivir, 1 mg ",,,7.51,7.51,2 APC,09201,Rabies ig ht&sol human im/ ,,,243.2,243.2,2 APC,09203,Inj cyclophosphamd auromed ,,,0.49,0.49,2 APC,09204,"Inj tisotu vedotin-tftv, 1 ",,,196.12,196.12,2 APC,09205,Inj lon tesirin-lpyl 0.075 ,,,226.61,226.61,2 APC,09206,Inj plasminogen tvmh 1mg ,,,38.42,38.42,2 APC,09208,Agalsidase beta injection ,,,232.72,232.72,2 APC,09209,Laronidase injection ,,,41.49,41.49,2 APC,09213,Inj. pemetrexed nos 10mg ,,,6.95,6.95,2 APC,09214,Bevacizumab injection ,,,74.82,74.82,2 APC,09215,Cetuximab injection ,,,81.67,81.67,2 APC,09217,Leuprolide acetate suspnsi ,,,160.34,160.34,2 APC,09219,Procainamide hcl injection ,,,295.36,295.36,2 APC,09224,Galsulfase injection ,,,525.97,525.97,2 APC,09225,Fluocinolone acetonide imp ,,,338.8,338.8,2 APC,09230,Abatacept injection ,,,45.86,45.86,2 APC,09233,Ranibizumab injection ,,,51.09,51.09,2 APC,09235,Panitumumab injection ,,,182.19,182.19,2 APC,09237,"Inj, lanreotide acetate ",,,37.43,37.43,2 APC,09239,Buprenorphine xr over 100 ,,,2068.16,2068.16,2 APC,09240,"Injection, ixabepilone ",,,139.75,139.75,2 APC,09241,Inj sirolimus prot part 1 ,,,91.03,91.03,2 APC,09243,"Inj, bendamustine hcl, 1mg ",,,2.96,2.96,2 APC,09246,"Inj, abilify asimtufii, 1 ",,,6.18,6.18,2 APC,09247,"Inj, amisulpride, 1 mg ",,,9.57,9.57,2 APC,09250,Inj epcoritamab-bysp 0.16 ,,,57.99,57.99,2 APC,09251,C1 esterase inhibitor inj ,,,66.75,66.75,2 APC,09252,Plerixafor injection ,,,28.49,28.49,2 APC,09253,Temozolomide injection ,,,10.41,10.41,2 APC,09254,Flotufolastat f18 diag 1 m ,,,727.56,727.56,2 APC,09255,"Inj, invega sustenna, 1 mg ",,,15.43,15.43,2 APC,09256,Dexamethasone intra implan ,,,203.66,203.66,2 APC,09257,"Inj., emicizumab-kxwh 0.5 ",,,58.03,58.03,2 APC,09258,Telavancin injection ,,,7.48,7.48,2 APC,09259,Pralatrexate injection ,,,386.12,386.12,2 APC,09260,Ofatumumab injection ,,,62.23,62.23,2 APC,09262,Inj tofersen intrathec 1 m ,,,164.82,164.82,2 APC,09263,Ecallantide injection ,,,595.94,595.94,2 APC,09264,Tocilizumab injection ,,,5.41,5.41,2 APC,09266,"Inj, uzedy, 1 mg ",,,26.18,26.18,2 APC,09267,"Inj, rezafungin, 1 mg ",,,11.0,11.0,2 APC,09268,Inj. acthar gel to 40 unit ,,,4133.45,4133.45,2 APC,09269,"C-1 esterase, berinert ",,,79.26,79.26,2 APC,09270,Gammaplex IVIG ,,,66.27,66.27,2 APC,09271,Velaglucerase alfa ,,,392.84,392.84,2 APC,09272,"Inj, denosumab ",,,30.1,30.1,2 APC,09273,Sipuleucel-T auto CD54+ ,,,55932.43,55932.43,2 APC,09274,Crotalidae Poly Immune Fab ,,,1874.98,1874.98,2 APC,09275,"Inj. (ani), up to 40 units ",,,3674.68,3674.68,2 APC,09276,Cabazitaxel injection ,,,233.73,233.73,2 APC,09277,Altuviiio per factor viii ,,,4.63,4.63,2 APC,09278,Incobotulinumtoxin A ,,,5.29,5.29,2 APC,09280,"Inj, retifanlimab-dlwr, 1 ",,,30.98,30.98,2 APC,09281,"Injection, pegloticase ",,,3929.34,3929.34,2 APC,09284,Ipilimumab injection ,,,190.43,190.43,2 APC,09285,Inj allopurinol sodium 1 m ,,,4.07,4.07,2 APC,09286,Belatacept injection ,,,3.88,3.88,2 APC,09287,Brentuximab vedotin inj ,,,279.21,279.21,2 APC,09293,"Injection, glucarpidase ",,,441.59,441.59,2 APC,09294,"Inj, taliglucerase alfa 10 ",,,42.67,42.67,2 APC,09295,"Injection, Carfilzomib, 1 ",,,60.29,60.29,2 APC,09296,"Inj, ziv-aflibercept, 1mg ",,,8.67,8.67,2 APC,09299,Inj. jivi 1 iu ,,,2.76,2.76,2 APC,09300,Omalizumab injection ,,,46.59,46.59,2 APC,09301,"Aminolevulinic acid, 10% g ",,,1.85,1.85,2 APC,09302,"Inj daunorubicin, cytarabi ",,,272.89,272.89,2 APC,09304,"Inj., cemiplimab-rwlc, 1 m ",,,29.67,29.67,2 APC,09305,"Inj., lumoxiti, 0.01 mg ",,,23.39,23.39,2 APC,09306,"Inj., tildrakizumab, 1 mg ",,,124.27,124.27,2 APC,09308,Dexametha opth insert 0.1 ,,,90.02,90.02,2 APC,09309,Inj. tagraxofusp-erzs 10 m ,,,357.52,357.52,2 APC,09310,"Inj., emapalumab-lzsg, 1 m ",,,392.78,392.78,2 APC,09311,"Inj., omadacycline, 1 mg ",,,4.19,4.19,2 APC,09312,"Inj., ravulizumab-cwvz 10 ",,,226.92,226.92,2 APC,09313,Inj. belrapzo/bendamustine ,,,11.6,11.6,2 APC,09314,"Inj. herceptin hylecta, 10 ",,,58.34,58.34,2 APC,09320,Carbidopa levodopa ent 100 ,,,244.5,244.5,2 APC,09321,Fosphenytoin inj pe ,,,0.67,0.67,2 APC,09322,Bcg live intravesical 1mg ,,,3.38,3.38,2 APC,09323,Gallium ga-68 dotatoc ,,,3.61,3.61,2 APC,09324,Phenylep ketorolac opth so ,,,96.31,96.31,2 APC,09325,"Inj., eravacycline, 1 mg ",,,1.38,1.38,2 APC,09326,"Inj., lanadelumab-flyo, 1 ",,,88.22,88.22,2 APC,09327,Inj. romosozumab-aqqg 1 mg ,,,12.73,12.73,2 APC,09328,"Inj., yutiq, 0.01 mg ",,,529.89,529.89,2 APC,09329,Inj mvasi 10 mg ,,,24.53,24.53,2 APC,09330,"Inj., kanjinti, 10 mg ",,,60.52,60.52,2 APC,09331,"Inj, polatuzumab vedotin 1 ",,,143.61,143.61,2 APC,09335,Oral busulfan ,,,10.12,10.12,2 APC,09336,Inj truxima 10 mg ,,,34.56,34.56,2 APC,09338,"Inj., triluron, 1 mg ",,,10.43,10.43,2 APC,09340,"Inj, brolucizumab-dbll, 1 ",,,359.71,359.71,2 APC,09341,Inj ogivri 10 mg ,,,31.95,31.95,2 APC,09343,Inj givosiran 0.5 mg ,,,120.92,120.92,2 APC,09345,Inj pegfilgrastim-bmez 0.5 ,,,132.1,132.1,2 APC,09346,Mometasone sinus sinuva ,,,11.35,11.35,2 APC,09347,Inj luspatercept-aamt 0.25 ,,,43.51,43.51,2 APC,09348,"Inj., zirabev, 10 mg ",,,25.89,25.89,2 APC,09349,Inj herzuma 10 mg ,,,54.94,54.94,2 APC,09350,"Inj., trazimera, 10 mg ",,,13.03,13.03,2 APC,09351,Inj bimatoprost itc imp 1m ,,,213.76,213.76,2 APC,09353,Inj fam-trastu deru-nxki 1 ,,,32.87,32.87,2 APC,09354,Inj recombin esperoct per ,,,2.3,2.3,2 APC,09355,Inj. teprotumumab-trbw 10 ,,,379.9,379.9,2 APC,09357,Inj. eptinezumab-jjmr 1 mg ,,,21.1,21.1,2 APC,09358,Inj xipere 1 mg ,,,47.77,47.77,2 APC,09359,Inj crizanlizumab-tmca 5mg ,,,129.94,129.94,2 APC,09361,Inj. cetirizine hcl 0.5mg ,,,16.87,16.87,2 APC,09364,Inj enfort vedo-ejfv 0.25m ,,,36.66,36.66,2 APC,09367,"Inj ruxience, 10 mg ",,,16.16,16.16,2 APC,09370,Fluoroestradiol F 18 ,,,460.42,460.42,2 APC,09372,"Inj. xembify, 100 mg ",,,15.24,15.24,2 APC,09374,Mitomycin instillation ,,,329.94,329.94,2 APC,09375,"Inj., evomela, 1 mg ",,,18.04,18.04,2 APC,09376,Sacituzumab govitecan-hziy ,,,37.64,37.64,2 APC,09377,Inj. isatuximab-irfc 10 mg ,,,88.16,88.16,2 APC,09378,"Daratumumab, hyaluronidase ",,,57.05,57.05,2 APC,09381,"Inj. avsola, 10 mg ",,,30.83,30.83,2 APC,09382,Inj ontruzant 10 mg ,,,20.99,20.99,2 APC,09383,Copper cu 64 dotatate diag ,,,594.28,594.28,2 APC,09385,"Inj., tafasitamab-cxix ",,,14.43,14.43,2 APC,09388,Inj. fe derisomaltose 10 m ,,,21.08,21.08,2 APC,09389,"Inj. lurbinectedin, 0.1 mg ",,,215.95,215.95,2 APC,09390,"Pertuzu, trastuzu, 10 mg ",,,59.9,59.9,2 APC,09391,Brexucabtagene car pos t ,,,510103.9,510103.9,2 APC,09392,Inj. asceniv ,,,509.14,509.14,2 APC,09394,"Inj. inebilizumab-cdon, 1 ",,,510.65,510.65,2 APC,09395,Factor viia recomb sevenfa ,,,2.19,2.19,2 APC,09396,"Afamelanotide implant, 1 m ",,,2943.42,2943.42,2 APC,09398,Covid-19 Vaccine Administr ,,,40.83,40.83,2 APC,09399,"Pneumococcal, Influenza, H ",,,36.23,36.23,2 APC,09406,"Inj, nyvepria ",,,136.91,136.91,2 APC,09407,"Inj. lumasiran, 0.5 mg ",,,336.97,336.97,2 APC,09408,"Inj. naxitamab-gqgk, 1 mg ",,,684.9,684.9,2 APC,09409,Gallium ga-68 psma-11 ucsf ,,,550.13,550.13,2 APC,09410,"Gallium ga-68 psma-11, ucl ",,,363.5,363.5,2 APC,09411,"Inj. riabni, 10 mg ",,,18.53,18.53,2 APC,09412,"Injection, casimersen, 10 ",,,166.17,166.17,2 APC,09413,lisocabtagene car pos t ,,,579570.6,579570.6,2 APC,09414,"Inj, cabote rilpivir 2mg 3 ",,,24.67,24.67,2 APC,09415,"Injection, trilaciclib, 1m ",,,5.46,5.46,2 APC,09416,"Inj, evinacumab-dgnb, 5 mg ",,,197.63,197.63,2 APC,09418,"Inj. margetuximab-cmkb, 5 ",,,56.44,56.44,2 APC,09419,Inj fensolvi 0.25 mg ,,,145.31,145.31,2 APC,09420,Eptifibatide injection ,,,3.87,3.87,2 APC,09421,"Inj, granisetron, xr, 0.1 ",,,3.22,3.22,2 APC,09422,Idecabtagene vicleucel car ,,,567977.8,567977.8,2 APC,09426,"Inj, cefiderocol, 10 mg ",,,2.55,2.55,2 APC,09427,"Injection, oritavancin 10 ",,,47.41,47.41,2 APC,09428,Inj romidepsin non-lyo 0.1 ,,,33.59,33.59,2 APC,09429,Inj romidepsin lyophil 0.1 ,,,30.71,30.71,2 APC,09430,"Piflu f-18, dia 1 millicur ",,,346.49,346.49,2 APC,09431,"Inj, dostarlimab-gxly, 10 ",,,251.3,251.3,2 APC,09432,"Inj, amivantamab-vmjw ",,,23.22,23.22,2 APC,09433,Inj aval alfa-nqpt 4mg ,,,83.94,83.94,2 APC,09434,Inj anifrolumab-fnia 1mg ,,,18.51,18.51,2 APC,09436,Inj pegfilgrast ex bio 0.5 ,,,143.23,143.23,2 APC,09437,"Inj, aspara, rylaze, 0.1 m ",,,58.7,58.7,2 APC,09439,"Inj, susvimo 0.1 mg ",,,74.8,74.8,2 APC,09440,"Instill, bupivac and melox ",,,0.85,0.85,2 APC,09441,Inj ferric carboxymaltos 1 ,,,1.13,1.13,2 APC,09442,"Inj. pemetrexed, 10 mg ",,,7.99,7.99,2 APC,09443,Gallium illuccix 1 millicu ,,,478.52,478.52,2 APC,09444,"Inj, sutimlimab-jome, 10 m ",,,19.64,19.64,2 APC,09445,"Injection, ruconest ",,,37.83,37.83,2 APC,09446,"Inj, tebentafusp-tebn, 1 m ",,,228.01,228.01,2 APC,09447,"Inj, releuko 1 mcg ",,,0.31,0.31,2 APC,09448,"Oral netupitant, palonoset ",,,474.04,474.04,2 APC,09449,"Injection, blinatumomab ",,,172.9,172.9,2 APC,09450,Fluocinol acet intravit im ,,,516.41,516.41,2 APC,09451,"Injection, peramivir ",,,1.68,1.68,2 APC,09452,Inj ceftolozane tazobactam ,,,10.04,10.04,2 APC,09453,"Injection, nivolumab ",,,34.22,34.22,2 APC,09454,"Inj, pasireotide long acti ",,,616.71,616.71,2 APC,09455,"Injection, siltuximab ",,,174.07,174.07,2 APC,09456,"Injection, isavuconazonium ",,,1.03,1.03,2 APC,09458,Florbetaben f18 diagnostic ,,,1558.14,1558.14,2 APC,09459,Flutemetamol f18 diagnosti ,,,1911.47,1911.47,2 APC,09460,"Injection, cangrelor ",,,20.27,20.27,2 APC,09461,Choline c-11 ,,,2516.43,2516.43,2 APC,09463,"Inj., aprepitant, 1 mg ",,,1.59,1.59,2 APC,09466,"Inj., benralizumab, 1 mg ",,,165.56,165.56,2 APC,09467,"Inj rituximab, hyaluronida ",,,36.39,36.39,2 APC,09468,Factor ix recomb gly rebin ,,,4.67,4.67,2 APC,09469,Inj triamcinolone ace xr 1 ,,,19.28,19.28,2 APC,09470,Aripirazole lauroxil 1 mg ,,,3.56,3.56,2 APC,09471,"Hyaluronan, hymo or hymo o ",,,18.13,18.13,2 APC,09472,Inj talimogene laherparepv ,,,77.34,77.34,2 APC,09473,"Injection, mepolizumab, 1m ",,,32.28,32.28,2 APC,09474,Inj irinotecan liposome 1 ,,,65.86,65.86,2 APC,09475,"Injection, necitumumab, 1 ",,,5.73,5.73,2 APC,09476,"Injection, daratumumab 10 ",,,73.77,73.77,2 APC,09477,"Injection, elotuzumab, 1mg ",,,8.19,8.19,2 APC,09478,Inj sebelipase alfa 1 mg ,,,539.6,539.6,2 APC,09480,Injection trabectedin 0.1m ,,,410.48,410.48,2 APC,09481,"Injection, reslizumab ",,,11.73,11.73,2 APC,09483,"Inj, atezolizumab,10 mg ",,,96.55,96.55,2 APC,09484,"Inj, eteplirsen, 10 mg ",,,167.43,167.43,2 APC,09487,"Ustekinumab, iv inject,1 m ",,,11.36,11.36,2 APC,09489,"Inj, nusinersen, 0.1mg ",,,1333.45,1333.45,2 APC,09490,"Inj, bezlotoxumab, 10 mg ",,,39.83,39.83,2 APC,09491,"Injection, avelumab, 10 mg ",,,108.64,108.64,2 APC,09492,"Inj., durvalumab, 10 mg ",,,87.95,87.95,2 APC,09493,"Injection, edaravone, 1 mg ",,,6.46,6.46,2 APC,09494,"Injection, ocrelizumab ",,,60.97,60.97,2 APC,09495,Gemtuzumab ozogamicin inj ,,,247.37,247.37,2 APC,09496,"Inj, faricimab-svoa, 0.1mg ",,,32.38,32.38,2 APC,09498,Ciltacabtagene car-pos t ,,,587977.8,587977.8,2 APC,09500,"Platelets, irradiated ",,,392.97,392.97,2 APC,09501,Platelet pheres leukoreduc ,,,511.59,511.59,2 APC,09502,Platelet pheresis irradiat ,,,949.13,949.13,2 APC,09503,Fr frz plasma donor retest ,,,53.25,53.25,2 APC,09504,RBC deglycerolized ,,,313.0,313.0,2 APC,09505,RBC irradiated ,,,145.22,145.22,2 APC,09507,"Platelets, pheresis ",,,308.96,308.96,2 APC,09508,Plasma 1 donor frz w/in 8 ,,,85.98,85.98,2 APC,09509,"Frozen plasma, pooled, sd ",,,55.96,55.96,2 APC,09510,Whole blood for transfusio ,,,189.84,189.84,2 APC,09511,Cryoprecipitate each unit ,,,71.95,71.95,2 APC,09512,RBC leukocytes reduced ,,,184.91,184.91,2 APC,09513,"Plasma, frz between 8-24ho ",,,73.77,73.77,2 APC,09514,"Plasma protein fract,5%,50 ",,,8.11,8.11,2 APC,09515,"Platelets, each unit ",,,53.17,53.17,2 APC,09516,Plaelet rich plasma unit ,,,559.79,559.79,2 APC,09517,Red blood cells unit ,,,150.57,150.57,2 APC,09518,Washed red blood cells uni ,,,368.58,368.58,2 APC,09519,"Plasmaprotein fract,5%,250 ",,,35.32,35.32,2 APC,09520,Blood split unit ,,,155.84,155.84,2 APC,09521,Platelets leukoreduced irr ,,,189.59,189.59,2 APC,09522,RBC leukoreduced irradiate ,,,265.41,265.41,2 APC,09523,Cryoprecipitatereducedplas ,,,132.05,132.05,2 APC,09524,"Blood, l/r, cmv-neg ",,,151.58,151.58,2 APC,09525,"Platelets, hla-m, l/r, uni ",,,708.06,708.06,2 APC,09526,Platelets leukocytes reduc ,,,144.26,144.26,2 APC,09527,"Blood, l/r, froz/degly/was ",,,265.19,265.19,2 APC,09528,"Plt, aph/pher, l/r, cmv-ne ",,,250.49,250.49,2 APC,09529,"Blood, l/r, irradiated ",,,84.55,84.55,2 APC,09530,Plate pheres leukoredu irr ,,,680.61,680.61,2 APC,09531,"Plt, pher, l/r cmv-neg, ir ",,,503.45,503.45,2 APC,09532,"RBC, frz/deg/wsh, l/r, irr ",,,422.69,422.69,2 APC,09533,"RBC, l/r, cmv-neg, irrad ",,,249.4,249.4,2 APC,09534,Pathogen reduced plasma po ,,,55.78,55.78,2 APC,09535,Pathogen reduced plasma si ,,,294.48,294.48,2 APC,09536,Platelets pheresis path re ,,,607.43,607.43,2 APC,09537,Blood component/product no ,,,35.32,35.32,2 APC,09538,Plasma cryo redu path each ,,,133.76,133.76,2 APC,09539,Cryo fib comp path redu ea ,,,549.28,549.28,2 APC,09540,Covid-19 convalescent plas ,,,680.03,680.03,2 APC,09541,Rbc o2 co2 reduced ,,,511.59,511.59,2 APC,1064,"I131 iodide cap, rx ",,,23.59,51.75,43 APC,1138,"Hepagam b intravenous, in ",,,69.58,69.58,1 APC,1138,"Hepagam b intravenous, inj ",,,64.3,141.06,42 APC,1139,Protein c concentrate ,,,14.77,32.4,43 APC,1142,Supprelin LA implant ,,,36742.13,80607.74,43 APC,1150,"I131 iodide sol, rx ",,,20.35,44.66,43 APC,1168,"Inj, temsirolimus ",,,20.32,70.26,43 APC,1178,Busulfan injection ,,,0.89,2.22,43 APC,1203,Verteporfin injection ,,,11.15,24.45,43 APC,1207,"Octreotide injection, dep ",,,199.17,199.17,1 APC,1207,"Octreotide injection, depo ",,,203.93,447.4,42 APC,1213,Antihemophilic viii/vwf c ,,,1.24,1.24,1 APC,1213,Antihemophilic viii/vwf co ,,,1.24,2.73,42 APC,1214,Inj IVIG privigen 500 mg ,,,50.19,110.12,43 APC,1232,Mitomycin injection ,,,26.1,73.33,43 APC,1235,Valrubicin injection ,,,1222.11,2681.15,43 APC,1237,Inj iron dextran ,,,18.08,40.83,43 APC,1238,Topotecan oral ,,,122.83,269.47,43 APC,1253,Triamcinolone a inj prs-f ,,,24.49,24.49,1 APC,1253,Triamcinolone a inj prs-fr ,,,18.8,41.25,42 APC,1263,Antithrombin iii injectio ,,,4.05,4.05,1 APC,1263,Antithrombin iii injection ,,,4.09,8.97,42 APC,1268,Xyntha inj ,,,1.34,2.95,43 APC,1274,Edetate calcium disodium ,,,6209.68,6209.68,1 APC,1274,Edetate calcium disodium i ,,,6065.7,13307.4,42 APC,1281,Bevacizumab injection ,,,1.83,4.02,43 APC,1289,AbobotulinumtoxinA ,,,8.77,19.23,43 APC,1295,Sm 153 lexidronam ,,,3096.6,6793.57,43 APC,1296,Degarelix injection ,,,4.39,9.63,43 APC,1297,"Ferumoxytol, non-esrd ",,,0.36,0.8,43 APC,1311,Canakinumab injection ,,,147.74,336.56,43 APC,1312,Hizentra injection ,,,14.54,32.0,43 APC,1327,Imiglucerase injection ,,,42.46,93.15,43 APC,1340,"Collagenase, clost hist i ",,,75.75,75.75,1 APC,1340,"Collagenase, clost hist in ",,,76.73,168.34,42 APC,1352,Wilate injection ,,,1.3,2.85,43 APC,1353,Belimumab injection ,,,57.13,125.34,43 APC,1413,Lumizyme injection ,,,206.91,453.93,43 APC,1415,Glassia injection ,,,5.47,12.0,43 APC,1416,Factor xiii anti-hem fact ,,,10.76,10.76,1 APC,1416,Factor xiii anti-hem facto ,,,11.01,24.16,42 APC,1417,Gel-one ,,,522.92,1147.22,43 APC,1420,Aflibercept injection ,,,728.73,1598.75,43 APC,1421,Imported lipodox inj ,,,292.77,642.29,43 APC,1426,Eribulin mesylate injecti ,,,72.61,72.61,1 APC,1426,Eribulin mesylate injectio ,,,58.78,128.95,42 APC,1431,Centruroides immune f(ab) ,,,1051.34,1051.34,1 APC,1441,Dom nonHEU Tc99m add-on/do ,,,9.8,21.5,42 APC,1446,Visualization adjunct ,,,9.81,23.37,43 APC,1458,Phentolaine mesylate inj ,,,282.85,620.54,43 APC,1464,Factor viii (porcine) ,,,5.35,11.74,42 APC,1467,Factor ix recombinan rixu ,,,1.74,1.74,1 APC,1467,Factor ix recombinan rixub ,,,1.68,3.69,42 APC,1468,"Inj, abilify maintena, 1 ",,,7.28,7.28,1 APC,1468,"Inj, abilify maintena, 1 m ",,,7.31,16.04,42 APC,1469,Inj filgrastim excl biosi ,,,1.0,1.0,1 APC,1469,Inj filgrastim excl biosim ,,,0.99,2.16,42 APC,1471,"Injection, Pertuzumab, 1 ",,,17.01,17.01,1 APC,1471,"Injection, Pertuzumab, 1 m ",,,16.86,36.98,42 APC,1474,Certolizumab pegol inj 1m ,,,3.87,3.87,1 APC,1474,Certolizumab pegol inj 1mg ,,,3.38,7.4,42 APC,1475,Golimumab for iv use 1mg ,,,10.81,23.73,43 APC,1476,Obinutuzumab inj ,,,81.63,181.6,43 APC,1478,Inj human fibrinogen con ,,,1.52,1.52,1 APC,1478,Inj human fibrinogen con n ,,,1.46,3.2,42 APC,1480,"Elosulfase alfa, injectio ",,,311.94,311.94,1 APC,1480,"Elosulfase alfa, injection ",,,313.13,686.96,42 APC,1482,"Darbepoetin alfa, esrd us ",,,3.02,3.02,1 APC,1482,"Darbepoetin alfa, esrd use ",,,2.86,6.28,42 APC,1485,"Ferumoxytol, esrd use ",,,0.36,0.8,43 APC,1486,Factor ix fc fusion recom ,,,3.6,3.6,1 APC,1486,Factor ix fc fusion recomb ,,,3.64,7.98,42 APC,1488,"Injection, ramucirumab ",,,75.03,164.61,43 APC,1489,Inj vedolizumab iv 1 mg ,,,21.19,46.49,43 APC,1490,Inj pembrolizumab ,,,59.43,130.39,43 APC,1491,New Technology - Level 1 ,,,4.92,4.92,1 APC,1491,New Technology - Level 1A ,,,4.82,10.57,42 APC,1492,New Technology - Level 1 ,,,15.24,15.24,1 APC,1492,New Technology - Level 1B ,,,14.94,32.77,42 APC,1493,New Technology - Level 1 ,,,25.07,25.07,1 APC,1493,New Technology - Level 1C ,,,24.57,53.91,42 APC,1494,New Technology - Level 1 ,,,34.91,34.91,1 APC,1494,New Technology - Level 1D ,,,34.21,75.05,42 APC,1495,New Technology - Level 1 ,,,44.74,44.74,1 APC,1495,New Technology - Level 1E ,,,43.84,96.19,42 APC,1496,New Technology - Level 1 ,,,4.92,4.92,1 APC,1496,New Technology - Level 1A ,,,4.82,10.57,42 APC,1497,New Technology - Level 1 ,,,15.24,15.24,1 APC,1497,New Technology - Level 1B ,,,14.94,32.77,42 APC,1498,New Technology - Level 1 ,,,25.07,25.07,1 APC,1498,New Technology - Level 1C ,,,24.57,53.91,42 APC,1499,New Technology - Level 1 ,,,34.91,34.91,1 APC,1499,New Technology - Level 1D ,,,34.21,75.05,42 APC,1500,New Technology - Level 1 ,,,44.74,44.74,1 APC,1500,New Technology - Level 1E ,,,43.84,96.19,42 APC,1502,New Technology - Level 2 ,,,74.24,74.24,1 APC,1502,New Technology - Level 2 ( ,,,72.75,159.61,42 APC,1503,New Technology - Level 3 ,,,147.98,147.98,1 APC,1503,New Technology - Level 3 ( ,,,145.02,318.16,42 APC,1504,New Technology - Level 4 ,,,246.31,246.31,1 APC,1504,New Technology - Level 4 ( ,,,241.38,529.56,42 APC,1505,New Technology - Level 5 ,,,344.63,344.63,1 APC,1505,New Technology - Level 5 ( ,,,337.74,740.96,42 APC,1506,New Technology - Level 6 ,,,442.96,442.96,1 APC,1506,New Technology - Level 6 ( ,,,434.1,952.36,42 APC,1507,New Technology - Level 7 ,,,541.28,541.28,1 APC,1507,New Technology - Level 7 ( ,,,530.46,1163.76,42 APC,1508,New Technology - Level 8 ,,,639.61,639.61,1 APC,1508,New Technology - Level 8 ( ,,,626.82,1375.16,42 APC,1509,New Technology - Level 9 ,,,737.94,737.94,1 APC,1509,New Technology - Level 9 ( ,,,723.18,1586.56,42 APC,1510,New Technology - Level 10 ,,,819.54,1797.96,43 APC,1511,New Technology - Level 11 ,,,915.9,2009.37,43 APC,1512,New Technology - Level 12 ,,,1012.26,2220.77,43 APC,1513,New Technology - Level 13 ,,,1108.62,2432.17,43 APC,1514,New Technology - Level 14 ,,,1204.98,2643.57,43 APC,1515,New Technology - Level 15 ,,,1301.34,2854.97,43 APC,1516,New Technology - Level 16 ,,,1397.69,3066.37,43 APC,1517,New Technology - Level 17 ,,,1494.05,3277.77,43 APC,1518,New Technology - Level 18 ,,,1590.41,3489.17,43 APC,1519,New Technology - Level 19 ,,,1686.77,3700.57,43 APC,1520,New Technology - Level 20 ,,,1783.13,3911.97,43 APC,1521,New Technology - Level 21 ,,,1879.49,4123.38,43 APC,1522,New Technology - Level 22 ,,,2168.57,4757.58,43 APC,1523,New Technology - Level 23 ,,,2650.37,5814.58,43 APC,1524,New Technology - Level 24 ,,,3132.17,6871.59,43 APC,1525,New Technology - Level 25 ,,,3613.96,7928.59,43 APC,1526,New Technology - Level 26 ,,,4095.76,8985.6,43 APC,1527,New Technology - Level 27 ,,,4577.56,10042.6,43 APC,1528,New Technology - Level 28 ,,,5059.35,11099.6,43 APC,1529,New Technology - Level 29 ,,,5541.15,12156.61,43 APC,1530,New Technology - Level 30 ,,,6022.95,13213.61,43 APC,1531,New Technology - Level 31 ,,,6504.75,14270.62,43 APC,1532,New Technology - Level 32 ,,,6986.54,15327.62,43 APC,1533,New Technology - Level 33 ,,,7468.34,16384.63,43 APC,1534,New Technology - Level 34 ,,,7950.14,17441.63,43 APC,1535,New Technology - Level 35 ,,,8431.94,18498.64,43 APC,1536,New Technology - Level 36 ,,,8913.73,19555.64,43 APC,1537,New Technology - Level 37 ,,,9395.53,20612.64,43 APC,1539,New Technology - Level 2 ,,,74.24,74.24,1 APC,1539,New Technology - Level 2 ( ,,,72.75,159.61,42 APC,1540,New Technology - Level 3 ,,,147.98,147.98,1 APC,1540,New Technology - Level 3 ( ,,,145.02,318.16,42 APC,1541,New Technology - Level 4 ,,,246.31,246.31,1 APC,1541,New Technology - Level 4 ( ,,,241.38,529.56,42 APC,1542,New Technology - Level 5 ,,,344.63,344.63,1 APC,1542,New Technology - Level 5 ( ,,,337.74,740.96,42 APC,1543,New Technology - Level 6 ,,,442.96,442.96,1 APC,1543,New Technology - Level 6 ( ,,,434.1,952.36,42 APC,1544,New Technology - Level 7 ,,,541.28,541.28,1 APC,1544,New Technology - Level 7 ( ,,,530.46,1163.76,42 APC,1545,New Technology - Level 8 ,,,639.61,639.61,1 APC,1545,New Technology - Level 8 ( ,,,626.82,1375.16,42 APC,1546,New Technology - Level 9 ,,,737.94,737.94,1 APC,1546,New Technology - Level 9 ( ,,,723.18,1586.56,42 APC,1547,New Technology - Level 10 ,,,819.54,1797.96,43 APC,1548,New Technology - Level 11 ,,,915.9,2009.37,43 APC,1549,New Technology - Level 12 ,,,1012.26,2220.77,43 APC,1550,New Technology - Level 13 ,,,1108.62,2432.17,43 APC,1551,New Technology - Level 14 ,,,1204.98,2643.57,43 APC,1552,New Technology - Level 15 ,,,1301.34,2854.97,43 APC,1553,New Technology - Level 16 ,,,1397.69,3066.37,43 APC,1554,New Technology - Level 17 ,,,1494.05,3277.77,43 APC,1555,New Technology - Level 18 ,,,1590.41,3489.17,43 APC,1556,New Technology - Level 19 ,,,1686.77,3700.57,43 APC,1557,New Technology - Level 20 ,,,1783.13,3911.97,43 APC,1558,New Technology - Level 21 ,,,1879.49,4123.38,43 APC,1559,New Technology - Level 22 ,,,2168.57,4757.58,43 APC,1560,New Technology - Level 23 ,,,2650.37,5814.58,43 APC,1561,New Technology - Level 24 ,,,3132.17,6871.59,43 APC,1562,New Technology - Level 25 ,,,3613.96,7928.59,43 APC,1563,New Technology - Level 26 ,,,4095.76,8985.6,43 APC,1564,New Technology - Level 27 ,,,4577.56,10042.6,43 APC,1565,New Technology - Level 28 ,,,5059.35,11099.6,43 APC,1566,New Technology - Level 29 ,,,5541.15,12156.61,43 APC,1567,New Technology - Level 30 ,,,6022.95,13213.61,43 APC,1568,New Technology - Level 31 ,,,6504.75,14270.62,43 APC,1569,New Technology - Level 32 ,,,6986.54,15327.62,43 APC,1570,New Technology - Level 33 ,,,7468.34,16384.63,43 APC,1571,New Technology - Level 34 ,,,7950.14,17441.63,43 APC,1572,New Technology - Level 35 ,,,8431.94,18498.64,43 APC,1573,New Technology - Level 36 ,,,8913.73,19555.64,43 APC,1574,New Technology - Level 37 ,,,9395.53,20612.64,43 APC,1575,New Technology - Level 38 ,,,12045.42,26426.17,43 APC,1576,New Technology - Level 39 ,,,16863.39,36996.21,43 APC,1577,New Technology - Level 40 ,,,21681.36,47566.26,43 APC,1578,New Technology - Level 41 ,,,26499.34,58136.3,43 APC,1579,New Technology - Level 42 ,,,33726.3,73991.37,43 APC,1580,New Technology - Level 43 ,,,43362.25,95131.46,43 APC,1581,New Technology - Level 44 ,,,52998.19,116271.55,43 APC,1582,New Technology - Level 45 ,,,62634.14,137411.64,43 APC,1583,New Technology - Level 46 ,,,72270.09,158551.73,43 APC,1584,New Technology - Level 47 ,,,81906.04,179691.82,43 APC,1585,New Technology - Level 48 ,,,91542.0,200831.93,43 APC,1589,New Technology - Level 38 ,,,12045.42,26426.17,43 APC,1590,New Technology - Level 39 ,,,16863.39,36996.21,43 APC,1591,New Technology - Level 40 ,,,21681.36,47566.26,43 APC,1592,New Technology - Level 41 ,,,26499.34,58136.3,43 APC,1593,New Technology - Level 42 ,,,33726.3,73991.37,43 APC,1594,New Technology - Level 43 ,,,43362.25,95131.46,43 APC,1595,New Technology - Level 44 ,,,52998.19,116271.55,43 APC,1596,New Technology - Level 45 ,,,62634.14,137411.64,43 APC,1597,New Technology - Level 46 ,,,72270.09,158551.73,43 APC,1598,New Technology - Level 47 ,,,81906.04,179691.82,43 APC,1599,New Technology - Level 48 ,,,91542.0,200831.93,43 APC,1609,"Rho(D) immune globulin h, ",,,33.91,76.95,43 APC,1613,Trastuzumab injection ,,,68.84,151.02,43 APC,1630,"Hep b ig, im ",,,134.21,294.45,43 APC,1643,"Y90 ibritumomab, rx ",,,55688.06,122172.78,43 APC,1656,Factor viii fc fusion rec ,,,2.47,2.47,1 APC,1656,Factor viii fc fusion reco ,,,2.53,5.54,42 APC,1658,"Injection, belinostat, 10 ",,,53.11,53.11,1 APC,1658,"Injection, belinostat, 10m ",,,53.36,117.06,42 APC,1660,"Injection, oritavancin ",,,28.47,63.91,43 APC,1662,Inj tedizolid phosphate ,,,1.96,4.47,43 APC,1664,Florbetapir f18 ,,,1789.13,3925.13,43 APC,1670,Tetanus immune globulin i ,,,588.54,588.54,1 APC,1670,Tetanus immune globulin in ,,,583.12,1279.29,42 APC,1675,P32 na phosphate ,,,272.68,598.22,43 APC,1683,Basiliximab ,,,4781.07,10545.86,43 APC,1685,"Darbepoetin alfa, non-esr ",,,3.02,3.02,1 APC,1685,"Darbepoetin alfa, non-esrd ",,,2.86,6.28,42 APC,1686,"Epoetin alfa, non-esrd ",,,6.74,14.78,43 APC,1687,Digoxin immune fab (ovine ,,,5166.99,5166.99,1 APC,1687,Digoxin immune fab (ovine) ,,,5275.65,11574.14,42 APC,1688,Ethanolamine oleate ,,,517.08,1176.63,43 APC,1689,Fomepizole ,,,6.06,13.3,43 APC,1690,Hemin ,,,35.1,77.02,43 APC,1694,Ziconotide injection ,,,10.56,23.2,43 APC,1696,Palifermin injection ,,,36.63,83.18,43 APC,1700,Inj secretin synthetic hu ,,,40.44,40.44,1 APC,1700,Inj secretin synthetic hum ,,,42.14,92.45,42 APC,1701,Treprostinil injection ,,,53.65,117.69,43 APC,1704,"Humate-P, inj ",,,1.49,3.3,43 APC,1705,Factor viia recomb novose ,,,2.62,2.62,1 APC,1705,Factor viia recomb novosev ,,,2.72,5.96,42 APC,1710,Clofarabine injection ,,,14.37,34.93,43 APC,1712,Paclitaxel protein bound ,,,6.45,14.16,43 APC,1744,Zidovudine ,,,1.48,3.25,42 APC,1745,Radium ra223 dichloride t ,,,171.92,171.92,1 APC,1745,Radium ra223 dichloride th ,,,177.92,390.33,42 APC,1746,Factor xiii recomb a-subu ,,,18.56,18.56,1 APC,1746,Factor xiii recomb a-subun ,,,18.73,41.1,42 APC,1747,Monovisc inj per dose ,,,553.97,1215.34,43 APC,1748,Inj tbo filgrastim 1 micr ,,,0.25,0.25,1 APC,1748,Inj tbo filgrastim 1 micro ,,,0.23,0.51,42 APC,1761,"Rolapitant, oral, 1mg ",,,2.0,2.0,1 APC,1809,"Injection, alemtuzumab ",,,2447.1,5471.61,43 APC,1822,"Injection, zarxio ",,,0.35,0.76,43 APC,1823,"Injection, dalbavancin ",,,11.07,24.28,43 APC,1824,Ceftaroline fosamil inj ,,,4.24,9.44,43 APC,1825,Ceftazidime and avibactam ,,,104.71,236.0,43 APC,1826,Hyqvia 100mg immuneglobul ,,,18.32,18.32,1 APC,1826,Hyqvia 100mg immuneglobuli ,,,17.98,39.45,42 APC,1827,Factor viii recomb obizur ,,,3.17,6.96,43 APC,1829,Penicillin g benzathine i ,,,31.96,31.96,1 APC,1829,Penicillin g benzathine in ,,,31.94,70.07,42 APC,1832,Dimethyl sulfoxide 50% 50 ,,,733.9,1610.09,43 APC,1844,Factor viii pegylated rec ,,,2.16,2.16,1 APC,1844,Factor viii pegylated reco ,,,2.08,4.56,42 APC,1846,Factor viii nuwiq recomb ,,,1.13,1.13,1 APC,1846,Factor viii nuwiq recomb 1 ,,,1.2,2.63,42 APC,1847,"Injection, inflectra ",,,24.22,59.58,43 APC,1848,Artiss fibrin sealant ,,,142.47,313.2,43 APC,1850,Gamma globulin 1 cc inj ,,,47.9,105.08,43 APC,1851,Gamma globulin > 10 cc in ,,,104.52,104.52,1 APC,1851,Gamma globulin > 10 cc inj ,,,159.27,349.42,42 APC,1853,Minocycline hydrochloride ,,,2.67,5.88,43 APC,1854,Pentobarbital sodium inj ,,,18.91,41.49,42 APC,1856,Factor viii recomb novoei ,,,1.55,1.55,1 APC,1856,Factor viii recomb novoeig ,,,1.41,3.1,42 APC,1857,"Inj, factor x, (human), 1 ",,,9.92,9.92,1 APC,1857,"Inj, factor x, (human), 1i ",,,9.75,21.4,42 APC,1859,Argatroban nonesrd use 1m ,,,0.61,0.61,1 APC,1859,Argatroban nonesrd use 1mg ,,,0.85,1.86,42 APC,1861,"Inj., bendeka 1 mg ",,,12.28,26.94,43 APC,1862,Gelsyn-3 injection 0.1 mg ,,,0.57,1.26,43 APC,1901,New Technology - Level 49 ,,,103586.88,227256.93,43 APC,1902,New Technology - Level 49 ,,,103586.88,227256.93,43 APC,1903,New Technology - Level 50 ,,,118040.8,258967.07,43 APC,1904,New Technology - Level 50 ,,,118040.8,258967.07,43 APC,1905,New Technology - Level 51 ,,,132494.73,290677.21,43 APC,1906,New Technology - Level 51 ,,,132494.73,290677.21,43 APC,1907,New Technology - Level 52 ,,,146948.65,322387.34,43 APC,1908,New Technology - Level 52 ,,,146948.65,322387.34,43 APC,2041,"Cath, bladed, vasc prep ",,,,,0 APC,2042,"Endo, single, pulmonary ",,,,,0 APC,2043,Orth/matrx/bn fill drug-e ,,,,,0 APC,2043,Orth/matrx/bn fill drug-el ,,,,,0 APC,2044,"Ret dev, laser, ivc filte ",,,,,0 APC,2044,"Ret dev, laser, ivc filter ",,,,,0 APC,2045,"Grft, trnsmurl/trnsvens b ",,,,,0 APC,2045,"Grft, trnsmurl/trnsvens by ",,,,,0 APC,2046,"Pmkr, dual, leadless ",,,,,0 APC,2047,"Adapter, us to endoscope ",,,,,0 APC,2049,"Suprt dev, a-v fistula, i ",,,,,0 APC,2049,"Suprt dev, a-v fistula, im ",,,,,0 APC,2050,Cath coronary drug-delive ,,,,,0 APC,2050,Cath coronary drug-deliver ,,,,,0 APC,2051,Cath renal denerv radiofr ,,,,,0 APC,2051,Cath renal denerv radiofre ,,,,,0 APC,2052,Cath renal denerv ultrasn ,,,,,0 APC,2052,Cath renal denerv ultrasnd ,,,,,0 APC,2053,Si&pelvis fusn&fixn dev ,,,,,0 APC,2054,Power endo us-guid bx dev ,,,,,0 APC,2055,"Tissue marker, detectable ",,,,,0 APC,2062,"Inj zanidatamab-hrii, 2 m ",,,25.0,25.0,1 APC,2062,"Inj zanidatamab-hrii, 2 mg ",,,25.15,55.18,42 APC,2064,"Inj marstacim-hncq, 0.5 m ",,,50.47,50.47,1 APC,2064,"Inj marstacim-hncq, 0.5 mg ",,,50.17,110.06,42 APC,2065,"Flurpiridaz f18, diag, 1 ",,,530.0,530.0,1 APC,2065,"Flurpiridaz f18, diag, 1 m ",,,519.4,1139.5,42 APC,2066,Inj bortezomib boruzu 0.1 ,,,24.25,53.21,43 APC,2067,Afamitresgene autoleucel ,,,770620.0,1750029.91,43 APC,2068,"Inj, aflibercept-ayyh, 1 ",,,866.2,866.2,1 APC,2068,"Inj, aflibercept-ayyh, 1 m ",,,787.19,1727.0,42 APC,2069,"Inj, testosterone, azmiro ",,,1.27,2.79,43 APC,2070,"Inj, eculizumab, 2 mg ",,,43.31,95.03,43 APC,2071,Inj ocrelizumab 1mg hya-o ,,,47.05,47.05,1 APC,2071,Inj ocrelizumab 1mg hya-oc ,,,47.1,103.33,42 APC,2072,"Inj, erzofri, 1 mg ",,,15.3,34.13,43 APC,2073,Inj atezolizumb 5mg hya-t ,,,32.1,32.1,1 APC,2073,Inj atezolizumb 5mg hya-tq ,,,31.9,69.99,42 APC,2074,"Lt vent pacing syst, sequ ",,,,,0 APC,2074,"Lt vent pacing syst, seque ",,,,,0 APC,2075,Inj acetaminoph 10mg/ibu ,,,0.09,0.09,1 APC,2075,Inj acetaminoph 10mg/ibu 3 ,,,0.09,0.2,42 APC,2076,"Inj, pemetrexed dipotassi ",,,81.23,81.23,1 APC,2076,"Inj, pemetrexed dipotassiu ",,,72.2,158.39,42 APC,2077,Anchor/screw bone absorb ,,,,,0 APC,2078,"Pressure sens syst, cont ",,,,,0 APC,2078,"Pressure sens syst, cont i ",,,,,0 APC,2086,Neurostim integ rechg ,,,,,0 APC,2087,"Prosthesis, dual mob cmc1 ",,,,,0 APC,2088,Scafld endovas resrb drg e ,,,,,0 APC,2089,Vert dev motion-preserv ,,,,,0 APC,2616,"Brachytx, non-str,Yttrium ",,,17771.01,17771.01,1 APC,2616,"Brachytx, non-str,Yttrium- ",,,17415.59,38207.67,42 APC,2632,Iodine I-125 sodium iodid ,,,396.32,396.32,1 APC,2632,Iodine I-125 sodium iodide ,,,388.39,852.09,42 APC,2634,"Brachytx, non-str, HA, I- ",,,174.06,174.06,1 APC,2634,"Brachytx, non-str, HA, I-1 ",,,170.58,374.23,42 APC,2635,"Brachytx, non-str, HA, P- ",,,106.75,106.75,1 APC,2635,"Brachytx, non-str, HA, P-1 ",,,104.61,229.51,42 APC,2636,"Brachy linear, non-str,P- ",,,89.4,89.4,1 APC,2636,"Brachy linear, non-str,P-1 ",,,87.61,192.21,42 APC,2638,"Brachytx, stranded, I-125 ",,,34.55,75.81,43 APC,2639,"Brachytx, non-stranded,I- ",,,36.64,36.64,1 APC,2639,"Brachytx, non-stranded,I-1 ",,,35.91,78.78,42 APC,2640,"Brachytx, stranded, P-103 ",,,86.49,189.76,43 APC,2641,"Brachytx, non-stranded,P- ",,,64.48,64.48,1 APC,2641,"Brachytx, non-stranded,P-1 ",,,63.19,138.63,42 APC,2642,"Brachytx, stranded, C-131 ",,,116.73,256.09,43 APC,2643,"Brachytx, non-stranded,C- ",,,99.8,99.8,1 APC,2643,"Brachytx, non-stranded,C-1 ",,,97.8,214.57,42 APC,2645,"Brachytx, non-str, Gold-1 ",,,513.57,513.57,1 APC,2645,"Brachytx, non-str, Gold-19 ",,,503.3,1104.18,42 APC,2646,"Brachytx, non-str, HDR Ir ",,,357.49,357.49,1 APC,2646,"Brachytx, non-str, HDR Ir- ",,,350.34,768.6,42 APC,2647,"Brachytx, NS, Non-HDRIr-1 ",,,908.7,908.7,1 APC,2647,"Brachytx, NS, Non-HDRIr-19 ",,,890.53,1953.7,42 APC,2648,"Brachytx planar, p-103 ",,,4.6,10.08,43 APC,2698,"Brachytx, stranded, NOS ",,,34.55,75.81,43 APC,2699,"Brachytx, non-stranded, N ",,,36.64,36.64,1 APC,2699,"Brachytx, non-stranded, NO ",,,35.91,78.78,42 APC,2731,"Immune globulin, powder ",,,78.89,174.07,43 APC,4017,Radiation tx delivery lvl ,,,76.6,168.04,42 APC,4018,Radiation tx delivery lvl ,,,306.08,671.49,42 APC,4019,Radiation tx delivery lvl ,,,377.21,827.55,42 APC,5012,Clinic Visits and Related ,,,131.07,287.55,43 APC,5021,Level 1 Type A ED Visits ,,,83.01,182.12,25 APC,5022,Level 2 Type A ED Visits ,,,151.16,331.62,25 APC,5023,Level 3 Type A ED Visits ,,,268.74,589.58,25 APC,5024,Level 4 Type A ED Visits ,,,410.78,901.2,25 APC,5025,Level 5 Type A ED Visits ,,,586.28,1286.23,25 APC,5031,Level 1 Type B ED Visits ,,,73.18,160.54,25 APC,5032,Level 2 Type B ED Visits ,,,91.45,200.62,25 APC,5033,Level 3 Type B ED Visits ,,,169.22,371.24,25 APC,5034,Level 4 Type B ED Visits ,,,260.2,570.85,25 APC,5035,Level 5 Type B ED Visits ,,,404.34,887.08,25 APC,5041,Critical Care ,,,813.2,1784.05,43 APC,5045,Trauma Response with Crit ,,,1338.98,1338.98,1 APC,5045,Trauma Response with Criti ,,,1312.2,2878.82,42 APC,5051,Level 1 Skin Procedures ,,,197.52,433.33,43 APC,5052,Level 2 Skin Procedures ,,,400.2,877.99,43 APC,5053,Level 3 Skin Procedures ,,,727.59,1596.25,43 APC,5054,Level 4 Skin Procedures ,,,2031.23,4456.27,43 APC,5055,Level 5 Skin Procedures ,,,3488.68,7653.73,43 APC,5061,Hyperbaric Oxygen ,,,135.47,297.21,43 APC,5071,Level 1 Excision/ Biopsy/ ,,,697.13,1529.42,43 APC,5072,Level 2 Excision/ Biopsy/ ,,,1625.94,3567.11,43 APC,5073,Level 3 Excision/ Biopsy/ ,,,2859.59,6273.6,43 APC,5091,Level 1 Breast/Lymphatic ,,,3933.28,3933.28,1 APC,5091,Level 1 Breast/Lymphatic S ,,,3854.61,8456.54,42 APC,5092,Level 2 Breast/Lymphatic ,,,6670.43,6670.43,1 APC,5092,Level 2 Breast/Lymphatic S ,,,6537.02,14341.42,42 APC,5093,Level 3 Breast/Lymphatic ,,,8210.63,8210.63,1 APC,5093,Level 3 Breast/Lymphatic S ,,,8046.42,17652.86,42 APC,5094,Level 4 Breast/Lymphatic ,,,13843.75,13843.75,1 APC,5094,Level 4 Breast/Lymphatic S ,,,13566.88,29764.06,42 APC,5101,Level 1 Strapping and Cas ,,,163.24,163.24,1 APC,5101,Level 1 Strapping and Cast ,,,159.98,350.97,42 APC,5102,Level 2 Strapping and Cas ,,,280.97,280.97,1 APC,5102,Level 2 Strapping and Cast ,,,275.35,604.08,42 APC,5111,Level 1 Musculoskeletal P ,,,247.79,247.79,1 APC,5111,Level 1 Musculoskeletal Pr ,,,242.84,532.75,42 APC,5112,Level 2 Musculoskeletal P ,,,1615.32,1615.32,1 APC,5112,Level 2 Musculoskeletal Pr ,,,1583.01,3472.94,42 APC,5113,Level 3 Musculoskeletal P ,,,3286.91,3286.91,1 APC,5113,Level 3 Musculoskeletal Pr ,,,3221.17,7066.86,42 APC,5114,Level 4 Musculoskeletal P ,,,7289.28,7289.28,1 APC,5114,Level 4 Musculoskeletal Pr ,,,7143.49,15671.95,42 APC,5115,Level 5 Musculoskeletal P ,,,12897.19,12897.19,1 APC,5115,Level 5 Musculoskeletal Pr ,,,12639.25,27728.96,42 APC,5116,Level 6 Musculoskeletal P ,,,17613.72,17613.72,1 APC,5116,Level 6 Musculoskeletal Pr ,,,17261.45,37869.5,42 APC,5117,Level 7 Musculoskeletal Pr ,,,26712.52,58603.99,42 APC,5151,Level 1 Airway Endoscopy ,,,196.51,431.11,43 APC,5152,Level 2 Airway Endoscopy ,,,385.04,844.74,43 APC,5153,Level 3 Airway Endoscopy ,,,1752.25,3844.22,43 APC,5154,Level 4 Airway Endoscopy ,,,3670.43,8052.47,43 APC,5155,Level 5 Airway Endoscopy ,,,6947.83,15242.68,43 APC,5161,Level 1 ENT Procedures ,,,233.17,511.55,43 APC,5162,Level 2 ENT Procedures ,,,530.95,1164.84,43 APC,5163,Level 3 ENT Procedures ,,,1527.48,3351.11,43 APC,5164,Level 4 ENT Procedures ,,,3263.96,7160.72,43 APC,5165,Level 5 ENT Procedures ,,,5827.87,12785.63,43 APC,5166,Cochlear Implant Procedur ,,,33122.37,33122.37,1 APC,5166,Cochlear Implant Procedure ,,,32459.92,71213.1,42 APC,5181,Level 1 Vascular Procedur ,,,630.16,630.16,1 APC,5181,Level 1 Vascular Procedure ,,,617.56,1354.85,42 APC,5182,Level 2 Vascular Procedur ,,,1581.33,1581.33,1 APC,5182,Level 2 Vascular Procedure ,,,1549.7,3399.86,42 APC,5183,Level 3 Vascular Procedur ,,,3171.87,3171.87,1 APC,5183,Level 3 Vascular Procedure ,,,3108.43,6819.52,42 APC,5184,Level 4 Vascular Procedur ,,,5589.84,5589.84,1 APC,5184,Level 4 Vascular Procedure ,,,5478.05,12018.16,42 APC,5191,Level 1 Endovascular Proc ,,,3256.7,3256.7,1 APC,5191,Level 1 Endovascular Proce ,,,3191.57,7001.92,42 APC,5192,Level 2 Endovascular Proc ,,,5717.5,5717.5,1 APC,5192,Level 2 Endovascular Proce ,,,5603.15,12292.63,42 APC,5193,Level 3 Endovascular Proc ,,,11596.79,11596.79,1 APC,5193,Level 3 Endovascular Proce ,,,11364.85,24933.1,42 APC,5194,Level 4 Endovascular Proc ,,,18415.17,18415.17,1 APC,5194,Level 4 Endovascular Proce ,,,18046.87,39592.62,42 APC,5200,Implantation Wireless PA ,,,28814.06,28814.06,1 APC,5200,Implantation Wireless PA P ,,,28237.78,61950.23,42 APC,5211,Level 1 Electrophysiologi ,,,1223.09,1223.09,1 APC,5211,Level 1 Electrophysiologic ,,,1198.63,2629.64,42 APC,5212,Level 2 Electrophysiologi ,,,7835.21,7835.21,1 APC,5212,Level 2 Electrophysiologic ,,,7678.5,16845.69,42 APC,5213,Level 3 Electrophysiologi ,,,26256.96,26256.96,1 APC,5213,Level 3 Electrophysiologic ,,,25731.82,56452.46,42 APC,5221,Level 1 Pacemaker and Sim ,,,3753.99,3753.99,1 APC,5221,Level 1 Pacemaker and Simi ,,,3678.91,8071.07,42 APC,5222,Level 2 Pacemaker and Sim ,,,8313.1,8313.1,1 APC,5222,Level 2 Pacemaker and Simi ,,,8146.84,17873.17,42 APC,5223,Level 3 Pacemaker and Sim ,,,10499.62,10499.62,1 APC,5223,Level 3 Pacemaker and Simi ,,,10289.63,22574.18,42 APC,5224,Level 4 Pacemaker and Sim ,,,19349.46,19349.46,1 APC,5224,Level 4 Pacemaker and Simi ,,,18962.47,41601.34,42 APC,5231,Level 1 ICD and Similar P ,,,22344.94,22344.94,1 APC,5231,Level 1 ICD and Similar Pr ,,,21898.04,48041.62,42 APC,5232,Level 2 ICD and Similar P ,,,31531.9,31531.9,1 APC,5232,Level 2 ICD and Similar Pr ,,,30901.26,67793.59,42 APC,5241,Level 1 Blood Product Exc ,,,443.18,443.18,1 APC,5241,Level 1 Blood Product Exch ,,,434.32,952.85,42 APC,5242,Level 2 Blood Product Exc ,,,1564.52,1564.52,1 APC,5242,Level 2 Blood Product Exch ,,,1533.23,3363.73,42 APC,5243,Level 3 Blood Product Exc ,,,4375.35,4375.35,1 APC,5243,Level 3 Blood Product Exch ,,,4287.84,9407.0,42 APC,5244,Level 4 Blood Product Exc ,,,63187.75,63187.75,1 APC,5244,Level 4 Blood Product Exch ,,,61923.99,135853.66,42 APC,5301,Level 1 Upper GI Procedur ,,,911.12,911.12,1 APC,5301,Level 1 Upper GI Procedure ,,,892.9,1958.9,42 APC,5302,Level 2 Upper GI Procedur ,,,1927.65,1927.65,1 APC,5302,Level 2 Upper GI Procedure ,,,1889.1,4144.45,42 APC,5303,Level 3 Upper GI Procedur ,,,3873.04,3873.04,1 APC,5303,Level 3 Upper GI Procedure ,,,3795.58,8327.04,42 APC,5311,Level 1 Lower GI Procedur ,,,934.2,934.2,1 APC,5311,Level 1 Lower GI Procedure ,,,915.51,2008.52,42 APC,5312,Level 2 Lower GI Procedur ,,,1202.09,1202.09,1 APC,5312,Level 2 Lower GI Procedure ,,,1178.05,2584.5,42 APC,5313,Level 3 Lower GI Procedur ,,,2788.31,2788.31,1 APC,5313,Level 3 Lower GI Procedure ,,,2732.54,5994.86,42 APC,5331,Complex GI Procedures ,,,5976.59,13111.91,43 APC,5341,Level 1 Abdominal/Periton ,,,3596.72,3596.72,1 APC,5341,Level 1 Abdominal/Peritone ,,,3524.78,7732.94,42 APC,5342,Level 2 Abdominal/Periton ,,,6503.32,6503.32,1 APC,5342,Level 2 Abdominal/Peritone ,,,6373.25,13982.14,42 APC,5361,Level 1 Laparoscopy and R ,,,6073.08,6073.08,1 APC,5361,Level 1 Laparoscopy and Re ,,,5951.61,13057.11,42 APC,5362,Level 2 Laparoscopy and R ,,,10678.27,10678.27,1 APC,5362,Level 2 Laparoscopy and Re ,,,10464.7,22958.28,42 APC,5371,Level 1 Urology and Relat ,,,250.99,250.99,1 APC,5371,Level 1 Urology and Relate ,,,245.97,539.62,42 APC,5372,Level 2 Urology and Relat ,,,700.47,700.47,1 APC,5372,Level 2 Urology and Relate ,,,686.46,1506.02,42 APC,5373,Level 3 Urology and Relat ,,,2099.91,2099.91,1 APC,5373,Level 3 Urology and Relate ,,,2057.91,4514.8,42 APC,5374,Level 4 Urology and Relat ,,,3541.04,3541.04,1 APC,5374,Level 4 Urology and Relate ,,,3470.22,7613.24,42 APC,5375,Level 5 Urology and Relat ,,,5386.23,5386.23,1 APC,5375,Level 5 Urology and Relate ,,,5278.5,11580.39,42 APC,5376,Level 6 Urology and Relat ,,,9509.6,9509.6,1 APC,5376,Level 6 Urology and Relate ,,,9319.41,20445.64,42 APC,5377,Level 7 Urology and Relat ,,,13253.58,13253.58,1 APC,5377,Level 7 Urology and Relate ,,,12988.51,28495.2,42 APC,5378,Level 8 Urology and Relat ,,,20820.57,20820.57,1 APC,5378,Level 8 Urology and Relate ,,,20404.16,44764.23,42 APC,5401,Dialysis ,,,675.65,1482.3,43 APC,5411,Level 1 Gynecologic Proce ,,,203.09,203.09,1 APC,5411,Level 1 Gynecologic Proced ,,,199.03,436.65,42 APC,5412,Level 2 Gynecologic Proce ,,,306.12,306.12,1 APC,5412,Level 2 Gynecologic Proced ,,,300.0,658.15,42 APC,5413,Level 3 Gynecologic Proce ,,,925.25,925.25,1 APC,5413,Level 3 Gynecologic Proced ,,,906.74,1989.28,42 APC,5414,Level 4 Gynecologic Proce ,,,3251.88,3251.88,1 APC,5414,Level 4 Gynecologic Proced ,,,3186.84,6991.54,42 APC,5415,Level 5 Gynecologic Proce ,,,5025.24,5025.24,1 APC,5415,Level 5 Gynecologic Proced ,,,4924.74,10804.28,42 APC,5416,Level 6 Gynecologic Proce ,,,7449.23,7449.23,1 APC,5416,Level 6 Gynecologic Proced ,,,7300.24,16015.84,42 APC,5431,Level 1 Nerve Procedures ,,,1922.39,4217.49,43 APC,5432,Level 2 Nerve Procedures ,,,3363.08,7378.19,43 APC,5433,Level 3 Nerve Procedures ,,,8639.52,18954.06,42 APC,5441,Level 1 Nerve Injections ,,,302.18,662.95,43 APC,5442,Level 2 Nerve Injections ,,,694.92,1524.56,43 APC,5443,Level 3 Nerve Injections ,,,870.73,1910.28,43 APC,5461,Level 1 Neurostimulator a ,,,3512.04,3512.04,1 APC,5461,Level 1 Neurostimulator an ,,,3441.8,7550.88,42 APC,5462,Level 2 Neurostimulator a ,,,6402.03,6402.03,1 APC,5462,Level 2 Neurostimulator an ,,,6273.99,13764.38,42 APC,5463,Level 3 Neurostimulator a ,,,11193.47,11193.47,1 APC,5463,Level 3 Neurostimulator an ,,,10969.6,24065.96,42 APC,5464,Level 4 Neurostimulator a ,,,19488.52,19488.52,1 APC,5464,Level 4 Neurostimulator an ,,,19098.75,41900.32,42 APC,5465,Level 5 Neurostimulator a ,,,30998.31,30998.31,1 APC,5465,Level 5 Neurostimulator an ,,,30378.34,66646.37,42 APC,5471,Implantation of Drug Infu ,,,18105.99,18105.99,1 APC,5471,Implantation of Drug Infus ,,,17743.87,38927.88,42 APC,5481,Laser Eye Procedures ,,,541.45,1187.88,43 APC,5491,Level 1 Intraocular Proce ,,,2318.34,2318.34,1 APC,5491,Level 1 Intraocular Proced ,,,2271.97,4984.43,42 APC,5492,Level 2 Intraocular Proce ,,,4152.26,4152.26,1 APC,5492,Level 2 Intraocular Proced ,,,4069.21,8927.35,42 APC,5493,Level 3 Intraocular Proce ,,,5345.55,5345.55,1 APC,5493,Level 3 Intraocular Proced ,,,5238.64,11492.94,42 APC,5494,Level 4 Intraocular Proce ,,,14572.21,14572.21,1 APC,5494,Level 4 Intraocular Proced ,,,14280.77,31330.25,42 APC,5495,Level 5 Intraocular Proce ,,,14016.54,14016.54,1 APC,5495,Level 5 Intraocular Proced ,,,13736.21,30135.56,42 APC,5496,Level 6 Intraocular Proce ,,,16535.84,16535.84,1 APC,5496,Level 6 Intraocular Proced ,,,16205.12,35552.06,42 APC,5501,"Level 1 Extraocular, Repa ",,,318.85,318.85,1 APC,5501,"Level 1 Extraocular, Repai ",,,312.47,685.53,42 APC,5502,"Level 2 Extraocular, Repa ",,,1001.42,1001.42,1 APC,5502,"Level 2 Extraocular, Repai ",,,981.39,2153.06,42 APC,5503,"Level 3 Extraocular, Repa ",,,2388.32,2388.32,1 APC,5503,"Level 3 Extraocular, Repai ",,,2340.55,5134.89,42 APC,5504,"Level 4 Extraocular, Repa ",,,3949.31,3949.31,1 APC,5504,"Level 4 Extraocular, Repai ",,,3870.33,8491.02,42 APC,5521,Level 1 Imaging without C ,,,87.42,87.42,1 APC,5521,Level 1 Imaging without Co ,,,85.67,187.96,42 APC,5522,Level 2 Imaging without C ,,,105.02,105.02,1 APC,5522,Level 2 Imaging without Co ,,,102.92,225.8,42 APC,5523,Level 3 Imaging without C ,,,239.69,239.69,1 APC,5523,Level 3 Imaging without Co ,,,234.9,515.33,42 APC,5524,Level 4 Imaging without C ,,,548.9,548.9,1 APC,5524,Level 4 Imaging without Co ,,,537.93,1180.15,42 APC,5571,Level 1 Imaging with Cont ,,,176.2,176.2,1 APC,5571,Level 1 Imaging with Contr ,,,172.68,378.83,42 APC,5572,Level 2 Imaging with Cont ,,,350.46,350.46,1 APC,5572,Level 2 Imaging with Contr ,,,343.45,753.5,42 APC,5573,Level 3 Imaging with Cont ,,,787.49,787.49,1 APC,5573,Level 3 Imaging with Contr ,,,771.74,1693.11,42 APC,5591,Level 1 Nuclear Medicine ,,,401.59,401.59,1 APC,5591,Level 1 Nuclear Medicine a ,,,393.56,863.42,42 APC,5592,Level 2 Nuclear Medicine ,,,545.44,545.44,1 APC,5592,Level 2 Nuclear Medicine a ,,,534.53,1172.7,42 APC,5593,Level 3 Nuclear Medicine ,,,1300.55,1300.55,1 APC,5593,Level 3 Nuclear Medicine a ,,,1274.54,2796.18,42 APC,5594,Level 4 Nuclear Medicine ,,,1436.46,1436.46,1 APC,5594,Level 4 Nuclear Medicine a ,,,1407.73,3088.4,42 APC,5611,Level 1 Therapeutic Radia ,,,135.02,135.02,1 APC,5611,Level 1 Therapeutic Radiat ,,,132.32,290.3,42 APC,5612,Level 2 Therapeutic Radia ,,,376.14,376.14,1 APC,5612,Level 2 Therapeutic Radiat ,,,368.61,808.69,42 APC,5613,Level 3 Therapeutic Radia ,,,1390.44,1390.44,1 APC,5613,Level 3 Therapeutic Radiat ,,,1362.63,2989.44,42 APC,5621,Level 1 Radiation Therapy ,,,100.45,220.36,43 APC,5622,Level 2 Radiation Therapy ,,,379.7,833.03,43 APC,5623,Level 3 Radiation Therapy ,,,543.96,1193.38,43 APC,5624,Level 4 Radiation Therapy ,,,685.66,1504.24,43 APC,5625,Level 5 Radiation Therapy ,,,1230.33,2699.19,43 APC,5626,Level 6 Radiation Therapy ,,,1760.28,3861.83,43 APC,5627,Level 7 Radiation Therapy ,,,7250.88,15907.54,43 APC,5661,Therapeutic Nuclear Medic ,,,234.4,234.4,1 APC,5661,Therapeutic Nuclear Medici ,,,229.71,503.96,42 APC,5671,Level 1 Pathology ,,,51.3,112.55,43 APC,5672,Level 2 Pathology ,,,167.72,367.96,43 APC,5673,Level 3 Pathology ,,,352.88,774.17,43 APC,5674,Level 4 Pathology ,,,793.16,1740.1,43 APC,5691,Level 1 Drug Administrati ,,,47.04,47.04,1 APC,5691,Level 1 Drug Administratio ,,,46.1,101.13,42 APC,5692,Level 2 Drug Administrati ,,,72.33,72.33,1 APC,5692,Level 2 Drug Administratio ,,,70.88,155.51,42 APC,5693,Level 3 Drug Administrati ,,,213.67,213.67,1 APC,5693,Level 3 Drug Administratio ,,,209.4,459.4,42 APC,5694,Level 4 Drug Administrati ,,,331.81,331.81,1 APC,5694,Level 4 Drug Administratio ,,,325.17,713.39,42 APC,5721,Level 1 Diagnostic Tests ,,,129.26,129.26,1 APC,5721,Level 1 Diagnostic Tests a ,,,126.67,277.91,42 APC,5722,Level 2 Diagnostic Tests ,,,216.91,216.91,1 APC,5722,Level 2 Diagnostic Tests a ,,,212.57,466.35,42 APC,5723,Level 3 Diagnostic Tests ,,,374.86,374.86,1 APC,5723,Level 3 Diagnostic Tests a ,,,367.36,805.94,42 APC,5724,Level 4 Diagnostic Tests ,,,862.65,862.65,1 APC,5724,Level 4 Diagnostic Tests a ,,,845.4,1854.7,42 APC,5731,Level 1 Minor Procedures ,,,28.47,62.47,43 APC,5732,Level 2 Minor Procedures ,,,36.77,80.67,43 APC,5733,Level 3 Minor Procedures ,,,58.08,127.41,43 APC,5734,Level 4 Minor Procedures ,,,130.98,287.36,43 APC,5735,Level 5 Minor Procedures ,,,439.78,964.83,43 APC,5741,Level 1 Electronic Analys ,,,37.49,37.49,1 APC,5741,Level 1 Electronic Analysi ,,,36.74,80.61,42 APC,5742,Level 2 Electronic Analys ,,,95.5,95.5,1 APC,5742,Level 2 Electronic Analysi ,,,93.59,205.33,42 APC,5743,Level 3 Electronic Analys ,,,308.54,308.54,1 APC,5743,Level 3 Electronic Analysi ,,,302.37,663.35,42 APC,5771,Cardiac Rehabilitation ,,,126.91,278.41,43 APC,5781,Resuscitation and Cardiov ,,,663.96,663.96,1 APC,5781,Resuscitation and Cardiove ,,,650.68,1427.51,42 APC,5791,Pulmonary Treatment ,,,215.58,472.95,43 APC,5801,Ventilation Initiation an ,,,620.6,620.6,1 APC,5801,Ventilation Initiation and ,,,608.19,1334.3,42 APC,5811,Manipulation Therapy ,,,21.26,46.64,43 APC,5821,Level 1 Health and Behavi ,,,37.64,37.64,1 APC,5821,Level 1 Health and Behavio ,,,36.89,80.92,42 APC,5822,Level 2 Health and Behavi ,,,102.05,102.05,1 APC,5822,Level 2 Health and Behavio ,,,100.01,219.41,42 APC,5823,Level 3 Health and Behavi ,,,178.3,178.3,1 APC,5823,Level 3 Health and Behavio ,,,174.74,383.35,42 APC,5851,Intensive Outpatient (3 s ,,,125.6,125.6,1 APC,5851,Intensive Outpatient (3 se ,,,123.09,270.04,42 APC,5852,Intensive Outpatient (4 o ,,,164.58,164.58,1 APC,5852,Intensive Outpatient (4 or ,,,161.29,353.84,42 APC,5853,Partial Hospitalization ( ,,,125.6,125.6,1 APC,5853,Partial Hospitalization (3 ,,,123.09,270.04,42 APC,5854,Partial Hospitalization ( ,,,164.58,164.58,1 APC,5854,Partial Hospitalization (4 ,,,161.29,353.84,42 APC,5861,Intensive Outpatient (3 s ,,,314.03,314.03,1 APC,5861,Intensive Outpatient (3 se ,,,307.75,675.17,42 APC,5862,Intensive Outpatient (4 o ,,,411.45,411.45,1 APC,5862,Intensive Outpatient (4 or ,,,403.22,884.61,42 APC,5863,Partial Hospitalization ( ,,,314.03,314.03,1 APC,5863,Partial Hospitalization (3 ,,,307.75,675.17,42 APC,5864,Partial Hospitalization ( ,,,411.45,411.45,1 APC,5864,Partial Hospitalization (4 ,,,403.22,884.61,42 APC,5871,Dental Procedures ,,,636.44,1396.28,43 APC,5881,Ancillary Outpatient Serv ,,,13990.69,13990.69,1 APC,5881,Ancillary Outpatient Servi ,,,13710.88,30079.98,42 APC,6000,PMA Skin Substitute Produc ,,,122.51,268.78,42 APC,6001,510K Skin Substitute Produ ,,,122.51,268.78,42 APC,6002,HCT/P Skin Substitute Prod ,,,122.51,268.78,42 APC,701,Sr89 strontium ,,,4063.41,8914.62,43 APC,702,"Inj, human-lans, per i.u ",,,1.7,3.73,43 APC,703,Inj daxibotulinumtoxina-l ,,,3.11,3.11,1 APC,703,Inj daxibotulinumtoxina-la ,,,3.01,6.59,42 APC,704,"Inj, aflibercept hd, 1 mg ",,,292.71,642.17,43 APC,7043,Infliximab not biosimil 1 ,,,32.42,32.42,1 APC,7043,Infliximab not biosimil 10 ,,,30.85,67.68,42 APC,7046,Doxorubicin inj 10mg ,,,104.01,250.7,43 APC,7048,Alteplase recombinant ,,,93.83,211.96,43 APC,705,Inj avacincaptad pegol 0. ,,,102.92,102.92,1 APC,705,Inj avacincaptad pegol 0.1 ,,,101.14,221.89,42 APC,706,Inj talquetamab-tgvs 0.25 ,,,74.92,164.95,43 APC,707,"Cantharidin top, applicat ",,,656.5,656.5,1 APC,707,"Cantharidin top, applicato ",,,681.3,1494.7,42 APC,708,"Inj, elranatamab-bcmm, 1 ",,,188.52,188.52,1 APC,708,"Inj, elranatamab-bcmm, 1 m ",,,188.63,413.84,42 APC,709,Flortaucipir inj 1 millic ,,,371.0,371.0,1 APC,709,Flortaucipir inj 1 millicu ,,,363.58,797.65,42 APC,710,Inj velmanase alfa-tycv 1 ,,,465.23,1030.26,43 APC,711,"Inj, artesunate, 1mg ",,,50.79,111.43,43 APC,713,Inj roctavian ml 2x10^13v ,,,12553.71,12553.71,1 APC,713,Inj roctavian ml 2x10^13vc ,,,12302.64,26990.48,42 APC,714,Inj delandistrogene mox r ,,,3327860.0,3327860.0,1 APC,714,Inj delandistrogene mox ro ,,,3250559.06,7131328.55,42 APC,715,Pegunigalsidase alfa-iwxj ,,,221.15,485.18,43 APC,716,"Vyjuvek 5x10^9pfu/ml, 0.1 ",,,1011.79,2219.74,43 APC,717,"Instill adstiladrin, tx d ",,,64274.79,64274.79,1 APC,717,"Instill adstiladrin, tx do ",,,63044.98,138312.96,42 APC,719,Inj cyclophos frindovyx 5 ,,,8.74,19.18,43 APC,720,"Inj glofitamab gxbm, 2.5 ",,,2843.59,2843.59,1 APC,720,"Inj glofitamab gxbm, 2.5 m ",,,2807.38,6159.06,42 APC,721,Inj rozanolixizum-noli 1 ,,,23.38,23.38,1 APC,721,Inj rozanolixizum-noli 1 m ,,,23.12,50.71,42 APC,723,Inj efgart-alfa 2mg hya-q ,,,34.12,34.12,1 APC,723,Inj efgart-alfa 2mg hya-qv ,,,33.57,73.65,42 APC,725,Inj secukinumab intrav 1m ,,,18.07,18.07,1 APC,725,Inj secukinumab intrav 1mg ,,,17.87,39.2,42 APC,726,Dexrazoxane HCl injection ,,,40.61,89.1,43 APC,727,"Inj, adzynma, 10 iu ",,,35.48,77.86,43 APC,728,"Inj, mirikizumab-mrkz, 1 ",,,41.92,41.92,1 APC,728,"Inj, mirikizumab-mrkz, 1 m ",,,32.0,70.21,42 APC,729,"Inj, motixafortide, 0.25 ",,,26.48,26.48,1 APC,729,"Inj, motixafortide, 0.25 m ",,,25.95,56.93,42 APC,730,Inj melphalan (hepzato) 1 ,,,785.45,1723.18,43 APC,7308,Aminolevulinic acid hcl t ,,,389.83,389.83,1 APC,7308,Aminolevulinic acid hcl to ,,,381.49,836.95,42 APC,731,Sargramostim injection ,,,61.22,134.32,43 APC,732,"Inj, brixadi, 7 days or l ",,,420.05,420.05,1 APC,732,"Inj, brixadi, 7 days or le ",,,421.96,925.74,42 APC,733,"Inj brixadi, more than 7 ",,,1680.21,1680.21,1 APC,733,"Inj brixadi, more than 7 d ",,,1687.86,3702.96,42 APC,734,"Inj, levothyroxine, fresk ",,,6.94,6.94,1 APC,734,"Inj, levothyroxine, freska ",,,6.7,14.7,42 APC,736,Amphotericin b liposome i ,,,20.72,20.72,1 APC,736,Amphotericin b liposome in ,,,19.45,42.67,42 APC,737,"Inj, cipaglucosidase, 5 m ",,,91.2,91.2,1 APC,737,"Inj, cipaglucosidase, 5 mg ",,,94.38,207.05,42 APC,738,Rasburicase ,,,379.7,833.02,43 APC,739,"Inj, rykindo, 0.5 mg ",,,12.77,28.01,43 APC,740,Inj hydroxocobalamin iv 2 ,,,5.44,5.44,1 APC,740,Inj hydroxocobalamin iv 25 ,,,5.34,11.7,42 APC,741,Inj cyclophos dr reddys 5 ,,,0.49,1.07,42 APC,741,Inj cyclophosphamd (ingen ,,,0.7,0.7,1 APC,742,Anacaulase-bcdb 8.8% gel ,,,57.17,57.17,1 APC,743,"Inj, cyclophosphamide, no ",,,0.58,0.58,1 APC,743,"Inj, cyclophosphamide, nos ",,,0.56,1.24,42 APC,744,Inst tauro 1.35mg/hep 100 ,,,5.97,5.97,1 APC,744,Inst tauro 1.35mg/hep 100u ,,,4.12,9.05,42 APC,745,"Inj, toripalimab-tpzi, 1 ",,,40.21,40.21,1 APC,745,"Inj, toripalimab-tpzi, 1 m ",,,40.08,87.92,42 APC,746,"Inj, betibeglogene autote ",,,2939969.0,2939969.0,1 APC,746,"Inj, betibeglogene autotem ",,,2871654.8,6300059.0,42 APC,747,"Inj, zolbetuximab-clzb, 2 ",,,33.25,72.94,43 APC,748,"Inj, lovotibeglogene auto ",,,3252508.0,3252508.0,1 APC,748,"Inj, lovotibeglogene autot ",,,3170597.92,6955903.6,42 APC,749,Inj travoprost intra impl ,,,192.81,423.0,43 APC,750,"Inj, nithiodote, 3mg / 12 ",,,2.17,2.17,1 APC,750,"Inj, nithiodote, 3mg / 125 ",,,2.12,4.66,42 APC,752,Dactinomycin injection ,,,301.26,660.93,43 APC,755,Oral methotrexate (jylamv ,,,18.64,18.64,1 APC,755,Oral methotrexate (jylamvo ,,,16.14,35.4,42 APC,756,Oral methotrexate (xatmep ,,,22.43,22.43,1 APC,756,Oral methotrexate (xatmep) ,,,22.46,49.27,42 APC,757,"Docetaxel (docivyx), 1 mg ",,,45.36,99.52,43 APC,759,"Naltrexone, depot form ",,,4.24,9.73,43 APC,760,Tc-99m graphite crucible ,,,322.03,706.49,43 APC,761,"Inj, focinvez, 1mg ",,,2.41,5.28,43 APC,763,"Inj, bupivacaine liposome ",,,1.42,3.13,43 APC,764,Ketorolac tromethamine in ,,,0.33,0.33,1 APC,764,Ketorolac tromethamine inj ,,,0.28,0.61,42 APC,765,"Inj, donanemab-azbt, 2 mg ",,,4.08,8.95,43 APC,766,Tc99m exametazime ,,,927.71,927.71,1 APC,767,"Inj, nogapendekin pmln 1 ",,,94.73,94.73,1 APC,767,"Inj, nogapendekin pmln 1 m ",,,92.42,202.76,42 APC,768,"Inj, tarlatamab-dlle, 1 m ",,,1566.59,1566.59,1 APC,768,"Inj, tarlatamab-dlle, 1 mg ",,,1580.17,3466.71,42 APC,770,In111 oxyquinoline ,,,814.83,1787.64,43 APC,771,In111 pentetate ,,,730.71,1603.08,43 APC,772,"Inj, pegulicianine, 1 mg ",,,36.76,80.64,43 APC,774,Tc99m bicisate ,,,760.01,1667.37,43 APC,776,Technetium tc-99m auto wb ,,,934.13,934.13,1 APC,776,Technetium tc-99m auto wbc ,,,915.45,2008.38,42 APC,777,Indium in-111 auto wbc ,,,1081.13,2371.86,43 APC,778,"Inj, vasopressin (baxter) ",,,1.72,3.77,43 APC,779,Indium in-111 pentetreoti ,,,2000.94,2000.94,1 APC,779,Indium in-111 pentetreotid ,,,1960.92,4302.02,42 APC,780,Iodine i-123 iobenguane ,,,2271.15,4982.63,43 APC,781,Iodine i-123 ioflupane ,,,1359.99,2983.64,43 APC,782,"Inj, pemrydi rtu, 10 mg ",,,66.58,146.06,43 APC,784,"Inj, tyenne, 1 mg ",,,3.97,8.72,43 APC,785,"Inj, cyclophosphamd, sand ",,,3.84,3.84,1 APC,785,"Inj, cyclophosphamd, sando ",,,3.37,7.39,42 APC,786,"Inj, tofidence, 1 mg ",,,4.91,10.78,43 APC,798,"Inj, sezaby, 1 mg ",,,1.09,2.4,43 APC,800,Leuprolide acetate ,,,1763.87,3958.71,43 APC,8004,Ultrasound Composite ,,,289.63,635.41,43 APC,8005,CT and CTA without Contra ,,,222.29,222.29,1 APC,8005,CT and CTA without Contras ,,,217.84,477.91,42 APC,8006,CT and CTA with Contrast ,,,431.55,431.55,1 APC,8006,CT and CTA with Contrast C ,,,422.92,927.84,42 APC,8007,MRI and MRA without Contr ,,,528.85,528.85,1 APC,8007,MRI and MRA without Contra ,,,518.27,1137.02,42 APC,8008,MRI and MRA with Contrast ,,,835.51,1833.01,43 APC,8010,Mental Health Services Co ,,,411.45,411.45,1 APC,8010,Mental Health Services Com ,,,403.22,884.61,42 APC,8011,Comprehensive Observation ,,,2574.87,5648.95,16 APC,802,Etoposide oral 50 mg ,,,86.29,189.32,42 APC,804,"Capecitabine, oral, 50 mg ",,,0.04,0.17,43 APC,805,"Hiv prep, inj, cabotegrav ",,,7.15,7.15,1 APC,805,"Hiv prep, inj, cabotegravi ",,,7.15,15.68,42 APC,806,"Hiv prep, ftc/tdf 200/300 ",,,1.34,1.34,1 APC,806,"Hiv prep, ftc/tdf 200/300m ",,,0.44,0.97,42 APC,807,Aldesleukin injection ,,,3272.09,7178.57,43 APC,808,"Hiv prep, ftc/taf 200/25m ",,,71.33,71.33,1 APC,808,"Hiv prep, ftc/taf 200/25mg ",,,70.0,153.57,42 APC,810,Goserelin acetate implant ,,,777.5,777.5,1 APC,811,"Inj, nyposi 1 mcg ",,,1.0,2.22,43 APC,812,Carmustine injection ,,,232.62,516.02,43 APC,813,"Injection, imetelstat, 1 ",,,58.3,58.3,1 APC,813,"Injection, imetelstat, 1 m ",,,58.34,127.99,42 APC,814,"Inj, magtrace per study d ",,,1254.0,1254.0,1 APC,814,"Inj, magtrace per study do ",,,1228.92,2696.1,42 APC,815,"Inj, palonosetron (posfre ",,,58.58,58.58,1 APC,815,"Inj, palonosetron (posfrea ",,,54.13,118.74,42 APC,816,"Inj, tislelizumab-jsgr ",,,57.01,125.06,43 APC,818,"Inj, crovalimab-akkz, 10 ",,,551.51,551.51,1 APC,818,"Inj, crovalimab-akkz, 10 m ",,,540.48,1185.75,42 APC,819,"Inj, alyglo, 500 mg ",,,119.11,261.32,43 APC,821,Indigotindisulfonate sod ,,,9.3,9.3,1 APC,821,Indigotindisulfonate sod 1 ,,,9.11,20.0,42 APC,822,"Inj, romiplostim 1 microg ",,,11.05,11.05,1 APC,822,"Inj, romiplostim 1 microgr ",,,11.38,24.98,42 APC,824,"Inj, exagamglogene autote ",,,2332000.0,2332000.0,1 APC,824,"Inj, exagamglogene autotem ",,,2254888.86,4946950.05,42 APC,825,Nelarabine injection ,,,64.1,140.63,43 APC,827,Floxuridine injection ,,,4254.92,9452.46,43 APC,831,Obecbtge autol up to 400 ,,,278250.0,278250.0,1 APC,831,Obecbtge autol up to 400 m ,,,272685.0,598237.5,42 APC,835,"Datopotamab deruxtecan, 1 ",,,51.45,112.87,43 APC,837,"Inj, treosulfan, 50 mg ",,,31.21,69.51,43 APC,839,Inj axatilimab-csfr 0.1 m ,,,55.65,55.65,1 APC,839,Inj axatilimab-csfr 0.1 mg ,,,55.33,121.39,42 APC,840,Inj melpha hydroch nos 50 ,,,86.94,225.53,43 APC,841,"Inj, docetaxel (beizray) ",,,47.44,47.44,1 APC,841,"Inj, docetaxel (beizray) 1 ",,,45.87,100.64,42 APC,842,"Inj, melphalan (apotex) 1 ",,,63.48,139.27,43 APC,843,Pegaspargase injection ,,,28424.06,63777.51,43 APC,844,Pentostatin injection ,,,2537.1,5800.67,43 APC,845,"Inj, atidarsagene autotem ",,,4505000.0,4505000.0,1 APC,845,"Inj, atidarsagene autotemc ",,,4414900.0,9685750.0,42 APC,846,"Inj, eculizumab-aeeb, 2 m ",,,42.35,42.35,1 APC,846,"Inj, eculizumab-aeeb, 2 mg ",,,40.34,88.51,42 APC,847,Inj thiotepa nos 1 mg ,,,4.83,10.6,43 APC,848,Inj nivolumab 2 mg hyalur ,,,27.8,27.8,1 APC,848,Inj nivolumab 2 mg hyaluro ,,,27.58,60.5,42 APC,852,"Inj, eculizumab-aagh, 2 m ",,,31.67,31.67,1 APC,852,"Inj, eculizumab-aagh, 2 mg ",,,31.14,68.32,42 APC,853,Inj zenocutuzumab-zbco 1 ,,,33.57,33.57,1 APC,853,Inj zenocutuzumab-zbco 1 m ,,,33.19,72.81,42 APC,854,In111 capromab ,,,1695.68,3720.12,42 APC,855,"Inj ustekinumab-stba, 1 mg ",,,3.01,6.61,42 APC,856,Porfimer sodium injection ,,,24228.42,24228.42,1 APC,858,Inj cladribine per 1 mg ,,,7.42,17.6,43 APC,859,"Inj ustekinumab-aekn, 1 m ",,,43.2,43.2,1 APC,859,"Inj ustekinumab-aekn, 1 mg ",,,10.32,22.64,42 APC,860,"I131 iodobenguate, dx ",,,933.95,2048.97,42 APC,861,"I125 serum albumin, dx ",,,459.68,1008.48,42 APC,862,Cr51 chromate ,,,1879.6,4123.61,42 APC,863,"I125 iothalamate, dx ",,,636.65,1396.73,42 APC,864,Mitoxantrone hydrochl ,,,29.11,63.86,43 APC,865,"Inj, hercessi, 10 mg ",,,31.81,69.79,43 APC,866,"Inj, sod thiosulfate (hope ",,,0.82,1.81,42 APC,869,"Inj ustekinumab-kfce, 1 mg ",,,3.22,7.07,42 APC,870,Inj. calaspargase pegol-m ,,,82.08,82.08,1 APC,870,Inj. calaspargase pegol-mk ,,,84.07,184.45,42 APC,871,Inj pemetrexed (bluepoint ,,,10.6,10.6,1 APC,871,Inj pemetrexed (bluepoint) ,,,10.39,22.79,42 APC,872,"Inj. denosumab-bbdz, 1 mg ",,,27.11,59.48,43 APC,874,Synvisc or synvisc-one ,,,5.9,12.94,43 APC,875,Euflexxa inj per dose ,,,96.17,210.99,43 APC,876,Gallium gozellix 1 millic ,,,1171.3,1171.3,1 APC,876,Gallium gozellix 1 millicu ,,,1147.87,2518.29,42 APC,877,Orthovisc inj per dose ,,,98.32,215.71,43 APC,878,Aztreonam/avibactam 10 mg ,,,1.68,3.81,43 APC,879,Inj ceftobipole medocarl ,,,1.12,1.12,1 APC,879,Inj ceftobipole medocarl 3 ,,,1.08,2.36,42 APC,880,"Hiv prep, inj, lenacapavi ",,,16.13,16.13,1 APC,880,"Hiv prep, inj, lenacapavir ",,,15.76,34.57,42 APC,881,"Hiv prep, oral lenacapavi ",,,623.15,623.15,1 APC,881,"Hiv prep, oral lenacapavir ",,,608.49,1334.95,42 APC,882,Inj glucagon (gvoke) 0.01 ,,,1.76,3.87,43 APC,883,"Inj, ethacrynate sod, 1 m ",,,12.88,12.88,1 APC,883,"Inj, ethacrynate sod, 1 mg ",,,12.17,26.71,42 APC,884,"Inj, fosdenopterin, 0.1mg ",,,17.24,38.13,43 APC,885,"Inj, isoniazid, 1 mg ",,,0.3,0.65,43 APC,886,Inj. remestemcel-l-rknd/ ,,,201669.0,201669.0,1 APC,886,Inj. remestemcel-l-rknd/ t ,,,199586.6,437868.57,42 APC,887,Azathioprine parenteral ,,,249.66,547.73,43 APC,888,"Inj. concizumab-mtci, 0.5 ",,,84.43,185.24,43 APC,889,Injection fitusiran 0.04 ,,,132.62,132.62,1 APC,889,Injection fitusiran 0.04 m ,,,128.58,282.08,42 APC,890,Lymphocyte immune globuli ,,,5307.93,5307.93,1 APC,890,Lymphocyte immune globulin ,,,5437.98,11930.27,42 APC,891,"Inj, denosumab-bmwo, 1 mg ",,,25.46,55.85,43 APC,892,"Inj, denosumab-bnht, 1 mg ",,,28.24,61.96,43 APC,893,"Inj, nipocalimab-aahu, 3 ",,,32.74,32.74,1 APC,893,"Inj, nipocalimab-aahu, 3 m ",,,31.92,70.02,42 APC,894,Telisotuzumab vedotin-tll ,,,145.87,145.87,1 APC,894,Telisotuzumab vedotin-tllv ,,,143.14,314.03,42 APC,895,Inj ustekinumab-aauz 1 mg ,,,12.89,32.96,43 APC,896,"Inj, carboprost, 0.1 mg ",,,13.7,35.2,43 APC,897,"Revakinagene, per implant ",,,256348.11,562396.35,43 APC,898,Inj meloxicam (azurity) 1m ,,,1.04,2.28,42 APC,900,"Inj, liothyronine, 1 mcg ",,,39.32,86.27,42 APC,9002,Tenecteplase injection ,,,186.97,467.46,43 APC,9003,Rsv mab im 50mg ,,,428.01,939.01,43 APC,9004,"Injection, inclisiran, 1 ",,,12.69,12.69,1 APC,9004,"Injection, inclisiran, 1 m ",,,12.65,27.75,42 APC,9005,Reteplase injection ,,,2904.57,2904.57,1 APC,9006,Tacrolimus injection ,,,262.45,576.58,43 APC,9007,Inj cutaquig 100 mg ,,,13.75,30.16,43 APC,9008,"Inj tezepelumab-ekko, 1mg ",,,17.56,38.53,43 APC,9009,"Inj, vutrisiran, 1 mg ",,,4912.35,10777.09,43 APC,901,Alpha 1 proteinase inhibi ,,,5.37,5.37,1 APC,901,Alpha 1 proteinase inhibit ,,,5.03,11.04,42 APC,9010,Inj efgartigimod 2mg ,,,31.9,69.99,43 APC,9013,Inj risankizumab-rzaaÂ1 ,,,14.93,14.93,1 APC,9013,Inj risankizumab-rzaaÂ1 m ,,,14.24,31.24,42 APC,9014,"Inj., cerliponase alfa 1 ",,,121.2,121.2,1 APC,9014,"Inj., cerliponase alfa 1 m ",,,120.91,265.26,42 APC,9016,"Inj., triptorelin xr 3.75 ",,,3743.54,8212.86,43 APC,9017,"Inj. byooviz, 0.1 mg ",,,60.22,518.09,43 APC,9018,"Inj, rimabotulinumtoxinB ",,,13.02,28.57,43 APC,902,"Injection,onabotulinumtox ",,,6.51,6.51,1 APC,902,"Injection,onabotulinumtoxi ",,,6.38,13.99,42 APC,9020,Argatroban nonesrd (accor ,,,1.81,1.81,1 APC,9020,Argatroban nonesrd (accord ,,,1.78,3.9,42 APC,9025,"Inj glucagon hcl, freseni ",,,143.25,143.25,1 APC,9025,"Inj glucagon hcl, freseniu ",,,126.7,277.95,42 APC,9026,"Inj, bortezomib, dr. redd ",,,3.46,3.46,1 APC,9026,"Inj, bortezomib, dr. reddy ",,,3.39,7.44,42 APC,9027,"Inj, bortezomib fresenius ",,,6.97,6.97,1 APC,9027,"Inj, bortezomib freseniusk ",,,6.83,14.99,42 APC,9028,Inj inotuzumab ozogam 0.1 ,,,2815.64,6177.17,43 APC,9029,"Inj., guselkumab, 1 mg ",,,65.58,143.88,43 APC,903,Cytomegalovirus imm IV /v ,,,1808.33,1808.33,1 APC,903,Cytomegalovirus imm IV /vi ,,,1821.64,3996.47,42 APC,9031,"Inj, etelcalcetide, 0.1 m ",,,2.3,2.3,1 APC,9031,"Inj, etelcalcetide, 0.1 mg ",,,2.42,5.3,42 APC,9032,Baclofen 10 MG injection ,,,181.47,400.13,43 APC,9033,Cidofovir injection ,,,524.48,1151.83,43 APC,9034,"Inj cuvitru, 100 mg ",,,17.26,39.02,43 APC,9035,Axicabtagene ciloleucel c ,,,532192.2,532192.2,1 APC,9035,Axicabtagene ciloleucel ca ,,,551250.88,1209376.94,42 APC,9036,"Injection, renflexis ",,,26.08,57.22,43 APC,9038,Inj estrogen conjugate ,,,391.76,863.23,43 APC,904,Testosterone pellet 75 mg ,,,71.34,156.52,42 APC,9042,Glucagon hydrochloride ,,,114.98,252.26,43 APC,9043,"Inj, afstyla, 1 i.u. ",,,1.58,3.48,43 APC,9044,Ibutilide fumarate inject ,,,198.51,198.51,1 APC,9044,Ibutilide fumarate injecti ,,,172.37,378.16,42 APC,9045,Idursulfase injection ,,,558.1,1225.59,43 APC,9046,"Inj., fibryga, 1 mg ",,,1.21,2.65,43 APC,9048,"Inj, alymsys, 10 mg ",,,33.01,171.88,43 APC,905,"Inj, posaconazole, 1 mg ",,,0.34,0.74,42 APC,9050,"Leuprolide inj, camcevi, ",,,57.03,57.03,1 APC,9050,"Leuprolide inj, camcevi, 1 ",,,41.22,90.43,42 APC,9051,"Inj, lanreotide, (cipla) ",,,38.22,38.22,1 APC,9051,"Inj, lanreotide, (cipla) 1 ",,,19.92,43.71,42 APC,9052,Fluciclovine f-18 ,,,315.82,692.88,43 APC,9053,Fluorodopa f-18 diag per ,,,855.55,855.55,1 APC,9053,Fluorodopa f-18 diag per m ,,,838.44,1839.43,42 APC,9054,Lutetium lu 177 vipivotid ,,,259.31,259.31,1 APC,9054,Lutetium lu 177 vipivotide ,,,261.97,574.73,42 APC,9055,Gallium locametz 1 millic ,,,362.5,362.5,1 APC,9055,Gallium locametz 1 millicu ,,,355.25,779.38,42 APC,9056,Gallium ga-68 ,,,48.64,106.7,43 APC,9057,Inj nivol relatlimab 3mg/ ,,,201.65,201.65,1 APC,9057,Inj nivol relatlimab 3mg/1 ,,,201.4,441.85,42 APC,9059,Vonvendi inj 1 iu vwf:rco ,,,1.77,3.89,43 APC,906,Inj elivaldogene autotemec ,,,3116400.0,6837000.0,42 APC,9063,Rh ig minidose im ,,,78.4,172.0,42 APC,9067,Lutetium lu 177 dotatat t ,,,320.76,320.76,1 APC,9067,Lutetium lu 177 dotatat th ,,,343.2,752.95,42 APC,9068,Smallpox&monkeypox vac 0. ,,,0.01,0.01,1 APC,9068,Smallpox&monkeypox vac 0.5 ,,,0.01,0.02,42 APC,907,"Inj, cyclophos (baxter) 5 ",,,4.92,4.92,1 APC,907,"Inj, cyclophos (baxter) 5m ",,,4.3,9.43,42 APC,9070,Inj luxturna 1 billion ve ,,,3026.8,3026.8,1 APC,9070,Inj luxturna 1 billion vec ,,,3008.25,6599.72,42 APC,9071,Capsaicin 8% patch ,,,3.42,7.54,43 APC,9073,Buprenorph xr 100 mg or l ,,,1998.53,1998.53,1 APC,9073,Buprenorph xr 100 mg or le ,,,2026.79,4446.53,42 APC,9075,"Inj, kovaltry, 1 i.u. ",,,1.56,3.43,43 APC,9078,Testosterone undecanoate ,,,2.07,2.07,1 APC,9078,Testosterone undecanoate 1 ,,,2.11,4.62,42 APC,9079,"Genvisc 850, inj, 1mg ",,,3.73,8.19,43 APC,908,Topi adm prad zami per tre ,,,3220067.34,7064433.45,42 APC,9087,"Inj, clevidipine, 1 mg ",,,2.78,6.1,43 APC,9088,Peng benzathine/procaine ,,,19.52,19.52,1 APC,9088,Peng benzathine/procaine i ,,,19.13,41.97,42 APC,909,Inj gemcitabin (avyxa) 200 ,,,392.33,860.72,42 APC,9094,Radiesse injection ,,,342.21,750.76,43 APC,9095,"Inj, sculptra, 0.5mg ",,,2.12,4.64,43 APC,9097,Inj retacrit non-esrd use ,,,7.57,17.13,43 APC,9099,"Inj fosnetupitant, palono ",,,546.93,546.93,1 APC,9099,"Inj fosnetupitant, palonos ",,,493.77,1083.27,42 APC,9101,Vaccinia vrs vac 0.3 ml p ,,,0.01,0.01,1 APC,9101,Vaccinia vrs vac 0.3 ml pe ,,,0.01,0.02,42 APC,9102,"Inj, fulvestrant (teva) ",,,40.84,89.59,43 APC,9103,"Inj, fulvestrant (freseni ",,,27.11,27.11,1 APC,9103,"Inj, fulvestrant (freseniu ",,,26.57,58.29,42 APC,9104,Antithymocyte globuln rab ,,,1009.75,1009.75,1 APC,9104,Antithymocyte globuln rabb ,,,1036.64,2274.25,42 APC,9105,Inj pemetrexed (teva) 10m ,,,15.33,15.33,1 APC,9105,Inj pemetrexed (teva) 10mg ,,,10.77,23.62,42 APC,9107,"Inj, aponvie, 1 mg ",,,1.96,1.96,1 APC,9108,Thyrotropin injection ,,,2115.49,4641.12,43 APC,9109,"Inj, elahere, 1 mg ",,,70.55,154.78,43 APC,911,"Inj pozelimab-bbfg, 1 mg ",,,89.9,197.22,43 APC,9110,"Inj, tremelimumab-actl, 1 ",,,143.02,315.82,43 APC,9111,Inj teclistamab cqyv 0.5 ,,,34.58,34.58,1 APC,9111,Inj teclistamab cqyv 0.5 m ,,,34.62,75.94,42 APC,9112,Inj teplizumab mzwv 5 mcg ,,,38.39,84.32,43 APC,9113,Inj olipudase alfa-rpcp 1 ,,,395.52,395.52,1 APC,9113,Inj olipudase alfa-rpcp 1m ,,,396.85,870.64,42 APC,9114,Inj eflapegrastim-xnst 0. ,,,23.55,23.55,1 APC,9114,Inj eflapegrastim-xnst 0.1 ,,,37.79,82.91,42 APC,9115,"Inj, spesolimab-sbzo, 1 m ",,,65.73,65.73,1 APC,9115,"Inj, spesolimab-sbzo, 1 mg ",,,64.41,141.32,42 APC,9116,"Chloroprocaine opht gel, ",,,0.58,0.58,1 APC,9117,"Inj, cimerli, 0.1 mg ",,,80.88,177.44,43 APC,9118,"Inj, fylnetra, 0.5 mg ",,,103.01,225.98,43 APC,9119,"Inj, pedmark, 100 mg ",,,94.84,208.07,43 APC,912,"Inj, wezlana, iv, 1 mg ",,,2.31,11.64,43 APC,9122,Triptorelin pamoate ,,,457.04,1002.68,43 APC,9123,"Inj pemetrexed, hospira 1 ",,,4.19,4.19,1 APC,9123,"Inj pemetrexed, hospira 10 ",,,2.88,6.33,42 APC,9125,"Risperidone, long acting ",,,10.88,23.88,43 APC,9126,Natalizumab injection ,,,23.92,52.47,43 APC,9127,Inj pemetrexed (accord) 1 ,,,9.74,9.74,1 APC,9127,Inj pemetrexed (accord) 10 ,,,9.54,20.93,42 APC,9129,"Inj, stimufend, 0.5 mg ",,,140.8,308.9,43 APC,913,Mitomycin intravesical ins ,,,268.86,589.84,42 APC,9130,"Inj, Imm Glob Bivigam, 50 ",,,79.64,79.64,1 APC,9130,"Inj, imm glob bivigam, 500 ",,,79.62,174.67,42 APC,9131,"Inj, Ado-trastuzumab Emt ",,,42.19,42.19,1 APC,9131,"Inj, Ado-trastuzumab Emt 1 ",,,42.75,93.8,42 APC,9132,Prothrombin complex kcent ,,,2.09,2.09,1 APC,9132,Prothrombin complex kcentr ,,,1.97,4.33,42 APC,9133,"Rabies ig, im/sc ",,,275.56,604.55,43 APC,9134,"Rabies ig, heat treated ",,,345.39,757.75,43 APC,9135,"Varicella-zoster ig, im ",,,2363.39,5370.13,43 APC,9136,Inj leu acet lutr dpt 7.5 ,,,673.54,1477.67,43 APC,9138,"Inj, hemgenix, per tx dos ",,,3685267.0,3685267.0,1 APC,9138,"Inj, hemgenix, per tx dose ",,,3617621.0,7936617.5,42 APC,9139,"Rabies vaccine, im ",,,319.75,713.75,43 APC,914,Ustekinumab-ttwe iv inj 1 ,,,8.27,18.39,43 APC,9140,"Rabies vaccine, id ",,,232.12,509.25,43 APC,9141,Inj onase abepar-xioi tre ,,,2588981.0,2588981.0,1 APC,9141,Inj onase abepar-xioi trea ,,,2626437.24,5762081.7,42 APC,9142,FecalÂmicrobiota jslm 1 ,,,64.63,64.63,1 APC,9142,FecalÂmicrobiota jslm 1 m ,,,64.29,141.05,42 APC,9144,"Inj, panzyga, 500 mg ",,,69.92,153.39,43 APC,9145,"Inj, invega hafyera/trinz ",,,12.99,12.99,1 APC,9145,"Inj, invega hafyera/trinza ",,,13.0,28.51,42 APC,9146,"Inj, ixinity, 1 i.u. ",,,1.9,4.17,43 APC,9149,"Inj ublituximab-xiiy, 1 m ",,,70.18,70.18,1 APC,9149,"Inj ublituximab-xiiy, 1 mg ",,,70.79,155.31,42 APC,915,"Inj cosibelimab-ipdl, 2 mg ",,,21.83,47.89,42 APC,9150,"Inj mosunetuzumab-axgb, 1 ",,,655.38,1450.16,43 APC,9154,"Inj, vivimusta, 1 mg ",,,29.31,64.31,43 APC,9155,Inj lenacapavir (hiv tx) ,,,22.3,22.3,1 APC,9155,Inj lenacapavir (hiv tx) 1 ,,,22.48,49.31,42 APC,9156,Inj pemetrexed ditrometha ,,,0.13,0.13,1 APC,9157,"Inj, lecanemab-irmb, 1 mg ",,,1.33,1.33,1 APC,9157,"Lecanemab-irmb, for iv inj ",,,1.32,2.89,42 APC,9158,"Inj, pegcetacoplan, 1mg ",,,138.05,320.23,43 APC,9159,"Inj, vegzelma, 10 mg ",,,23.17,50.84,43 APC,916,Inj linvoseltamab-gcpt 1 m ,,,97.32,213.51,42 APC,9166,"Inj, fosaprepitant (teva) ",,,0.04,0.64,43 APC,917,"Inj, carboplatin (avyxa) ",,,5.1,11.19,42 APC,9171,Factor ix idelvion inj ,,,5.32,11.84,43 APC,9173,"Injection, fulphila ",,,65.68,144.1,43 APC,9174,"Inj, durolane 1 mg ",,,6.11,13.41,43 APC,9178,"Inj., meropenem, vaborbac ",,,2.18,2.18,1 APC,9178,"Inj., meropenem, vaborbact ",,,2.18,4.78,42 APC,9179,"Inj., aristada initio, 1 ",,,3.25,3.25,1 APC,9179,"Inj., aristada initio, 1 m ",,,3.39,7.44,42 APC,918,"Inj, jobevne, 10 mg ",,,80.59,176.81,42 APC,9180,"Inj., patisiran, 0.1 mg ",,,99.01,217.21,43 APC,9181,"Inj., perseris, 0.5 mg ",,,11.96,26.24,43 APC,9182,"Inj mogamulizumab-kpkc, 1 ",,,253.37,555.85,43 APC,9183,"Inj., plazomicin, 5 mg ",,,3.45,7.57,43 APC,9186,"Inj., rituximab, 10 mg ",,,71.81,157.55,43 APC,9187,"Injection, burosumab-twza ",,,498.02,1103.75,43 APC,9188,Inj crotalidae im f(ab')2 ,,,4925.16,4925.16,1 APC,9189,"Inj., ibalizumab-uiyk, 10 ",,,77.54,170.95,43 APC,9190,"Inj., vestronidase alfa-v ",,,280.09,280.09,1 APC,9190,"Inj., vestronidase alfa-vj ",,,285.71,626.8,42 APC,9193,Nivestym ,,,0.28,0.69,43 APC,9194,Tisagenlecleucel car-pos ,,,566531.3,566531.3,1 APC,9194,Tisagenlecleucel car-pos t ,,,599459.34,1315140.38,42 APC,9195,"Injection, udenyca 0.5 mg ",,,146.15,320.64,43 APC,9196,"Inj, trivisc 1 mg ",,,2.98,6.53,43 APC,9198,"Inj andexxa, 10 mg ",,,128.54,282.0,43 APC,9199,"Injection, caplacizumab-y ",,,802.25,802.25,1 APC,9199,"Injection, caplacizumab-yh ",,,822.39,1804.21,42 APC,920,Tc99m succimer ,,,646.73,1418.85,42 APC,9200,"Inj, remdesivir, 1 mg ",,,6.9,16.15,43 APC,9201,Rabies ig ht&sol human im ,,,240.13,240.13,1 APC,9201,Rabies ig ht&sol human im/ ,,,238.33,522.88,42 APC,9203,Inj cyclophosphamd aurome ,,,0.61,0.61,1 APC,9203,Inj cyclophosphamd auromed ,,,0.48,1.05,42 APC,9204,"Inj tisotu vedotin-tftv, ",,,196.07,196.07,1 APC,9204,"Inj tisotu vedotin-tftv, 1 ",,,192.2,421.66,42 APC,9205,Inj lon tesirin-lpyl 0.07 ,,,221.22,221.22,1 APC,9205,Inj lon tesirin-lpyl 0.075 ,,,222.08,487.21,42 APC,9206,Inj plasminogen tvmh 1mg ,,,34.65,82.61,43 APC,9208,Agalsidase beta injection ,,,228.07,500.35,43 APC,9209,Laronidase injection ,,,39.95,89.2,43 APC,921,"Inj, tyruko, 1 mg ",,,24.0,52.66,42 APC,9213,Inj. pemetrexed nos 10mg ,,,3.59,14.95,43 APC,9214,Bevacizumab injection ,,,73.33,160.87,43 APC,9215,Cetuximab injection ,,,80.03,175.58,43 APC,9217,Leuprolide acetate suspns ,,,170.78,170.78,1 APC,9217,Leuprolide acetate suspnsi ,,,157.14,344.74,42 APC,9219,Procainamide hcl injectio ,,,344.53,344.53,1 APC,9219,Procainamide hcl injection ,,,289.45,635.03,42 APC,922,Inj onase abepar-brve trea ,,,2610943.44,5728090.2,42 APC,9224,Galsulfase injection ,,,513.86,1130.83,43 APC,9225,Fluocinolone acetonide im ,,,338.94,338.94,1 APC,9225,Fluocinolone acetonide imp ,,,332.03,728.43,42 APC,923,Inj yimmugo 100 mg ,,,23.66,51.91,42 APC,9230,Abatacept injection ,,,44.77,98.6,43 APC,9233,Ranibizumab injection ,,,50.07,109.84,43 APC,9235,Panitumumab injection ,,,173.67,391.71,43 APC,9237,"Inj, lanreotide acetate ",,,35.39,80.47,43 APC,9239,Buprenorphine xr over 100 ,,,1998.53,4446.53,43 APC,924,Inj zopapogene per ther do ,,,119462.0,262085.0,42 APC,9240,"Injection, ixabepilone ",,,136.96,300.47,43 APC,9241,Inj sirolimus prot part 1 ,,,87.11,195.71,43 APC,9243,"Inj, bendamustine hcl, 1m ",,,2.05,2.05,1 APC,9243,"Inj, bendamustine hcl, 1mg ",,,2.9,6.36,42 APC,9246,"Inj, abilify asimtufii, 1 ",,,6.02,13.3,43 APC,9247,"Inj, amisulpride, 1 mg ",,,9.38,20.57,43 APC,925,Factor viii ,,,1.11,2.68,43 APC,9250,Inj epcoritamab-bysp 0.16 ,,,56.8,124.68,43 APC,9251,C1 esterase inhibitor inj ,,,65.42,143.52,43 APC,9252,Plerixafor injection ,,,27.92,61.25,43 APC,9253,Temozolomide injection ,,,10.2,22.38,43 APC,9254,Flotufolastat f18 diag 1 ,,,671.22,671.22,1 APC,9254,Flotufolastat f18 diag 1 m ,,,713.01,1564.25,42 APC,9255,"Inj, invega sustenna, 1 m ",,,15.11,15.11,1 APC,9255,"Inj, invega sustenna, 1 mg ",,,15.12,33.18,42 APC,9256,Dexamethasone intra impla ,,,204.54,204.54,1 APC,9256,Dexamethasone intra implan ,,,199.58,437.86,42 APC,9257,"Inj., emicizumab-kxwh 0.5 ",,,56.46,124.77,43 APC,9258,Telavancin injection ,,,7.33,16.09,43 APC,9259,Pralatrexate injection ,,,378.4,830.16,43 APC,926,Gemcitabine intravesical s ,,,71524.56,156916.12,42 APC,9260,Ofatumumab injection ,,,60.99,133.8,43 APC,9262,Inj tofersen intrathec 1 ,,,160.01,160.01,1 APC,9262,Inj tofersen intrathec 1 m ,,,161.52,354.35,42 APC,9263,Ecallantide injection ,,,579.75,1281.28,43 APC,9264,Tocilizumab injection ,,,5.3,11.63,43 APC,9266,"Inj, uzedy, 1 mg ",,,25.04,56.29,43 APC,9267,"Inj, rezafungin, 1 mg ",,,10.78,23.65,43 APC,9268,Inj. acthar gel to 40 uni ,,,4172.53,4172.53,1 APC,9268,Inj. acthar gel to 40 unit ,,,4050.78,8886.92,42 APC,9269,"C-1 esterase, berinert ",,,75.86,170.41,43 APC,927,Factor viii recombinant ,,,1.55,3.4,43 APC,9270,Gammaplex IVIG ,,,63.93,142.48,43 APC,9271,Velaglucerase alfa ,,,384.99,844.61,43 APC,9272,"Inj, denosumab ",,,29.46,64.72,43 APC,9273,Sipuleucel-T auto CD54+ ,,,54404.11,120254.72,43 APC,9274,Crotalidae Poly Immune Fab ,,,1868.77,4099.85,42 APC,9274,Crotalidae poly immune fa ,,,1826.52,1826.52,1 APC,9275,"Inj. (ani), up to 40 unit ",,,3551.74,3551.74,1 APC,9275,"Inj. (ani), up to 40 units ",,,3601.18,7900.56,42 APC,9276,Cabazitaxel injection ,,,229.06,502.52,43 APC,9277,Altuviiio per factor viii ,,,4.54,9.96,43 APC,9278,Incobotulinumtoxin A ,,,5.18,11.36,43 APC,928,Factor ix complex ,,,1.7,3.76,43 APC,9280,"Inj, retifanlimab-dlwr, 1 ",,,30.36,66.61,43 APC,9281,"Injection, pegloticase ",,,3768.81,8448.07,43 APC,9284,Ipilimumab injection ,,,186.62,409.43,43 APC,9285,Inj allopurinol sodium 1 ,,,4.4,4.4,1 APC,9285,Inj allopurinol sodium 1 m ,,,3.99,8.76,42 APC,9286,Belatacept injection ,,,3.81,8.35,43 APC,9287,Brentuximab vedotin inj ,,,268.45,600.3,43 APC,929,Anti-inhibitor ,,,2.4,5.26,43 APC,9293,"Injection, glucarpidase ",,,440.12,965.57,42 APC,9294,"Inj, taliglucerase alfa 1 ",,,40.94,40.94,1 APC,9294,"Inj, taliglucerase alfa 10 ",,,41.82,91.75,42 APC,9295,"Injection, Carfilzomib, 1 ",,,55.61,129.63,43 APC,9296,"Inj, ziv-aflibercept, 1mg ",,,7.22,18.65,43 APC,9299,Inj. jivi 1 iu ,,,2.65,5.93,43 APC,930,Pembrolizumab 1mg berahyal ,,,31.3,68.67,42 APC,9300,Omalizumab injection ,,,45.5,100.16,43 APC,9301,"Aminolevulinic acid, 10% ",,,1.79,1.79,1 APC,9301,"Aminolevulinic acid, 10% g ",,,1.81,3.97,42 APC,9302,"Inj daunorubicin, cytarab ",,,260.49,260.49,1 APC,9302,"Inj daunorubicin, cytarabi ",,,267.43,586.7,42 APC,9304,"Inj., cemiplimab-rwlc, 1 ",,,28.69,28.69,1 APC,9304,"Inj., cemiplimab-rwlc, 1 m ",,,29.07,63.79,42 APC,9305,"Inj., lumoxiti, 0.01 mg ",,,22.93,50.3,43 APC,9306,"Inj., tildrakizumab, 1 mg ",,,121.79,267.19,43 APC,9308,Dexametha opth insert 0.1 ,,,88.22,193.54,43 APC,9309,Inj. tagraxofusp-erzs 10 ,,,357.02,357.02,1 APC,9309,Inj. tagraxofusp-erzs 10 m ,,,350.37,768.67,42 APC,931,Factor IX non-recombinant ,,,1.37,3.02,43 APC,9310,"Inj., emapalumab-lzsg, 1 ",,,384.13,384.13,1 APC,9310,"Inj., emapalumab-lzsg, 1 m ",,,384.92,844.48,42 APC,9311,"Inj., omadacycline, 1 mg ",,,4.1,9.0,43 APC,9312,"Inj., ravulizumab-cwvz 10 ",,,222.38,487.88,43 APC,9313,Inj. belrapzo/bendamustin ,,,13.65,13.65,1 APC,9313,Inj. belrapzo/bendamustine ,,,11.37,24.94,42 APC,9314,"Inj. herceptin hylecta, 1 ",,,61.07,61.07,1 APC,9314,"Inj. herceptin hylecta, 10 ",,,57.18,125.44,42 APC,932,Factor ix recombinant nos ,,,1.83,4.01,43 APC,9320,Carbidopa levodopa ent 10 ,,,243.79,243.79,1 APC,9320,Carbidopa levodopa ent 100 ,,,239.61,525.67,42 APC,9321,Fosphenytoin inj pe ,,,0.65,1.43,43 APC,9322,Bcg live intravesical 1mg ,,,3.31,7.26,42 APC,9323,Gallium ga-68 dotatoc ,,,3.54,7.76,43 APC,9324,Phenylep ketorolac opth s ,,,97.54,97.54,1 APC,9324,Phenylep ketorolac opth so ,,,94.38,207.06,42 APC,9325,"Inj., eravacycline, 1 mg ",,,1.29,2.97,43 APC,9326,"Inj., lanadelumab-flyo, 1 ",,,86.45,189.66,43 APC,9327,Inj. romosozumab-aqqg 1 m ,,,12.11,12.11,1 APC,9327,Inj. romosozumab-aqqg 1 mg ,,,12.48,27.37,42 APC,9328,"Inj., yutiq, 0.01 mg ",,,519.29,1139.26,43 APC,9329,Inj mvasi 10 mg ,,,23.84,52.75,43 APC,933,"Suzetrigine, orl, 1mg ",,,0.31,0.67,42 APC,9330,"Inj., kanjinti, 10 mg ",,,51.44,130.12,43 APC,9331,"Inj, polatuzumab vedotin ",,,136.77,136.77,1 APC,9331,"Inj, polatuzumab vedotin 1 ",,,140.74,308.76,42 APC,9335,Oral busulfan ,,,9.92,21.76,43 APC,9336,Inj truxima 10 mg ,,,30.14,74.31,43 APC,9338,"Inj., triluron, 1 mg ",,,10.12,22.42,43 APC,934,"Inj, denosumab-nxxp, 1 mg ",,,15.35,33.67,42 APC,9340,"Inj, brolucizumab-dbll, 1 ",,,352.52,773.38,43 APC,9341,Inj ogivri 10 mg ,,,31.31,68.68,43 APC,9343,Inj givosiran 0.5 mg ,,,118.5,259.97,43 APC,9345,Inj pegfilgrastim-bmez 0. ,,,119.29,119.29,1 APC,9345,Inj pegfilgrastim-bmez 0.5 ,,,129.45,284.01,42 APC,9346,Mometasone sinus sinuva ,,,11.12,24.39,43 APC,9347,Inj luspatercept-aamt 0.2 ,,,42.77,42.77,1 APC,9347,Inj luspatercept-aamt 0.25 ,,,42.64,93.56,42 APC,9348,"Inj., zirabev, 10 mg ",,,25.37,55.66,43 APC,9349,Inj herzuma 10 mg ,,,53.84,118.13,43 APC,935,"Inj. ferumoxytol, 1 mg ",,,0.4,0.87,42 APC,9350,"Inj., trazimera, 10 mg ",,,8.21,28.02,43 APC,9351,Inj bimatoprost itc imp 1 ,,,213.89,213.89,1 APC,9351,Inj bimatoprost itc imp 1m ,,,209.48,459.58,42 APC,9353,Inj fam-trastu deru-nxki ,,,31.3,31.3,1 APC,9353,Inj fam-trastu deru-nxki 1 ,,,32.22,70.68,42 APC,9354,Inj recombin esperoct per ,,,2.24,4.94,43 APC,9355,Inj. teprotumumab-trbw 10 ,,,369.31,816.78,43 APC,9357,Inj. eptinezumab-jjmr 1 m ,,,20.5,20.5,1 APC,9357,Inj. eptinezumab-jjmr 1 mg ,,,20.68,45.37,42 APC,9358,Inj xipere 1 mg ,,,46.81,102.71,43 APC,9359,Inj crizanlizumab-tmca 5m ,,,129.59,129.59,1 APC,9359,Inj crizanlizumab-tmca 5mg ,,,127.34,279.36,42 APC,936,"Inj, leucovorin cal (avyxa ",,,2.52,5.54,42 APC,9361,Inj. cetirizine hcl 0.5mg ,,,16.81,36.89,43 APC,9364,Inj enfort vedo-ejfv 0.25 ,,,36.72,36.72,1 APC,9364,Inj enfort vedo-ejfv 0.25m ,,,35.92,78.81,42 APC,9367,"Inj ruxience, 10 mg ",,,13.27,34.74,43 APC,937,Inj fosfomycin disodium 20 ,,,0.61,1.35,42 APC,9370,Fluoroestradiol F 18 ,,,451.21,989.9,43 APC,9372,"Inj. xembify, 100 mg ",,,14.94,32.77,43 APC,9374,Mitomycin instillation ,,,323.34,709.36,43 APC,9375,"Inj., evomela, 1 mg ",,,17.68,38.79,43 APC,9376,Sacituzumab govitecan-hzi ,,,36.98,36.98,1 APC,9376,Sacituzumab govitecan-hziy ,,,36.89,80.93,42 APC,9377,Inj. isatuximab-irfc 10 m ,,,84.3,84.3,1 APC,9377,Inj. isatuximab-irfc 10 mg ,,,86.4,189.54,42 APC,9378,"Daratumumab, hyaluronidas ",,,55.06,55.06,1 APC,9378,"Daratumumab, hyaluronidase ",,,55.91,122.66,42 APC,938,"Narsoplimab-wuug, 1 mg ",,,100.41,220.28,42 APC,9381,"Inj. avsola, 10 mg ",,,23.81,66.28,43 APC,9382,Inj ontruzant 10 mg ,,,20.57,45.13,43 APC,9383,Copper cu 64 dotatate dia ,,,594.28,594.28,1 APC,9383,Copper cu 64 dotatate diag ,,,582.39,1277.7,42 APC,9385,"Inj., tafasitamab-cxix ",,,14.14,31.02,43 APC,9388,Inj. fe derisomaltose 10 ,,,22.83,22.83,1 APC,9388,Inj. fe derisomaltose 10 m ,,,20.66,45.32,42 APC,9389,"Inj. lurbinectedin, 0.1 m ",,,210.78,210.78,1 APC,9389,"Inj. lurbinectedin, 0.1 mg ",,,211.63,464.29,42 APC,939,"Inj, qivigy, 100mg ",,,28.99,63.61,42 APC,9390,"Pertuzu, trastuzu, 10 mg ",,,58.7,128.77,43 APC,9391,Brexucabtagene car pos t ,,,489450.2,1096723.39,43 APC,9392,Inj. asceniv ,,,490.46,1094.65,43 APC,9394,"Inj. inebilizumab-cdon, 1 ",,,495.55,1097.9,43 APC,9395,Factor viia recomb sevenf ,,,2.35,2.35,1 APC,9395,Factor viia recomb sevenfa ,,,2.15,4.72,42 APC,9396,"Afamelanotide implant, 1 ",,,2943.42,2943.42,1 APC,9396,"Afamelanotide implant, 1 m ",,,2884.55,6328.36,42 APC,9398,Covid-19 Vaccine Administ ,,,40.83,40.83,1 APC,9398,Covid-19 Vaccine Administr ,,,40.01,87.77,42 APC,9399,"Pneumococcal, Influenza, ",,,36.23,36.23,1 APC,9399,"Pneumococcal, Influenza, H ",,,35.51,77.9,42 APC,940,Inj depemokimab-ulaa 1 mg ,,,262.44,575.77,42 APC,9406,"Inj, nyvepria ",,,133.05,294.36,43 APC,9407,"Inj. lumasiran, 0.5 mg ",,,328.02,724.49,43 APC,9408,"Inj. naxitamab-gqgk, 1 mg ",,,671.2,1472.53,43 APC,9409,Gallium ga-68 psma-11 ucs ,,,550.13,550.13,1 APC,9409,Gallium ga-68 psma-11 ucsf ,,,539.13,1182.78,42 APC,941,Riboflavin epioxa/hd<=2ml ,,,39618.95,86919.13,42 APC,9410,"Gallium ga-68 psma-11, uc ",,,363.5,363.5,1 APC,9410,"Gallium ga-68 psma-11, ucl ",,,356.23,781.52,42 APC,9411,"Inj. riabni, 10 mg ",,,18.16,39.85,43 APC,9412,"Injection, casimersen, 10 ",,,162.85,357.27,43 APC,9413,lisocabtagene car pos t ,,,562201.2,1246076.79,43 APC,9414,"Inj, cabote rilpivir 2mg ",,,24.16,24.16,1 APC,9414,"Inj, cabote rilpivir 2mg 3 ",,,24.17,53.03,42 APC,9415,"Injection, trilaciclib, 1 ",,,5.42,5.42,1 APC,9415,"Injection, trilaciclib, 1m ",,,5.35,11.75,42 APC,9416,"Inj, evinacumab-dgnb, 5 m ",,,197.17,197.17,1 APC,9416,"Inj, evinacumab-dgnb, 5 mg ",,,193.68,424.91,42 APC,9418,"Inj. margetuximab-cmkb, 5 ",,,53.75,121.35,43 APC,9419,Inj fensolvi 0.25 mg ,,,139.88,312.42,43 APC,942,Inj amivantamab 5mg hyalur ,,,39.93,87.6,42 APC,9420,Eptifibatide injection ,,,3.52,8.32,43 APC,9421,"Inj, granisetron, xr, 0.1 ",,,3.15,6.92,43 APC,9422,Idecabtagene vicleucel ca ,,,558081.8,558081.8,1 APC,9422,Idecabtagene vicleucel car ,,,556618.24,1221152.27,42 APC,9426,"Inj, cefiderocol, 10 mg ",,,2.42,5.48,43 APC,9427,"Injection, oritavancin 10 ",,,43.06,101.93,43 APC,9428,Inj romidepsin non-lyo 0. ,,,28.52,28.52,1 APC,9428,Inj romidepsin non-lyo 0.1 ,,,32.92,72.21,42 APC,9429,Inj romidepsin lyophil 0. ,,,30.91,30.91,1 APC,9429,Inj romidepsin lyophil 0.1 ,,,30.1,66.03,42 APC,943,Octagam injection ,,,46.11,101.17,43 APC,9430,"Piflu f-18, dia 1 millicu ",,,346.49,346.49,1 APC,9430,"Piflu f-18, dia 1 millicur ",,,339.56,744.95,42 APC,9431,"Inj, dostarlimab-gxly, 10 ",,,246.27,540.29,43 APC,9432,"Inj, amivantamab-vmjw ",,,22.55,49.92,43 APC,9433,Inj aval alfa-nqpt 4mg ,,,81.3,180.48,43 APC,9434,Inj anifrolumab-fnia 1mg ,,,18.14,39.79,43 APC,9436,Inj pegfilgrast ex bio 0. ,,,122.84,122.84,1 APC,9436,Inj pegfilgrast ex bio 0.5 ,,,140.37,307.95,42 APC,9437,"Inj, aspara, rylaze, 0.1 ",,,56.18,56.18,1 APC,9437,"Inj, aspara, rylaze, 0.1 m ",,,57.52,126.2,42 APC,9439,"Inj, susvimo 0.1 mg ",,,73.3,160.81,43 APC,944,Gammagard liquid injectio ,,,47.29,47.29,1 APC,944,Gammagard liquid/erc inj ,,,48.32,106.0,42 APC,9440,"Instill, bupivac and melo ",,,0.83,0.83,1 APC,9440,"Instill, bupivac and melox ",,,0.83,1.82,42 APC,9441,Inj ferric carboxymaltos ,,,1.11,1.11,1 APC,9441,Inj ferric carboxymaltos 1 ,,,1.11,2.43,42 APC,9442,"Inj. pemetrexed, 10 mg ",,,7.83,39.93,43 APC,9443,Gallium illuccix 1 millic ,,,478.52,478.52,1 APC,9443,Gallium illuccix 1 millicu ,,,468.95,1028.82,42 APC,9444,"Inj, sutimlimab-jome, 10 ",,,19.03,19.03,1 APC,9444,"Inj, sutimlimab-jome, 10 m ",,,19.25,42.23,42 APC,9445,"Injection, ruconest ",,,36.78,81.34,43 APC,9446,"Inj, tebentafusp-tebn, 1 ",,,222.21,222.21,1 APC,9446,"Inj, tebentafusp-tebn, 1 m ",,,223.45,490.21,42 APC,9447,"Inj, releuko 1 mcg ",,,0.3,0.67,43 APC,9448,"Oral netupitant, palonose ",,,380.19,380.19,1 APC,9448,"Oral netupitant, palonoset ",,,464.56,1019.18,42 APC,9449,"Injection, blinatumomab ",,,163.68,371.74,43 APC,9450,Fluocinol acet intravit i ,,,507.44,507.44,1 APC,9450,Fluocinol acet intravit im ,,,506.08,1110.27,42 APC,9451,"Injection, peramivir ",,,1.64,3.61,43 APC,9452,Inj ceftolozane tazobacta ,,,8.95,8.95,1 APC,9452,Inj ceftolozane tazobactam ,,,9.84,21.58,42 APC,9453,"Injection, nivolumab ",,,33.54,73.58,43 APC,9454,"Inj, pasireotide long act ",,,575.07,575.07,1 APC,9454,"Inj, pasireotide long acti ",,,604.37,1325.92,42 APC,9455,"Injection, siltuximab ",,,168.68,374.24,43 APC,9456,"Injection, isavuconazoniu ",,,1.01,1.01,1 APC,9456,"Injection, isavuconazonium ",,,1.01,2.21,42 APC,9458,Florbetaben f18 diagnosti ,,,1584.67,1584.67,1 APC,9458,Florbetaben f18 diagnostic ,,,1552.98,3407.04,42 APC,9459,Flutemetamol f18 diagnost ,,,1944.01,1944.01,1 APC,9459,Flutemetamol f18 diagnosti ,,,1905.13,4179.62,42 APC,946,Hepagam b im injection ,,,64.3,141.06,43 APC,9460,"Injection, cangrelor ",,,19.87,43.59,43 APC,9461,Choline c-11 ,,,2466.1,5410.32,43 APC,9463,"Inj., aprepitant, 1 mg ",,,1.56,3.42,43 APC,9466,"Inj., benralizumab, 1 mg ",,,162.25,355.96,43 APC,9467,"Inj rituximab, hyaluronid ",,,36.87,36.87,1 APC,9467,"Inj rituximab, hyaluronida ",,,35.66,78.24,42 APC,9468,Factor ix recomb gly rebi ,,,4.55,4.55,1 APC,9468,Factor ix recomb gly rebin ,,,4.58,10.05,42 APC,9469,Inj triamcinolone ace xr ,,,18.58,18.58,1 APC,9469,Inj triamcinolone ace xr 1 ,,,18.89,41.45,42 APC,947,Flebogamma injection ,,,88.93,195.09,42 APC,9470,Aripirazole lauroxil 1 mg ,,,3.34,7.65,43 APC,9471,"Hyaluronan, hymo or hymo ",,,17.64,17.64,1 APC,9471,"Hyaluronan, hymo or hymo o ",,,17.77,38.98,42 APC,9472,Inj talimogene laherparep ,,,73.94,73.94,1 APC,9472,Inj talimogene laherparepv ,,,75.79,166.28,42 APC,9473,"Injection, mepolizumab, 1 ",,,31.89,31.89,1 APC,9473,"Injection, mepolizumab, 1m ",,,31.64,69.4,42 APC,9474,Inj irinotecan liposome 1 ,,,64.54,141.6,43 APC,9475,"Injection, necitumumab, 1 ",,,5.62,12.32,43 APC,9476,"Injection, daratumumab 10 ",,,70.79,158.61,43 APC,9477,"Injection, elotuzumab, 1m ",,,8.04,8.04,1 APC,9477,"Injection, elotuzumab, 1mg ",,,8.03,17.61,42 APC,9478,Inj sebelipase alfa 1 mg ,,,528.81,1160.14,43 APC,948,Gamunex-C/Gammaked ,,,48.03,105.38,43 APC,9480,Injection trabectedin 0.1 ,,,391.07,391.07,1 APC,9480,Injection trabectedin 0.1m ,,,402.27,882.53,42 APC,9481,"Injection, reslizumab ",,,11.13,25.22,43 APC,9482,Sotalol hydrochloride IV ,,,25.09,25.09,1 APC,9483,"Inj, atezolizumab,10 mg ",,,93.91,207.57,43 APC,9484,"Inj, eteplirsen, 10 mg ",,,164.08,359.96,43 APC,9487,"Ustekinumab, iv inject,1 ",,,12.49,12.49,1 APC,9487,"Ustekinumab, iv inject,1 m ",,,11.13,24.42,42 APC,9489,"Inj, nusinersen, 0.1mg ",,,1286.15,2866.92,43 APC,949,"Inj, denosumab-qbde, 1 mg ",,,4.04,8.86,42 APC,9490,"Inj, bezlotoxumab, 10 mg ",,,39.03,85.62,43 APC,9491,"Injection, avelumab, 10 m ",,,104.99,104.99,1 APC,9491,"Injection, avelumab, 10 mg ",,,106.46,233.57,42 APC,9492,"Inj., durvalumab, 10 mg ",,,86.19,189.09,43 APC,9493,"Injection, edaravone, 1 m ",,,17.47,17.47,1 APC,9493,"Injection, edaravone, 1 mg ",,,6.33,13.9,42 APC,9494,"Injection, ocrelizumab ",,,59.32,131.09,43 APC,9495,Gemtuzumab ozogamicin inj ,,,240.16,531.85,43 APC,9496,"Inj, faricimab-svoa, 0.1m ",,,32.9,32.9,1 APC,9496,"Inj, faricimab-svoa, 0.1mg ",,,31.73,69.62,42 APC,9497,Loxapine for inhalation 1 ,,,15.9,15.9,1 APC,9498,Ciltacabtagene car-pos t ,,,576218.24,1264152.27,43 APC,950,"Inj, tocilizumab-anoh, 1 m ",,,4.6,10.09,42 APC,9500,"Platelets, irradiated ",,,385.11,844.89,43 APC,9501,Platelet pheres leukoredu ,,,511.59,511.59,1 APC,9501,Platelet pheres leukoreduc ,,,501.36,1099.92,42 APC,9502,Platelet pheresis irradia ,,,949.13,949.13,1 APC,9502,Platelet pheresis irradiat ,,,930.15,2040.63,42 APC,9503,Fr frz plasma donor retes ,,,53.25,53.25,1 APC,9503,Fr frz plasma donor retest ,,,52.19,114.49,42 APC,9504,RBC deglycerolized ,,,306.74,672.95,43 APC,9505,RBC irradiated ,,,142.32,312.22,43 APC,9507,"Platelets, pheresis ",,,302.78,664.26,43 APC,9508,Plasma 1 donor frz w/in 8 ,,,84.26,184.86,43 APC,9509,"Frozen plasma, pooled, sd ",,,54.84,120.31,43 APC,951,"Inj, denosumab-kyqq, 1 mg ",,,13.72,30.1,42 APC,9510,Whole blood for transfusi ,,,189.84,189.84,1 APC,9510,Whole blood for transfusio ,,,186.04,408.16,42 APC,9511,Cryoprecipitate each unit ,,,70.51,154.69,43 APC,9512,RBC leukocytes reduced ,,,181.21,397.56,43 APC,9513,"Plasma, frz between 8-24h ",,,73.77,73.77,1 APC,9513,"Plasma, frz between 8-24ho ",,,72.29,158.61,42 APC,9514,"Plasma protein fract,5%,5 ",,,8.11,8.11,1 APC,9514,"Plasma protein fract,5%,50 ",,,7.95,17.44,42 APC,9515,"Platelets, each unit ",,,52.11,114.32,43 APC,9516,Plaelet rich plasma unit ,,,548.59,1203.55,43 APC,9517,Red blood cells unit ,,,147.56,323.73,43 APC,9518,Washed red blood cells un ,,,368.58,368.58,1 APC,9518,Washed red blood cells uni ,,,361.21,792.45,42 APC,9519,"Plasmaprotein fract,5%,25 ",,,35.32,35.32,1 APC,9519,"Plasmaprotein fract,5%,250 ",,,34.61,75.94,42 APC,952,"Inj ustekinumab-srlf, 1 mg ",,,11.32,24.83,42 APC,9520,Blood split unit ,,,152.72,335.06,43 APC,9521,Platelets leukoreduced ir ,,,189.59,189.59,1 APC,9521,Platelets leukoreduced irr ,,,185.8,407.62,42 APC,9522,RBC leukoreduced irradiat ,,,265.41,265.41,1 APC,9522,RBC leukoreduced irradiate ,,,260.1,570.63,42 APC,9523,Cryoprecipitatereducedpla ,,,132.05,132.05,1 APC,9523,Cryoprecipitatereducedplas ,,,129.41,283.91,42 APC,9524,"Blood, l/r, cmv-neg ",,,148.55,325.9,43 APC,9525,"Platelets, hla-m, l/r, un ",,,708.06,708.06,1 APC,9525,"Platelets, hla-m, l/r, uni ",,,693.9,1522.33,42 APC,9526,Platelets leukocytes redu ,,,144.26,144.26,1 APC,9526,Platelets leukocytes reduc ,,,141.37,310.16,42 APC,9527,"Blood, l/r, froz/degly/wa ",,,265.19,265.19,1 APC,9527,"Blood, l/r, froz/degly/was ",,,259.89,570.16,42 APC,9528,"Plt, aph/pher, l/r, cmv-n ",,,250.49,250.49,1 APC,9528,"Plt, aph/pher, l/r, cmv-ne ",,,245.48,538.55,42 APC,9529,"Blood, l/r, irradiated ",,,82.86,181.78,43 APC,953,Ibuprofen injection ,,,3.19,6.99,42 APC,9530,Plate pheres leukoredu ir ,,,680.61,680.61,1 APC,9530,Plate pheres leukoredu irr ,,,667.0,1463.31,42 APC,9531,"Plt, pher, l/r cmv-neg, i ",,,503.45,503.45,1 APC,9531,"Plt, pher, l/r cmv-neg, ir ",,,493.38,1082.42,42 APC,9532,"RBC, frz/deg/wsh, l/r, ir ",,,422.69,422.69,1 APC,9532,"RBC, frz/deg/wsh, l/r, irr ",,,414.24,908.78,42 APC,9533,"RBC, l/r, cmv-neg, irrad ",,,244.41,536.21,43 APC,9534,Pathogen reduced plasma p ,,,55.78,55.78,1 APC,9534,Pathogen reduced plasma po ,,,54.66,119.93,42 APC,9535,Pathogen reduced plasma s ,,,294.48,294.48,1 APC,9535,Pathogen reduced plasma si ,,,288.59,633.13,42 APC,9536,Platelets pheresis path r ,,,607.43,607.43,1 APC,9536,Platelets pheresis path re ,,,595.28,1305.97,42 APC,9537,Blood component/product n ,,,35.32,35.32,1 APC,9537,Blood component/product no ,,,34.61,75.94,42 APC,9538,Plasma cryo redu path eac ,,,133.76,133.76,1 APC,9538,Plasma cryo redu path each ,,,131.08,287.58,42 APC,9539,Cryo fib comp path redu e ,,,549.28,549.28,1 APC,9539,Cryo fib comp path redu ea ,,,538.29,1180.95,42 APC,9540,Covid-19 convalescent pla ,,,680.03,680.03,1 APC,9540,Covid-19 convalescent plas ,,,666.43,1462.06,42 APC,9541,Rbc o2 co2 reduced ,,,501.36,1099.92,43 APC,957,Inj belantamab mafodot blm ,,,35.52,77.94,42 APC,961,"Albumin (human),5%, 50ml ",,,10.4,22.82,43 APC,963,"Albumin (human), 5%, 250 ",,,53.08,53.08,1 APC,963,"Albumin (human), 5%, 250 m ",,,52.02,114.12,42 APC,964,"Albumin (human), 25%, 20 ",,,21.23,21.23,1 APC,964,"Albumin (human), 25%, 20 m ",,,20.9,45.86,42 APC,965,"Albumin (human), 25%, 50m ",,,53.08,53.08,1 APC,965,"Albumin (human), 25%, 50ml ",,,52.26,114.65,42 APC,T0002,Maternity Observation ,,,1496.26,1496.26,2 APC,T0003,Debride abdom wall ,,,335.01,335.01,2 APC,T0004,Breast reconstruction ,,,1200.34,1200.34,2 APC,T0008,"Thoracoscopy, surgical ",,,801.68,801.68,2 APC,T0010,Removal of gallbladder ,,,1122.32,1122.32,2 APC,T0011,Removal of gallbladder ,,,1307.44,1307.44,2 APC,T0012,Removal of fallopian tube ,,,704.89,704.89,2 APC,T0013,Removal of ovary/tube(s) ,,,1485.79,1485.79,2 APC,T0014,Revise fallopian tube(s) ,,,640.99,640.99,2 APC,T0017,Laparoscopic banding revis ,,,585.09,585.09,2 APC,T0018,Laparoscopic banding adjus ,,,60.18,60.18,2 APC,T0020,Methadone Opioid Treatment ,,,151.01,151.01,2 APC,T0130,Laparoscopic ileostomy or ,,,3615.62,3615.62,2 APC,T0175,Intensive Outpatient Progr ,,,217.2,217.2,2 APC,T1084,Denileukin diftitox inj ,,,2070.74,2070.74,2 APC,T1239,Rotavirus vacc 2 dose oral ,,,139.27,139.27,2 APC,T1355,Itraconazole injection ,,,0.4,0.4,2 APC,T1357,Inj protirelin per 250 mcg ,,,38.15,38.15,2 APC,T1361,Enfuvirtide injection ,,,22.7,22.7,2 APC,T1435,Injection estrone per 1 MG ,,,1.98,1.98,2 APC,T1842,Leuprolide acetate implant ,,,205.36,205.36,2 APC,T2644,Brachytx cesium-131 chlori ,,,122.16,122.16,2 APC,T3050,Sermorelin acetate injecti ,,,2.3,2.3,2 APC,T5122,Level 2 Musculoskeletal Pr ,,,2920.68,2920.68,2 APC,T5271,Blood Product Exchange and ,,,1277.42,1277.42,2 APC,T5521,Level 1 Imaging without Co ,,,74.11,74.11,2 APC,T5861,Partial Hospitalization (m ,,,223.6,223.6,2 APC,T9060,Diazoxide injection ,,,841.04,841.04,2 APC,T9506,"Granulocytes, pheresis uni ",,,1882.84,1882.84,2 APR-DRG,0011,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT ,,,1157.0,52717.3,16 APR-DRG,0012,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT ,,,1157.0,54773.9,16 APR-DRG,0013,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT ,,,1157.0,71311.6,16 APR-DRG,0014,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT ,,,1157.0,138409.0,16 APR-DRG,0021,HEART AND/OR LUNG TRANSPLANT ,,,1157.0,59215.6,16 APR-DRG,0022,HEART AND/OR LUNG TRANSPLANT ,,,1157.0,76449.7,16 APR-DRG,0023,HEART AND/OR LUNG TRANSPLANT ,,,1157.0,95165.9,16 APR-DRG,0024,HEART AND/OR LUNG TRANSPLANT ,,,1157.0,386382.0,16 APR-DRG,0041,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE ,,,1157.0,39413.28,17 APR-DRG,0042,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE ,,,1157.0,48029.22,17 APR-DRG,0043,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE ,,,1157.0,73458.64,17 APR-DRG,0044,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE ,,,1157.0,114253.02,17 APR-DRG,0051,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE ,,,1157.0,39489.11,17 APR-DRG,0052,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE ,,,1157.0,48341.49,17 APR-DRG,0053,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE ,,,1157.0,52934.98,17 APR-DRG,0054,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE ,,,1157.0,73483.61,17 APR-DRG,0061,PANCREAS TRANSPLANT ,,,1157.0,73101.6,16 APR-DRG,0062,PANCREAS TRANSPLANT ,,,1157.0,74057.8,16 APR-DRG,0063,PANCREAS TRANSPLANT ,,,1157.0,81878.2,16 APR-DRG,0064,PANCREAS TRANSPLANT ,,,1157.0,126699.0,16 APR-DRG,0071,ALLOGENEIC BONE MARROW TRANSPLANT ,,,1157.0,71836.3,16 APR-DRG,0072,ALLOGENEIC BONE MARROW TRANSPLANT ,,,1157.0,109400.0,16 APR-DRG,0073,ALLOGENEIC BONE MARROW TRANSPLANT ,,,1157.0,162825.0,16 APR-DRG,0074,ALLOGENEIC BONE MARROW TRANSPLANT ,,,1157.0,461442.0,16 APR-DRG,0081,AUTOLOGOUS BONE MARROW TRANSPLANT ,,,1157.0,40625.6,16 APR-DRG,0082,AUTOLOGOUS BONE MARROW TRANSPLANT ,,,1157.0,48504.8,16 APR-DRG,0083,AUTOLOGOUS BONE MARROW TRANSPLANT ,,,1157.0,93179.2,16 APR-DRG,0084,AUTOLOGOUS BONE MARROW TRANSPLANT ,,,1157.0,137854.0,16 APR-DRG,0091,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) ,,,1157.0,61140.06,17 APR-DRG,0092,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) ,,,1157.0,63044.01,17 APR-DRG,0093,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) ,,,1157.0,95855.91,17 APR-DRG,0094,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) ,,,1157.0,195107.54,17 APR-DRG,0111,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,1157.0,30485.05,17 APR-DRG,0112,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,1157.0,53605.46,17 APR-DRG,0113,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,1157.0,77137.16,17 APR-DRG,0114,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,1157.0,135744.73,17 APR-DRG,0201,OPEN CRANIOTOMY FOR TRAUMA ,,,1157.0,11738.64,17 APR-DRG,0202,OPEN CRANIOTOMY FOR TRAUMA ,,,1157.0,14024.01,17 APR-DRG,0203,OPEN CRANIOTOMY FOR TRAUMA ,,,1157.0,24996.7,17 APR-DRG,0204,OPEN CRANIOTOMY FOR TRAUMA ,,,1157.0,39759.44,17 APR-DRG,0211,OPEN CRANIOTOMY EXCEPT TRAUMA ,,,1157.0,12671.44,17 APR-DRG,0212,OPEN CRANIOTOMY EXCEPT TRAUMA ,,,1157.0,17216.29,17 APR-DRG,0213,OPEN CRANIOTOMY EXCEPT TRAUMA ,,,1157.0,27088.9,17 APR-DRG,0214,OPEN CRANIOTOMY EXCEPT TRAUMA ,,,1157.0,47331.53,17 APR-DRG,0221,VENTRICULAR SHUNT PROCEDURES ,,,1157.0,7081.81,17 APR-DRG,0222,VENTRICULAR SHUNT PROCEDURES ,,,1157.0,8707.4,17 APR-DRG,0223,VENTRICULAR SHUNT PROCEDURES ,,,1157.0,12974.79,17 APR-DRG,0224,VENTRICULAR SHUNT PROCEDURES ,,,1157.0,46974.65,17 APR-DRG,0231,SPINAL PROCEDURES ,,,1157.0,8957.66,17 APR-DRG,0232,SPINAL PROCEDURES ,,,1157.0,13024.75,17 APR-DRG,0233,SPINAL PROCEDURES ,,,1157.0,26532.61,17 APR-DRG,0234,SPINAL PROCEDURES ,,,1157.0,54500.33,17 APR-DRG,0241,OPEN EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,5119.43,17 APR-DRG,0242,OPEN EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,7796.46,17 APR-DRG,0243,OPEN EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,13956.2,17 APR-DRG,0244,OPEN EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,26852.91,17 APR-DRG,0261,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES ,,,1157.0,7797.8,17 APR-DRG,0262,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES ,,,1157.0,12615.68,17 APR-DRG,0263,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES ,,,1157.0,19108.64,17 APR-DRG,0264,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES ,,,1157.0,50845.89,17 APR-DRG,0271,OTHER OPEN CRANIOTOMY ,,,1157.0,10622.95,17 APR-DRG,0272,OTHER OPEN CRANIOTOMY ,,,1157.0,17670.86,17 APR-DRG,0273,OTHER OPEN CRANIOTOMY ,,,1157.0,24718.78,17 APR-DRG,0274,OTHER OPEN CRANIOTOMY ,,,1157.0,27258.41,17 APR-DRG,0291,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES ,,,1157.0,18203.5,17 APR-DRG,0292,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES ,,,1157.0,19271.46,17 APR-DRG,0293,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES ,,,1157.0,26082.05,17 APR-DRG,0294,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES ,,,1157.0,29595.97,17 APR-DRG,0301,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,11992.03,17 APR-DRG,0302,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,15801.71,17 APR-DRG,0303,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,21453.78,17 APR-DRG,0304,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES ,,,1157.0,30051.44,17 APR-DRG,0401,SPINAL DISORDERS AND INJURIES ,,,1157.0,6078.99,17 APR-DRG,0402,SPINAL DISORDERS AND INJURIES ,,,1157.0,13109.5,17 APR-DRG,0403,SPINAL DISORDERS AND INJURIES ,,,1157.0,16970.94,17 APR-DRG,0404,SPINAL DISORDERS AND INJURIES ,,,1157.0,26178.41,17 APR-DRG,0411,NERVOUS SYSTEM MALIGNANCY ,,,1157.0,4533.25,17 APR-DRG,0412,NERVOUS SYSTEM MALIGNANCY ,,,1157.0,4874.08,17 APR-DRG,0413,NERVOUS SYSTEM MALIGNANCY ,,,1157.0,6701.3,17 APR-DRG,0414,NERVOUS SYSTEM MALIGNANCY ,,,1157.0,11502.66,17 APR-DRG,0421,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS ,,,1157.0,4176.38,17 APR-DRG,0422,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS ,,,1157.0,5779.65,17 APR-DRG,0423,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS ,,,1157.0,9083.01,17 APR-DRG,0424,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS ,,,1157.0,22503.0,17 APR-DRG,0431,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES ",,,1157.0,5536.98,17 APR-DRG,0432,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES ",,,1157.0,8235.42,17 APR-DRG,0433,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES ",,,1157.0,26266.74,17 APR-DRG,0434,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES ",,,1157.0,63114.94,17 APR-DRG,0441,INTRACRANIAL HEMORRHAGE ,,,1157.0,4878.54,17 APR-DRG,0442,INTRACRANIAL HEMORRHAGE ,,,1157.0,7866.06,17 APR-DRG,0443,INTRACRANIAL HEMORRHAGE ,,,1157.0,9662.05,17 APR-DRG,0444,INTRACRANIAL HEMORRHAGE ,,,1157.0,15173.16,17 APR-DRG,0451,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION ,,,1157.0,4580.54,17 APR-DRG,0452,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION ,,,1157.0,6065.16,17 APR-DRG,0453,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION ,,,1157.0,9016.1,17 APR-DRG,0454,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION ,,,1157.0,16103.28,17 APR-DRG,0461,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION ,,,1157.0,5000.76,17 APR-DRG,0462,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION ,,,1157.0,5041.81,17 APR-DRG,0463,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION ,,,1157.0,8024.88,17 APR-DRG,0464,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION ,,,1157.0,10666.22,17 APR-DRG,0471,TRANSIENT ISCHEMIA ,,,1157.0,3644.18,17 APR-DRG,0472,TRANSIENT ISCHEMIA ,,,1157.0,4582.77,17 APR-DRG,0473,TRANSIENT ISCHEMIA ,,,1157.0,5927.31,17 APR-DRG,0474,TRANSIENT ISCHEMIA ,,,1157.0,10865.63,17 APR-DRG,0481,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS ",,,1157.0,3537.56,17 APR-DRG,0482,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS ",,,1157.0,3678.97,17 APR-DRG,0483,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS ",,,1157.0,5137.73,17 APR-DRG,0484,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS ",,,1157.0,21900.32,17 APR-DRG,0491,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM ,,,1157.0,6515.71,17 APR-DRG,0492,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM ,,,1157.0,13079.61,17 APR-DRG,0493,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM ,,,1157.0,13828.18,17 APR-DRG,0494,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM ,,,1157.0,28228.24,17 APR-DRG,0501,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS ,,,1157.0,3492.51,17 APR-DRG,0502,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS ,,,1157.0,11851.5,17 APR-DRG,0503,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS ,,,1157.0,18389.53,17 APR-DRG,0504,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS ,,,1157.0,36145.15,17 APR-DRG,0511,VIRAL MENINGITIS ,,,1157.0,2396.0,17 APR-DRG,0512,VIRAL MENINGITIS ,,,1157.0,3901.14,17 APR-DRG,0513,VIRAL MENINGITIS ,,,1157.0,5628.42,17 APR-DRG,0514,VIRAL MENINGITIS ,,,1157.0,16744.31,17 APR-DRG,0521,ALTERATION IN CONSCIOUSNESS ,,,1157.0,3357.34,17 APR-DRG,0522,ALTERATION IN CONSCIOUSNESS ,,,1157.0,4312.44,17 APR-DRG,0523,ALTERATION IN CONSCIOUSNESS ,,,1157.0,5485.68,17 APR-DRG,0524,ALTERATION IN CONSCIOUSNESS ,,,1157.0,14846.61,17 APR-DRG,0531,SEIZURE ,,,1157.0,2804.63,17 APR-DRG,0532,SEIZURE ,,,1157.0,3771.32,17 APR-DRG,0533,SEIZURE ,,,1157.0,5458.46,17 APR-DRG,0534,SEIZURE ,,,1157.0,12712.03,17 APR-DRG,0541,MIGRAINE AND OTHER HEADACHES ,,,1157.0,3191.84,17 APR-DRG,0542,MIGRAINE AND OTHER HEADACHES ,,,1157.0,3986.79,17 APR-DRG,0543,MIGRAINE AND OTHER HEADACHES ,,,1157.0,5077.94,17 APR-DRG,0544,MIGRAINE AND OTHER HEADACHES ,,,1157.0,11352.76,17 APR-DRG,0551,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE ,,,1157.0,3436.3,17 APR-DRG,0552,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE ,,,1157.0,5818.46,17 APR-DRG,0553,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE ,,,1157.0,8751.56,17 APR-DRG,0554,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE ,,,1157.0,15857.47,17 APR-DRG,0561,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR N ",,,1157.0,4275.41,17 APR-DRG,0562,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR N ",,,1157.0,6029.03,17 APR-DRG,0563,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR N ",,,1157.0,9210.15,17 APR-DRG,0564,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR N ",,,1157.0,17680.24,17 APR-DRG,0571,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, CO ",,,1157.0,2584.7,17 APR-DRG,0572,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, CO ",,,1157.0,4564.04,17 APR-DRG,0573,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, CO ",,,1157.0,8718.11,17 APR-DRG,0574,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, CO ",,,1157.0,21763.38,17 APR-DRG,0581,OTHER DISORDERS OF NERVOUS SYSTEM ,,,1157.0,4710.8,17 APR-DRG,0582,OTHER DISORDERS OF NERVOUS SYSTEM ,,,1157.0,6666.95,17 APR-DRG,0583,OTHER DISORDERS OF NERVOUS SYSTEM ,,,1157.0,10682.73,17 APR-DRG,0584,OTHER DISORDERS OF NERVOUS SYSTEM ,,,1157.0,21588.06,17 APR-DRG,0591,ANOXIC AND OTHER SEVERE BRAIN DAMAGE ,,,1157.0,7652.83,17 APR-DRG,0592,ANOXIC AND OTHER SEVERE BRAIN DAMAGE ,,,1157.0,9484.5,17 APR-DRG,0593,ANOXIC AND OTHER SEVERE BRAIN DAMAGE ,,,1157.0,14263.11,17 APR-DRG,0594,ANOXIC AND OTHER SEVERE BRAIN DAMAGE ,,,1157.0,24692.9,17 APR-DRG,0731,ORBIT AND EYE PROCEDURES ,,,1157.0,5908.57,17 APR-DRG,0732,ORBIT AND EYE PROCEDURES ,,,1157.0,8048.06,17 APR-DRG,0733,ORBIT AND EYE PROCEDURES ,,,1157.0,11529.43,17 APR-DRG,0734,ORBIT AND EYE PROCEDURES ,,,1157.0,29536.65,17 APR-DRG,0821,EYE INFECTIONS AND OTHER EYE DISORDERS ,,,1157.0,2629.75,17 APR-DRG,0822,EYE INFECTIONS AND OTHER EYE DISORDERS ,,,1157.0,5041.36,17 APR-DRG,0823,EYE INFECTIONS AND OTHER EYE DISORDERS ,,,1157.0,9008.96,17 APR-DRG,0824,EYE INFECTIONS AND OTHER EYE DISORDERS ,,,1157.0,15654.5,17 APR-DRG,0891,MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,11925.11,17 APR-DRG,0892,MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,12876.2,17 APR-DRG,0893,MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,23518.78,17 APR-DRG,0894,MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,44192.78,17 APR-DRG,0911,OTHER MAJOR HEAD AND NECK PROCEDURES ,,,1157.0,6053.11,17 APR-DRG,0912,OTHER MAJOR HEAD AND NECK PROCEDURES ,,,1157.0,13047.05,17 APR-DRG,0913,OTHER MAJOR HEAD AND NECK PROCEDURES ,,,1157.0,28821.1,17 APR-DRG,0914,OTHER MAJOR HEAD AND NECK PROCEDURES ,,,1157.0,40169.41,17 APR-DRG,0921,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,9071.86,17 APR-DRG,0922,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,10650.16,17 APR-DRG,0923,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,32826.63,17 APR-DRG,0924,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES ,,,1157.0,34033.76,17 APR-DRG,0951,CLEFT LIP AND PALATE REPAIR ,,,1157.0,5167.61,17 APR-DRG,0952,CLEFT LIP AND PALATE REPAIR ,,,1157.0,7531.49,17 APR-DRG,0953,CLEFT LIP AND PALATE REPAIR ,,,1157.0,10639.9,17 APR-DRG,0954,CLEFT LIP AND PALATE REPAIR ,,,1157.0,21090.66,17 APR-DRG,0971,TONSIL AND ADENOID PROCEDURES ,,,1157.0,4017.13,17 APR-DRG,0972,TONSIL AND ADENOID PROCEDURES ,,,1157.0,5668.13,17 APR-DRG,0973,TONSIL AND ADENOID PROCEDURES ,,,1157.0,7576.54,17 APR-DRG,0974,TONSIL AND ADENOID PROCEDURES ,,,1157.0,17487.51,17 APR-DRG,0981,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES ",,,1157.0,6331.04,17 APR-DRG,0982,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES ",,,1157.0,8935.36,17 APR-DRG,0983,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES ",,,1157.0,15446.61,17 APR-DRG,0984,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES ",,,1157.0,28717.61,17 APR-DRG,1101,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES ",,,1157.0,3824.85,17 APR-DRG,1102,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES ",,,1157.0,6125.82,17 APR-DRG,1103,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES ",,,1157.0,6588.88,17 APR-DRG,1104,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES ",,,1157.0,12151.72,17 APR-DRG,1111,VERTIGO AND OTHER LABYRINTH DISORDERS ,,,1157.0,2850.57,17 APR-DRG,1112,VERTIGO AND OTHER LABYRINTH DISORDERS ,,,1157.0,3905.15,17 APR-DRG,1113,VERTIGO AND OTHER LABYRINTH DISORDERS ,,,1157.0,4622.02,17 APR-DRG,1114,VERTIGO AND OTHER LABYRINTH DISORDERS ,,,1157.0,7635.43,17 APR-DRG,1131,INFECTIONS OF UPPER RESPIRATORY TRACT ,,,1157.0,1700.97,17 APR-DRG,1132,INFECTIONS OF UPPER RESPIRATORY TRACT ,,,1157.0,2578.9,17 APR-DRG,1133,INFECTIONS OF UPPER RESPIRATORY TRACT ,,,1157.0,7679.59,17 APR-DRG,1134,INFECTIONS OF UPPER RESPIRATORY TRACT ,,,1157.0,12417.16,17 APR-DRG,1141,DENTAL DISEASES AND DISORDERS ,,,1157.0,2654.29,17 APR-DRG,1142,DENTAL DISEASES AND DISORDERS ,,,1157.0,3254.74,17 APR-DRG,1143,DENTAL DISEASES AND DISORDERS ,,,1157.0,4761.66,17 APR-DRG,1144,DENTAL DISEASES AND DISORDERS ,,,1157.0,15679.04,17 APR-DRG,1151,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES ",,,1157.0,2627.07,17 APR-DRG,1152,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES ",,,1157.0,4695.19,17 APR-DRG,1153,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES ",,,1157.0,9153.95,17 APR-DRG,1154,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES ",,,1157.0,16827.74,17 APR-DRG,1201,MAJOR RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,10540.86,17 APR-DRG,1202,MAJOR RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,10783.1,17 APR-DRG,1203,MAJOR RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,15204.83,17 APR-DRG,1204,MAJOR RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,44842.29,17 APR-DRG,1211,OTHER RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,7918.7,17 APR-DRG,1212,OTHER RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,11032.91,17 APR-DRG,1213,OTHER RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,22633.26,17 APR-DRG,1214,OTHER RESPIRATORY AND CHEST PROCEDURES ,,,1157.0,41849.41,17 APR-DRG,1301,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS ,,,1157.0,22424.94,17 APR-DRG,1302,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS ,,,1157.0,26192.69,17 APR-DRG,1303,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS ,,,1157.0,29959.99,17 APR-DRG,1304,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS ,,,1157.0,44123.19,17 APR-DRG,1311,CYSTIC FIBROSIS - PULMONARY DISEASE ,,,1157.0,7331.64,17 APR-DRG,1312,CYSTIC FIBROSIS - PULMONARY DISEASE ,,,1157.0,12842.29,17 APR-DRG,1313,CYSTIC FIBROSIS - PULMONARY DISEASE ,,,1157.0,17358.6,17 APR-DRG,1314,CYSTIC FIBROSIS - PULMONARY DISEASE ,,,1157.0,23334.09,17 APR-DRG,1321,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD ,,,1157.0,2656.96,17 APR-DRG,1322,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD ,,,1157.0,5010.14,17 APR-DRG,1323,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD ,,,1157.0,8495.95,17 APR-DRG,1324,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD ,,,1157.0,14207.35,17 APR-DRG,1331,RESPIRATORY FAILURE ,,,1157.0,2943.36,17 APR-DRG,1332,RESPIRATORY FAILURE ,,,1157.0,4586.34,17 APR-DRG,1333,RESPIRATORY FAILURE ,,,1157.0,8662.79,17 APR-DRG,1334,RESPIRATORY FAILURE ,,,1157.0,12579.99,17 APR-DRG,1341,PULMONARY EMBOLISM ,,,1157.0,3941.73,17 APR-DRG,1342,PULMONARY EMBOLISM ,,,1157.0,4551.55,17 APR-DRG,1343,PULMONARY EMBOLISM ,,,1157.0,6800.77,17 APR-DRG,1344,PULMONARY EMBOLISM ,,,1157.0,13451.21,17 APR-DRG,1351,MAJOR CHEST AND RESPIRATORY TRAUMA ,,,1157.0,4228.13,17 APR-DRG,1352,MAJOR CHEST AND RESPIRATORY TRAUMA ,,,1157.0,5600.77,17 APR-DRG,1353,MAJOR CHEST AND RESPIRATORY TRAUMA ,,,1157.0,6697.27,17 APR-DRG,1354,MAJOR CHEST AND RESPIRATORY TRAUMA ,,,1157.0,11018.64,17 APR-DRG,1361,RESPIRATORY MALIGNANCY ,,,1157.0,5041.81,17 APR-DRG,1362,RESPIRATORY MALIGNANCY ,,,1157.0,6704.86,17 APR-DRG,1363,RESPIRATORY MALIGNANCY ,,,1157.0,9483.16,17 APR-DRG,1364,RESPIRATORY MALIGNANCY ,,,1157.0,13495.83,17 APR-DRG,1371,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS ,,,1157.0,3589.31,17 APR-DRG,1372,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS ,,,1157.0,5146.2,17 APR-DRG,1373,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS ,,,1157.0,7513.64,17 APR-DRG,1374,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS ,,,1157.0,13880.36,17 APR-DRG,1381,BRONCHIOLITIS AND RSV PNEUMONIA ,,,1157.0,1842.39,17 APR-DRG,1382,BRONCHIOLITIS AND RSV PNEUMONIA ,,,1157.0,2568.64,17 APR-DRG,1383,BRONCHIOLITIS AND RSV PNEUMONIA ,,,1157.0,4387.38,17 APR-DRG,1384,BRONCHIOLITIS AND RSV PNEUMONIA ,,,1157.0,9807.04,17 APR-DRG,1391,OTHER PNEUMONIA ,,,1157.0,2201.5,17 APR-DRG,1392,OTHER PNEUMONIA ,,,1157.0,3420.69,17 APR-DRG,1393,OTHER PNEUMONIA ,,,1157.0,5408.5,17 APR-DRG,1394,OTHER PNEUMONIA ,,,1157.0,9283.76,17 APR-DRG,1401,CHRONIC OBSTRUCTIVE PULMONARY DISEASE ,,,1157.0,3373.4,17 APR-DRG,1402,CHRONIC OBSTRUCTIVE PULMONARY DISEASE ,,,1157.0,3911.84,17 APR-DRG,1403,CHRONIC OBSTRUCTIVE PULMONARY DISEASE ,,,1157.0,4587.24,17 APR-DRG,1404,CHRONIC OBSTRUCTIVE PULMONARY DISEASE ,,,1157.0,6731.63,17 APR-DRG,1411,ASTHMA ,,,1157.0,2134.59,17 APR-DRG,1412,ASTHMA ,,,1157.0,3119.56,17 APR-DRG,1413,ASTHMA ,,,1157.0,3952.88,17 APR-DRG,1414,ASTHMA ,,,1157.0,8061.45,17 APR-DRG,1421,INTERSTITIAL AND ALVEOLAR LUNG DISEASES ,,,1157.0,3767.3,17 APR-DRG,1422,INTERSTITIAL AND ALVEOLAR LUNG DISEASES ,,,1157.0,5955.41,17 APR-DRG,1423,INTERSTITIAL AND ALVEOLAR LUNG DISEASES ,,,1157.0,6047.31,17 APR-DRG,1424,INTERSTITIAL AND ALVEOLAR LUNG DISEASES ,,,1157.0,7594.82,17 APR-DRG,1431,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,2815.77,17 APR-DRG,1432,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,4062.17,17 APR-DRG,1433,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,6302.93,17 APR-DRG,1434,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,9972.54,17 APR-DRG,1441,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,2485.66,17 APR-DRG,1442,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,3985.0,17 APR-DRG,1443,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,7884.35,17 APR-DRG,1444,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES ",,,1157.0,9953.8,17 APR-DRG,1451,ACUTE BRONCHITIS AND RELATED SYMPTOMS ,,,1157.0,1796.89,17 APR-DRG,1452,ACUTE BRONCHITIS AND RELATED SYMPTOMS ,,,1157.0,3330.57,17 APR-DRG,1453,ACUTE BRONCHITIS AND RELATED SYMPTOMS ,,,1157.0,5567.31,17 APR-DRG,1454,ACUTE BRONCHITIS AND RELATED SYMPTOMS ,,,1157.0,8352.31,17 APR-DRG,1601,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY ,,,18175.35,22273.71,17 APR-DRG,1602,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY ,,,23160.56,28383.04,17 APR-DRG,1603,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY ,,,33333.0,40849.26,17 APR-DRG,1604,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY ,,,78877.66,96663.8,17 APR-DRG,1611,IMPLANTABLE HEART ASSIST SYSTEMS ,,,60387.07,74003.76,17 APR-DRG,1612,IMPLANTABLE HEART ASSIST SYSTEMS ,,,63671.96,78029.36,17 APR-DRG,1613,IMPLANTABLE HEART ASSIST SYSTEMS ,,,88575.42,108548.31,17 APR-DRG,1614,IMPLANTABLE HEART ASSIST SYSTEMS ,,,169940.77,208260.75,17 APR-DRG,1621,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,25650.06,31433.9,17 APR-DRG,1622,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,28908.38,35426.94,17 APR-DRG,1623,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,38714.25,47443.94,17 APR-DRG,1624,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,68807.51,84322.92,17 APR-DRG,1631,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,16364.73,20054.81,17 APR-DRG,1632,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,20332.51,24917.29,17 APR-DRG,1633,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,27464.68,33657.7,17 APR-DRG,1634,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,41008.65,50255.7,17 APR-DRG,1651,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,16434.62,20140.46,17 APR-DRG,1652,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,19232.81,23569.63,17 APR-DRG,1653,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,23319.63,28577.98,17 APR-DRG,1654,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,35468.32,43466.07,17 APR-DRG,1661,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,13792.95,16903.13,17 APR-DRG,1662,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,15230.46,18664.78,17 APR-DRG,1663,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,19490.54,23885.46,17 APR-DRG,1664,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS ,,,27410.45,33591.24,17 APR-DRG,1671,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES ,,,14602.16,17894.8,17 APR-DRG,1672,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES ,,,17773.47,21781.21,17 APR-DRG,1673,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES ,,,22713.18,27834.78,17 APR-DRG,1674,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES ,,,52288.8,64079.41,17 APR-DRG,1691,MAJOR ABDOMINAL VASCULAR PROCEDURES ,,,13336.11,16343.28,17 APR-DRG,1692,MAJOR ABDOMINAL VASCULAR PROCEDURES ,,,13347.39,16357.1,17 APR-DRG,1693,MAJOR ABDOMINAL VASCULAR PROCEDURES ,,,18927.04,23194.9,17 APR-DRG,1694,MAJOR ABDOMINAL VASCULAR PROCEDURES ,,,36740.55,45025.19,17 APR-DRG,1701,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK ",,,10599.8,12989.95,17 APR-DRG,1702,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK ",,,12159.25,14901.04,17 APR-DRG,1703,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK ",,,14901.75,18261.95,17 APR-DRG,1704,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK ",,,22897.37,28060.5,17 APR-DRG,1711,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK ",,,6213.76,7614.9,17 APR-DRG,1712,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK ",,,7526.04,9223.09,17 APR-DRG,1713,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK ",,,10768.7,13196.94,17 APR-DRG,1714,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK ",,,25934.0,31781.86,17 APR-DRG,1741,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI ,,,8027.65,9837.81,17 APR-DRG,1742,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI ,,,9379.61,11494.63,17 APR-DRG,1743,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI ,,,10898.29,13355.75,17 APR-DRG,1744,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI ,,,17815.34,21832.53,17 APR-DRG,1751,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI ,,,8947.89,10965.55,17 APR-DRG,1752,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI ,,,10555.02,12935.07,17 APR-DRG,1753,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI ,,,14301.85,17526.78,17 APR-DRG,1754,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI ,,,23480.52,28775.15,17 APR-DRG,1761,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES ",,,5370.7,6581.74,17 APR-DRG,1762,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES ",,,6546.47,8022.64,17 APR-DRG,1763,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES ",,,14859.52,18210.2,17 APR-DRG,1764,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES ",,,26628.54,32633.01,17 APR-DRG,1771,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT ,,,5227.64,6406.43,17 APR-DRG,1772,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT ,,,9005.04,11035.59,17 APR-DRG,1773,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT ,,,12782.08,15664.31,17 APR-DRG,1774,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT ,,,18228.13,22338.4,17 APR-DRG,1781,EXTERNAL HEART ASSIST DEVICES ,,,1157.0,32944.39,17 APR-DRG,1782,EXTERNAL HEART ASSIST DEVICES ,,,1157.0,35938.61,17 APR-DRG,1783,EXTERNAL HEART ASSIST DEVICES ,,,1157.0,41873.5,17 APR-DRG,1784,EXTERNAL HEART ASSIST DEVICES ,,,1157.0,65432.88,17 APR-DRG,1791,DEFIBRILLATOR IMPLANTS ,,,1157.0,15600.52,17 APR-DRG,1792,DEFIBRILLATOR IMPLANTS ,,,1157.0,20882.78,17 APR-DRG,1793,DEFIBRILLATOR IMPLANTS ,,,1157.0,24652.75,17 APR-DRG,1794,DEFIBRILLATOR IMPLANTS ,,,1157.0,32150.79,17 APR-DRG,1801,OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES ,,,1157.0,26833.29,17 APR-DRG,1802,OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES ,,,1157.0,23001.3,17 APR-DRG,1803,OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES ,,,1157.0,19169.31,17 APR-DRG,1804,OTHER PERIPHERAL VASCULAR AND CIRCULATORY PROCEDURES ,,,1157.0,29618.27,17 APR-DRG,1811,LOWER VASCULAR PROCEDURES ,,,1157.0,8207.32,17 APR-DRG,1812,LOWER VASCULAR PROCEDURES ,,,1157.0,12455.52,17 APR-DRG,1813,LOWER VASCULAR PROCEDURES ,,,1157.0,20520.99,17 APR-DRG,1814,LOWER VASCULAR PROCEDURES ,,,1157.0,39108.14,17 APR-DRG,1821,OTHER UPPER VASCULAR PROCEDURES ,,,1157.0,9202.13,17 APR-DRG,1822,OTHER UPPER VASCULAR PROCEDURES ,,,1157.0,12877.09,17 APR-DRG,1823,OTHER UPPER VASCULAR PROCEDURES ,,,1157.0,17061.05,17 APR-DRG,1824,OTHER UPPER VASCULAR PROCEDURES ,,,1157.0,50285.59,17 APR-DRG,1831,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES ,,,1157.0,22782.71,17 APR-DRG,1832,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES ,,,1157.0,23949.7,17 APR-DRG,1833,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES ,,,1157.0,36890.59,17 APR-DRG,1834,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES ,,,1157.0,37819.36,17 APR-DRG,1901,ACUTE MYOCARDIAL INFARCTION ,,,1157.0,4413.25,17 APR-DRG,1902,ACUTE MYOCARDIAL INFARCTION ,,,1157.0,4746.49,17 APR-DRG,1903,ACUTE MYOCARDIAL INFARCTION ,,,1157.0,6295.79,17 APR-DRG,1904,ACUTE MYOCARDIAL INFARCTION ,,,1157.0,11109.64,17 APR-DRG,1911,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE ,,,1157.0,4841.95,17 APR-DRG,1912,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE ,,,1157.0,5773.41,17 APR-DRG,1913,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE ,,,1157.0,8010.6,17 APR-DRG,1914,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE ,,,1157.0,9994.4,17 APR-DRG,1921,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS ,,,1157.0,6891.34,17 APR-DRG,1922,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS ,,,1157.0,7412.83,17 APR-DRG,1923,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS ,,,1157.0,12664.74,17 APR-DRG,1924,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS ,,,1157.0,20484.85,17 APR-DRG,1931,ACUTE AND SUBACUTE ENDOCARDITIS ,,,1157.0,9458.19,17 APR-DRG,1932,ACUTE AND SUBACUTE ENDOCARDITIS ,,,1157.0,12117.83,17 APR-DRG,1933,ACUTE AND SUBACUTE ENDOCARDITIS ,,,1157.0,20251.99,17 APR-DRG,1934,ACUTE AND SUBACUTE ENDOCARDITIS ,,,1157.0,24145.54,17 APR-DRG,1941,HEART FAILURE ,,,1157.0,2914.81,17 APR-DRG,1942,HEART FAILURE ,,,1157.0,3844.93,17 APR-DRG,1943,HEART FAILURE ,,,1157.0,5888.5,17 APR-DRG,1944,HEART FAILURE ,,,1157.0,14579.85,17 APR-DRG,1961,CARDIAC ARREST AND SHOCK ,,,1157.0,2921.05,17 APR-DRG,1962,CARDIAC ARREST AND SHOCK ,,,1157.0,3857.86,17 APR-DRG,1963,CARDIAC ARREST AND SHOCK ,,,1157.0,5603.45,17 APR-DRG,1964,CARDIAC ARREST AND SHOCK ,,,1157.0,12012.55,17 APR-DRG,1971,PERIPHERAL AND OTHER VASCULAR DISORDERS ,,,1157.0,3318.53,17 APR-DRG,1972,PERIPHERAL AND OTHER VASCULAR DISORDERS ,,,1157.0,4706.34,17 APR-DRG,1973,PERIPHERAL AND OTHER VASCULAR DISORDERS ,,,1157.0,6226.2,17 APR-DRG,1974,PERIPHERAL AND OTHER VASCULAR DISORDERS ,,,1157.0,13570.33,17 APR-DRG,1981,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS ,,,1157.0,2769.83,17 APR-DRG,1982,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS ,,,1157.0,3533.1,17 APR-DRG,1983,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS ,,,1157.0,4322.25,17 APR-DRG,1984,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS ,,,1157.0,7327.61,17 APR-DRG,1991,HYPERTENSION ,,,1157.0,3289.97,17 APR-DRG,1992,HYPERTENSION ,,,1157.0,3573.25,17 APR-DRG,1993,HYPERTENSION ,,,1157.0,5201.06,17 APR-DRG,1994,HYPERTENSION ,,,1157.0,9585.33,17 APR-DRG,2001,CARDIAC STRUCTURAL AND VALVULAR DISORDERS ,,,1157.0,6759.29,17 APR-DRG,2002,CARDIAC STRUCTURAL AND VALVULAR DISORDERS ,,,1157.0,11293.89,17 APR-DRG,2003,CARDIAC STRUCTURAL AND VALVULAR DISORDERS ,,,1157.0,15828.48,17 APR-DRG,2004,CARDIAC STRUCTURAL AND VALVULAR DISORDERS ,,,1157.0,126144.24,17 APR-DRG,2011,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS ,,,1157.0,2704.7,17 APR-DRG,2012,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS ,,,1157.0,3434.96,17 APR-DRG,2013,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS ,,,1157.0,5297.88,17 APR-DRG,2014,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS ,,,1157.0,8764.95,17 APR-DRG,2031,CHEST PAIN ,,,1157.0,2657.41,17 APR-DRG,2032,CHEST PAIN ,,,1157.0,3218.16,17 APR-DRG,2033,CHEST PAIN ,,,1157.0,3539.35,17 APR-DRG,2034,CHEST PAIN ,,,1157.0,7207.61,17 APR-DRG,2041,SYNCOPE AND COLLAPSE ,,,1157.0,2874.21,17 APR-DRG,2042,SYNCOPE AND COLLAPSE ,,,1157.0,3803.44,17 APR-DRG,2043,SYNCOPE AND COLLAPSE ,,,1157.0,4182.17,17 APR-DRG,2044,SYNCOPE AND COLLAPSE ,,,1157.0,13933.0,17 APR-DRG,2051,CARDIOMYOPATHY ,,,1157.0,3120.91,17 APR-DRG,2052,CARDIOMYOPATHY ,,,1157.0,4128.65,17 APR-DRG,2053,CARDIOMYOPATHY ,,,1157.0,5257.73,17 APR-DRG,2054,CARDIOMYOPATHY ,,,1157.0,49281.43,17 APR-DRG,2061,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE ",,,1157.0,3968.05,17 APR-DRG,2062,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE ",,,1157.0,4646.56,17 APR-DRG,2063,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE ",,,1157.0,9680.79,17 APR-DRG,2064,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE ",,,1157.0,21401.59,17 APR-DRG,2071,OTHER CIRCULATORY SYSTEM DIAGNOSES ,,,1157.0,3554.06,17 APR-DRG,2072,OTHER CIRCULATORY SYSTEM DIAGNOSES ,,,1157.0,4635.41,17 APR-DRG,2073,OTHER CIRCULATORY SYSTEM DIAGNOSES ,,,1157.0,6618.76,17 APR-DRG,2074,OTHER CIRCULATORY SYSTEM DIAGNOSES ,,,1157.0,24355.65,17 APR-DRG,2201,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,8546.8,17 APR-DRG,2202,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,10438.26,17 APR-DRG,2203,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,20519.65,17 APR-DRG,2204,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,55753.42,17 APR-DRG,2221,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,4299.5,17 APR-DRG,2222,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,8521.83,17 APR-DRG,2223,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,18685.74,17 APR-DRG,2224,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES ",,,1157.0,26515.66,17 APR-DRG,2231,OTHER SMALL AND LARGE BOWEL PROCEDURES ,,,1157.0,6079.44,17 APR-DRG,2232,OTHER SMALL AND LARGE BOWEL PROCEDURES ,,,1157.0,7680.04,17 APR-DRG,2233,OTHER SMALL AND LARGE BOWEL PROCEDURES ,,,1157.0,10564.06,17 APR-DRG,2234,OTHER SMALL AND LARGE BOWEL PROCEDURES ,,,1157.0,35018.3,17 APR-DRG,2241,PERITONEAL ADHESIOLYSIS ,,,1157.0,6706.65,17 APR-DRG,2242,PERITONEAL ADHESIOLYSIS ,,,1157.0,9767.77,17 APR-DRG,2243,PERITONEAL ADHESIOLYSIS ,,,1157.0,14859.1,17 APR-DRG,2244,PERITONEAL ADHESIOLYSIS ,,,1157.0,40784.14,17 APR-DRG,2261,ANAL AND PERINEAL PROCEDURES ,,,1157.0,5094.45,17 APR-DRG,2262,ANAL AND PERINEAL PROCEDURES ,,,1157.0,7259.81,17 APR-DRG,2263,ANAL AND PERINEAL PROCEDURES ,,,1157.0,8412.98,17 APR-DRG,2264,ANAL AND PERINEAL PROCEDURES ,,,1157.0,24568.44,17 APR-DRG,2271,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL ",,,1157.0,6501.44,17 APR-DRG,2272,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL ",,,1157.0,8391.11,17 APR-DRG,2273,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL ",,,1157.0,12364.96,17 APR-DRG,2274,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL ",,,1157.0,38988.59,17 APR-DRG,2281,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES ",,,1157.0,4565.38,17 APR-DRG,2282,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES ",,,1157.0,6163.3,17 APR-DRG,2283,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES ",,,1157.0,10217.0,17 APR-DRG,2284,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES ",,,1157.0,19646.19,17 APR-DRG,2291,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES ,,,1157.0,6064.26,17 APR-DRG,2292,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES ,,,1157.0,8412.09,17 APR-DRG,2293,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES ,,,1157.0,17118.59,17 APR-DRG,2294,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES ,,,1157.0,23462.11,17 APR-DRG,2301,MAJOR SMALL BOWEL PROCEDURES ,,,1157.0,7944.13,17 APR-DRG,2302,MAJOR SMALL BOWEL PROCEDURES ,,,1157.0,11645.41,17 APR-DRG,2303,MAJOR SMALL BOWEL PROCEDURES ,,,1157.0,17339.86,17 APR-DRG,2304,MAJOR SMALL BOWEL PROCEDURES ,,,1157.0,47160.66,17 APR-DRG,2311,MAJOR LARGE BOWEL PROCEDURES ,,,1157.0,7717.51,17 APR-DRG,2312,MAJOR LARGE BOWEL PROCEDURES ,,,1157.0,9796.77,17 APR-DRG,2313,MAJOR LARGE BOWEL PROCEDURES ,,,1157.0,13746.98,17 APR-DRG,2314,MAJOR LARGE BOWEL PROCEDURES ,,,1157.0,28608.31,17 APR-DRG,2321,GASTRIC FUNDOPLICATION ,,,1157.0,4567.6,17 APR-DRG,2322,GASTRIC FUNDOPLICATION ,,,1157.0,6265.9,17 APR-DRG,2323,GASTRIC FUNDOPLICATION ,,,1157.0,9085.25,17 APR-DRG,2324,GASTRIC FUNDOPLICATION ,,,1157.0,18458.22,17 APR-DRG,2331,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,6099.06,17 APR-DRG,2332,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,8436.17,17 APR-DRG,2333,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,10841.54,17 APR-DRG,2334,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,30596.57,17 APR-DRG,2341,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,4368.65,17 APR-DRG,2342,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,5741.29,17 APR-DRG,2343,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,7143.83,17 APR-DRG,2344,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS ,,,1157.0,19075.19,17 APR-DRG,2401,DIGESTIVE MALIGNANCY ,,,1157.0,4667.52,17 APR-DRG,2402,DIGESTIVE MALIGNANCY ,,,1157.0,5347.39,17 APR-DRG,2403,DIGESTIVE MALIGNANCY ,,,1157.0,7502.04,17 APR-DRG,2404,DIGESTIVE MALIGNANCY ,,,1157.0,12621.91,17 APR-DRG,2411,PEPTIC ULCER AND GASTRITIS ,,,1157.0,3781.14,17 APR-DRG,2412,PEPTIC ULCER AND GASTRITIS ,,,1157.0,4425.75,17 APR-DRG,2413,PEPTIC ULCER AND GASTRITIS ,,,1157.0,7242.41,17 APR-DRG,2414,PEPTIC ULCER AND GASTRITIS ,,,1157.0,17597.26,17 APR-DRG,2421,MAJOR ESOPHAGEAL DISORDERS ,,,1157.0,3868.56,17 APR-DRG,2422,MAJOR ESOPHAGEAL DISORDERS ,,,1157.0,4164.78,17 APR-DRG,2423,MAJOR ESOPHAGEAL DISORDERS ,,,1157.0,6674.52,17 APR-DRG,2424,MAJOR ESOPHAGEAL DISORDERS ,,,1157.0,15411.82,17 APR-DRG,2431,OTHER ESOPHAGEAL DISORDERS ,,,1157.0,2696.66,17 APR-DRG,2432,OTHER ESOPHAGEAL DISORDERS ,,,1157.0,4078.68,17 APR-DRG,2433,OTHER ESOPHAGEAL DISORDERS ,,,1157.0,6341.29,17 APR-DRG,2434,OTHER ESOPHAGEAL DISORDERS ,,,1157.0,12803.04,17 APR-DRG,2441,DIVERTICULITIS AND DIVERTICULOSIS ,,,1157.0,3178.01,17 APR-DRG,2442,DIVERTICULITIS AND DIVERTICULOSIS ,,,1157.0,4009.99,17 APR-DRG,2443,DIVERTICULITIS AND DIVERTICULOSIS ,,,1157.0,5354.97,17 APR-DRG,2444,DIVERTICULITIS AND DIVERTICULOSIS ,,,1157.0,17804.25,17 APR-DRG,2451,INFLAMMATORY BOWEL DISEASE ,,,1157.0,3942.17,17 APR-DRG,2452,INFLAMMATORY BOWEL DISEASE ,,,1157.0,5556.6,17 APR-DRG,2453,INFLAMMATORY BOWEL DISEASE ,,,1157.0,7737.14,17 APR-DRG,2454,INFLAMMATORY BOWEL DISEASE ,,,1157.0,25463.31,17 APR-DRG,2461,GASTROINTESTINAL VASCULAR INSUFFICIENCY ,,,1157.0,6950.21,17 APR-DRG,2462,GASTROINTESTINAL VASCULAR INSUFFICIENCY ,,,1157.0,7799.59,17 APR-DRG,2463,GASTROINTESTINAL VASCULAR INSUFFICIENCY ,,,1157.0,8648.51,17 APR-DRG,2464,GASTROINTESTINAL VASCULAR INSUFFICIENCY ,,,1157.0,93736.95,17 APR-DRG,2471,INTESTINAL OBSTRUCTION ,,,1157.0,2474.51,17 APR-DRG,2472,INTESTINAL OBSTRUCTION ,,,1157.0,3470.2,17 APR-DRG,2473,INTESTINAL OBSTRUCTION ,,,1157.0,5627.99,17 APR-DRG,2474,INTESTINAL OBSTRUCTION ,,,1157.0,12081.25,17 APR-DRG,2481,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS ,,,1157.0,1986.48,17 APR-DRG,2482,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS ,,,1157.0,4323.14,17 APR-DRG,2483,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS ,,,1157.0,6120.48,17 APR-DRG,2484,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS ,,,1157.0,20434.45,17 APR-DRG,2491,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING ",,,1157.0,1849.52,17 APR-DRG,2492,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING ",,,1157.0,2900.98,17 APR-DRG,2493,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING ",,,1157.0,4982.02,17 APR-DRG,2494,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING ",,,1157.0,14900.15,17 APR-DRG,2511,ABDOMINAL PAIN ,,,1157.0,2534.74,17 APR-DRG,2512,ABDOMINAL PAIN ,,,1157.0,3647.75,17 APR-DRG,2513,ABDOMINAL PAIN ,,,1157.0,4958.84,17 APR-DRG,2514,ABDOMINAL PAIN ,,,1157.0,10361.09,17 APR-DRG,2521,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE ",,,1157.0,3508.13,17 APR-DRG,2522,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE ",,,1157.0,4131.76,17 APR-DRG,2523,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE ",,,1157.0,6095.94,17 APR-DRG,2524,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE ",,,1157.0,21377.95,17 APR-DRG,2531,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE ,,,1157.0,3078.09,17 APR-DRG,2532,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE ,,,1157.0,4179.95,17 APR-DRG,2533,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE ,,,1157.0,5728.8,17 APR-DRG,2534,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE ,,,1157.0,9706.21,17 APR-DRG,2541,OTHER DIGESTIVE SYSTEM DIAGNOSES ,,,1157.0,2875.55,17 APR-DRG,2542,OTHER DIGESTIVE SYSTEM DIAGNOSES ,,,1157.0,4771.91,17 APR-DRG,2543,OTHER DIGESTIVE SYSTEM DIAGNOSES ,,,1157.0,7768.36,17 APR-DRG,2544,OTHER DIGESTIVE SYSTEM DIAGNOSES ,,,1157.0,17169.45,17 APR-DRG,2601,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES ",,,1157.0,11903.25,17 APR-DRG,2602,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES ",,,1157.0,12970.76,17 APR-DRG,2603,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES ",,,1157.0,19458.39,17 APR-DRG,2604,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES ",,,1157.0,42369.56,17 APR-DRG,2611,MAJOR BILIARY TRACT PROCEDURES ,,,1157.0,8354.99,17 APR-DRG,2612,MAJOR BILIARY TRACT PROCEDURES ,,,1157.0,12199.46,17 APR-DRG,2613,MAJOR BILIARY TRACT PROCEDURES ,,,1157.0,24601.9,17 APR-DRG,2614,MAJOR BILIARY TRACT PROCEDURES ,,,1157.0,37219.36,17 APR-DRG,2631,CHOLECYSTECTOMY ,,,1157.0,5632.0,17 APR-DRG,2632,CHOLECYSTECTOMY ,,,1157.0,6993.49,17 APR-DRG,2633,CHOLECYSTECTOMY ,,,1157.0,8916.63,17 APR-DRG,2634,CHOLECYSTECTOMY ,,,1157.0,24640.26,17 APR-DRG,2641,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES ",,,1157.0,10642.57,17 APR-DRG,2642,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES ",,,1157.0,13597.99,17 APR-DRG,2643,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES ",,,1157.0,16552.94,17 APR-DRG,2644,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES ",,,1157.0,31535.61,17 APR-DRG,2791,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS ,,,1157.0,2658.75,17 APR-DRG,2792,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS ,,,1157.0,3984.11,17 APR-DRG,2793,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS ,,,1157.0,5437.05,17 APR-DRG,2794,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS ,,,1157.0,15855.69,17 APR-DRG,2801,ALCOHOLIC LIVER DISEASE ,,,1157.0,2761.8,17 APR-DRG,2802,ALCOHOLIC LIVER DISEASE ,,,1157.0,3658.01,17 APR-DRG,2803,ALCOHOLIC LIVER DISEASE ,,,1157.0,5698.02,17 APR-DRG,2804,ALCOHOLIC LIVER DISEASE ,,,1157.0,14505.79,17 APR-DRG,2811,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS ,,,1157.0,4565.38,17 APR-DRG,2812,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS ,,,1157.0,5179.65,17 APR-DRG,2813,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS ,,,1157.0,6842.71,17 APR-DRG,2814,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS ,,,1157.0,10250.9,17 APR-DRG,2821,DISORDERS OF PANCREAS EXCEPT MALIGNANCY ,,,1157.0,2997.79,17 APR-DRG,2822,DISORDERS OF PANCREAS EXCEPT MALIGNANCY ,,,1157.0,4140.69,17 APR-DRG,2823,DISORDERS OF PANCREAS EXCEPT MALIGNANCY ,,,1157.0,7009.55,17 APR-DRG,2824,DISORDERS OF PANCREAS EXCEPT MALIGNANCY ,,,1157.0,24788.81,17 APR-DRG,2831,OTHER DISORDERS OF THE LIVER ,,,1157.0,2795.25,17 APR-DRG,2832,OTHER DISORDERS OF THE LIVER ,,,1157.0,3973.85,17 APR-DRG,2833,OTHER DISORDERS OF THE LIVER ,,,1157.0,5320.18,17 APR-DRG,2834,OTHER DISORDERS OF THE LIVER ,,,1157.0,21805.75,17 APR-DRG,2841,DISORDERS OF GALLBLADDER AND BILIARY TRACT ,,,1157.0,3784.7,17 APR-DRG,2842,DISORDERS OF GALLBLADDER AND BILIARY TRACT ,,,1157.0,5025.75,17 APR-DRG,2843,DISORDERS OF GALLBLADDER AND BILIARY TRACT ,,,1157.0,7537.73,17 APR-DRG,2844,DISORDERS OF GALLBLADDER AND BILIARY TRACT ,,,1157.0,14184.15,17 APR-DRG,3031,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK ,,,1157.0,26898.86,17 APR-DRG,3032,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK ,,,1157.0,36514.07,17 APR-DRG,3033,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK ,,,1157.0,50326.19,17 APR-DRG,3034,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK ,,,1157.0,59489.95,17 APR-DRG,3041,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK ,,,1157.0,15759.77,17 APR-DRG,3042,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK ,,,1157.0,19014.96,17 APR-DRG,3043,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK ,,,1157.0,30945.42,17 APR-DRG,3044,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK ,,,1157.0,49421.05,17 APR-DRG,3051,AMPUTATION OF LOWER LIMB EXCEPT TOES ,,,1157.0,6693.26,17 APR-DRG,3052,AMPUTATION OF LOWER LIMB EXCEPT TOES ,,,1157.0,8741.75,17 APR-DRG,3053,AMPUTATION OF LOWER LIMB EXCEPT TOES ,,,1157.0,13562.3,17 APR-DRG,3054,AMPUTATION OF LOWER LIMB EXCEPT TOES ,,,1157.0,24339.15,17 APR-DRG,3081,HIP AND FEMUR FRACTURE REPAIR ,,,1157.0,7299.51,17 APR-DRG,3082,HIP AND FEMUR FRACTURE REPAIR ,,,1157.0,9049.56,17 APR-DRG,3083,HIP AND FEMUR FRACTURE REPAIR ,,,1157.0,12792.77,17 APR-DRG,3084,HIP AND FEMUR FRACTURE REPAIR ,,,1157.0,26743.18,17 APR-DRG,3091,OTHER SIGNIFICANT HIP AND FEMUR SURGERY ,,,1157.0,8619.08,17 APR-DRG,3092,OTHER SIGNIFICANT HIP AND FEMUR SURGERY ,,,1157.0,12135.68,17 APR-DRG,3093,OTHER SIGNIFICANT HIP AND FEMUR SURGERY ,,,1157.0,17098.53,17 APR-DRG,3094,OTHER SIGNIFICANT HIP AND FEMUR SURGERY ,,,1157.0,22574.83,17 APR-DRG,3101,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES ,,,1157.0,6718.69,17 APR-DRG,3102,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES ,,,1157.0,10571.2,17 APR-DRG,3103,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES ,,,1157.0,16180.45,17 APR-DRG,3104,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES ,,,1157.0,30617.54,17 APR-DRG,3121,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,7334.31,17 APR-DRG,3122,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,11057.0,17 APR-DRG,3123,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,17120.38,17 APR-DRG,3124,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,32107.06,17 APR-DRG,3131,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT ,,,1157.0,7427.55,17 APR-DRG,3132,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT ,,,1157.0,10175.96,17 APR-DRG,3133,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT ,,,1157.0,16962.46,17 APR-DRG,3134,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT ,,,1157.0,29305.13,17 APR-DRG,3141,FOOT AND TOE PROCEDURES ,,,1157.0,5989.32,17 APR-DRG,3142,FOOT AND TOE PROCEDURES ,,,1157.0,7280.34,17 APR-DRG,3143,FOOT AND TOE PROCEDURES ,,,1157.0,9480.49,17 APR-DRG,3144,FOOT AND TOE PROCEDURES ,,,1157.0,17000.83,17 APR-DRG,3151,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT ",,,1157.0,4885.22,17 APR-DRG,3152,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT ",,,1157.0,8584.27,17 APR-DRG,3153,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT ",,,1157.0,13467.27,17 APR-DRG,3154,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT ",,,1157.0,45178.65,17 APR-DRG,3161,HAND AND WRIST PROCEDURES ,,,1157.0,5258.61,17 APR-DRG,3162,HAND AND WRIST PROCEDURES ,,,1157.0,7676.91,17 APR-DRG,3163,HAND AND WRIST PROCEDURES ,,,1157.0,8730.15,17 APR-DRG,3164,HAND AND WRIST PROCEDURES ,,,1157.0,23783.31,17 APR-DRG,3171,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES ",,,1157.0,6911.41,17 APR-DRG,3172,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES ",,,1157.0,8066.8,17 APR-DRG,3173,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES ",,,1157.0,11878.71,17 APR-DRG,3174,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES ",,,1157.0,18448.86,17 APR-DRG,3201,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES ,,,1157.0,6937.73,17 APR-DRG,3202,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES ,,,1157.0,8384.42,17 APR-DRG,3203,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES ,,,1157.0,13347.73,17 APR-DRG,3204,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES ,,,1157.0,23097.65,17 APR-DRG,3211,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES ,,,1157.0,10714.4,17 APR-DRG,3212,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES ,,,1157.0,13565.41,17 APR-DRG,3213,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES ,,,1157.0,17664.17,17 APR-DRG,3214,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES ,,,1157.0,26907.79,17 APR-DRG,3221,SHOULDER AND ELBOW JOINT REPLACEMENT ,,,1157.0,9665.63,17 APR-DRG,3222,SHOULDER AND ELBOW JOINT REPLACEMENT ,,,1157.0,11657.01,17 APR-DRG,3223,SHOULDER AND ELBOW JOINT REPLACEMENT ,,,1157.0,15687.95,17 APR-DRG,3224,SHOULDER AND ELBOW JOINT REPLACEMENT ,,,1157.0,24934.69,17 APR-DRG,3231,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT ,,,1157.0,8973.27,17 APR-DRG,3232,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT ,,,1157.0,11134.17,17 APR-DRG,3233,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT ,,,1157.0,14140.89,17 APR-DRG,3234,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT ,,,1157.0,21865.09,17 APR-DRG,3241,ELECTIVE HIP JOINT REPLACEMENT ,,,1157.0,8610.6,17 APR-DRG,3242,ELECTIVE HIP JOINT REPLACEMENT ,,,1157.0,9050.9,17 APR-DRG,3243,ELECTIVE HIP JOINT REPLACEMENT ,,,1157.0,15664.76,17 APR-DRG,3244,ELECTIVE HIP JOINT REPLACEMENT ,,,1157.0,22452.15,17 APR-DRG,3251,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT ,,,1157.0,12687.5,17 APR-DRG,3252,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT ,,,1157.0,13846.46,17 APR-DRG,3253,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT ,,,1157.0,16104.61,17 APR-DRG,3254,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT ,,,1157.0,27617.53,17 APR-DRG,3261,ELECTIVE KNEE JOINT REPLACEMENT ,,,1157.0,7903.54,17 APR-DRG,3262,ELECTIVE KNEE JOINT REPLACEMENT ,,,1157.0,8373.27,17 APR-DRG,3263,ELECTIVE KNEE JOINT REPLACEMENT ,,,1157.0,11597.23,17 APR-DRG,3264,ELECTIVE KNEE JOINT REPLACEMENT ,,,1157.0,19438.75,17 APR-DRG,3401,FRACTURE OF FEMUR ,,,1157.0,2246.11,17 APR-DRG,3402,FRACTURE OF FEMUR ,,,1157.0,3627.67,17 APR-DRG,3403,FRACTURE OF FEMUR ,,,1157.0,6062.04,17 APR-DRG,3404,FRACTURE OF FEMUR ,,,1157.0,13399.02,17 APR-DRG,3411,FRACTURE OF PELVIS OR DISLOCATION OF HIP ,,,1157.0,3035.7,17 APR-DRG,3412,FRACTURE OF PELVIS OR DISLOCATION OF HIP ,,,1157.0,4692.06,17 APR-DRG,3413,FRACTURE OF PELVIS OR DISLOCATION OF HIP ,,,1157.0,5565.09,17 APR-DRG,3414,FRACTURE OF PELVIS OR DISLOCATION OF HIP ,,,1157.0,11259.54,17 APR-DRG,3421,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK ",,,1157.0,3232.88,17 APR-DRG,3422,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK ",,,1157.0,3549.16,17 APR-DRG,3423,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK ",,,1157.0,7150.96,17 APR-DRG,3424,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK ",,,1157.0,9766.44,17 APR-DRG,3431,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALI ,,,1157.0,6455.5,17 APR-DRG,3432,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALI ,,,1157.0,7913.79,17 APR-DRG,3433,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALI ,,,1157.0,9372.09,17 APR-DRG,3434,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALI ,,,1157.0,23115.5,17 APR-DRG,3441,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS ",,,1157.0,4179.95,17 APR-DRG,3442,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS ",,,1157.0,5280.48,17 APR-DRG,3443,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS ",,,1157.0,7361.53,17 APR-DRG,3444,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS ",,,1157.0,14094.05,17 APR-DRG,3461,CONNECTIVE TISSUE DISORDERS ,,,1157.0,4950.8,17 APR-DRG,3462,CONNECTIVE TISSUE DISORDERS ,,,1157.0,6528.21,17 APR-DRG,3463,CONNECTIVE TISSUE DISORDERS ,,,1157.0,12791.89,17 APR-DRG,3464,CONNECTIVE TISSUE DISORDERS ,,,1157.0,29952.41,17 APR-DRG,3471,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES ",,,1157.0,3978.75,17 APR-DRG,3472,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES ",,,1157.0,5740.4,17 APR-DRG,3473,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES ",,,1157.0,7307.99,17 APR-DRG,3474,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES ",,,1157.0,17030.26,17 APR-DRG,3491,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE ",,,1157.0,2734.14,17 APR-DRG,3492,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE ",,,1157.0,4881.21,17 APR-DRG,3493,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE ",,,1157.0,6385.46,17 APR-DRG,3494,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE ",,,1157.0,13387.88,17 APR-DRG,3511,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,3570.57,17 APR-DRG,3512,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,4131.76,17 APR-DRG,3513,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,7408.81,17 APR-DRG,3514,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES ,,,1157.0,21498.39,17 APR-DRG,3611,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES ,,,1157.0,8391.11,17 APR-DRG,3612,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES ,,,1157.0,15693.75,17 APR-DRG,3613,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES ,,,1157.0,17495.99,17 APR-DRG,3614,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES ,,,1157.0,40386.66,17 APR-DRG,3621,MASTECTOMY PROCEDURES ,,,1157.0,7949.92,17 APR-DRG,3622,MASTECTOMY PROCEDURES ,,,1157.0,12872.17,17 APR-DRG,3623,MASTECTOMY PROCEDURES ,,,1157.0,13094.34,17 APR-DRG,3624,MASTECTOMY PROCEDURES ,,,1157.0,20533.04,17 APR-DRG,3631,BREAST PROCEDURES EXCEPT MASTECTOMY ,,,1157.0,5307.24,17 APR-DRG,3632,BREAST PROCEDURES EXCEPT MASTECTOMY ,,,1157.0,10377.15,17 APR-DRG,3633,BREAST PROCEDURES EXCEPT MASTECTOMY ,,,1157.0,15071.89,17 APR-DRG,3634,BREAST PROCEDURES EXCEPT MASTECTOMY ,,,1157.0,20380.46,17 APR-DRG,3641,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES ",,,1157.0,3837.79,17 APR-DRG,3642,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES ",,,1157.0,5916.16,17 APR-DRG,3643,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES ",,,1157.0,10982.5,17 APR-DRG,3644,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES ",,,1157.0,22004.71,17 APR-DRG,3801,SKIN ULCERS ,,,1157.0,3079.43,17 APR-DRG,3802,SKIN ULCERS ,,,1157.0,3993.48,17 APR-DRG,3803,SKIN ULCERS ,,,1157.0,5749.76,17 APR-DRG,3804,SKIN ULCERS ,,,1157.0,17274.29,17 APR-DRG,3811,MAJOR SKIN DISORDERS ,,,1157.0,1941.43,17 APR-DRG,3812,MAJOR SKIN DISORDERS ,,,1157.0,3538.45,17 APR-DRG,3813,MAJOR SKIN DISORDERS ,,,1157.0,6320.33,17 APR-DRG,3814,MAJOR SKIN DISORDERS ,,,1157.0,23818.55,17 APR-DRG,3821,MALIGNANT BREAST DISORDERS ,,,1157.0,3635.7,17 APR-DRG,3822,MALIGNANT BREAST DISORDERS ,,,1157.0,4825.0,17 APR-DRG,3823,MALIGNANT BREAST DISORDERS ,,,1157.0,7405.69,17 APR-DRG,3824,MALIGNANT BREAST DISORDERS ,,,1157.0,13998.14,17 APR-DRG,3831,CELLULITIS AND OTHER SKIN INFECTIONS ,,,1157.0,2293.84,17 APR-DRG,3832,CELLULITIS AND OTHER SKIN INFECTIONS ,,,1157.0,3500.09,17 APR-DRG,3833,CELLULITIS AND OTHER SKIN INFECTIONS ,,,1157.0,5506.2,17 APR-DRG,3834,CELLULITIS AND OTHER SKIN INFECTIONS ,,,1157.0,15302.53,17 APR-DRG,3841,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE ",,,1157.0,2850.13,17 APR-DRG,3842,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE ",,,1157.0,4642.1,17 APR-DRG,3843,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE ",,,1157.0,6999.74,17 APR-DRG,3844,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE ",,,1157.0,21683.07,17 APR-DRG,3851,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS ",,,1157.0,2341.57,17 APR-DRG,3852,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS ",,,1157.0,3951.99,17 APR-DRG,3853,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS ",,,1157.0,8615.95,17 APR-DRG,3854,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS ",,,1157.0,16455.69,17 APR-DRG,4011,ADRENAL PROCEDURES ,,,1157.0,8832.31,17 APR-DRG,4012,ADRENAL PROCEDURES ,,,1157.0,26372.91,17 APR-DRG,4013,ADRENAL PROCEDURES ,,,1157.0,30948.55,17 APR-DRG,4014,ADRENAL PROCEDURES ,,,1157.0,27675.52,17 APR-DRG,4031,PROCEDURES FOR OBESITY ,,,5067.12,9924.0,17 APR-DRG,4032,PROCEDURES FOR OBESITY ,,,5716.15,9924.0,17 APR-DRG,4033,PROCEDURES FOR OBESITY ,,,9723.98,11916.64,17 APR-DRG,4034,PROCEDURES FOR OBESITY ,,,9924.0,14781.49,17 APR-DRG,4041,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES ",,,1157.0,7122.86,17 APR-DRG,4042,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES ",,,1157.0,9744.58,17 APR-DRG,4043,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES ",,,1157.0,22696.61,17 APR-DRG,4044,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES ",,,1157.0,29858.72,17 APR-DRG,4051,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS ",,,1157.0,11218.05,17 APR-DRG,4052,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS ",,,1157.0,13192.47,17 APR-DRG,4053,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS ",,,1157.0,15166.91,17 APR-DRG,4054,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS ",,,1157.0,27775.45,17 APR-DRG,4201,DIABETES ,,,1157.0,2550.35,17 APR-DRG,4202,DIABETES ,,,1157.0,3223.06,17 APR-DRG,4203,DIABETES ,,,1157.0,4998.09,17 APR-DRG,4204,DIABETES ,,,1157.0,10401.24,17 APR-DRG,4211,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS ",,,1157.0,3476.89,17 APR-DRG,4212,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS ",,,1157.0,6187.84,17 APR-DRG,4213,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS ",,,1157.0,8957.21,17 APR-DRG,4214,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS ",,,1157.0,22561.0,17 APR-DRG,4221,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS ,,,1157.0,1429.3,17 APR-DRG,4222,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS ,,,1157.0,2403.14,17 APR-DRG,4223,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS ,,,1157.0,4285.68,17 APR-DRG,4224,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS ,,,1157.0,10664.44,17 APR-DRG,4231,INBORN ERRORS OF METABOLISM ,,,1157.0,9046.44,17 APR-DRG,4232,INBORN ERRORS OF METABOLISM ,,,1157.0,12146.38,17 APR-DRG,4233,INBORN ERRORS OF METABOLISM ,,,1157.0,15246.31,17 APR-DRG,4234,INBORN ERRORS OF METABOLISM ,,,1157.0,18853.48,17 APR-DRG,4241,OTHER ENDOCRINE DISORDERS ,,,1157.0,3825.3,17 APR-DRG,4242,OTHER ENDOCRINE DISORDERS ,,,1157.0,4857.13,17 APR-DRG,4243,OTHER ENDOCRINE DISORDERS ,,,1157.0,7781.3,17 APR-DRG,4244,OTHER ENDOCRINE DISORDERS ,,,1157.0,20197.13,17 APR-DRG,4251,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS ,,,1157.0,2544.1,17 APR-DRG,4252,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS ,,,1157.0,2578.0,17 APR-DRG,4253,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS ,,,1157.0,4338.76,17 APR-DRG,4254,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS ,,,1157.0,9935.96,17 APR-DRG,4261,NON-HYPOVOLEMIC SODIUM DISORDERS ,,,1157.0,2891.16,17 APR-DRG,4262,NON-HYPOVOLEMIC SODIUM DISORDERS ,,,1157.0,3541.58,17 APR-DRG,4263,NON-HYPOVOLEMIC SODIUM DISORDERS ,,,1157.0,5429.91,17 APR-DRG,4264,NON-HYPOVOLEMIC SODIUM DISORDERS ,,,1157.0,13109.5,17 APR-DRG,4271,THYROID DISORDERS ,,,1157.0,2234.95,17 APR-DRG,4272,THYROID DISORDERS ,,,1157.0,3559.43,17 APR-DRG,4273,THYROID DISORDERS ,,,1157.0,4159.88,17 APR-DRG,4274,THYROID DISORDERS ,,,1157.0,13978.06,17 APR-DRG,4401,KIDNEY TRANSPLANT ,,,1157.0,38136.8,16 APR-DRG,4402,KIDNEY TRANSPLANT ,,,1157.0,40684.3,16 APR-DRG,4403,KIDNEY TRANSPLANT ,,,1157.0,63254.5,16 APR-DRG,4404,KIDNEY TRANSPLANT ,,,1157.0,103349.0,16 APR-DRG,4411,MAJOR BLADDER PROCEDURES ,,,1157.0,8586.95,17 APR-DRG,4412,MAJOR BLADDER PROCEDURES ,,,1157.0,13357.09,17 APR-DRG,4413,MAJOR BLADDER PROCEDURES ,,,1157.0,16889.3,17 APR-DRG,4414,MAJOR BLADDER PROCEDURES ,,,1157.0,69861.3,17 APR-DRG,4421,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY ,,,1157.0,8330.0,17 APR-DRG,4422,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY ,,,1157.0,9821.31,17 APR-DRG,4423,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY ,,,1157.0,15709.36,17 APR-DRG,4424,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY ,,,1157.0,46717.25,17 APR-DRG,4431,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY ,,,1157.0,5926.43,17 APR-DRG,4432,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY ,,,1157.0,8210.0,17 APR-DRG,4433,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY ,,,1157.0,12901.18,17 APR-DRG,4434,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY ,,,1157.0,29633.0,17 APR-DRG,4441,RENAL DIALYSIS ACCESS PROCEDURES ,,,1157.0,5086.86,17 APR-DRG,4442,RENAL DIALYSIS ACCESS PROCEDURES ,,,1157.0,7347.25,17 APR-DRG,4443,RENAL DIALYSIS ACCESS PROCEDURES ,,,1157.0,12950.25,17 APR-DRG,4444,RENAL DIALYSIS ACCESS PROCEDURES ,,,1157.0,25499.9,17 APR-DRG,4451,OTHER BLADDER PROCEDURES ,,,1157.0,4992.74,17 APR-DRG,4452,OTHER BLADDER PROCEDURES ,,,1157.0,7687.63,17 APR-DRG,4453,OTHER BLADDER PROCEDURES ,,,1157.0,11780.13,17 APR-DRG,4454,OTHER BLADDER PROCEDURES ,,,1157.0,24085.76,17 APR-DRG,4461,URETHRAL AND TRANSURETHRAL PROCEDURES ,,,1157.0,5098.91,17 APR-DRG,4462,URETHRAL AND TRANSURETHRAL PROCEDURES ,,,1157.0,6000.03,17 APR-DRG,4463,URETHRAL AND TRANSURETHRAL PROCEDURES ,,,1157.0,10908.9,17 APR-DRG,4464,URETHRAL AND TRANSURETHRAL PROCEDURES ,,,1157.0,19622.99,17 APR-DRG,4471,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES ",,,1157.0,4842.4,17 APR-DRG,4472,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES ",,,1157.0,7644.8,17 APR-DRG,4473,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES ",,,1157.0,12348.9,17 APR-DRG,4474,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES ",,,1157.0,55319.81,17 APR-DRG,4611,KIDNEY AND URINARY TRACT MALIGNANCY ,,,1157.0,4962.4,17 APR-DRG,4612,KIDNEY AND URINARY TRACT MALIGNANCY ,,,1157.0,5581.14,17 APR-DRG,4613,KIDNEY AND URINARY TRACT MALIGNANCY ,,,1157.0,10757.23,17 APR-DRG,4614,KIDNEY AND URINARY TRACT MALIGNANCY ,,,1157.0,23160.11,17 APR-DRG,4621,NEPHRITIS AND NEPHROSIS ,,,1157.0,3418.45,17 APR-DRG,4622,NEPHRITIS AND NEPHROSIS ,,,1157.0,4909.31,17 APR-DRG,4623,NEPHRITIS AND NEPHROSIS ,,,1157.0,11155.15,17 APR-DRG,4624,NEPHRITIS AND NEPHROSIS ,,,1157.0,24732.61,17 APR-DRG,4631,KIDNEY AND URINARY TRACT INFECTIONS ,,,1157.0,2315.7,17 APR-DRG,4632,KIDNEY AND URINARY TRACT INFECTIONS ,,,1157.0,3280.16,17 APR-DRG,4633,KIDNEY AND URINARY TRACT INFECTIONS ,,,1157.0,5034.67,17 APR-DRG,4634,KIDNEY AND URINARY TRACT INFECTIONS ,,,1157.0,9571.05,17 APR-DRG,4651,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION ,,,1157.0,2957.19,17 APR-DRG,4652,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION ,,,1157.0,4158.09,17 APR-DRG,4653,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION ,,,1157.0,7074.24,17 APR-DRG,4654,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION ,,,1157.0,12650.91,17 APR-DRG,4661,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE ",,,1157.0,3062.91,17 APR-DRG,4662,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE ",,,1157.0,3698.6,17 APR-DRG,4663,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE ",,,1157.0,5911.25,17 APR-DRG,4664,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE ",,,1157.0,9421.16,17 APR-DRG,4681,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS ",,,1157.0,3400.61,17 APR-DRG,4682,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS ",,,1157.0,3808.79,17 APR-DRG,4683,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS ",,,1157.0,6932.38,17 APR-DRG,4684,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS ",,,1157.0,29387.65,17 APR-DRG,4691,ACUTE KIDNEY INJURY ,,,1157.0,2941.58,17 APR-DRG,4692,ACUTE KIDNEY INJURY ,,,1157.0,3719.13,17 APR-DRG,4693,ACUTE KIDNEY INJURY ,,,1157.0,6449.25,17 APR-DRG,4694,ACUTE KIDNEY INJURY ,,,1157.0,15808.85,17 APR-DRG,4701,CHRONIC KIDNEY DISEASE ,,,1157.0,4148.71,17 APR-DRG,4702,CHRONIC KIDNEY DISEASE ,,,1157.0,5303.23,17 APR-DRG,4703,CHRONIC KIDNEY DISEASE ,,,1157.0,6457.73,17 APR-DRG,4704,CHRONIC KIDNEY DISEASE ,,,1157.0,10095.66,17 APR-DRG,4801,MAJOR MALE PELVIC PROCEDURES ,,,1157.0,7619.81,17 APR-DRG,4802,MAJOR MALE PELVIC PROCEDURES ,,,1157.0,13963.34,17 APR-DRG,4803,MAJOR MALE PELVIC PROCEDURES ,,,1157.0,14089.14,17 APR-DRG,4804,MAJOR MALE PELVIC PROCEDURES ,,,1157.0,30311.08,17 APR-DRG,4821,TRANSURETHRAL PROSTATECTOMY ,,,1157.0,4718.39,17 APR-DRG,4822,TRANSURETHRAL PROSTATECTOMY ,,,1157.0,5616.82,17 APR-DRG,4823,TRANSURETHRAL PROSTATECTOMY ,,,1157.0,10953.51,17 APR-DRG,4824,TRANSURETHRAL PROSTATECTOMY ,,,1157.0,20595.49,17 APR-DRG,4831,"PENIS, TESTES AND SCROTAL PROCEDURES ",,,1157.0,5080.18,17 APR-DRG,4832,"PENIS, TESTES AND SCROTAL PROCEDURES ",,,1157.0,7233.49,17 APR-DRG,4833,"PENIS, TESTES AND SCROTAL PROCEDURES ",,,1157.0,8378.63,17 APR-DRG,4834,"PENIS, TESTES AND SCROTAL PROCEDURES ",,,1157.0,44671.89,17 APR-DRG,4841,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,7973.57,17 APR-DRG,4842,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,8875.14,17 APR-DRG,4843,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,10621.61,17 APR-DRG,4844,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,28304.52,17 APR-DRG,5001,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM ",,,1157.0,5050.29,17 APR-DRG,5002,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM ",,,1157.0,6168.65,17 APR-DRG,5003,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM ",,,1157.0,9386.81,17 APR-DRG,5004,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM ",,,1157.0,13005.56,17 APR-DRG,5011,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY ,,,1157.0,2227.38,17 APR-DRG,5012,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY ,,,1157.0,3712.88,17 APR-DRG,5013,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY ,,,1157.0,5507.99,17 APR-DRG,5014,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY ,,,1157.0,7308.89,17 APR-DRG,5101,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCED ",,,1157.0,5446.43,17 APR-DRG,5102,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCED ",,,1157.0,6835.13,17 APR-DRG,5103,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCED ",,,1157.0,16643.05,17 APR-DRG,5104,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCED ",,,1157.0,31095.76,17 APR-DRG,5111,GYNECOLOGIC PROCEDURES FOR MALIGNANCY ,,,1157.0,6479.14,17 APR-DRG,5112,GYNECOLOGIC PROCEDURES FOR MALIGNANCY ,,,1157.0,7960.64,17 APR-DRG,5113,GYNECOLOGIC PROCEDURES FOR MALIGNANCY ,,,1157.0,14785.05,17 APR-DRG,5114,GYNECOLOGIC PROCEDURES FOR MALIGNANCY ,,,1157.0,30552.41,17 APR-DRG,5121,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY ,,,1157.0,7604.65,17 APR-DRG,5122,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY ,,,1157.0,8522.71,17 APR-DRG,5123,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY ,,,1157.0,15284.24,17 APR-DRG,5124,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY ,,,1157.0,26484.44,17 APR-DRG,5131,GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY ,,,1157.0,4778.61,17 APR-DRG,5132,GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY ,,,1157.0,5590.95,17 APR-DRG,5133,GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY ,,,1157.0,10281.24,17 APR-DRG,5134,GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY ,,,1157.0,32170.41,17 APR-DRG,5141,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,1157.0,6368.5,17 APR-DRG,5142,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,1157.0,8653.88,17 APR-DRG,5143,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,1157.0,14799.32,17 APR-DRG,5144,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,1157.0,26538.86,17 APR-DRG,5171,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES ,,,1157.0,3596.9,17 APR-DRG,5172,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES ,,,1157.0,5387.09,17 APR-DRG,5173,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES ,,,1157.0,8281.83,17 APR-DRG,5174,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES ,,,1157.0,22662.71,17 APR-DRG,5181,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,4424.85,17 APR-DRG,5182,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,6456.84,17 APR-DRG,5183,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,13193.81,17 APR-DRG,5184,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES ,,,1157.0,23479.07,17 APR-DRG,5191,GYNECOLOGIC PROCEDURES FOR LEIOMYOMA ,,,1157.0,4706.79,17 APR-DRG,5192,GYNECOLOGIC PROCEDURES FOR LEIOMYOMA ,,,1157.0,5771.17,17 APR-DRG,5193,GYNECOLOGIC PROCEDURES FOR LEIOMYOMA ,,,1157.0,9916.77,17 APR-DRG,5194,GYNECOLOGIC PROCEDURES FOR LEIOMYOMA ,,,1157.0,22274.16,17 APR-DRG,5301,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY ,,,1157.0,3753.03,17 APR-DRG,5302,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY ,,,1157.0,4772.36,17 APR-DRG,5303,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY ,,,1157.0,7732.22,17 APR-DRG,5304,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY ,,,1157.0,11532.55,17 APR-DRG,5311,FEMALE REPRODUCTIVE SYSTEM INFECTIONS ,,,1157.0,2681.5,17 APR-DRG,5312,FEMALE REPRODUCTIVE SYSTEM INFECTIONS ,,,1157.0,3920.31,17 APR-DRG,5313,FEMALE REPRODUCTIVE SYSTEM INFECTIONS ,,,1157.0,5957.65,17 APR-DRG,5314,FEMALE REPRODUCTIVE SYSTEM INFECTIONS ,,,1157.0,11343.4,17 APR-DRG,5321,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS ,,,1157.0,2422.76,17 APR-DRG,5322,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS ,,,1157.0,2751.09,17 APR-DRG,5323,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS ,,,1157.0,7880.34,17 APR-DRG,5324,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS ,,,1157.0,12528.69,17 APR-DRG,5391,CESAREAN SECTION WITH STERILIZATION ,,,1157.0,2724.78,17 APR-DRG,5392,CESAREAN SECTION WITH STERILIZATION ,,,1157.0,3285.51,17 APR-DRG,5393,CESAREAN SECTION WITH STERILIZATION ,,,1157.0,5184.56,17 APR-DRG,5394,CESAREAN SECTION WITH STERILIZATION ,,,1157.0,12987.73,17 APR-DRG,5401,CESAREAN SECTION WITHOUT STERILIZATION ,,,1113.0,3824.0,22 APR-DRG,5402,CESAREAN SECTION WITHOUT STERILIZATION ,,,1113.0,3824.0,22 APR-DRG,5403,CESAREAN SECTION WITHOUT STERILIZATION ,,,1113.0,4404.34,22 APR-DRG,5404,CESAREAN SECTION WITHOUT STERILIZATION ,,,1113.0,8637.81,22 APR-DRG,5411,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C ,,,1113.0,2716.3,22 APR-DRG,5412,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C ,,,1113.0,3046.85,22 APR-DRG,5413,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C ,,,1113.0,3377.41,22 APR-DRG,5414,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C ,,,1113.0,9310.52,22 APR-DRG,5421,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C ,,,1113.0,2512.0,22 APR-DRG,5422,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C ,,,1113.0,2512.0,22 APR-DRG,5423,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C ,,,1113.0,3811.91,22 APR-DRG,5424,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C ,,,1113.0,9070.08,22 APR-DRG,5431,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,2557.92,17 APR-DRG,5432,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,3293.99,17 APR-DRG,5433,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,5163.59,17 APR-DRG,5434,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,14407.65,17 APR-DRG,5471,ANTEPARTUM WITH O.R. PROCEDURE ,,,1157.0,3491.61,17 APR-DRG,5472,ANTEPARTUM WITH O.R. PROCEDURE ,,,1157.0,4827.24,17 APR-DRG,5473,ANTEPARTUM WITH O.R. PROCEDURE ,,,1157.0,8463.84,17 APR-DRG,5474,ANTEPARTUM WITH O.R. PROCEDURE ,,,1157.0,18763.8,17 APR-DRG,5481,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,3092.36,17 APR-DRG,5482,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,5801.06,17 APR-DRG,5483,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,8372.39,17 APR-DRG,5484,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,21744.64,17 APR-DRG,5601,VAGINAL DELIVERY ,,,1113.0,2512.0,22 APR-DRG,5602,VAGINAL DELIVERY ,,,1113.0,2512.0,22 APR-DRG,5603,VAGINAL DELIVERY ,,,1113.0,2615.03,22 APR-DRG,5604,VAGINAL DELIVERY ,,,1113.0,4454.74,22 APR-DRG,5611,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE ,,,1157.0,1477.92,17 APR-DRG,5612,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE ,,,1157.0,2428.56,17 APR-DRG,5613,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE ,,,1157.0,4027.38,17 APR-DRG,5614,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE ,,,1157.0,7894.16,17 APR-DRG,5641,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,1631.39,17 APR-DRG,5642,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,2233.61,17 APR-DRG,5643,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,4289.24,17 APR-DRG,5644,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,1157.0,16064.91,17 APR-DRG,5661,ANTEPARTUM WITHOUT O.R. PROCEDURE ,,,1157.0,1480.6,17 APR-DRG,5662,ANTEPARTUM WITHOUT O.R. PROCEDURE ,,,1157.0,2017.26,17 APR-DRG,5663,ANTEPARTUM WITHOUT O.R. PROCEDURE ,,,1157.0,3189.6,17 APR-DRG,5664,ANTEPARTUM WITHOUT O.R. PROCEDURE ,,,1157.0,5842.55,17 APR-DRG,5801,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE ",,,1157.0,1606.85,17 APR-DRG,5802,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE ",,,1157.0,2338.9,17 APR-DRG,5803,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE ",,,1157.0,3778.01,17 APR-DRG,5804,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE ",,,1157.0,6840.92,17 APR-DRG,5811,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE ",,,596.26,1157.0,17 APR-DRG,5812,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE ",,,962.46,1179.49,17 APR-DRG,5813,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE ",,,1157.0,1725.51,17 APR-DRG,5814,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE ",,,1157.0,3339.94,17 APR-DRG,5831,NEONATE WITH ECMO ,,,1157.0,125874.35,17 APR-DRG,5832,NEONATE WITH ECMO ,,,1157.0,142954.58,17 APR-DRG,5833,NEONATE WITH ECMO ,,,1157.0,286897.7,17 APR-DRG,5834,NEONATE WITH ECMO ,,,1157.0,338816.91,17 APR-DRG,5881,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,107974.64,17 APR-DRG,5882,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,114549.24,17 APR-DRG,5883,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,115075.19,17 APR-DRG,5884,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,214465.54,17 APR-DRG,5891,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL ",,,1157.0,90492.47,17 APR-DRG,5892,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL ",,,1157.0,87705.69,17 APR-DRG,5893,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL ",,,1157.0,82265.96,17 APR-DRG,5894,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL ",,,1157.0,15148.63,17 APR-DRG,5911,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,42601.99,17 APR-DRG,5912,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,59086.67,17 APR-DRG,5913,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,71563.16,17 APR-DRG,5914,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,108676.35,17 APR-DRG,5931,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,13219.25,17 APR-DRG,5932,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,50626.41,17 APR-DRG,5933,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,64438.07,17 APR-DRG,5934,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE ,,,1157.0,90221.69,17 APR-DRG,6021,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,20503.59,17 APR-DRG,6022,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,40499.96,17 APR-DRG,6023,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,53603.23,17 APR-DRG,6024,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,82939.13,17 APR-DRG,6031,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,15014.79,17 APR-DRG,6032,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,28486.09,17 APR-DRG,6033,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,35562.55,17 APR-DRG,6034,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,93253.38,17 APR-DRG,6071,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,21869.99,17 APR-DRG,6072,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,26682.06,17 APR-DRG,6073,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,37086.43,17 APR-DRG,6074,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,58508.53,17 APR-DRG,6081,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,13550.7,17 APR-DRG,6082,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,21593.41,17 APR-DRG,6083,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,28281.76,17 APR-DRG,6084,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION ,,,1157.0,71360.19,17 APR-DRG,6091,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,12762.44,17 APR-DRG,6092,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,13226.39,17 APR-DRG,6093,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,50876.67,17 APR-DRG,6094,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE ,,,1157.0,158162.52,17 APR-DRG,6111,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY ,,,1157.0,11038.71,17 APR-DRG,6112,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY ,,,1157.0,14756.95,17 APR-DRG,6113,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY ,,,1157.0,25208.6,17 APR-DRG,6114,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY ,,,1157.0,64364.03,17 APR-DRG,6121,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,12174.04,17 APR-DRG,6122,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,17281.86,17 APR-DRG,6123,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,24103.16,17 APR-DRG,6124,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,41240.49,17 APR-DRG,6131,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,9311.86,17 APR-DRG,6132,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,13687.2,17 APR-DRG,6133,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,23277.88,17 APR-DRG,6134,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,55449.63,17 APR-DRG,6141,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION ,,,1157.0,6823.52,17 APR-DRG,6142,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION ,,,1157.0,11092.25,17 APR-DRG,6143,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION ,,,1157.0,21020.63,17 APR-DRG,6144,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION ,,,1157.0,47524.69,17 APR-DRG,6211,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,4845.98,17 APR-DRG,6212,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,10301.31,17 APR-DRG,6213,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,23548.21,17 APR-DRG,6214,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,78760.07,17 APR-DRG,6221,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,7745.61,17 APR-DRG,6222,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,10912.46,17 APR-DRG,6223,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,13434.26,17 APR-DRG,6224,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER ,,,1157.0,20189.99,17 APR-DRG,6231,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,6226.2,17 APR-DRG,6232,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,9422.05,17 APR-DRG,6233,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,17115.47,17 APR-DRG,6234,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,38852.53,17 APR-DRG,6251,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,6835.13,17 APR-DRG,6252,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,9274.39,17 APR-DRG,6253,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,15329.74,17 APR-DRG,6254,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,41359.6,17 APR-DRG,6261,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBL ",,,826.68,1157.0,17 APR-DRG,6262,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBL ",,,1126.63,1380.67,17 APR-DRG,6263,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBL ",,,1157.0,3605.38,17 APR-DRG,6264,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBL ",,,1157.0,19206.34,17 APR-DRG,6301,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE ,,,1157.0,15805.27,17 APR-DRG,6302,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE ,,,1157.0,27148.67,17 APR-DRG,6303,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE ,,,1157.0,75211.36,17 APR-DRG,6304,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE ,,,1157.0,159576.66,17 APR-DRG,6311,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE ,,,1157.0,10964.21,17 APR-DRG,6312,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE ,,,1157.0,22471.77,17 APR-DRG,6313,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE ,,,1157.0,41696.4,17 APR-DRG,6314,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE ,,,1157.0,112625.66,17 APR-DRG,6331,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,1563.57,17 APR-DRG,6332,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,6096.39,17 APR-DRG,6333,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,16655.54,17 APR-DRG,6334,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY ,,,1157.0,59854.85,17 APR-DRG,6341,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MA ,,,1157.0,4314.23,17 APR-DRG,6342,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MA ,,,1157.0,7406.14,17 APR-DRG,6343,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MA ,,,1157.0,10308.45,17 APR-DRG,6344,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MA ,,,1157.0,30440.0,17 APR-DRG,6361,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,3298.45,17 APR-DRG,6362,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,5539.21,17 APR-DRG,6363,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,10461.91,17 APR-DRG,6364,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION ,,,1157.0,17889.45,17 APR-DRG,6391,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,3214.59,17 APR-DRG,6392,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,6615.2,17 APR-DRG,6393,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,11058.79,17 APR-DRG,6394,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION ,,,1157.0,20971.1,17 APR-DRG,6401,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM ",,,360.74,1157.0,17 APR-DRG,6402,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM ",,,613.37,1157.0,17 APR-DRG,6403,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM ",,,1157.0,2023.95,17 APR-DRG,6404,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM ",,,1157.0,21586.28,17 APR-DRG,6501,SPLENIC PROCEDURES ,,,1157.0,7361.07,17 APR-DRG,6502,SPLENIC PROCEDURES ,,,1157.0,10507.85,17 APR-DRG,6503,SPLENIC PROCEDURES ,,,1157.0,16076.51,17 APR-DRG,6504,SPLENIC PROCEDURES ,,,1157.0,24653.65,17 APR-DRG,6511,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,6287.31,17 APR-DRG,6512,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,8665.03,17 APR-DRG,6513,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,10442.73,17 APR-DRG,6514,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,48179.56,17 APR-DRG,6601,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULA ,,,1157.0,5790.36,17 APR-DRG,6602,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULA ,,,1157.0,5830.96,17 APR-DRG,6603,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULA ,,,1157.0,9452.84,17 APR-DRG,6604,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULA ,,,1157.0,38860.55,17 APR-DRG,6611,COAGULATION AND PLATELET DISORDERS ,,,1157.0,5389.32,17 APR-DRG,6612,COAGULATION AND PLATELET DISORDERS ,,,1157.0,5884.49,17 APR-DRG,6613,COAGULATION AND PLATELET DISORDERS ,,,1157.0,27290.99,17 APR-DRG,6614,COAGULATION AND PLATELET DISORDERS ,,,1157.0,33286.1,17 APR-DRG,6621,SICKLE CELL ANEMIA CRISIS ,,,1157.0,3026.78,17 APR-DRG,6622,SICKLE CELL ANEMIA CRISIS ,,,1157.0,4258.46,17 APR-DRG,6623,SICKLE CELL ANEMIA CRISIS ,,,1157.0,6822.64,17 APR-DRG,6624,SICKLE CELL ANEMIA CRISIS ,,,1157.0,17789.08,17 APR-DRG,6631,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,2687.75,17 APR-DRG,6632,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,3736.52,17 APR-DRG,6633,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,6134.3,17 APR-DRG,6634,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS ,,,1157.0,10397.23,17 APR-DRG,6801,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,10387.41,17 APR-DRG,6802,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,11860.88,17 APR-DRG,6803,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,26178.86,17 APR-DRG,6804,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,71563.16,17 APR-DRG,6811,"OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,11379.09,17 APR-DRG,6812,"OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,11976.41,17 APR-DRG,6813,"OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,25677.45,17 APR-DRG,6814,"OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS ",,,1157.0,96717.77,17 APR-DRG,6901,ACUTE LEUKEMIA ,,,1157.0,19815.26,17 APR-DRG,6902,ACUTE LEUKEMIA ,,,1157.0,23883.24,17 APR-DRG,6903,ACUTE LEUKEMIA ,,,1157.0,27950.76,17 APR-DRG,6904,ACUTE LEUKEMIA ,,,1157.0,63503.94,17 APR-DRG,6911,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA ",,,1157.0,6860.11,17 APR-DRG,6912,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA ",,,1157.0,8612.83,17 APR-DRG,6913,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA ",,,1157.0,17976.0,17 APR-DRG,6914,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA ",,,1157.0,34802.84,17 APR-DRG,6921,RADIOTHERAPY ,,,1157.0,6025.9,17 APR-DRG,6922,RADIOTHERAPY ,,,1157.0,10486.44,17 APR-DRG,6923,RADIOTHERAPY ,,,1157.0,15445.27,17 APR-DRG,6924,RADIOTHERAPY ,,,1157.0,28755.08,17 APR-DRG,6941,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR ,,,1157.0,3732.06,17 APR-DRG,6942,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR ,,,1157.0,5077.5,17 APR-DRG,6943,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR ,,,1157.0,7700.56,17 APR-DRG,6944,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR ,,,1157.0,34450.43,17 APR-DRG,6951,CHEMOTHERAPY FOR ACUTE LEUKEMIA ,,,1157.0,4771.03,17 APR-DRG,6952,CHEMOTHERAPY FOR ACUTE LEUKEMIA ,,,1157.0,5619.06,17 APR-DRG,6953,CHEMOTHERAPY FOR ACUTE LEUKEMIA ,,,1157.0,16814.8,17 APR-DRG,6954,CHEMOTHERAPY FOR ACUTE LEUKEMIA ,,,1157.0,49218.07,17 APR-DRG,6961,OTHER CHEMOTHERAPY ,,,1157.0,4417.71,17 APR-DRG,6962,OTHER CHEMOTHERAPY ,,,1157.0,6277.05,17 APR-DRG,6963,OTHER CHEMOTHERAPY ,,,1157.0,10684.51,17 APR-DRG,6964,OTHER CHEMOTHERAPY ,,,1157.0,18945.81,17 APR-DRG,7101,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE ,,,1157.0,5931.33,17 APR-DRG,7102,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE ,,,1157.0,8542.35,17 APR-DRG,7103,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE ,,,1157.0,14806.91,17 APR-DRG,7104,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE ,,,1157.0,35877.49,17 APR-DRG,7111,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE ",,,1157.0,7053.71,17 APR-DRG,7112,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE ",,,1157.0,9046.44,17 APR-DRG,7113,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE ",,,1157.0,16713.54,17 APR-DRG,7114,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE ",,,1157.0,30129.95,17 APR-DRG,7201,SEPTICEMIA AND DISSEMINATED INFECTIONS ,,,1157.0,2851.46,17 APR-DRG,7202,SEPTICEMIA AND DISSEMINATED INFECTIONS ,,,1157.0,4112.59,17 APR-DRG,7203,SEPTICEMIA AND DISSEMINATED INFECTIONS ,,,1157.0,6861.0,17 APR-DRG,7204,SEPTICEMIA AND DISSEMINATED INFECTIONS ,,,1157.0,16718.0,17 APR-DRG,7211,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS ",,,1157.0,3430.95,17 APR-DRG,7212,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS ",,,1157.0,4907.09,17 APR-DRG,7213,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS ",,,1157.0,8605.25,17 APR-DRG,7214,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS ",,,1157.0,17304.17,17 APR-DRG,7221,FEVER AND INFLAMMATORY CONDITIONS ,,,1157.0,1739.79,17 APR-DRG,7222,FEVER AND INFLAMMATORY CONDITIONS ,,,1157.0,2578.45,17 APR-DRG,7223,FEVER AND INFLAMMATORY CONDITIONS ,,,1157.0,4532.36,17 APR-DRG,7224,FEVER AND INFLAMMATORY CONDITIONS ,,,1157.0,5772.96,17 APR-DRG,7231,VIRAL ILLNESS ,,,1157.0,1948.56,17 APR-DRG,7232,VIRAL ILLNESS ,,,1157.0,2803.29,17 APR-DRG,7233,VIRAL ILLNESS ,,,1157.0,5869.76,17 APR-DRG,7234,VIRAL ILLNESS ,,,1157.0,34403.59,17 APR-DRG,7241,OTHER INFECTIOUS AND PARASITIC DISEASES ,,,1157.0,2906.34,17 APR-DRG,7242,OTHER INFECTIOUS AND PARASITIC DISEASES ,,,1157.0,3389.46,17 APR-DRG,7243,OTHER INFECTIOUS AND PARASITIC DISEASES ,,,1157.0,7157.65,17 APR-DRG,7244,OTHER INFECTIOUS AND PARASITIC DISEASES ,,,1157.0,18910.13,17 APR-DRG,7401,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,8721.67,17 APR-DRG,7402,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,9020.11,17 APR-DRG,7403,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,17607.51,17 APR-DRG,7404,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE ,,,1157.0,31064.97,17 APR-DRG,7501,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS ,,,1157.0,2467.38,17 APR-DRG,7502,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS ,,,1157.0,2865.29,17 APR-DRG,7503,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS ,,,1157.0,4387.83,17 APR-DRG,7504,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS ,,,1157.0,15500.59,17 APR-DRG,7511,DEPRESSIVE DISORDERS ,,,1157.0,1772.35,17 APR-DRG,7512,DEPRESSIVE DISORDERS ,,,1157.0,2135.48,17 APR-DRG,7513,DEPRESSIVE DISORDERS ,,,1157.0,3364.47,17 APR-DRG,7514,DEPRESSIVE DISORDERS ,,,1157.0,4593.48,17 APR-DRG,7521,PERSONALITY DISORDERS ,,,1157.0,2052.5,17 APR-DRG,7522,PERSONALITY DISORDERS ,,,1157.0,2450.42,17 APR-DRG,7523,PERSONALITY DISORDERS ,,,1157.0,6042.85,17 APR-DRG,7524,PERSONALITY DISORDERS ,,,1157.0,16483.8,17 APR-DRG,7531,BIPOLAR DISORDERS ,,,1157.0,2143.5,17 APR-DRG,7532,BIPOLAR DISORDERS ,,,1157.0,2654.74,17 APR-DRG,7533,BIPOLAR DISORDERS ,,,1157.0,5342.04,17 APR-DRG,7534,BIPOLAR DISORDERS ,,,1157.0,12299.84,17 APR-DRG,7541,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER ,,,1157.0,1496.21,17 APR-DRG,7542,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER ,,,1157.0,2105.14,17 APR-DRG,7543,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER ,,,1157.0,3783.36,17 APR-DRG,7544,DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER ,,,1157.0,10922.29,17 APR-DRG,7551,ADJUSTMENT DISORDERS ,,,1150.29,1409.67,17 APR-DRG,7552,ADJUSTMENT DISORDERS ,,,1157.0,2334.88,17 APR-DRG,7553,ADJUSTMENT DISORDERS ,,,1157.0,5174.3,17 APR-DRG,7554,ADJUSTMENT DISORDERS ,,,1157.0,9849.41,17 APR-DRG,7561,ACUTE ANXIETY AND STRESS SYNDROMES ,,,1157.0,2539.2,17 APR-DRG,7562,ACUTE ANXIETY AND STRESS SYNDROMES ,,,1157.0,3231.54,17 APR-DRG,7563,ACUTE ANXIETY AND STRESS SYNDROMES ,,,1157.0,4864.71,17 APR-DRG,7564,ACUTE ANXIETY AND STRESS SYNDROMES ,,,1157.0,5704.26,17 APR-DRG,7571,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES ,,,1157.0,1956.14,17 APR-DRG,7572,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES ,,,1157.0,5734.15,17 APR-DRG,7573,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES ,,,1157.0,8127.02,17 APR-DRG,7574,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES ,,,1157.0,18326.19,17 APR-DRG,7581,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT ,,,1151.02,1410.56,17 APR-DRG,7582,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT ,,,1157.0,2145.29,17 APR-DRG,7583,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT ,,,1157.0,2238.07,17 APR-DRG,7584,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT ,,,1157.0,9177.59,17 APR-DRG,7591,EATING DISORDERS ,,,1157.0,6872.6,17 APR-DRG,7592,EATING DISORDERS ,,,1157.0,8554.39,17 APR-DRG,7593,EATING DISORDERS ,,,1157.0,16922.75,17 APR-DRG,7594,EATING DISORDERS ,,,1157.0,24711.2,17 APR-DRG,7601,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS ,,,1157.0,2164.91,17 APR-DRG,7602,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS ,,,1157.0,5235.86,17 APR-DRG,7603,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS ,,,1157.0,8147.55,17 APR-DRG,7604,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS ,,,1157.0,11059.24,17 APR-DRG,7701,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE ",,,1157.0,1517.19,17 APR-DRG,7702,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE ",,,1157.0,2028.41,17 APR-DRG,7703,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE ",,,1157.0,3233.78,17 APR-DRG,7704,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE ",,,1157.0,7512.75,17 APR-DRG,7721,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY ,,,1157.0,1679.11,17 APR-DRG,7722,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY ,,,1157.0,1990.05,17 APR-DRG,7723,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY ,,,1157.0,2542.76,17 APR-DRG,7724,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY ,,,1157.0,14551.74,17 APR-DRG,7731,OPIOID ABUSE AND DEPENDENCE ,,,1118.26,1370.41,17 APR-DRG,7732,OPIOID ABUSE AND DEPENDENCE ,,,1157.0,2226.04,17 APR-DRG,7733,OPIOID ABUSE AND DEPENDENCE ,,,1157.0,3608.05,17 APR-DRG,7734,OPIOID ABUSE AND DEPENDENCE ,,,1157.0,10878.11,17 APR-DRG,7741,COCAINE ABUSE AND DEPENDENCE ,,,1157.0,1497.11,17 APR-DRG,7742,COCAINE ABUSE AND DEPENDENCE ,,,1157.0,2495.48,17 APR-DRG,7743,COCAINE ABUSE AND DEPENDENCE ,,,1157.0,3662.91,17 APR-DRG,7744,COCAINE ABUSE AND DEPENDENCE ,,,1157.0,9567.04,17 APR-DRG,7751,ALCOHOL ABUSE AND DEPENDENCE ,,,1157.0,2270.2,17 APR-DRG,7752,ALCOHOL ABUSE AND DEPENDENCE ,,,1157.0,3068.71,17 APR-DRG,7753,ALCOHOL ABUSE AND DEPENDENCE ,,,1157.0,5399.14,17 APR-DRG,7754,ALCOHOL ABUSE AND DEPENDENCE ,,,1157.0,9856.55,17 APR-DRG,7761,OTHER DRUG ABUSE AND DEPENDENCE ,,,1157.0,1789.3,17 APR-DRG,7762,OTHER DRUG ABUSE AND DEPENDENCE ,,,1157.0,2720.31,17 APR-DRG,7763,OTHER DRUG ABUSE AND DEPENDENCE ,,,1157.0,5144.86,17 APR-DRG,7764,OTHER DRUG ABUSE AND DEPENDENCE ,,,1157.0,9992.61,17 APR-DRG,7921,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,7786.65,17 APR-DRG,7922,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,12506.38,17 APR-DRG,7923,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,25776.04,17 APR-DRG,7924,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,49433.1,17 APR-DRG,7931,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,4406.56,17 APR-DRG,7932,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,8206.88,17 APR-DRG,7933,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,20581.66,17 APR-DRG,7934,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,26916.71,17 APR-DRG,7941,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,3361.35,17 APR-DRG,7942,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,6128.06,17 APR-DRG,7943,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,8546.8,17 APR-DRG,7944,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,16771.09,17 APR-DRG,8101,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION ,,,1157.0,2158.22,17 APR-DRG,8102,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION ,,,1157.0,4084.93,17 APR-DRG,8103,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION ,,,1157.0,6215.05,17 APR-DRG,8104,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION ,,,1157.0,28566.82,17 APR-DRG,8111,ALLERGIC REACTIONS ,,,1157.0,1718.81,17 APR-DRG,8112,ALLERGIC REACTIONS ,,,1157.0,3179.35,17 APR-DRG,8113,ALLERGIC REACTIONS ,,,1157.0,5825.6,17 APR-DRG,8114,ALLERGIC REACTIONS ,,,1157.0,9798.56,17 APR-DRG,8121,POISONING OF MEDICINAL AGENTS ,,,1157.0,1895.92,17 APR-DRG,8122,POISONING OF MEDICINAL AGENTS ,,,1157.0,2826.04,17 APR-DRG,8123,POISONING OF MEDICINAL AGENTS ,,,1157.0,4255.34,17 APR-DRG,8124,POISONING OF MEDICINAL AGENTS ,,,1157.0,8786.81,17 APR-DRG,8131,OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,3449.24,17 APR-DRG,8132,OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,4291.47,17 APR-DRG,8133,OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,6862.34,17 APR-DRG,8134,OTHER COMPLICATIONS OF TREATMENT ,,,1157.0,18079.49,17 APR-DRG,8151,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES ",,,1157.0,2493.25,17 APR-DRG,8152,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES ",,,1157.0,3797.64,17 APR-DRG,8153,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES ",,,1157.0,8852.39,17 APR-DRG,8154,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES ",,,1157.0,29044.15,17 APR-DRG,8161,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES ,,,1157.0,4351.69,17 APR-DRG,8162,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES ,,,1157.0,7054.16,17 APR-DRG,8163,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES ,,,1157.0,7908.44,17 APR-DRG,8164,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES ,,,1157.0,8762.71,17 APR-DRG,8171,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE ,,,1157.0,2193.03,17 APR-DRG,8172,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE ,,,1157.0,2749.31,17 APR-DRG,8173,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE ,,,1157.0,4299.5,17 APR-DRG,8174,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE ,,,1157.0,9336.4,17 APR-DRG,8411,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT ,,,1157.0,31702.45,17 APR-DRG,8412,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT ,,,1157.0,31950.93,17 APR-DRG,8413,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT ,,,1157.0,49167.66,17 APR-DRG,8414,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT ,,,1157.0,113761.88,17 APR-DRG,8421,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS ,,,1157.0,6490.29,17 APR-DRG,8422,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS ,,,1157.0,9836.04,17 APR-DRG,8423,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS ,,,1157.0,18891.84,17 APR-DRG,8424,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS ,,,1157.0,38808.81,17 APR-DRG,8431,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT ,,,1157.0,3396.15,17 APR-DRG,8432,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT ,,,1157.0,6306.5,17 APR-DRG,8433,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT ,,,1157.0,7586.35,17 APR-DRG,8434,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT ,,,1157.0,21052.74,17 APR-DRG,8441,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT ,,,1157.0,2590.05,17 APR-DRG,8442,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT ,,,1157.0,3847.15,17 APR-DRG,8443,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT ,,,1157.0,6370.74,17 APR-DRG,8444,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT ,,,1157.0,18298.53,17 APR-DRG,8501,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEAL ",,,1157.0,8498.63,17 APR-DRG,8502,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEAL ",,,1157.0,15152.19,17 APR-DRG,8503,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEAL ",,,1157.0,23121.3,17 APR-DRG,8504,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEAL ",,,1157.0,109658.66,17 APR-DRG,8601,REHABILITATION ,,,1157.0,3811.91,17 APR-DRG,8602,REHABILITATION ,,,1157.0,5489.25,17 APR-DRG,8603,REHABILITATION ,,,1157.0,8000.77,17 APR-DRG,8604,REHABILITATION ,,,1157.0,12473.36,17 APR-DRG,8611,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS ",,,1157.0,2268.86,17 APR-DRG,8612,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS ",,,1157.0,3655.34,17 APR-DRG,8613,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS ",,,1157.0,6943.98,17 APR-DRG,8614,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS ",,,1157.0,14148.91,17 APR-DRG,8621,OTHER AFTERCARE AND CONVALESCENCE ,,,1157.0,6463.98,17 APR-DRG,8622,OTHER AFTERCARE AND CONVALESCENCE ,,,1157.0,8733.27,17 APR-DRG,8623,OTHER AFTERCARE AND CONVALESCENCE ,,,1157.0,13052.4,17 APR-DRG,8624,OTHER AFTERCARE AND CONVALESCENCE ,,,1157.0,19420.91,17 APR-DRG,8631,NEONATAL AFTERCARE ,,,1157.0,4337.86,17 APR-DRG,8632,NEONATAL AFTERCARE ,,,1157.0,11546.82,17 APR-DRG,8633,NEONATAL AFTERCARE ,,,1157.0,17617.34,17 APR-DRG,8634,NEONATAL AFTERCARE ,,,1157.0,75940.73,17 APR-DRG,8901,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS ,,,1157.0,5161.81,17 APR-DRG,8902,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS ,,,1157.0,5585.6,17 APR-DRG,8903,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS ,,,1157.0,9792.76,17 APR-DRG,8904,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS ,,,1157.0,20671.77,17 APR-DRG,8921,HIV WITH MAJOR HIV RELATED CONDITION ,,,1157.0,3732.51,17 APR-DRG,8922,HIV WITH MAJOR HIV RELATED CONDITION ,,,1157.0,4661.74,17 APR-DRG,8923,HIV WITH MAJOR HIV RELATED CONDITION ,,,1157.0,7250.89,17 APR-DRG,8924,HIV WITH MAJOR HIV RELATED CONDITION ,,,1157.0,10983.84,17 APR-DRG,8931,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS ,,,1157.0,3237.79,17 APR-DRG,8932,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS ,,,1157.0,4647.46,17 APR-DRG,8933,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS ,,,1157.0,6482.26,17 APR-DRG,8934,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS ,,,1157.0,12190.1,17 APR-DRG,8941,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS ,,,1157.0,4018.9,17 APR-DRG,8942,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS ,,,1157.0,4682.25,17 APR-DRG,8943,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS ,,,1157.0,6831.56,17 APR-DRG,8944,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS ,,,1157.0,8981.3,17 APR-DRG,9101,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,15227.14,17 APR-DRG,9102,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,15771.38,17 APR-DRG,9103,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,20645.9,17 APR-DRG,9104,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,54303.15,17 APR-DRG,9111,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,8277.36,17 APR-DRG,9112,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,9246.29,17 APR-DRG,9113,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,17224.76,17 APR-DRG,9114,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,46006.16,17 APR-DRG,9121,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,12526.01,17 APR-DRG,9122,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,13076.49,17 APR-DRG,9123,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,19914.3,17 APR-DRG,9124,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ,,,1157.0,44134.34,17 APR-DRG,9301,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE ,,,1157.0,5217.13,17 APR-DRG,9302,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE ,,,1157.0,7306.65,17 APR-DRG,9303,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE ,,,1157.0,9395.74,17 APR-DRG,9304,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE ,,,1157.0,22534.68,17 APR-DRG,9501,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,7680.92,17 APR-DRG,9502,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,11552.17,17 APR-DRG,9503,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,18677.71,17 APR-DRG,9504,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,52690.95,17 APR-DRG,9511,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,5138.16,17 APR-DRG,9512,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,7703.67,17 APR-DRG,9513,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,15355.61,17 APR-DRG,9514,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,36746.05,17 APR-DRG,9521,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,5718.54,17 APR-DRG,9522,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,7676.02,17 APR-DRG,9523,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,22386.57,17 APR-DRG,9524,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS ,,,1157.0,46430.4,17 CDM,100004,CMPNT KN SZ4,47048.0,47048.0,6116.24,39990.8,28 CDM,100005,BMP TOTAL CALCIUM,2156.23,2156.23,129.37,1832.8,14 CDM,100005,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",2156.23,2156.23,8.29,58.19,80 CDM,100006,BASIC METABOLIC CALC ION,2325.0,2325.0,139.5,1976.25,14 CDM,100007,DEVICE WNDCLS 45CM SZ0,1905.5,1905.5,114.33,1619.67,49 CDM,100008,DEVICE WNDCLS 45CM SZ2,1891.5,1891.5,113.49,1607.78,49 CDM,100015,HEPATIC FUNCTION PANEL,2201.0,2201.0,132.06,1870.85,14 CDM,100015,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",2201.0,2201.0,6.01,56.2,80 CDM,100018,CANNULA PRFSN SAPH VEIN,627.0,627.0,37.62,532.95,49 CDM,100019,STENT EPRSTH 5CM 13MM,88865.0,88865.0,11552.45,75535.25,28 CDM,100020,STENT EPRSTH 5CM 11MM,88865.0,88865.0,11552.45,75535.25,28 CDM,100021,STENT EPRSTH 10CM 10MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100026,DEVICE UNIT SUT FASTNER,10092.0,10092.0,1311.96,8578.2,28 CDM,100031,SCREW BN CORT 30MMX4.5MM,2135.0,2135.0,277.55,1814.75,28 CDM,100032,SCREW BN 4.5MM 28M,2135.0,2135.0,277.55,1814.75,28 CDM,100033,INSERT TIB KN BRNG 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,100041,SCREW BN 4.5MM 28MM,6676.0,6676.0,867.88,5674.6,28 CDM,100042,SCREW BN 4.5MM 64MM,6676.0,6676.0,867.88,5674.6,28 CDM,100053,CAROTID ART STNT COM/INN,30038.23,30038.23,1802.29,25532.5,37 CDM,100056,CAROTID ART STENT W/ DEP,30038.23,30038.23,1802.29,25532.5,37 CDM,100059,CATH BLNDIL 2MM 120MM,6303.5,6303.5,378.21,5357.98,49 CDM,100060,CELL CT&DIFF BODY FL,840.0,840.0,50.4,714.0,14 CDM,100061,URETEROSCOPE FLEX DISP,38517.5,38517.5,2311.05,32739.88,49 CDM,100067,STENT VNS 14X40MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,100068,DIALYSIS CIRC INTRV STNT,29707.65,29707.65,1782.46,25251.5,37 CDM,100071,SHEATH GD 5FR 90CM,4244.5,4244.5,254.67,3607.82,49 CDM,100076,COIL EMBL 40CM 18MM,29105.0,29105.0,3783.65,24739.25,28 CDM,100077,MCTH INFS 3-2.4FR 150CM,10423.5,10423.5,625.41,8859.98,49 CDM,100078,COIL EMBL INTL 50CM 18CM,22475.0,22475.0,2921.75,19103.75,28 CDM,100079,COIL EMBL INTL 50CM 20CM,22475.0,22475.0,2921.75,19103.75,28 CDM,100080,CERULOPLASMIN,564.0,564.0,33.84,479.4,14 CDM,100080,Ceruloplasmin ,564.0,564.0,9.02,73.85,80 CDM,100081,COIL EMBL SM 60CM 22MM,22475.0,22475.0,2921.75,19103.75,28 CDM,100086,KIT NRSTM LD LF45 30.5CM,3495.0,3495.0,454.35,2970.75,28 CDM,100087,KIT NRSTM LD PNE 30.5CM,2135.0,2135.0,277.55,1814.75,28 CDM,100093,CANNULA GREEN 8.5X72MM,1441.5,1441.5,86.49,1225.28,49 CDM,100097,CATH PLM ART SEG/SUB,3312.47,3312.47,198.75,2815.6,34 CDM,100098,NDL/INCATH EXT ART,1903.85,1903.85,114.23,1618.27,37 CDM,100099,DIALYSIS CIRC THRMB,15377.15,15377.15,922.63,13070.58,37 CDM,100100,DIALYSIS CIRC THRMB/BLN,29707.65,29707.65,1782.46,25251.5,37 CDM,100103,KIT HRTMT 3 CONTROLLER,100000.0,100000.0,6000.0,85000.0,43 CDM,100103,"Microprocessor control unit for use with electric ventricular assist device, replacement only ",100000.0,100000.0,17628.24,38674.2,45 CDM,100105,SCREW BN 3.5MM 6MM 36MM,897.0,897.0,116.61,762.45,28 CDM,100108,SURG NRV STIM DISP,17431.0,17431.0,1045.86,14816.35,49 CDM,100124,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,100125,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,100127,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,100134,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,100136,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,100137,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,100155,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100156,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100157,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100161,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100162,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100164,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100176,IV CONCURRENT INFUSION,138.08,138.08,8.28,117.37,44 CDM,100180,CHLORIDE BLD,597.0,597.0,35.82,507.45,14 CDM,100180,Chloride; blood ,597.0,597.0,3.86,31.68,80 CDM,100186,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100188,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100189,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100192,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100193,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100194,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100196,IVP SINGLE/INITIAL DRUG,339.57,339.57,20.37,288.63,39 CDM,100198,IVP SINGLE/INITIAL DRUG,339.57,339.57,20.37,288.63,39 CDM,100200,CHLORIDE UR,467.0,467.0,28.02,396.95,14 CDM,100200,Chloride; urine ,467.0,467.0,4.83,39.55,80 CDM,100202,INJECTION IM OR SQ,329.65,329.65,19.78,280.2,39 CDM,100220,IV EACH ADD HOUR,201.55,201.55,12.09,171.32,39 CDM,100221,IV EACH ADD HOUR,201.55,201.55,12.09,171.32,39 CDM,100229,IV INITIAL UP TO 1 HOUR,624.69,624.69,37.48,530.99,39 CDM,100236,SCREW BN 3.5MM 12MM,1778.0,1778.0,231.14,1511.3,28 CDM,100250,CATH BLNDIL 8MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,100251,INSERT TIB KN ONLAY SZ4,14331.0,14331.0,1863.03,12181.35,28 CDM,100253,GRAFT CV 14MM 20CM,57116.0,57116.0,7425.08,48548.6,28 CDM,100254,REM TUN INTRAPERIT CATH,8081.89,8081.89,484.91,6869.61,37 CDM,100260,GRAFT EVAS 28.5MM 3.3CM,95753.0,95753.0,12447.89,81390.05,28 CDM,100261,STENT 20FR 31X31MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,100262,STENT EPRSTH 7.5MM 5.0CM,100000.0,100000.0,13000.0,85000.0,28 CDM,100269,STENT BIL 6FR 4MM 15MM,41503.0,41503.0,5395.39,35277.55,28 CDM,100270,STENT BIL 6FR 6MM 14MM,41503.0,41503.0,5395.39,35277.55,28 CDM,100271,STENT BIL 6FR 7MM 15MM,41503.0,41503.0,5395.39,35277.55,28 CDM,100272,STENT BIL 6FR 4MM 19MM,26949.0,26949.0,3503.37,22906.65,28 CDM,100273,STENT BIL 7FR 7MM 19MM,38429.0,38429.0,4995.77,32664.65,28 CDM,100274,STENT BIL 6FR 10MM 57MM,44478.0,44478.0,5782.14,37806.3,28 CDM,100275,STENT BIL 6FR 7MM 57MM,38846.0,38846.0,5049.98,33019.1,28 CDM,100276,STENT BIL 6FR 8MM 57MM,38846.0,38846.0,5049.98,33019.1,28 CDM,100278,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,100279,CATH BLNDIL 4MM 220MM,6303.5,6303.5,378.21,5357.98,49 CDM,100280,CATH BLNDIL 8MM 40MM,9943.0,9943.0,596.58,8451.55,49 CDM,100281,CATH BLNDIL 8MM 60MM,7714.0,7714.0,462.84,6556.9,49 CDM,100282,CATH BLNDIL 8MM 80MM,7714.0,7714.0,462.84,6556.9,49 CDM,100283,CATH BLNDIL 1.5MM 20MM,12721.5,12721.5,763.29,10813.27,49 CDM,100284,CATH BLNDIL 145CM 40MM,6452.0,6452.0,387.12,5484.2,49 CDM,100285,CATH BLNDIL 145CM 40MM,10212.5,10212.5,612.75,8680.63,49 CDM,100287,CATH BLNDIL 144CM 20MM,10212.5,10212.5,612.75,8680.63,49 CDM,100288,CATH BLNDIL 145CM 40MM,6452.0,6452.0,387.12,5484.2,49 CDM,100289,CATH BLNDIL 5MM 120MM,5478.5,5478.5,328.71,4656.73,49 CDM,100291,CATH BLNDIL 6MM 80MM,5719.0,5719.0,343.14,4861.15,49 CDM,100293,CATH BLNDIL 6MM 120MM,7049.0,7049.0,422.94,5991.65,49 CDM,100294,CATH BLNDIL 7MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,100295,CATH BLNDIL 7MM 120MM,5478.5,5478.5,328.71,4656.73,49 CDM,100297,CATH BLNDIL 2MM 80MM,6303.5,6303.5,378.21,5357.98,49 CDM,100300,CMV IGG QUAL,1175.0,1175.0,70.5,998.75,14 CDM,100305,KIT GSTRMY 20FR 6.7MM,2990.5,2990.5,179.43,2541.93,49 CDM,100306,DEVICE WNDCLS 23CM SZ2,1715.5,1715.5,102.93,1458.17,49 CDM,100307,CATH BLNDIL 2MM 120MM,15846.5,15846.5,950.79,13469.52,49 CDM,100308,CATH BLNDIL 2MM 150MM,6968.5,6968.5,418.11,5923.23,49 CDM,100309,CATH BLNDIL 2MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,100310,"Antibody; cytomegalovirus (CMV), IgM ",1175.0,1175.0,14.15,115.93,80 CDM,100310,CMV IGM QUAL,1175.0,1175.0,70.5,998.75,14 CDM,100312,CATH BLNDIL 2.5MM 120MM,11970.0,11970.0,718.2,10174.5,49 CDM,100313,CATH BLNDIL 2.5MM 220MM,6968.5,6968.5,418.11,5923.23,49 CDM,100315,CATH BLNDIL 3MM 120MM,6319.5,6319.5,379.17,5371.57,49 CDM,100316,CATH BLNDIL 3MM 150MM,11970.0,11970.0,718.2,10174.5,49 CDM,100317,CATH BLNDIL 3MM 220MM,15846.5,15846.5,950.79,13469.52,49 CDM,100318,CATH BLNDIL 3.5MM 80MM,6319.5,6319.5,379.17,5371.57,49 CDM,100319,CATH BLNDIL 3.5MM 120MM,15846.5,15846.5,950.79,13469.52,49 CDM,100320,CMV AMP PROBE,1041.0,1041.0,62.46,884.85,14 CDM,100320,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",1041.0,1041.0,29.48,241.36,80 CDM,100321,CATH BLNDIL 3.5MM 150MM,15846.5,15846.5,950.79,13469.52,49 CDM,100322,CATH BLNDIL 3.5MM 220MM,15846.5,15846.5,950.79,13469.52,49 CDM,100323,CATH BLNDIL 4MM 80MM,6319.5,6319.5,379.17,5371.57,49 CDM,100324,CATH BLNDIL 4MM 150MM,6452.0,6452.0,387.12,5484.2,49 CDM,100326,CATH BLNDIL 4MM 220MM,11970.0,11970.0,718.2,10174.5,49 CDM,100327,CATH BLNDIL 2MM 150MM,6303.5,6303.5,378.21,5357.98,49 CDM,100328,CATH BLNDIL 2.5MM 120MM,6319.5,6319.5,379.17,5371.57,49 CDM,100329,CATH BLNDIL 2.5MM 150MM,6303.5,6303.5,378.21,5357.98,49 CDM,100330,CATH BLNDIL 3MM 120MM,6303.5,6303.5,378.21,5357.98,49 CDM,100331,CATH BLNDIL 3MM 150MM,6303.5,6303.5,378.21,5357.98,49 CDM,100332,CATH BLNDIL 3.5MM 120MM,6319.5,6319.5,379.17,5371.57,49 CDM,100333,CATH BLNDIL 3.5MM 150MM,15846.5,15846.5,950.79,13469.52,49 CDM,100334,CATH BLNDIL 4MM 120MM,6303.5,6303.5,378.21,5357.98,49 CDM,100335,CATH BLNDIL 4MM 150MM,6303.5,6303.5,378.21,5357.98,49 CDM,100338,STENT COR 4.00X48MM,22297.0,22297.0,2898.61,18952.45,28 CDM,100339,OCCULDER CV 230X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100340,Antibody; Coccidioides ,1091.96,1091.96,9.63,78.92,80 CDM,100340,COCCIDIOID AB QUAL,1091.96,1091.96,65.52,928.17,14 CDM,100342,CATH BLNDIL 5MM 15MM,5247.0,5247.0,314.82,4459.95,49 CDM,100343,STENT VSC 10X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,100344,CATH BLNDIL 4X20MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,100345,CATH BLNDIL 4X20MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,100346,CATH BLNDIL 7X40MM 135CM,3973.0,3973.0,238.38,3377.05,49 CDM,100349,PLATE BN 3HL73X2.7/3.5MM,19633.0,19633.0,2552.29,16688.05,28 CDM,100354,KIT DLV FILTER EMBL JUG,57400.0,57400.0,7462.0,48790.0,28 CDM,100357,BAG EQUIP SHOWER,16114.0,16114.0,966.84,13696.9,27 CDM,100357,"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only ",16114.0,16114.0,619.58,1359.27,45 CDM,100358,DEVICE VNTRC ASST HLSTR,14127.0,14127.0,847.62,12007.95,27 CDM,100359,BAG FOR POCK CONTROLLER,11339.0,11339.0,680.34,9638.15,27 CDM,100360,COMPLEMENT C3,467.0,467.0,28.02,396.95,14 CDM,100362,BAG EQUIP CONSOLIDATION,11634.0,11634.0,698.04,9888.9,27 CDM,100363,VEST HOLSTER SMALL,13769.0,13769.0,826.14,11703.65,27 CDM,100364,VEST HOLSTER MEDIUM,14127.0,14127.0,847.62,12007.95,27 CDM,100365,VEST HOLSTER LG,13769.0,13769.0,826.14,11703.65,27 CDM,100367,INTRO OC-135 9FR 47CM,14438.0,14438.0,866.28,12272.3,49 CDM,100370,COMPLEMENT C4,467.0,467.0,28.02,396.95,14 CDM,100371,CABLE MODULAR LVAD DVC,100000.0,100000.0,6000.0,85000.0,33 CDM,100373,KIT HRT IMPLANT LVAS,100000.0,100000.0,13000.0,85000.0,28 CDM,100374,"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only ",34429.0,34429.0,567.9,1245.9,45 CDM,100374,DEVICE VNTRC ASST BTRY,34429.0,34429.0,2065.74,29264.65,27 CDM,100375,BATTERY REPL LVAD,17761.0,17761.0,1065.66,15096.85,27 CDM,100376,"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only ",100000.0,100000.0,5067.43,11117.33,45 CDM,100376,DEVICE VNTRC ASST BTRY,100000.0,100000.0,6000.0,85000.0,27 CDM,100379,MODULE POWER UNIT,100000.0,100000.0,6000.0,85000.0,27 CDM,100379,"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only ",100000.0,100000.0,14527.03,31870.52,45 CDM,100380,COMPLEMENT TOT CH50,658.0,658.0,39.48,559.3,14 CDM,100380,Complement; total hemolytic (CH50) ,658.0,658.0,17.07,139.73,80 CDM,100387,REVSC LOW EXTR IVL ANGIO,27679.65,27679.65,1660.78,23527.7,37 CDM,100390,DIRECT COOMBS AHG EA,513.01,513.01,30.78,436.06,15 CDM,100396,SCREW BN 3.5X16MM,4713.0,4713.0,612.69,4006.05,28 CDM,100398,COGSKLS DVLMNT EA15M SP,208.5,208.5,12.51,177.22,20 CDM,100398,"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage t",208.5,208.5,20.72,120.8,62 CDM,100399,COGSKLS DVLMNT INT15M SP,547.96,547.96,32.88,465.77,20 CDM,100399,"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage t",547.96,547.96,19.49,126.47,105 CDM,100400,COPPER BLD,651.0,651.0,39.06,553.35,14 CDM,100403,WIRE CAP SFX 1.1MM 9 IN,26985.0,26985.0,1619.1,22937.25,49 CDM,100409,CATH BLNDIL 26X4.5X110,21508.5,21508.5,1290.51,18282.22,49 CDM,100410,COPPER URINE,625.1,625.1,37.51,531.34,14 CDM,100412,CATH BLNDIL 1.25MM 10MM,2905.5,2905.5,174.33,2469.68,49 CDM,100413,TUBE ENDBR BLCKR 7F 65CM,8522.0,8522.0,511.32,7243.7,49 CDM,100414,SET INTRO 8-14FR 14CM,6106.0,6106.0,366.36,5190.1,49 CDM,100415,SHEATH INTRO 6FR 15.5CM,2905.5,2905.5,174.33,2469.68,49 CDM,100416,INTRODUCER 10FR 45CM,2969.0,2969.0,178.14,2523.65,49 CDM,100417,INTRO SHTH 12F 45CM,2969.0,2969.0,178.14,2523.65,49 CDM,100419,TUBE TRCH CUF 100X12.3X7,2905.5,2905.5,174.33,2469.68,49 CDM,100421,CRT DEFIB CARD 71X51X12,100000.0,100000.0,13000.0,85000.0,28 CDM,100423,CATH SET 6F 135MM,79654.5,79654.5,4779.27,67706.32,49 CDM,100424,CATH SET 6FR 110CM,89361.0,89361.0,5361.66,75956.85,49 CDM,100427,CATH SET 8FR 110CM,79654.5,79654.5,4779.27,67706.32,49 CDM,100429,CATH SET 8F 85CM,82740.0,82740.0,4964.4,70329.0,49 CDM,100431,GWIRE 0.018IN 320CM,23110.5,23110.5,1386.63,19643.92,49 CDM,100450,CORTISOL TOTAL,1565.0,1565.0,93.9,1330.25,14 CDM,100451,CORTISOL TOTAL AM,1565.0,1565.0,93.9,1330.25,14 CDM,100452,CORTISOL TOTAL PM,1565.0,1565.0,93.9,1330.25,14 CDM,100456,STENT COVRD 8MM 80MM,85476.0,85476.0,11111.88,72654.6,28 CDM,100459,STENT COVRD 7MM 60MM,82423.0,82423.0,10714.99,70059.55,28 CDM,100461,CATH DBC 8X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 CDM,100462,CANNULA PRFS 23FR .038IN,17607.0,17607.0,1056.42,14965.95,49 CDM,100472,KIT CUFF MINI APICAL,17863.0,17863.0,1071.78,15183.55,49 CDM,100473,PATCH CV .1MM 20X15CM,59498.0,59498.0,7734.74,50573.3,28 CDM,100476,CORD AC PWR MOBILE UNIT,2034.0,2034.0,122.04,1728.9,27 CDM,100476,"Monitor control cable for use with electric ventricular assist device, replacement only ",2034.0,2034.0,426.48,935.64,45 CDM,100480,CREAT KINASE (CK) TOTAL,1009.0,1009.0,60.54,857.65,14 CDM,100480,"Creatine kinase (CK), (CPK); total ",1009.0,1009.0,5.47,44.8,80 CDM,100489,CREATININE BLD,604.0,604.0,36.24,513.4,14 CDM,100489,Creatinine; blood ,604.0,604.0,4.3,35.2,80 CDM,100490,CREATININE CLEARANCE,981.0,981.0,58.86,833.85,14 CDM,100490,Creatinine; clearance ,981.0,981.0,7.95,65.07,80 CDM,100510,CREATININE UR,675.0,675.0,40.5,573.75,14 CDM,100511,BUPROPION XL 300 MG PO,45.21,45.21,2.71,38.43,30 CDM,100512,BUPROPION XL 150 MG PO,30.93,30.93,1.86,26.29,30 CDM,100513,CMPD TACROL 0.5MG/ML PO,16.65,16.65,1.0,14.15,46 CDM,100540,CROSSMATCH IMM SPIN,265.0,265.0,15.9,225.25,23 CDM,100540,Compatibility test each unit; immediate spin technique ,265.0,265.0,140.77,457.76,20 CDM,100550,CRYOGLOBULINS QL SQN,410.15,410.15,24.61,348.63,14 CDM,100550,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",410.15,410.15,5.43,44.53,80 CDM,100580,CRYSTALS BODY FL,597.0,597.0,35.82,507.45,14 CDM,100580,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",597.0,597.0,6.16,50.41,80 CDM,1006,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",2545.27,2545.27,272.65,2232.45,78 CDM,1006,EGFR COMMON VARIANTS,2545.27,2545.27,152.72,2163.48,15 CDM,100600,AFB CONCENTRATION,1476.0,1476.0,88.56,1254.6,14 CDM,100610,CULTURE ANAEROBIC,1510.02,1510.02,90.6,1283.52,14 CDM,100610,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",1510.02,1510.02,7.95,65.16,80 CDM,100624,STENT COR 2.5MM 23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100625,STENT COR 2.25MM 8MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100626,STENT COR RX 2.25X12MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100627,STENT COR 2.25MM 15MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100628,STENT COR 2.25MM 18MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100629,STENT COR 2.25MM 23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100631,STENT COR 2.25MM 28MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100632,STENT COR 2.25MM 33MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100633,STENT COR 2.25MM 38MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100634,STENT COR 2.5MM 8MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100635,STENT COR 2.5MM 12MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100636,STENT COR 2.5MM 15MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100637,STENT COR 2.5MM 18MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100638,STENT COR 2.5MM 28MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100639,STENT COR 2.5MM 33MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100640,CULTURE BLOOD,1492.0,1492.0,89.52,1268.2,14 CDM,100640,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",1492.0,1492.0,8.67,70.95,80 CDM,100641,STENT COR 2.5MM 38MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100642,STENT COR 2.75MM 8MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100643,STENT COR 2.75MM 12MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100644,STENT COR 2.75MM 15MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100645,STENT COR 2.75MM 18MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100646,STENT COR 2.75MM 23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100647,STENT COR 2.75MM 28MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100648,STENT COR 2.75MM 33MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100649,STENT COR 2.75MM 38MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100650,STENT COR 3MM 8MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100651,STENT COR 3MM 12MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100652,STENT COR 3MM 15MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100653,STENT COR 3MM 18MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100654,STENT COR RX 3X23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100655,STENT COR 3MM 28MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100656,STENT COR 3MM 33MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100657,STENT COR 3MM 38MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100658,STENT COR 3.25MM 8MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100659,STENT COR 3.25MM 12MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100661,STENT COR 3.25MM 15MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100662,STENT COR 3.25MM 18MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100663,STENT COR 3.25MM 23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100664,STENT COR RX 3.25X28MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100665,STENT COR 3.25MM 33MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100666,STENT COR 3.25MM 38MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100667,STENT COR 3.5MM 8MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100668,STENT COR RX 3.5X12MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100669,STENT COR 3.5MM 15MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100670,STENT COR 3.5MM 18MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100671,STENT COR RX 3.5X23MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100672,STENT COR RX 3.5X28MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100673,STENT COR RX 3.5X33MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100674,STENT COR 3.5MM 38MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100675,STENT COR 4MM 8MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100676,STENT COR 4MM 12MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100677,STENT COR 4MM 15MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100678,STENT COR 4MM 18MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100679,KIT INST SNGLUSE EXTRMTY,13896.0,13896.0,833.76,11811.6,49 CDM,100680,CULT CHLAMYDIA,1027.0,1027.0,61.62,872.95,14 CDM,100680,"Culture, chlamydia, any source ",1027.0,1027.0,16.46,134.85,80 CDM,100681,STENT COR 4MM 23MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100682,STENT COR 4MM 28MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100683,STENT COR 4MM 33MM,19427.0,19427.0,2525.51,16512.95,28 CDM,100684,STENT COR 4MM 38MM,19076.0,19076.0,2479.88,16214.6,28 CDM,100690,CULT CMV,647.53,647.53,38.85,550.4,14 CDM,100700,STENT SLFEXP 18X40X75CM,25948.0,25948.0,3373.24,22055.8,28 CDM,100701,GRAFT VASC THIN 90CM 6MM,98725.0,98725.0,12834.25,83916.25,28 CDM,100709,SCREW BN 4.5MM 54MM,6676.0,6676.0,867.88,5674.6,28 CDM,100711,STEM FEM 15X250MM,60285.0,60285.0,7837.05,51242.25,28 CDM,100712,TUBE TRACH 8MM,2905.5,2905.5,174.33,2469.68,49 CDM,100713,TUBE TRACH 6.0MM,2905.5,2905.5,174.33,2469.68,49 CDM,100715,CULT ECOLI 0157 H7 SCR,1039.21,1039.21,62.35,883.33,14 CDM,100723,CATH CORN 3.0MM 12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,100730,INTRO SHEATH 16FR 33CM,14790.0,14790.0,887.4,12571.5,49 CDM,100732,STENT EPRSTH 5MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 CDM,100733,STENT EPRSTH 5CM 10MM,90635.0,90635.0,11782.55,77039.75,28 CDM,100734,STENT EPRSTH 10CM 11MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100735,STENT EPRSTH 10CM 13MM,98373.0,98373.0,12788.49,83617.05,28 CDM,100736,CATH 1 OR M 2ND OD RNL,10816.79,10816.79,649.01,9194.27,37 CDM,100740,CULT FUNGUS OTHER SRC,1208.0,1208.0,72.48,1026.8,14 CDM,100740,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",1208.0,1208.0,7.06,57.83,80 CDM,100742,UNLISTED CARDIO SERVICE,3199.26,3199.26,191.96,2719.37,39 CDM,100742,Unlisted cardiovascular service or procedure ,3199.26,3199.26,323.74,446.87,5 CDM,100748,CATH BLNDIL 7MM 150MM,45571.5,45571.5,2734.29,38735.78,49 CDM,100749,CATH BLNDIL 10X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,100750,CULT GC SCR,497.0,497.0,29.82,422.45,14 CDM,100752,GUIDEWIRE VASC 230CM,7395.0,7395.0,443.7,6285.75,49 CDM,100755,CLIP LIGA 17MM 235CM,12651.0,12651.0,1644.63,10753.35,28 CDM,100758,GDWIRE VASC 185CM,19875.5,19875.5,1192.53,16894.17,49 CDM,100759,CATH CORN 2.5MM 12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,100760,CATH CORN 3.5MM 12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,100763,PROBE CRYO TIP 11IN 8MM,75494.5,75494.5,4529.67,64170.32,49 CDM,100768,PLATE BN RT 18MM,40326.0,40326.0,5242.38,34277.1,28 CDM,100775,CULTURE CSF,1039.0,1039.0,62.34,883.15,14 CDM,100781,SCREW BN 2.4MM 12MM,2541.0,2541.0,330.33,2159.85,28 CDM,100782,STENT GRAFT 15X13X100MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100783,STENT GRAFT 15X20X140MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100788,SUTURE CV-2 TH-26 36IN,1346.5,1346.5,80.79,1144.53,49 CDM,100790,CULT LEGIONELLA SCR,981.19,981.19,58.87,834.01,14 CDM,100795,SUTURE CV-4 TH-18 36IN,1336.5,1336.5,80.19,1136.03,49 CDM,100798,SUTURE CV-5 TTC-13 36IN,1264.0,1264.0,75.84,1074.4,49 CDM,100803,SP VERT ANGIO UNILAT,25511.86,25511.86,1530.71,21685.08,37 CDM,100810,CULT MYCOPLASMA,741.16,741.16,44.47,629.99,14 CDM,100810,"Culture, mycoplasma, any source ",741.16,741.16,12.93,105.89,80 CDM,100813,DRESSING FOM 8X4IN,347.5,347.5,20.85,295.38,49 CDM,100825,CULTURE WOUND,1039.0,1039.0,62.34,883.15,14 CDM,100833,BIT DRILL LCK 4.2MM 360M,5520.5,5520.5,331.23,4692.43,49 CDM,100837,INSERT TIB KN ONLAY SZ2,14331.0,14331.0,1863.03,12181.35,28 CDM,100838,PUMP INFL STRL,100000.0,100000.0,13000.0,85000.0,28 CDM,100840,CULTURE STOOL,1298.0,1298.0,77.88,1103.3,14 CDM,100840,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",1298.0,1298.0,7.93,64.89,80 CDM,100846,HEAD FEM HIP +0X32MM,17397.0,17397.0,2261.61,14787.45,28 CDM,100850,CULT STREP GROUP B SCR,1020.74,1020.74,61.24,867.63,14 CDM,100851,CRT-P CRD 59X46.5X11MM,89002.0,89002.0,11570.26,75651.7,28 CDM,100852,CATH SLITTER UNV 2,1453.0,1453.0,87.18,1235.05,49 CDM,100855,CATH BLN 8F 12MM 4X75CM,9152.0,9152.0,549.12,7779.2,49 CDM,100856,CATH DIL 20MMX4CM 100CM,21508.5,21508.5,1290.51,18282.22,49 CDM,100857,CATH DIL 22MMX4CM 100CM,16551.0,16551.0,993.06,14068.35,49 CDM,100858,CATH BLNDIL 9X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 CDM,100859,CATH BLNDIL 7F 40 75X9X8,6684.5,6684.5,401.07,5681.82,49 CDM,100860,CULT COLONY COUNT UR,1242.0,1242.0,74.52,1055.7,14 CDM,100860,"Culture, bacterial; quantitative colony count, urine ",1242.0,1242.0,6.78,55.48,80 CDM,100861,CATH BLN ANGIO 40MM 80CM,9226.5,9226.5,553.59,7842.52,49 CDM,100876,RETRIEVER VASC 6FR 90CM,19212.5,19212.5,1152.75,16330.63,49 CDM,100878,GRAFT STNT 13FR 14X120MM,91581.0,91581.0,11905.53,77843.85,28 CDM,100879,TROCAR LAPSCP 100X12MM,415.0,415.0,24.9,352.75,49 CDM,100880,CULT VIBRIO SCR,590.82,590.82,35.45,502.2,14 CDM,100881,SUTURE BLU MONO 6-0 30IN,821.5,821.5,49.29,698.27,49 CDM,100883,RELOAD STPLR 45MM,7395.0,7395.0,961.35,6285.75,28 CDM,100888,CURETTE CRVD 7MM,244.0,244.0,14.64,207.4,49 CDM,100889,VACCURETTE CURVED 8MM,221.5,221.5,13.29,188.28,49 CDM,100890,CULT VIRUS CPE,1835.76,1835.76,110.15,1560.4,14 CDM,100891,CURETTE CRVD 9MM,221.5,221.5,13.29,188.28,49 CDM,100893,OSTEO FLEX 6MM 67MM,18581.0,18581.0,1114.86,15793.85,49 CDM,100900,CULT YERSINIA SCR,680.5,680.5,40.83,578.42,14 CDM,100905,INS TUNLD PLEURAL CATH,16161.16,16161.16,969.67,13736.99,37 CDM,100908,GRAFT EVAS 20MM 9.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,100909,GRAFT EVAS 18MM 11.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,100911,GRAFT EVAS 26X14.5M 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,100913,TUNNLER INTRO CATH,7395.0,7395.0,443.7,6285.75,49 CDM,100914,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,100915,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,100916,IVP SINGLE/INITIAL DRUG,339.57,339.57,20.37,288.63,39 CDM,10092,T-TUBE DEAVER 10FR,420.5,420.5,25.23,357.43,49 CDM,100921,STENT VASC 46MM 80MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100922,STENT VASC 46MM 120MM,100000.0,100000.0,13000.0,85000.0,28 CDM,100927,LEAD PCNG 54MM,8007.0,8007.0,1040.91,6805.95,28 CDM,100930,CYCLOSPORINE QUANT,475.0,475.0,28.5,403.75,14 CDM,100930,Cyclosporine ,475.0,475.0,15.16,124.17,80 CDM,100932,TOOL WRENCH TORQUE,1046.0,1046.0,62.76,889.1,49 CDM,100933,SHEATH INTRO 8FR 25CM,2563.0,2563.0,153.78,2178.55,49 CDM,100934,SCREW BN 2.2MM 12MM,19633.0,19633.0,2552.29,16688.05,28 CDM,100950,D-DIMER QUANT,1060.0,1060.0,63.6,901.0,14 CDM,100953,GUIDEWIRE PRESSURE,20383.5,20383.5,1223.01,17325.97,49 CDM,100954,CATHSND 3FR 1MM,21601.0,21601.0,1296.06,18360.85,49 CDM,100955,INTRODCR SPLTBL 8FR 13CM,2020.0,2020.0,121.2,1717.0,49 CDM,100956,INTO SHTH 10.06FR 47CM,13037.5,13037.5,782.25,11081.88,49 CDM,100957,INTRO SHTH 10FR 13CM,2020.0,2020.0,121.2,1717.0,49 CDM,100958,KIT STYLET LEAD 46CM,2905.5,2905.5,174.33,2469.68,49 CDM,100959,KWIRE ORTH 3.2MM,2905.5,2905.5,174.33,2469.68,49 CDM,100960,BIT DRILL 3.2MM,11445.0,11445.0,686.7,9728.25,49 CDM,100962,BASEPLATE GLND SHLDR SM,40850.0,40850.0,5310.5,34722.5,28 CDM,100964,SCREW BN 34MM 4.5MM,4160.0,4160.0,540.8,3536.0,28 CDM,100965,STEM HUM SHLDR 15MM,52119.0,52119.0,6775.47,44301.15,28 CDM,100967,PROBE CRYOSPHERE 18IN 8M,78576.0,78576.0,4714.56,66789.6,49 CDM,100970,SYSTM EMBL 18 6% 1.5ML,81657.5,81657.5,4899.45,69408.88,49 CDM,100977,BIT DRILL 2.3MM 20MM,2905.5,2905.5,174.33,2469.68,49 CDM,100990,DHEA,1569.36,1569.36,94.16,1333.96,14 CDM,100990,Dehydroepiandrosterone (DHEA) ,1569.36,1569.36,21.23,173.85,80 CDM,100991,NEEDLE DLV 12GA 10CM,2608.0,2608.0,156.48,2216.8,49 CDM,100994,INSERT TIB KN 11MM,26764.0,26764.0,3479.32,22749.4,28 CDM,101006,PORT IMPL INFSN 9.6FR,20212.0,20212.0,2627.56,17180.2,28 CDM,101007,PROSTH PENL PUMP PS 14CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101008,RELOAD STPLR 75MM,2905.5,2905.5,377.71,2469.68,28 CDM,101009,RELOAD STPLR 75MM,4561.5,4561.5,593.0,3877.28,28 CDM,101012,CATH CHLGM 4FR 50CM,5206.5,5206.5,312.39,4425.52,49 CDM,101014,BLADE OPTH 3MM,1285.0,1285.0,77.1,1092.25,49 CDM,101017,DRUG TEST DEF 1-7 CLASS,3111.02,3111.02,186.66,2644.37,15 CDM,101017,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",3111.02,3111.02,96.12,787.08,80 CDM,101030,DIGITOXIN QN,621.15,621.15,37.27,527.98,14 CDM,101040,DIGOXIN QN,582.0,582.0,34.92,494.7,14 CDM,101040,Digoxin; total ,582.0,582.0,11.16,91.31,80 CDM,101050,PHENYTOIN DILANT TOT QN,1067.0,1067.0,64.02,906.95,14 CDM,101050,Phenytoin; total ,1067.0,1067.0,11.13,91.13,80 CDM,101060,PHENYTOIN DILANTIN FR QN,1720.0,1720.0,103.2,1462.0,14 CDM,101060,Phenytoin; free ,1720.0,1720.0,11.56,94.66,80 CDM,101061,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,101062,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,101080,DS DNA AB,553.0,553.0,33.18,470.05,14 CDM,101080,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,553.0,553.0,11.54,94.48,80 CDM,101082,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,101083,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,101084,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,101085,IV EACH ADD HOUR,201.55,201.55,12.09,171.32,39 CDM,101086,IV ADDL SEQ INF UP TO 1H,201.55,201.55,12.09,171.32,39 CDM,101087,IV CONCURRENT INFUSION,138.08,138.08,8.28,117.37,44 CDM,101089,IMMUNIZ ADMIN EA ADDTL,370.05,370.05,22.2,314.54,44 CDM,101090,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,1011,STAPLER PURSESTRING 45TE,7607.0,7607.0,456.42,6465.95,49 CDM,101150,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",736.0,736.0,11.02,90.23,80 CDM,101150,EBV EARLY AB QUAL,736.0,736.0,44.16,625.6,14 CDM,101153,SHEATH GD 14FR 63CM,4119.0,4119.0,247.14,3501.15,49 CDM,101160,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",735.88,735.88,12.84,105.16,80 CDM,101160,EBV NUCLEAR AG AB QUAL,735.88,735.88,44.15,625.5,14 CDM,101166,COIL EMBL 10CM 6MM,17827.0,17827.0,2317.51,15152.95,28 CDM,101167,COIL EMBL 2D 20CM 8MM,21020.0,21020.0,2732.6,17867.0,28 CDM,101168,COIL EMBL 20MM 40CM,29105.0,29105.0,3783.65,24739.25,28 CDM,101169,COIL EMBL 10CM 4MM,17827.0,17827.0,2317.51,15152.95,28 CDM,101190,ELECTROLYTE PANEL,1761.0,1761.0,105.66,1496.85,14 CDM,101190,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,1761.0,1761.0,6.87,48.24,80 CDM,101192,DEVICE CLSR CLP INT 40MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101193,DEVICE CLSR CLP INT 45MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101194,DEVICE CLSR CLP INT 50MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101195,SEALER CURV JAW 45CM,17607.0,17607.0,1056.42,14965.95,49 CDM,101200,ANTIBODY ELUTION EA,684.0,684.0,41.04,581.4,23 CDM,101200,"Antibody elution (RBC), each elution ",684.0,684.0,126.87,457.76,20 CDM,101214,SHEATH GD SM 71CM,33752.5,33752.5,2025.15,28689.63,49 CDM,101215,BURR CATH ARTHRM 1.50MM,59317.0,59317.0,3559.02,50419.45,49 CDM,101218,KIT FLD MGMT HYSCP,8961.0,8961.0,537.66,7616.85,49 CDM,101224,BIT DRILL 340MM 4.2MM,5587.0,5587.0,335.22,4748.95,49 CDM,101228,OCCLUDER CV 11FR 37MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101230,ERYTHROPOIETIN QN,1577.0,1577.0,94.62,1340.45,14 CDM,101230,Erythropoietin ,1577.0,1577.0,15.78,129.23,80 CDM,101231,CARTRIDGE SUT MANAGER,8187.5,8187.5,491.25,6959.38,49 CDM,101240,ESTRADIOL TOTAL,1736.0,1736.0,104.16,1475.6,14 CDM,101240,Estradiol; total ,1736.0,1736.0,23.47,192.13,80 CDM,101241,KIT DEVICE GUIDED 3CM,100000.0,100000.0,6000.0,85000.0,49 CDM,101242,DEVICE CLSR CLP INT 50MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101250,ESTRIOL,1008.87,1008.87,60.53,857.54,14 CDM,101250,Estriol ,1008.87,1008.87,20.31,166.34,80 CDM,101260,ESTROGEN TOTAL,1947.85,1947.85,116.87,1655.67,14 CDM,101260,Estrogens; total ,1947.85,1947.85,18.23,149.23,80 CDM,101280,ESTRONE,523.56,523.56,31.41,445.03,14 CDM,101280,Estrone ,523.56,523.56,20.96,171.59,80 CDM,101285,GDCATH LIVER 41CM 10FR,18704.0,18704.0,1122.24,15898.4,49 CDM,101286,SET BX NDL ACC 18G 100,19875.0,19875.0,1192.5,16893.75,49 CDM,101287,CATH DBC 6X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 CDM,101288,STENT EPRSTH 6CM 8-10MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101289,GUIDEWIRE ENDO 200CM,4600.5,4600.5,276.03,3910.43,49 CDM,101291,SCREW BN STERNAL 3X8MM,2777.0,2777.0,361.01,2360.45,28 CDM,101293,PROSTHESIS PENL TTN 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101294,GWIRE ORTH 3MM 100CM,6286.0,6286.0,377.16,5343.1,49 CDM,1013,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",1148.66,1148.66,147.34,1206.37,78 CDM,1013,BRAF V600 VARIANTS,1148.66,1148.66,68.92,976.36,15 CDM,101301,DILATOR BLN 40MM 90CM,18757.5,18757.5,1125.45,15943.88,49 CDM,101302,BASEPLATE TIB STD 75MM,66767.0,66767.0,8679.71,56751.95,28 CDM,101304,INSERT ACTB HIP SZE 36MM,18312.0,18312.0,2380.56,15565.2,28 CDM,101305,BAG SPEC RETRVL 235ML,6521.0,6521.0,391.26,5542.85,49 CDM,101306,BAG SPEC RETRVL 125ML,11901.0,11901.0,714.06,10115.85,49 CDM,101310,"Clotting; factor II, prothrombin, specific ",2199.74,2199.74,10.9,89.23,80 CDM,101310,FACTOR 2 PROTHROMBIN,2199.74,2199.74,131.98,1869.78,14 CDM,101317,STENT SLFEXP 14X40X75CM,25185.0,25185.0,3274.05,21407.25,28 CDM,101320,Clotting; factor IX (PTC or Christmas) ,1815.97,1815.97,15.99,130.95,80 CDM,101320,FACTOR 9 ACTIVITY,1815.97,1815.97,108.96,1543.57,14 CDM,101326,STENT SLFEXP 12X40X135CM,27488.0,27488.0,3573.44,23364.8,28 CDM,101330,"Clotting; factor V (AcG or proaccelerin), labile factor ",1761.0,1761.0,14.83,121.36,80 CDM,101330,FACTOR 5 LABILE,1761.0,1761.0,105.66,1496.85,14 CDM,101336,SHEATH ACC 45CRV 63CM,7043.0,7043.0,422.58,5986.55,49 CDM,101338,SHEATH WIRE 45F 230CM,29890.0,29890.0,1793.4,25406.5,49 CDM,101339,DEFIB ICD 69X51X12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101340,"Clotting; factor VII (proconvertin, stable factor) ",1966.32,1966.32,15.04,123.08,80 CDM,101340,FACTOR 7 STABLE,1966.32,1966.32,117.98,1671.37,14 CDM,101341,BASEPLATE GLENOID SML RT,30990.0,30990.0,4028.7,26341.5,28 CDM,101342,PEG TRBCLR TITNM MTB SRT,37187.0,37187.0,4834.31,31608.95,28 CDM,101343,CATH ANGIO 6FR 80CM,4140.5,4140.5,248.43,3519.43,49 CDM,101344,PROSTHESIS PNL 75ML,76221.0,76221.0,9908.73,64787.85,28 CDM,101345,BDY HUM SMR RVRVS TI LCK,68177.0,68177.0,8863.01,57950.45,28 CDM,101347,GRAFT EVAS 12MM 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101348,SYSTEM URTH SUPP 2.7MM,31274.0,31274.0,4065.62,26582.9,28 CDM,101350,"Clotting; factor VIII (AHG), 1-stage ",2102.0,2102.0,15.04,123.08,80 CDM,101350,FACTOR 8 ACTIVITY 1STAGE,2102.0,2102.0,126.12,1786.7,14 CDM,101352,OCCLUDER CARDIAC LT 16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101353,OCCLUDER CARDIAC LT 20MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101354,OCCLUDER CARDIAC LT 18MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101357,COIL EMBL 5MM 8CM,12935.0,12935.0,1681.55,10994.75,28 CDM,101358,COIL EMBL 6MM 20CM,12935.0,12935.0,1681.55,10994.75,28 CDM,101359,COIL EMBL 8MM 20CM,12935.0,12935.0,1681.55,10994.75,28 CDM,101361,COIL EMBL 14MM 30CM,12935.0,12935.0,1681.55,10994.75,28 CDM,101362,COIL EMBL 6MM 10CM,12935.0,12935.0,1681.55,10994.75,28 CDM,101363,CATH ULTSND 4.0MM 40MM,84738.5,84738.5,5084.31,72027.73,49 CDM,101366,CMPNT FEM KN LT SZ4,42258.0,42258.0,5493.54,35919.3,28 CDM,101368,OCCLUDER CARDIAC LT 22MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101369,OCCLUDER CARDIAC LT 28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101370,Clotting; factor X (Stuart-Prower) ,1815.97,1815.97,15.04,123.08,80 CDM,101370,FACTOR 10 ASSAY,1815.97,1815.97,108.96,1543.57,14 CDM,101371,OCCLUDER CARDIAC LT 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101372,OCCLUDER CARDIAC LT 31MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101373,OCCLUDER CARDIAC LT 34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101374,JOINT TOE 20MM MED HEMI,41554.0,41554.0,5402.02,35320.9,28 CDM,101375,OCCULDER CV 7X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101376,OCCULDER CV 9X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101377,CATH BLNOCC 9FR 23CM,12642.0,12642.0,758.52,10745.7,49 CDM,101379,LINE MNTR 2 PT,1892.5,1892.5,113.55,1608.63,49 CDM,101380,Clotting; factor XI (PTA) ,1815.97,1815.97,15.04,123.08,80 CDM,101380,FACTOR 11 ACTIVITY,1815.97,1815.97,108.96,1543.57,14 CDM,101381,SET TUBING XTN 108IN,1034.0,1034.0,62.04,878.9,49 CDM,101382,RESERVOIR ATF DISP 3L,6273.0,6273.0,376.38,5332.05,49 CDM,101385,SHEATH NVGRT 12/14F 46CM,4164.5,4164.5,249.87,3539.82,49 CDM,101386,COMPNT FEM KN RT SZ6,42258.0,42258.0,5493.54,35919.3,28 CDM,101387,BASEPLT TIB KN LT SZ2,25355.0,25355.0,3296.15,21551.75,28 CDM,101390,Clotting; factor XII (Hageman) ,1815.97,1815.97,16.25,133.13,80 CDM,101390,FACTOR 12 ASSAY,1815.97,1815.97,108.96,1543.57,14 CDM,101391,INSERT TIB KN SZ2 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,101392,PROSTHESIS PENILE TITAN,100000.0,100000.0,13000.0,85000.0,28 CDM,101393,COIL EMBL 2D 3X4,17827.0,17827.0,2317.51,15152.95,28 CDM,101394,COIL EMBL 2D 20CM 6MM,21020.0,21020.0,2732.6,17867.0,28 CDM,101395,COIL EMBL 10CM 8MM,17827.0,17827.0,2317.51,15152.95,28 CDM,101396,STENT SLFEXP 20X40X75CM,25948.0,25948.0,3373.24,22055.8,28 CDM,101397,COIL EMBL 2D 20CM 10MM,21020.0,21020.0,2732.6,17867.0,28 CDM,101398,COIL EMBL 40CM 10MM INTL,29105.0,29105.0,3783.65,24739.25,28 CDM,101399,CATH BLN 1.2X12MM 145CM,8275.5,8275.5,496.53,7034.18,49 CDM,101400,Clotting; factor XIII (fibrin stabilizing) ,1565.4,1565.4,13.73,112.4,80 CDM,101400,FACTOR 13 ACTIVITY QN,1565.4,1565.4,93.92,1330.59,14 CDM,101401,COIL EMBL 20CM 12MM INTL,22021.0,22021.0,2862.73,18717.85,28 CDM,101402,COIL EMBL 40CM 12MM INTL,29105.0,29105.0,3783.65,24739.25,28 CDM,101403,COIL EMBL 15MM X 20CM,21020.0,21020.0,2732.6,17867.0,28 CDM,101404,COIL EMBL 20CM 18MM INTL,21020.0,21020.0,2732.6,17867.0,28 CDM,101406,INTRO SHEATH 18FR 65CM,23912.0,23912.0,1434.72,20325.2,49 CDM,101408,STENT VASC 9X80X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101410,FECAL FAT QUAL,489.0,489.0,29.34,415.65,14 CDM,101410,"Fat or lipids, feces; qualitative ",489.0,489.0,4.28,35.11,80 CDM,101419,LEAD PCNG 58CM,5971.0,5971.0,776.23,5075.35,28 CDM,101420,FECAL FAT QUANT,507.73,507.73,30.46,431.57,14 CDM,101420,"Fat or lipids, feces; quantitative ",507.73,507.73,14.11,115.57,80 CDM,101421,CATH BLNDL 75CM 12X60MM,44680.5,44680.5,2680.83,37978.43,49 CDM,101430,KWIRE 1.6MM 6IN,4809.5,4809.5,288.57,4088.07,49 CDM,101431,KIT FX REAMER C/C 16MM,6273.0,6273.0,376.38,5332.05,49 CDM,101433,SCREW SPN PAX LCK 3X10MM,5265.0,5265.0,684.45,4475.25,28 CDM,101434,SCREW BN LCK 3X14MM,5265.0,5265.0,684.45,4475.25,28 CDM,101435,SCREW BN 3MM 16MM,5616.0,5616.0,730.08,4773.6,28 CDM,101437,SEALER TISS CURVED 37CM,16806.0,16806.0,1008.36,14285.1,49 CDM,101440,FERRITIN,1325.0,1325.0,79.5,1126.25,14 CDM,101440,Ferritin ,1325.0,1325.0,11.45,93.76,80 CDM,101441,PLATE BN STD 0D 18MM,40326.0,40326.0,5242.38,34277.1,28 CDM,101442,INSERT TIB KN LT 1-2 9MM,18312.0,18312.0,2380.56,15565.2,28 CDM,101450,FETAL SCREEN (ROSETTE),1047.12,1047.12,62.83,890.05,14 CDM,101450,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",1047.12,1047.12,7.86,64.35,80 CDM,101451,PACEMAKER 23F 105CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101454,SCREW BN 2.4MM 20MM SS,4709.0,4709.0,612.17,4002.65,28 CDM,101459,SUT MONO SZ 2-0 18IN,1144.0,1144.0,68.64,972.4,49 CDM,101469,LEAD PCNG 90CM,21221.0,21221.0,2758.73,18037.85,28 CDM,101470,FIBRINOGEN ACTIVITY,960.0,960.0,57.6,816.0,14 CDM,101470,Fibrinogen; activity ,960.0,960.0,8.16,66.88,80 CDM,101476,STENT VASC 6X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,101478,KWIRE FX 1.2MM 4MM,1511.0,1511.0,90.66,1284.35,49 CDM,101491,STENT COR 3.50 X 12MM,20184.0,20184.0,2623.92,17156.4,28 CDM,101492,STENT COR 3.50 X 16MM,19820.0,19820.0,2576.6,16847.0,28 CDM,101493,STENT COR 3.50 X 20MM,20184.0,20184.0,2623.92,17156.4,28 CDM,101494,STENT COR 4.00 X 12MM,19820.0,19820.0,2576.6,16847.0,28 CDM,101495,STENT COR 4.00 X 16MM,19820.0,19820.0,2576.6,16847.0,28 CDM,101497,STENT COR 4.50 X 12MM,20184.0,20184.0,2623.92,17156.4,28 CDM,101500,STENT COR 5.00 X 12MM,20184.0,20184.0,2623.92,17156.4,28 CDM,101504,JOINT FNGR 1PC SZ 00,27778.0,27778.0,3611.14,23611.3,28 CDM,101506,CATH EP 7FR 95CM,23573.0,23573.0,1414.38,20037.05,49 CDM,101507,GWIRE VASC 190CM .014IN,3678.5,3678.5,220.71,3126.72,49 CDM,101510,FOLATE (FOLIC ACID) SER,1304.0,1304.0,78.24,1108.4,14 CDM,101510,Folic acid; serum ,1304.0,1304.0,12.35,101.09,80 CDM,101511,CLIP LIGA 17MM 235CM,9385.0,9385.0,1220.05,7977.25,28 CDM,101513,PROSTH PENL 18CM 12.5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101514,SUTURE 2-0 SH-2 10X30,2764.0,2764.0,165.84,2349.4,49 CDM,101516,CATH ATHRCM 1.50MM 145CM,96863.0,96863.0,5811.78,82333.55,49 CDM,101518,RESERVOIR BOWL 150UM,2277.0,2277.0,136.62,1935.45,49 CDM,101526,CATH ANGIO ALW CRV 65CM,2899.0,2899.0,173.94,2464.15,49 CDM,101527,GWIRE VASC FLX 260CM,6273.0,6273.0,376.38,5332.05,49 CDM,101529,CATH ULTSND 5FR 150CM,22340.5,22340.5,1340.43,18989.42,49 CDM,101530,FSH,1654.0,1654.0,99.24,1405.9,14 CDM,101530,Gonadotropin; follicle stimulating hormone (FSH) ,1654.0,1654.0,15.61,127.79,80 CDM,101541,TRANSCTH STNT PLC EA AD,28681.89,28681.89,1720.91,24379.61,37 CDM,101543,GWIRE VASC .014IN 300CM,2905.5,2905.5,174.33,2469.68,49 CDM,101544,IMPLANT COLLAGEN MEDIUM,100000.0,100000.0,13000.0,85000.0,28 CDM,101545,ANCHOR BN SHLD,82410.0,82410.0,10713.3,70048.5,28 CDM,101546,ANCHOR SUT TENDONS,82410.0,82410.0,10713.3,70048.5,28 CDM,101547,ANCHOR BN SUTURE 5.5MM,37642.0,37642.0,4893.46,31995.7,28 CDM,101549,SUTURE W/ NDL #2 38IN,1203.0,1203.0,72.18,1022.55,49 CDM,101558,REV TRNVEN INTRHEP SHUNT,32634.63,32634.63,1958.08,27739.44,37 CDM,101560,"Culture, fungi, definitive identification, each organism; yeast ",1289.78,1289.78,8.67,70.95,80 CDM,101560,YEAST ID,1289.78,1289.78,77.39,1096.31,14 CDM,101566,CATH BLNDIL 28X4.5X110,21508.5,21508.5,1290.51,18282.22,49 CDM,101567,BASEPLATE HUM SHLDR 30MM,38737.0,38737.0,5035.81,32926.45,28 CDM,101569,SCREW BN 5.0MM 14MM,3079.0,3079.0,400.27,2617.15,28 CDM,101574,DEV HEMOSPRAY 10FR 220CM,70872.5,70872.5,4252.35,60241.63,44 CDM,101574,"Hemostatic agent, gastrointestinal, topical ",70872.5,70872.5,14.87,22.9,5 CDM,101578,CANN AOR ROOT STD 21012,938.5,938.5,56.31,797.73,49 CDM,101579,CATH BLNDL 5X220MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,101580,SMEAR FUNGUS STAIN,316.51,316.51,18.99,269.03,14 CDM,101584,CANNULA PRFSN 32F 15IN,1502.0,1502.0,90.12,1276.7,49 CDM,101585,CANNLA PRFSN VNS 24F14IN,1454.5,1454.5,87.27,1236.33,49 CDM,101588,CANNULA PRFSN 22FR 12IN,1971.5,1971.5,118.29,1675.78,49 CDM,101589,CANULA PRFSN 33.02CM 22F,2420.5,2420.5,145.23,2057.43,49 CDM,101590,GAMMA GT,940.0,940.0,56.4,799.0,14 CDM,101590,"Glutamyltransferase, gamma (GGT) ",940.0,940.0,6.05,49.5,80 CDM,101591,CANNULA PRFSN GUND SIL A,3192.0,3192.0,191.52,2713.2,49 CDM,101596,KIT ATSBWL 125ML,3230.5,3230.5,193.83,2745.93,49 CDM,101597,SET VAC TUBING LINE,642.5,642.5,38.55,546.13,49 CDM,101598,KIT PROCESSING 225ML,3800.0,3800.0,228.0,3230.0,49 CDM,101600,GASTRIN,1265.0,1265.0,75.9,1075.25,14 CDM,101600,Gastrin ,1265.0,1265.0,14.81,121.27,80 CDM,101602,CANNULA AOR CURV21F 37.6,2802.0,2802.0,168.12,2381.7,49 CDM,101608,SUCKER INTRCRD 24F .25IN,729.0,729.0,43.74,619.65,49 CDM,101609,PACK SURG 225ML,6273.0,6273.0,376.38,5332.05,49 CDM,101610,GENTAMICIN (GARAMYCIN)QN,1332.0,1332.0,79.92,1132.2,14 CDM,101612,JAW TISSUE SEAL 25CM,15260.5,15260.5,915.63,12971.42,49 CDM,101615,INSERT HIP 0D E 36MM,21129.0,21129.0,2746.77,17959.65,28 CDM,101618,CATH THRMB 7FR 130CM,100000.0,100000.0,6000.0,85000.0,49 CDM,101619,PROSTH PENL PUMP PL 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101626,CRRT/SLEDD,3919.0,3919.0,235.14,3331.15,49 CDM,101632,LINER HUM 0MM 36MM,22538.0,22538.0,2929.94,19157.3,28 CDM,101633,STENT BIL 10X40MM,29764.0,29764.0,3869.32,25299.4,28 CDM,101634,PLATE BN 8HL 3.5MM 128MM,42689.0,42689.0,5549.57,36285.65,28 CDM,101639,CATH SZ BLN 4X80CM 30MM,10164.5,10164.5,609.87,8639.83,49 CDM,101640,GLUCOSE BLD QN,199.0,199.0,11.94,169.15,14 CDM,101640,"Glucose; quantitative, blood (except reagent strip) ",199.0,199.0,3.3,27.06,80 CDM,101641,SUTURE GRN/WHT 2-0 36IN,1833.5,1833.5,110.01,1558.47,49 CDM,101647,CATH CV PED 9FR 2LUM,5093.0,5093.0,305.58,4329.05,49 CDM,101648,SHEATH GD 8FR 65CM,4558.5,4558.5,273.51,3874.72,49 CDM,101649,SHEATH GD 8FR 90CM,5269.5,5269.5,316.17,4479.07,49 CDM,101651,INTRODUCER VASC 14F 45CM,5206.5,5206.5,312.39,4425.52,49 CDM,101666,PROSTHESIS PENL TTN 11CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101667,INTRO SHEATH 26FR 65CM,24405.0,24405.0,1464.3,20744.25,49 CDM,101670,GTT 1ST 3 SPECIMENS,832.16,832.16,49.93,707.34,14 CDM,101670,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",832.16,832.16,10.81,88.51,80 CDM,101687,KIT CATH 7D + 7F 50CM,80425.0,80425.0,4825.5,68361.25,49 CDM,101688,CATH DCB 10X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 CDM,101690,GLUCOSE BODY FLD QN,207.0,207.0,12.42,175.95,14 CDM,101691,CATH DBC 5X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 CDM,101694,BLADE SHVR 4.5MM,2905.5,2905.5,174.33,2469.68,49 CDM,101695,CANNULA ENDO 72X7MM,1441.5,1441.5,86.49,1225.28,49 CDM,101696,CRT-D CRD 5.37X8.18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101697,ICD CHAMBER 1,100000.0,100000.0,13000.0,85000.0,28 CDM,101699,SCREW BN NONLCK 3.5X12MM,5616.0,5616.0,730.08,4773.6,28 CDM,101701,CANNULA PRFSN 29-37F14.5,2627.5,2627.5,157.65,2233.38,49 CDM,101721,BIT DRILL BIT 4.0MM CALI,3931.0,3931.0,235.86,3341.35,49 CDM,101723,STENT VASC 10X80X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101724,STENT VASC 6X40X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101725,STENT VASC 6X80X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101730,G-6-PD QUANT,865.0,865.0,51.9,735.25,14 CDM,101730,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,865.0,865.0,8.15,66.7,80 CDM,101731,STENT VASC 8X80X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101732,STENT VASC 8X100X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101733,STENT VASC 10X60X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101734,CATH THRMB 140CM .044IN,56534.5,56534.5,3392.07,48054.32,49 CDM,101735,CATH ANGIO 5F 90CM 40CM,12813.0,12813.0,768.78,10891.05,49 CDM,101740,HEMOGLOBIN A1C,566.0,566.0,33.96,481.1,14 CDM,101740,Hemoglobin; glycosylated (A1C) ,566.0,566.0,8.16,66.79,80 CDM,101741,WIRE GUIDE ESOPHAGE 250M,5227.5,5227.5,313.65,4443.38,49 CDM,101742,COMPONENT FEM KN 3CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101743,INSERT TIB KN STD 14MM,21346.0,21346.0,2774.98,18144.1,28 CDM,101746,SCREW BN 2.7MM 13MM,2440.0,2440.0,317.2,2074.0,28 CDM,101747,SCREW BN 2.7MM 15MM,2440.0,2440.0,317.2,2074.0,28 CDM,101755,CAP PROTCT 4MM,205.0,205.0,12.3,174.25,49 CDM,101762,WAND HEMOSTAT DISP 6.0,16198.5,16198.5,971.91,13768.73,49 CDM,101767,KIT CATH PICC 5FR 55CM,9920.0,9920.0,595.2,8432.0,49 CDM,101768,TRAY CATH PICC PRVN 4FR,9217.5,9217.5,553.05,7834.88,49 CDM,101770,GRAM STAIN PRIMARY SRCE,795.23,795.23,47.71,675.95,14 CDM,101771,CATH ANGIO 6FR 125CM,615.5,615.5,36.93,523.17,49 CDM,101780,GROWTH HORMONE (HGH),820.29,820.29,49.22,697.25,14 CDM,101780,"Growth hormone, human (HGH) (somatotropin) ",820.29,820.29,14.0,114.66,80 CDM,101784,STENT VASC 8X40X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101790,INTRO SHEATH 22FR 65CM,23912.0,23912.0,1434.72,20325.2,49 CDM,101791,VALVE AORTIC 27/29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101792,GUIDEWIRE VASC 180CM,6273.0,6273.0,376.38,5332.05,49 CDM,101804,STENT VASC 7X40X80,19080.0,19080.0,2480.4,16218.0,28 CDM,101807,STENT EPRSTH 14FR 3.9CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101808,STENT EPRSTH 14FR 4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,101810,HAPTOGLOBIN QUANT,533.0,533.0,31.98,453.05,14 CDM,101810,Haptoglobin; quantitative ,533.0,533.0,10.57,86.52,80 CDM,101811,ELECTRD SURG WND 90D,19945.5,19945.5,1196.73,16953.67,49 CDM,101813,ADAPTER IRR PORT STRL,2504.0,2504.0,150.24,2128.4,49 CDM,101816,BLADE SHAVER INCIS 4.0MM,7036.5,7036.5,422.19,5981.02,49 CDM,101817,ELECTRODE ESURG J 33CM,1757.0,1757.0,105.42,1493.45,49 CDM,101820,HCG QUALITATIVE SERUM,901.0,901.0,54.06,765.85,14 CDM,101827,DEVICE WNDCLS 30CM SZ2,1695.5,1695.5,101.73,1441.17,49 CDM,101828,DRILL BIT 2.5MMX127MM,787.0,787.0,47.22,668.95,49 CDM,101829,KIT CELLSAVER TBG ANCOAG,1162.5,1162.5,69.75,988.13,49 CDM,101830,HCG BETA QUANTITATIVE,930.0,930.0,55.8,790.5,14 CDM,101831,DILATOR VASC 14-26F 25CM,7043.0,7043.0,422.58,5986.55,49 CDM,101835,TUBESET STERILE,18564.0,18564.0,1113.84,15779.4,49 CDM,101839,INJ ANES CELIAC PLEX,4267.65,4267.65,256.06,3627.5,37 CDM,101840,VASC EMBOL ART VEN HEM,56971.77,56971.77,3418.31,48426.0,37 CDM,101841,INJ LYMPHANGIOGRAM,1128.98,1128.98,67.74,959.63,37 CDM,101842,CANNULATION THORACICDUCT,2393.86,2393.86,143.63,2034.78,37 CDM,101843,BSCP FLX DSP SLM 3.8MM,8839.0,8839.0,530.34,7513.15,49 CDM,101845,TRAY CATH 3FR P PICC,8857.5,8857.5,531.45,7528.88,49 CDM,101850,PREG URINE QUAL BY DOO,573.68,573.68,34.42,487.63,14 CDM,101850,"Urine pregnancy test, by visual color comparison methods ",573.68,573.68,7.23,59.19,80 CDM,101852,STENT VASC 7X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 CDM,101857,SHEATH INTRO 8.5FR 13CM,1940.0,1940.0,116.4,1649.0,49 CDM,101859,BRNCHOSCP DISP 3.8MM,9138.5,9138.5,548.31,7767.73,49 CDM,101860,HDL CHOLESTEROL DM,1109.0,1109.0,66.54,942.65,14 CDM,101860,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",1109.0,1109.0,6.88,56.29,80 CDM,101865,CATH BLN 4X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,101867,ELECTRODE ESURG ABC STRL,2905.5,2905.5,174.33,2469.68,49 CDM,101868,SP INCRAN ANGIO,5668.43,5668.43,340.11,4818.17,37 CDM,101872,MATRISTEM MICROMATRX 1MG,138.0,138.0,8.28,117.3,25 CDM,101874,PURAPLY 1SQCM,3779.0,3779.0,226.74,3212.15,25 CDM,101876,PURAPLY 1SQCM,3420.0,3420.0,205.2,2907.0,25 CDM,101879,INTEGRA MESHED 1SQCM,2276.0,2276.0,136.56,1934.6,30 CDM,101887,GWIRE VASC .014IN 300CM,2905.5,2905.5,174.33,2469.68,49 CDM,101894,CATH BLNOCC 12FR 24CM,17607.0,17607.0,1056.42,14965.95,49 CDM,101896,REM ECMO OPEN PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,101897,INS ECMO OPEN PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,1019,MORPH ANAL MAN MLP PROBE,1735.53,1735.53,104.13,1475.2,23 CDM,1019,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",1735.53,1735.53,289.87,2463.32,20 CDM,101900,Blood count; hematocrit (Hct) ,348.0,348.0,1.99,16.29,80 CDM,101900,HEMATOCRIT,348.0,348.0,20.88,295.8,14 CDM,101901,KIT CARDIO PROC PACK,846.5,846.5,50.79,719.52,49 CDM,101903,CATH SUCKER INTRO 14.5IN,1488.0,1488.0,89.28,1264.8,49 CDM,101910,Blood count; hemoglobin (Hgb) ,398.0,398.0,1.99,16.29,80 CDM,101910,HEMOGLOBIN,398.0,398.0,23.88,338.3,14 CDM,101912,SHEATH INTRO 15FR 65CM,33895.5,33895.5,2033.73,28811.17,49 CDM,101913,SET IV ADMN KIT CSTM,2442.5,2442.5,146.55,2076.13,49 CDM,101914,INTRODUCER SHTH 8FR 63CM,2990.0,2990.0,179.4,2541.5,49 CDM,101920,HEMOGLOBIN PLASMA,1132.84,1132.84,67.97,962.91,14 CDM,101920,Hemoglobin; plasma ,1132.84,1132.84,6.14,50.32,80 CDM,101934,BLADE TAPERED 27X38MM,2905.5,2905.5,174.33,2469.68,49 CDM,101935,SNARE POLY HEX MED,439.0,439.0,26.34,373.15,49 CDM,101936,IMPLNT UROL COAPTITE 1M,14118.0,14118.0,1835.34,12000.3,22 CDM,101938,KIT INST RCUF DISP,11445.0,11445.0,686.7,9728.25,49 CDM,101939,KIT CATH AK-25123-F,4114.5,4114.5,246.87,3497.32,49 CDM,101940,CATHETER ART 8FR 110CM,7219.0,7219.0,433.14,6136.15,49 CDM,101943,INTRO SHTH 10.6FR,13037.5,13037.5,782.25,11081.88,49 CDM,101946,WRNCH TORGUE DISP,2529.0,2529.0,151.74,2149.65,49 CDM,101959,TAVR HEART VALVE 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,101960,HEP A AB TOTAL,1067.0,1067.0,64.02,906.95,14 CDM,101960,Hepatitis A antibody (HAAb) ,1067.0,1067.0,10.41,85.25,80 CDM,101964,CTHGD 7F 100CM M1 AR1,2150.5,2150.5,129.03,1827.92,49 CDM,101965,CTHGD 7F 100CM M1 AR2,2150.5,2150.5,129.03,1827.92,49 CDM,101966,CTHGD 7F 100CM M1 HS,2150.5,2150.5,129.03,1827.92,49 CDM,101967,CTHGD 7F 100CM M1 MP1,2150.5,2150.5,129.03,1827.92,49 CDM,101968,CTHGD 8F 100CM M1 AR1,2150.5,2150.5,129.03,1827.92,49 CDM,101969,CTHGD 8F 100CM M1 AR2,2150.5,2150.5,129.03,1827.92,49 CDM,101971,STENT COR 3.50 X 24MM,19820.0,19820.0,2576.6,16847.0,28 CDM,101972,STENT COR 3.50 X 28MM,24422.0,24422.0,3174.86,20758.7,28 CDM,101974,STENT COR 3.50 X 8MM,24422.0,24422.0,3174.86,20758.7,28 CDM,101982,CATH ULTSND 8FR 90CM,92565.5,92565.5,5553.93,78680.68,49 CDM,101984,TUBE TRACH XL 6MM 110MM,5280.5,5280.5,316.83,4488.43,49 CDM,101985,TUBE TRACH ADJ 6X110MM,6696.5,6696.5,401.79,5692.02,49 CDM,101987,TUBE TRACH XL 7MM 120MM,4490.0,4490.0,269.4,3816.5,49 CDM,101988,CATH ANGIO 1.7MM 100CM,2778.0,2778.0,166.68,2361.3,49 CDM,101990,HEP B CORE AB IGM QL,1604.0,1604.0,96.24,1363.4,14 CDM,101990,Hepatitis B core antibody (HBcAb); IgM antibody ,1604.0,1604.0,9.89,81.0,80 CDM,101992,GWIRE VASC 18F 90CM,70811.0,70811.0,4248.66,60189.35,49 CDM,101993,APLR HLX W/ANCH 114CM,100000.0,100000.0,6000.0,85000.0,49 CDM,101998,CANNULA PRFSN 24FR 60CM,30814.0,30814.0,1848.84,26191.9,49 CDM,101999,DEVICE CLSR VASC 26-29FR,67910.0,67910.0,8828.3,57723.5,28 CDM,102000,HEP B SURFACE AB QUAL,1149.0,1149.0,68.94,976.65,14 CDM,102000,Hepatitis B surface antibody (HBsAb) ,1149.0,1149.0,9.02,73.85,80 CDM,102002,GFT VASC 20-80CM 3-6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102004,MESH HRN PP 25X30IN S,100000.0,100000.0,13000.0,85000.0,28 CDM,102006,STENT VASC 6X140MM 125CM,73112.0,73112.0,9504.56,62145.2,28 CDM,102007,CRTD XT MRI QUAD DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102008,MODEL ANTM ACRYL BN,59459.0,59459.0,3567.54,50540.15,49 CDM,102010,HEP B S AG EIA QL,1149.0,1149.0,68.94,976.65,14 CDM,102010,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",1149.0,1149.0,8.68,71.04,80 CDM,102011,GUIDE SURG TI MANDIBLE,100000.0,100000.0,6000.0,85000.0,49 CDM,102016,SEPARATOR THRMB 190CM,50997.5,50997.5,3059.85,43347.88,49 CDM,102020,HEPATITIS BE AB QL,1232.0,1232.0,73.92,1047.2,14 CDM,102020,Hepatitis Be antibody (HBeAb) ,1232.0,1232.0,9.72,79.55,80 CDM,102027,COIL EMBL 2MM 6CM,15314.0,15314.0,1990.82,13016.9,28 CDM,102035,KIT CARDIAC CATHETER,4893.0,4893.0,293.58,4159.05,49 CDM,102037,LEAD PCNG 53CM,5831.0,5831.0,758.03,4956.35,28 CDM,102038,LEAD PCNG 60CM,5831.0,5831.0,758.03,4956.35,28 CDM,102039,LEAD PCNG VNS 78CM,23629.0,23629.0,3071.77,20084.65,28 CDM,102040,HEPATITIS C AB QUAL,1534.0,1534.0,92.04,1303.9,14 CDM,102040,Hepatitis C antibody; ,1534.0,1534.0,11.99,98.19,80 CDM,102045,HEP C AMP PROBE AMP,1746.08,1746.08,104.76,1484.17,14 CDM,102045,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",1746.08,1746.08,29.48,241.36,80 CDM,102047,CRT-D HF-T DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102049,CATH RTVR THRMB 12F 80CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102052,REM ECMO PERC PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,102053,REPOS ECMO OPEN =>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,102062,KIT STYL ASORT 58CM,2905.5,2905.5,174.33,2469.68,49 CDM,102066,CATH BLNDIL 2.5MM 150MM,6968.5,6968.5,418.11,5923.23,49 CDM,102067,COIL EMBL 40CM 15MM,29105.0,29105.0,3783.65,24739.25,28 CDM,102069,CATH BLN 1.5X20MM 145CM,8275.5,8275.5,496.53,7034.18,49 CDM,102070,HEMOGLOBIN ELECTRO,717.43,717.43,43.05,609.82,14 CDM,102070,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",717.43,717.43,10.81,88.51,80 CDM,102071,CATH BLNDIL 2X20MM 145CM,8275.5,8275.5,496.53,7034.18,49 CDM,102080,HISTAMINE BLOOD,1047.12,1047.12,62.83,890.05,14 CDM,102080,Histamine ,1047.12,1047.12,24.81,203.08,80 CDM,102091,SCREW BN LCK 5MM 60MM,4992.0,4992.0,648.96,4243.2,28 CDM,102092,MESH HRN PLGLY 10X6CM,29687.0,29687.0,3859.31,25233.95,28 CDM,102093,PEG BN GLND SZS-R MED,37187.0,37187.0,4834.31,31608.95,28 CDM,102095,SCREW CORT BN 4.5MM 30MM,1779.0,1779.0,231.27,1512.15,28 CDM,102098,REM RVAD PERC SEP SESS,10743.91,10743.91,644.63,9132.32,37 CDM,102099,REM LVAD PERC SEP SESS,4028.97,4028.97,241.74,3424.62,37 CDM,1021,M A IHC QT/SQT EA AB MAN,372.0,372.0,22.32,316.2,23 CDM,1021,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",372.0,372.0,289.87,572.77,20 CDM,102100,Antibody; HIV-1 ,1255.0,1255.0,7.47,61.18,80 CDM,102100,HIV-1 AB QUAL,1255.0,1255.0,75.3,1066.75,14 CDM,102101,COIL EMBL 4CM 2MM,15314.0,15314.0,1990.82,13016.9,28 CDM,102107,GWIRE VASC .014IN 182CM,2905.5,2905.5,174.33,2469.68,49 CDM,102108,IPG NRSTM 44MM 51MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102109,KIT NRSTM PT PROGRAMMER,47238.0,47238.0,2834.28,40152.3,49 CDM,102112,CANNUAL W GUIDE 30CM,78576.0,78576.0,4714.56,66789.6,49 CDM,102113,NEEDLE INTSTM 5IN 20GA,3249.5,3249.5,194.97,2762.07,49 CDM,102114,CANNULA AOR 15FR 17CM,17607.0,17607.0,1056.42,14965.95,49 CDM,102115,CANNULA AOR 17FR 17CM,17607.0,17607.0,1056.42,14965.95,49 CDM,102116,CANNULA DUAL 31FR 51CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102117,CANNULA INTROD 29FX46CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102119,CANNULA PRFSN 21FR 72CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102121,INTRCR SHTH 23FR 55.7CM,18488.5,18488.5,1109.31,15715.23,49 CDM,102125,STENT VASC 6FR 40X5MM,20606.0,20606.0,2678.78,17515.1,28 CDM,102126,STENT VASC 6FR 60X5MM,20606.0,20606.0,2678.78,17515.1,28 CDM,102129,STENT VASC 5X37MM 135CM,65634.0,65634.0,8532.42,55788.9,28 CDM,102130,STENT VASC 5X26MM 135CM,65634.0,65634.0,8532.42,55788.9,28 CDM,102135,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",1252.0,1252.0,6.74,55.2,80 CDM,102135,IGG SUBCLASSES EA,1252.0,1252.0,75.12,1064.2,14 CDM,102142,BURR CATH ARTHRM 1.25MM,59317.0,59317.0,3559.02,50419.45,49 CDM,102145,TUBING CNTRST INJ 48IN,329.5,329.5,19.77,280.07,49 CDM,102146,CATH GD LG .75 CRV 6FR,2150.5,2150.5,129.03,1827.92,49 CDM,102147,STENT VASC 6X37MM 135CM,65634.0,65634.0,8532.42,55788.9,28 CDM,102148,STENT VASC 7X26MM 135CM,82423.0,82423.0,10714.99,70059.55,28 CDM,102150,C1Q BINDING IMM COMP,775.45,775.45,46.53,659.13,14 CDM,102150,Immune complex assay ,775.45,775.45,20.47,167.61,80 CDM,102153,CTHGD 8F 100CM M1 MP1,2150.5,2150.5,129.03,1827.92,49 CDM,102157,CTHGD 8F 100CM M1 IM,2150.5,2150.5,129.03,1827.92,49 CDM,102158,STENT COR 4.00 X 28MM,22202.0,22202.0,2886.26,18871.7,28 CDM,102159,STENT COR 4.00 X 8MM,20184.0,20184.0,2623.92,17156.4,28 CDM,102162,STENT COR 5.00 X 32MM,24422.0,24422.0,3174.86,20758.7,28 CDM,102164,STENT COR 4.50 X 8MM,22202.0,22202.0,2886.26,18871.7,28 CDM,102165,COUNTERSINK LAG 2/2.5MM,22063.0,22063.0,1323.78,18753.55,49 CDM,102166,STENT COR 5.00 X 8MM,19820.0,19820.0,2576.6,16847.0,28 CDM,102167,STENT COR 4.50 X 24MM,24422.0,24422.0,3174.86,20758.7,28 CDM,102173,CTHGD 7F 100CM M1 JR4,2150.5,2150.5,129.03,1827.92,49 CDM,102175,CTHGD 7F 100CM M1 IM,2150.5,2150.5,129.03,1827.92,49 CDM,102177,GRAFT ENDO AAA 36X14MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102178,GUIDE AAA 16FR 28MM,54263.5,54263.5,3255.81,46123.97,49 CDM,102179,LEAD PCNG 4.1FR 59CM,6040.0,6040.0,785.2,5134.0,28 CDM,102181,CATH ANGIO VNGR BLN P1,2731.5,2731.5,163.89,2321.78,49 CDM,102183,CRTD HF QUAD MRI IS4 DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102185,GWIRE VASC .017X.014 PGW,6273.0,6273.0,376.38,5332.05,49 CDM,102186,CANNULA VNS 19FR 69.9CM,11973.0,11973.0,718.38,10177.05,49 CDM,102187,ADAPTER 3.25IN 6FR .25IN,240.5,240.5,14.43,204.43,49 CDM,102188,KIT PROCESSING 125ML,3360.0,3360.0,201.6,2856.0,49 CDM,102190,IGA EA,1015.47,1015.47,60.93,863.15,14 CDM,102198,CATH IMAGING 20MM 150CM,21570.0,21570.0,1294.2,18334.5,49 CDM,102199,ANCHOR SUT 1.8MM,17670.0,17670.0,2297.1,15019.5,28 CDM,102203,CANNULA ART FEM 21F/55CM,12219.5,12219.5,733.17,10386.58,49 CDM,102204,CANNULA VENOUS FEM 23FR,11045.0,11045.0,662.7,9388.25,49 CDM,102205,CANNULA VENOUS 25FR,15522.5,15522.5,931.35,13194.13,49 CDM,102206,DEVICE CLS WND +3-0 15CM,1433.0,1433.0,85.98,1218.05,49 CDM,102209,MATRISTEM MICROMATRX 1MG,151.0,151.0,9.06,128.35,25 CDM,102210,Gammaglobulin (immunoglobulin); IgE ,1226.0,1226.0,13.83,113.22,80 CDM,102210,IGE,1226.0,1226.0,73.56,1042.1,14 CDM,102212,KIT CRDPLG TUBE .25 IN,3214.5,3214.5,192.87,2732.32,49 CDM,102213,PROBE CRYO-ABLTN 10CM,23367.5,23367.5,1402.05,19862.38,49 CDM,102216,OCCLUDER CV 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102217,CATH DRN 8FR 2.7MM 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,102219,CATH DRN 10FR 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,102220,IGG EA,1027.0,1027.0,61.62,872.95,14 CDM,102225,VALVE AORTIC 27/29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102229,CATH JJNSTM 13G 30CM,5227.5,5227.5,313.65,4443.38,49 CDM,102230,SUSC 1-12 DISKS,978.55,978.55,58.71,831.77,14 CDM,102230,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",978.55,978.55,6.28,51.4,80 CDM,102234,LEAD PCNG 86CM,27407.0,27407.0,3562.91,23295.95,28 CDM,102239,SLEEVE CONN 1S4/DF4,4516.5,4516.5,587.14,3839.03,28 CDM,102240,IGM EA,1027.0,1027.0,61.62,872.95,14 CDM,102241,STENT BIL 6FR 7MM 37MM,21020.0,21020.0,2732.6,17867.0,28 CDM,102257,CRTD HF MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 CDM,102258,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,102261,CATH GD 6FR 125CM,2150.5,2150.5,129.03,1827.92,49 CDM,102262,ARTH JNTBRS MJR WO US,1886.0,1886.0,113.16,1603.1,37 CDM,102265,ICD DEFIB 68X51X13MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102266,PATCH FBRN SEALANT 2X4IN,25698.0,25698.0,1541.88,21843.3,49 CDM,102269,ELECTRD ESRG CBLTN FLW50,17767.5,17767.5,1066.05,15102.38,49 CDM,102271,BLADE SHAVER 3.5MM,4220.0,4220.0,253.2,3587.0,49 CDM,102272,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,102273,DRESSING KIT WND LG,7758.5,7758.5,465.51,6594.73,49 CDM,102274,TTVR - EA ADDL DEVICE,71298.34,71298.34,4277.9,60603.59,37 CDM,102275,MESH PERM CIRC 12X12CM,59257.0,59257.0,7703.41,50368.45,28 CDM,102278,CATH BLNDIL 4MM 120MM,7049.0,7049.0,422.94,5991.65,49 CDM,102280,INSULIN TOTAL,675.0,675.0,40.5,573.75,14 CDM,102280,Insulin; total ,675.0,675.0,9.6,78.64,80 CDM,102282,SEALANT FIBRN PREFL 4ML,7241.0,7241.0,434.46,6154.85,49 CDM,102284,SLING ORTHO ARM,1894.0,1894.0,113.64,1609.9,38 CDM,102284,Slings ,1894.0,1894.0,10.76,23.61,50 CDM,102287,SCREW BN 5MM 47.5MM,17147.0,17147.0,2229.11,14574.95,28 CDM,102289,LEAD CRT PACING 88CM,26589.0,26589.0,3456.57,22600.65,28 CDM,102290,INSULIN AB,981.0,981.0,58.86,833.85,14 CDM,102290,Insulin antibodies ,981.0,981.0,17.98,147.24,80 CDM,102291,GRAFT VASC 12X30X30MM,34435.0,34435.0,4476.55,29269.75,28 CDM,102295,PERIPH ATH ILI ART EACH,83266.34,83266.34,4995.98,70776.39,37 CDM,102301,STENT BIL 7FR 10MM 25MM,21020.0,21020.0,2732.6,17867.0,28 CDM,102302,STENT BIL 7FR 9MM 25MM,21020.0,21020.0,2732.6,17867.0,28 CDM,102303,VALVE MITRAL 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102304,VALVE MITRAL 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102305,VALVE MITRAL 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102306,VALVE MITRAL 31MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102307,VALVE MITRAL SIZE 33,100000.0,100000.0,13000.0,85000.0,28 CDM,102308,CATH GD 4FR 135CM,6273.0,6273.0,376.38,5332.05,49 CDM,102310,IRON BINDING,979.0,979.0,58.74,832.15,14 CDM,102310,Iron binding capacity ,979.0,979.0,7.34,60.09,80 CDM,102320,IRON,795.0,795.0,47.7,675.75,14 CDM,102320,Iron ,795.0,795.0,5.43,44.53,80 CDM,102323,ELECTRODE LOOP 24FR,14612.5,14612.5,876.75,12420.63,49 CDM,102324,KWIRE FX 1.15MM 3MM,1636.5,1636.5,98.19,1391.03,49 CDM,102326,BIT DRILL 2.1MM,6441.5,6441.5,386.49,5475.27,49 CDM,102330,SCREW BN HD 4MM 40MM,6240.0,6240.0,811.2,5304.0,28 CDM,102340,SYSTEM CBL HIP 23X121MM,88962.0,88962.0,11565.06,75617.7,28 CDM,102341,SCREW BN 4.5MM 42MM,6676.0,6676.0,867.88,5674.6,28 CDM,102347,SCREW BN 5MM 42MM,17147.0,17147.0,2229.11,14574.95,28 CDM,102359,PATCH REF EXTERNAL,15095.0,15095.0,905.7,12830.75,49 CDM,102360,CATH GD 9FR 50CM,8698.0,8698.0,521.88,7393.3,49 CDM,102361,STYLET LD KIT ACC 17CM,1627.5,1627.5,97.65,1383.38,49 CDM,102369,GWIRE VASC 190CM .014IN,5018.5,5018.5,301.11,4265.73,49 CDM,102371,GWIRE VASC 190CM .014IN,5018.5,5018.5,301.11,4265.73,49 CDM,102372,GWIRE STRAIGHT 190CM,3098.0,3098.0,185.88,2633.3,49 CDM,102378,ADHESIVE SURGICAL TUBE,1068.0,1068.0,138.84,907.8,28 CDM,102379,KIT LD CAP 4FR 3.2MM,915.0,915.0,118.95,777.75,28 CDM,102381,STENT ILAC 6X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102382,STENT ILAC 8X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102383,STENT ILAC 8X40MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102384,STENT ILAC 8X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102385,STENT ILAC 10X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102386,STENT ILAC 10X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,102387,STENT BIL 6FR 7MM 17MM,21020.0,21020.0,2732.6,17867.0,28 CDM,102388,STENT BIL 6FR 8MM 17MM,21020.0,21020.0,2732.6,17867.0,28 CDM,102390,DEST CELIAC PLEXUS,3845.01,3845.01,230.7,3268.26,37 CDM,102391,CATH BLN 5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102393,CATH BLN 5X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102394,CATH BLN 5X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102395,CATH BLN 5X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102396,CATH BLN 6X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102397,CATH BLN 6X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102398,CATH BLN 6X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102399,CATH BLN 6X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102400,ICD CRD 5.3X7.79X0.99CM,100000.0,100000.0,13000.0,85000.0,28 CDM,102403,CANNULA ART 21FR 3/8IN,15318.5,15318.5,919.11,13020.73,49 CDM,102404,HEMOSTAT ABS NWVN 4X4IN,4164.5,4164.5,249.87,3539.82,49 CDM,102405,GWIRE IAB .018IN 260CM,17607.0,17607.0,1056.42,14965.95,49 CDM,102406,PURAPLY AM 1SQCM,4327.0,4327.0,259.62,3677.95,25 CDM,102406,"Puraply am, per square centimeter (add-on, list separately in addition to primary procedure) ",4327.0,4327.0,166.66,307.44,8 CDM,102408,CATH GD 90D 7.1FR,7677.0,7677.0,460.62,6525.45,49 CDM,102410,LACTIC ACID,632.0,632.0,37.92,537.2,14 CDM,102412,LEAD ANCH SLV KT 4/6/9FR,443.0,443.0,57.59,376.55,28 CDM,102413,STYLET LD 65CM .014 KIT,1627.5,1627.5,97.65,1383.38,49 CDM,102414,SYS INTRO 23CM 11FR 18GA,2905.5,2905.5,174.33,2469.68,49 CDM,102416,LEAD CRT PCNG 8.6FR 72CM,48627.0,48627.0,6321.51,41332.95,28 CDM,102417,GRAFT BN LGII 8CC 3X4IN,100000.0,100000.0,13000.0,85000.0,28 CDM,102420,LDH (LD),1021.0,1021.0,61.26,867.85,14 CDM,102424,GWIRE ENDO .035IN 450CM,4284.0,4284.0,257.04,3641.4,49 CDM,102425,PLUG VASC 4MM 10MM,30398.0,30398.0,3951.74,25838.3,28 CDM,102426,PLUG VASC 5MM 10.5MM,30398.0,30398.0,3951.74,25838.3,28 CDM,102427,PLUG VASC 6MM 11MM,30398.0,30398.0,3951.74,25838.3,28 CDM,102428,PLUG VASC 7MM 12.5MM,30398.0,30398.0,3951.74,25838.3,28 CDM,102429,PLUG VASC 8MM 13.5MM,30398.0,30398.0,3951.74,25838.3,28 CDM,102430,KIT CATH CANNL 31FR 36CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102431,PCMKR CRD 4.45X4.81X0.75,42819.0,42819.0,5566.47,36396.15,28 CDM,102432,DEVICE CLS WND +2-0 15CM,1311.0,1311.0,78.66,1114.35,49 CDM,102436,CATH ABL 8FR 115CM F CRV,100000.0,100000.0,6000.0,85000.0,49 CDM,102437,LEAD PACING 59CM,5971.0,5971.0,776.23,5075.35,28 CDM,102445,TUBE ENDBR 9FR 78CM 7MM,8522.0,8522.0,511.32,7243.7,49 CDM,102448,KIT SUPRAPUBIC 12FR,4391.0,4391.0,263.46,3732.35,49 CDM,102449,GRAFT CV 6MM 45CM,92467.0,92467.0,12020.71,78596.95,28 CDM,102452,SCREW BN 3MM 16MM,5265.0,5265.0,684.45,4475.25,28 CDM,102453,SCREW BN NLCK 3X12MM,5727.0,5727.0,744.51,4867.95,28 CDM,102454,INTRO SHTH 7FR 25CM,2534.0,2534.0,152.04,2153.9,49 CDM,102455,CATH BLN PTCA 3X15MM,21398.5,21398.5,1283.91,18188.72,49 CDM,102456,CATH BLN PTCA 2.5X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,102460,LEAD BLOOD,741.16,741.16,44.47,629.99,14 CDM,102460,Lead ,741.16,741.16,10.17,83.26,80 CDM,102472,KIT INSTR FOR STPL 18MM,17607.0,17607.0,1056.42,14965.95,49 CDM,102473,ENVELOPE NEURO 6.3X6.9CM,27322.0,27322.0,3551.86,23223.7,28 CDM,102474,CATH BLNDL 21MM 110CM,21508.5,21508.5,1290.51,18282.22,49 CDM,102475,CATH BLNDL 23MM 110CM,21508.5,21508.5,1290.51,18282.22,49 CDM,102476,ICD XT MRI DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102479,KIT INSTRUMENT ORTHO,18396.0,18396.0,1103.76,15636.6,49 CDM,102489,ICD DC DR-T DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102491,LEAD ICD ENDO 65CM,46682.0,46682.0,6068.66,39679.7,28 CDM,102492,LEGIONELLA AG EIA,398.0,398.0,23.88,338.3,14 CDM,102494,BOLT PLT BN 3.5MM 32MM,19633.0,19633.0,2552.29,16688.05,28 CDM,102496,BOLT BN THRD 3.5MM 36MM,17866.0,17866.0,2322.58,15186.1,28 CDM,102497,INTRO SHTH 8.5FR 40CM,32509.0,32509.0,1950.54,27632.65,49 CDM,102498,SCREW BN 4.5MM 38MM,6676.0,6676.0,867.88,5674.6,28 CDM,102499,SCREW BN 4.5MM 44MM,6676.0,6676.0,867.88,5674.6,28 CDM,102501,SCREW BN 4.5X6.5X1.75MM,6676.0,6676.0,867.88,5674.6,28 CDM,102502,CATH BLN 6X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102503,CATH BLN 2.5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102504,CATH BLN 2.5X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102505,CATH BLN 2.5X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102506,CATH BLN 2.5X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102507,CATH BLN .014 2.5X120MM,6273.0,6273.0,376.38,5332.05,49 CDM,102508,CATH BLN 3X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102509,CATH BLN 3.0X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102511,CATH BLN 3X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102513,CATH BLN PTA 3X100MM,6273.0,6273.0,376.38,5332.05,49 CDM,102514,CATH BLN 3X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102515,CATH BLN 3.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102516,CATH BLN 3.5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102517,CATH BLN 3.5X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102518,CATH BLN 3.5X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102519,CATH BLN 3.5X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102520,CATH BLN 3.5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102521,CATH BLN 4X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102522,CATH BLN 4X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102523,CATH BLN 4X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102524,CATH BLN 4X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102525,CATH BLN 4X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102526,CATH BLN 4X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102528,CRTD HF MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,102529,CATH BLNDL 25MM 110CM,21508.5,21508.5,1290.51,18282.22,49 CDM,102530,LIPASE,865.0,865.0,51.9,735.25,14 CDM,102530,Lipase ,865.0,865.0,5.79,47.42,80 CDM,102533,GWIRE VASC 190CM .014IN,3764.0,3764.0,225.84,3199.4,49 CDM,102534,GWIRE VASC 190CM .014IN,5018.5,5018.5,301.11,4265.73,49 CDM,102535,MESH HRN 9X9CM,33325.0,33325.0,4332.25,28326.25,28 CDM,102536,MESH HRN PP 12CM 18CM,88885.0,88885.0,11555.05,75552.25,28 CDM,102540,LIPID PANEL,1565.0,1565.0,93.9,1330.25,14 CDM,102540,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",1565.0,1565.0,7.66,92.13,80 CDM,102542,CATH THRMB 12FR 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102548,KIT CATH PERI 8.3FR,5018.5,5018.5,301.11,4265.73,49 CDM,102551,CATH GD 9FR 50CM,20553.0,20553.0,1233.18,17470.05,49 CDM,102552,CRT DEFIB CARD DF1,100000.0,100000.0,13000.0,85000.0,28 CDM,102555,NDL CSCP 35CM 23GA 3.7F,2731.5,2731.5,163.89,2321.78,49 CDM,102556,CATH BLN 3X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102557,CATH BLN 3.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102558,CATH BLN 3.5X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102559,CATH BLN 3.5X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102560,LITHIUM QN,820.0,820.0,49.2,697.0,14 CDM,102560,Lithium ,820.0,820.0,5.55,45.43,80 CDM,102562,CATH BLN 3.5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102563,CATH BLN 2X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102564,CATH BLN 2X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102565,CATH BLN 2X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102566,CATH BLN 2X120MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102567,CATH BLN 2X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102568,CATH BLN 2.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102569,CATH BLN 2.5X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102570,CATH BLN 2.5X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102571,CATH BLN 2.5X120MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102572,CATH BLN 2.5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102573,CATH BLN 3X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102574,CATH BLN 3X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102575,CATH BLN 3X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102576,CATH BLN 3X120MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,102577,CATH BLN 5X60MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102578,CATH BLN 5X80MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102579,CATH BLN 5X100MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102580,CATH BLN 5X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102581,CATH BLN 5X240MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102582,CATH BLN 6X60MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102583,CATH BLN 6X80MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102584,CATH BLN 6X100MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102585,CATH BLN 6X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102586,CATH BLN 6X240MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102587,CATH BLN 7X60MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102588,CATH BLN 7X80MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102589,CATH BLN 7X100MM 135CM,2905.5,2905.5,174.33,2469.68,49 CDM,102591,CATH BLN 7X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 CDM,102592,CATH BLN 2X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102593,CATH BLN 2X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102594,CATH BLN 2X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102595,CATH BLN 2X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102596,CATH BLN 2X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102597,CATH BLN 2.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102600,Gonadotropin; luteinizing hormone (LH) ,1952.0,1952.0,15.56,127.42,80 CDM,102600,LH,1952.0,1952.0,117.12,1659.2,14 CDM,102605,GRAFT VASC 10X14MM 30CM,30476.0,30476.0,3961.88,25904.6,28 CDM,102606,GRAFT VASC 8X12MM 30CM,30476.0,30476.0,3961.88,25904.6,28 CDM,102607,GRAFT CV 18MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,102608,GRAFT CV 14MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,102611,CATH BLN 3X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102614,SYSTEM DELIVERY ICD,30814.0,30814.0,1848.84,26191.9,49 CDM,102621,SCREW BN 5MM 40MM,6420.0,6420.0,834.6,5457.0,28 CDM,102624,TOOL TUNNELING VASC GRFT,14086.0,14086.0,845.16,11973.1,49 CDM,102626,CANNULA INNR 7.0MM,174.5,174.5,10.47,148.32,49 CDM,102629,FORCEP BX 2.2MM 240CM,2003.0,2003.0,120.18,1702.55,49 CDM,102630,MAGNESIUM BLD,925.79,925.79,55.55,786.92,14 CDM,102633,PORT IMPL INFSN 6FR,12566.0,12566.0,1633.58,10681.1,28 CDM,102634,NAIL BN 11.5MM 18CM,33794.0,33794.0,4393.22,28724.9,28 CDM,102636,BLADE SHVR DISP 4MM,2150.5,2150.5,129.03,1827.92,49 CDM,102637,IMPLANT COLLAGEN LARGE,100000.0,100000.0,13000.0,85000.0,28 CDM,102640,SMR BLD PARASIT/INCL BDY,795.23,795.23,47.71,675.95,14 CDM,102640,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",795.23,795.23,5.03,41.18,80 CDM,102643,CATH BLNDIL 18MM 6X100CM,15345.0,15345.0,920.7,13043.25,49 CDM,102646,CATH BLNDIL 20MM 5X100CM,15345.0,15345.0,920.7,13043.25,49 CDM,102648,CMPD KETAMIN 1000MG 100B,61.86,61.86,3.71,52.58,30 CDM,102651,SCREW BN 5X37MM,6420.0,6420.0,834.6,5457.0,28 CDM,102653,CRT DEFIB CARD 51X74MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102654,LEAD ICD DEFIB 58CM,67522.0,67522.0,8777.86,57393.7,28 CDM,102655,GRAFT ENDO AAA 26X12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102658,CATH THRMB 4F 80CM,1918.0,1918.0,115.08,1630.3,49 CDM,102659,DEVICE CLOSURE 14FR,29794.0,29794.0,3873.22,25324.9,28 CDM,102660,CATH BLN 5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102661,KIT INJ ORAL NDL 1CC,22648.5,22648.5,1358.91,19251.22,27 CDM,102662,CUFF URTH SPHNCR AB 4.5C,100000.0,100000.0,13000.0,85000.0,28 CDM,102664,CATH INFS 5FR 135CM,5395.0,5395.0,323.7,4585.75,49 CDM,102665,SPHERE EMBL 500UM 2ML,6240.0,6240.0,811.2,5304.0,28 CDM,102667,KIT ARTHSCP CRVD INSRTR,22178.5,22178.5,1330.71,18851.72,49 CDM,102668,CATH BLN 2X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,102676,ANCHOR SUT 4.5MM 12MM,10013.0,10013.0,1301.69,8511.05,28 CDM,102679,DRILL BIT 3.6MM,7315.0,7315.0,438.9,6217.75,49 CDM,102680,"Hemoglobin; methemoglobin, quantitative ",316.51,316.51,6.89,56.38,80 CDM,102680,METHEMOGLOBIN QUANT,316.51,316.51,18.99,269.03,14 CDM,102681,TAP FOR 4.5MM ANCHOR,7980.0,7980.0,478.8,6783.0,49 CDM,102686,GWIRE VASC .014IN 190CM,6147.5,6147.5,368.85,5225.38,49 CDM,102687,GWIRE VASC MIC.014 300CM,6147.5,6147.5,368.85,5225.38,49 CDM,102689,STENT EPRSTH 10MM 8CM,100000.0,100000.0,13000.0,85000.0,28 CDM,102691,CATH EP 6FR 110CM PSH,5535.0,5535.0,332.1,4704.75,49 CDM,102692,DEVICE ASST TRAVEL CASE,6273.0,6273.0,376.38,5332.05,49 CDM,102694,CATH MAPPING 3.0CM,74684.0,74684.0,4481.04,63481.4,49 CDM,102695,CATH MAPPING 1.5CM,74684.0,74684.0,4481.04,63481.4,49 CDM,102696,CATH ANGIO 6FR 100CM,434.5,434.5,26.07,369.32,49 CDM,102698,LEAD CRT PCNG 5.3FR 88CM,20827.0,20827.0,2707.51,17702.95,28 CDM,102700,METHOTREXATE RHEUMAT QN,1346.49,1346.49,80.79,1144.52,27 CDM,102700,Methotrexate ,1346.49,1346.49,32.4,204.79,67 CDM,102701,DRILL SURG DISP 35MM,15459.0,15459.0,927.54,13140.15,49 CDM,102702,CATH ULTSND IVL 3.5X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102703,GRAFT VASC STD 60CM 6MM,69877.0,69877.0,9084.01,59395.45,28 CDM,102705,CATH ULTSND IVL 5X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102706,CATH ULTSND IVL 5.5X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102707,CATH ULTSND IVL 6X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102708,CATH ULTSND IVL 6.5X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102709,CATH ULTSND IVL 7X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102710,CATH ULTSND IVL 8X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102720,CATH ATHRCM 2MM 145CM,100000.0,100000.0,6000.0,85000.0,49 CDM,102723,SCREW BN 4MM 6MM 55MM,747.0,747.0,97.11,634.95,28 CDM,102724,DILATOR BLN 8X180CM,5546.5,5546.5,332.79,4714.52,49 CDM,102725,SCREW BN 6.0MM,3629.0,3629.0,471.77,3084.65,28 CDM,102726,IMPLANT TOE JOINT 20MM,84376.0,84376.0,10968.88,71719.6,28 CDM,102727,CATH ULTSND IVL 4.0X60MM,100000.0,100000.0,6000.0,85000.0,49 CDM,102728,DEVICE CLSR FEM ART 14F,3274.0,3274.0,425.62,2782.9,28 CDM,102729,DEVICE CLSR FEM ART 8F,2541.0,2541.0,330.33,2159.85,28 CDM,102730,DEVICE CLSR VASC 18FR,29794.0,29794.0,3873.22,25324.9,28 CDM,102742,A/V FIST UP EXT SEP PERC,15002.98,15002.98,900.18,12752.53,37 CDM,102743,A/V FIST UP EXT SGL PERC,15002.98,15002.98,900.18,12752.53,37 CDM,102745,RETRCTR WND XLG 11-17CM,3973.0,3973.0,238.38,3377.05,49 CDM,102749,SUTURE CLR MONO 2-0 27IN,159.5,159.5,9.57,135.57,49 CDM,102750,Heterophile antibodies; screening ,736.0,736.0,4.35,35.66,80 CDM,102750,MONO SCR (HETEROPHILE),736.0,736.0,44.16,625.6,14 CDM,102751,SYSTEM XTRT 17CM,13205.5,13205.5,792.33,11224.67,49 CDM,102752,SYSTEM XTRT 14CM,13205.5,13205.5,792.33,11224.67,49 CDM,102753,CATHETER DRN 36FR,623.0,623.0,37.38,529.55,49 CDM,102754,PLEDGET CV 1.5X7X3MM,118.5,118.5,7.11,100.72,49 CDM,102755,PROSTH PENL PS 10CM 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,102756,PERC PLEUR DRN W/ IMG,6768.66,6768.66,406.12,5753.36,37 CDM,102764,TENDON PTLR PSHP 10/10MM,97014.0,97014.0,12611.82,82461.9,28 CDM,102765,RETRACTOR SG 32.5X18.3CM,2912.0,2912.0,174.72,2475.2,49 CDM,102767,KIT SHTH 6FR 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,102768,SYSTEM ACC FX CRV DBL,30814.0,30814.0,1848.84,26191.9,49 CDM,102769,SYSTEM ACC FX CRV SGL,30814.0,30814.0,1848.84,26191.9,49 CDM,102773,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,102774,VALVE HEART 52MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102775,CATHETER THRMB 4FR 80CM,4675.0,4675.0,280.5,3973.75,49 CDM,102777,EXPANDER TISS 500-600CC,54975.0,54975.0,7146.75,46728.75,28 CDM,102778,SUTURE BRD NDL ASSY SZ5,2905.5,2905.5,174.33,2469.68,49 CDM,102779,BLADE SHVR LILAC 4MM,2150.5,2150.5,129.03,1827.92,49 CDM,102786,CANNULA VASC 27FR 76.2CM,11973.0,11973.0,718.38,10177.05,49 CDM,102787,GWIRE VASC 190CM .014IN,5018.5,5018.5,301.11,4265.73,49 CDM,102788,GWIRE VASC 190CM .014IN,3764.0,3764.0,225.84,3199.4,49 CDM,102790,MYCOPLASMA AB IGG QL,811.06,811.06,48.66,689.4,14 CDM,102795,PLATE BN 6HL 3.5MM 194MM,43560.0,43560.0,5662.8,37026.0,28 CDM,102803,STENT COR 4.50MMX22MM,17981.0,17981.0,2337.53,15283.85,28 CDM,102804,STENT COR 5.00MMX30MM,17981.0,17981.0,2337.53,15283.85,28 CDM,102805,STENT COR 5.00MMX26MM,17981.0,17981.0,2337.53,15283.85,28 CDM,102806,STENT COR 5.00MMX22MM,17981.0,17981.0,2337.53,15283.85,28 CDM,102807,STENT COR 5.00MMX18MM,16346.0,16346.0,2124.98,13894.1,28 CDM,102808,STENT COR 5.00MMX15MM,16346.0,16346.0,2124.98,13894.1,28 CDM,102809,STENT COR 5.00MMX12MM,16346.0,16346.0,2124.98,13894.1,28 CDM,102811,STENT COR 4.50MMX30MM,14860.0,14860.0,1931.8,12631.0,28 CDM,102812,STENT COR 4.50MMX26MM,16346.0,16346.0,2124.98,13894.1,28 CDM,102813,STENT COR 4.50MMX18MM,14860.0,14860.0,1931.8,12631.0,28 CDM,102814,STENT COR 4.50MMX15MM,17981.0,17981.0,2337.53,15283.85,28 CDM,102815,STENT COR 4.50MMX12MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102816,STENT COR 4.00MMX38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102818,STENT COR 4.00MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102819,STENT COR 4.00MMX26MM,13542.0,13542.0,1760.46,11510.7,28 CDM,102820,MYOGLOBIN BLD,466.85,466.85,28.01,396.82,14 CDM,102821,STENT COR 4.00MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102822,STENT COR 4.00MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102823,STENT COR 4.00MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102824,STENT COR 4.00MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102825,STENT COR 4.00MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102826,STENT COR 3.50MMX38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102827,STENT COR 3.50MMX34MM,13542.0,13542.0,1760.46,11510.7,28 CDM,102828,STENT COR 3.50MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102829,STENT COR 3.50MMX26MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102830,MYOGLOBIN URINE,467.0,467.0,28.02,396.95,14 CDM,102831,STENT COR 3.50MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102832,STENT COR 3.50MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102833,STENT COR 3.50MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102834,STENT COR 3.50MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102835,STENT COR 3.50MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102836,STENT COR 3.00MMX38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102837,STENT COR 3.00MMX34MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102838,STENT COR 3.00MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102839,STENT COR 3.00MMX26MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102841,STENT COR 3.00MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102842,STENT COR 3.00MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102843,STENT COR 3.00MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102844,STENT COR 3.00MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102846,STENT COR 3.00MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102847,STENT COR 2.75MM 38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102848,STENT COR 2.75MMX34MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102849,STENT COR 2.75MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102851,STENT COR 2.75MMX26MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102852,STENT COR 2.75MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102853,STENT COR 2.75MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102854,STENT COR 2.75MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102855,STENT COR 2.75MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102856,STENT COR 2.75MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102857,STENT COR 2.50MMX38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102858,STENT COR 2.50MMX34MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102859,STENT COR 2.50MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102860,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",385.0,385.0,3.68,30.14,80 CDM,102860,OCCULT BLD SCN 3 SPEC,385.0,385.0,23.1,327.25,14 CDM,102861,STENT COR 2.50MMX26MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102862,STENT COR 2.50MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102863,STENT COR 2.50MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102864,STENT COR 2.50MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102865,STENT COR 2.50MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102866,STENT COR 2.50MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102867,STENT COR 2.25MMX38MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102868,STENT COR 2.25X34MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102869,STENT COR 2.25MMX30MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102870,OCC BLD PEROX OTH SOURCE,385.0,385.0,23.1,327.25,14 CDM,102871,STENT COR 2.25MMX26MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102872,STENT COR 2.25MMX22MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102873,STENT COR 2.25MMX18MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102874,STENT COR 2.25MMX15MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102875,STENT COR 2.25MMX12MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102876,STENT COR 2.25MMX08MM,13298.0,13298.0,1728.74,11303.3,28 CDM,102877,STENT COR 2.00MMX30MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102878,STENT COR 2.00MMX26MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102879,STENT COR 2.00MM X22 MM,16652.0,16652.0,2164.76,14154.2,28 CDM,102880,OLIGOCLONAL BANDS,1337.0,1337.0,80.22,1136.45,14 CDM,102880,Oligoclonal immune (oligoclonal bands) ,1337.0,1337.0,23.01,188.42,80 CDM,102881,STENT COR 2.00MMX18MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102882,STENT COR 2.0MMX15MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102883,STENT COR 2.00MMX12MM,14592.0,14592.0,1896.96,12403.2,28 CDM,102884,STENT COR 2.00MMX08MM,14860.0,14860.0,1931.8,12631.0,28 CDM,102885,ADAPTER Y VNT CLR,527.0,527.0,31.62,447.95,49 CDM,102891,SYSTEM URTH SUPP BLU,29010.0,29010.0,3771.3,24658.5,28 CDM,102892,INTEGRA MESHED 1SQCM,5343.0,5343.0,320.58,4541.55,30 CDM,102894,CATH BLN 7X60MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102895,CATH BLN 7X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102896,CATH BLN 6X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102897,CATH BLN 6X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102898,CATH BLN 6X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102899,CATH BLN 6X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102900,OSMOLALITY BLD,843.0,843.0,50.58,716.55,14 CDM,102900,Osmolality; blood ,843.0,843.0,5.55,45.43,80 CDM,102901,CATH BLN 5X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102902,CATH BLN 5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102903,CATH BLN 5X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102904,CATH BLN 6X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102905,CATH BLN 6X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102906,CATH BLN 5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102907,CATH BLN 4X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102908,CATH BLN 3.5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102909,CATH BLN 3X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102910,OSMOLALITY UR,843.0,843.0,50.58,716.55,14 CDM,102910,Osmolality; urine ,843.0,843.0,5.73,46.88,80 CDM,102911,CATH BLN 2.5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102912,CATH BLN 2X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,102913,GUIDEWIRE .36/.27 190/15,5018.5,5018.5,301.11,4265.73,49 CDM,102922,SCREW BN HDLS 2.5X10MM,13744.0,13744.0,1786.72,11682.4,28 CDM,102923,"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in ",2014.65,2014.65,46.38,64.02,5 CDM,102923,ECHO DOPPLER LTD,2014.65,2014.65,120.88,1712.45,44 CDM,102925,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",3379.24,3379.24,235.9,449.33,17 CDM,102925,TEE 2D W/WOM MODE COMP,3379.24,3379.24,202.75,2872.35,33 CDM,102926,TTE2D W OR W/WO CN W DOP,4974.84,4974.84,298.49,4228.61,39 CDM,102926,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral",4974.84,4974.84,1593.12,2199.05,5 CDM,102928,ECHO2D COMP W CF DOP,3379.24,3379.24,202.75,2872.35,39 CDM,102928,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc",3379.24,3379.24,317.09,437.7,5 CDM,102929,"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); complete ",2733.21,2733.21,83.49,115.25,5 CDM,102929,ECHO DOPPLER COMP,2733.21,2733.21,163.99,2323.23,44 CDM,102930,O&P SMEAR CONC ID,795.0,795.0,47.7,675.75,14 CDM,102930,"Ova and parasites, direct smears, concentration and identification ",795.0,795.0,7.48,61.18,80 CDM,102932,Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) ,2014.65,2014.65,52.28,72.16,5 CDM,102932,ECHO COLOR FLOW MAPPING,2014.65,2014.65,120.88,1712.45,44 CDM,102933,ECHO STRESS W CONT ECG,3379.24,3379.24,202.75,2872.35,39 CDM,102933,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",3379.24,3379.24,349.97,483.08,5 CDM,102934,ECHO STRESS,3379.24,3379.24,202.75,2872.35,33 CDM,102934,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",3379.24,3379.24,185.11,382.98,18 CDM,102935,OXALATE,1151.0,1151.0,69.06,978.35,14 CDM,102935,Oxalate ,1151.0,1151.0,12.14,99.37,80 CDM,102936,ECHO 2D W/WOM MODE LTD,1568.74,1568.74,94.12,1333.43,33 CDM,102936,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",1568.74,1568.74,98.24,238.63,17 CDM,102937,INTRACARDIAC ECHO,4808.3,4808.3,625.08,4087.05,20 CDM,102938,3D ECHO TEE/TTE CONG CA,4808.3,4808.3,288.5,4087.05,38 CDM,102938,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",4808.3,4808.3,23.73,101.82,18 CDM,102941,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",8481.68,8481.68,219.53,764.8,17 CDM,102941,TEE GUIDANCE INTRACARD,8481.68,8481.68,508.9,7209.43,38 CDM,102942,TTE W W/WO STRS CONT ECG,4974.84,4974.84,298.49,4228.61,39 CDM,102942,"Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardio",4974.84,4974.84,1593.12,2199.05,5 CDM,102945,TRANS ANGIO SAME ART EAD,24875.5,24875.5,1492.53,21144.17,37 CDM,102948,INIT ECMO VENO-ARTERIAL,25490.95,25490.95,1529.46,21667.31,37 CDM,102951,CHEMODNRV TRNK MUSCL 1-5,4209.78,4209.78,252.59,3578.31,37 CDM,102952,SCREW BN 2.5MM 18MM,15432.0,15432.0,2006.16,13117.2,28 CDM,102953,CATH EP 6FR 95CM,23881.0,23881.0,1432.86,20298.85,49 CDM,102954,SCREW BN CANN 3.5X16MM,13744.0,13744.0,1786.72,11682.4,28 CDM,102955,GRFT EVAS 125X46X40-42MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102958,SPACER SPN 60MM 24MM,88841.0,88841.0,11549.33,75514.85,28 CDM,102969,BLADE SHAVER 3.5MM,6273.0,6273.0,376.38,5332.05,49 CDM,102972,SCREW BN 14MM 3.5X34MM,17866.0,17866.0,2322.58,15186.1,28 CDM,102978,BOLT BN PLATE 3.5X40MM,19211.0,19211.0,2497.43,16329.35,28 CDM,102979,GRAFT EVAS 30MM 96MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102980,GRAFT EVAS 20MM 90MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102981,GRAFT EVAS 56MM 14F 16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,102982,DILATOR SURG HDRPH 16FR,8310.5,8310.5,498.63,7063.93,49 CDM,102983,DILATOR SURG HDRPH.035IN,8310.5,8310.5,498.63,7063.93,49 CDM,102985,STENT CARTID SYS 10X30MM,74792.0,74792.0,9722.96,63573.2,28 CDM,102986,CATH BLNDIL 2.5X8MM,2905.5,2905.5,174.33,2469.68,49 CDM,102987,KIT IMPL 2.5MM,33466.0,33466.0,4350.58,28446.1,28 CDM,102988,SET ORTH DRL BUR DISP,16533.0,16533.0,991.98,14053.05,49 CDM,102989,MESH SURG FEM SUI 3MM,29654.0,29654.0,3855.02,25205.9,28 CDM,102990,PTT,924.0,924.0,55.44,785.4,14 CDM,102991,SILICA CLOTTING TIME,1004.91,1004.91,60.29,854.17,14 CDM,102992,KIT IMP HMRTOE 3X3MM 10D,27067.0,27067.0,3518.71,23006.95,28 CDM,102993,SCREW BN NONLCK 3.5X40MM,5616.0,5616.0,730.08,4773.6,28 CDM,102994,CATH BLNDIL 2.5MM 10MM,2905.5,2905.5,174.33,2469.68,49 CDM,102995,CATH BLN PTCA 2.25MM,20029.5,20029.5,1201.77,17025.08,49 CDM,102996,CATH BLN PTCA 3.0X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,102997,CATH BLN PTCA 2.5X15MM,21398.5,21398.5,1283.91,18188.72,49 CDM,102999,CATH BLN PTCA 3.5X15MM,21398.5,21398.5,1283.91,18188.72,49 CDM,103000,CATH BLN PTCA 4.0X10MM,21570.0,21570.0,1294.2,18334.5,49 CDM,103001,CATH BLN PTCA 4.0X15MM,20029.5,20029.5,1201.77,17025.08,49 CDM,103002,CATH BLNDIL 2.5MM 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,103003,CATH BLNDIL 2.5MM 18MM,2905.5,2905.5,174.33,2469.68,49 CDM,103004,CATH BLNDIL 2.75X8MM,2905.5,2905.5,174.33,2469.68,49 CDM,103005,CATH BLNDIL 2.75X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,103006,CATH BLNDIL 2.75X12MM,2905.5,2905.5,174.33,2469.68,49 CDM,103007,CATH BLNDIL 2.75X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,103008,CATH BLNDIL 3X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,103009,CATH BLNDIL 3X12MM,2905.5,2905.5,174.33,2469.68,49 CDM,103010,PH BODY FLUID,427.0,427.0,25.62,362.95,14 CDM,103010,"pH; body fluid, not otherwise specified ",427.0,427.0,3.01,24.62,80 CDM,103011,CATH BLNDIL 3X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,103012,CATH BLN PTCA 2.25X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,103013,CATH BLN PTCA 3.5X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,103016,PROSTHES PENL INFL 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103018,BASEPLATE S-R 10D 27MM,42118.0,42118.0,5475.34,35800.3,28 CDM,103019,LINER HUM +3MM 36MM,21552.0,21552.0,2801.76,18319.2,28 CDM,103020,PHENOBARBITAL LUMINAL QN,636.0,636.0,38.16,540.6,14 CDM,103020,Phenobarbital ,636.0,636.0,12.85,105.25,80 CDM,103024,CTHGD 6F 100CM M1 JR4,2150.5,2150.5,129.03,1827.92,49 CDM,103026,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,103027,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,103028,CATH GD 6FR 100CM AL1,2150.5,2150.5,129.03,1827.92,49 CDM,103029,CATH GD 6FR 100CM AL2,2150.5,2150.5,129.03,1827.92,49 CDM,103030,THERAPEUTIC PHLEB,1019.81,1019.81,61.19,866.84,44 CDM,103031,CTHGD 6F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 CDM,103032,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,103033,CTHGD 6F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 CDM,103035,CTHGD 6F 100CM M1 JL4,2150.5,2150.5,129.03,1827.92,49 CDM,103039,CATH GD 6FR 100CM IM,2150.5,2150.5,129.03,1827.92,49 CDM,103041,STENT EPRSTH 24F 34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103042,INTRO SHEATH 24FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,103044,STENT EPRSTH 8X12MM 6CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103045,CATH BLNDIL 6MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,103046,MODEL CUSTOM THORACIC,100000.0,100000.0,6000.0,85000.0,49 CDM,103047,GUIDE CUT THORACIC SM,100000.0,100000.0,6000.0,85000.0,49 CDM,103048,KIT GUIDE CUT THORACIC,100000.0,100000.0,6000.0,85000.0,49 CDM,103049,KIT IMP HMRTOE 0D 3X3MM,27067.0,27067.0,3518.71,23006.95,28 CDM,103050,PHOSPHORUS BLD,739.0,739.0,44.34,628.15,14 CDM,103051,CATH BLNDIL 6MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,103052,FORCEPS ENDO 5.0MM 115CM,1287.5,1287.5,77.25,1094.38,49 CDM,103053,FORCEP BX 5MM 115MM,1325.0,1325.0,79.5,1126.25,49 CDM,103055,GRAFT EVAS 127MM 36-12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103056,GRAFT EVAS 13MMX107MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103057,SCREW BN 4.5MM 20MM,6676.0,6676.0,867.88,5674.6,28 CDM,103060,PHOSPHORUS UR,738.52,738.52,44.31,627.74,14 CDM,103060,Phosphorus inorganic (phosphate); urine ,738.52,738.52,4.86,39.73,80 CDM,103062,SHEATH LSR 80HZ 16FR,96910.5,96910.5,5814.63,82373.93,49 CDM,103063,SHEATH LSR 80HZ 14FR,96910.5,96910.5,5814.63,82373.93,49 CDM,103064,SHEATH LSR 80HZ 12FR,96910.5,96910.5,5814.63,82373.93,49 CDM,103065,SHEATH LASER 16FR 50CM,97526.5,97526.5,5851.59,82897.52,49 CDM,103066,SHEATH LASER 14F,97526.5,97526.5,5851.59,82897.52,49 CDM,103069,CATH ATHRCM 7FR 135CM,69177.5,69177.5,4150.65,58800.88,49 CDM,103071,CATH ATHRCM 6FR 130CM,69177.5,69177.5,4150.65,58800.88,49 CDM,103072,CATH ATHRCM 6FR 130CM,69177.5,69177.5,4150.65,58800.88,49 CDM,103073,CATH ATHRCM 2.5MM 112CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103075,CATH ARTHRCM 2.5X.035IN,78576.0,78576.0,4714.56,66789.6,49 CDM,103079,CATH ATHRCM 1.7MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103080,CATH ATHRCM 1.7MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103081,CATH ATHRCM 1.4MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103082,CATH ATHRCM 1.4MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103083,CATH LASR 4F 0.9MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103084,CATH ATHRCM 0.9MM 150CM,78576.0,78576.0,4714.56,66789.6,49 CDM,103085,BASEPLATE TIB KN SZ4,24088.0,24088.0,3131.44,20474.8,28 CDM,103087,PLATE BN LAT LT SMALL,71144.0,71144.0,9248.72,60472.4,28 CDM,103088,SCREW BN 4MM 14MM,10799.0,10799.0,1403.87,9179.15,28 CDM,103089,SCREW BN 3.5MM 18MM,13744.0,13744.0,1786.72,11682.4,28 CDM,103091,SCREW BN 3.5MM 14MM,10799.0,10799.0,1403.87,9179.15,28 CDM,103092,SCREW BN NLCK 3.5X34MM,10799.0,10799.0,1403.87,9179.15,28 CDM,103093,SCREW BN NLCK 3.5X38MM,10799.0,10799.0,1403.87,9179.15,28 CDM,103094,SCREW BN 3.5MM 12MM,12762.0,12762.0,1659.06,10847.7,28 CDM,103095,CATH IAB 7FR 30ML,16515.5,16515.5,990.93,14038.17,49 CDM,103096,CATH IAB 8FR 40CC,17607.0,17607.0,1056.42,14965.95,49 CDM,103099,APLIGRAF 1SQCM,1473.0,1473.0,88.38,1252.05,25 CDM,103099,"Apligraf, per square centimeter (add-on, list separately in addition to primary procedure) ",1473.0,1473.0,66.99,94.54,8 CDM,103101,GRAFIX STRAVIX PL 1SQCM,6023.0,6023.0,361.38,5119.55,30 CDM,103101,"Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure) ",6023.0,6023.0,329.56,424.88,3 CDM,103102,GRFT EVAS 113X34X30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103103,STENT VASC 36MM 180MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103105,STNT URE APMTZ 8.5X20,4617.0,4617.0,600.21,3924.45,28 CDM,103106,SET STENT 8.5FR 22CM,4617.0,4617.0,600.21,3924.45,28 CDM,103107,STENT URE 8.5FR 24CM,4617.0,4617.0,600.21,3924.45,28 CDM,103108,STENT URET 8.5FR 26CM,4617.0,4617.0,600.21,3924.45,28 CDM,103110,PLATELET ANTIBODIES,2193.15,2193.15,131.59,1864.18,14 CDM,103111,SCREW BN 4.0MM 46MM,19633.0,19633.0,2552.29,16688.05,28 CDM,103112,SYSTEM EMBL PLUG LQ 1GM,100000.0,100000.0,6000.0,85000.0,49 CDM,103113,CTHGD 8F 100CM M1 CLS3.5,2150.5,2150.5,129.03,1827.92,49 CDM,103114,CATH BLNDIL 10MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,103115,CATH BLNDIL 5MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,103116,CATH BLNDIL 6MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,103117,SCREW BN 3.5MM 12MM,10799.0,10799.0,1403.87,9179.15,28 CDM,103118,BLADE SAW 40.0MM,5320.0,5320.0,319.2,4522.0,49 CDM,103119,DISSECTOR LPSCP 5MM 40CM,387.0,387.0,23.22,328.95,49 CDM,103120,STAPLER CUTTER ENDO 40MM,10173.5,10173.5,610.41,8647.48,49 CDM,103122,PLATE BN 22X51MM,24771.0,24771.0,3220.23,21055.35,28 CDM,103123,SCREW BN 2.7MM 12MM,3786.0,3786.0,492.18,3218.1,28 CDM,103124,LEAD ICD PCNG 8.6FR 65CM,53004.0,53004.0,6890.52,45053.4,28 CDM,103125,ICD MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 CDM,103127,STENT EPRSTH 40X40X20CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103128,STENT EPRSTH 40X40X15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103133,SUTURE WOUND 3X3X1.5MM,3646.5,3646.5,218.79,3099.53,49 CDM,103134,CUFF URTH SPHNCR AB 5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103135,"Blood count; platelet, automated ",427.0,427.0,3.76,30.77,80 CDM,103135,PLATELET AUTOMATED,427.0,427.0,25.62,362.95,14 CDM,103136,IPG NRSTM RECHGFRE 1.1CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103137,HNDSET PRGRM SPN PT,27579.0,27579.0,1654.74,23442.15,49 CDM,103138,URETEROSCOPE DGTL DISP,38517.5,38517.5,2311.05,32739.88,49 CDM,103139,SCOPE FLEX URETER DISP,24620.5,24620.5,1477.23,20927.42,49 CDM,103141,PLATE BN 6HL 2.4MM 66MM,26737.0,26737.0,3475.81,22726.45,28 CDM,103142,PLATE DVR MED LF,27908.0,27908.0,3628.04,23721.8,28 CDM,103143,GRAFT VASC THIN 80CM 8MM,75005.0,75005.0,9750.65,63754.25,28 CDM,103144,GRAFT VASC. STR 14MM 30C,34435.0,34435.0,4476.55,29269.75,28 CDM,103145,GRAFT VASC 30CM 16MM,34435.0,34435.0,4476.55,29269.75,28 CDM,103146,GRAFT VASC 20CM 20MM,25368.0,25368.0,3297.84,21562.8,28 CDM,103149,COIL EMBL 10CM 3MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103150,COIL EMBL 8CM 3.5MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103151,COIL EMBL 13CM 4MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103152,COIL EMBL 10CM 4.5MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103153,COIL EMBL 17CM 5MM,26679.0,26679.0,3468.27,22677.15,28 CDM,103154,COIL EMBL 20CM 6MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103155,COIL EMBL 20CM 7MM,26453.0,26453.0,3438.89,22485.05,28 CDM,103156,COIL EMBL 30CM 8MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103157,COIL EMBL 30CM 9MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103158,COIL EMBL 40CM 10MM,29105.0,29105.0,3783.65,24739.25,28 CDM,103166,IMPLANT VASC DETACHER,6273.0,6273.0,376.38,5332.05,49 CDM,103167,COIL EMBL HLCL 8CM 2MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103168,COIL EMBL HLCL 15CM 3MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103171,COIL EMBL HLCL 20CM 4MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103172,COIL EMBL HLCL 20CM 5MM,26453.0,26453.0,3438.89,22485.05,28 CDM,103173,COIL EMBL HLCL 20CM 6MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103174,COIL EMBL HLCL 20CM 7MM,26453.0,26453.0,3438.89,22485.05,28 CDM,103175,COIL EMBL HLCL 30CM 8MM,29687.0,29687.0,3859.31,25233.95,28 CDM,103176,COIL EMBL HLCL 30CM 9MM,25871.0,25871.0,3363.23,21990.35,28 CDM,103177,COIL EMBL HLCL 40CM 10MM,29105.0,29105.0,3783.65,24739.25,28 CDM,103178,KIT INSTR DISP 2/2.5MM,12325.0,12325.0,739.5,10476.25,49 CDM,103179,SCREW BN 3.5X14MM,6951.0,6951.0,903.63,5908.35,28 CDM,103181,COIL EMBL 3CM 1.5MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103183,COIL EMBL 4CM 2MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103184,COIL EMBL 6CM 2MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103185,COIL EMBL 5CM 2.5MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103197,COIL EMBL HLCL 3CM 1.5MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103198,COIL EMBL HLCL 3CM 1MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103200,POTASSIUM BLD,574.0,574.0,34.44,487.9,14 CDM,103200,"Potassium; serum, plasma or whole blood ",574.0,574.0,4.0,32.76,80 CDM,103201,COIL EMBL 10CM 6MM 190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103202,COIL EMBL 11.9CM 6MM MCR,40423.0,40423.0,5254.99,34359.55,28 CDM,103203,COIL EMBL 17CM 5MM 190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103204,COIL EMBL 20CM 6MM 190CM,57788.0,57788.0,7512.44,49119.8,28 CDM,103205,COIL EMBL 4MM 10X190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103206,COIL EMBL 21CM 7MM 190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103207,GW VSC AGL 014 350,17607.0,17607.0,1056.42,14965.95,49 CDM,103208,CTH INFUS 2.3F 150 PROWL,29249.0,29249.0,1754.94,24861.65,49 CDM,103209,COIL EMBL 15CM 5MM 190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103210,POTASSIUM UR,574.0,574.0,34.44,487.9,14 CDM,103210,Potassium; urine ,574.0,574.0,3.97,32.49,80 CDM,103211,COIL EMBL 10CM 5MM 190CM,40423.0,40423.0,5254.99,34359.55,28 CDM,103213,CATH BLNDIL 3MM 8MM,4066.0,4066.0,243.96,3456.1,49 CDM,103214,CATH BLNDIL 2.5MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,103215,CATH BLNDIL 2.5MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,103217,GRAFT HMDL 19F 5MM 40CM,90547.0,90547.0,11771.11,76964.95,28 CDM,103218,PIN EXFX 3.2MM 45MM,3161.5,3161.5,189.69,2687.28,49 CDM,103220,PREALBUMIN,915.0,915.0,54.9,777.75,14 CDM,103220,Prealbumin ,915.0,915.0,12.26,100.36,80 CDM,103221,GRAFT EVAS 32MM 96MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103222,GRAFT EVAS 16F 56X20X6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103223,INTRO SHTH 18FR 30CM,4119.0,4119.0,247.14,3501.15,49 CDM,103224,GRAFT EVAS 16FR 24X39MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103225,INSERT TIB KN 3-4 11MM,18312.0,18312.0,2380.56,15565.2,28 CDM,103226,CMPNT PTLR KN 9MM 32MM,7166.0,7166.0,931.58,6091.1,28 CDM,103229,BODY CONE HIP SZD 60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103231,PLATE BN 8HL 246MM,23475.0,23475.0,3051.75,19953.75,28 CDM,103232,WIRE BN CERC 1.8MM 24IN,8769.0,8769.0,1139.97,7453.65,28 CDM,103233,STENT EPRSTH 10MM 4CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103234,KIT CATH CANN 18F 105CM,100000.0,100000.0,6000.0,85000.0,49 CDM,103236,CTHGD CLS3.5 7FR 0.081IN,2150.5,2150.5,129.03,1827.92,49 CDM,103237,CTHGD 7F 100CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 CDM,103238,CTHGD 7F 100CM M1 AL2,2150.5,2150.5,129.03,1827.92,49 CDM,103239,CTHGD 8F 100CM M1 AL2,2150.5,2150.5,129.03,1827.92,49 CDM,103242,VALVE TAVR 20MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103243,VALVE TAVR 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103244,VALVE TAVR 26MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103245,VALVE TAVR 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103247,STENT EPRSTH 7CM 8-10MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103252,SUTURE ANBCTRL +1 36IN,117.0,117.0,7.02,99.45,49 CDM,103253,CTHGD 8F 100CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 CDM,103254,MCTH INFS 20CM 150CM,10063.0,10063.0,603.78,8553.55,49 CDM,103255,STENT EPRSTH 10MM 5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103256,MCTH INFS 3-2.4FR 150CM,12230.0,12230.0,733.8,10395.5,49 CDM,103257,GRAFT EVAS 201X32X28-29,100000.0,100000.0,13000.0,85000.0,28 CDM,103258,COIL EMBL HLCL 4CM 2MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103259,COIL EMBL HLCL 6CM 2MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103261,COIL EMBL HLCL 5CM 2.5MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103262,COIL EMBL HLCL 10CM 3MM,22637.0,22637.0,2942.81,19241.45,28 CDM,103265,COIL EMBL 3CM 3MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103270,PROGESTERONE,936.0,936.0,56.16,795.6,14 CDM,103270,Progesterone ,936.0,936.0,17.52,143.44,80 CDM,103275,STENT VASC 6FR 80X5MM,20606.0,20606.0,2678.78,17515.1,28 CDM,103276,STENT VASC 6FR 100X5MM,20606.0,20606.0,2678.78,17515.1,28 CDM,103277,DEVICE CLSR VASC 6/7FR,8050.0,8050.0,1046.5,6842.5,28 CDM,103278,PLATE BN 13HL LT 128MM,57631.0,57631.0,7492.03,48986.35,28 CDM,103279,KIT FX REAMER C/C 18MM,6273.0,6273.0,376.38,5332.05,49 CDM,103280,PROLACTIN,1597.0,1597.0,95.82,1357.45,14 CDM,103280,Prolactin ,1597.0,1597.0,16.28,133.31,80 CDM,103281,STAPLE BN 14X14X18MM,39970.0,39970.0,5196.1,33974.5,28 CDM,103282,SCREW BN PLT NLCK 3X14MM,5616.0,5616.0,730.08,4773.6,28 CDM,103283,CRTD XT MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,103284,ANCHR SUT 4.5MM KNTLS,12958.0,12958.0,1684.54,11014.3,28 CDM,103285,GLENOSPHERE SHLDR 36MM,36624.0,36624.0,4761.12,31130.4,28 CDM,103293,SIZER STAPLE ORTH,6655.5,6655.5,399.33,5657.18,49 CDM,103294,GRAFT BN ALGRF INJ 3.0CC,81935.0,81935.0,10651.55,69644.75,28 CDM,103295,KIT JOINT PREP INST ORTH,6273.0,6273.0,376.38,5332.05,49 CDM,103297,PIN FX STNM 2.5X100MM,1627.5,1627.5,97.65,1383.38,49 CDM,103298,GRAFT BN WDG 6X14X24MM,22987.0,22987.0,2988.31,19538.95,28 CDM,103299,PLATE BN 4H 31MM 3.5MM,31756.0,31756.0,4128.28,26992.6,28 CDM,103300,PROTEIN ELECTRO CSF,1604.0,1604.0,96.24,1363.4,14 CDM,103301,PLATE NAR MINI LK DVR RT,24771.0,24771.0,3220.23,21055.35,28 CDM,103302,VALVE TAVR 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103303,STENT VASC 5X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 CDM,103304,STENT VASC 5X100MM 125CM,54796.0,54796.0,7123.48,46576.6,28 CDM,103305,STENT VASC 5X140MM 125CM,73112.0,73112.0,9504.56,62145.2,28 CDM,103306,STENT VASC 5X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 CDM,103307,STENT VASC 5X60MM 125CM,45638.0,45638.0,5932.94,38792.3,28 CDM,103308,STENT VASC 5X80MM 125CM,54796.0,54796.0,7123.48,46576.6,28 CDM,103309,STENT VASC 7X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 CDM,103310,PROS SPEC AG (PSA) TOTAL,1274.0,1274.0,76.44,1082.9,14 CDM,103310,Prostate specific antigen (PSA); total ,1274.0,1274.0,15.45,126.52,80 CDM,103311,GRAFT EVAS 155X32X28-29,100000.0,100000.0,13000.0,85000.0,28 CDM,103313,CATH ULTSNC 9.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103314,CATH ULTSNC 12.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103320,"Clotting inhibitors or anticoagulants; protein C, antigen ",2850.0,2850.0,10.09,82.63,80 CDM,103320,PROTEIN C AG,2850.0,2850.0,171.0,2422.5,14 CDM,103321,CLAMP SURG 40GF 0MM,2905.5,2905.5,174.33,2469.68,49 CDM,103328,VERT W FRAC RED & BB EAD,3454.9,3454.9,207.29,2936.66,37 CDM,103329,MOLD FOR BN GRF SUBS,6273.0,6273.0,376.38,5332.05,49 CDM,103330,PLATE BN 4HL 3.5X87MM,42071.0,42071.0,5469.23,35760.35,28 CDM,103331,TRAY CATH PICC 3FR 55CM,8788.5,8788.5,527.31,7470.23,49 CDM,103332,NAIL TIB 10MMX34CM,49348.0,49348.0,6415.24,41945.8,28 CDM,103333,KIT FX 10GA 15MM,65788.5,65788.5,3947.31,55920.22,49 CDM,103335,CATH OCL L40 OD3FR,2215.0,2215.0,132.9,1882.75,49 CDM,103336,FILLER BN 10ML,74378.0,74378.0,9669.14,63221.3,28 CDM,103340,PROTEIN ELECTRO SER,1689.0,1689.0,101.34,1435.65,14 CDM,103340,"Protein; electrophoretic fractionation and quantitation, serum ",1689.0,1689.0,9.02,73.85,80 CDM,103346,DILATOR PENL DISP 9-16MM,11462.5,11462.5,687.75,9743.13,49 CDM,103347,CANNULA PRFSN 14FR 18MM,3396.0,3396.0,203.76,2886.6,49 CDM,103348,IPG NRSTM MRI 1.5T,100000.0,100000.0,13000.0,85000.0,28 CDM,103350,PROTEIN ELECTRO URINE,1689.0,1689.0,101.34,1435.65,14 CDM,103358,INIT ECMO VENO-VENOUS,25490.95,25490.95,1529.46,21667.31,37 CDM,103359,ICD DR MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,103360,TOT PROTEIN BODY FLDS QN,798.0,798.0,47.88,678.3,14 CDM,103361,SCREW EXFX HIP 200X5MM,4222.0,4222.0,253.32,3588.7,49 CDM,103362,SCREW BN 5.0MM 65MM,6985.0,6985.0,908.05,5937.25,28 CDM,103363,SCREW BN 3.5X75MM,4750.0,4750.0,617.5,4037.5,28 CDM,103367,REAMER ORTHO 2.7MM,6273.0,6273.0,376.38,5332.05,49 CDM,103368,STAPLE BN 8X8MM,54975.0,54975.0,7146.75,46728.75,28 CDM,103369,CATH GD LG 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 CDM,103370,PROS SPEC AG (PSA) SCR,1273.95,1273.95,76.44,1082.86,21 CDM,103370,Prostate cancer screening; prostate specific antigen test (psa) ,1273.95,1273.95,18.92,132.85,67 CDM,103371,KWIRE FX 1.2MM 65MM,3931.0,3931.0,235.86,3341.35,49 CDM,103372,CATH ATHRCM 200CM 1.50MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103373,DRSG WND ADH 6X3.6IN,49.5,49.5,2.97,42.08,49 CDM,103374,LIGATOR ENDO 7BAND 2.8MM,7284.0,7284.0,437.04,6191.4,49 CDM,103377,SHEATH INTRO 21G 6F 16CM,2789.5,2789.5,167.37,2371.07,49 CDM,103378,SHEATH INTRO 21G 5F 10CM,2789.5,2789.5,167.37,2371.07,49 CDM,103379,SHEATH INTRO 21G 6F 10CM,2789.5,2789.5,167.37,2371.07,49 CDM,103380,"Protein, total, except by refractometry; serum, plasma or whole blood ",782.0,782.0,3.08,25.25,80 CDM,103380,TOTAL PROTEIN BLD,782.0,782.0,46.92,664.7,14 CDM,103381,SHEATH INTRO 6FR 10CM,2905.5,2905.5,174.33,2469.68,49 CDM,103382,CEMENT BN PMMA 40GM,7504.0,7504.0,975.52,6378.4,28 CDM,103386,TUBING IRR CO2 DISP,1058.0,1058.0,63.48,899.3,49 CDM,103387,KIT BUNDLE EP CABL 2F 6F,78576.0,78576.0,4714.56,66789.6,49 CDM,103388,CATHETER THRMB 6FR 50CM,11788.0,11788.0,707.28,10019.8,49 CDM,103390,"Protein, total, except by refractometry; urine ",798.0,798.0,3.08,25.25,80 CDM,103390,TOTAL PROTEIN URINE QN,798.0,798.0,47.88,678.3,14 CDM,103391,GEN PLS CARD MOD SYS,100000.0,100000.0,13000.0,85000.0,28 CDM,103393,KIT CATH THRMB 8FR 50CM,80425.0,80425.0,4825.5,68361.25,49 CDM,103394,STENT COR DES 2.25X9MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103395,STENT RX ELT 2.25X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103396,STENT RX ELT 2.25X15X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103397,STENT RX ELT 2.25X18X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103398,STENT RX ELT 2.25X22X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103399,STENT RX ELT 2.25X26X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103400,PROTIME,798.0,798.0,47.88,678.3,14 CDM,103402,STENT COR 2.5MM 9MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103406,STENT RX ELUT 2.5X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103407,STENT COR 2.5MM 15MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103408,STENT COR 2.5MM 18MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103409,STENT COR 2.5MM 22MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103411,STENT COR 2.5MM 26MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103412,STENT RX ELUT 2.5X30X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103413,STENT COR 2.5MM 35MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103414,STENT RX ELUT 2.5X40X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103415,STENT RX ELUT 2.75X9X140,18334.5,18334.5,2383.49,15584.33,28 CDM,103416,STENT RX ELT 2.75X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103417,STENT COR 2.75MM 15MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103418,STENT COR 15X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103419,STENT COR 22X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103420,STENT COR 26X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103421,STENT RX ELT 2.75X30X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103422,STENT RX ELT 2.75X35X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103423,STENT RX ELT 2.75X40X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103424,STENT RX ELUT 3X9X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103425,STENT RX ELUT 3X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103426,STENT COR 3MM 15MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103427,STENT COR 15X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103428,STENT COR 22X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103429,STENT COR 26X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 CDM,103430,PT SUBSTITUTION MIXING,1255.48,1255.48,75.33,1067.16,14 CDM,103430,"Prothrombin time; substitution, plasma fractions, each ",1255.48,1255.48,3.31,27.06,80 CDM,103431,STENT COR 3MM 30MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103432,STENT COR 3MM 35MM,18334.5,18334.5,2383.49,15584.33,28 CDM,103433,STENT RX ELUT 3.5X9X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103434,STENT RX ELUT 3.5X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103435,STENT COR 3.5MM 15MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103436,STENT RX ELUT 3.5X18X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103437,STENT COR 3.5MM 22MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103438,STENT COR 3.5MM 26MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103439,STENT COR 3.5MM 30MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103440,PTT SUBSTITUTION MIXING,924.0,924.0,55.44,785.4,14 CDM,103441,STENT COR 3.5MM 35MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103442,STENT COR 3.5MM 40MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103443,STENT RX ELUT 4X9X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103444,STENT RX ELUT 4X13X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103445,STENT RX ELUT 4X18X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103446,STENT COR 4MM 15MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103447,STENT COR 4MM 22MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103448,STENT RX ELUT 4X26X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103449,STENT RX ELUT 4X30X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103450,STENT RX ELUT 4X35X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103451,STENT COR 4MM 40MM,18164.0,18164.0,2361.32,15439.4,28 CDM,103452,STENT RX ELT 2.25X30X140,18164.0,18164.0,2361.32,15439.4,28 CDM,103456,CLOSURE STRNL TGRTAPE,7449.0,7449.0,968.37,6331.65,28 CDM,103457,KIT LIPO FAT GRAFT,11445.0,11445.0,686.7,9728.25,49 CDM,103458,CATH GD 1.8FR 135CM,5018.5,5018.5,301.11,4265.73,49 CDM,103459,SCREW BN 4.5MM 36MM,1779.0,1779.0,231.27,1512.15,28 CDM,103461,STEM HUM 60X11MM CMNTLS,23552.0,23552.0,3061.76,20019.2,28 CDM,103462,CLIP GASTRO 16MM,3555.0,3555.0,213.3,3021.75,49 CDM,103464,CUFF SENSOR HEMO LG,11092.5,11092.5,665.55,9428.63,49 CDM,103465,CUFF SENSOR HEMO MED,11092.5,11092.5,665.55,9428.63,49 CDM,103466,CUFF SENSOR HEMO SM,11092.5,11092.5,665.55,9428.63,49 CDM,103467,FILTER EMBL 3MM 320CM,29304.5,29304.5,1758.27,24908.83,49 CDM,103469,PATCH CV 10X5CM ENCAP,7863.0,7863.0,1022.19,6683.55,28 CDM,103470,RPR QUAL,659.0,659.0,39.54,560.15,14 CDM,103471,OSTEO FLEX 12MM X 120MM,11797.0,11797.0,707.82,10027.45,49 CDM,103472,WEDGE TIB 10MM,25469.0,25469.0,3310.97,21648.65,28 CDM,103473,WEDGE TIB KN 10MM,15264.0,15264.0,1984.32,12974.4,28 CDM,103474,STM FEM HIP 150MM 16MM,91475.0,91475.0,11891.75,77753.75,28 CDM,103475,AUGMENT FEM KN RM/LL SZE,79977.0,79977.0,10397.01,67980.45,28 CDM,103476,NAIL 130D 11X180MM,37967.0,37967.0,4935.71,32271.95,28 CDM,103477,CATH BLNDIL 2.25MM 20MM,3317.0,3317.0,199.02,2819.45,49 CDM,103478,PEG TRBCLR TI MTLBLK LNG,42687.0,42687.0,5549.31,36283.95,28 CDM,103479,BASEPLATE AUG +2MM 27MM,42118.0,42118.0,5475.34,35800.3,28 CDM,103480,ANTIBODY ID EA,2147.0,2147.0,128.82,1824.95,23 CDM,103480,"Antibody identification, RBC antibodies, each panel for each serum technique ",2147.0,2147.0,174.24,904.08,20 CDM,103481,SCREW BN 4.5MM 40MM,1779.0,1779.0,231.27,1512.15,28 CDM,103482,CATH BLNDIL 3MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,103483,CATH BLNDIL 3.75MM 15MM,3136.5,3136.5,188.19,2666.03,49 CDM,103484,CATH BLNDIL 5MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,103485,CATH GD 6FR 100CM AL3,2150.5,2150.5,129.03,1827.92,49 CDM,103486,CATH GD 100CM 6FR JL6,2150.5,2150.5,129.03,1827.92,49 CDM,103487,CATH GD 100CM 6FR JL5,2150.5,2150.5,129.03,1827.92,49 CDM,103489,PLT BN FEM RT316MM 13HL,57631.0,57631.0,7492.03,48986.35,28 CDM,103490,RENIN,1660.0,1660.0,99.6,1411.0,14 CDM,103490,Renin ,1660.0,1660.0,18.47,151.23,80 CDM,103491,BLADE SAW GIGLI 12IN,1251.5,1251.5,75.09,1063.78,49 CDM,103493,ELCTRDE ESRG 24F 12D-30D,15381.5,15381.5,922.89,13074.27,49 CDM,103494,PORT ACC 5MM 120MM,4788.0,4788.0,287.28,4069.8,49 CDM,103495,PLATE BN 105MM 2.7MM,19633.0,19633.0,2552.29,16688.05,28 CDM,103496,SCREW BN 3.5MM 16MM,1292.0,1292.0,167.96,1098.2,28 CDM,103497,DOME PTELA 38 OVL 3PEG,6535.0,6535.0,849.55,5554.75,28 CDM,103498,INS TIB 3X15 STAB+,14332.0,14332.0,1863.16,12182.2,28 CDM,103499,STAPLER CMPCT 45MM,12019.0,12019.0,721.14,10216.15,49 CDM,103501,STAPLER STD 45MM,29994.0,29994.0,1799.64,25494.9,49 CDM,103503,STAPLER LONG 60MM,14148.0,14148.0,848.88,12025.8,49 CDM,103504,CATH BLN 4X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,103505,CATH BLN 4X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,103507,CATH BLN 4X150MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,103508,CATH BLN 4X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,103510,"Blood typing, serologic; Rh (D) ",257.0,257.0,2.51,106.64,78 CDM,103510,RH TYPE,257.0,257.0,15.42,218.45,15 CDM,103516,TRAY TIB KN DISP,2621.0,2621.0,157.26,2227.85,49 CDM,103521,INSERT TIB KN SZ1-2 9MM,18312.0,18312.0,2380.56,15565.2,28 CDM,103523,GWIRE VASC .016IN 180CM,8698.0,8698.0,521.88,7393.3,49 CDM,103524,KIT MINTRDCR 40CM 5FR,1159.5,1159.5,69.57,985.58,49 CDM,103525,SCREW BN 3.7MM 28MM,27164.0,27164.0,3531.32,23089.4,28 CDM,103526,CATH BLN 4X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,103527,KWIRE FX 150MM 1.6MM,1453.0,1453.0,87.18,1235.05,49 CDM,103528,SCREW BN 3.7MM 36MM,27164.0,27164.0,3531.32,23089.4,28 CDM,103529,TIP CAP OBT STD 8MM,17933.0,17933.0,1075.98,15243.05,49 CDM,103530,GRAFT EVAS 26X14.5M 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103531,CATH VASC GD 1.8FR 90CM,5018.5,5018.5,301.11,4265.73,49 CDM,103533,STAPLER STD 60MM,35532.0,35532.0,2131.92,30202.2,49 CDM,103534,GRAFT EVAS 40X40X10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103535,GRAFT EVAS 45X45MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103536,STENT GRFT 36MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103537,STENT GRFT 32MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103539,GRAFT EVAS 113MM 30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103542,GRAFT EVAS 13X13X56MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103543,STENT EPRSTH 10MM 120CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103544,STENT EPRSTH 10X13X39MM,87308.0,87308.0,11350.04,74211.8,28 CDM,103545,CATH GD 1.8FR 135CM,13966.0,13966.0,837.96,11871.1,49 CDM,103546,CATH EP 2FR 1.3MM 130CM,45297.0,45297.0,2717.82,38502.45,49 CDM,103547,GWIRE VASC 175CM .014IN,18488.5,18488.5,1109.31,15715.23,49 CDM,103548,CATH ATHR 112CM 2.5MM,78576.0,78576.0,4714.56,66789.6,49 CDM,103549,STENT AAA XCLDR 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103550,GRAFT EVAS 20MM 13.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103553,CATH 3D MAP 1.5CM CRV D,74466.0,74466.0,4467.96,63296.1,49 CDM,103558,CATH SUPP GD 90CM,5018.5,5018.5,301.11,4265.73,49 CDM,103559,CATH GD 3.1FR 135CM,5018.5,5018.5,301.11,4265.73,49 CDM,103560,"Clotting; factor VIII, VW factor, ristocetin cofactor ",3013.44,3013.44,19.27,157.74,80 CDM,103560,FACTOR 8 RISTOCETIN,3013.44,3013.44,180.81,2561.42,14 CDM,103561,CATH GD 3.1FR 150CM,5018.5,5018.5,301.11,4265.73,49 CDM,103563,RELOAD STPLR 60MM,16990.0,16990.0,2208.7,14441.5,28 CDM,103566,CATH BLNDIL 6MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,103567,KIT ACC GRAFT PLACEMENT,19875.5,19875.5,1192.53,16894.17,49 CDM,103568,GRAFT HMDIAL 7.4MM 50CM,48216.0,48216.0,6268.08,40983.6,28 CDM,103570,COIL EMBL 1CM 1MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103573,COIL EMBL 3CM 1MM,23284.0,23284.0,3026.92,19791.4,28 CDM,103578,TIP MNPLT 11.4CM 3.8CM,2905.5,2905.5,174.33,2469.68,49 CDM,103579,IMPLANT BREAST 320CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103580,IMPLANT BREAST 340CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103581,IMPLANT BREAST 390CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103582,IMPLANT BREAST 430CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103583,IMPLANT BREAST 450CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103584,IMPLANT BREAST 325CC,37189.0,37189.0,4834.57,31610.65,28 CDM,103585,IMPLANT BREAST 350CC,37189.0,37189.0,4834.57,31610.65,28 CDM,103586,IMPLANT BREAST 440CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103587,IMPLANT BREAST 465CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103589,DEVICE ICM 46.5X9.4X3.1,64679.0,64679.0,8408.27,54977.15,28 CDM,103590,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",882.27,882.27,10.06,82.36,80 CDM,103590,ROTAVIRUS AG EIA,882.27,882.27,52.94,749.93,14 CDM,103591,DEVICE ICM 49X9.4X4.4,67522.0,67522.0,8777.86,57393.7,28 CDM,103592,KIT ABDOMEN CLOSURE 50CM,100000.0,100000.0,6000.0,85000.0,49 CDM,103593,CATH BLNDIL 3.5X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,103594,CATH BLN PTCA 2.0X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,103599,KIT FX REAMER C/C 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,103600,RPR QUANT,924.0,924.0,55.44,785.4,14 CDM,103601,KIT REAMER CUP/CONE 24MM,12325.0,12325.0,739.5,10476.25,49 CDM,103602,SCREW BN 3MM 12MM,5265.0,5265.0,684.45,4475.25,28 CDM,103603,STAPLE BN 18X14X14MM,44530.0,44530.0,5788.9,37850.5,28 CDM,103604,SCREW BN 3MM 18MM,5616.0,5616.0,730.08,4773.6,28 CDM,103605,SCREW BN 3.0MM 22MM,6951.0,6951.0,903.63,5908.35,28 CDM,103606,PLATE CLAVICLE 8H RT,47731.0,47731.0,6205.03,40571.35,28 CDM,103607,SCREW BN 2.8MM 16MM,6198.0,6198.0,805.74,5268.3,28 CDM,103608,SCREW BN 2.8MM 12MM,6198.0,6198.0,805.74,5268.3,28 CDM,103609,SCREW BN 2.8MM 14MM,6198.0,6198.0,805.74,5268.3,28 CDM,103611,SCREW BN 2.8MM 18MM,6198.0,6198.0,805.74,5268.3,28 CDM,103612,SCREW BN 2.8MM 20MM,6198.0,6198.0,805.74,5268.3,28 CDM,103613,SCREW BN 2.8MM 14MM,3786.0,3786.0,492.18,3218.1,28 CDM,103614,SCREW BN 2.8MM 20MM,3786.0,3786.0,492.18,3218.1,28 CDM,103616,CATH BLNDIL 6MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,103618,CATH PULM ART UNI,2554.52,2554.52,153.27,2171.34,34 CDM,103619,TRNSCTH TX ART/VEN FINAL,1592.75,1592.75,95.56,1353.84,37 CDM,103621,SCREW BN 3.5MM 36MM,5616.0,5616.0,730.08,4773.6,28 CDM,103622,BRNCHOSCP DISP 3.8MM,9138.5,9138.5,548.31,7767.73,49 CDM,103623,CAP LD DF4 IS-1,1239.0,1239.0,161.07,1053.15,28 CDM,103625,CATH URET 2W 18FR 5CC,194.0,194.0,11.64,164.9,49 CDM,103626,CATH URET 2W 16FR 5CC,381.0,381.0,22.86,323.85,49 CDM,103630,RUBELLA IGM,1197.0,1197.0,71.82,1017.45,14 CDM,103631,CLIP ENDOSCP 2.6MM 18MM,3536.0,3536.0,459.68,3005.6,28 CDM,103632,CMPNT KN RT SZ6,38596.0,38596.0,5017.48,32806.6,28 CDM,103633,CATH DEL 6.5FR 8FR 40CM,15529.5,15529.5,931.77,13200.08,49 CDM,103634,SCREW BN 1.5MM 14MM SS,1992.0,1992.0,258.96,1693.2,28 CDM,103635,SCREW BN 1.5MM 10MM SS,1992.0,1992.0,258.96,1693.2,28 CDM,103636,ADAPTER CRDPLG M LUER BR,248.0,248.0,14.88,210.8,49 CDM,103637,STD AOR ROOT CANN,919.0,919.0,55.14,781.15,49 CDM,103638,CANNULA CRDPLG 9FR 31CM,1672.0,1672.0,100.32,1421.2,49 CDM,103639,CATH VENT PEDIA 13FR LF,1091.0,1091.0,65.46,927.35,49 CDM,103640,RUBEOLA IGG,988.0,988.0,59.28,839.8,14 CDM,103641,DEVICE SUMP PRICRD .25IN,718.0,718.0,43.08,610.3,49 CDM,103643,KIT INSERT FEM 23F,14210.0,14210.0,852.6,12078.5,49 CDM,103644,CANNULA FEM VNS 25F 60CM,14210.0,14210.0,852.6,12078.5,49 CDM,103650,RUSSELL VIPER DILUTED,820.0,820.0,49.2,697.0,14 CDM,103650,Russell viper venom time (includes venom); diluted ,820.0,820.0,8.05,65.88,80 CDM,103652,CANNULA PRFSN 18FR 24CM,9260.5,9260.5,555.63,7871.43,49 CDM,103653,CANNULA PRFSN 20FR 24CM,9260.5,9260.5,555.63,7871.43,49 CDM,103655,KIT PROCESSING 70ML,4192.5,4192.5,251.55,3563.63,49 CDM,103656,CANNLA PRFSN AOR 12GA5.5,1091.0,1091.0,65.46,927.35,49 CDM,103657,CANN PRFSN ADLT 9F 5.75,6820.5,6820.5,409.23,5797.43,49 CDM,103658,CANN PRFSN 90D 12F 7.5IN,1206.0,1206.0,72.36,1025.1,49 CDM,103659,CANN PRFSN 45D 12F 7.5IN,1206.0,1206.0,72.36,1025.1,49 CDM,103661,CANN PRFSN 15FR 10IN,2584.0,2584.0,155.04,2196.4,49 CDM,103663,CANN PRFSN 3/8IN 28F VN,1605.0,1605.0,96.3,1364.25,49 CDM,103664,CANN PRFSN 30FR 12-15IN,1605.0,1605.0,96.3,1364.25,49 CDM,103668,CANN PRFSN 22FR 12-15IN,1837.5,1837.5,110.25,1561.88,49 CDM,103669,CANNULA PRFSN 24FR 15IN,1837.5,1837.5,110.25,1561.88,49 CDM,103670,CULT TYPE AGGLUT,778.09,778.09,46.69,661.38,14 CDM,103670,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",778.09,778.09,4.35,35.66,80 CDM,103671,CANN PRFSN 28FR 12-15IN,1837.5,1837.5,110.25,1561.88,49 CDM,103672,CANNULA VNS 15IN 30FR,1837.5,1837.5,110.25,1561.88,49 CDM,103673,CANNULA PRFSN 25F 14IN,1780.0,1780.0,106.8,1513.0,49 CDM,103674,CANNULA PRFSN 20FR 12IN,2507.0,2507.0,150.42,2130.95,49 CDM,103675,CATH VENTR 18FR 35.5CM,1058.0,1058.0,63.48,899.3,49 CDM,103678,MESH HERNIA PP 20X10CM,51741.0,51741.0,6726.33,43979.85,28 CDM,103679,CUP ACTB HIP 28MM 46MM,12898.0,12898.0,1676.74,10963.3,28 CDM,103685,TENSIONER CERCLAGE DISP,16163.5,16163.5,969.81,13738.98,49 CDM,103686,SCREW BN 3.0MM 14MM,13744.0,13744.0,1786.72,11682.4,28 CDM,103689,CANNULA AORTIC ROOT 14GA,1111.5,1111.5,66.69,944.77,49 CDM,103690,SED RATE MANUAL,648.0,648.0,38.88,550.8,14 CDM,103690,"Sedimentation rate, erythrocyte; non-automated ",648.0,648.0,3.59,29.41,80 CDM,103691,PLATE BN LT SMALL,92908.0,92908.0,12078.04,78971.8,28 CDM,103692,SCREW BN LCK 3.5MM 28MM,12409.0,12409.0,1613.17,10547.65,28 CDM,103693,SCREW BN LCK 3.5MM 26MM,12409.0,12409.0,1613.17,10547.65,28 CDM,103694,SCREW BN LCK 3.5MM 34MM,12409.0,12409.0,1613.17,10547.65,28 CDM,103695,SCREW BN LCK 3.5MM 32MM,12409.0,12409.0,1613.17,10547.65,28 CDM,103696,SCREW BN LCK 3.5MM 38MM,12409.0,12409.0,1613.17,10547.65,28 CDM,103697,GEN PLS CARD SMART MINI,100000.0,100000.0,13000.0,85000.0,28 CDM,103698,CATH THRMB 100CM 135CM,100000.0,100000.0,6000.0,85000.0,49 CDM,103699,CATH THRMB 115CM 135CM,100000.0,100000.0,6000.0,85000.0,49 CDM,103701,GRAFT EVAS 14.5MM 14CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103702,CATH ULTSNC 10.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103705,GRAFT EVAS 79MM 34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103707,ELECTRODE ESURG 9FT,236.0,236.0,14.16,200.6,49 CDM,103710,SEROTONIN,1565.0,1565.0,93.9,1330.25,14 CDM,103710,Serotonin ,1565.0,1565.0,26.02,213.04,80 CDM,103713,SCREW BN 4.5MM 26MM,4160.0,4160.0,540.8,3536.0,28 CDM,103714,CATH GD 1.5FR 150CM,5018.5,5018.5,301.11,4265.73,49 CDM,103715,SCREW BN 2.4MM 18MM,2541.0,2541.0,330.33,2159.85,28 CDM,103716,PLATE BN XPLATE 8H,16492.0,16492.0,2143.96,14018.2,28 CDM,103717,CATH GD 1.5FR 135CM,5018.5,5018.5,301.11,4265.73,49 CDM,103718,SNARE ENDO 2.4MM 230CM,872.0,872.0,52.32,741.2,49 CDM,103720,AST (SGOT),1029.0,1029.0,61.74,874.65,14 CDM,103720,Transferase; aspartate amino (AST) (SGOT) ,1029.0,1029.0,4.35,35.66,80 CDM,103722,PROSTHESIS PENL TTN 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103723,HEAD HUM SHLDR -4MM 36MM,19721.0,19721.0,2563.73,16762.85,28 CDM,103724,STEM HUM SHLDR SZ12 48MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103725,INSERT HUM SHLDR +4 36MM,19017.0,19017.0,2472.21,16164.45,28 CDM,103726,SCREW BN 5MM 22MM,2787.0,2787.0,362.31,2368.95,28 CDM,103727,SCREW BN 5MN 30MM,3079.0,3079.0,400.27,2617.15,28 CDM,103729,BRNCHOSCP DISP 5.8MM,9138.5,9138.5,548.31,7767.73,49 CDM,103730,ALT (SGPT),1029.0,1029.0,61.74,874.65,14 CDM,103730,Transferase; alanine amino (ALT) (SGPT) ,1029.0,1029.0,4.45,36.47,80 CDM,103731,BRONCHOSCOPE DISP 3.8MM,9138.5,9138.5,548.31,7767.73,49 CDM,103732,BRNCHOSCP DISP 5.8MM,10212.5,10212.5,612.75,8680.63,49 CDM,103733,DEVICE SUT SPRL 3-0 30CM,1241.5,1241.5,74.49,1055.28,49 CDM,103734,IMPLANT BREAST 530CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103735,IMPLANT BREAST 480CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103736,IMPLANT BREAST 545CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103737,IMPLANT BREAST 590CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103738,IMPLANT BREAST 630CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103739,SLITTLER CATH DISP,2034.0,2034.0,122.04,1728.9,49 CDM,103740,TOOL SURG LCK,2905.5,2905.5,174.33,2469.68,49 CDM,103741,CATH GD MD 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 CDM,103744,CATHETER THRMB 3FR 80CM,1975.5,1975.5,118.53,1679.17,49 CDM,103745,CATHETER THRMB 5FR 80CM,1975.5,1975.5,118.53,1679.17,49 CDM,103747,RETRIEVAL BASKET 1.9FR,6273.0,6273.0,376.38,5332.05,49 CDM,103748,LINR ACTB HIP R3 58MM,42258.0,42258.0,5493.54,35919.3,28 CDM,103749,HIP HEAD FEM +0 12/14 22,18312.0,18312.0,2380.56,15565.2,28 CDM,103750,SICKLE CELL SCREEN,393.0,393.0,23.58,334.05,14 CDM,103750,"Sickling of RBC, reduction ",393.0,393.0,4.63,37.92,80 CDM,103753,DRAIN WND RND 32FR,1282.0,1282.0,76.92,1089.7,49 CDM,103754,DRESSING ABS ANMC 4X4IN,404.5,404.5,24.27,343.82,49 CDM,103757,TUBIN IRR WITH BURR,2700.0,2700.0,162.0,2295.0,49 CDM,103759,DVC INTRCRD VNTRC ASST,100000.0,100000.0,6000.0,85000.0,49 CDM,103760,SJOGRENS A AB (SSA),1283.18,1283.18,76.99,1090.7,14 CDM,103761,GRAFT EVAS 18MM 9.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103762,TUBING IRR 2IN,3944.0,3944.0,236.64,3352.4,49 CDM,103766,KIT INTRO 25FR 50CM,14628.0,14628.0,877.68,12433.8,49 CDM,103767,CATH GD 6.8MM 105MM,51200.5,51200.5,3072.03,43520.43,49 CDM,103768,CATH EXTRACT 6.8MM 105MM,92442.0,92442.0,5546.52,78575.7,49 CDM,103769,HEAD SHLDR HUM 13X42MM,26031.0,26031.0,3384.03,22126.35,28 CDM,103770,SJOGRENS B AB (SSB),1283.0,1283.0,76.98,1090.55,14 CDM,103771,PLUG CARDIAC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103773,CATH THRMB 3F 80CM,1918.0,1918.0,115.08,1630.3,49 CDM,103775,PLATE BN RT 93MM 3.5MM,41579.0,41579.0,5405.27,35342.15,28 CDM,103776,GRAFT EVAS 23X14.5M 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103777,GRAFT EVAS 7CM 12MM,94329.0,94329.0,12262.77,80179.65,28 CDM,103779,CLSR STERNAL 2MM 36IN,7449.0,7449.0,968.37,6331.65,28 CDM,103780,SODIUM BLD,625.0,625.0,37.5,531.25,14 CDM,103780,"Sodium; serum, plasma or whole blood ",625.0,625.0,4.04,33.12,80 CDM,103781,PROBE ABL 17GA 20CM,57006.0,57006.0,3420.36,48455.1,49 CDM,103783,TOOL PCMKR 2 WRNCH BIDIR,1685.5,1685.5,101.13,1432.67,49 CDM,103785,IMPLANT BREAST 675CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103786,IMPLANT BREAST 730CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103787,IMPLANT BREAST 635CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103788,IMPLANT BREAST 685CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103789,IMPLANT BREAST 740CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103790,SODIUM UR,625.0,625.0,37.5,531.25,14 CDM,103790,Sodium; urine ,625.0,625.0,4.25,34.84,80 CDM,103791,IMPLANT BREAST 775CC,42040.0,42040.0,5465.2,35734.0,28 CDM,103792,IMPLANT BREAST 650CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103793,IMPLANT BREAST 700CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103794,IMPLANT BREAST 755CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103795,IMPLANT BREAST 630CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103796,IMPLANT BREAST 700CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103797,IMPLANT BREAST 775CC,33147.0,33147.0,4309.11,28174.95,28 CDM,103804,CATH BLNDIL 5.0X35MM,11938.0,11938.0,716.28,10147.3,49 CDM,103805,SCREW BN 2.0MM 12MM,10999.0,10999.0,1429.87,9349.15,28 CDM,103806,SUTURE TAPE 1.4MM 40IN,2905.5,2905.5,174.33,2469.68,49 CDM,103807,ANCHOR SUT 4.5X20MM,11584.0,11584.0,1505.92,9846.4,28 CDM,103808,CATH BLNDIL 4.0X25MM,11938.0,11938.0,716.28,10147.3,49 CDM,103809,CATH BLNDIL 5.0X25MM,11938.0,11938.0,716.28,10147.3,49 CDM,103811,CATH BLNDIL 6.0X25MM,11938.0,11938.0,716.28,10147.3,49 CDM,103812,PROBE ABL PREC 15CM 15GA,57006.0,57006.0,3420.36,48455.1,49 CDM,103813,TIP MNPLT 6.7MM 12CM,2627.0,2627.0,157.62,2232.95,49 CDM,103815,PORT ACC 8MM 120MM,16303.0,16303.0,978.18,13857.55,49 CDM,103816,SLING MALE ADVANCE XP,100000.0,100000.0,13000.0,85000.0,28 CDM,103818,LINER REV SHO +0MM 40MM,21552.0,21552.0,2801.76,18319.2,28 CDM,103819,BIT DRILL AO QC 3MM,4809.5,4809.5,288.57,4088.07,49 CDM,103820,STREP A AG IA,795.0,795.0,47.7,675.75,14 CDM,103822,SCREW SPN 6.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,103824,SCREW BN 4.0MM 38MM,10406.0,10406.0,1352.78,8845.1,28 CDM,103825,HEAD HUM SHLDR 36MM,19721.0,19721.0,2563.73,16762.85,28 CDM,103826,STEM HUM SHLDR 10X108MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103827,INSERT SCKT SHLDR 36MM,19017.0,19017.0,2472.21,16164.45,28 CDM,103828,SCREW BN 5MM 26MM,2787.0,2787.0,362.31,2368.95,28 CDM,103829,CATH IVL 2.5X12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103830,CATH IVL 3.0X12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103831,CATH IVL 3.5X12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103832,CATH IVL 4.0X12MM,100000.0,100000.0,6000.0,85000.0,49 CDM,103835,EXPANDER BREAST 350CC,67263.0,67263.0,8744.19,57173.55,28 CDM,103836,EXPANDER TISS BRST 455CC,67263.0,67263.0,8744.19,57173.55,28 CDM,103837,EXPAND BRST 535CC,67263.0,67263.0,8744.19,57173.55,28 CDM,103838,EXPAND BRST 650CC,67263.0,67263.0,8744.19,57173.55,28 CDM,103839,EXPAND BRST 700CC,67263.0,67263.0,8744.19,57173.55,28 CDM,103842,CAT 1 ED PROCEDURE,639.66,639.66,83.16,543.71,44 CDM,103843,CAT 2 ED PROCEDURE,1284.09,1284.09,166.93,1091.48,44 CDM,103844,CAT 3 ED PROCEDURE,2138.96,2138.96,278.06,1818.12,44 CDM,103845,LVL 1 FREE STD EMER DEPT,430.64,430.64,72.35,366.04,9 CDM,103846,LVL 2 FREE STD EMER DEPT,799.45,799.45,134.31,679.53,9 CDM,103847,LVL 3 FREE STD EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CDM,103848,LVL 4 FREE STD EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CDM,103849,LVL 5 FREE STD EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CDM,103850,T3 FREE,979.0,979.0,58.74,832.15,14 CDM,103850,Triiodothyronine T3; free ,979.0,979.0,14.23,116.47,80 CDM,103851,IV HYDRAT INIT UP TO 1HR,909.75,909.75,54.59,773.29,39 CDM,103852,IV HYDRAT EA ADD HR,394.19,394.19,23.65,335.06,39 CDM,103853,IV INITIAL UP TO 1 HOUR,909.75,909.75,54.59,773.29,39 CDM,103854,IV EACH ADD HOUR,394.19,394.19,23.65,335.06,39 CDM,103855,IV ADDL SEQ INF UP TO 1H,394.19,394.19,23.65,335.06,39 CDM,103856,IV CONCURRENT INFUSION,394.19,394.19,23.65,335.06,44 CDM,103857,IVP SINGLE/INITIAL DRUG,1138.03,1138.03,68.28,967.33,39 CDM,103858,IVP EA ADD SEQ NEW DRUG,1138.03,1138.03,68.28,967.33,39 CDM,103859,IVP EA ADD SEQ SAME DRUG,1138.03,1138.03,68.28,967.33,44 CDM,103860,T3 TOTAL,1761.0,1761.0,105.66,1496.85,14 CDM,103860,Triiodothyronine T3; total (TT-3) ,1761.0,1761.0,11.91,97.56,80 CDM,103861,INJECTION IM OR SQ,825.12,825.12,49.51,701.35,39 CDM,103862,CRIT CARE ECH ADD 30M ER,1265.6,1265.6,164.53,1075.76,23 CDM,103863,EMERGENT DIALYSIS ESRD,3316.59,3316.59,431.16,2819.1,33 CDM,103864,CRIT CARE 1ST 30-74M ER,4396.96,4396.96,571.6,3737.42,15 CDM,103865,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,103866,IMMUNIZ ADMIN SGL,346.13,346.13,20.77,294.21,39 CDM,103867,CAT 1 ED PROCEDURE,639.66,639.66,83.16,543.71,44 CDM,103868,CAT 2 ED PROCEDURE,1284.09,1284.09,166.93,1091.48,44 CDM,103869,CAT 3 ED PROCEDURE,2138.96,2138.96,278.06,1818.12,44 CDM,103871,SCREW BN 4.5MM 46MM,4160.0,4160.0,540.8,3536.0,28 CDM,103872,STEM HUM PRSFT 14MM,52119.0,52119.0,6775.47,44301.15,28 CDM,103873,CATH BLNDIL 3.5X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,103874,CATH BLN PTCA 2.0X15MM,21398.5,21398.5,1283.91,18188.72,49 CDM,103875,CATH BLNDIL 4X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,103877,FILTER EMBL 4MM 320CM,29304.5,29304.5,1758.27,24908.83,49 CDM,103878,FILTER EMBL 7MM 320CM,29304.5,29304.5,1758.27,24908.83,49 CDM,103880,THYROXINE T4 TOTAL,1039.0,1039.0,62.34,883.15,14 CDM,103880,Thyroxine; total ,1039.0,1039.0,5.77,47.24,80 CDM,103881,MESH HRN PP 20X20IN,100000.0,100000.0,13000.0,85000.0,28 CDM,103882,PCMKR 4.45X5.88X0.75CM,42819.0,42819.0,5566.47,36396.15,28 CDM,103883,CATH GD 7FR 69CM,15529.5,15529.5,931.77,13200.08,49 CDM,103884,OCCLUDER CV 9F 18MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103885,OCCLUDER PFO RT25/LT18MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103886,OCCLUDER CV 9F 30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103887,OCCLUDER PFO RT35/LT25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,103889,CATH DIL VASC 1.5X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,103890,T4 FREE,741.0,741.0,44.46,629.85,14 CDM,103890,Thyroxine; free ,741.0,741.0,7.58,62.08,80 CDM,103891,CATH DIL VASC 1.5X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,103895,CATH DIL VASC 2X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,103896,CATH DIL VASC 2X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,103897,CATH DIL VASC 2X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,103900,CATH DIL VASC 2.25X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,103901,CATH DIL VASC 2.25X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,103902,CATH DIL VASC 2.25X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,103905,CATH DIL VASC 2.5X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,103906,PROSTH PENL LCK-OUT 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,103907,GWIRE PRESSR 3.2CM 280CM,100000.0,100000.0,6000.0,85000.0,49 CDM,103908,SCREW BN 2.4X3.5X22X5MM,6519.0,6519.0,847.47,5541.15,28 CDM,103909,SCREW BN 2.4X3.5X26X6MM,6519.0,6519.0,847.47,5541.15,28 CDM,103910,TESTOSTERONE TOTAL,1898.0,1898.0,113.88,1613.3,14 CDM,103910,Testosterone; total ,1898.0,1898.0,21.68,177.56,80 CDM,103911,GWIRE ORTH .8MM 100MM,688.0,688.0,41.28,584.8,49 CDM,103912,SCREW BN CANN 3MM 30MM,6597.0,6597.0,857.61,5607.45,28 CDM,103913,SCREW BN 3X4X1.2X36X16MM,6597.0,6597.0,857.61,5607.45,28 CDM,103914,SCREW BN 3.0MM 32MM 14MM,6597.0,6597.0,857.61,5607.45,28 CDM,103915,SCREW BN 3X4X1.2X38X18MM,6597.0,6597.0,857.61,5607.45,28 CDM,103916,GWIRE ORTH 1.1MM 150MM,1281.5,1281.5,76.89,1089.28,49 CDM,103917,TUBE ESOPHGL TEMP MGMT,23881.0,23881.0,1432.86,20298.85,49 CDM,103920,TESTOSTERONE FREE,2531.0,2531.0,151.86,2151.35,14 CDM,103920,Testosterone; free ,2531.0,2531.0,21.39,175.21,80 CDM,103923,INTRO SHEATH 14FR 65CM,23912.0,23912.0,1434.72,20325.2,49 CDM,103925,SHEATH INTRO 20FR 65CM,24405.0,24405.0,1464.3,20744.25,49 CDM,103926,SHEATH INTRO 16FR 28CM,7043.0,7043.0,422.58,5986.55,49 CDM,103927,SHEATH INTRO 20FR 28CM,8803.5,8803.5,528.21,7482.98,49 CDM,103928,SHEATH INTRO 22FR 28CM,8803.5,8803.5,528.21,7482.98,49 CDM,103929,SHEATH INTRO 24F 28CM,8803.5,8803.5,528.21,7482.98,49 CDM,103930,THEOPHYLLINE QUANT,524.0,524.0,31.44,445.4,14 CDM,103930,Theophylline ,524.0,524.0,11.88,97.29,80 CDM,103931,LVL 1 FREE STD EMER DEPT,430.64,430.64,72.35,366.04,9 CDM,103932,LVL 2 FREE STD EMER DEPT,799.45,799.45,134.31,679.53,9 CDM,103933,LVL 3 FREE STD EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CDM,103934,LVL 4 FREE STD EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CDM,103935,LVL 5 FREE STD EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CDM,103936,IV HYDRAT INIT UP TO 1HR,909.75,909.75,54.59,773.29,39 CDM,103937,IV HYDRAT EA ADD HR,394.19,394.19,23.65,335.06,39 CDM,103938,IV INITIAL UP TO 1 HOUR,909.75,909.75,54.59,773.29,39 CDM,103939,IV EACH ADD HOUR,394.19,394.19,23.65,335.06,39 CDM,103940,IV ADDL SEQ INF UP TO 1H,394.19,394.19,23.65,335.06,39 CDM,103941,IV CONCURRENT INFUSION,394.19,394.19,23.65,335.06,44 CDM,103942,IVP SINGLE/INITIAL DRUG,1138.03,1138.03,68.28,967.33,39 CDM,103943,IVP EA ADD SEQ NEW DRUG,1138.03,1138.03,68.28,967.33,39 CDM,103944,IVP EA ADD SEQ SAME DRUG,1138.03,1138.03,68.28,967.33,44 CDM,103945,INJECTION IM OR SQ,825.12,825.12,49.51,701.35,39 CDM,103946,CRIT CARE ECH ADD 30M ER,1265.6,1265.6,164.53,1075.76,23 CDM,103947,EMERGENT DIALYSIS ESRD,3316.59,3316.59,431.16,2819.1,33 CDM,103948,CRIT CARE 1ST 30-74M ER,4396.96,4396.96,571.6,3737.42,15 CDM,103949,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,103950,THROMBIN TIME,924.0,924.0,55.44,785.4,14 CDM,103950,Thrombin time; plasma ,924.0,924.0,4.85,39.73,80 CDM,103951,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,103952,VANCOMYCIN 125 MG PO,13.33,13.33,0.8,11.33,49 CDM,103953,VANCOMYCIN 250 MG PO,13.27,13.27,0.8,11.28,49 CDM,103954,CT ORBIT/SELLA/IAC W&WO,18451.21,18451.21,1107.07,15683.53,14 CDM,103955,CT UP EXTREM W/O CONT RT,12007.71,12007.71,720.46,10206.55,14 CDM,103956,CT C-SPINE W/O CONTRAST,15401.19,15401.19,924.07,13091.01,14 CDM,103957,CT MAXIFAC W/O CNT,12011.15,12011.15,720.67,10209.48,14 CDM,103959,CTA CHEST,20534.93,20534.93,1232.1,17454.69,14 CDM,103960,THYROGLOBULIN,658.08,658.08,39.48,559.37,14 CDM,103960,Thyroglobulin ,658.08,658.08,13.49,110.5,80 CDM,103961,CT LOWER EXTRM W/CON BI,21967.2,21967.2,1318.03,18672.12,14 CDM,103962,CT LOWER EXTRM W/CON LT,10985.32,10985.32,659.12,9337.52,14 CDM,103963,CTA HEAD,12961.41,12961.41,777.68,11017.2,14 CDM,103964,CTA ABDOMEN,1604.0,1604.0,96.24,1363.4,14 CDM,103965,CTA NECK,12961.41,12961.41,777.68,11017.2,14 CDM,103966,CTA ABD AORTA IF LWEX RO,18984.73,18984.73,1139.08,16137.02,14 CDM,103990,TSH,1736.0,1736.0,104.16,1475.6,14 CDM,103990,Thyroid stimulating hormone (TSH) ,1736.0,1736.0,14.11,115.57,80 CDM,104000,THYROXINE BG (TBG),978.55,978.55,58.71,831.77,14 CDM,104000,Thyroxine binding globulin (TBG) ,978.55,978.55,12.42,101.63,80 CDM,104004,CATH ANGIO CRV 5F 100CM,1151.0,1151.0,69.06,978.35,49 CDM,104007,CATH ANGIO 5FR 125CM,1151.0,1151.0,69.06,978.35,49 CDM,104008,CMPNT FEM HIP 15MM 165MM,53527.0,53527.0,6958.51,45497.95,28 CDM,104009,PLATE BN RT 1.5MM,16432.0,16432.0,2136.16,13967.2,28 CDM,104010,TOBRAMYCIN QUANT,573.68,573.68,34.42,487.63,14 CDM,104011,SCREW BN 1.5MM 18MM,1992.0,1992.0,258.96,1693.2,28 CDM,104012,SCREW BN 1.5MM 16MM,4077.0,4077.0,530.01,3465.45,28 CDM,104013,GRAFT CV 55X85CM 8MM,37465.0,37465.0,4870.45,31845.25,28 CDM,104014,GRAFT CV 55X85CM 8MM,36374.0,36374.0,4728.62,30917.9,28 CDM,104015,PROSTH PENL PUMP PS 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,104016,NAIL BN 130D 10MM 38CM,55518.0,55518.0,7217.34,47190.3,28 CDM,104017,PACK PROBE AND CONN,17607.0,17607.0,1056.42,14965.95,49 CDM,104018,KNIFE SURG DISP 193MM,6515.0,6515.0,390.9,5537.75,49 CDM,104019,KIT KNIFE AND GUIDE,5227.5,5227.5,313.65,4443.38,49 CDM,104020,CAGE SPNL 8D 50X18X103,84516.0,84516.0,10987.08,71838.6,28 CDM,104021,INTERBODY SPN 50X18X8MM,84516.0,84516.0,10987.08,71838.6,28 CDM,104022,SCREW SPN 5.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,104023,SCREW SPN 6.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,104024,ROD SPN CRVD 130MM,5265.0,5265.0,684.45,4475.25,28 CDM,104025,SET SCREW SPN,2201.0,2201.0,286.13,1870.85,28 CDM,104026,BAG SPEC RETRVL 300ML,2905.5,2905.5,174.33,2469.68,49 CDM,104028,BURR SURG 4.0MM,2150.5,2150.5,129.03,1827.92,49 CDM,104029,MANIFOLD IV 6 PORT,470.5,470.5,28.23,399.93,49 CDM,104030,Antibody; Toxoplasma ,882.0,882.0,12.09,99.01,80 CDM,104030,TOXOPLASMA IGG QUAL,882.0,882.0,52.92,749.7,14 CDM,104031,CT ABD&PELVIS W/CONT,33231.87,33231.87,1993.91,28247.09,14 CDM,104032,CT ABD&PELVIS W/O CONT,28317.96,28317.96,1699.08,24070.27,14 CDM,104034,CT ABD&PELVIS W&WO CONT,34935.48,34935.48,2096.13,29695.16,14 CDM,104036,CTA HEAD VIZ AI TECH,14224.24,14224.24,853.45,12090.6,14 CDM,104038,LUNG CA SCREEN WO CON,1363.58,1363.58,81.81,1159.04,17 CDM,104040,"Antibody; Toxoplasma, IgM ",882.27,882.27,12.1,99.1,80 CDM,104040,TOXOPLASMA IGM QUAL,882.27,882.27,52.94,749.93,14 CDM,104042,CT MAXIFAC W&W/O CONT,13889.93,13889.93,833.4,11806.44,14 CDM,104043,CT NECK W&W/O CONT,15820.23,15820.23,949.21,13447.2,14 CDM,104045,CT CHEST W&W/O CONT,13798.33,13798.33,827.9,11728.58,14 CDM,104047,CT T-SPINE W&W/O CONT,18492.42,18492.42,1109.55,15718.56,14 CDM,104048,CT CHEST W/CONTRAST,13662.09,13662.09,819.73,11612.78,14 CDM,104050,TRANSFERRIN,798.0,798.0,47.88,678.3,14 CDM,104050,Transferrin ,798.0,798.0,10.72,87.78,80 CDM,104051,CTA ABD&PEL W CONT,25743.08,25743.08,1544.58,21881.62,14 CDM,104054,CT L-SPINE W/CONTRAST,15401.19,15401.19,924.07,13091.01,14 CDM,104056,CTA LOW EXTREMITY BI,19079.76,19079.76,1144.79,16217.8,14 CDM,104060,TRIGLYCERIDES,1149.0,1149.0,68.94,976.65,14 CDM,104061,CTA LOW EXTREMITY LT,19079.76,19079.76,1144.79,16217.8,14 CDM,104062,CTA LOW EXTREMITY RT,19079.76,19079.76,1144.79,16217.8,14 CDM,104063,CT C-SPINE W/CONTRAST,18746.59,18746.59,1124.8,15934.6,14 CDM,104064,CT ABDOMEN W/O CONT,16054.93,16054.93,963.3,13646.69,14 CDM,104065,TROPONIN QUANT,1328.0,1328.0,79.68,1128.8,14 CDM,104067,CT ABDOMEN W/CONT,17162.05,17162.05,1029.72,14587.74,14 CDM,104068,CT HEAD/BRAIN W/CONT,15401.19,15401.19,924.07,13091.01,14 CDM,104069,CT CHEST W/O CONTRAST,12982.02,12982.02,778.92,11034.72,14 CDM,104070,NEEDLE ASP 8GA 15CM,1453.0,1453.0,87.18,1235.05,49 CDM,104071,CATH RTVR THRMB 80CM,100000.0,100000.0,6000.0,85000.0,49 CDM,104072,SHEATH RTVR CLOT 20FR,100000.0,100000.0,6000.0,85000.0,49 CDM,104073,MESH HRN PP 12X10IN,31045.0,31045.0,4035.85,26388.25,28 CDM,104075,DRILL BIT CANN 2.6MM,6273.0,6273.0,376.38,5332.05,49 CDM,104076,CTHGD 7F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 CDM,104077,CTHGD 8F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 CDM,104078,SCREW BN 3MM 30MM,15143.0,15143.0,1968.59,12871.55,28 CDM,104079,SCREW BN 2.7MM 2MM 10MM,4909.0,4909.0,638.17,4172.65,28 CDM,104083,CT HD/BR W&W/O CONT,17300.58,17300.58,1038.03,14705.49,14 CDM,104084,CT HEAD/BRAIN W/O CONT,10014.44,10014.44,600.87,8512.27,14 CDM,104085,URINE UREA NITROGEN,791.0,791.0,47.46,672.35,14 CDM,104085,"Urea nitrogen, urine ",791.0,791.0,4.67,38.28,80 CDM,104088,CT ORBIT/SELLA/IAC W,17005.2,17005.2,1020.31,14454.42,14 CDM,104090,URIC ACID BLD,622.0,622.0,37.32,528.7,14 CDM,104090,Uric acid; blood ,622.0,622.0,3.8,31.13,80 CDM,104092,CT L-SPINE W/O CONTRAST,13909.39,13909.39,834.56,11822.98,14 CDM,104093,CT L-SPINE W&W/O CONT,19844.55,19844.55,1190.67,16867.87,14 CDM,104095,CT NECK W/O CONTRAST,14652.43,14652.43,879.15,12454.57,14 CDM,104096,CT LW EXTRM W&W/O CON RT,12653.43,12653.43,759.21,10755.42,14 CDM,104098,CT LW EXTRM W&W/O CON LT,12653.43,12653.43,759.21,10755.42,14 CDM,104100,URIC ACID BODY FLD,622.47,622.47,37.35,529.1,14 CDM,104101,CT LOWER EXTRM W/O C LT,6515.63,6515.63,390.94,5538.29,14 CDM,104105,CT LOWER EXTRM W/O C RT,6515.63,6515.63,390.94,5538.29,14 CDM,104106,CT PELVIS W/O CONTRAST,12264.17,12264.17,735.85,10424.54,14 CDM,104108,CT PELVIS W/CONTRAST,16066.38,16066.38,963.98,13656.42,14 CDM,104109,CT PELVIS W&W/O CONT,16922.77,16922.77,1015.37,14384.35,14 CDM,104110,URIC ACID UR,622.0,622.0,37.32,528.7,14 CDM,104112,CT MAXIFAC W/CONTRAST,13169.78,13169.78,790.19,11194.31,14 CDM,104113,CT T-SPINE W/O CONTRAST,17524.98,17524.98,1051.5,14896.23,14 CDM,104114,CT LOWER EXTRM W/CON RT,10985.32,10985.32,659.12,9337.52,14 CDM,104115,CT NECK W/CONTRAST,15677.12,15677.12,940.63,13325.55,14 CDM,104116,CT ABDOMEN W&WO CONT,18010.42,18010.42,1080.63,15308.86,14 CDM,104117,CTA PELVIS,20534.93,20534.93,1232.1,17454.69,14 CDM,104118,CT UP EXTREM W/CONT RT,6515.63,6515.63,390.94,5538.29,14 CDM,104119,CT UP EXTREM W/CONT LT,6515.63,6515.63,390.94,5538.29,14 CDM,104120,UA W O MICRO AUTO,345.0,345.0,20.7,293.25,14 CDM,104121,CT UP EXTREM W/O CONT LT,12007.71,12007.71,720.46,10206.55,14 CDM,104131,SCREW BN 2.7MM 2MM 14MM,4909.0,4909.0,638.17,4172.65,28 CDM,104132,SCREW BN 2.7MM 16MM,4909.0,4909.0,638.17,4172.65,28 CDM,104133,PLATE BN LT 10D SM,59050.0,59050.0,7676.5,50192.5,28 CDM,104134,SUTURE BLU MONO 2-0 30IN,2700.0,2700.0,162.0,2295.0,49 CDM,104135,INTRO SHEATH 24FR 65CM,23912.0,23912.0,1434.72,20325.2,49 CDM,104138,GWIRE FLPY 330X2.2CM,6273.0,6273.0,376.38,5332.05,49 CDM,104139,BIT DRILL 30MM 2MM,1453.0,1453.0,87.18,1235.05,49 CDM,104140,UA W MICRO AUTO,708.0,708.0,42.48,601.8,14 CDM,104140,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",708.0,708.0,2.66,21.81,80 CDM,104141,STENT BIL 8.5FR 7CM,5286.0,5286.0,687.18,4493.1,28 CDM,104142,STENT BIL 8.5FR 9CM,5286.0,5286.0,687.18,4493.1,28 CDM,104143,SNARE POLY OVAL SM,439.0,439.0,26.34,373.15,49 CDM,104144,CANNULA ARTHSCP 8.25MM,1575.0,1575.0,94.5,1338.75,49 CDM,104145,DILATOR ESOPHAGEAL 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,104146,DILATOR ESOPHAGEAL 17MM,2905.5,2905.5,174.33,2469.68,49 CDM,104148,DILATOR ESOPHAGEAL 8MM,2905.5,2905.5,174.33,2469.68,49 CDM,104149,DILATOR ESOPHAGEAL 10MM,2905.5,2905.5,174.33,2469.68,49 CDM,104150,ICD DEFB DLCHMBR MRI IS1,100000.0,100000.0,13000.0,85000.0,28 CDM,104151,EXPAND BRST 850CC,67263.0,67263.0,8744.19,57173.55,28 CDM,104152,EXPAND BRST 850CC,57562.0,57562.0,7483.06,48927.7,28 CDM,104153,EXPAND BRST 800CC,57562.0,57562.0,7483.06,48927.7,28 CDM,104154,FLEX ALLOPATCH HD 1SQCM,1479.0,1479.0,88.74,1257.15,30 CDM,104155,SCREW BN 2.7MM 16MM,8992.0,8992.0,1168.96,7643.2,28 CDM,104157,GRAFT EVAS 109MM 28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,104158,SCREW BN 3.5X2.9X85MM,4750.0,4750.0,617.5,4037.5,28 CDM,104161,PLATE BN 102MM SS 3.5MM,42229.0,42229.0,5489.77,35894.65,28 CDM,104162,SCREW BN 3.5MM 80MM,4750.0,4750.0,617.5,4037.5,28 CDM,104163,GFT VSC STRCH 6X70X80,49332.0,49332.0,6413.16,41932.2,28 CDM,104164,GFT VSC STRCH 8X70X80,51805.0,51805.0,6734.65,44034.25,28 CDM,104166,IMPLANT BREAST 215CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104167,IMPLANT BREAST 235CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104168,IMPLANT BREAST 255CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104169,IMPLANT BREAST 275CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104171,IMPLANT BREAST 300CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104172,IMPLANT BREAST 320CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104173,IMPLANT BREAST 340ML,32338.0,32338.0,4203.94,27487.3,28 CDM,104174,IMPLANT BREAST 360CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104175,IMPLANT BREAST 385CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104176,IMPLANT BREAST 405CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104177,IMPLANT BREAST 425CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104178,IMPLANT BREAST 445CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104179,IMPLANT BREAST 470CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104181,IMPLANT BREAST 635CC,42040.0,42040.0,5465.2,35734.0,28 CDM,104182,IMPLANT BREAST 700CC,42040.0,42040.0,5465.2,35734.0,28 CDM,104183,IMPLANT BREAST 775CC,42040.0,42040.0,5465.2,35734.0,28 CDM,104185,STENT GRFT 26MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,104186,CMPNT KN RT SZ4,38596.0,38596.0,5017.48,32806.6,28 CDM,104187,CATH DIL VASC 2.5X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104188,CATH DIL VASC 2.5X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104189,CATH DIL VASC 2.5X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,104190,VALPROIC ACID (DEPAKENE),1060.0,1060.0,63.6,901.0,14 CDM,104190,Valproic acid (dipropylacetic acid); total ,1060.0,1060.0,11.37,93.12,80 CDM,104193,CATH DIL VASC 2.75X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104194,CATH DIL VASC 2.75X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104195,CATH DIL VASC 2.75X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104197,CATH DIL VASC 3.00X6MM,4600.5,4600.5,276.03,3910.43,49 CDM,104198,CATH DIL VASC 3X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104199,CATH DIL VASC 3X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104200,VANCOMYCIN QUANT,499.0,499.0,29.94,424.15,14 CDM,104201,CATH DIL VASC 3X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104202,CATH DIL VASC 3X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,104205,CATH DIL VASC 3.25X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104206,CATH DIL VASC 3.25X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104207,CATH DIL VASC 3.25X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104210,VMA URINE,1265.0,1265.0,75.9,1075.25,14 CDM,104210,"Vanillylmandelic acid (VMA), urine ",1265.0,1265.0,13.02,106.61,80 CDM,104211,CATH DIL VASC 3.50X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104212,CATH DIL VASC 3.50X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104213,CATH DIL VASC 3.50X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104214,CATH DIL VASC 3.50X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,104216,CATH DIL VASC 3.75X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104217,CATH DIL VASC 3.75X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104218,CATH DIL VASC 3.75X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104221,CATH DIL VASC 4.00X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104222,CATH DIL VASC 4.00X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104223,CATH DIL VASC 4.00X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104225,CATH DIL VASC 4.50X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104226,CATH DIL VASC 4.50X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104227,CATH DIL VASC 4.50X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104228,SYSTEM INFL SYR 60ML STR,1569.0,1569.0,94.14,1333.65,49 CDM,104229,CATH DIL VASC 4.5X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,104231,CATH DIL VASC 5.00X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,104232,CATH DIL VASC 5.00X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104233,CATH DIL VASC 5.00X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104235,VARICELLA ZOSTER DNA AMP,1401.0,1401.0,84.06,1190.85,14 CDM,104236,CATH DIL VASC 5.50X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104237,CATH DIL VASC 5.50X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104239,CATH DIL VASC 6.00X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,104241,CATH DIL VASC 6.00X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,104243,BASEPLATE KN TIB RT SZ6,25355.0,25355.0,3296.15,21551.75,28 CDM,104244,KIT INTRO 5FR 21GA 10CM,2905.5,2905.5,174.33,2469.68,49 CDM,104245,KT INTRO SHTH 6FR 10CM,2905.5,2905.5,174.33,2469.68,49 CDM,104246,KIT INTRO SHTH 7FR 10CM,2905.5,2905.5,174.33,2469.68,49 CDM,104248,KIT INTRODUCER CATH 7FR,3596.5,3596.5,215.79,3057.03,49 CDM,104249,CATH GD 5.1FR 150CM,20799.5,20799.5,1247.97,17679.58,49 CDM,104251,CTHGD 7F 100CM M1 AI.75,2150.5,2150.5,129.03,1827.92,49 CDM,104252,CATH GD 5.7FR 150CM,20799.5,20799.5,1247.97,17679.58,49 CDM,104253,CATH INTVN 6.5FR 150CM,20799.5,20799.5,1247.97,17679.58,49 CDM,104254,CATH GD 7FR 25CM,13205.5,13205.5,792.33,11224.67,49 CDM,104256,DEVICE CATH 2FR 97-112CM,9684.0,9684.0,581.04,8231.4,49 CDM,104257,CATHETER ANGIO .038IN 4F,1511.0,1511.0,90.66,1284.35,49 CDM,104258,GWIRE VASC 180CM .035IN,439.0,439.0,26.34,373.15,49 CDM,104259,GWIRE VASC 260CM .035IN,2195.0,2195.0,131.7,1865.75,49 CDM,104260,VITAMIN A,1982.0,1982.0,118.92,1684.7,14 CDM,104260,Vitamin A ,1982.0,1982.0,9.75,79.82,80 CDM,104262,GWIRE VASC .035IN 260CM,1662.0,1662.0,99.72,1412.7,49 CDM,104263,CTHGD 7F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 CDM,104264,CTHGD 8F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 CDM,104265,CTHGD 8F 100CM M1 AL.75,2150.5,2150.5,129.03,1827.92,49 CDM,104266,CTHGD 8F 90CM M1 HS,2150.5,2150.5,129.03,1827.92,49 CDM,104267,IMPLANT BREAST 250CC,32338.0,32338.0,4203.94,27487.3,28 CDM,104270,Thiamine (Vitamin B-1) ,1025.0,1025.0,17.83,145.98,80 CDM,104270,VITAMIN B1 THIAMINE,1025.0,1025.0,61.5,871.25,14 CDM,104271,SCREW BIOSURE INTRF RGNS,10210.0,10210.0,1327.3,8678.5,28 CDM,104272,SUTURE POLY SZ5 40IN,2905.5,2905.5,174.33,2469.68,49 CDM,104273,SUTURE FIB #2 48IN,4035.0,4035.0,524.55,3429.75,28 CDM,104274,SPHNTM GW 20MM 260CM,13527.5,13527.5,811.65,11498.38,49 CDM,104275,CATH THRMB 7FR 130CM,100000.0,100000.0,6000.0,85000.0,49 CDM,104276,DEVICE WNDCLS 15CM SZ3,1614.5,1614.5,96.87,1372.33,49 CDM,104277,DEVICE WNDCLS 15CM SZ3,1614.5,1614.5,96.87,1372.33,49 CDM,104279,SCREW EXFX 5X175X60MM,5103.5,5103.5,306.21,4337.98,49 CDM,104280,Cyanocobalamin (Vitamin B-12); ,1932.0,1932.0,12.67,103.71,80 CDM,104280,VITAMIN B12,1932.0,1932.0,115.92,1642.2,14 CDM,104282,KIT LEAD TRIAL STM BILAT,13744.0,13744.0,1924.16,11682.4,24 CDM,104283,PLATE LONG RT 5D 18MM,40326.0,40326.0,5242.38,34277.1,28 CDM,104285,LEAD TRIAL STIM IMPLANT,885.0,885.0,123.9,752.25,24 CDM,104286,SCREW BN 3.0MM 18MM,6951.0,6951.0,903.63,5908.35,28 CDM,104290,"Ascorbic acid (Vitamin C), blood ",1308.24,1308.24,8.31,68.06,80 CDM,104290,VIT C ASCORBIC ACID,1308.24,1308.24,78.49,1112.0,14 CDM,104294,KIT PNE LEAD IMPLANT,1589.0,1589.0,222.46,1350.65,24 CDM,104297,KIT PRSTHS PENL ASSMBLY,22895.0,22895.0,1373.7,19460.75,49 CDM,104298,IMPL GEL VOC CRD INJ 1ML,22032.0,22032.0,1321.92,18727.2,27 CDM,104300,VITAMIN D 1-25 W/WO FRAC,2586.0,2586.0,155.16,2198.1,14 CDM,104300,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",2586.0,2586.0,32.34,264.8,80 CDM,104301,CAT 1 ED PROCEDURE,639.66,639.66,83.16,543.71,44 CDM,104302,CAT 2 ED PROCEDURE,1284.09,1284.09,166.93,1091.48,44 CDM,104303,CAT 3 ED PROCEDURE,2138.96,2138.96,278.06,1818.12,44 CDM,104304,LVL 1 FREE STD EMER DEPT,430.64,430.64,72.35,366.04,9 CDM,104305,LVL 2 FREE STD EMER DEPT,799.45,799.45,134.31,679.53,9 CDM,104306,LVL 3 FREE STD EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CDM,104307,LVL 4 FREE STD EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CDM,104308,LVL 5 FREE STD EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CDM,104309,IV HYDRAT INIT UP TO 1HR,909.75,909.75,54.59,773.29,39 CDM,104311,IV HYDRAT EA ADD HR,394.19,394.19,23.65,335.06,39 CDM,104312,IV INITIAL UP TO 1 HOUR,909.75,909.75,54.59,773.29,39 CDM,104313,IV EACH ADD HOUR,394.19,394.19,23.65,335.06,39 CDM,104314,IV ADDL SEQ INF UP TO 1H,394.19,394.19,23.65,335.06,39 CDM,104315,IV CONCURRENT INFUSION,394.19,394.19,23.65,335.06,44 CDM,104316,IVP SINGLE/INITIAL DRUG,1138.03,1138.03,68.28,967.33,39 CDM,104317,IVP EA ADD SEQ NEW DRUG,1138.03,1138.03,68.28,967.33,39 CDM,104318,IVP EA ADD SEQ SAME DRUG,1138.03,1138.03,68.28,967.33,44 CDM,104319,INJECTION IM OR SQ,825.6,825.6,49.54,701.76,39 CDM,104320,Tocopherol alpha (Vitamin E) ,1040.52,1040.52,11.91,97.56,80 CDM,104320,VITAMIN E,1040.52,1040.52,62.43,884.44,14 CDM,104322,EMERGENT DIALYSIS ESRD,2952.81,2952.81,383.87,2509.89,33 CDM,104323,CRIT CARE 1ST 30-74M ER,4396.96,4396.96,571.6,3737.42,15 CDM,104324,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,104325,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,104326,CAT 1 ED PROCEDURE,639.66,639.66,83.16,543.71,44 CDM,104327,CAT 2 ED PROCEDURE,1284.09,1284.09,166.93,1091.48,44 CDM,104328,CAT 3 ED PROCEDURE,2138.96,2138.96,278.06,1818.12,44 CDM,104329,LVL 1 FREE STD EMER DEPT,430.64,430.64,72.35,366.04,9 CDM,104330,LVL 2 FREE STD EMER DEPT,799.45,799.45,134.31,679.53,9 CDM,104331,LVL 3 FREE STD EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CDM,104332,LVL 4 FREE STD EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CDM,104333,LVL 5 FREE STD EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CDM,104334,IV HYDRAT INIT UP TO 1HR,909.75,909.75,54.59,773.29,39 CDM,104335,IV HYDRAT EA ADD HR,394.19,394.19,23.65,335.06,39 CDM,104336,IV INITIAL UP TO 1 HOUR,909.75,909.75,54.59,773.29,39 CDM,104337,IV EACH ADD HOUR,394.19,394.19,23.65,335.06,39 CDM,104338,IV ADDL SEQ INF UP TO 1H,394.19,394.19,23.65,335.06,39 CDM,104339,IV CONCURRENT INFUSION,394.19,394.19,23.65,335.06,44 CDM,104341,IVP SINGLE/INITIAL DRUG,1138.03,1138.03,68.28,967.33,39 CDM,104342,IVP EA ADD SEQ NEW DRUG,1138.03,1138.03,68.28,967.33,39 CDM,104343,IVP EA ADD SEQ SAME DRUG,1138.03,1138.03,68.28,967.33,44 CDM,104344,INJECTION IM OR SQ,825.6,825.6,49.54,701.76,39 CDM,104346,EMERGENT DIALYSIS ESRD,2952.81,2952.81,383.87,2509.89,33 CDM,104347,CRIT CARE 1ST 30-74M ER,4396.96,4396.96,571.6,3737.42,15 CDM,104348,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,104349,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,104354,STAPLE INT BN 45MM,6273.0,6273.0,376.38,5332.05,49 CDM,104355,SNARE 2.4MM 230CM,639.5,639.5,38.37,543.58,49 CDM,104356,STENT BIL 8.5FR 12CM,5286.0,5286.0,687.18,4493.1,28 CDM,104357,STENT VASC 8X100MM 125CM,54796.0,54796.0,7123.48,46576.6,28 CDM,104358,NAIL BN LT 10MM 40CM,55518.0,55518.0,7217.34,47190.3,28 CDM,104359,PLUG VASC 10MM 14MM,26906.0,26906.0,3497.78,22870.1,28 CDM,104363,SHEATH INTRO 7FR 10CM,1244.0,1244.0,74.64,1057.4,49 CDM,104370,ZINC BLOOD,450.0,450.0,27.0,382.5,14 CDM,104370,Zinc ,450.0,450.0,9.57,78.37,80 CDM,104410,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,67.25,67.25,35.39,134.39,64 CDM,104410,COVID-19 AB MULTISTEP,67.25,67.25,4.04,57.16,30 CDM,104430,COVID-19 DNA/RNA AMP,58.03,58.03,3.48,49.33,30 CDM,104430,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",58.03,58.03,43.1,163.68,64 CDM,104440,SARSCOV CORONAVIRU AG IA,36.93,36.93,2.22,31.39,30 CDM,104477,US ABDOMEN COMPLETE,5487.26,5487.26,329.24,4664.17,16 CDM,104478,US EXTREM NON VASC LTD,2870.66,2870.66,172.24,2440.06,16 CDM,104479,US RETRO LTD,4926.96,4926.96,295.62,4187.92,16 CDM,104480,US PELVIC COMPLETE,4793.13,4793.13,287.59,4074.16,16 CDM,104481,US PREGNANCY LTD,3022.64,3022.64,181.36,2569.24,16 CDM,104482,US PELVIC LTD OR FU,1050.27,1050.27,63.02,892.73,16 CDM,104483,US PREG AFTER 1ST TRI,4311.09,4311.09,258.67,3664.43,16 CDM,104484,US RETROPERITONEAL COM,4506.18,4506.18,270.37,3830.25,16 CDM,104485,US SCROTUM AND CNTS,3666.87,3666.87,220.01,3116.84,16 CDM,104486,US HEAD AND NECK,3587.47,3587.47,215.25,3049.35,16 CDM,104487,US CHST W/MEDIASTINUM,5319.4,5319.4,319.16,4521.49,16 CDM,104488,US TRANSVAGINAL,2568.96,2568.96,154.14,2183.62,16 CDM,104489,US ABDOMEN LTD,2624.54,2624.54,157.47,2230.86,16 CDM,104490,US PREG UT TRANSVAGINAL,2993.15,2993.15,179.59,2544.18,16 CDM,104491,US PREG 1ST TRIMTR,3817.72,3817.72,229.06,3245.06,16 CDM,104492,DUP LE ART BIL,3835.42,3835.42,230.13,3260.11,33 CDM,104493,DUP EXTRACRANIAL BIL,5074.2,5074.2,304.45,4313.07,33 CDM,104494,DUP VEIN BIL,6121.78,6121.78,367.31,5203.51,33 CDM,104495,DUP VEIN UNI/LTD,3565.22,3565.22,213.91,3030.44,33 CDM,104496,DUP LE ART UNI/LTD,2253.16,2253.16,135.19,1915.19,33 CDM,104497,XR ABD ACUTE W/CHEST,3507.2,3507.2,210.43,2981.12,17 CDM,104498,XR HAND 2 V RT,1891.29,1891.29,113.48,1607.6,17 CDM,104499,XR HAND 2 V LT,1891.29,1891.29,113.48,1607.6,17 CDM,104500,XR ANKLE 2 VIEWS RT,1890.12,1890.12,113.41,1606.6,17 CDM,104501,XR ANKLE 3 + V RT,2315.48,2315.48,138.93,1968.16,17 CDM,104502,XR C-SPINE 6 + V,4506.74,4506.74,270.4,3830.73,17 CDM,104503,XR RIBS UNI W/CXR 3+V RT,4878.21,4878.21,292.69,4146.48,17 CDM,104504,XR RIBS UNI W/CXR 3+V LT,4878.21,4878.21,292.69,4146.48,17 CDM,104505,Bone age studies ,1455.38,1455.38,26.06,433.75,33 CDM,104505,XR BONE AGE STUDIES,1455.38,1455.38,87.32,1237.07,17 CDM,104506,XR HIP W PEL BI MIN5 VW,3002.15,3002.15,180.13,2551.83,17 CDM,104507,XR UP EXTREM INFANT2V BI,2839.28,2839.28,170.36,2413.39,17 CDM,104508,XR SPINE 2 OR 3 VIEWS,1913.55,1913.55,114.81,1626.52,17 CDM,104511,XR HIP W PEL BI 3-4 VIEW,2429.15,2429.15,145.75,2064.78,17 CDM,104512,XR FEMUR MIN 2 V RT,1953.4,1953.4,117.2,1660.39,17 CDM,104513,XR FEMUR MIN 2 V LT,1953.4,1953.4,117.2,1660.39,17 CDM,104514,XR ANKLE 3 + V LT,2315.48,2315.48,138.93,1968.16,17 CDM,104515,XR ANKLE 2 VIEWS LT,1890.12,1890.12,113.41,1606.6,17 CDM,104519,XR ELBOW 2 VIEWS RT,1774.11,1774.11,106.45,1507.99,17 CDM,104520,XR ELBOW 3 + V LT,2042.45,2042.45,122.55,1736.08,17 CDM,104521,XR ELBOW 3 + V RT,2042.45,2042.45,122.55,1736.08,17 CDM,104522,XR FACIAL BONES < 3 V,2908.41,2908.41,174.5,2472.15,17 CDM,104523,XR FOOT 2 VIEWS RT,1975.65,1975.65,118.54,1679.3,17 CDM,104524,XR FOREARM 2 VIEWS RT,2038.93,2038.93,122.34,1733.09,17 CDM,104525,XR FOOT 3 + V RT,2383.44,2383.44,143.01,2025.92,17 CDM,104526,XR WRIST 2 VIEWS RT,2860.37,2860.37,171.62,2431.31,17 CDM,104527,XR HAND 3 + V RT,2067.06,2067.06,124.02,1757.0,17 CDM,104528,XR HUMERUS 2 + V RT,1921.75,1921.75,115.31,1633.49,17 CDM,104529,XR ELBOW 2 VIEWS LT,1774.11,1774.11,106.45,1507.99,17 CDM,104530,XR KNEE 1 OR 2 V RT,1838.56,1838.56,110.31,1562.78,17 CDM,104531,XR KNEE 3 V RT,2246.35,2246.35,134.78,1909.4,17 CDM,104532,XR KNEE AP STAND BI,4026.3,4026.3,241.58,3422.36,17 CDM,104533,XR KNEE 4 + V RT,2920.13,2920.13,175.21,2482.11,17 CDM,104534,XR MANDIBLE < 4 V,1504.59,1504.59,90.28,1278.9,17 CDM,104535,XR TIBIA/FIBULA 2 V RT,2185.41,2185.41,131.12,1857.6,17 CDM,104536,XR MANDIBLE 4 + V,2702.17,2702.17,162.13,2296.84,17 CDM,104537,XR FOOT 2 VIEWS LT,1975.65,1975.65,118.54,1679.3,17 CDM,104538,XR FOOT 3 + V LT,2383.44,2383.44,143.01,2025.92,17 CDM,104539,XR HAND 3 + V LT,2067.06,2067.06,124.02,1757.0,17 CDM,104540,XR FOREARM 2 VIEWS LT,2038.93,2038.93,122.34,1733.09,17 CDM,104541,XR NASAL BONES COMP,1820.98,1820.98,109.26,1547.83,17 CDM,104542,XR NECK SOFT TISSUE,1729.58,1729.58,103.77,1470.14,17 CDM,104543,XR KNEE 3 V LT,2246.35,2246.35,134.78,1909.4,17 CDM,104544,XR TIB/FIB INFANT 2V BI,2098.7,2098.7,125.92,1783.89,17 CDM,104545,XR RIBS BI 3 V,4878.21,4878.21,292.69,4146.48,17 CDM,104546,XR PELVIS 1/2 VIEWS,2003.78,2003.78,120.23,1703.21,17 CDM,104547,XR CALCANEUS 2 + V LT,1891.29,1891.29,113.48,1607.6,17 CDM,104548,XR WRIST 2 VIEWS LT,2860.37,2860.37,171.62,2431.31,17 CDM,104549,XR SACRUM/COCCYX 2 + V,2075.26,2075.26,124.52,1763.97,17 CDM,104550,XR HUMERUS 2 + V LT,1921.75,1921.75,115.31,1633.49,17 CDM,104551,XR SHOULDER 1 V RT,1871.37,1871.37,112.28,1590.66,17 CDM,104552,XR TIBIA/FIBULA 2 V LT,2185.41,2185.41,131.12,1857.6,17 CDM,104553,XR SHOULDER 2 + V RT,2393.99,2393.99,143.64,2034.89,17 CDM,104554,XR SINUSES 3 + V,3570.48,3570.48,214.23,3034.91,17 CDM,104555,XR SINUSES < 3 V,2185.41,2185.41,131.12,1857.6,17 CDM,104556,XR SKULL 4 + V,3995.84,3995.84,239.75,3396.46,17 CDM,104557,XR SKULL < 4 V,2140.88,2140.88,128.45,1819.75,17 CDM,104558,XR C-SPINE 2-3 VIEWS,2172.52,2172.52,130.35,1846.64,17 CDM,104559,XR L-SPINE 4 + VIEWS,4139.97,4139.97,248.4,3518.97,17 CDM,104560,XR T-SPINE 3 VIEWS,3563.45,3563.45,213.81,3028.93,17 CDM,104561,XR L-SPINE 2/3 VIEWS,2222.91,2222.91,133.37,1889.47,17 CDM,104562,XR STERNUM 2 + V,2137.36,2137.36,128.24,1816.76,17 CDM,104564,XR KNEE 1 OR 2 V LT,1838.56,1838.56,110.31,1562.78,17 CDM,104565,XR WRIST 3 + V RT,1915.9,1915.9,114.95,1628.52,17 CDM,104566,XR CLAVICLE COMP LT,1921.75,1921.75,115.31,1633.49,17 CDM,104567,XR CLAVICLE COMP RT,1921.75,1921.75,115.31,1633.49,17 CDM,104568,XR SCAPULA COMP LT,2044.8,2044.8,122.69,1738.08,17 CDM,104569,XR RIBS UNI 2 V LT,2356.5,2356.5,141.39,2003.03,17 CDM,104570,XR SCAPULA COMP RT,2044.8,2044.8,122.69,1738.08,17 CDM,104571,XR CALCANEUS 2 + V RT,1891.29,1891.29,113.48,1607.6,17 CDM,104572,XR RIBS UNI 2 V RT,2356.5,2356.5,141.39,2003.03,17 CDM,104573,XR SHOULDER 2 + V LT,2393.99,2393.99,143.64,2034.89,17 CDM,104574,XR SHOULDER 1 V LT,1871.37,1871.37,112.28,1590.66,17 CDM,104575,XR FACIAL BONES 3 + V,2213.54,2213.54,132.81,1881.51,17 CDM,104576,XR T-L-SPINE 2 VIEWS,3998.18,3998.18,239.89,3398.45,17 CDM,104577,XR WRIST 3 + V LT,1915.9,1915.9,114.95,1628.52,17 CDM,104578,XR SCAPULA COMP BI,2044.8,2044.8,122.69,1738.08,17 CDM,104579,CHEST XRAY 1 V,1716.69,1716.69,103.0,1459.19,17 CDM,104580,CHEST XRAY 2 V,1933.47,1933.47,116.01,1643.45,17 CDM,104581,CHEST XRAY 3 V,2108.07,2108.07,126.48,1791.86,17 CDM,104582,ABD XR 2V,1897.15,1897.15,113.83,1612.58,17 CDM,104583,ABD XR 1V,1423.74,1423.74,85.42,1210.18,17 CDM,104584,ABD XR 3+V,1995.58,1995.58,119.73,1696.24,17 CDM,104585,XR RIBS BI W/CXR 4 + V,2487.74,2487.74,149.26,2114.58,17 CDM,104600,GRFT EVAS 20FR 122X34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,104601,BLADE URTHM COLD KNIFE,4496.5,4496.5,269.79,3822.03,49 CDM,104686,GUAIFE 200MG/10ML LIQ PO,5.95,5.95,0.36,5.06,49 CDM,104689,CATH BLN 3.0X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 CDM,104902,KIT CATH CV 8FR 16CM,5846.5,5846.5,350.79,4969.52,49 CDM,104903,IMPLANT BREAST 800CC,19633.0,19633.0,2552.29,16688.05,28 CDM,104904,PLUG VASC 12MM 16MM,26906.0,26906.0,3497.78,22870.1,28 CDM,104905,PLUG VASC 14MM 18MM,26906.0,26906.0,3497.78,22870.1,28 CDM,104906,PLUG VASC 16MM 20MM,26906.0,26906.0,3497.78,22870.1,28 CDM,104907,PLUG VASC 18MM 22MM,25399.0,25399.0,3301.87,21589.15,28 CDM,104908,CRIT CARE ECH ADD 30M ER,1265.6,1265.6,164.53,1075.76,23 CDM,104909,CRIT CARE ECH ADD 30M ER,1265.6,1265.6,164.53,1075.76,23 CDM,104910,LEAD PCNG 52CM,6844.0,6844.0,889.72,5817.4,28 CDM,105032,CATH GD 40CM 2.4MM,7254.5,7254.5,435.27,6166.32,49 CDM,105033,CATH GD 5.4-7.0F 30CM,7254.5,7254.5,435.27,6166.32,49 CDM,105034,PROSTH PENL 28CM LCK-OUT,100000.0,100000.0,13000.0,85000.0,28 CDM,105036,XR KNEE 4 + V LT,2920.13,2920.13,175.21,2482.11,17 CDM,105040,CATH ULTSND 4MM 40MM,84738.5,84738.5,5084.31,72027.73,49 CDM,105043,PLUG VASC 7MM 10MM,26906.0,26906.0,3497.78,22870.1,28 CDM,105044,CATH UTLSND 14IN 150CM,22032.0,22032.0,1321.92,18727.2,49 CDM,105045,GRAFT SFT TIS TNDN 10MM,33111.0,33111.0,4304.43,28144.35,28 CDM,105050,DUP VEIN UNI RT,5543.4,5543.4,332.6,4711.89,33 CDM,105051,SHEATH RETR 7F 10-35MM,100000.0,100000.0,6000.0,85000.0,49 CDM,105063,VALVE AORTA 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105064,CATH DLV 5.4/7FR 43CM,12325.0,12325.0,739.5,10476.25,49 CDM,105065,SCREW BN 4MM 24MM,6240.0,6240.0,811.2,5304.0,28 CDM,105066,SCREW BN 4MM 38MM,6240.0,6240.0,811.2,5304.0,28 CDM,105067,PIN TEMP FX MNI 1.1X10MM,3345.5,3345.5,200.73,2843.68,49 CDM,105083,PLATE BN STR 4 HL,19633.0,19633.0,2552.29,16688.05,28 CDM,105084,SCREW BN NONLCK 2X16MM,1017.0,1017.0,132.21,864.45,28 CDM,105085,SCREW BN LCK 2X12MM,7657.0,7657.0,995.41,6508.45,28 CDM,105086,PLATE BN STR 5HL,19633.0,19633.0,2552.29,16688.05,28 CDM,105087,SCREW BN 2.0MM 10MM,1017.0,1017.0,132.21,864.45,28 CDM,105088,SCREW BN 2.7MM 16MM,5590.0,5590.0,726.7,4751.5,28 CDM,105089,SCREW BN NON 2.7MM 20MM,1017.0,1017.0,132.21,864.45,28 CDM,105090,SCREW BN 2.0MM 20MM,1017.0,1017.0,132.21,864.45,28 CDM,105091,SCREW BN 2.4MM 16MM,7657.0,7657.0,995.41,6508.45,28 CDM,105133,CLIP IRR STRL,3868.5,3868.5,232.11,3288.22,49 CDM,105155,SYSTEM CBL HIP 23X53MM,55686.0,55686.0,7239.18,47333.1,28 CDM,105156,SHTH INTRO SPLT 9FR 13CM,2690.5,2690.5,161.43,2286.93,49 CDM,105157,CATH INTRVASC INTRO,1046.0,1046.0,62.76,889.1,49 CDM,105158,RETAINER VISCERAL MED,1126.0,1126.0,67.56,957.1,49 CDM,105159,STENT URET 6FR 80CM,6349.0,6349.0,825.37,5396.65,28 CDM,105161,SCREW BN 5.0MM 55M,39049.0,39049.0,5076.37,33191.65,28 CDM,105165,BIORPHEN 20 MCG INJJW,0.86,0.86,0.05,0.73,24 CDM,105166,BIORPHEN 20 MCG INJ,0.86,0.86,0.05,0.73,24 CDM,105169,TROCAR LAPSCP 150X5MM,1001.5,1001.5,60.09,851.27,49 CDM,105171,ELECTRD ESURG KNF 90D,2905.5,2905.5,174.33,2469.68,49 CDM,105172,DLV DISP CMNT NDL 10G,11888.5,11888.5,713.31,10105.23,49 CDM,105173,INTRO SHTH 9.5FR,2905.5,2905.5,174.33,2469.68,49 CDM,105174,VERETEBRO CERVICOTHOR,18152.42,18152.42,1089.15,15429.56,37 CDM,105175,GWIRE BEAD TIP STRL,14667.0,14667.0,880.02,12466.95,49 CDM,105176,PROSTHESIS PENL 13MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105177,SMOOTHER SURG 9.5MM,5884.5,5884.5,353.07,5001.82,49 CDM,105178,AZTREONAM 100 MG INJ JW,14.85,14.85,0.89,12.62,24 CDM,105179,AZTREONAM 100 MG INJ,14.85,14.85,0.89,12.62,24 CDM,105181,GRAFT EVAS 20FR 26X109MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105182,STYLET LEAD .014IN 65CM,1627.5,1627.5,97.65,1383.38,49 CDM,105185,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,105186,PUNCH SURG 3MM,217.0,217.0,13.02,184.45,49 CDM,105187,ADMIN INFLUENZA VACCINE,279.41,279.41,16.76,237.5,39 CDM,105187,Administration of influenza virus vaccine ,279.41,279.41,55.67,76.84,5 CDM,105188,IMPLANT BREAST 465CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105189,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,105190,PLATE TIB KN SZ2 62X41MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105191,CMPNT FEM KN LT SZC,100000.0,100000.0,13000.0,85000.0,28 CDM,105192,STEM FEM KN 15MM 100MM,20113.0,20113.0,2614.69,17096.05,28 CDM,105193,INSERT TIB KN 20MM,49981.0,49981.0,6497.53,42483.85,28 CDM,105194,STYLET LD 52CM .014IN KT,1627.5,1627.5,97.65,1383.38,49 CDM,105195,CATH EP 6FR 105CM,4856.5,4856.5,291.39,4128.02,49 CDM,105196,KIT STYL BALL TIP 58CM,1627.5,1627.5,97.65,1383.38,49 CDM,105197,DILATOR VASC 230CM,30660.0,30660.0,1839.6,26061.0,49 CDM,105198,IMPLANT BREAST 480CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105199,IMPLANT BREAST 520CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105205,KIT ANCHOR SUTURE,56592.0,56592.0,7356.96,48103.2,28 CDM,105206,CRTD XT MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 CDM,105207,SHEATH DLVRY 14FR 75CM,22648.5,22648.5,1358.91,19251.22,49 CDM,105208,SUTURE ANBCTRL +3-0 27IN,95.0,95.0,5.7,80.75,49 CDM,105237,KIT INTRO 8.5FR 10CM,5553.0,5553.0,333.18,4720.05,49 CDM,105239,ALLOGRAFT FIBER 5CC,25362.0,25362.0,3297.06,21557.7,28 CDM,105244,GRAFT EVAS 22MM 85MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105245,GRAFT EVAS 14FR 11X56MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105246,GRAFT EVAS 11MM 39MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105247,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,105248,HEAD SHLDR HUM 15MM 46MM,22313.0,22313.0,2900.69,18966.05,28 CDM,105249,CLIP ENDO 2.5MM 235CM,14620.0,14620.0,1900.6,12427.0,28 CDM,105253,STYLET LD 65CM .014IN,1627.5,1627.5,97.65,1383.38,49 CDM,105254,SHEATH CATH GW 7FR 55CM,2905.5,2905.5,174.33,2469.68,49 CDM,105255,GRAFT EVAS 82MM 28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105256,VALVE AOR TRNS CATH 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105257,SHEATH CATH 7FR 45CM,17718.5,17718.5,1063.11,15060.73,49 CDM,105259,CATH BLNDIL 1.50X6MM,4600.5,4600.5,276.03,3910.43,49 CDM,105260,CATH BLNDIL1.50X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,105261,CATH BLNDIL 1.50X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,105262,CATH BLNDIL1.50X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,105263,CATH BLNDIL 1.5X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,105264,CATH BLNDIL 2.0X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,105265,CATH BLNDIL 2X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,105267,CATH BLNDIL 2.25X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,105270,CATH BLNDIL 2.50X25MM,4600.5,4600.5,276.03,3910.43,49 CDM,105272,CATH BLNDIL 3X6MM,4600.5,4600.5,276.03,3910.43,49 CDM,105273,SHELL ACTB HIP RT 68MM,57623.0,57623.0,7490.99,48979.55,28 CDM,105274,GRAFT CV 32MM 30CM,13909.0,13909.0,1808.17,11822.65,28 CDM,105276,SCREW BN 6.5X25MM,2541.0,2541.0,330.33,2159.85,28 CDM,105277,SCREW BN 6.5X35MM,2541.0,2541.0,330.33,2159.85,28 CDM,105278,SCREW BN 6.5X30MM,2541.0,2541.0,330.33,2159.85,28 CDM,105279,LINER ACTB 10D 11.2X36MM,21129.0,21129.0,2746.77,17959.65,28 CDM,105280,SLEEVE FEM HIP V40,2201.0,2201.0,286.13,1870.85,28 CDM,105281,HEAD HIP CTAP 36MM,19721.0,19721.0,2563.73,16762.85,28 CDM,105324,STIMULATOR NERVE DISP,19290.0,19290.0,1157.4,16396.5,49 CDM,105334,SHELL ACTB HIP 13H 64MM,59901.0,59901.0,7787.13,50915.85,28 CDM,105335,DEVICE LEAD LCK 65CM SS,18591.0,18591.0,1115.46,15802.35,49 CDM,105336,KIT PRP BRDGE LEAD EXTR,10212.5,10212.5,612.75,8680.63,49 CDM,105337,CATH BLN BRDG OCL 90CM,28657.0,28657.0,1719.42,24358.45,49 CDM,105338,SHEATH DIL 12FR 33CM,8980.0,8980.0,538.8,7633.0,49 CDM,105339,SHEATH DIL 5MM,8980.0,8980.0,538.8,7633.0,49 CDM,105340,IMPLANT BREAST 545CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105341,IMPLANT BREAST 585CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105342,WEDGE TIB KN CONE SZSM,100000.0,100000.0,13000.0,85000.0,28 CDM,105370,DILATOR SHTH 33CM 16FR,8980.0,8980.0,538.8,7633.0,49 CDM,105371,SHEATH DIL ROT SZ13FR,70410.0,70410.0,4224.6,59848.5,49 CDM,105377,EXPAND BRST 750CC,67263.0,67263.0,8744.19,57173.55,28 CDM,105385,PLATE BN 2.7/3.5MM 83MM,86712.0,86712.0,11272.56,73705.2,28 CDM,105386,DRILL SURG 2MM,2905.5,2905.5,174.33,2469.68,49 CDM,105387,SCREW BN 3.5MM 26MM,1420.0,1420.0,184.6,1207.0,28 CDM,105388,SCREW BN 3.5MM 28MM,1420.0,1420.0,184.6,1207.0,28 CDM,105389,SCREW BN 3.5X32MM,1420.0,1420.0,184.6,1207.0,28 CDM,105390,SCREW BN T8 2.7X50MM,1850.0,1850.0,240.5,1572.5,28 CDM,105391,SCREW BN 2.7MM 55MM,1850.0,1850.0,240.5,1572.5,28 CDM,105392,SCREW BN LCK 2.7MM 16MM,4707.0,4707.0,611.91,4000.95,28 CDM,105393,SCREW BN 2.7X4.5X20MM,4707.0,4707.0,611.91,4000.95,28 CDM,105395,PLUG BN TRICAPHOS 7.5MM,22540.0,22540.0,2930.2,19159.0,28 CDM,105396,SCREW BN 6.5MM 80MM,40617.0,40617.0,5280.21,34524.45,28 CDM,105397,SCREW BN 5.0X35MM,39051.0,39051.0,5076.63,33193.35,28 CDM,105398,NAIL TIB 11X200MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105399,SCREW BN 5.0MM 30MM,39049.0,39049.0,5076.37,33191.65,28 CDM,105400,SYS NEG PRS 10X20CM,18645.0,18645.0,1118.7,15848.25,49 CDM,105401,DEVICE WNDCLS 23CM SZ0,1633.0,1633.0,97.98,1388.05,49 CDM,105402,SUTURE BLK BRD 2-0 18IN,24.0,24.0,1.44,20.4,49 CDM,105404,SCREW BN 5MM 60MM,39049.0,39049.0,5076.37,33191.65,28 CDM,105405,PUTTY DBM ALGRF 5CC,41412.0,41412.0,5383.56,35200.2,28 CDM,105406,SCREW BN 5MM 45MM,39049.0,39049.0,5076.37,33191.65,28 CDM,105407,GWIRE 3.2MM 350MM,8064.0,8064.0,483.84,6854.4,49 CDM,105408,KWIRE LRG 2.0MM 300MM,7817.5,7817.5,469.05,6644.88,49 CDM,105409,DRILL BUR CANN 4.3MM,17134.0,17134.0,1028.04,14563.9,49 CDM,105410,NAIL BN LT 34CM 13MM,55518.0,55518.0,7217.34,47190.3,28 CDM,105411,CATH BLNDIL 30FR 12CM,7003.5,7003.5,420.21,5952.98,49 CDM,105412,DEVICE INFLATION 20ML,1624.5,1624.5,97.47,1380.83,49 CDM,105413,GRAFT EVAS 28MM 155MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105414,PUTTY SYN BN SM 3.75G,51209.0,51209.0,6657.17,43527.65,28 CDM,105415,STAPLE BN 14X18X18MM,44530.0,44530.0,5788.9,37850.5,28 CDM,105416,BLADE SAW OSCIL SNG USE,11621.0,11621.0,697.26,9877.85,49 CDM,105417,COMPNT BRNG KN LT TIB F5,59162.0,59162.0,7691.06,50287.7,28 CDM,105418,PLATE BN STD LT 18MM,40326.0,40326.0,5242.38,34277.1,28 CDM,105419,CATH ATHRCM STRL 1.75MM,3917.0,3917.0,235.02,3329.45,49 CDM,105426,CATH XTRN DRN .7X1.5MM,8029.0,8029.0,481.74,6824.65,49 CDM,105427,PUTTY DBM CRUSH 2.5CC,35752.0,35752.0,4647.76,30389.2,28 CDM,105428,PUTTY DBM CRUSH 5.0CC,48959.0,48959.0,6364.67,41615.15,28 CDM,105430,SHEATH TEFLON 30FR./20CM,1799.5,1799.5,107.97,1529.58,49 CDM,105432,CATH THRMBCTM 6FR 120CM,100000.0,100000.0,6000.0,85000.0,49 CDM,105433,KIT CATH THROM 8FR 100CM,100000.0,100000.0,6000.0,85000.0,49 CDM,105436,SNARE VASC 16F 20MM 94CM,59410.5,59410.5,3564.63,50498.93,49 CDM,105437,EXTRACTOR TIP 3.5MM-4.5M,12853.5,12853.5,771.21,10925.48,49 CDM,105438,EXTRACTOR SCREW V2,64709.5,64709.5,3882.57,55003.07,49 CDM,105439,CATH BLNOCC 9FR 23CM,14755.0,14755.0,885.3,12541.75,49 CDM,105471,NAIL FEM LT 11.5MM 36CM,55518.0,55518.0,7217.34,47190.3,28 CDM,105472,DEVICE VASC CLMP 86MM,5185.0,5185.0,311.1,4407.25,49 CDM,105487,PORT ACC 12MM 120MM,15976.5,15976.5,958.59,13580.02,49 CDM,105496,TROCAR LAPSCP 100X12MM,994.0,994.0,59.64,844.9,49 CDM,105497,REAMER FX 83MM 2.5MM,6273.0,6273.0,376.38,5332.05,49 CDM,105498,SCREW BN 3MM 20MM,5616.0,5616.0,730.08,4773.6,28 CDM,105499,IMPLANT BREAST 275CC,19633.0,19633.0,2552.29,16688.05,28 CDM,105500,IMPLANT BREAST 300CC,19633.0,19633.0,2552.29,16688.05,28 CDM,105501,IMPLANT BREAST 325CC,19633.0,19633.0,2552.29,16688.05,28 CDM,105502,IMPLANT BREAST 350CC,19633.0,19633.0,2552.29,16688.05,28 CDM,105506,IMPLANT BREAST 225CC,32338.0,32338.0,4203.94,27487.3,28 CDM,105507,IMPLANT BREAST 190CC,32338.0,32338.0,4203.94,27487.3,28 CDM,105508,IMPLANT BREAST 425CC,32338.0,32338.0,4203.94,27487.3,28 CDM,105509,CATH THRMB 10FR 100CM,100000.0,100000.0,6000.0,85000.0,49 CDM,105511,SUTURE LOOP BLU SZ2 20IN,20781.0,20781.0,1246.86,17663.85,49 CDM,105512,SCREW BN 20MM 10MM,10210.0,10210.0,1327.3,8678.5,28 CDM,105513,ANCH BN RND 10X30MM,10956.0,10956.0,1424.28,9312.6,28 CDM,105514,SCREW BN 11MM 25MM,10210.0,10210.0,1327.3,8678.5,28 CDM,105515,TUBE FD CONN GSTRM 24FR,1857.5,1857.5,111.45,1578.88,49 CDM,105516,TUBE GASTROSTMY SIL 18FR,1224.5,1224.5,73.47,1040.83,49 CDM,105517,TUBE GASTROSTMY SIL 16FR,1224.5,1224.5,73.47,1040.83,49 CDM,105519,IMPLANT BREAST 375CC,32338.0,32338.0,4203.94,27487.3,28 CDM,105520,MNPLT SURG CUP 3.5CM,2948.5,2948.5,176.91,2506.22,49 CDM,105522,TUBE JJNSTM 8FR 43IN,2965.0,2965.0,177.9,2520.25,49 CDM,105525,SIZER BREAST 200CC,5018.5,5018.5,301.11,4265.73,49 CDM,105527,KIT PEG GSTRM 24FR,2905.5,2905.5,174.33,2469.68,49 CDM,105528,KIT PEG FEEDING 24FR,3524.0,3524.0,211.44,2995.4,49 CDM,105529,KIT JJN TUBE 22FR 45CM,6953.0,6953.0,417.18,5910.05,49 CDM,105531,TUBE FD CONN GSTRM 16FR,1857.5,1857.5,111.45,1578.88,49 CDM,105533,TUBE FD CONN GSTRM 20FR,1213.5,1213.5,72.81,1031.47,49 CDM,105535,TUBE FD CONN GSTRM 28FR,1213.5,1213.5,72.81,1031.47,49 CDM,105538,SIZER BREAST 225CC,5018.5,5018.5,301.11,4265.73,49 CDM,105539,SIZER BREAST 300CC,5018.5,5018.5,301.11,4265.73,49 CDM,105540,SIZER BREAST 325CC,5018.5,5018.5,301.11,4265.73,49 CDM,105541,SIZER BREAST 350CC,5018.5,5018.5,301.11,4265.73,49 CDM,105542,TUBE FD CONN GSTRM 14FR,1103.0,1103.0,66.18,937.55,49 CDM,105545,PIN BN 5.5X150MM,6273.0,6273.0,376.38,5332.05,49 CDM,105546,PLATE BN SINUS RT SM,48507.0,48507.0,6305.91,41230.95,28 CDM,105547,SCREW BN LCKG 3.5X40MM,7657.0,7657.0,995.41,6508.45,28 CDM,105548,SCREW BN 3.5X42MM,7657.0,7657.0,995.41,6508.45,28 CDM,105549,SCREW BN 3.5X38MM,7657.0,7657.0,995.41,6508.45,28 CDM,105550,SCREW BN 4MM 60MM,6240.0,6240.0,811.2,5304.0,28 CDM,105551,SCREW BN 3.5MM 55MM,7657.0,7657.0,995.41,6508.45,28 CDM,105552,SCREW BN 3.5MM 60MM,7657.0,7657.0,995.41,6508.45,28 CDM,105553,SCREW BN 7MM 20MM,10210.0,10210.0,1327.3,8678.5,28 CDM,105554,CATH BLNOCC 12FR 1.5CM,17572.0,17572.0,1054.32,14936.2,49 CDM,105556,CANN SCREW ASCP 9MM,1088.5,1088.5,65.31,925.23,49 CDM,105564,PLATE BN 5HL RT 2.7MM,20608.0,20608.0,2679.04,17516.8,28 CDM,105565,PLATE BN 2.7MM 3.5MM,40420.0,40420.0,5254.6,34357.0,28 CDM,105566,SCREW BN 3.5MM 28MM SS,1292.0,1292.0,167.96,1098.2,28 CDM,105567,SCREW BN 2.7MM 34MM,1619.0,1619.0,210.47,1376.15,28 CDM,105568,SCREW BN 3.5X22MM,1292.0,1292.0,167.96,1098.2,28 CDM,105569,PLATE BN 10HL 2.7/3.5MM,40824.0,40824.0,5307.12,34700.4,28 CDM,105570,SCREW BN 2.7MM 36MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,105571,SCREW BN 2.7MM 32MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,105572,SCREW BN 3.5MM 30MM SS,1292.0,1292.0,167.96,1098.2,28 CDM,105573,SCREW BN 3.5MM 28MM,5218.0,5218.0,678.34,4435.3,28 CDM,105574,SCREW BN 3.5MM 26MM SS,1292.0,1292.0,167.96,1098.2,28 CDM,105575,GRAFT CV SYN 38X154MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105576,GRAFT EVAS 79MM 38MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105577,KIT TISS XPNDR FILL,920.0,920.0,55.2,782.0,49 CDM,105580,DEVICE CLSR 20MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105581,DEVICE CLSR 24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105582,DEVICE CLSR 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105583,DEVICE CLSR 31MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105584,DEVICE CLSR 35MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105585,DEVICE CLSR 40MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105586,GRAFT CV 30MM 50CM,59437.0,59437.0,7726.81,50521.45,28 CDM,105589,FORCEP BX 1 PRNH URO,8909.0,8909.0,534.54,7572.65,49 CDM,105592,NAIL BN 13X18X125,40150.0,40150.0,5219.5,34127.5,28 CDM,105593,CTHGD VBT 7F 078 XB3 100,2274.5,2274.5,136.47,1933.33,49 CDM,105596,IMPLANT BREAST 270CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105597,IMPLANT BREAST 295CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105598,IMPLANT BREAST 350CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105599,IMPLANT BREAST 400CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105600,IMPLANT BREAST 430CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105601,IMPLANT BREAST 470CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105602,IMPLANT BREAST 500CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105603,IMPLANT BREAST 545CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105604,IMPLANT BREAST 580CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105605,IMPLANT BREAST 415CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105606,IMPLANT BREAST 450CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105608,IMPLANT BREAST 490CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105610,IMPLANT BREAST 535CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105611,GRAFT EVAS 161X34X30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105612,IMPLANT BREAST 560CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105613,IMPLANT BREAST 595CC,37189.0,37189.0,4834.57,31610.65,28 CDM,105614,VALVE SYS HEART 48MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105615,CATH EP ABL DF 8FR 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,105616,ANCHOR KNOTLESS 4.5X20MM,11584.0,11584.0,1505.92,9846.4,28 CDM,105619,PEG SHLDR RT XLONG SM,37187.0,37187.0,4834.31,31608.95,28 CDM,105620,BASEPLATE SHLDR RT SM,42118.0,42118.0,5475.34,35800.3,28 CDM,105621,LINER HUM RVRS SMR 36MM,21552.0,21552.0,2801.76,18319.2,28 CDM,105625,TRAY CATH 16FR,1005.0,1005.0,60.3,854.25,49 CDM,105628,CATHETER THRMB 2FR 60CM,2905.5,2905.5,174.33,2469.68,49 CDM,105629,CATH THRMB 5F 80CM,1918.0,1918.0,115.08,1630.3,49 CDM,105631,PORT PLUG IS-1,2829.0,2829.0,367.77,2404.65,28 CDM,105632,COIL EMBL 2CM 2MM SOFT,24254.0,24254.0,3153.02,20615.9,28 CDM,105633,COIL EMBL 4CM 2MM SOFT,24254.0,24254.0,3153.02,20615.9,28 CDM,105634,COIL EMBL 5CM 3MM SOFT,24254.0,24254.0,3153.02,20615.9,28 CDM,105635,COIL EMBL 15CM .02IN 3MM,30722.0,30722.0,3993.86,26113.7,28 CDM,105636,COIL EMBL 6CM .02IN 4MM,24254.0,24254.0,3153.02,20615.9,28 CDM,105637,COIL EMBL 15CM 4MM,30722.0,30722.0,3993.86,26113.7,28 CDM,105638,COIL EMBL 20CM .02IN 6MM,30722.0,30722.0,3993.86,26113.7,28 CDM,105639,COIL EMBL 30CM .02IN 6MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105640,COIL EMBL 35CM 8MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105641,COIL EMBL 8MM 60MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105642,COIL EMBL SOFT 50CM 16MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105643,COIL EMBL SOFT 60CM 20MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105644,COIL EMBL STD 35CM 10MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105645,COIL EMBL 60CM 12MM STD,40423.0,40423.0,5254.99,34359.55,28 CDM,105646,COIL EMBL 60CM .02IN14MM,40423.0,40423.0,5254.99,34359.55,28 CDM,105647,COIL EMBL 3MM 20CM,54652.0,54652.0,7104.76,46454.2,28 CDM,105648,COIL EMBL 30CM 3.25-4MM,54652.0,54652.0,7104.76,46454.2,28 CDM,105649,COIL EMBL 30CM 5MM,54652.0,54652.0,7104.76,46454.2,28 CDM,105650,COIL EMBL 50CM 6MM,54652.0,54652.0,7104.76,46454.2,28 CDM,105651,COIL EMBL 8MM 60CM,54652.0,54652.0,7104.76,46454.2,28 CDM,105652,COIL EMBL 60CM 8-10MM,54652.0,54652.0,7104.76,46454.2,28 CDM,105653,COIL EMBL POD J-SFT 5CM,30722.0,30722.0,3993.86,26113.7,28 CDM,105654,COIL EMBL 15CM,30722.0,30722.0,3993.86,26113.7,28 CDM,105655,COIL EMBL 30CM,40423.0,40423.0,5254.99,34359.55,28 CDM,105656,COIL EMBL 45CM,40423.0,40423.0,5254.99,34359.55,28 CDM,105657,COIL EMBL 60CM,40423.0,40423.0,5254.99,34359.55,28 CDM,105658,CATH DLV SYS 135CM,18180.5,18180.5,1090.83,15453.42,49 CDM,105659,CATH DLV SYS 135CM 45D,18180.5,18180.5,1090.83,15453.42,49 CDM,105660,CATH DLV SYS 150CM STRGT,18180.5,18180.5,1090.83,15453.42,49 CDM,105661,HANDLE COIL PERPH DTCH,7923.5,7923.5,475.41,6734.98,49 CDM,105662,COIL EMBL 1MMX2CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105663,COIL EMBL 1MMX5CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105664,COIL EMBL 2MMX2CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105665,COIL EMBL 2MMX4CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105666,COIL EMBL 2MMX10CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105667,COIL EMBL 3MMX4CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105668,COIL EMBL 3MMX10CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105669,COIL EMBL 3MMX15CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105670,COIL EMBL 4MMX6CM,25547.0,25547.0,3321.11,21714.95,28 CDM,105671,COIL EMBL 4MMX15CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105672,COIL EMBL 4MMX30CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105673,COIL EMBL LP 5MM 10CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105674,COIL EMBL LP 5MM 30CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105675,COIL EMBL LP 6MM 10CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105676,COIL EMBL LP 6MM 30MM,41393.0,41393.0,5381.09,35184.05,28 CDM,105677,COIL EMBL 7MM 40CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105678,COIL EMBL 8MM 60CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105679,PACKING COIL LP 10CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105680,PACKING COIL LP 15CM,31692.0,31692.0,4119.96,26938.2,28 CDM,105681,PACKING COIL LP 30CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105682,COIL EMBL PK 45CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105683,COIL EMBL PK 60CM,41393.0,41393.0,5381.09,35184.05,28 CDM,105684,HANDLE LP DETACHMENT,7923.5,7923.5,475.41,6734.98,49 CDM,105685,ALLOGRAFT FIBER 2.5CC,18193.0,18193.0,2365.09,15464.05,28 CDM,105687,KNIFE BLADE STRAIGHT,4043.0,4043.0,242.58,3436.55,49 CDM,105688,INSERT TIB KN SZ3 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105689,PATCH CARD 8X14CM,18882.0,18882.0,2454.66,16049.7,28 CDM,105690,CUTTER LEAD PCNG 8IN,4140.5,4140.5,248.43,3519.43,49 CDM,105691,KIT ACCSSRY LEAD LCK DEV,5436.5,5436.5,326.19,4621.02,49 CDM,105692,KIT LD LCK 65CM,18591.0,18591.0,1115.46,15802.35,49 CDM,105693,KIT LD LCK 65CM,18591.0,18591.0,1115.46,15802.35,49 CDM,105694,KIT LD LCK 85CM,18591.0,18591.0,1115.46,15802.35,49 CDM,105695,SHEATH DIL 13FR,57160.0,57160.0,3429.6,48586.0,49 CDM,105696,SHEATH DIL 11FR,57160.0,57160.0,3429.6,48586.0,49 CDM,105697,SHEATH DIL 9FR,57160.0,57160.0,3429.6,48586.0,49 CDM,105698,SHEATH DIL 0.145IN,70410.0,70410.0,4224.6,59848.5,49 CDM,105699,KIT CATH BLND 30FR 12CM,7479.5,7479.5,448.77,6357.57,49 CDM,105700,STENT URET 6FR 22CM,3804.0,3804.0,494.52,3233.4,28 CDM,105701,STENT URET 6FR 24CM,3804.0,3804.0,494.52,3233.4,28 CDM,105702,STENT URET 6FR 26CM,3804.0,3804.0,494.52,3233.4,28 CDM,105703,STENT URET 4.8FR 28CM,3804.0,3804.0,494.52,3233.4,28 CDM,105705,CRTD XT QUAD MRI DF1,100000.0,100000.0,13000.0,85000.0,28 CDM,105706,STENT URET 8FR 20CM,7580.0,7580.0,985.4,6443.0,28 CDM,105707,STENT URET 8FR 24CM,7580.0,7580.0,985.4,6443.0,28 CDM,105708,BSKT RTRVL 120CM 11MM,6273.0,6273.0,376.38,5332.05,49 CDM,105709,SUTURE UND BRD +5-0 27IN,85.5,85.5,5.13,72.67,49 CDM,105710,SCISSORS ENDO235CM 2.6MM,12853.5,12853.5,771.21,10925.48,49 CDM,105711,SCISSOR ENDO 3PK 2.6MM,12853.5,12853.5,771.21,10925.48,49 CDM,105714,ICD DEFIB CARD 7.36CM,100000.0,100000.0,13000.0,85000.0,28 CDM,105715,PLATE BN L 100D 4HL,14764.0,14764.0,1919.32,12549.4,28 CDM,105716,SCREW BN 2.4MM 10MM,2541.0,2541.0,330.33,2159.85,28 CDM,105717,BALFAXAR 1 U IX INJ,7.38,7.38,0.44,6.27,20 CDM,105718,CYCLOPHOS NOS 500 MGINJ,1517.4,1517.4,91.04,1289.79,19 CDM,105718,"Injection, cyclophosphamide, not otherwise specified, 5 mg ",1517.4,1517.4,0.77,2.77,10 CDM,105719,SYSTEM MNTR 2X15MM 4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,105720,IMPLANT BREAST 454CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105721,IMPLANT BREAST 580CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105722,LEAD PCNG MYO 6.6FR 53CM,6040.0,6040.0,785.2,5134.0,28 CDM,105723,LEAD PCNG 6.6FR 35CM,6040.0,6040.0,785.2,5134.0,28 CDM,105724,PIN BN KN FIX,10960.0,10960.0,1424.8,9316.0,28 CDM,105725,CMPNT KN FEM LT ELP 7CM,100000.0,100000.0,13000.0,85000.0,28 CDM,105727,STYLET LD .014IN 45CM,1627.5,1627.5,97.65,1383.38,49 CDM,105728,LEAD CRT PCNG VNS 78CM,20827.0,20827.0,2707.51,17702.95,28 CDM,105729,CATH GD VASC 9FR 45CM,8698.0,8698.0,521.88,7393.3,49 CDM,105731,OR PER MIN LEVEL 1,438.0,438.0,26.28,372.3,37 CDM,105733,OR PER MIN LEVEL 2,381.0,381.0,22.86,323.85,37 CDM,105735,OR PER MIN LEVEL 3,373.0,373.0,22.38,317.05,37 CDM,105737,OR PER MIN LEVEL 4,295.0,295.0,17.7,250.75,37 CDM,105739,OR PER MIN LEVEL 5,247.0,247.0,14.82,209.95,37 CDM,105741,ANESTH PER MINUTE,79.0,79.0,4.74,67.15,49 CDM,105742,CAT 1 ENDO PROCEDURE,2200.0,2200.0,132.0,1870.0,37 CDM,105743,CAT 2 ENDO PROCEDURE,2200.0,2200.0,132.0,1870.0,37 CDM,105744,CAT 3 ENDO PROCEDURE,4042.0,4042.0,242.52,3435.7,37 CDM,105745,CAT 4 ENDO PROCEDURE,7776.0,7776.0,466.56,6609.6,37 CDM,105746,CAT 5 ENDO PROCEDURE,23693.0,23693.0,1421.58,20139.05,37 CDM,105747,BASIC ANES SERVICES,1620.0,1620.0,97.2,1377.0,49 CDM,105748,BASIC OR SERVICES,2700.0,2700.0,162.0,2295.0,37 CDM,105749,BASIC PHASE 1 SERVICES,1080.0,1080.0,64.8,918.0,49 CDM,105750,DRILL SURG 3.5MM,2905.5,2905.5,174.33,2469.68,49 CDM,105751,PLATE TIB RT 6H 91MM,41558.0,41558.0,5402.54,35324.3,28 CDM,105752,SCREW BN 3.5MM 80MM,4950.0,4950.0,643.5,4207.5,28 CDM,105753,SCREW BN 3.5MM 75MM,4950.0,4950.0,643.5,4207.5,28 CDM,105754,SCREW BN 3.5MM 70MM,4950.0,4950.0,643.5,4207.5,28 CDM,105755,SCREW BN 3.5MM 75MM,1596.0,1596.0,207.48,1356.6,28 CDM,105756,SCREW BN 3.5MM 46MM,1420.0,1420.0,184.6,1207.0,28 CDM,105757,SCREW BN 3.5MM 40MM,1420.0,1420.0,184.6,1207.0,28 CDM,105758,SCREW BN 3.5MM 30MM,1420.0,1420.0,184.6,1207.0,28 CDM,105759,KIT LO PRFL COMP SHTH 7F,100000.0,100000.0,6000.0,85000.0,49 CDM,105760,SYSTEM NEG PRSS 125MMHG,17607.0,17607.0,1056.42,14965.95,49 CDM,105761,GRAFT EVAS 161MM 30-34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105762,IMPLANT SPNL 175MM,36624.0,36624.0,4761.12,31130.4,28 CDM,105763,CATH GD 10.06FR 47CM,13037.5,13037.5,782.25,11081.88,49 CDM,105764,CARTRIDGE DRILL .095,8803.5,8803.5,528.21,7482.98,49 CDM,105765,BOLT BN 3.5MM 42MM,19211.0,19211.0,2497.43,16329.35,28 CDM,105766,PLATE BN 10HL 232MM,45683.0,45683.0,5938.79,38830.55,28 CDM,105768,GRAFT EVAS 74MM 16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105769,IMPLANT TIB ALKL RT SZ3X,100000.0,100000.0,13000.0,85000.0,28 CDM,105770,DOME TALAR 36X37 SZ4 RT,100000.0,100000.0,13000.0,85000.0,28 CDM,105771,INSERT TIB RT SZ3 11MM,70674.0,70674.0,9187.62,60072.9,28 CDM,105772,PIN BN SHRT SHDR,2905.5,2905.5,174.33,2469.68,49 CDM,105773,PIN FX DISP LONG,2905.5,2905.5,174.33,2469.68,49 CDM,105774,DRILL TIP FT/ANKL 4IN,2905.5,2905.5,174.33,2469.68,49 CDM,105775,PIN BN SHRT STRT FT/ANKL,2709.5,2709.5,162.57,2303.07,49 CDM,105776,PIN BN MED SHDR,2905.5,2905.5,174.33,2469.68,49 CDM,105777,STENT PANC 5FR 7CM,3074.0,3074.0,399.62,2612.9,28 CDM,105778,GRAFT CV 28MM 50CM,50369.0,50369.0,6547.97,42813.65,28 CDM,105779,GRAFT CV 7.6CM 5.1CM,4014.0,4014.0,521.82,3411.9,28 CDM,105780,GRAFT CV 15.2CM 5.1CM,6969.0,6969.0,905.97,5923.65,28 CDM,105781,SHEATH INSTRUMENT SP RBT,1830.5,1830.5,109.83,1555.92,49 CDM,105782,SHEATH INSTRUMENT CAMERA,2905.5,2905.5,174.33,2469.68,49 CDM,105783,PORT LPSCRP GD 100X25,6655.5,6655.5,399.33,5657.18,49 CDM,105784,TIP CAUT 5MM DVNC EWRST,3734.5,3734.5,224.07,3174.32,49 CDM,105785,TIP CAUT 5MM DVNC EWRST,3734.5,3734.5,224.07,3174.32,49 CDM,105786,KIT ACCESS PORT LARGE,17563.0,17563.0,1053.78,14928.55,49 CDM,105787,KIT ACCESS PORT SM,17563.0,17563.0,1053.78,14928.55,49 CDM,105788,SCREW DISTRACTION 12MM,1151.0,1151.0,69.06,978.35,49 CDM,105789,IMPLANT BREAST 400CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105790,IMPLANT BREAST 435CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105791,IMPLANT BREAST 470CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105792,IMPLANT BREAST 500CC,42040.0,42040.0,5465.2,35734.0,28 CDM,105793,LEAD CRT-D 1.6MM 87CM,16065.0,16065.0,2088.45,13655.25,28 CDM,105794,INTRO SHTH 6FR 45CM,2905.5,2905.5,174.33,2469.68,49 CDM,105795,CATH GD 8.7FR 45CM,6945.0,6945.0,416.7,5903.25,49 CDM,105796,CATHETER GD 5FR 59CM,6945.0,6945.0,416.7,5903.25,49 CDM,105797,KIT INTRO SHTH 9.5F 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,105798,KIT INTRO SHEATH,2905.5,2905.5,174.33,2469.68,49 CDM,105799,NAIL FEM LT 11.5MM 32CM,55518.0,55518.0,7217.34,47190.3,28 CDM,105800,SCREW BN 105MM 4.5MM,20050.0,20050.0,2606.5,17042.5,28 CDM,105801,SUTURE BLK MONO 3-0 30IN,158.0,158.0,9.48,134.3,49 CDM,105802,SUTURE ANBCTRL +0 27IN,88.0,88.0,5.28,74.8,49 CDM,105804,SUTURE ANBCTRL +2-0 18IN,589.5,589.5,35.37,501.07,49 CDM,105805,SUTURE CT-1 SZ1 8X18IN,596.5,596.5,35.79,507.02,49 CDM,105806,SUTURE VIO BRD +0 27IN,591.5,591.5,35.49,502.77,49 CDM,105807,SUTURE ANBCTRL +3-0 27IN,120.0,120.0,7.2,102.0,49 CDM,105810,SUTURE UND BRD +3-0 18IN,439.0,439.0,26.34,373.15,49 CDM,105811,SUTURE UND BRD 0 18IN,264.0,264.0,15.84,224.4,49 CDM,105812,SUTURE VIO BRD +0 54IN,101.0,101.0,6.06,85.85,49 CDM,105813,SUTURE ANBCTRL +2-0 54IN,102.0,102.0,6.12,86.7,49 CDM,105815,SUTURE VIOL BRD +1 54IN,103.5,103.5,6.21,87.97,49 CDM,105818,NAIL BN 11.5MM 38CM,55518.0,55518.0,7217.34,47190.3,28 CDM,105819,SHEATH CATH 6.5FR 45CM,14438.0,14438.0,866.28,12272.3,49 CDM,105821,GWIRE VASC 40CM 4FR,1275.5,1275.5,76.53,1084.17,49 CDM,105822,WAND ESURG 30D 1.4MM,16080.0,16080.0,964.8,13668.0,49 CDM,105823,ICU W/ECMO,58839.51,58839.51,,,0 CDM,105824,CATH GD VSC 130D 7F 42CM,7501.0,7501.0,450.06,6375.85,49 CDM,105825,CRT-D HF-T DF1 360D,100000.0,100000.0,13000.0,85000.0,28 CDM,105826,CATH DLYS 2.5MM 2 CUFF,4475.0,4475.0,268.5,3803.75,49 CDM,105827,FIBER LASER 365UM,6273.0,6273.0,376.38,5332.05,49 CDM,105828,LASER FIBER THLM 200,11268.5,11268.5,676.11,9578.23,49 CDM,105829,FIBER LASER 200,6273.0,6273.0,376.38,5332.05,49 CDM,105830,TRACTION MECHANCL PTCQ,507.28,507.28,30.44,431.19,20 CDM,105831,THER EXERCIS 15 MIN PTCQ,336.92,336.92,20.22,286.38,20 CDM,105832,SELFHOME ONEONE 15M PTCQ,429.72,429.72,25.78,365.26,20 CDM,105833,ORTH MGT TRN EA 15M PTCQ,274.62,274.62,16.48,233.43,32 CDM,105834,WHELCHAR MGT 15M PTCQ,282.25,282.25,16.93,239.91,20 CDM,105835,THER ACTV DIR 15 MN PTCQ,244.1,244.1,14.65,207.49,20 CDM,105836,GAIT TRAINNG 15 MN PTCQ,218.68,218.68,13.12,185.88,20 CDM,105837,NEROMUSC REDUCT 15M PTCQ,282.25,282.25,16.93,239.91,20 CDM,105838,ELECTRODE ESURG 30D 3MM,16080.0,16080.0,964.8,13668.0,49 CDM,105839,PROSTH PENL PUMP PL 21CM,100000.0,100000.0,13000.0,85000.0,28 CDM,105840,CRT-D CRD 5.37X8.08X0.99,100000.0,100000.0,13000.0,85000.0,28 CDM,105841,BURR SURG RND 3.0MM,6273.0,6273.0,376.38,5332.05,49 CDM,105842,BURR SURG RND 4.0MM,6273.0,6273.0,376.38,5332.05,49 CDM,105843,BURR SURG DMND 3.0MM,6273.0,6273.0,376.38,5332.05,49 CDM,105844,BURR SURG 4MM,6273.0,6273.0,376.38,5332.05,49 CDM,105845,BURR SURG 13CM 4MM RND,6273.0,6273.0,376.38,5332.05,49 CDM,105847,KIT INTRO SHTH 9FR 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,105848,PCMKR 2CH W HOME MNTR,36784.0,36784.0,4781.92,31266.4,28 CDM,105849,LEAD PCNG 46CM,6180.0,6180.0,803.4,5253.0,28 CDM,105850,DEVICE BX NDL 22GA,12501.0,12501.0,750.06,10625.85,49 CDM,105853,DEVICE IPG SLEEP 51MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105854,ELCTRD EMG RSPN 18ML,4956.0,4956.0,297.36,4212.6,49 CDM,105855,PROBE STIM TIP 1.3MM,5004.5,5004.5,300.27,4253.82,49 CDM,105856,ANCHOR SUTURE 4.75MM,41231.0,41231.0,5360.03,35046.35,28 CDM,105857,ANCHOR SUTURE 5.5MM,9130.0,9130.0,1186.9,7760.5,28 CDM,105858,ANCHOR SUT 1.8MM,8835.0,8835.0,1148.55,7509.75,28 CDM,105859,ANCHOR SUT BLUE 1.8MM,8835.0,8835.0,1148.55,7509.75,28 CDM,105860,ANCHOR SUT 2.8MM,42606.0,42606.0,5538.78,36215.1,28 CDM,105864,SUTURE ANBCTRL +2-0 27IN,120.5,120.5,7.23,102.42,49 CDM,105865,SUTURE ANTIBACT +0 27IN,4429.5,4429.5,265.77,3765.07,49 CDM,105866,SUTURE NYL SZ9-0 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,105869,SYSTEM CALIB 36FR 107CM,8416.5,8416.5,504.99,7154.02,49 CDM,105870,SYSTEM GSTRC CLBRT 40FR,8416.5,8416.5,504.99,7154.02,49 CDM,105871,TTE2D W OR W&WO LIMITED,4440.7,4440.7,266.44,3774.59,39 CDM,105871,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited st",4440.7,4440.7,893.53,1233.38,5 CDM,105872,MYOCARD STRAIN IMAGE,2216.72,2216.72,133.0,1884.21,44 CDM,105872,Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging) ,2216.72,2216.72,21.56,47.41,5 CDM,105873,ECHO2D COMP W/O CF DOP,1412.5,1412.5,84.75,1200.63,33 CDM,105873,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",1412.5,1412.5,136.66,313.15,17 CDM,105874,SUTURE BLK BRD 3-0 18IN,471.5,471.5,28.29,400.77,49 CDM,105875,SUTURE GUT 3-0 27IN,150.0,150.0,9.0,127.5,49 CDM,105876,LEAD PACEMAKER 65CM,6180.0,6180.0,803.4,5253.0,28 CDM,105877,CATH ART 7.5FR 110CM,6424.5,6424.5,385.47,5460.82,49 CDM,105878,STENT VASC 7MM 30MM,79229.0,79229.0,10299.77,67344.65,28 CDM,105879,INSERT TIB KN SZ4 10MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105880,PIN DSTRCT 12MM,7547.5,7547.5,452.85,6415.38,49 CDM,105881,TUBE TRCH 95MM 6MM,2905.5,2905.5,174.33,2469.68,49 CDM,105882,TB TRACH EXT 73110080,2905.5,2905.5,174.33,2469.68,49 CDM,105883,TUBE TRACH XLT SIZE 8,2905.5,2905.5,174.33,2469.68,49 CDM,105884,GRAFT CV 26MM 47CM,47011.0,47011.0,6111.43,39959.35,28 CDM,105885,SUB BNGF FOAM 5CC,19959.0,19959.0,2594.67,16965.15,28 CDM,105886,GRAFT BN FIB SEG SHFT,30198.0,30198.0,3925.74,25668.3,28 CDM,105887,GRAFT BN SHFT FIB 100MM,34032.0,34032.0,4424.16,28927.2,28 CDM,105890,PUMP PAIN INFN 20ML,100000.0,100000.0,13000.0,85000.0,28 CDM,105891,KIT PATIENT PRGRMR,40397.5,40397.5,2423.85,34337.88,49 CDM,105892,PLATE SPN 2LVL 32MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105893,SCREW SPN 4MM 14MM,2633.0,2633.0,342.29,2238.05,28 CDM,105894,SCREW SPN 3.5MM 8MM,2633.0,2633.0,342.29,2238.05,28 CDM,105895,BIT DRILL 2.8MM,1453.0,1453.0,87.18,1235.05,49 CDM,105896,SCREW SET SPN,2201.0,2201.0,286.13,1870.85,28 CDM,105897,SCREW BN 3.5X12MM,12898.0,12898.0,1676.74,10963.3,28 CDM,105898,ROD SPN 3.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 CDM,105899,SUB BNGF FOAM 10CC,36845.0,36845.0,4789.85,31318.25,28 CDM,105900,NAIL BN 130D 11.5MM 18CM,40150.0,40150.0,5219.5,34127.5,28 CDM,105901,CATH URET 2W 20FR 5CC,194.0,194.0,11.64,164.9,49 CDM,105902,TUBE TRACH 12.7MM 79MM,2116.0,2116.0,126.96,1798.6,49 CDM,105903,NEEDLE TRNSPTL 21GA 71CM,4809.5,4809.5,288.57,4088.07,49 CDM,105904,SHEATH INTRO 14FR 25CM,1092.5,1092.5,65.55,928.63,49 CDM,105905,CUFF SENSOR HEMO ADLT,11092.5,11092.5,665.55,9428.63,49 CDM,105906,CATH URET 2W 22FR 30CC,241.0,241.0,14.46,204.85,49 CDM,105907,TUBE TRACH IC 9.0MM,2131.5,2131.5,127.89,1811.78,49 CDM,105908,TUBE FD CONN GSTRM 22FR,1213.5,1213.5,72.81,1031.47,49 CDM,105909,TUBE FD CONN GSTRM 26FR,1111.5,1111.5,66.69,944.77,49 CDM,105911,PROGRAMMER PATIENT,43140.0,43140.0,2588.4,36669.0,49 CDM,105912,PLATE BN 6H 2.4MM,24302.0,24302.0,3159.26,20656.7,28 CDM,105913,SCREW BN 2.4MM 26MM SS,4332.0,4332.0,563.16,3682.2,28 CDM,105915,PLATE SPN XPND 5X8-12MM,12898.0,12898.0,1676.74,10963.3,28 CDM,105916,SCREW SPN 2MM 6MM,2201.0,2201.0,286.13,1870.85,28 CDM,105917,SUTURE ANBCTRL +2 54IN,162.5,162.5,9.75,138.13,49 CDM,105918,BURR SURG CRNL 7.5MM,7720.0,7720.0,463.2,6562.0,49 CDM,105919,HEMODIALYSIS,2821.0,2821.0,169.26,2397.85,49 CDM,105920,CRRT/SLEDD,3919.0,3919.0,235.14,3331.15,49 CDM,105921,DIALYSIS CAPD,3014.0,3014.0,180.84,2561.9,49 CDM,105922,DIALYSIS CCPD,4971.0,4971.0,298.26,4225.35,49 CDM,105924,ESWL-UNILATERAL,62531.0,62531.0,3751.86,53151.35,37 CDM,105925,ESWL-BILATERAL,62531.0,62531.0,3751.86,53151.35,37 CDM,105926,CYSTO ADD ON TO ESWL,17761.0,17761.0,1065.66,15096.85,37 CDM,105933,PHASE 1 PER MINUTE,45.0,45.0,2.7,38.25,49 CDM,105934,BIT DRILL 1.15MM,4405.5,4405.5,264.33,3744.68,49 CDM,105935,KIT W/PWER BN MILL CRTDG,21620.0,21620.0,1297.2,18377.0,49 CDM,105936,BLADE BN MILL MED,17607.0,17607.0,1056.42,14965.95,49 CDM,105937,CAGE SPN 11D 28X9X11MM,95785.0,95785.0,12452.05,81417.25,28 CDM,105938,BLADE SAW 12X11.5MM,3197.5,3197.5,191.85,2717.88,49 CDM,105939,PLATE MNDB MDFC TI,100000.0,100000.0,13000.0,85000.0,28 CDM,105940,TUBE TRACH CFLS 100X7MM,2905.5,2905.5,174.33,2469.68,49 CDM,105941,GRAFT EVAS 161MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105942,CONTROLLER NRSTM EXTN,27579.0,27579.0,1654.74,23442.15,49 CDM,105943,PLATE SPN 2LVL 36MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105944,BAG DRN MNTR ICP CATH SY,4809.5,4809.5,288.57,4088.07,49 CDM,105945,PLATE SPN 1LVL 11MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105946,STENT VASC 9X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105947,STENT VASC 9X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105948,STENT VASC 9X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105949,STENT VASC 9X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105950,STENT VASC 7X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105951,STENT VASC 7X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105952,STENT VASC 6X12MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105953,STENT VASC 6X16MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105954,STENT VASC 7X12MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105955,STENT VASC 7X16MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105956,STENT VASC 7X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105957,STENT VASC 7X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,105958,CAGE SPN 0D 9X28X10MM,95785.0,95785.0,12452.05,81417.25,28 CDM,105959,LEAD WIRE DISP 72IN,3764.0,3764.0,225.84,3199.4,49 CDM,105960,DILATOR SURG 8/13/18MM,8980.0,8980.0,538.8,7633.0,49 CDM,105962,KIT INST ANTI-DRIF BOLT,13980.0,13980.0,838.8,11883.0,49 CDM,105963,OCCLUSIVE DEVICE VEN/ART,2420.0,2420.0,145.2,2057.0,32 CDM,105963,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",2420.0,2420.0,1672.0,2358.0,2 CDM,105964,MODEL ANTM PLANNED OUTCM,59459.0,59459.0,3567.54,50540.15,49 CDM,105965,SCREW BN 1.85MM 8MM,3697.0,3697.0,480.61,3142.45,28 CDM,105966,TUBE TRCH 100MM 7MM,2905.5,2905.5,174.33,2469.68,49 CDM,105967,CATH BLNDIL 4.0X35MM,11938.0,11938.0,716.28,10147.3,49 CDM,105968,PLATE SPN 2LVL 38MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105969,SCREW BN 6.5MM 50MM,17670.0,17670.0,2297.1,15019.5,28 CDM,105971,STENT 34MMX34MMX15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,105973,MESH SURG 10CM 17CM,19633.0,19633.0,2552.29,16688.05,28 CDM,105974,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,105975,MESH HRN PP 17CM 10CM,19633.0,19633.0,2552.29,16688.05,28 CDM,105976,SCREW BN 2.7MM 18MM,1850.0,1850.0,240.5,1572.5,28 CDM,105977,SCREW BN 1.85MM 6MM,3517.0,3517.0,457.21,2989.45,28 CDM,105978,PLATE SPN 2LVL 46MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105979,PLATE SPNL 2LVL 34MM,26764.0,26764.0,3479.32,22749.4,28 CDM,105980,ROD SPN 3.5MM 55MM,5265.0,5265.0,684.45,4475.25,28 CDM,105981,COMPNT FEM KN RT SZ8,47048.0,47048.0,6116.24,39990.8,28 CDM,105982,CMPNT TIB KN SZ7,36624.0,36624.0,4761.12,31130.4,28 CDM,105983,PLATE BN 2.7/3.5MM 81MM,27600.0,27600.0,3588.0,23460.0,28 CDM,105984,SCREW BN 2.7MM 18MM,4707.0,4707.0,611.91,4000.95,28 CDM,105985,PIN FX 2.5MM 14MM,2905.5,2905.5,174.33,2469.68,49 CDM,105986,PROBE ABL PREC 20CM 15GA,57006.0,57006.0,3420.36,48455.1,49 CDM,105987,CATHETER BLNDIL 1.25X8MM,2905.5,2905.5,174.33,2469.68,49 CDM,105988,ROD SPN 3.5MM 75MM,5265.0,5265.0,684.45,4475.25,28 CDM,105989,STENT URET 4.8FR 26CM,6072.0,6072.0,789.36,5161.2,28 CDM,105990,STENT URET 6FR 22CM,6072.0,6072.0,789.36,5161.2,28 CDM,105991,STENT URET 6FR 24CM,6072.0,6072.0,789.36,5161.2,28 CDM,105992,STENT URET 6FR 26CM,6072.0,6072.0,789.36,5161.2,28 CDM,105993,STENT URET 6FR 28CM,6072.0,6072.0,789.36,5161.2,28 CDM,105994,STENT URET 7FR 22CM,6072.0,6072.0,789.36,5161.2,28 CDM,105995,STENT URET 7FR 26CM,6072.0,6072.0,789.36,5161.2,28 CDM,105996,CAGE SPN 4D 9X25X11MM,56344.0,56344.0,7324.72,47892.4,28 CDM,105997,GRAFT ENDO AAA 32X14MM,100000.0,100000.0,13000.0,85000.0,28 CDM,105998,CATH GD LG XLNG 9FR 65CM,13037.5,13037.5,782.25,11081.88,49 CDM,105999,SYSTEM VALVE TAVR 52MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106000,SYSTEM VALVE TAVR 48MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106002,CATH BLNDIL 8MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,106003,PLATE SPN 40MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106004,BURR SURG 5MM,9597.0,9597.0,575.82,8157.45,49 CDM,106005,CATH URN 5.8FR 75CM,6783.0,6783.0,406.98,5765.55,49 CDM,106006,CATH BLN PTCA 1.75X10MM,21398.5,21398.5,1283.91,18188.72,49 CDM,106008,CATH BLN PTCA 2.75X10MM,23110.5,23110.5,1386.63,19643.92,49 CDM,106009,CATH BLN PTCA 2.75X15MM,21398.5,21398.5,1283.91,18188.72,49 CDM,106010,SET DRAIN LG BORE 48IN,297.0,297.0,17.82,252.45,49 CDM,106011,CATH BLNDIL 10MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,106019,EXPAND BREAST 450CC,57562.0,57562.0,7483.06,48927.7,28 CDM,106020,KIT W/MILL-BLADES FINE,17607.0,17607.0,1056.42,14965.95,49 CDM,106028,HEMOSTAT ABS 3IN 4IN,2905.5,2905.5,174.33,2469.68,49 CDM,106029,BLADE SAW 90X18MM,1441.5,1441.5,86.49,1225.28,49 CDM,106030,GRAFT NRV 2-3MM 70MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106031,SUTURE ANBCTRL +2-0 18IN,701.0,701.0,42.06,595.85,49 CDM,106033,DEVICE CLS WND +3-0 45CM,1443.5,1443.5,86.61,1226.97,49 CDM,106034,GRAFT WEDGE CRST SZ 18H,40832.0,40832.0,5308.16,34707.2,28 CDM,106035,PASSER SURG SHRT 36CM,3754.5,3754.5,225.27,3191.32,49 CDM,106036,SCREW BN SPN CERV 4X16MM,2633.0,2633.0,342.29,2238.05,28 CDM,106039,PLATE SPN 3LVL 54MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106040,CABLE SPN TI W/ CRMP,10130.0,10130.0,1316.9,8610.5,28 CDM,106044,KIT CATH BLNDIL 18FR 6CM,7478.5,7478.5,448.71,6356.73,49 CDM,106046,PLATE SPN 3LVL 48MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106048,CATH ANGIO 5FR 80CM,767.5,767.5,46.05,652.38,49 CDM,106049,LEAD PCNG 52CM,6278.0,6278.0,816.14,5336.3,28 CDM,106050,SYSTEM TRCSD 1CLIP 1CATH,100000.0,100000.0,13000.0,85000.0,28 CDM,106051,PANTOPRAZOLE 40 MG INJ,17.63,17.63,1.06,14.99,25 CDM,106052,PANTOPRAZ 0.4 MG/ML INJ,17.63,17.63,1.06,14.99,25 CDM,106053,505WG CEFAZOL 2 G INJ,25.23,25.23,1.51,21.45,24 CDM,106054,505WG CEFAZOL 3 G INJ,26.55,26.55,1.59,22.57,24 CDM,106057,"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote) ",1046.52,1046.52,3.76,6.24,8 CDM,106057,NITHIODOT 300MG/12.5GINJ,1046.52,1046.52,62.79,889.54,20 CDM,106060,PLATE SPNL 3LVL 57MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106063,GRAFT EVAS 23X14.5M 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106064,GRAFT STNT 7CM 10MM,95753.0,95753.0,12447.89,81390.05,28 CDM,106065,PLATE SPN 1LVL 20MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106068,LEAD STIM SLEEP APNEA,63060.0,63060.0,8197.8,53601.0,28 CDM,106069,LEAD SENSING RESP,53130.0,53130.0,6906.9,45160.5,28 CDM,106070,LEAD PACEMAKER 46CM,6180.0,6180.0,803.4,5253.0,28 CDM,106071,LEAD PCNG 6FR 58CM,6180.0,6180.0,803.4,5253.0,28 CDM,106072,SCREW SPN 4.5MM 6MM,2633.0,2633.0,342.29,2238.05,28 CDM,106073,SCREW SPN 4.5MM 8MM,2633.0,2633.0,342.29,2238.05,28 CDM,106074,PLATE SPN SM 32MM,42258.0,42258.0,5493.54,35919.3,28 CDM,106075,SCREW SPN 4.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 CDM,106076,SCREW SPN 3.5MM 10MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106077,ROD SPN 115D 3.5MM 125MM,5265.0,5265.0,684.45,4475.25,28 CDM,106080,PIN FX 14MM 2MM,2905.5,2905.5,174.33,2469.68,49 CDM,106082,IMPLANT SCFLD LARGE MINI,100000.0,100000.0,13000.0,85000.0,28 CDM,106084,DRAIN WND FLT 15F 3/16,744.0,744.0,44.64,632.4,49 CDM,106085,CUP OCCLDR 2.5CM,3663.5,3663.5,219.81,3113.97,49 CDM,106086,SLEEVE SMIT 100MM,2417.0,2417.0,314.21,2054.45,28 CDM,106087,KIT IMPLANT URO DEVICE,32338.0,32338.0,4203.94,27487.3,28 CDM,106088,IMPLANT CARTRIDGE PROST,32338.0,32338.0,4203.94,27487.3,28 CDM,106091,SLEEVE SMIT CERV 40MM,18673.0,18673.0,2427.49,15872.05,28 CDM,106094,GRAFT EVAS 12MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106095,GRAFT EVAS 23MM 3.3CM,92650.0,92650.0,12044.5,78752.5,28 CDM,106096,PUTTY DBM ALGRF 2.5CC,31579.0,31579.0,4105.27,26842.15,28 CDM,106098,PATCH CARDIO 6X8CM,19633.0,19633.0,2552.29,16688.05,28 CDM,106099,GLENOID HUM PEG E SZ54,28172.0,28172.0,3662.36,23946.2,28 CDM,106100,STEM HUM SHLDR SZ3,92968.0,92968.0,12085.84,79022.8,28 CDM,106101,HEAD HUM SHLDR 18MM 50MM,35215.0,35215.0,4577.95,29932.75,28 CDM,106102,PIN GUIDE 3.2MM,6273.0,6273.0,376.38,5332.05,49 CDM,106103,GWIRE 2.4MM,2441.0,2441.0,146.46,2074.85,49 CDM,106104,PLATE SPN ANT 1LVL 24MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106105,PLATE SPN CERV 3LVL 51MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106106,FIBER LASER 1000UM,6655.5,6655.5,399.33,5657.18,49 CDM,106107,CATH URET 6FR 70CM,483.5,483.5,29.01,410.98,49 CDM,106109,URETEROSCOPE 7.5FR,19994.0,19994.0,1199.64,16994.9,49 CDM,106110,SYSTEM CATH SINGLE,100000.0,100000.0,6000.0,85000.0,49 CDM,106111,SCREW SPN 2MM 4MM,2201.0,2201.0,286.13,1870.85,28 CDM,106112,ACTHIB 4 DOSE VAC IM,63.29,63.29,3.8,53.8,24 CDM,106112,"Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use ",63.29,63.29,14.55,46.02,10 CDM,106114,CEMENT BN PMMA 20GM,11438.0,11438.0,1486.94,9722.3,28 CDM,106115,CATH BLNDIL 2.0X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,106116,LEAD DEFIB 60CM,67522.0,67522.0,8777.86,57393.7,28 CDM,106117,CATH ANGIO 5FR 80CM,767.5,767.5,46.05,652.38,49 CDM,106118,CATH ANGIO 5FR 100CM,1151.0,1151.0,69.06,978.35,49 CDM,106120,PLATE SPNL 66MM 3LVL,26764.0,26764.0,3479.32,22749.4,28 CDM,106121,NAIL BN 10MM 18CM,40150.0,40150.0,5219.5,34127.5,28 CDM,106123,CATH GD 6.5MM 105MM,51200.5,51200.5,3072.03,43520.43,49 CDM,106125,PROBE ESURG 2.3MM 220CM,9201.5,9201.5,552.09,7821.27,49 CDM,106126,KIT ADPT SPLTR HI V DF 4,100000.0,100000.0,13000.0,85000.0,28 CDM,106127,CATH BLNDIL 3.50MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106128,CATH BLNDIL 3MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106129,CATH BLNDIL 2.75MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106130,CATH BLNDIL 2.50MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106131,CATH BLNDIL 2.25MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106132,CATH BLNDIL 2MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106133,CATH BLNDIL 4MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106134,CATH BLNDIL 3.50MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106135,CATH DCB 3MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106136,CATH BLNDIL 2.75MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106137,CATH DCB 2.5MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106138,CATH BLNDIL 2.25MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106139,CATH BLNDIL 2MM 20MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106140,CATH BLNDIL 4MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106141,CATH BLNDIL 3.50MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106142,CATH BLNDIL 3MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106143,CATH BLNDIL 2.75MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106144,CATH BLNDIL 2.50MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106145,CATH BLNDIL 2.25MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106146,CATH BLNDIL 2MM 15MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106147,CATH BLNDIL 4MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106148,CATH BLNDIL 3.50MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106149,CATH BLNDIL 3MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106150,CATH BLNDIL 2.75MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106151,CATH BLNDIL 2.50MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106152,CATH BLNDIL 2.25MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106153,CATH BLNDIL 2MM 12MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106154,NEEDLE ASP BRONCH 21GA,7580.0,7580.0,454.8,6443.0,49 CDM,106155,KIT GD SHEATH DISP,5035.0,5035.0,302.1,4279.75,49 CDM,106156,BLN ULTR ENDOSC BFUC160F,1322.0,1322.0,79.32,1123.7,49 CDM,106157,NEEDLE ENDO 21GA 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,106158,NEEDLE BX 2 FLX 19GA 2MM,9085.5,9085.5,545.13,7722.68,49 CDM,106159,NEEDLE ASP 21G 20-40MM,6303.5,6303.5,378.21,5357.98,49 CDM,106161,NEEDLE ASP DISP 22G,6303.5,6303.5,378.21,5357.98,49 CDM,106162,PROSTH PENL PUMP PS 21CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106163,ANCHOR STIMULATION LEAD,5200.0,5200.0,676.0,4420.0,28 CDM,106164,LEAD SPN CLMN STIMU 50CM,19633.0,19633.0,2552.29,16688.05,28 CDM,106165,IMPLANT PULSE 8.5X15.5IN,100000.0,100000.0,13000.0,85000.0,28 CDM,106166,KIT ACC PROSTH PENL,34666.0,34666.0,2079.96,29466.1,49 CDM,106167,PROSTH PENL PUMP PS 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106168,KIT CHARGER,23110.5,23110.5,1386.63,19643.92,49 CDM,106169,TOOL TUNNELING 35CM,3136.5,3136.5,188.19,2666.03,49 CDM,106170,SUTURE SILK BLK 60IN,375.0,375.0,22.5,318.75,49 CDM,106173,CAGE SPN 4D 12X14X8MM,53527.0,53527.0,6958.51,45497.95,28 CDM,106174,KIT PEG GSTRM 20FR,3524.0,3524.0,211.44,2995.4,49 CDM,106175,CATHETER RENAL 6FR,100000.0,100000.0,6000.0,85000.0,44 CDM,106183,LEAD TINED 30CM 1.3MM,92390.0,92390.0,12010.7,78531.5,28 CDM,106184,CONTROL REMOTE PT NRSTM,21693.5,21693.5,1301.61,18439.47,49 CDM,106185,NRSTM NON RECHARGEABLE,100000.0,100000.0,13000.0,85000.0,28 CDM,106186,KIT IMPLANT TOOL,10881.5,10881.5,652.89,9249.27,49 CDM,106188,ROD SPN 5.5MM 100MM,5265.0,5265.0,684.45,4475.25,28 CDM,106190,SCREW BN 5MM 30MM,5408.0,5408.0,703.04,4596.8,28 CDM,106192,CATHETER ART 19FR 18CM,15688.0,15688.0,941.28,13334.8,49 CDM,106193,CATHETER ART 21FR 18CM,15688.0,15688.0,941.28,13334.8,49 CDM,106194,CATHETER ART 23FR 18CM,15688.0,15688.0,941.28,13334.8,49 CDM,106195,CATHETER ART 25FR 18CM,15688.0,15688.0,941.28,13334.8,49 CDM,106196,CATH DRN 15FR,17607.0,17607.0,1056.42,14965.95,49 CDM,106197,CATH DRN 17FR,17607.0,17607.0,1056.42,14965.95,49 CDM,106198,CATH DRN 19FR,17607.0,17607.0,1056.42,14965.95,49 CDM,106199,CATHETER ART 21FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,106200,CATHETER ART 23FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,106201,SPACER SPN 4D 11X25X9MM,56344.0,56344.0,7324.72,47892.4,28 CDM,106202,CATH IAB 7FR 258MM,27069.0,27069.0,1624.14,23008.65,49 CDM,106205,PERIPROC EVAL/PROG PM,605.0,605.0,36.3,514.25,44 CDM,106205,"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualifi",605.0,605.0,47.22,65.18,5 CDM,106206,END CAP 13MM 28-39MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106207,END CAP 0D 13MM,81201.0,81201.0,10556.13,69020.85,28 CDM,106209,HOOK SPN II STD BLD SM,8599.0,8599.0,1117.87,7309.15,28 CDM,106210,HOOK SPN XIA SM PDCL,8599.0,8599.0,1117.87,7309.15,28 CDM,106214,DRILL AND PIN SET SHARP,830.5,830.5,49.83,705.92,49 CDM,106216,INSERT TIB POLY SZ2 14MM,15495.0,15495.0,2014.35,13170.75,28 CDM,106217,GDPIN HEADLESS 46MM,3678.5,3678.5,220.71,3126.72,49 CDM,106218,UNIT NAVIGATION ORTHO AL,20029.5,20029.5,1201.77,17025.08,49 CDM,106219,CATH GD SM 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 CDM,106220,REPOS ECMO PERC =>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,106221,REM ECMO PERC PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,106222,INIT ECMO VENO-ARTERIAL,25490.95,25490.95,1529.46,21667.31,37 CDM,106223,INS ECMO PERC PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,106224,510K SKN SUB NOS 1SQCM,2491.0,2491.0,149.46,2117.35,28 CDM,106225,SCREW BN 2.0MM 11MM,10449.0,10449.0,1358.37,8881.65,28 CDM,106226,SCREW BN 2X11MM,6240.0,6240.0,811.2,5304.0,28 CDM,106227,SCREW BN 3.5MM 50MM,6240.0,6240.0,811.2,5304.0,28 CDM,106228,CANNULA BIOLNE COATD 23F,15778.0,15778.0,946.68,13411.3,49 CDM,106229,INIT ECMO VENO-VENOUS,25490.95,25490.95,1529.46,21667.31,37 CDM,106230,ANALYSIS ANTITACHY PCMKR,1721.83,1721.83,103.31,1463.56,39 CDM,106230,"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpret",1721.83,1721.83,79.28,109.43,5 CDM,106231,SCREW BN 3.0MM 32MM,10406.0,10406.0,1352.78,8845.1,28 CDM,106232,SCREW BN 3.0X20MM,10406.0,10406.0,1352.78,8845.1,28 CDM,106233,GWIRE DBL 0.9X150MM,1453.0,1453.0,87.18,1235.05,49 CDM,106234,BIT DRILL 1.6MM,4809.5,4809.5,288.57,4088.07,49 CDM,106235,COUNTERSINK CANN 3.0MM,9684.0,9684.0,581.04,8231.4,49 CDM,106236,SCREW BN 4.0MM 40MM,11127.0,11127.0,1446.51,9457.95,28 CDM,106238,SCREW SPN 6.5MM 55MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106239,ROD SPN 5.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 CDM,106241,KIT CANN 15FR 31.8CM,12783.0,12783.0,766.98,10865.55,49 CDM,106242,STENT GFT 18F 70MM 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106243,COMPNT FEM W CBLT SZ3 3D,50710.0,50710.0,6592.3,43103.5,28 CDM,106244,PORT ACC 12MM 150MM,3555.0,3555.0,213.3,3021.75,49 CDM,106245,BURR 7.5MM MED ACORN,2993.5,2993.5,179.61,2544.47,49 CDM,106246,PLATE BN STD RT 18MM,49047.0,49047.0,6376.11,41689.95,28 CDM,106249,CATH VENT 16FR 16IN,1189.5,1189.5,71.37,1011.08,49 CDM,106253,CATH GD 7FR 3DRC 100CM,2690.5,2690.5,161.43,2286.93,49 CDM,106256,KIT NRSTM TRQ WRNCH,3136.5,3136.5,188.19,2666.03,49 CDM,106257,KIT TOOL ELEVATOR,2905.5,2905.5,174.33,2469.68,49 CDM,106258,INSERT TIB PLY SZ4 16MM,15495.0,15495.0,2014.35,13170.75,28 CDM,106266,SUTURE LOOP 36IN SZ 2,1743.5,1743.5,104.61,1481.97,49 CDM,106267,KIT LEAD SURGICAL 70CM,42040.0,42040.0,5465.2,35734.0,28 CDM,106270,CATH EP 5FR 115CM,6273.0,6273.0,376.38,5332.05,49 CDM,106271,CATH BLNDIL 4MM 30MM,100000.0,100000.0,6000.0,85000.0,44 CDM,106274,SCREW BN HDLSS 2.3X40MM,27488.0,27488.0,3573.44,23364.8,28 CDM,106275,KIT DRILL BUNION,11969.5,11969.5,718.17,10174.08,49 CDM,106276,KIT INSTRUMENT BUNION,17607.0,17607.0,1056.42,14965.95,49 CDM,106277,KIT SURG GUIDE AND K-WR,11607.0,11607.0,696.42,9865.95,49 CDM,106278,PLATE BN SHRT OFST 3.5MM,53293.0,53293.0,6928.09,45299.05,28 CDM,106279,SCREW BN 2.7MM 22MM,4071.0,4071.0,529.23,3460.35,28 CDM,106280,SCREW BN NLCK 2.7X18MM,4071.0,4071.0,529.23,3460.35,28 CDM,106281,SCREW BN LCK 3MM 22MM,6106.0,6106.0,793.78,5190.1,28 CDM,106284,ROD SPN 110MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,106285,DOPAMINE 1600 MCG/ML INJ,17.28,17.28,1.04,14.69,20 CDM,106287,SUTURE SPLIT 20IN LOOP,1743.5,1743.5,104.61,1481.97,49 CDM,106288,SHUNT T-TUBE CATH,23218.0,23218.0,3018.34,19735.3,28 CDM,106289,KIT IPG TEMPLATE DISP,3136.5,3136.5,188.19,2666.03,49 CDM,106290,CAGE SPN 12D 12X27X37MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106291,CAGE SPN 18D 37X27X14MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106292,SCREW SPN 5.5MM 30MM,2633.0,2633.0,342.29,2238.05,28 CDM,106293,SCREW SPN 5.5MM 25MM,2633.0,2633.0,342.29,2238.05,28 CDM,106294,CATH VASC 19F 1CM 23CM,11549.0,11549.0,692.94,9816.65,49 CDM,106295,CAGE SPN 4D 6X12X14MM,23947.0,23947.0,3113.11,20354.95,28 CDM,106296,SET PLANTAR PLATE IMPLAN,42687.0,42687.0,5549.31,36283.95,28 CDM,106297,SOLUTION EMBOLIC 2ML,75494.5,75494.5,4529.67,64170.32,49 CDM,106298,SOLUTION EMBOLIC 6ML,100000.0,100000.0,6000.0,85000.0,49 CDM,106299,SOLUTION EMBOLIC 2ML,75494.5,75494.5,4529.67,64170.32,49 CDM,106301,GABAPENTIN 300MG/6ML LIQ,23.11,23.11,1.39,19.64,49 CDM,106302,SOLUTION EMBOLIC 6ML,100000.0,100000.0,6000.0,85000.0,49 CDM,106303,SCREW SPNL LCK 2.4X12MM,5590.0,5590.0,726.7,4751.5,28 CDM,106304,STAPLE BN 18MM 18MM 18MM,39970.0,39970.0,5196.1,33974.5,28 CDM,106305,WIRE OLIVE IMPLANT,2905.5,2905.5,174.33,2469.68,49 CDM,106306,K-WIRE 1.4MM 24IN,1453.0,1453.0,87.18,1235.05,49 CDM,106307,SCREW SPN 6.5X45MM,16904.0,16904.0,2197.52,14368.4,28 CDM,106308,SCREW BN SPN 6.5X40MM,16904.0,16904.0,2197.52,14368.4,28 CDM,106309,ROD SPNL 5.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 CDM,106310,ROD SPNL 5.5MM 130MM,5265.0,5265.0,684.45,4475.25,28 CDM,106311,BLADE SAW 90X18X1.27MM,2199.0,2199.0,131.94,1869.15,49 CDM,106313,CAGE SPN 8D 45LX22WX10H,84516.0,84516.0,10987.08,71838.6,28 CDM,106314,DRAIN CHEST 500ML,2905.5,2905.5,174.33,2469.68,49 CDM,106318,BATTERY VAD BKUP 11V,17431.0,17431.0,1045.86,14816.35,27 CDM,106319,PLATE SPN 2LVL 42MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106320,INTRO SHTH STRBL SZ LG,67637.0,67637.0,4058.22,57491.45,49 CDM,106321,SCISSORS MNPLR 33CM 5MM,2272.5,2272.5,136.35,1931.63,49 CDM,106322,GRAFT EV 20FR 30MM 125MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106324,INTRO SHTH STRBL SZ MED,67637.0,67637.0,4058.22,57491.45,49 CDM,106326,NEEDLE ASP 8GA 6IN,3555.0,3555.0,213.3,3021.75,49 CDM,106327,GDWIRE ORTH 1.4X620MM,2905.5,2905.5,174.33,2469.68,49 CDM,106328,CAGE INTERBODY 10X28MM,95785.0,95785.0,12452.05,81417.25,28 CDM,106329,SCREW SPN 6.5MM 40MM,15651.0,15651.0,2034.63,13303.35,28 CDM,106330,SCREW SPN 6.5MM 45MM,15651.0,15651.0,2034.63,13303.35,28 CDM,106332,ROD SPN 50MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,106334,GRAFT EVAS 36MM 95MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106335,GRAFT EVAS 16FR 24X74MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106336,SHEATH VASC 8FR 65CM,3262.0,3262.0,195.72,2772.7,49 CDM,106338,LINER ACTB HIP 50MM 28MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106342,PLATE BN 6HL 2.4MM 51MM,23427.0,23427.0,3045.51,19912.95,28 CDM,106343,PLATE BN TIB LT 6H 119MM,42134.0,42134.0,5477.42,35813.9,28 CDM,106345,BIT DRILL DISP 2.8MM 80M,5851.5,5851.5,351.09,4973.77,49 CDM,106346,PLATE TIB SS 4H 105MM,28016.0,28016.0,3642.08,23813.6,28 CDM,106347,CATH DX US INTRCAR 10F,98605.0,98605.0,5916.3,83814.25,49 CDM,106348,CATH URET 2LUM 10FR,2905.5,2905.5,174.33,2469.68,49 CDM,106349,SUTURE BLK 2-0 30IN,81.0,81.0,4.86,68.85,49 CDM,106350,CATHETER DRN 5FR 7CM,803.5,803.5,48.21,682.98,49 CDM,106351,GWIRE VASC ANG .035X260,3032.0,3032.0,181.92,2577.2,49 CDM,106352,CATHETER DRN 5FR 10CM,803.5,803.5,48.21,682.98,49 CDM,106354,GWIRE VASC 300CM .014IN,3136.5,3136.5,188.19,2666.03,49 CDM,106355,STENT URET 7FR 22-30CM,4837.0,4837.0,628.81,4111.45,28 CDM,106356,GWIRE VASC 180CM .014IN,2927.5,2927.5,175.65,2488.38,49 CDM,106358,SHEATH VASC 6FR 65CM,3262.0,3262.0,195.72,2772.7,49 CDM,106359,PLATE SPN 2LVL 44MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106360,CATH BLN BIB 28.0MM 5.0C,50385.0,50385.0,3023.1,42827.25,49 CDM,106361,CATH BLN BIB 30MM 110CM,50385.0,50385.0,3023.1,42827.25,49 CDM,106362,SYSTEM SCFLD 2.5MM 38MM,82344.0,82344.0,10704.72,69992.4,28 CDM,106363,SYSTEM SCFLD 3MM 28MM,88930.0,88930.0,11560.9,75590.5,28 CDM,106364,SYSTEM SCFLD 3MM 38MM,82344.0,82344.0,10704.72,69992.4,28 CDM,106365,SYSTEM SCFLD 3.5MM 28MM,88930.0,88930.0,11560.9,75590.5,28 CDM,106366,SYSTEM SCFLD 3.5MM 38MM,82344.0,82344.0,10704.72,69992.4,28 CDM,106367,SYSTEM SCFLD 3.75MM 38MM,82344.0,82344.0,10704.72,69992.4,28 CDM,106368,PROSTH PENL PUMP PS 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106369,SUTURE 2-0 1.5MM,302.0,302.0,18.12,256.7,49 CDM,106370,SUTURE GRN BRD 2-0 30IN,288.0,288.0,17.28,244.8,49 CDM,106372,CAGE SPN 4DG 14X12X7MM,53527.0,53527.0,6958.51,45497.95,28 CDM,106374,HYDROMORPH 2 MG INJ,51.32,51.32,3.08,43.62,24 CDM,106375,HYDROMORPH 1 MG INJ,54.82,54.82,3.29,46.6,24 CDM,106376,HYDROMORPH 10 MG INJ,67.65,67.65,4.06,57.5,24 CDM,106378,HYDROMORPH 0.5 MG INJ,27.99,27.99,1.68,23.79,24 CDM,106379,505HK CEFAZOLIN 3 G INJ,26.03,26.03,1.56,22.13,24 CDM,106379,"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg ",26.03,26.03,0.85,3.13,10 CDM,106380,CANNULA VNS 17FR 31.8CM,12783.0,12783.0,766.98,10865.55,49 CDM,106381,CANNULA ART 25FR 76.2CM,12536.5,12536.5,752.19,10656.02,49 CDM,106382,TUBE JJNSTM 10FR 36IN,2187.0,2187.0,131.22,1858.95,49 CDM,106383,FIBER LASER HOLMIUM,8980.0,8980.0,538.8,7633.0,49 CDM,106384,SHEATH VASC 6F 45CM,3131.5,3131.5,187.89,2661.78,49 CDM,106385,STENT ENDO 7FR 8X135CM,89506.0,89506.0,11635.78,76080.1,28 CDM,106386,STENT ENDO 7FR 8X135CM,89506.0,89506.0,11635.78,76080.1,28 CDM,106387,STENT EPRSTH 7.5CM 9MM,99671.0,99671.0,12957.23,84720.35,28 CDM,106388,FIBER LASER 272UM,10388.5,10388.5,623.31,8830.23,49 CDM,106390,CATH BLNDIL 3MM 135CM,33895.5,33895.5,2033.73,28811.17,49 CDM,106391,CATH BLNDIL 3.5MM 135CM,33895.5,33895.5,2033.73,28811.17,49 CDM,106392,CATH BLNDIL 4MM 135CM,33895.5,33895.5,2033.73,28811.17,49 CDM,106393,CATH BLNDIL 4.5MM 135CM,33895.5,33895.5,2033.73,28811.17,49 CDM,106394,CATH BLNDIL 5X12MM,33895.5,33895.5,2033.73,28811.17,49 CDM,106396,CAGE SPN 6D 30X25X10MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106397,INSERT TIB KN SZ3 10MM,15495.0,15495.0,2014.35,13170.75,28 CDM,106398,SCREW SET FOR TIB INSERT,4160.0,4160.0,540.8,3536.0,28 CDM,106399,CATH VASC 25F20CM 55CM,15778.0,15778.0,946.68,13411.3,49 CDM,106401,INTRO SHTH VASC 6F 90CM,4001.5,4001.5,240.09,3401.28,49 CDM,106405,NAIL BN BENT 8/7MM 16CM,38774.0,38774.0,5040.62,32957.9,28 CDM,106406,SCREW BN CANC 5MM 44MM,6420.0,6420.0,834.6,5457.0,28 CDM,106407,SCREW BN CANC 5MM 46MM,5895.0,5895.0,766.35,5010.75,28 CDM,106408,SCREW BN 5MM 42MM,5895.0,5895.0,766.35,5010.75,28 CDM,106409,SCREW BN TI CORT 4X22MM,6420.0,6420.0,834.6,5457.0,28 CDM,106411,STENT 5X19MM 6FR 135CM,83853.0,83853.0,10900.89,71275.05,28 CDM,106412,STENT ENDO 6X15MM 135CM,83853.0,83853.0,10900.89,71275.05,28 CDM,106413,STENT ENDO 6X19MM 135CM,85955.0,85955.0,11174.15,73061.75,28 CDM,106414,STENT ENDO 6X29MM 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106415,STENT ENDO 6FR 6X135CM,92487.0,92487.0,12023.31,78613.95,28 CDM,106416,STENT BLN ENDO 6FR 135CM,92487.0,92487.0,12023.31,78613.95,28 CDM,106417,STENT ENDO 6FR 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106418,STENT ENDO 6FR 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106419,STENT ENDO 6FR 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106420,STENT ENDO 6FR 7X135CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106421,STENT ENDO 7FR 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106422,STENT ENDO 7FR 135CM,92487.0,92487.0,12023.31,78613.95,28 CDM,106423,STENT ENDO 7FR 135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106424,STENT ENDO 8FR 8X135CM,94815.0,94815.0,12325.95,80592.75,28 CDM,106425,STENT ENDO 8FR 8X135CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106426,TOTAL JOINT KN FEM SZ6,50710.0,50710.0,6592.3,43103.5,28 CDM,106429,CLAMP ISLTR SYNRGY 6.3MM,80116.5,80116.5,4806.99,68099.02,49 CDM,106430,CLAMP ESURG ISLTR LNG,100000.0,100000.0,6000.0,85000.0,49 CDM,106431,"Injection, lidocaine hcl in 5% dextrose, 1 mg ",32.39,32.39,0.01,0.03,10 CDM,106431,LIDO D5W 2G/500 ML INJ,32.39,32.39,1.94,27.53,24 CDM,106432,LIDO 4% 200MG/5ML INJ,35.86,35.86,2.15,30.48,25 CDM,106433,LIDO 2% 40MG/2ML INJ,29.68,29.68,1.78,25.23,25 CDM,106434,DALBAVANCIN 500 MG INJ,8519.96,8519.96,511.2,7241.97,19 CDM,106434,"Injection, dalbavancin, 5 mg ",8519.96,8519.96,15.0,48.52,10 CDM,106435,GEMCITABINE NOS 2 G INJ,144.83,144.83,8.69,123.11,24 CDM,106435,"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg ",144.83,144.83,3.24,13.77,10 CDM,106435,"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg Chemotherapy Drugs",144.83,144.83,,,0 CDM,106436,LIDO 2% 100MG/5ML INJ,32.14,32.14,1.93,27.32,25 CDM,106437,LIDO 2% 200MG/10ML INJ,33.38,33.38,2.0,28.37,25 CDM,106438,LIDO 1% 300MG/30ML INJ,32.14,32.14,1.93,27.32,25 CDM,106439,LIDO 1% 20MG/2ML INJ,17.31,17.31,1.04,14.71,25 CDM,106440,LIDO 1% 50MG/5ML INJ,29.68,29.68,1.78,25.23,25 CDM,106446,GRAFT EVAS 217X36-40X35,100000.0,100000.0,13000.0,85000.0,28 CDM,106448,INTRO SHTH VASC 6F 90CM,4001.5,4001.5,240.09,3401.28,49 CDM,106449,SHEATH GUIDE 8F 45CM,3131.5,3131.5,187.89,2661.78,49 CDM,106451,ANCHOR SUT 2.3MM,19241.0,19241.0,2501.33,16354.85,28 CDM,106452,GWIRE VASC .035IN 260CM,1906.0,1906.0,114.36,1620.1,49 CDM,106453,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,106454,CATH ANGIO 4FR 100CM,2905.5,2905.5,174.33,2469.68,49 CDM,106455,CATH ELECTR MAP D-F/36P,70718.5,70718.5,4243.11,60110.72,49 CDM,106456,SCREW SPN 2MM 8MM,2201.0,2201.0,286.13,1870.85,28 CDM,106457,GRAFT EVAS 23MM 14CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106459,LIDO/EPI 1 MG INJ,17.28,17.28,1.04,14.69,25 CDM,106460,LIDO 400MG/EPI 0.1MG INJ,38.33,38.33,2.3,32.58,25 CDM,106462,STENT URET 6FR 24CM,7428.0,7428.0,965.64,6313.8,28 CDM,106463,STENT URET 6FR 22-30CM,4837.0,4837.0,628.81,4111.45,28 CDM,106464,IMPLANT SCAFFOLD MEDIUM,97014.0,97014.0,12611.82,82461.9,28 CDM,106466,GRAFT ENDO AAA 28.5X12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106467,GRAFT EVAS 16MM 13.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106468,GRAFT EVAS 16MM 11.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106469,510K SKN SUB NOS 1SQCM,1839.0,1839.0,110.34,1563.15,28 CDM,106470,510K SKN SUB NOS 1SQCM,1719.0,1719.0,103.14,1461.15,28 CDM,106473,GRFT EVAS 167X37X33-34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106475,CATH HMDIAL 12.5FR 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,106476,CATH HMDIAL 12.5FR 16CM,2905.5,2905.5,174.33,2469.68,49 CDM,106477,CATH HMDL GRN 30CM 12.5F,2905.5,2905.5,174.33,2469.68,49 CDM,106478,ROD SPN 3.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 CDM,106479,CATH GD 6FR 90CM,2150.5,2150.5,129.03,1827.92,49 CDM,106480,PLATE SPN 52MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106481,0.9% NACL 500 ML IRR,17.28,17.28,1.04,14.69,49 CDM,106482,510K SKN SUB NOS 1SQCM,2191.0,2191.0,131.46,1862.35,28 CDM,106483,SCREW BN P-AX LCK 3X16MM,6240.0,6240.0,811.2,5304.0,28 CDM,106484,SCREW BN NLCK 2.7X16MM,4285.0,4285.0,557.05,3642.25,28 CDM,106486,PLATE BN RT 6H 3H 51MM,28000.0,28000.0,3640.0,23800.0,28 CDM,106487,SCREW BN 2.4MM 4MM 16MM,2366.0,2366.0,307.58,2011.1,28 CDM,106488,SCREW BN 2.4MM 4MM 14MM,2366.0,2366.0,307.58,2011.1,28 CDM,106489,CATH BLN 6X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106490,CATH IMAGING 9FR 90CM,100000.0,100000.0,6000.0,85000.0,49 CDM,106491,CATH IMAGING,25422.0,25422.0,1525.32,21608.7,49 CDM,106493,LIDO 1 MG INJ,17.28,17.28,1.04,14.69,25 CDM,106494,THROMBATE III 1 U INJ,18.89,18.89,1.13,16.06,19 CDM,106495,CUFF URTH SPHNCR AB 5.5C,100000.0,100000.0,13000.0,85000.0,28 CDM,106496,SPACER SYS RDTHPY 10ML,92264.0,92264.0,11994.32,78424.4,28 CDM,106497,MARKER IMAG SPHR 100CT,998.0,998.0,59.88,848.3,49 CDM,106498,PIN NVG PRCSN 150X3MM,5248.5,5248.5,314.91,4461.23,49 CDM,106499,MARKER FDCL RAD LOCATOR,751.0,751.0,45.06,638.35,49 CDM,106500,BIT DRILL SHT DISP 2.5MM,15494.5,15494.5,929.67,13170.33,49 CDM,106501,BIT DRL FLTD 3MM,15494.5,15494.5,929.67,13170.33,49 CDM,106502,BIT DRILL SURG 3.5MM,15494.5,15494.5,929.67,13170.33,49 CDM,106503,BIT DRILL SURG 4.0MM,15494.5,15494.5,929.67,13170.33,49 CDM,106504,BIT DRILL SURG 4.5MM,15494.5,15494.5,929.67,13170.33,49 CDM,106505,BIT DRILL SURG 5.0MM,15494.5,15494.5,929.67,13170.33,49 CDM,106506,BIT DRILL SURG 5.5MM,15494.5,15494.5,929.67,13170.33,49 CDM,106507,KIT LAPSCP DLYS DIL GD,7043.0,7043.0,422.58,5986.55,49 CDM,106510,TROCAR PRTNL DLYS FALLER,3450.5,3450.5,207.03,2932.93,49 CDM,106512,CONNECTOR CATH DLYS DISP,6273.0,6273.0,376.38,5332.05,49 CDM,106513,TOOL EMBEDDING DISP,5855.0,5855.0,351.3,4976.75,49 CDM,106515,VALVE AORTIC 19MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106516,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106517,VALVE AORTIC 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106518,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106519,VALVE AORTIC 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106520,VALVE AORTIC 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106521,FIBER LASER 550UM,11445.0,11445.0,686.7,9728.25,49 CDM,106522,KIT MINTRDCR 5FR 7CM,1682.5,1682.5,100.95,1430.13,49 CDM,106523,FIBER LASER 272UM,10388.5,10388.5,623.31,8830.23,49 CDM,106524,FIBER LASER 272UM,10388.5,10388.5,623.31,8830.23,49 CDM,106526,CATH EP 5FR 110CM,9684.0,9684.0,581.04,8231.4,49 CDM,106527,SYSTEM URETHRAL BULKING,42040.0,42040.0,5465.2,35734.0,22 CDM,106528,ADMELOG 20 U INJ,17.28,17.28,1.04,14.69,41 CDM,106529,STAPLE BN NITL 30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106531,DISC BN ANKL 4MM,45274.0,45274.0,5885.62,38482.9,28 CDM,106532,DRILL BIT 3.0MM,4809.5,4809.5,288.57,4088.07,49 CDM,106534,PROSTH PENL PUMP PS 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106535,NAIL BN TROCH 11.5M 20CM,40150.0,40150.0,5219.5,34127.5,28 CDM,106536,PROSTH PENL PUMP PS 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106537,SCREW BN HD 4MM 30MM,6240.0,6240.0,811.2,5304.0,28 CDM,106538,REAMER SURG 20MM,17431.0,17431.0,1045.86,14816.35,49 CDM,106539,REAMER SURG 20MM,17431.0,17431.0,1045.86,14816.35,49 CDM,106540,PIN STPL LOC DISP 3MM,2905.5,2905.5,174.33,2469.68,49 CDM,106541,CATH DYLS PED 62CM 3MM,4140.5,4140.5,248.43,3519.43,49 CDM,106542,"Injection, risankizumab-rzaa, intravenous, 1 mg ",52654.54,52654.54,14.6,47.49,10 CDM,106542,RISANKIZU-RZAA 600MG INJ,52654.54,52654.54,3159.27,44756.36,19 CDM,106543,STERILE WATER 1 L IRRIG,51.84,51.84,3.11,44.06,49 CDM,106544,EXPANDER BREAST 375CC,67263.0,67263.0,8744.19,57173.55,28 CDM,106545,EXPANDER BREAST 475CC,67263.0,67263.0,8744.19,57173.55,28 CDM,106546,EXPAND BRST 450CC,57562.0,57562.0,7483.06,48927.7,28 CDM,106547,EXPAND BRST 550CC,57562.0,57562.0,7483.06,48927.7,28 CDM,106548,IMPLANT BREAST 265CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106549,IMPLANT BREAST 260CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106550,IMPLANT BREAST 310CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106551,IMPLANT BREAST 330CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106552,IMPLANT BREAST 375CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106553,CRT-P 4.45X6.13X0.75CM,88722.0,88722.0,11533.86,75413.7,28 CDM,106554,CAP LD IS-1 DF-1 4.75MM,1169.0,1169.0,151.97,993.65,28 CDM,106555,BLADE OSTME 12MM,9508.0,9508.0,570.48,8081.8,49 CDM,106556,BLADE OSTEOTOME 8MM 3IN,9508.0,9508.0,570.48,8081.8,49 CDM,106558,510K SKN SUB NOS 1SQCM,2434.0,2434.0,146.04,2068.9,28 CDM,106559,CATH GD MP1 6FR 100CM,2905.5,2905.5,174.33,2469.68,49 CDM,106560,KIT PEG 20FR,3049.0,3049.0,182.94,2591.65,49 CDM,106561,NEEDLE BSCP 22GA SYR STR,3069.5,3069.5,184.17,2609.07,49 CDM,106562,KIT SURG JOINT IMPL,14086.0,14086.0,845.16,11973.1,49 CDM,106563,INSERT TIB KN CR LAT C,4686.0,4686.0,609.18,3983.1,28 CDM,106564,INSERT TIB MDL 6MM,4686.0,4686.0,609.18,3983.1,28 CDM,106565,INSERT TIB CR LAT A,4686.0,4686.0,609.18,3983.1,28 CDM,106566,TRAY TIBIAL KN CR CMNT,33779.0,33779.0,4391.27,28712.15,28 CDM,106567,CMPNT FEM KN COCR CMNT,42258.0,42258.0,5493.54,35919.3,28 CDM,106568,INSERT TIB MDL 7MM,4686.0,4686.0,609.18,3983.1,28 CDM,106569,INSERT TIB CR LAT B,4686.0,4686.0,609.18,3983.1,28 CDM,106571,INSERT TIB MDL 8MM,4686.0,4686.0,609.18,3983.1,28 CDM,106572,SUTURE SZ 2-0 10X30IN,2636.5,2636.5,158.19,2241.03,49 CDM,106573,SCREW SPN 6.5MM 35MM,15651.0,15651.0,2034.63,13303.35,28 CDM,106574,IMPLANT BREAST 290CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106575,KIT PEG GSTRM 20FR,2905.5,2905.5,174.33,2469.68,49 CDM,106577,SCREW SPN 4.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106578,CLIP LIGATION 50MM,58209.0,58209.0,7567.17,49477.65,28 CDM,106579,SCREW SPN 04.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106580,SPACER SPN SM 12D,95785.0,95785.0,12452.05,81417.25,28 CDM,106581,CLIP LIGATION 40MM,58209.0,58209.0,7567.17,49477.65,28 CDM,106582,MARKER FDCL 1.2MM 3MM,1512.0,1512.0,196.56,1285.2,28 CDM,106583,SCREW BN 3-2.5X100X30MM,4942.0,4942.0,642.46,4200.7,28 CDM,106584,WRENCH ALLEN 3MM,1278.5,1278.5,76.71,1086.72,49 CDM,106585,COMP FEM KN LT SZ7,42258.0,42258.0,5493.54,35919.3,28 CDM,106586,ROD SPN HXHD 5.5X40MM,5265.0,5265.0,684.45,4475.25,28 CDM,106588,BLADE SURG REPRC 3IN,9508.0,9508.0,570.48,8081.8,49 CDM,106590,SCREW SPN 4MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,106591,GRAFT EVAS 23MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106592,BLADE OSTM CRV SHRT 12MM,9508.0,9508.0,570.48,8081.8,49 CDM,106593,COMPNT FEM KN LT SZ7,42258.0,42258.0,5493.54,35919.3,28 CDM,106594,BASEPLATE KN TIB LT SZ7,50945.0,50945.0,6622.85,43303.25,28 CDM,106595,WEDGE AUG KN SZ7-8 10MM,26075.0,26075.0,3389.75,22163.75,28 CDM,106596,STEM FEM KN 120MM 10MM,23545.0,23545.0,3060.85,20013.25,28 CDM,106597,INSERT TIB KN SZ7-8 9MM,37034.0,37034.0,4814.42,31478.9,28 CDM,106598,PLATE BN SMALL 4HL,23310.0,23310.0,3030.3,19813.5,28 CDM,106599,PLATE BN SQ LRG 4HL,24577.0,24577.0,3195.01,20890.45,28 CDM,106600,SCREW BN 2.7MM 10MM,7147.0,7147.0,929.11,6074.95,28 CDM,106602,PROSTH PENL 13MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106603,STENT ESPH 18.5FR 23MM,71670.0,71670.0,9317.1,60919.5,28 CDM,106604,STENT COL 27X22MM 9CM,79474.0,79474.0,10331.62,67552.9,28 CDM,106605,STENT COL 27/22MM 12CM,79474.0,79474.0,10331.62,67552.9,28 CDM,106606,SCREW BN 2.7MM 11MM,7147.0,7147.0,929.11,6074.95,28 CDM,106608,NEEDLE BX INS 8GA 15MM,15834.5,15834.5,950.07,13459.33,49 CDM,106609,AGENT HMST CLGN 12.5,2905.5,2905.5,174.33,2469.68,49 CDM,106610,ROD SPN HEX 5.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 CDM,106611,DRILL TRACKER TOOL,58547.0,58547.0,3512.82,49764.95,49 CDM,106612,SCREW DISC 1.5X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106613,SCREW DISC 1.5X5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106616,BIT DRILL 2.3MM,1453.0,1453.0,87.18,1235.05,49 CDM,106617,PLATE SPNL 1LVL 38MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106618,CATH URET 18FR 2W 30CC,558.0,558.0,33.48,474.3,49 CDM,106619,PLATE BN LCK 6HL 1.5X2.3,13508.0,13508.0,1756.04,11481.8,28 CDM,106620,CARTRIDG CLIP VES WDE SM,416.0,416.0,54.08,353.6,28 CDM,106621,CLIP LIGATION 35MM,58209.0,58209.0,7567.17,49477.65,28 CDM,106622,CLIP LIGATION 45MM,58209.0,58209.0,7567.17,49477.65,28 CDM,106624,SCREW BN 3.0MM 14MM,10502.0,10502.0,1365.26,8926.7,28 CDM,106625,SCREW BN 3.0MM 16MM,10502.0,10502.0,1365.26,8926.7,28 CDM,106626,SCREW SPN LOCKING,4423.0,4423.0,574.99,3759.55,28 CDM,106627,CAGE SPNL 22X17X30-38MM,76001.0,76001.0,9880.13,64600.85,28 CDM,106628,CAGE SPN 17X22X8MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106629,PLATE BN 2.4MM,29061.0,29061.0,3777.93,24701.85,28 CDM,106631,CUFF URTH SPHNC AB 3.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106632,SPACER SPNL BN 8MM 14X2D,23947.0,23947.0,3113.11,20354.95,28 CDM,106633,CONN ROD SPN 35-40MM,10032.0,10032.0,1304.16,8527.2,28 CDM,106634,CATH BLN 3X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106635,CATH BLN 3.5X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106636,CATH BLN 5X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106637,CATH BLN 5X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106638,CATH BLN 5X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106639,CATH BLN 5X150MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106640,CATH BLN 5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106641,CATH BLN 6X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106642,CATH BLN 6X80MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106643,CATH BLN 6.0X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106644,CATH BLN 6X150MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106645,CATH BLN 7X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106646,CATH BLN 7X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106647,CATH BLNDL 7MM 150CM,6064.0,6064.0,363.84,5154.4,49 CDM,106648,OCCLUDER CV 3X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106649,OCCLUDER CV 4X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106650,OCCLUDER CV 4X6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106651,OCCLUDER CV 5X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106652,OCCLUDER CV 5X6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106653,OCCLUDER CV 6X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106654,OCCLUDER VAS 6X12X6.25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106657,ROD SPN 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,28 CDM,106659,CONNECTOR IV NEEDLE FREE,43.5,43.5,2.61,36.98,49 CDM,106661,GWIRE VASC .035IN 260CM,8666.5,8666.5,519.99,7366.52,49 CDM,106662,PIN NVG ORTH 3X100 EX FX,8839.0,8839.0,530.34,7513.15,49 CDM,106664,GRFT EVAS 20F 34MM 137MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106666,CALC ACET 667MG NESRD PO,5.4,5.4,0.32,4.59,49 CDM,106668,CATH INTHCL 4FR 140CM,29105.0,29105.0,3783.65,24739.25,28 CDM,106669,NEUROSTIM RECHARGEABLE,100000.0,100000.0,13000.0,85000.0,28 CDM,106671,CATH GD 7FR 100CM,2274.5,2274.5,136.47,1933.33,49 CDM,106672,CATH GD XB3.5 6FR 100CM,6651.5,6651.5,399.09,5653.77,49 CDM,106673,CABLE SPN SGL W CRIMP,9803.0,9803.0,1274.39,8332.55,28 CDM,106674,SPACER SPN 12X19X12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106675,CAGE SPN 5D 48-64MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106676,SCREW SPN 3.5MM 18MM,12898.0,12898.0,1676.74,10963.3,28 CDM,106677,ROD SPN 3.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 CDM,106678,KIT INSTR SUT ANCH 4.5MM,24266.5,24266.5,1455.99,20626.53,49 CDM,106679,KIT INSTR SUT ANCH 4.5MM,24266.5,24266.5,1455.99,20626.53,49 CDM,106680,ANCHOR SUT 4.5X13.5MM,29315.0,29315.0,3810.95,24917.75,28 CDM,106681,KIT ANCH SUT 4.5X15.5MM,31579.0,31579.0,4105.27,26842.15,28 CDM,106682,CATH ULTSND 2.5MM 40MM,84738.5,84738.5,5084.31,72027.73,49 CDM,106683,CATH ULTSND 3.5MM 40MM,84738.5,84738.5,5084.31,72027.73,49 CDM,106684,CATH IVL 2.5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106685,CATH BLN PRPF 80MM 150CM,100000.0,100000.0,6000.0,85000.0,49 CDM,106686,CATH IVL 3.5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106687,CATH IVL 4MM 80MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106688,CATH IVL 5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106689,CATH IVL 60MM 80MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106690,FIBER LASER HOLMIUM,17607.0,17607.0,1056.42,14965.95,49 CDM,106691,FIBER LASER 3M,12290.0,12290.0,737.4,10446.5,49 CDM,106692,FIBER LASER 272UM,7043.0,7043.0,422.58,5986.55,49 CDM,106693,ROD SPN 5.5MM 35MM,5265.0,5265.0,684.45,4475.25,28 CDM,106694,BUPIVAC LIPO 133MG INJ,1468.12,1468.12,88.09,1247.9,19 CDM,106698,NAFCILLIN 2 G INJ,29.43,29.43,1.77,25.02,24 CDM,106699,NAFCILLIN 1 G INJ,18.9,18.9,1.13,16.06,24 CDM,106700,NAFCILLIN 20 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106713,ROMIPLOSTIM 250 MCG INJ,14187.33,14187.33,851.24,12059.23,19 CDM,106714,ROMIPLOSTIM 125 MCG INJ,7093.75,7093.75,425.63,6029.69,19 CDM,106715,DEVICE SINUS INFL/DFLT,3118.0,3118.0,187.08,2650.3,49 CDM,106718,OCCLUDER CV 3X6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106719,PROSTH PENL PUMP,100000.0,100000.0,13000.0,85000.0,28 CDM,106720,CATH BLN 3X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106721,CATH BLN 3X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106722,CATH BLN 3X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106723,CATH BLN 3X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106724,CATH BLN 3X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106725,CATH BLN 4X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106726,CATH BLN 4X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106727,CATH BLN 4X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106728,CATH BLN 4X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106729,CATH BLN 5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106730,CATH BLN 5X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106731,CATH BLN 5X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106732,CATH BLN 5X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106733,CATH BLN 6.0X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106734,CATH BLN 6X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106735,CATH BLN 6X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106736,CATH BLN 6X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106737,CATH BLN 6X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106738,CATH BLN 4.0X135MM,30814.0,30814.0,1848.84,26191.9,49 CDM,106739,CATH BLN 4.0X80MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106740,CATH BLN 4X100MM,30814.0,30814.0,1848.84,26191.9,49 CDM,106741,CATH BLN 4X150 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106742,CATH BLN 5X80MMX135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106743,CATH BLN 5X100MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106744,CATH BLN 5.0X150MM,30814.0,30814.0,1848.84,26191.9,49 CDM,106745,CATH BLN 6X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106746,CATH BLN 6X80MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106747,CATH BLN 6X100MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106748,CATH BLN 6X150MM,30814.0,30814.0,1848.84,26191.9,49 CDM,106749,CATH BLN 7X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106750,CATH BLN 7X80MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106751,CATH BLN 7X100MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,106752,CATH BLN SINUS 6MM 16MM,60087.5,60087.5,3605.25,51074.38,49 CDM,106753,CATH PRF24MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 CDM,106754,CANNULA PRFSN 69.9CM 19F,17844.5,17844.5,1070.67,15167.83,49 CDM,106755,CATH BLN ANG 5.5MM 25MM,11938.0,11938.0,716.28,10147.3,49 CDM,106756,IMPLANT BREAST 370CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106757,IMPLANT BREAST 405CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106758,IMPLANT BREAST 440CC,42040.0,42040.0,5465.2,35734.0,28 CDM,106759,SET TUBING INSFL SMKEVC,21085.0,21085.0,1265.1,17922.25,49 CDM,106762,SUMP CARDIAC SUC 20FR,41.0,41.0,2.46,34.85,49 CDM,106763,INSERT TIB SZ2 16MM,15495.0,15495.0,2014.35,13170.75,28 CDM,106764,SCREW SPN 6.5MM 50MM,15651.0,15651.0,2034.63,13303.35,28 CDM,106765,PLATE SPN CRV 3LVL 63MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106767,GFT ST TIS TNDN 10-20MM,43299.0,43299.0,5628.87,36804.15,28 CDM,106768,EMPAGLIFLOZIN 10 MG PO,84.08,84.08,5.04,71.47,49 CDM,106769,DROPERIDOL 2.5 MG INJ,24.52,24.52,1.47,20.84,24 CDM,106770,SEVELAMER 800MG NESRD PO,87.78,87.78,5.27,74.61,49 CDM,106771,SEVELAM 0.8G NESRD LIQPO,356.92,356.92,21.42,303.38,49 CDM,106774,CRT-P 11X19.9X46.5,83291.0,83291.0,10827.83,70797.35,28 CDM,106775,STENT PANC 7FR 5CM,3483.0,3483.0,452.79,2960.55,28 CDM,106776,ANCHOR BN NO BUTTON,22605.0,22605.0,2938.65,19214.25,28 CDM,106777,ANCHOR BN W/BUTTON,24222.0,24222.0,3148.86,20588.7,28 CDM,106778,GUIDE PIN STRL 2.4MM,7184.0,7184.0,431.04,6106.4,49 CDM,106779,SUT WHT/BLUE NO NDL SZ2,4307.5,4307.5,258.45,3661.38,49 CDM,106780,CATH GD VASC 59CM,6273.0,6273.0,376.38,5332.05,49 CDM,106781,KIT BLN FX KYPH 11G 15MM,71052.5,71052.5,4263.15,60394.63,49 CDM,106782,NAIL BN RT 9MM 34CM,49348.0,49348.0,6415.24,41945.8,28 CDM,106783,SCREW BN TIB KN 5X60MM,6420.0,6420.0,834.6,5457.0,28 CDM,106784,SCREW BN 2.7X4.5X46MM,1850.0,1850.0,240.5,1572.5,28 CDM,106785,SCREW BN 2.7X4.3X46MM,4707.0,4707.0,611.91,4000.95,28 CDM,106788,ANCHOR BN 1.2X6.5X14MM,10210.0,10210.0,1327.3,8678.5,28 CDM,106789,KIT PRCRDCNTS PGT 8F40CM,4413.5,4413.5,264.81,3751.47,49 CDM,106790,SUTURE NO-NDL SZ 2,2905.5,2905.5,174.33,2469.68,49 CDM,106792,DMSO 50% 50 ML INJ,3679.67,3679.67,220.78,3127.72,19 CDM,106792,"Injection, dmso, dimethyl sulfoxide, 50%, 50 ml ",3679.67,3679.67,748.98,2317.85,10 CDM,106793,PCN G NA 5 MILLION U INJ,217.08,217.08,13.02,184.52,49 CDM,106795,SCREW BN 2.0MM 10MM,4202.0,4202.0,546.26,3571.7,28 CDM,106796,GRAFT EVAS 82MM 32MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106797,SCREW BN 2.0MM 12MM,4202.0,4202.0,546.26,3571.7,28 CDM,106798,GRFT EVAS 117X38X33-34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106799,PLATE BN MTRSL RT STNDRD,35572.0,35572.0,4624.36,30236.2,28 CDM,106800,PIN FIX MINI 1.1 X10MM,5646.0,5646.0,338.76,4799.1,49 CDM,106801,SCREW BN LCK 2.4X14MM,7657.0,7657.0,995.41,6508.45,28 CDM,106802,DRIVER SURG RETAIN T8,9332.0,9332.0,559.92,7932.2,49 CDM,106803,PLATE BN LT 5HL 99MM,19903.0,19903.0,2587.39,16917.55,28 CDM,106805,CANN PRFSN 17IN 19FR,7573.0,7573.0,454.38,6437.05,49 CDM,106808,SUTURE VIOL MON +1 27IN,127.0,127.0,7.62,107.95,49 CDM,106809,SCREW SPNL LCK 2.7X14MM,881.0,881.0,114.53,748.85,28 CDM,106810,SCREW BN 3.5MM 22MM,1420.0,1420.0,184.6,1207.0,28 CDM,106811,NET SPEC RET 8X4CM 3MM,4182.0,4182.0,250.92,3554.7,49 CDM,106812,KIT CAROTID EMBLC PRTCT,100000.0,100000.0,6000.0,85000.0,49 CDM,106813,SCREW BN 2.0MM 16MM,4202.0,4202.0,546.26,3571.7,28 CDM,106814,CATH VENTR 10FR 2CM,1766.5,1766.5,105.99,1501.53,49 CDM,106815,VARIBAR THIN LIQ 148G PO,31.21,31.21,1.87,26.53,33 CDM,106817,NAIL BN 10MM 38CM,38774.0,38774.0,5040.62,32957.9,28 CDM,106818,SCREW BN 5MM 85MM,6420.0,6420.0,834.6,5457.0,28 CDM,106822,SCREW BN 2MM 12MM,1017.0,1017.0,132.21,864.45,28 CDM,106824,SUTURE VIO BRD +0 27IN,85.5,85.5,5.13,72.67,49 CDM,106825,PLATE BN 2.7/3.5MM 61MM,49701.0,49701.0,6461.13,42245.85,28 CDM,106826,INSRT TIB HNG SM 23MM,89651.0,89651.0,11654.63,76203.35,28 CDM,106827,PIN FX KN XS/SM,6912.0,6912.0,898.56,5875.2,28 CDM,106828,VALVE TRICUSPID 48MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106829,VALVE TRICUSPID 52MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106830,VALVE AOR 56MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106831,VALVE TRICUSPID 44MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106832,PATCH VASC TPR .8X8CM,10367.0,10367.0,1347.71,8811.95,28 CDM,106835,CANNULA PRFSN 14G 5.5IN,1238.5,1238.5,74.31,1052.72,49 CDM,106836,GRAFT CV 28MM 47CM,47011.0,47011.0,6111.43,39959.35,28 CDM,106837,REAMER RTRGD 4.5MM 9MM,11092.5,11092.5,665.55,9428.63,49 CDM,106838,DRILL BIT 2.0MM 100MM,6231.5,6231.5,373.89,5296.77,49 CDM,106839,BIT DRILL DISP 2MM 30MM,5557.0,5557.0,333.42,4723.45,49 CDM,106840,REAMER RTRGD 4.5MM 10MM,11092.5,11092.5,665.55,9428.63,49 CDM,106841,BIT DRILL DISP 2.5X45MM,5005.0,5005.0,300.3,4254.25,49 CDM,106842,TUBE FD CNTR 14FR,4821.5,4821.5,289.29,4098.27,49 CDM,106843,CATH GD 8F 2.46MM 59CM,6273.0,6273.0,376.38,5332.05,49 CDM,106844,CATH BLN 5X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,106845,SUTURE CT-1 0 1X36IN,89.5,89.5,5.37,76.08,49 CDM,106846,HEMOSTAT ABS 4IN 8IN,2905.5,2905.5,174.33,2469.68,49 CDM,106847,FLEX ALLOPATCH HD 1SQCM,1496.0,1496.0,89.76,1271.6,30 CDM,106848,STAPLER INT CIR 29MM,9256.0,9256.0,555.36,7867.6,49 CDM,106850,INTRO CATH 12FR 30CM,2905.5,2905.5,174.33,2469.68,49 CDM,106851,SUTURE GRN BRD 2-0 30IN,2860.5,2860.5,171.63,2431.43,49 CDM,106852,GRAFT AOR ART 4/6-11CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106853,SCREW SPN 4MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,106854,CATH BLNDIL 1.5MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106855,CATH BLN PTCA 1.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106856,BALLOON PTCA 2MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106857,BALLOON PTCA 2MM 15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106859,BALLOON PTCA 2.5MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106860,BALLOON PTCA 2.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106861,BALLOON PTCA 3MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106862,BALLOON PTCA 3MM 15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106863,BALLOON PTCA 3.5MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106864,BALLOON PTCA 3.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106865,BALLOON PTCA 4MM 10MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106866,CATH BALLOON PTCA 4X15MM,36977.0,36977.0,2218.62,31430.45,49 CDM,106868,DEV BLN INFL 30ML 40ATM,2905.5,2905.5,174.33,2469.68,49 CDM,106871,STEM HUM SHLDR 10MM 48MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106872,INSERT HUM SHLDR 32MM,20932.0,20932.0,2721.16,17792.2,28 CDM,106874,DRILL BIT 2.5MM,10564.5,10564.5,633.87,8979.83,49 CDM,106875,DRILL GUIDE TAP 6.5MM,18488.5,18488.5,1109.31,15715.23,49 CDM,106876,STENT ESPH 23MM 120MM,93781.0,93781.0,12191.53,79713.85,28 CDM,106877,PLATE BN 11MM 81X10X2MM,27600.0,27600.0,3588.0,23460.0,28 CDM,106879,SCREW BN CANN 4X44MM,6420.0,6420.0,834.6,5457.0,28 CDM,106880,SCREW BN CORT 3.5X14MM,1778.0,1778.0,231.14,1511.3,28 CDM,106881,SCREW BN CRTX ST2.7X20MM,1850.0,1850.0,240.5,1572.5,28 CDM,106882,SCREW BN 2.7MM 16MM,1850.0,1850.0,240.5,1572.5,28 CDM,106884,KIT PLATE BN ANK FX,31724.0,31724.0,4124.12,26965.4,28 CDM,106885,ROD SPN 5.5MM 50MM,5265.0,5265.0,684.45,4475.25,28 CDM,106886,SUTURE ANBCTRL +0 54IN,103.5,103.5,6.21,87.97,49 CDM,106887,ROD SPN 5.5MM 65MM,5265.0,5265.0,684.45,4475.25,28 CDM,106888,SUTURE VIO BRD +1 18IN,621.0,621.0,37.26,527.85,49 CDM,106889,SUTURE SH 2-0 8X18IN,577.0,577.0,34.62,490.45,49 CDM,106890,CAGE SPN 12D 37X27X14MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106891,CAGE SPN 12D 37X27X16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106892,SCREW SPN 5.5MM 30MM,2633.0,2633.0,342.29,2238.05,28 CDM,106893,SCREW BN SPN 6.5X50MM,16904.0,16904.0,2197.52,14368.4,28 CDM,106894,ROD SPNL 5.5MM 105MM,5265.0,5265.0,684.45,4475.25,28 CDM,106895,CAGE SPN 7D 14X7X11MM,22538.0,22538.0,2929.94,19157.3,28 CDM,106896,CAGE SPN 7D 14X11X6MM,22538.0,22538.0,2929.94,19157.3,28 CDM,106897,PLATE SPN 1 LVL 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106898,PLATE SPN 1 LVL 10MM,26764.0,26764.0,3479.32,22749.4,28 CDM,106899,SIMVASTATIN 40 MG PO,5.4,5.4,0.32,4.59,49 CDM,106900,ACTI CHAR 25G/120MLLIQPO,80.89,80.89,4.85,68.76,49 CDM,106901,ACT CHAR SORB50G/240MLPO,127.76,127.76,7.67,108.6,49 CDM,106902,ACT CHAR SORB25G/120MLPO,71.23,71.23,4.27,60.55,49 CDM,106903,SCREW BN 4MM 42MM,5075.0,5075.0,659.75,4313.75,28 CDM,106904,DEVICE CLSR VASC 6/12FR,8639.0,8639.0,1123.07,7343.15,28 CDM,106905,ROD SPN 6X40MM,5265.0,5265.0,684.45,4475.25,28 CDM,106906,TAVR/TAVI PERC CARTD APR,123061.64,123061.64,15998.01,104602.39,15 CDM,106906,"Unlisted procedure, cardiac surgery ",123061.64,123061.64,633.31,13835.0,18 CDM,106907,23.4% NACL 30 ML INJ,38.72,38.72,2.32,32.91,25 CDM,106908,RELOAD STPLR 3.5MM,81492.0,81492.0,10593.96,69268.2,28 CDM,106909,STAPLER DISP 8MM 30MM,100000.0,100000.0,6000.0,85000.0,49 CDM,106910,RELOAD STPLR 2.5MM,81492.0,81492.0,10593.96,69268.2,28 CDM,106911,STAPLER RELOAD 8MM 30MM,81492.0,81492.0,10593.96,69268.2,28 CDM,106914,VALVE AORTA 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106916,CATH BIOPTOME 7F 104,8980.0,8980.0,538.8,7633.0,49 CDM,106917,CATH BIOPTOME 5.5F 104,8980.0,8980.0,538.8,7633.0,49 CDM,106919,PIP SOD/TAZ 3.375 G INJ,38.08,38.08,2.28,32.37,24 CDM,106920,SUMATRIPTAN 50 MG PO,5.4,5.4,0.32,4.59,49 CDM,106921,NRSTM XTRN WRLS,7173.5,7173.5,430.41,6097.48,49 CDM,106923,BURR ROUND FLUTED 4MM,4699.0,4699.0,281.94,3994.15,49 CDM,106924,SUTURE UND MON +3-0 27IN,98.5,98.5,5.91,83.72,49 CDM,106925,SUTURE UND MON +2-0 27IN,98.5,98.5,5.91,83.72,49 CDM,106926,SUTURE VIOL MON 2-0 27IN,126.0,126.0,7.56,107.1,49 CDM,106930,INFUVITE ADULT 10 ML,40.99,40.99,2.46,34.84,49 CDM,106931,CATH GD VASC 200CM,12149.0,12149.0,728.94,10326.65,49 CDM,106932,CLINIMIX E 5/20 1L INJ,425.31,425.31,25.52,361.51,30 CDM,106933,CLINIMIX E 5/15 1L INJ,422.84,422.84,25.37,359.41,30 CDM,106934,INDOCYANINE-GN 25 MG INJ,1032.43,1032.43,61.95,877.57,20 CDM,106935,VALPROIC ACD 30MG/ML INJ,17.28,17.28,1.04,14.69,30 CDM,106936,CEFOXITIN 40 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106938,LINEZOLID 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106939,CEFTAZIDIME 40 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106940,DOBUTAMNE 2000MCG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106941,CEFAZOLIN 330MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,106942,CLINIMIX E 5/20 2L INJ,817.25,817.25,49.03,694.66,30 CDM,106943,CLINIMIX E 5/15 2L INJ,448.8,448.8,26.93,381.48,30 CDM,106944,CLINIMIX E 4.25/10 1LINJ,565.02,565.02,33.9,480.27,30 CDM,106945,CLINIMIX E 4.25/5 1L INJ,272.01,272.01,16.32,231.21,30 CDM,106948,CLINIMIX 5/20 2L INJ,766.56,766.56,45.99,651.58,30 CDM,106949,CLINIMIX 5/15 2L INJ,289.57,289.57,17.37,246.13,30 CDM,106950,CLINIMIX 4.25/5 2L INJ,913.69,913.69,54.82,776.64,30 CDM,106951,CLINIMIX 5/20 1L INJ,422.84,422.84,25.37,359.41,30 CDM,106952,CLINIMIX 5/15 1L INJ,158.2,158.2,9.49,134.47,30 CDM,106953,CLINIMIX 4.25/5 1L INJ,356.08,356.08,21.36,302.67,30 CDM,106954,CLINIMIX E 4.25/10 2LINJ,363.5,363.5,21.81,308.98,30 CDM,106955,CLINIMIX E 4.25/5 2L INJ,361.02,361.02,21.66,306.87,30 CDM,106956,KNIFE EXCPC UTOME CLD,6260.0,6260.0,375.6,5321.0,49 CDM,106958,PROSTH PENL PUMP PS 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,106959,CAGE SPN 7D 14X12X6MM,53527.0,53527.0,6958.51,45497.95,28 CDM,106960,SCREW SPN 4MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,106961,SCREW SPN 4MM 14MM,2633.0,2633.0,342.29,2238.05,28 CDM,106962,PLATE BN LT 3HL 49MM,43107.0,43107.0,5603.91,36640.95,28 CDM,106963,SCREW BN 2.5MM 12MM,4243.0,4243.0,551.59,3606.55,28 CDM,106964,SCREW BN NLCK 2.5X14MM,4243.0,4243.0,551.59,3606.55,28 CDM,106965,GWIRE STRL NITINOL,8310.5,8310.5,498.63,7063.93,49 CDM,106966,BASEPLATE LAT SHLDR 25MM,39441.0,39441.0,5127.33,33524.85,28 CDM,106967,GLNSPHR HEAD SHLDR 36MM,50710.0,50710.0,6592.3,43103.5,28 CDM,106968,PIN GUIDE 220MM 2.5MM,1453.0,1453.0,87.18,1235.05,49 CDM,106969,INSERT SHLDR SZ3 36MM,55781.0,55781.0,7251.53,47413.85,28 CDM,106970,STEM HUM SHLDRSZ13 130MM,100000.0,100000.0,13000.0,85000.0,28 CDM,106971,SCREW BN GLND 6.5X40MM,11780.0,11780.0,1531.4,10013.0,28 CDM,106972,SCREW BN 6.5MM 45MM,11780.0,11780.0,1531.4,10013.0,28 CDM,106973,SCREW BN GLND 5.0X34MM,3120.0,3120.0,405.6,2652.0,28 CDM,106974,SCREW BN 5MM 26MM,3120.0,3120.0,405.6,2652.0,28 CDM,106975,SCREW BN 14MM 5MM,3120.0,3120.0,405.6,2652.0,28 CDM,106977,BX BONE DEEP,22731.21,22731.21,3182.37,19321.53,10 CDM,106977,"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur) ",22731.21,22731.21,510.77,3755.0,42 CDM,106978,INJ SINUS TRACT DX,875.48,875.48,113.81,744.16,29 CDM,106978,Injection of sinus tract; diagnostic (sinogram) ,875.48,875.48,948.0,5841.0,20 CDM,106979,ABLATION BONE TUMOR RF,13818.27,13818.27,1934.56,11745.53,10 CDM,106979,"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when p",13818.27,13818.27,948.0,16330.72,42 CDM,106980,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic ",18152.42,18152.42,1142.68,19751.0,39 CDM,106980,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic High Cost Surgery",18152.42,18152.42,2369.0,2369.0,5 CDM,106980,VERETEBRO CERVICOTHOR,18152.42,18152.42,2541.34,15429.56,10 CDM,106981,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral ",11634.79,11634.79,1142.68,19751.0,39 CDM,106981,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral High Cost Surgery",11634.79,11634.79,2369.0,2369.0,5 CDM,106981,VERTEBRO LUMBOSACRAL,11634.79,11634.79,1628.87,9889.57,10 CDM,106982,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",28272.9,28272.9,2369.0,19751.0,44 CDM,106982,VERT W FRAC RED & BB TH,28272.9,28272.9,3958.21,24031.97,10 CDM,106983,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",28272.9,28272.9,2369.0,19751.0,44 CDM,106983,VERT W FRAC RED & BB LU,28272.9,28272.9,3958.21,24031.97,10 CDM,106984,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",3454.9,3454.9,1672.0,19751.0,25 CDM,106984,VERT W FRAC RED & BB EAD,3454.9,3454.9,449.14,2936.66,26 CDM,106985,INS TUNLD PLEURAL CATH,10816.79,10816.79,1514.35,9194.27,10 CDM,106985,Insertion of indwelling tunneled pleural catheter with cuff ,10816.79,10816.79,948.0,15059.0,42 CDM,106986,REMVL PLEURL CATH W/CUFF,3154.36,3154.36,441.61,2681.21,10 CDM,106986,Removal of indwelling tunneled pleural catheter with cuff ,3154.36,3154.36,234.94,3244.0,42 CDM,106987,THORACENTESIS W/ IMAG,16300.98,16300.98,2282.14,13855.83,10 CDM,106987,"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance ",16300.98,16300.98,234.94,3128.0,42 CDM,106988,PERC PLEUR DRN W/ IMG,16300.98,16300.98,2282.14,13855.83,10 CDM,106988,"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance ",16300.98,16300.98,468.58,4452.98,42 CDM,106989,PERICARD W GUIDANCE,6836.62,6836.62,957.13,5811.13,11 CDM,106989,"Pericardiocentesis, including imaging guidance, when performed ",6836.62,6836.62,468.58,12909.0,41 CDM,106990,PERICARD DRN=>6Y WO CHD,6899.33,6899.33,896.91,5864.43,21 CDM,106990,"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly ",6899.33,6899.33,948.0,13835.0,16 CDM,106991,PERICARD DRN<5Y OR W/CHD,6962.06,6962.06,905.07,5917.75,21 CDM,106991,"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital card",6962.06,6962.06,948.0,13835.0,16 CDM,106992,INS PACEMAKER ATRIAL,7049.72,7049.72,422.98,5992.26,20 CDM,106992,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial ,7049.72,7049.72,3673.0,41580.0,30 CDM,106993,INS PACEMAKER VENT,60031.13,60031.13,3601.87,51026.46,20 CDM,106993,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular ,60031.13,60031.13,3673.0,41580.0,30 CDM,106994,INS PACEMAKER ATR/VENT,60031.13,60031.13,3601.87,51026.46,20 CDM,106994,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular ,60031.13,60031.13,3673.0,41580.0,30 CDM,106995,INS TEMP PACER SGL,61047.92,61047.92,3662.88,51890.73,20 CDM,106995,Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) ,61047.92,61047.92,2996.0,24035.0,28 CDM,106996,INS TEMP PACER DUAL,59937.96,59937.96,8391.31,50947.27,10 CDM,106996,Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) ,59937.96,59937.96,2996.0,24035.0,37 CDM,106996,Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) High Cost Surgery,59937.96,59937.96,2369.0,2369.0,5 CDM,106997,INS PPM GEN ONLY SGL LD,10861.39,10861.39,651.68,9232.18,20 CDM,106997,Insertion of pacemaker pulse generator only; with existing single lead ,10861.39,10861.39,2699.0,41580.0,30 CDM,106998,INS PPM GEN ONLY DUAL LD,10861.39,10861.39,651.68,9232.18,20 CDM,106998,Insertion of pacemaker pulse generator only; with existing dual leads ,10861.39,10861.39,2699.0,41580.0,30 CDM,107000,UPGRADE PPM SGL TO DUAL,10861.39,10861.39,651.68,9232.18,20 CDM,107000,"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lea",10861.39,10861.39,3673.0,41580.0,30 CDM,107001,REPOS PACER/DEFIB LEAD,28624.78,28624.78,1717.49,24331.06,20 CDM,107001,Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode ,28624.78,28624.78,1199.9,24035.0,28 CDM,107002,INS PACER/DEFIB LEAD SGL,6593.22,6593.22,395.59,5604.24,20 CDM,107002,"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator ",6593.22,6593.22,2996.0,24035.0,28 CDM,107003,INS PACER/DEFIB 2 LEADS,8097.13,8097.13,485.83,6882.56,20 CDM,107003,"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator ",8097.13,8097.13,2996.0,24035.0,28 CDM,107004,RELOCATE PACER POCKET,12779.21,12779.21,766.75,10862.33,20 CDM,107004,Relocation of skin pocket for pacemaker ,12779.21,12779.21,760.8,24035.0,28 CDM,107005,RELOCATE ICD POCKET,10514.9,10514.9,630.89,8937.67,20 CDM,107005,Relocation of skin pocket for implantable defibrillator ,10514.9,10514.9,760.8,24035.0,28 CDM,107006,INS LV LD W EXST PPM/ICD,60657.97,60657.97,3639.48,51559.27,20 CDM,107006,"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of po",60657.97,60657.97,2699.0,41580.0,30 CDM,107007,"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber syste",110294.84,110294.84,2996.0,41580.0,18 CDM,107007,LV LEAD NEW/UPGD PPM/ICD,110294.84,110294.84,6617.69,93750.61,30 CDM,107008,REPOS LV LD EXST PPM/ICD,17891.23,17891.23,2504.77,15207.55,10 CDM,107008,"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator) ",17891.23,17891.23,1174.13,24035.0,37 CDM,107008,"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator) High Cost Surgery",17891.23,17891.23,2369.0,2369.0,5 CDM,107009,REPL PACEMAKER GEN SGL,161039.02,161039.02,9662.34,136883.17,20 CDM,107009,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system ,161039.02,161039.02,2699.0,41580.0,30 CDM,107010,REPL PACEMAKER GEN DUAL,83563.92,83563.92,5013.84,71029.33,20 CDM,107010,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system ,83563.92,83563.92,2699.0,41580.0,30 CDM,107011,REPL PACEMAKER GEN MULTI,156121.38,156121.38,9367.28,132703.17,20 CDM,107011,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system ,156121.38,156121.38,2699.0,49995.09,30 CDM,107012,INS ICD GEN ONLY DUAL LD,156717.96,156717.96,9403.08,133210.27,20 CDM,107012,Insertion of implantable defibrillator pulse generator only; with existing dual leads ,156717.96,156717.96,2699.0,98753.0,30 CDM,107013,REMOVE PACER GENERATOR,23090.95,23090.95,1385.46,19627.31,20 CDM,107013,Removal of permanent pacemaker pulse generator only ,23090.95,23090.95,2195.0,24035.0,28 CDM,107014,REM ELECTRODE SGL LD SYS,12779.21,12779.21,766.75,10862.33,20 CDM,107014,"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular ",12779.21,12779.21,2046.07,24035.0,28 CDM,107015,REM ELECTRDE DUAL LD SYS,12779.21,12779.21,766.75,10862.33,20 CDM,107015,Removal of transvenous pacemaker electrode(s); dual lead system ,12779.21,12779.21,2007.21,24035.0,28 CDM,107016,INS ICD GEN ONLY SGL LD,6593.22,6593.22,395.59,5604.24,20 CDM,107016,Insertion of implantable defibrillator pulse generator only; with existing single lead ,6593.22,6593.22,3673.0,98753.0,30 CDM,107017,REMOVE ICD GENERATOR,12779.21,12779.21,766.75,10862.33,20 CDM,107017,Removal of implantable defibrillator pulse generator only ,12779.21,12779.21,1529.55,24035.0,28 CDM,107018,REMOVE ICD LEAD EXTRACT,12779.21,12779.21,766.75,10862.33,24 CDM,107018,Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction ,12779.21,12779.21,2996.0,24035.0,18 CDM,107019,INS ICD LEAD/GENERATOR,216668.89,216668.89,13000.13,184168.56,20 CDM,107019,"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber ",216668.89,216668.89,3673.0,98753.0,30 CDM,107020,REM/REPLACE ICD GEN SGL,179438.58,179438.58,10766.31,152522.79,20 CDM,107020,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system ,179438.58,179438.58,2699.0,98753.0,29 CDM,107021,REM/REPLACE ICD GEN DUAL,174418.45,174418.45,10465.11,148255.68,20 CDM,107021,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system ,174418.45,174418.45,2699.0,98753.0,29 CDM,107022,REM/REPLACE ICD GEN MULT,174418.45,174418.45,10465.11,148255.68,20 CDM,107022,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system ,174418.45,174418.45,2699.0,98753.0,29 CDM,107023,EXCL LAA THRSCP ANY METH,138872.61,138872.61,18053.44,118041.72,21 CDM,107023,"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) ",138872.61,138872.61,948.0,13835.0,16 CDM,107024,INS/REPL SQ ICD W/ ELEC,127611.06,127611.06,7656.66,108469.4,20 CDM,107024,"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of ",127611.06,127611.06,2699.0,98753.0,29 CDM,107025,INS SQ ICD ELECTRODE,27103.57,27103.57,1626.21,23038.03,20 CDM,107025,Insertion of subcutaneous implantable defibrillator electrode ,27103.57,27103.57,2699.0,98753.0,30 CDM,107026,REM SQ ICD ELECTRODE,36039.4,36039.4,2162.36,30633.49,24 CDM,107026,Removal of subcutaneous implantable defibrillator electrode ,36039.4,36039.4,2699.0,98753.0,20 CDM,107027,REPOS PREV SQ ICD ELECTR,6498.73,6498.73,389.92,5523.92,20 CDM,107027,Repositioning of previously implanted subcutaneous implantable defibrillator electrode ,6498.73,6498.73,1529.55,8146.35,28 CDM,107028,INS/REPL LDLS PPM VENT,66779.56,66779.56,4006.77,56762.63,25 CDM,107028,"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and dev",66779.56,66779.56,2996.0,43516.12,16 CDM,107029,INS SQ CARD RHYTHM MONTR,45357.89,45357.89,2721.47,38554.21,21 CDM,107029,"Insertion, subcutaneous cardiac rhythm monitor, including programming ",45357.89,45357.89,1986.0,20862.25,27 CDM,107030,REM SQ CARD RHYTHM MONTR,15926.76,15926.76,955.61,13537.75,21 CDM,107030,"Removal, subcutaneous cardiac rhythm monitor ",15926.76,15926.76,276.42,5841.0,27 CDM,107031,IMP WRLS P-ART PRES SNSR,176106.8,176106.8,22893.88,149690.78,16 CDM,107031,"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective",176106.8,176106.8,948.0,77863.78,28 CDM,107032,CLOSURE LAA W/ IMPLANT,138872.61,138872.61,18053.44,118041.72,21 CDM,107032,"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appen",138872.61,138872.61,948.0,17009.0,28 CDM,107033,TAVR/TAVI PERC FEM APRCH,123061.64,123061.64,15998.01,104602.39,20 CDM,107033,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach ,123061.64,123061.64,948.0,16732.36,17 CDM,107034,TAVR/TAVI OPN FEM APRCH,116901.89,116901.89,15197.25,99366.61,20 CDM,107034,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach ,116901.89,116901.89,948.0,18266.69,17 CDM,107035,TAVR/TAVI OPEN ILI APRCH,123061.64,123061.64,15998.01,104602.39,20 CDM,107035,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach ,123061.64,123061.64,948.0,19555.0,17 CDM,107036,PERC CP BYPS SUP W/ TAVR,78401.52,78401.52,10192.2,66641.29,20 CDM,107036,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separa",78401.52,78401.52,948.0,16207.0,17 CDM,107037,OPEN CP BYPS SUP W/ TAVR,87025.69,87025.69,11313.34,73971.84,20 CDM,107037,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (Li",87025.69,87025.69,948.0,16207.0,17 CDM,107038,PLC/REM CEPD W/ TAVR,21756.43,21756.43,2828.34,18492.97,29 CDM,107038,"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutane",21756.43,21756.43,948.0,5841.0,20 CDM,107039,TMVR PERC INITIAL DEVICE,122226.67,122226.67,15889.47,103892.67,20 CDM,107039,"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis ",122226.67,122226.67,948.0,22203.94,17 CDM,107040,TMVR PERC ADDTL DEVICE,71298.34,71298.34,9268.78,60603.59,29 CDM,107040,"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (List separately in addition to code for primary ",71298.34,71298.34,948.0,5841.0,8 CDM,107041,TPVI PERC APRCH,92827.4,92827.4,12067.56,78903.29,20 CDM,107041,"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed ",92827.4,92827.4,948.0,17009.0,29 CDM,107042,EVAS RPR THOR AORTA,5976.81,5976.81,776.99,5080.29,20 CDM,107042,"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment o",5976.81,5976.81,948.0,22042.83,17 CDM,107043,EVAS RPR THR ARTA NO LSA,6428.93,6428.93,835.76,5464.59,20 CDM,107043,"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment o",6428.93,6428.93,948.0,18919.37,17 CDM,107044,INS LVAD PERC ARTERIAL,3282.41,3282.41,426.71,2790.05,20 CDM,107044,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only ",3282.41,3282.41,948.0,16207.0,17 CDM,107045,INS LVAD ART/VEN ACCESS,295544.98,295544.98,38420.85,251213.23,20 CDM,107045,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture ",295544.98,295544.98,948.0,16207.0,17 CDM,107046,REM LVAD PERC SEP SESS,4351.29,4351.29,565.67,3698.6,20 CDM,107046,"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion ",4351.29,4351.29,948.0,16207.0,17 CDM,107047,INS RVAD PERC VENOUS,3626.07,3626.07,471.39,3082.16,21 CDM,107047,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only ",3626.07,3626.07,948.0,13835.0,16 CDM,107048,REM RVAD PERC SEP SESS,11603.42,11603.42,1508.44,9862.91,21 CDM,107048,"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion ",11603.42,11603.42,948.0,13835.0,16 CDM,107049,ART THRMB FEMPOP/AOI-LEG,33580.42,33580.42,4365.45,28543.36,15 CDM,107049,"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision ",33580.42,33580.42,948.0,13835.0,18 CDM,107050,EVAS RPR A-BIILIAC NORUP,36712.82,36712.82,4772.67,31205.9,21 CDM,107050,"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), ",36712.82,36712.82,948.0,18813.41,28 CDM,107051,EVAS RPR ABD AORT ADDL,47088.0,47088.0,6121.44,40024.8,21 CDM,107051,"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneury",47088.0,47088.0,948.0,13835.0,28 CDM,107052,ACC/CLS FEM ART PERC ADD,24346.29,24346.29,3165.02,20694.35,29 CDM,107052,"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in ",24346.29,24346.29,948.0,5841.0,20 CDM,107053,CONDU OPEN AX/SC ART UNI,1306.69,1306.69,169.87,1110.69,29 CDM,107053,"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision",1306.69,1306.69,948.0,5841.0,20 CDM,107054,OPEN FEM ART EXPOSE UNI,39200.76,39200.76,5096.1,33320.65,20 CDM,107054,"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (List separately in addition to code for primary procedure) ",39200.76,39200.76,948.0,16207.0,17 CDM,107055,RPR UE BLDVSL DIRECT,17875.78,17875.78,2323.85,15194.41,15 CDM,107055,"Repair blood vessel, direct; upper extremity ",17875.78,17875.78,948.0,13835.0,30 CDM,107056,RPR LE BLDVSL DIRECT,4240.02,4240.02,551.2,3604.02,15 CDM,107056,"Repair blood vessel, direct; lower extremity ",4240.02,4240.02,714.92,13835.0,30 CDM,107057,RPR LE BLDVSL NON VN GFT,33580.42,33580.42,4365.45,28543.36,15 CDM,107057,Repair blood vessel with graft other than vein; lower extremity ,33580.42,33580.42,948.0,13835.0,30 CDM,107058,THRMBOENDART COMMON FEM,18293.69,18293.69,2378.18,15549.64,20 CDM,107058,"Thromboendarterectomy, including patch graft, if performed; common femoral ",18293.69,18293.69,948.0,16207.0,17 CDM,107059,EXPLORE POSTOP EXTREMITY,16962.17,16962.17,2205.08,14417.84,15 CDM,107059,"Exploration for postoperative hemorrhage, thrombosis or infection; extremity ",16962.17,16962.17,948.0,13835.0,30 CDM,107061,INJ VENOGRAM LT,821.91,821.91,106.85,698.62,29 CDM,107062,INJ VENOGRAM RT,821.91,821.91,106.85,698.62,29 CDM,107063,INJ VENOGRAM BI,1232.87,1232.87,160.27,1047.94,29 CDM,107064,CATH IVC/SVC,2434.36,2434.36,316.47,2069.21,29 CDM,107065,CATH IVC/SVC BI,3651.54,3651.54,474.7,3103.81,29 CDM,107067,CATH 1ST ORDER VEN BI,1822.85,1822.85,236.97,1549.42,29 CDM,107069,CATH 2ND ORDER VEN BI,2061.96,2061.96,268.05,1752.67,29 CDM,107070,CATH RT HRT/PULM ART,2580.6,2580.6,154.84,2193.51,31 CDM,107070,"Introduction of catheter, right heart or main pulmonary artery ",2580.6,2580.6,1672.0,5841.0,15 CDM,107071,CATH PULM ART UNI RT,2888.03,2888.03,173.28,2454.83,31 CDM,107072,CATH PULM ART UNI LT,2888.03,2888.03,173.28,2454.83,31 CDM,107073,CATH PULM ART UNI BI,4332.04,4332.04,259.92,3682.23,31 CDM,107074,CATH PLM ART SEG/SUB RT,3373.81,3373.81,202.43,2867.74,31 CDM,107075,CATH PLM ART SEG/SUB LT,3373.81,3373.81,202.43,2867.74,31 CDM,107076,CATH PLM ART SEG/SUB BI,5060.72,5060.72,303.64,4301.61,31 CDM,107077,NDL/INCATH EXT ART,1903.85,1903.85,247.5,1618.27,29 CDM,107078,NDL/INCATH EXT ART 59,1903.85,1903.85,247.5,1618.27,29 CDM,107079,CATH AORTA,5975.7,5975.7,358.54,5079.35,31 CDM,107079,"Introduction of catheter, aorta ",5975.7,5975.7,1672.0,5841.0,15 CDM,107084,NSP THOR AORT W/ ANGIO,14172.39,14172.39,1842.41,12046.53,15 CDM,107084,"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervi",14172.39,14172.39,948.0,13835.0,30 CDM,107086,SP EX CAROTID ANGIO BI,25221.51,25221.51,3278.8,21438.28,15 CDM,107088,SP COM CAROTIDANGIO BI,21258.58,21258.58,2763.62,18069.79,15 CDM,107090,SP INT CAROTID ANGIO BI,30251.69,30251.69,3932.72,25713.94,15 CDM,107092,SP SUBCL ANGIO BI,21258.58,21258.58,2763.62,18069.79,15 CDM,107094,SP VERT ANGIO BI,38267.79,38267.79,4974.81,32527.62,15 CDM,107098,CATH 1ST OD LOW ART BI,8800.9,8800.9,1144.12,7480.77,29 CDM,107100,CATH 2ND OD LOW ART BI,12542.29,12542.29,1630.5,10660.95,29 CDM,107102,CATH 3RD OD LOW ART BI,8796.65,8796.65,1143.56,7477.15,29 CDM,107104,CATH 1ST OD RENAL RT,10816.79,10816.79,1406.18,9194.27,15 CDM,107105,CATH 1ST OD RENAL LT,10816.79,10816.79,1406.18,9194.27,15 CDM,107106,CATH 1ST OD RENAL BIL,10816.79,10816.79,1406.18,9194.27,15 CDM,107106,"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast inje",10816.79,10816.79,948.0,13835.0,30 CDM,107107,CATH 1 OR M 2ND OD RNLRT,10816.79,10816.79,1406.18,9194.27,15 CDM,107108,CATH 1 OR M 2ND OD RNLLT,10816.79,10816.79,1406.18,9194.27,15 CDM,107109,CATH 1 OR M 2ND OD RNLBI,10816.79,10816.79,1406.18,9194.27,15 CDM,107109,"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheter",10816.79,10816.79,948.0,13835.0,30 CDM,107110,INJ SCLEROSANT SNGL VEIN,326.88,326.88,45.76,277.85,11 CDM,107110,Injection of sclerosant; single incompetent vein (other than telangiectasia) ,326.88,326.88,74.13,5841.0,41 CDM,107111,INS CVC NON-TUN CENT=>5Y,7500.42,7500.42,1050.06,6375.36,10 CDM,107111,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older ,7500.42,7500.42,948.0,11153.0,44 CDM,107113,INS TUN CVC CENT WO=>5Y,12736.33,12736.33,1783.09,10825.88,10 CDM,107113,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older ",12736.33,12736.33,948.0,11153.0,44 CDM,107114,INS CVAD W PORT CENT=>5Y,24804.93,24804.93,3472.69,21084.19,10 CDM,107114,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older ",24804.93,24804.93,948.0,12562.0,44 CDM,107115,INS PICC WO PORT/IMG=>5Y,7657.21,7657.21,1072.01,6508.63,10 CDM,107115,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older ",7657.21,7657.21,468.58,11153.0,44 CDM,107116,RPR CVAD W/ P-P,3155.66,3155.66,441.79,2682.31,10 CDM,107116,"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",3155.66,3155.66,468.58,11153.0,44 CDM,107117,REPL NON-TUN CVC W/O P-P,3155.66,3155.66,441.79,2682.31,10 CDM,107117,"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",3155.66,3155.66,635.9,11153.0,44 CDM,107118,REPL TUN CV CATH W/O P-P,11587.74,11587.74,1622.28,9849.58,10 CDM,107118,"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",11587.74,11587.74,948.0,11153.0,44 CDM,107119,REM TUN CV CATH WO/P-P,10816.79,10816.79,1514.35,9194.27,10 CDM,107119,"Removal of tunneled central venous catheter, without subcutaneous port or pump ",10816.79,10816.79,234.94,11153.0,44 CDM,107120,REM TUN CVAD W/P-P,5616.16,5616.16,786.26,4773.74,10 CDM,107120,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion ",5616.16,5616.16,468.58,11153.0,44 CDM,107121,REPO PREV PLCD CVC FLURO,3486.25,3486.25,488.07,2963.31,10 CDM,107121,Repositioning of previously placed central venous catheter under fluoroscopic guidance ,3486.25,3486.25,468.58,11153.0,44 CDM,107122,DIALYSIS CIRC DX ANGIO,2728.37,2728.37,381.97,2319.11,11 CDM,107122,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",2728.37,2728.37,468.58,8211.95,41 CDM,107123,DIALYSIS CIRC BLN ANGIOP,15377.15,15377.15,2152.8,13070.58,11 CDM,107123,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",15377.15,15377.15,1853.13,13835.0,46 CDM,107124,DIALYSIS CIRC INTRV STNT,29707.65,29707.65,4159.07,25251.5,11 CDM,107124,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",29707.65,29707.65,948.0,27050.15,41 CDM,107125,DIALYSIS CIRC THRMB,15377.15,15377.15,2152.8,13070.58,11 CDM,107125,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",15377.15,15377.15,948.0,13835.0,43 CDM,107126,DIALYSIS CIRC THRMB/BLN,29707.65,29707.65,4159.07,25251.5,11 CDM,107126,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",29707.65,29707.65,3673.0,27050.15,48 CDM,107127,DIALYSIS CIRC THRMB/STNT,97747.1,97747.1,13684.59,83085.04,11 CDM,107127,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",97747.1,97747.1,948.0,43516.12,42 CDM,107128,DIAL SEG CTRL BLN ANGIOP,31013.03,31013.03,4031.69,26361.08,29 CDM,107128,"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplast",31013.03,31013.03,1672.0,7818.0,25 CDM,107129,DIAL SEG CTRL INTRV STNT,31013.03,31013.03,4031.69,26361.08,29 CDM,107129,"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perfo",31013.03,31013.03,948.0,5841.0,20 CDM,107130,DIALYSIS CIRCUIT EMBOLJ,43510.23,43510.23,5656.33,36983.7,29 CDM,107130,"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation neces",43510.23,43510.23,948.0,5841.0,20 CDM,107131,INS TRNVEN INTRHEP SHUNT,37351.79,37351.79,4855.73,31749.02,20 CDM,107131,"Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract format",37351.79,37351.79,948.0,16207.0,29 CDM,107132,REV TRNVEN INTRHEP SHUNT,18679.16,18679.16,2428.29,15877.29,15 CDM,107132,"Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannu",18679.16,18679.16,948.0,13835.0,30 CDM,107134,ART THRMB NCOR IN VSL BI,16760.28,16760.28,2346.44,14246.24,10 CDM,107135,ART THRMB NONCOR SUB VSL,4095.18,4095.18,532.37,3480.9,29 CDM,107135,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",4095.18,4095.18,948.0,5841.0,20 CDM,107136,SEC ART THRMB NONCOR,6145.37,6145.37,798.9,5223.56,29 CDM,107136,"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic ",6145.37,6145.37,948.0,5841.0,20 CDM,107138,VENOUS MECH THROMBECT BI,15764.6,15764.6,2207.04,13399.91,10 CDM,107139,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during cours",7508.26,7508.26,948.0,15059.0,42 CDM,107139,VEN THRMB REPEAT SUB DAY,7508.26,7508.26,1051.16,6382.02,10 CDM,107140,INSRT IVC FILTER W IMAG,24333.22,24333.22,3163.32,20683.24,15 CDM,107140,"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imagin",24333.22,24333.22,948.0,13835.0,30 CDM,107141,REPOS IVC FILTER W IMG,24333.22,24333.22,3163.32,20683.24,15 CDM,107141,"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and im",24333.22,24333.22,948.0,13835.0,30 CDM,107142,REMOVAL IVCF ENDO APRCH,24333.22,24333.22,3163.32,20683.24,15 CDM,107142,"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, ",24333.22,24333.22,948.0,13835.0,30 CDM,107143,TRANSCATH RTRV FB S&I,15876.31,15876.31,2222.68,13494.86,10 CDM,107143,"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound",15876.31,15876.31,948.0,15059.0,42 CDM,107145,TRNSCTH TX ART INI DY BI,7793.11,7793.11,1091.04,6624.14,10 CDM,107147,TRNSCTH TX VN INI DAY BI,6834.65,6834.65,956.85,5809.45,10 CDM,107148,TRNSCTH TX ART/VEN SUB,3211.84,3211.84,417.54,2730.06,15 CDM,107148,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",3211.84,3211.84,2012.0,15059.0,32 CDM,107149,TRNSCTH TX ART/VEN FINAL,1767.95,1767.95,229.83,1502.76,15 CDM,107149,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",1767.95,1767.95,2012.0,15059.0,32 CDM,107186,VASC EMBOLIZ VENOUS,56971.77,56971.77,7976.05,48426.0,10 CDM,107186,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, othe",56971.77,56971.77,2369.0,59899.7,44 CDM,107187,VASC EMBOLIZ ARTERIAL,66956.21,66956.21,9373.87,56912.78,10 CDM,107187,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, ot",66956.21,66956.21,2369.0,27050.15,44 CDM,107188,VASC EMBOL TUM/ORG/INF,131851.76,131851.76,18459.25,112074.0,10 CDM,107188,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, ",131851.76,131851.76,2369.0,27050.15,44 CDM,107189,VASC EMBOL ART VEN HEM,56971.77,56971.77,7406.33,48426.0,15 CDM,107189,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial",56971.77,56971.77,2369.0,27050.15,32 CDM,107190,TRANS ANGIO SAME ART INT,20640.51,20640.51,2889.67,17544.43,11 CDM,107190,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",20640.51,20640.51,2369.0,13835.0,51 CDM,107191,TRANS ANGIO SAME ART EAD,24875.5,24875.5,3233.82,21144.17,29 CDM,107191,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",24875.5,24875.5,1672.0,7818.0,30 CDM,107194,INTVSC US NONCORN INIT,939.51,939.51,122.14,798.58,29 CDM,107194,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List sepa",939.51,939.51,1672.0,5841.0,20 CDM,107195,INTVSC US NONCORN EADD,939.51,939.51,122.14,798.58,29 CDM,107195,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (L",939.51,939.51,1672.0,5841.0,20 CDM,107196,UL PROC VASC SURG,3603.85,3603.85,468.5,3063.27,15 CDM,107196,"Unlisted procedure, vascular surgery ",3603.85,3603.85,633.31,13835.0,30 CDM,107197,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) ",695.16,695.16,117.96,5841.0,41 CDM,107197,PLACE NG/OG TUBE FLUORO,695.16,695.16,97.32,590.89,11 CDM,107198,BX LIVER,3794.63,3794.63,531.25,3225.44,10 CDM,107198,"Biopsy of liver, needle; percutaneous ",3794.63,3794.63,510.77,3747.2,42 CDM,107199,CHLECYSTOSTMY PERC,2720.53,2720.53,353.67,2312.45,15 CDM,107199,"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation ",2720.53,2720.53,948.0,13835.0,18 CDM,107200,INJ CHOLANGIO EXST ACCES,12001.96,12001.96,1560.25,10201.67,16 CDM,107200,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",12001.96,12001.96,948.0,8488.5,29 CDM,107201,INJ CHOLANGIO NEW ACCES,802.31,802.31,104.3,681.96,15 CDM,107201,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",802.31,802.31,948.0,15059.0,30 CDM,107202,PLCMT BILIARY CATH,14001.21,14001.21,1960.17,11901.03,10 CDM,107202,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",14001.21,14001.21,948.0,15059.0,42 CDM,107203,PLC BILIARY CATH INT/EXT,14001.21,14001.21,1960.17,11901.03,10 CDM,107203,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",14001.21,14001.21,948.0,15059.0,42 CDM,107204,REMOVE BILIARY CATH,2199.16,2199.16,307.88,1869.29,10 CDM,107204,"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidan",2199.16,2199.16,351.7,3128.0,42 CDM,107205,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,17380.31,17380.31,351.7,3249.0,42 CDM,107205,PARACENTESIS W IMAGE,17380.31,17380.31,2433.24,14773.26,10 CDM,107206,IMG GD FLD COLL VISCERAL,7955.14,7955.14,1034.17,6761.87,15 CDM,107206,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",7955.14,7955.14,948.0,15059.0,30 CDM,107207,IMG GD FLD COLL PERI/RET,7955.14,7955.14,1113.72,6761.87,10 CDM,107207,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",7955.14,7955.14,510.77,15059.0,42 CDM,107208,IMG GD FLD COL PER TV/TR,6696.8,6696.8,937.55,5692.28,10 CDM,107208,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",6696.8,6696.8,510.77,12562.0,42 CDM,107209,INS DIAL TUN IP CATH OPN,21374.09,21374.09,2992.37,18167.98,10 CDM,107209,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",21374.09,21374.09,948.0,8488.5,42 CDM,107210,EXCHG CATH ABS/CYS,20434.05,20434.05,2860.77,17368.94,10 CDM,107210,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,20434.05,20434.05,593.22,13835.0,42 CDM,107211,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,11587.74,11587.74,948.0,5841.0,20 CDM,107211,INJ CATH ABS/CYST,11587.74,11587.74,1506.41,9849.58,29 CDM,107212,INS GASTRO TUBE PERC,11587.74,11587.74,1622.28,9849.58,10 CDM,107212,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,593.22,4251.7,42 CDM,107213,INS DUO/JEJSTMT TUBE,11587.74,11587.74,1622.28,9849.58,10 CDM,107213,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,593.22,4251.7,42 CDM,107214,INS CEC/OTHR COL TUBE,9014.87,9014.87,1262.08,7662.64,10 CDM,107214,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",9014.87,9014.87,450.72,13394.0,42 CDM,107215,CVRT GASTR TO GSJEJ TUBE,4332.99,4332.99,606.62,3683.04,10 CDM,107215,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",4332.99,4332.99,593.22,4251.7,42 CDM,107216,RPLC GAST OR CECO TUBE,11587.74,11587.74,1622.28,9849.58,10 CDM,107216,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,351.7,3128.0,42 CDM,107217,RPLC GASTROJEJNSTY TUBE,11587.74,11587.74,1622.28,9849.58,10 CDM,107217,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,351.7,3128.0,42 CDM,107218,CONT INJ GS/ DU/ JJ/ GJ/,615.45,615.45,80.01,523.13,16 CDM,107218,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",615.45,615.45,240.89,5841.0,29 CDM,107219,REPLACE NEPHRO CATH W FL,21968.11,21968.11,3075.54,18672.89,10 CDM,107219,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",21968.11,21968.11,685.44,4836.33,42 CDM,107220,REM NEPHROS TUBE W FL,782.71,782.71,109.58,665.3,10 CDM,107220,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",782.71,782.71,250.06,3128.0,42 CDM,107225,PLCMT NEPH CATH BI,13361.59,13361.59,1870.62,11357.35,10 CDM,107229,NEPH CATH EXCHANGE BI,13079.33,13079.33,1831.11,11117.43,10 CDM,107231,CHG URETEROSTMY TB,2200.47,2200.47,308.07,1870.4,10 CDM,107231,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,2200.47,2200.47,685.44,4836.33,42 CDM,107235,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",64546.66,64546.66,948.0,27050.15,30 CDM,107235,OCCLUDE ART BLN HD/NCK,64546.66,64546.66,8391.07,54864.66,15 CDM,107236,EMBLZ INTRACRAN/SP,101444.19,101444.19,13187.74,86227.56,20 CDM,107236,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",101444.19,101444.19,948.0,16207.0,29 CDM,107237,EMBOLIZE EXTRACRAN,96566.33,96566.33,12553.62,82081.38,15 CDM,107237,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",96566.33,96566.33,948.0,27050.15,30 CDM,107238,INTRCRN STNT W ANGIOP,38698.99,38698.99,5030.87,32894.14,20 CDM,107238,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",38698.99,38698.99,948.0,18059.01,17 CDM,107239,INTRCRN ART THROMBECTOMY,5793.88,5793.88,753.2,4924.8,20 CDM,107239,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",5793.88,5793.88,948.0,16207.0,29 CDM,107240,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",5195.4,5195.4,948.0,16207.0,19 CDM,107240,INTRCRN ENDOV RX ADM INI,5195.4,5195.4,675.4,4416.09,20 CDM,107241,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",3211.84,3211.84,948.0,16207.0,19 CDM,107241,INTRCRN ENDOV RX ADM ADD,3211.84,3211.84,417.54,2730.06,20 CDM,107242,PUNCTURE LUMBAR DX,2758.43,2758.43,386.18,2344.67,10 CDM,107242,"Spinal puncture, lumbar, diagnostic; ",2758.43,2758.43,276.0,3128.0,42 CDM,107243,INJ BLOOD PATCH,1498.78,1498.78,209.83,1273.96,10 CDM,107243,"Injection, epidural, of blood or clot patch ",1498.78,1498.78,276.0,3128.0,42 CDM,107244,DECMPRS DISC LUMB W/ NDL,4952.36,4952.36,693.33,4209.51,10 CDM,107244,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",4952.36,4952.36,692.94,15059.0,42 CDM,107245,INJ EPI C/T W IMAGING,2260.58,2260.58,316.48,1921.49,11 CDM,107245,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",2260.58,2260.58,276.0,5841.0,41 CDM,107246,INJ EPI L/S W IMAGING,3648.28,3648.28,510.76,3101.04,11 CDM,107246,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",3648.28,3648.28,276.0,5841.0,41 CDM,107247,SP AORTOGM ABD W/FILM 59,12082.9,12082.9,724.97,10270.47,17 CDM,107248,SP AORTOGM ABD W/RNF 59,12082.9,12082.9,724.97,10270.47,17 CDM,107249,SP ANGIO EXT UNI LT 59,7459.21,7459.21,447.55,6340.33,17 CDM,107250,SP ANGIO EXT BI 59,11142.84,11142.84,668.57,9471.41,17 CDM,107251,SP ANGIO PULM SEL BI 59,12492.9,12492.9,749.57,10618.97,17 CDM,107253,SP VENOGRAM EXT BI 59,7302.11,7302.11,438.13,6206.79,17 CDM,107254,PTCA SINGLE VESSEL RI,28874.99,28874.99,3753.75,24543.74,15 CDM,107255,PTCA SINGLE VESSEL RC,28874.99,28874.99,3753.75,24543.74,15 CDM,107256,PTCA SINGLE VESSEL LM,28874.99,28874.99,3753.75,24543.74,15 CDM,107257,PTCA SINGLE VESSEL LD,28874.99,28874.99,3753.75,24543.74,15 CDM,107258,PTCA SINGLE VESSEL LC,28874.99,28874.99,3753.75,24543.74,15 CDM,107262,COR ATH SGL ART LC,48088.31,48088.31,6251.48,40875.06,15 CDM,107263,COR ATH SGL ART RI,48978.83,48978.83,6367.25,41632.01,15 CDM,107290,COR ATH SGL ART LM,48978.83,48978.83,6367.25,41632.01,15 CDM,107291,COR ATH SGL ART RC,48978.83,48978.83,6367.25,41632.01,15 CDM,107292,COR ATH SGL ART LD,48978.83,48978.83,6367.25,41632.01,15 CDM,107296,PTCA STNT W ANG SGL RI,49008.38,49008.38,6371.09,41657.12,15 CDM,107297,PTCA STNT W ANG SGL LM,49008.38,49008.38,6371.09,41657.12,15 CDM,107298,PTCA STNT W ANG SGL LC,49008.38,49008.38,6371.09,41657.12,15 CDM,107299,PTCA STNT W ANG SGL RC,49008.38,49008.38,6371.09,41657.12,15 CDM,1073,COIL EMBL 6MM 7CM,3225.0,3225.0,419.25,2741.25,28 CDM,107300,PTCA STNT W ANG SGL LD,49008.38,49008.38,6371.09,41657.12,15 CDM,107311,PTCA STN W ATH SGL RI,39184.95,39184.95,5094.04,33307.21,15 CDM,107312,PTCA STN W ATH SGL LM,39184.95,39184.95,5094.04,33307.21,15 CDM,107313,PTCA STN W ATH SGL RC,39184.95,39184.95,5094.04,33307.21,15 CDM,107314,PTCA STN W ATH SGL LD,39184.95,39184.95,5094.04,33307.21,15 CDM,107315,PTCA STN W ATH SGL LC,39184.95,39184.95,5094.04,33307.21,15 CDM,107319,RVS GFT ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,15 CDM,107320,RVS GFT ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,15 CDM,107321,RVS GFT ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,15 CDM,107322,RVS GFT ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,15 CDM,107323,RVS GFT ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,15 CDM,107327,RVS AMI ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,20 CDM,107328,RVS AMI ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,20 CDM,107329,RVS AMI ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,20 CDM,107330,RVS AMI ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,20 CDM,107331,RVS AMI ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,20 CDM,107332,RVS TCO ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,15 CDM,107333,RVS TCO ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,15 CDM,107334,RVS TCO ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,15 CDM,107335,RVS TCO ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,15 CDM,107336,RVS TCO ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,15 CDM,107340,CPR,2664.71,2664.71,159.88,2265.0,26 CDM,107340,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",2664.71,2664.71,690.96,2358.0,3 CDM,107342,PERC TRANS CORON THROM,10262.63,10262.63,1334.14,8723.24,25 CDM,107342,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,10262.63,10262.63,11153.0,43890.0,7 CDM,107342,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) with Cardiac Cath,10262.63,10262.63,7818.0,7818.0,5 CDM,107342,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) without Cardiac Cath,10262.63,10262.63,5591.0,5591.0,5 CDM,107345,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,12100.0,12100.0,235.29,43890.0,19 CDM,107345,IVUS INITIAL VESSEL,12100.0,12100.0,1573.0,10285.0,20 CDM,107346,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,370.7,370.7,187.22,43890.0,19 CDM,107346,IVUS EA ADDL VESSEL,370.7,370.7,48.19,315.1,20 CDM,107347,PB VALVUPLSTY AORTIC VAL,27697.41,27697.41,3600.66,23542.8,15 CDM,107347,Percutaneous balloon valvuloplasty; aortic valve ,27697.41,27697.41,3673.0,43890.0,26 CDM,107347,Percutaneous balloon valvuloplasty; aortic valve with Cardiac Cath,27697.41,27697.41,7818.0,7818.0,5 CDM,107347,Percutaneous balloon valvuloplasty; aortic valve without Cardiac Cath,27697.41,27697.41,5591.0,5591.0,5 CDM,107348,PB VALVUPLSTY MITRAL VAL,57241.58,57241.58,7441.41,48655.34,15 CDM,107348,Percutaneous balloon valvuloplasty; mitral valve ,57241.58,57241.58,3673.0,43890.0,26 CDM,107348,Percutaneous balloon valvuloplasty; mitral valve with Cardiac Cath,57241.58,57241.58,7818.0,7818.0,5 CDM,107348,Percutaneous balloon valvuloplasty; mitral valve without Cardiac Cath,57241.58,57241.58,5591.0,5591.0,5 CDM,107349,PB VALVUPLSTY PULMON VAL,57241.58,57241.58,7441.41,48655.34,15 CDM,107349,Percutaneous balloon valvuloplasty; pulmonary valve ,57241.58,57241.58,3673.0,43890.0,26 CDM,107349,Percutaneous balloon valvuloplasty; pulmonary valve with Cardiac Cath,57241.58,57241.58,7818.0,7818.0,5 CDM,107349,Percutaneous balloon valvuloplasty; pulmonary valve without Cardiac Cath,57241.58,57241.58,5591.0,5591.0,5 CDM,107351,CATH HRT RT W SAT/CO,16964.7,16964.7,2205.41,14420.0,15 CDM,107352,CATH HRT RT W SAT/CO 59,16964.7,16964.7,2205.41,14420.0,15 CDM,107353,CATH HRT LT/INJ L VENT,42697.15,42697.15,5550.63,36292.58,15 CDM,107354,CATH HRT LT/INJ L VENT59,42697.15,42697.15,5550.63,36292.58,15 CDM,107355,CATH HRT R&L/INJ L VENT,59549.03,59549.03,7741.37,50616.68,15 CDM,107356,CATH HRT R&L/INJ LVNT59,59549.03,59549.03,7741.37,50616.68,15 CDM,107357,CATH PLC/INJ CORONRY ART,28681.91,28681.91,3728.65,24379.62,15 CDM,107358,CATH PLC/INJ CRNRY ART59,28681.91,28681.91,3728.65,24379.62,15 CDM,107359,CATH PLC/INJ BYPAS GRFTS,41797.27,41797.27,5433.65,35527.68,15 CDM,107360,CATH PLC/INJ BYPS GRFT59,41797.27,41797.27,5433.65,35527.68,15 CDM,107361,CTH PLC/INJ CR ART W RHC,45642.56,45642.56,5933.53,38796.18,15 CDM,107362,CTH PLC/INJ CR ART RHC59,45642.56,45642.56,5933.53,38796.18,15 CDM,107363,CTH PLC/INJ GRAFT W RHC,58765.99,58765.99,7639.58,49951.09,15 CDM,107364,CTH PLC/INJ GRFT W RHC59,58765.99,58765.99,7639.58,49951.09,15 CDM,107365,CTH PLC/INJ LHC & L VENT,65833.39,65833.39,8558.34,55958.38,15 CDM,107366,CTH PLC/INJ LHC&L VENT59,65833.39,65833.39,8558.34,55958.38,15 CDM,107367,CTH PLC/INJ LHC W GRAFT,78946.08,78946.08,10262.99,67104.17,15 CDM,107368,CTH PLC/INJ LHC W GRFT59,78946.08,78946.08,10262.99,67104.17,15 CDM,107369,CTH PLC/INJ R&LHC/L VENT,88229.58,88229.58,11469.85,74995.14,15 CDM,107370,CTH PLC/INJ R&LHC/LVNT59,88229.58,88229.58,11469.85,74995.14,15 CDM,107371,CTH PLC/INJ R&LHC/GRAFTS,104948.49,104948.49,13643.3,89206.22,15 CDM,107372,CTH PLC/INJ R&LHC/GRFT59,104948.49,104948.49,13643.3,89206.22,15 CDM,107373,LHC TRANS SEPTAL/APICAL,66333.03,66333.03,8623.29,56383.08,25 CDM,107373,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,66333.03,66333.03,2795.0,17384.0,23 CDM,107373,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) with Cardiac Cath,66333.03,66333.03,7818.0,7818.0,5 CDM,107374,PHARMACY AGENT ADMIN,2115.39,2115.39,126.92,1798.08,44 CDM,107374,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",2115.39,2115.39,237.81,328.26,5 CDM,107375,PHYSIO EXERCISE STUDY,8783.87,8783.87,527.03,7466.29,44 CDM,107375,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",8783.87,8783.87,382.87,528.49,5 CDM,107376,INSERTION FLO DR CATH,4684.74,4684.74,609.02,3982.03,26 CDM,107376,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",4684.74,4684.74,2434.0,17009.0,18 CDM,107376,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath",4684.74,4684.74,7818.0,7818.0,5 CDM,107377,BIOPSY ENDOMYOCARDIAL,15637.71,15637.71,2032.9,13292.05,15 CDM,107377,Endomyocardial biopsy ,15637.71,15637.71,2795.0,17384.0,26 CDM,107377,Endomyocardial biopsy with Cardiac Cath,15637.71,15637.71,7818.0,7818.0,5 CDM,107378,INJ SELECT CA CONGENITAL,28814.86,28814.86,1728.89,24492.63,30 CDM,107378,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",28814.86,28814.86,2358.0,17384.0,4 CDM,107379,INJ SELECT GRFT CONGENTL,7204.38,7204.38,432.26,6123.72,30 CDM,107379,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",7204.38,7204.38,2358.0,17384.0,4 CDM,107380,INJ SELECT LT VENT/ATRIA,8282.9,8282.9,496.97,7040.47,30 CDM,107380,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",8282.9,8282.9,2358.0,17384.0,4 CDM,107381,INJ SELECT RT VENT/ATRIA,8282.9,8282.9,496.97,7040.47,30 CDM,107381,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",8282.9,8282.9,2358.0,17384.0,4 CDM,107382,INJ SUPRAVALV AORTOGRM,9001.45,9001.45,540.09,7651.23,30 CDM,107382,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",9001.45,9001.45,2358.0,17384.0,4 CDM,107383,INJ PULM ANG NON SEL,8282.9,8282.9,496.97,7040.47,30 CDM,107383,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",8282.9,8282.9,2358.0,17384.0,4 CDM,107385,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",12605.0,12605.0,1672.0,2358.0,2 CDM,107385,VELOCITY BLD FLOW INT,12605.0,12605.0,756.3,10714.25,32 CDM,107386,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",7204.38,7204.38,1672.0,2358.0,2 CDM,107386,VELOCITY BLD FLOW EA ADD,7204.38,7204.38,432.26,6123.72,32 CDM,107387,INJ CATH SEL PUL ANG BI,10744.8,10744.8,644.69,9133.08,33 CDM,107387,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",10744.8,10744.8,1672.0,1672.0,1 CDM,107388,INJ CATH PUL VEN EACH VN,10744.8,10744.8,644.69,9133.08,33 CDM,107388,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",10744.8,10744.8,1672.0,1672.0,1 CDM,107389,INJ CATH PUL VEN EACH VS,13431.0,13431.0,805.86,11416.35,33 CDM,107389,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",13431.0,13431.0,1672.0,1672.0,1 CDM,107390,PER CL CON INT COM W/IMP,99081.83,99081.83,5944.91,84219.56,24 CDM,107390,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",99081.83,99081.83,3982.0,43890.0,22 CDM,107391,PER CL CON VT SP DF W/IM,99081.83,99081.83,5944.91,84219.56,24 CDM,107391,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,99081.83,99081.83,3982.0,43890.0,22 CDM,107392,PERC TRANS CLOS PDA,115356.18,115356.18,6921.37,98052.75,20 CDM,107392,Percutaneous transcatheter closure of patent ductus arteriosus ,115356.18,115356.18,3982.0,61050.09,24 CDM,107393,ABLATION SEPTAL REDUCTN,61469.41,61469.41,3688.16,52249.0,26 CDM,107393,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",61469.41,61469.41,1723.56,43890.0,23 CDM,107394,PER CLOS PARA LEAK MIT,90901.01,90901.01,5454.06,77265.86,16 CDM,107394,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",90901.01,90901.01,801.09,61050.09,33 CDM,107395,PER CLOS PARA LEAK AOR,90901.01,90901.01,5454.06,77265.86,16 CDM,107395,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",90901.01,90901.01,661.87,61050.09,33 CDM,107396,PER CLOS PARA LEAK EA A,45450.5,45450.5,2727.03,38632.93,33 CDM,107396,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,45450.5,45450.5,1672.0,36462.0,16 CDM,107397,RT CATH CHD NORMAL NAT,30348.69,30348.69,1820.92,25796.39,22 CDM,107397,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,30348.69,30348.69,3673.0,13036.0,24 CDM,107398,RT CATH CHD ABNORMAL NA,30348.69,30348.69,1820.92,25796.39,22 CDM,107398,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,30348.69,30348.69,3673.0,13036.0,24 CDM,107399,LT CATH CHD NOR ABN,30348.69,30348.69,1820.92,25796.39,22 CDM,107399,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",30348.69,30348.69,3673.0,13036.0,22 CDM,107400,RT LT CATH ANOM NNC,30348.69,30348.69,1820.92,25796.39,22 CDM,107400,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,30348.69,30348.69,3673.0,13036.0,24 CDM,107401,RT LT CATH ANOM ANC,30348.69,30348.69,1820.92,25796.39,22 CDM,107401,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,30348.69,30348.69,3673.0,13036.0,24 CDM,107402,CAR OUTPUT THER CHD,585.6,585.6,35.14,497.76,32 CDM,107402,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",585.6,585.6,1672.0,10843.0,2 CDM,107411,PERC DRUG EL COR STNT RI,39184.95,39184.95,5094.04,33307.21,15 CDM,107412,PERC DRUG EL COR STNT RC,39184.95,39184.95,5094.04,33307.21,15 CDM,107413,PERC DRUG EL COR STNT LM,39184.95,39184.95,5094.04,33307.21,15 CDM,107414,PERC DRUG EL COR STNT LD,39184.95,39184.95,5094.04,33307.21,15 CDM,107415,PERC DRUG EL COR STNT LC,39184.95,39184.95,5094.04,33307.21,15 CDM,107416,PERC D-EL COR STN AD LC,36416.81,36416.81,4734.19,30954.29,25 CDM,107417,PERC D-EL COR STN AD RC,36416.81,36416.81,4734.19,30954.29,25 CDM,107418,PERC D-EL COR STN AD LD,36416.81,36416.81,4734.19,30954.29,25 CDM,107419,PRC D-EL COR STNT ATH RI,120046.28,120046.28,15606.02,102039.34,15 CDM,107420,PRC D-EL COR STNT ATH RC,120046.28,120046.28,15606.02,102039.34,15 CDM,107421,PRC D-EL COR STNT ATH LM,120046.28,120046.28,15606.02,102039.34,15 CDM,107422,PRC D-EL COR STNT ATH LC,120046.28,120046.28,15606.02,102039.34,15 CDM,107423,PRC D-EL COR STNT ATH LD,120046.28,120046.28,15606.02,102039.34,15 CDM,107424,P D-EL COR STN ATH AD RC,43308.5,43308.5,5630.1,36812.22,25 CDM,107425,P D-EL COR STN ATH AD LD,43308.5,43308.5,5630.1,36812.22,25 CDM,107426,P D-EL COR STN ATH AD LC,43308.5,43308.5,5630.1,36812.22,25 CDM,107427,PRC D-EL COR RVSC CABGRI,37087.02,37087.02,4821.31,31523.97,15 CDM,107428,PRC D-EL COR RVSC CABGRC,37087.02,37087.02,4821.31,31523.97,15 CDM,107429,PRC D-EL COR RVSC CABGLM,37087.02,37087.02,4821.31,31523.97,15 CDM,107430,PRC D-EL COR RVSC CABGLC,37087.02,37087.02,4821.31,31523.97,15 CDM,107431,PRC D-EL COR RVSC CABGLD,37087.02,37087.02,4821.31,31523.97,15 CDM,107432,P D-EL COR RVS CABG A RC,43705.82,43705.82,5681.76,37149.95,25 CDM,107433,P D-EL COR RVS CABG A LD,43705.82,43705.82,5681.76,37149.95,25 CDM,107434,P D-EL COR RVS CABG A LC,43705.82,43705.82,5681.76,37149.95,25 CDM,107435,PRC D-E COR REVSC AMI LD,39184.95,39184.95,5094.04,33307.21,24 CDM,107436,PRC D-E COR REVSC AMI LM,39184.95,39184.95,5094.04,33307.21,24 CDM,107437,PRC D-E COR REVSC AMI LC,39184.95,39184.95,5094.04,33307.21,24 CDM,107438,PRC D-E COR REVSC AMI RI,39184.95,39184.95,5094.04,33307.21,24 CDM,107439,PRC D-E COR REVSC AMI RC,39184.95,39184.95,5094.04,33307.21,24 CDM,107440,PRC D-E COR REVSC CHRNRI,42917.41,42917.41,5579.26,36479.8,15 CDM,107441,PRC D-E COR REVSC CHRNRC,42917.41,42917.41,5579.26,36479.8,15 CDM,107442,PRC D-E COR REVSC CHRNLM,42917.41,42917.41,5579.26,36479.8,15 CDM,107443,PRC D-E COR REVSC CHRNLD,42917.41,42917.41,5579.26,36479.8,15 CDM,107444,PRC D-E COR REVSC CHRNLC,42917.41,42917.41,5579.26,36479.8,15 CDM,107445,PRC D-E COR REVSC COT LD,43705.82,43705.82,5681.76,37149.95,25 CDM,107446,PRC D-E COR REVSC COT RC,43705.82,43705.82,5681.76,37149.95,25 CDM,107447,PRC D-E COR REVSC COT LC,43705.82,43705.82,5681.76,37149.95,25 CDM,10745,KIT PRSS 3W STPCK FLSH,693.5,693.5,41.61,589.48,49 CDM,107453,ILC/FEM ART ANG AT CCATH,11680.91,11680.91,700.85,9928.77,34 CDM,107454,LIGHT CHAINS LAM FREE,545.0,545.0,32.7,463.25,27 CDM,107456,LDH ISOENZYMES,545.0,545.0,32.7,463.25,14 CDM,107456,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",545.0,545.0,10.74,87.97,80 CDM,107459,GWIRE VASC .014IN 180CM,4056.5,4056.5,243.39,3448.03,49 CDM,107460,DVC SKN CLSR 8CM,2905.5,2905.5,174.33,2469.68,49 CDM,107461,SCREW BN LCK 2.5MM 14MM,6872.0,6872.0,893.36,5841.2,28 CDM,107462,SCREW BN 2.5MM 18MM,6872.0,6872.0,893.36,5841.2,28 CDM,107463,SCREW BN 2.5MM 20MM,6872.0,6872.0,893.36,5841.2,28 CDM,107464,KWIRE TROCAR 1.6MM 150MM,2441.0,2441.0,146.46,2074.85,49 CDM,107465,BIT DRILL 1.8MM 130MM,8099.5,8099.5,485.97,6884.57,49 CDM,107466,GRAFT EVAS 38MM 217MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107468,SCREW BN 80MM 75MM,20050.0,20050.0,2606.5,17042.5,28 CDM,107469,PROSTHESIS PNLE 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107470,DEVICE WNDCLS 30CM SZ3,1657.5,1657.5,99.45,1408.88,49 CDM,107475,INSERT TIB KN SZ3 12MM,26764.0,26764.0,3479.32,22749.4,28 CDM,107478,CATH BLNDIL 3MM 12MM,3136.5,3136.5,188.19,2666.03,49 CDM,107479,IG GAMMA GLOBULIN 10MLIM,2339.28,2339.28,140.36,1988.39,19 CDM,107479,"Injection, gamma globulin, intramuscular, 1 cc ",2339.28,2339.28,48.95,151.07,10 CDM,107481,KIT CATH ASP TB 6F 132CM,100000.0,100000.0,6000.0,85000.0,49 CDM,107482,KIT CATH 12F 100CM W/TB,100000.0,100000.0,6000.0,85000.0,49 CDM,107483,ROD SPN 5.5MM 75MM,5265.0,5265.0,684.45,4475.25,28 CDM,107484,KIT CATH 12F 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,107485,KIT CATH 12F 100CM,100000.0,100000.0,6000.0,85000.0,49 CDM,107486,INSERT SHLDR SZ3/4 36MM,55781.0,55781.0,7251.53,47413.85,28 CDM,107487,BIT DRILL 3.2MM,4182.0,4182.0,250.92,3554.7,49 CDM,107488,SCREW SPN 5.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,107489,PUTTY BNGF SUBST 6CC,33761.0,33761.0,4388.93,28696.85,28 CDM,107490,PLATE BN 6H 117MM 3.5MM,46793.0,46793.0,6083.09,39774.05,28 CDM,107496,CLONIDINE 0.3 MG/DAY PAT,330.48,330.48,19.83,280.91,49 CDM,107497,CLONIDINE 0.2 MG/DAY PAT,238.19,238.19,14.29,202.46,49 CDM,107498,CLONIDINE 0.1 MG/DAY PAT,141.48,141.48,8.49,120.26,49 CDM,107499,AZITHROMYCIN 200MG PO,9.72,9.72,0.58,8.26,25 CDM,107500,PROBE ARTHRSCPE 13CM,5520.5,5520.5,331.23,4692.43,49 CDM,107501,SCREW BN 2.0MM 12MM,19633.0,19633.0,2552.29,16688.05,28 CDM,107502,CATH ULTSND 3.5FR 150CM,9032.0,9032.0,541.92,7677.2,49 CDM,107504,GWIRE VASC .035IN 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,107506,STENT ART 6F 5X29MM135CM,89506.0,89506.0,11635.78,76080.1,28 CDM,107507,STENT ENDO 5X39MM 135CM,89506.0,89506.0,11635.78,76080.1,28 CDM,107508,STENT ENDO 5X59MM 135CM,89506.0,89506.0,11635.78,76080.1,28 CDM,107509,STENT ENDO 5X79MM 135CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107510,BURR CRBD DMND 1.6MM,517.5,517.5,31.05,439.88,49 CDM,107511,ANCHOR SUT BLUE 1.8MM,45735.0,45735.0,5945.55,38874.75,28 CDM,107512,ANCHOR SUT BLUE 1.8MM,45735.0,45735.0,5945.55,38874.75,28 CDM,107513,SHELL ACTB HIP 46MM,83743.0,83743.0,10886.59,71181.55,28 CDM,107514,LINER ACTB HIP SZB 32MM,42258.0,42258.0,5493.54,35919.3,28 CDM,107516,HEAD FEM HIP -3MM 32MM,29299.0,29299.0,3808.87,24904.15,28 CDM,107517,CMPNT KN FEM PROX LT 7CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107518,CMPNT KN DPHSL SEG 3CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107519,STEM KN FEM 11X150MM,32984.0,32984.0,4287.92,28036.4,28 CDM,107521,PROBE ESOP TEMP DISP,20183.5,20183.5,1211.01,17155.97,49 CDM,107522,SUTURE ANBCTRL +2-0 27IN,135.0,135.0,8.1,114.75,49 CDM,107524,SET NEEDLE IO 45MM,7571.0,7571.0,454.26,6435.35,49 CDM,107526,ARGATROB 50MG ESRD INJ,357.1,357.1,21.43,303.54,24 CDM,107527,ARGATROB 250MG ESRD INJ,2584.33,2584.33,155.06,2196.68,24 CDM,107528,ACETAMINOPHEN 160MG PO,4.47,4.47,0.27,3.8,49 CDM,107529,ACETAMINOPHEN 650MG PO,5.22,5.22,0.31,4.44,49 CDM,107530,ACETAMINOPHEN 500MG PO,2.16,2.16,0.13,1.84,49 CDM,107531,ACETAMINOPHEN 325 MG PO,2.16,2.16,0.13,1.84,49 CDM,107532,LEAD PACNG 52CM,5971.0,5971.0,776.23,5075.35,28 CDM,107533,ICM 45.1X8.0X4.2MM,69895.0,69895.0,9086.35,59410.75,28 CDM,107534,INTEGRA MESHED 1SQCM,1727.0,1727.0,103.62,1467.95,30 CDM,107535,STENT AAA 13MMX90MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107536,GRFT EVAS 18FR 82MM 24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107537,PASSER SUT STR MINI,35821.5,35821.5,2149.29,30448.28,49 CDM,107538,SUTURE NABS BLU #2 26IN,4462.5,4462.5,267.75,3793.13,49 CDM,107539,DILATOR SURG 4.75MM,6867.0,6867.0,412.02,5836.95,49 CDM,107541,GRAFT EVAS 9MM 74MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107542,STNT ENDO 14FR 9MM 90MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107543,STENT EPRSTH 37X37X10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107545,HARVESTER GRAFT 9MM,16223.5,16223.5,973.41,13789.98,49 CDM,107546,ROD SPN 5.5MM 55MM,5265.0,5265.0,684.45,4475.25,28 CDM,107547,"Injection, rifampin, 1 mg ",369.36,369.36,0.17,0.5,10 CDM,107547,RIFAMPIN 600 MG INJ,369.36,369.36,22.16,313.96,24 CDM,107548,DOXYCYCL HYCL 100 MG INJ,133.38,133.38,8.0,113.37,24 CDM,107548,"Injection, doxycycline hyclate, 1 mg ",133.38,133.38,0.09,0.37,10 CDM,107549,SMX/TMP 3.2/0.64 MG/ML,17.28,17.28,1.04,14.69,24 CDM,107550,FAMOTIDINE 20 MG INJ,17.28,17.28,1.04,14.69,24 CDM,107551,FUROSEMIDE 100 MG INJ,89.23,89.23,5.35,75.85,24 CDM,107552,FUROSEMIDE 40 MG INJ,53.54,53.54,3.21,45.51,24 CDM,107553,FUROSEMIDE 20 MG INJ,51.16,51.16,3.07,43.49,24 CDM,107554,FUROSEMIDE 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,107555,FUROSEMIDE 10 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,107556,TACROLIMUS 0.2MG GRAN PO,27.05,27.05,1.62,22.99,40 CDM,107556,"Tacrolimus, granules, oral suspension, 0.1 mg ",27.05,27.05,1.28,4.02,10 CDM,107557,TACROLIMUS IMM 1 MG PO,40.39,40.39,2.42,34.33,24 CDM,107558,PUSHER KNOT SUT CUTR 2-0,6273.0,6273.0,376.38,5332.05,49 CDM,107559,SYSTEM MENISCAL REPAIR,18063.0,18063.0,2348.19,15353.55,28 CDM,107560,ANCHOR BN 1.3X3.5X11MM,10210.0,10210.0,1327.3,8678.5,28 CDM,107561,ROD SPN 5.5MM 90MM,5265.0,5265.0,684.45,4475.25,28 CDM,107562,SCREW SET SPN,2201.0,2201.0,286.13,1870.85,28 CDM,107563,ANCHOR SUT 2.3MM,18966.0,18966.0,2465.58,16121.1,28 CDM,107564,SUTURE ANCHOR 4.75MM,20373.0,20373.0,2648.49,17317.05,28 CDM,107565,IMPLANT BN DEL SYS BICEP,38560.0,38560.0,5012.8,32776.0,28 CDM,107566,GWIRE VASC 0.014IN 300CM,5928.0,5928.0,355.68,5038.8,49 CDM,107567,GDWIRE VASC .014IN 300CM,5928.0,5928.0,355.68,5038.8,49 CDM,107568,PLATE BN CRNMXF 20H .5MM,21711.0,21711.0,2822.43,18454.35,28 CDM,107569,PLATE BN MXF 3X4HL 0.7MM,12198.0,12198.0,1585.74,10368.3,28 CDM,107570,BIT DRILL 2.4MM 78MM,6273.0,6273.0,376.38,5332.05,49 CDM,107571,MYRIAD MORCELLS 4MG,462.0,462.0,27.72,392.7,41 CDM,107572,TIP HNDPC SURG ULTSNC,28318.5,28318.5,1699.11,24070.72,49 CDM,107573,TIP HNDPC SURG ULTSNC,28318.5,28318.5,1699.11,24070.72,49 CDM,107574,SUTURE BLU MONO 7-0 30IN,1385.5,1385.5,83.13,1177.67,49 CDM,107575,SUTURE BLU MONO 8-0 24IN,1564.5,1564.5,93.87,1329.83,49 CDM,107576,GRAFT EVAS 30X34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107577,DILATOR VASC 230CM,30660.0,30660.0,1839.6,26061.0,49 CDM,107578,SHEATH WIRE 45D 63CM,29890.0,29890.0,1793.4,25406.5,49 CDM,107580,DEXTROSE 10% 500 ML INJ,51.84,51.84,3.11,44.06,49 CDM,107581,BASIC METABOLIC CALC ION,2325.0,2325.0,139.5,1976.25,14 CDM,107582,AMIKACIN PEAK QN,735.88,735.88,44.15,625.5,14 CDM,107583,GENTAMICIN PEAK QN,1331.98,1331.98,79.92,1132.18,14 CDM,107584,GENTAMICIN TROUGH QN,1331.98,1331.98,79.92,1132.18,14 CDM,107585,SALICYLATE QN,896.78,896.78,53.81,762.26,27 CDM,107585,Salicylate ,896.78,896.78,15.66,98.82,67 CDM,107586,ALCOHOL QN EXC UA OR BRE,1027.34,1027.34,61.64,873.24,28 CDM,107586,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",1027.34,1027.34,14.51,91.62,65 CDM,107587,CARBON DIOXIDE BLD,736.0,736.0,44.16,625.6,14 CDM,107587,Carbon dioxide (bicarbonate) ,736.0,736.0,4.1,33.58,80 CDM,107588,CATECHOL FRACTION BLD,374.53,374.53,22.47,318.35,14 CDM,107589,FRUCTOSAMINE,895.46,895.46,53.73,761.14,14 CDM,107589,Glycated protein ,895.46,895.46,14.08,115.3,80 CDM,107590,BG WITH CALC O2 SAT,429.51,429.51,25.77,365.08,14 CDM,107591,ANTI-MPO AB ANCA,108.14,108.14,6.49,91.92,14 CDM,107592,ANTIGLOMERULAR B MIA QL,741.16,741.16,44.47,629.99,14 CDM,107593,ANTI-PR3 AB ANCA,108.14,108.14,6.49,91.92,14 CDM,107594,HCG QUANT TUMOR,929.75,929.75,55.78,790.29,14 CDM,107595,TRIGLYCERIDES OTHER,1148.66,1148.66,68.92,976.36,14 CDM,107596,PLT AGGREGATE COLL/ADP,377.17,377.17,22.63,320.59,14 CDM,107597,PLT AGGREGATE COLL/EPI,377.0,377.0,22.62,320.45,14 CDM,107598,HEPARIN ANTI XA,1226.0,1226.0,73.56,1042.1,14 CDM,107598,Heparin assay ,1226.0,1226.0,11.0,90.05,80 CDM,107599,PTT-LA MIXING STUDY,1004.91,1004.91,60.29,854.17,14 CDM,107600,PLT AGGREGATE P2Y12,4134.41,4134.41,248.06,3514.25,14 CDM,107601,ACTIN ASMA AB IGG QN IA,920.52,920.52,55.23,782.44,27 CDM,107601,"Actin (smooth muscle) antibody (ASMA), each ",920.52,920.52,9.69,64.67,67 CDM,107602,BETA 2 GLYCOPROT1 AB IGM,1047.12,1047.12,62.83,890.05,14 CDM,107603,COLD AGGLUTININ TITER,672.58,672.58,40.35,571.69,14 CDM,107603,Cold agglutinin; titer ,672.58,672.58,6.77,55.48,80 CDM,107604,C1 ESTERASE INHIBITOR IA,1359.68,1359.68,81.58,1155.73,14 CDM,107605,CENTROMERE B AB IA,1367.59,1367.59,82.06,1162.45,14 CDM,107606,IMMUNOFIX ELECTRO CSF,778.09,778.09,46.69,661.38,14 CDM,107607,MITOCHONDRIAL M2 AB IA,718.75,718.75,43.13,610.94,27 CDM,107607,"Mitochondrial antibody (eg, M2), each ",718.75,718.75,21.38,134.7,67 CDM,107608,EBV CAPSID IGG QUAL,735.88,735.88,44.15,625.5,14 CDM,107609,Antibody; Legionella ,1608.93,1608.93,12.85,105.25,80 CDM,107609,LEGIONELLA AB QUAL,1608.93,1608.93,96.54,1367.59,14 CDM,107610,MUMPS IGG QUAL,977.23,977.23,58.63,830.65,14 CDM,107611,MUMPS IGM QUAL,977.23,977.23,58.63,830.65,14 CDM,107612,PARVOVIRUS IGG,257.16,257.16,15.43,218.59,14 CDM,107613,Antibody; Treponema pallidum ,545.0,545.0,11.12,91.04,80 CDM,107613,TREPONEMA PALLIDUM AB,545.0,545.0,32.7,463.25,14 CDM,107614,VARIC ZOSTER IGM,510.37,510.37,30.62,433.81,14 CDM,107615,HEP C RNA QN,1163.17,1163.17,69.79,988.69,14 CDM,107615,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",1163.17,1163.17,35.99,294.67,80 CDM,107616,HIV 1 RNA QN,1035.25,1035.25,62.12,879.96,14 CDM,107616,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",1035.25,1035.25,71.48,585.35,80 CDM,107619,WEST NILE VIR AMP PROBE,809.74,809.74,48.58,688.28,14 CDM,107625,KIT IRRIGATION SINGL USE,2905.5,2905.5,174.33,2469.68,49 CDM,107626,SUTURE ANBCTRL +3-0 36IN,90.5,90.5,5.43,76.92,49 CDM,107627,INSERT TIB KN SZ5 8MM,21129.0,21129.0,2746.77,17959.65,28 CDM,107628,COMPNT PTLA DOME 32MM,10032.0,10032.0,1304.16,8527.2,28 CDM,107629,STERILE WATER 2 L IRRIG,51.84,51.84,3.11,44.06,49 CDM,107630,PRASUGREL 5 MG PO,5.4,5.4,0.32,4.59,49 CDM,107633,BUR DIAMOND ZB 164,1307.0,1307.0,78.42,1110.95,49 CDM,107634,BLADE SAW RECIP W 22.5,2905.5,2905.5,174.33,2469.68,49 CDM,107642,INS ECMO CENTRAL =>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,107643,REPOS ECMO CENTRAL =>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,107645,SPLINT OTHGN INTRMD,30280.5,30280.5,1816.83,25738.42,49 CDM,107646,MODEL ANTM MNDB ADLT,85984.0,85984.0,5159.04,73086.4,49 CDM,107647,KIT PLATE CRNL FIXTN,100000.0,100000.0,13000.0,85000.0,28 CDM,107648,KIT SURG ORTHOGNATHICS,100000.0,100000.0,13000.0,85000.0,28 CDM,107650,SCREW BN 2MM 6MM,3621.0,3621.0,470.73,3077.85,28 CDM,107651,SCREW BN 2MM 8MM,3498.0,3498.0,454.74,2973.3,28 CDM,107652,SCREW BN 5MM 57MM,6420.0,6420.0,834.6,5457.0,28 CDM,107653,PROBE LITHO 10.2FR 396MM,47762.0,47762.0,2865.72,40597.7,49 CDM,107654,FORCEP MGL 9.75IN,601.5,601.5,36.09,511.27,49 CDM,107656,KIT STAPLE BN 10MM 10MM,61628.0,61628.0,3697.68,52383.8,49 CDM,107657,SCREW BN 2.5MM 22MM,10406.0,10406.0,1352.78,8845.1,28 CDM,107658,ACL DISPOSABLE PACK BTB,11550.5,11550.5,693.03,9817.92,49 CDM,107659,SCREW BN 10MM 28MM,10367.0,10367.0,1347.71,8811.95,28 CDM,107660,MYCOPHE 200MG/1ML LIQ PO,25.27,25.27,1.52,21.48,40 CDM,107661,QUINIDINE SULF 300 MG PO,84.24,84.24,5.05,71.6,49 CDM,107662,STENT URET 8FR 22CM,7428.0,7428.0,965.64,6313.8,28 CDM,107664,NAIL FEMORAL 10MM 30CM,38774.0,38774.0,5040.62,32957.9,28 CDM,107667,CATH BLNDIL 8MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,107668,SUTURE SURG 30IN,707.5,707.5,42.45,601.38,49 CDM,107669,FILLER BN CERAMENT 5ML,32073.0,32073.0,4169.49,27262.05,28 CDM,107670,TRAY CATH CV 3FR 55CM,9789.5,9789.5,587.37,8321.08,49 CDM,107671,TRAY CATH CV 4FR 55CM,10070.5,10070.5,604.23,8559.92,49 CDM,107672,TRAY CATH CV 5FR 55CM,9025.0,9025.0,541.5,7671.25,49 CDM,107673,KIT CATH PICC 5FR 55CM,10783.0,10783.0,646.98,9165.55,49 CDM,107674,TRAY CATH CV 3FR 20CM,6274.5,6274.5,376.47,5333.32,49 CDM,107675,KIT CATH VASC 4FR 20CM,7355.0,7355.0,441.3,6251.75,49 CDM,107677,LEAD XTN SPN CLMN 25CM,16904.0,16904.0,2366.56,14368.4,24 CDM,107678,SPACER SPN 25X11X7MM,56344.0,56344.0,7324.72,47892.4,28 CDM,107679,BIT DRILL 4.2MM,16223.5,16223.5,973.41,13789.98,49 CDM,107680,SCREW BN 2.4MM 6MM,5007.0,5007.0,650.91,4255.95,28 CDM,107681,SCREW BN 2.4MM 8MM,5007.0,5007.0,650.91,4255.95,28 CDM,107682,CRYPTOCOCCUS AG OIA,1475.73,1475.73,88.54,1254.37,14 CDM,107683,LIPOPROTEIN (A),594.77,594.77,35.69,505.55,14 CDM,107683,Lipoprotein (a) ,594.77,594.77,12.03,98.46,80 CDM,107690,SUTURE ANBCTRL +1 36IN,93.5,93.5,5.61,79.47,49 CDM,107691,INTRO SHTH ANSL 6FR 55CM,2905.5,2905.5,174.33,2469.68,49 CDM,107692,GRAFT EVAS 13MM 74MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107694,BSPLTE GLND SHLDR 25MM,39441.0,39441.0,5127.33,33524.85,28 CDM,107696,DEVICE CLSR FEM 6FR,6291.0,6291.0,817.83,5347.35,28 CDM,107697,DEVICE CLSR FEM 7FR,6291.0,6291.0,817.83,5347.35,28 CDM,107698,CATH BLN ANG 4.5MM 35MM,11938.0,11938.0,716.28,10147.3,49 CDM,107699,LIGHT CHAINS KAP FREE,545.0,545.0,32.7,463.25,27 CDM,1077,STENT BIL 8.5FR 10X60MM,76447.0,76447.0,9938.11,64979.95,28 CDM,107700,ENCPH WST NIL AB IGM CSF,98.91,98.91,5.93,84.07,14 CDM,107701,ENCPH WST NIL AB IGG CSF,98.91,98.91,5.93,84.07,14 CDM,107702,COMP METABOLIC PANEL,2234.03,2234.03,134.04,1898.93,14 CDM,107703,AMYLASE BLD,1033.93,1033.93,62.04,878.84,14 CDM,107704,OCC BLD PEROX OTH SOURCE,385.09,385.09,23.11,327.33,14 CDM,107705,BG WITH CALC O2 SAT,429.51,429.51,25.77,365.08,14 CDM,107706,MAGNESIUM BLD,925.79,925.79,55.55,786.92,14 CDM,107707,PHOSPHORUS BLD,738.52,738.52,44.31,627.74,14 CDM,107708,HCG QL SERUM/URINE INSTR,207.05,207.05,12.42,175.99,14 CDM,107709,SARSCOV CORONAVIRU AG IA,36.93,36.93,2.22,31.39,30 CDM,107710,INFLUENZA B AG IA,627.74,627.74,37.66,533.58,14 CDM,107711,INFLUENZA A AG IA,627.74,627.74,37.66,533.58,14 CDM,107712,STREP A AG IA,795.23,795.23,47.71,675.95,14 CDM,107713,ROCKY MTN SF AB QN IGG,2634.94,2634.94,158.1,2239.7,14 CDM,107714,ROCKY MTN SF AB QN IGM,2634.94,2634.94,158.1,2239.7,14 CDM,107715,APC RESISTANCE,2356.68,2356.68,141.4,2003.18,14 CDM,107715,Activated Protein C (APC) resistance assay ,2356.68,2356.68,12.87,105.34,80 CDM,107716,BASIC OR SERVICES,2700.0,2700.0,162.0,2295.0,37 CDM,107717,OR PER MIN LEVEL 1,308.0,308.0,18.48,261.8,37 CDM,107718,OR PER MIN LEVEL 2,369.0,369.0,22.14,313.65,37 CDM,107719,OR PER MIN LEVEL 3,410.0,410.0,24.6,348.5,37 CDM,107720,OR PER MIN LEVEL 4,410.0,410.0,24.6,348.5,37 CDM,107721,OR PER MIN LEVEL 5,394.0,394.0,23.64,334.9,37 CDM,107722,NERVE BLOCK ANESTHETIC,1080.0,1080.0,64.8,918.0,49 CDM,107723,SPINAL ANESTHETIC,1080.0,1080.0,64.8,918.0,49 CDM,107724,LOCAL ANESTHETIC,1080.0,1080.0,64.8,918.0,49 CDM,107725,MONITORED ANES CARE,1080.0,1080.0,64.8,918.0,49 CDM,107726,CMPNT FEM HIP SZ 5,47893.0,47893.0,6226.09,40709.05,28 CDM,107727,HEAD FEM HIP -3.5/36MM,18312.0,18312.0,2380.56,15565.2,28 CDM,107728,SHVR SPN 1.3X1.8MM 165MM,34666.0,34666.0,2079.96,29466.1,49 CDM,107729,STENT VASC 12X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107731,DEVICE CMPR RADIAL 29CM,1918.0,1918.0,115.08,1630.3,49 CDM,107732,KIT CATH 9FR 11.5CM,5165.0,5165.0,309.9,4390.25,49 CDM,107733,SCREW BN 6.5X30MM XIA 3,17670.0,17670.0,2297.1,15019.5,28 CDM,107734,ROD SPN 5.5MM 30MM,5265.0,5265.0,684.45,4475.25,28 CDM,107735,SUTURE BLU MONO 4-0 36IN,627.0,627.0,37.62,532.95,49 CDM,107736,SUTURE BLU MONO 5-0 36IN,635.5,635.5,38.13,540.17,49 CDM,107737,SCREW BN 1.85MM 5MM,3697.0,3697.0,480.61,3142.45,28 CDM,107738,PROSTHESIS PENL INF 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107739,STENT URET 7FR 28CM,7428.0,7428.0,965.64,6313.8,28 CDM,107740,ADALIM-RYVK BS 40 MG INJ,2506.46,2506.46,150.39,2130.49,41 CDM,107740,"Injection, adalimumab-ryvk biosimilar, 1 mg ",2506.46,2506.46,25.64,41.28,8 CDM,107741,GRAFT EVAS 14FR 13X122MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107742,KIT SURG MNDB FULL,100000.0,100000.0,13000.0,85000.0,28 CDM,107743,COIL EMBL 7CM 8MM,3225.0,3225.0,419.25,2741.25,28 CDM,107744,COIL EMBL NSTR 12FR 20CM,4908.0,4908.0,638.04,4171.8,28 CDM,107745,SUTURE SLV STBLZR LEAD,2287.0,2287.0,297.31,1943.95,28 CDM,107746,SCREW BN SPN 4MM 34MM,12898.0,12898.0,1676.74,10963.3,28 CDM,107747,SCREW BN 2.7MM 8MM,4416.0,4416.0,574.08,3753.6,28 CDM,107748,INTRO SHEATH 14FR 33CM,14790.0,14790.0,887.4,12571.5,49 CDM,107749,CMPNT PTLA KN 34MM 9MM,7166.0,7166.0,931.58,6091.1,28 CDM,107750,COMP TIB KN ARTC 11MM,15495.0,15495.0,2014.35,13170.75,28 CDM,107751,COMP FEM KN LT SIZE C,42258.0,42258.0,5493.54,35919.3,28 CDM,107752,BASEPLATE TIB KN SZ4,28172.0,28172.0,3662.36,23946.2,28 CDM,107753,CATH DRN BIL 12FR 40CM,2927.0,2927.0,175.62,2487.95,49 CDM,107754,GRAFT AAA 31-32 161MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107755,SET SHTH INTRO 24FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,107756,GWIRE VASC .035IN 300CM,6273.0,6273.0,376.38,5332.05,49 CDM,107757,BLADE SAW 90X25MM,1569.0,1569.0,94.14,1333.65,49 CDM,107758,SHEARS LAPSCP 5MM 36CM,15142.0,15142.0,908.52,12870.7,49 CDM,107759,CATH BLN 4X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,107760,INSERT TIB KN SZ2 12MM,15495.0,15495.0,2014.35,13170.75,28 CDM,107761,CATH BLN 5X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 CDM,107762,CULT TYPING IFT,545.0,545.0,32.7,463.25,14 CDM,107762,"Culture, typing; immunofluorescent method, each antiserum ",545.0,545.0,4.68,38.28,80 CDM,107763,RSV AG IA,958.76,958.76,57.53,814.95,14 CDM,107764,SMEAR CALCOFLUOR WHITE,316.51,316.51,18.99,269.03,14 CDM,107765,PLATE SPN 3LVL 60MM,26764.0,26764.0,3479.32,22749.4,28 CDM,107766,TULIP SPN EXTNDED P-AX,6449.0,6449.0,838.37,5481.65,28 CDM,107767,PACEMAKER LDLS VR 38.0MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107768,SUTURE 2-0 GRN/WHT 6X36,2042.0,2042.0,122.52,1735.7,49 CDM,107769,CMPNT PTLR KN 8MM 28MM,7166.0,7166.0,931.58,6091.1,28 CDM,107770,PLATE BN FEM NK SYS 2 HL,25903.0,25903.0,3367.39,22017.55,28 CDM,107771,SCREW BN SLFTP 5X38MM,8458.0,8458.0,1099.54,7189.3,28 CDM,107772,SCREW BN 100MM,10484.0,10484.0,1362.92,8911.4,28 CDM,107773,BOLT FEM TI ALLOY 100MM,15550.0,15550.0,2021.5,13217.5,28 CDM,107774,CMPD LORAZPM 50MG 50B,43.2,43.2,2.59,36.72,30 CDM,107775,LANSOPRAZOLE ER 30MG PO,10.1,10.1,0.61,8.59,49 CDM,107777,COIL EMBL 14CM 14MM,3505.0,3505.0,455.65,2979.25,28 CDM,107778,SET DRILL AND PIN SMTH,830.5,830.5,49.83,705.92,49 CDM,107779,GRAFT EVAS 28MM 39MM,80393.0,80393.0,10451.09,68334.05,28 CDM,107780,GRAFT EVAS 18FR 39X26MM,80393.0,80393.0,10451.09,68334.05,28 CDM,107781,GRAFT EVAS 28MM 111MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107782,GRAFT EVAS 24MM 56MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107783,CALCIUM UR RANDOM QN,635.66,635.66,38.14,540.31,14 CDM,107784,HYDR2.5/APAP108/5MLLIQPO,45.74,45.74,2.74,38.88,49 CDM,107785,INTRO SHTH 10.6FR,13037.5,13037.5,782.25,11081.88,49 CDM,107786,INTRO SHTH 10.06FR,13037.5,13037.5,782.25,11081.88,49 CDM,107787,GLIADIN AB IGG IA QN,180.94,180.94,10.86,153.8,27 CDM,107788,GLIADIN AB IGA IA QN,180.94,180.94,10.86,153.8,27 CDM,107789,PLATELETS PATH RED EA UN,3569.1,3569.1,214.15,3033.74,27 CDM,107789,"Platelets, pheresis, pathogen-reduced, each unit ",3569.1,3569.1,1236.26,7570.05,17 CDM,107790,PLTS PHERESIS EACH UNIT,3569.1,3569.1,214.15,3033.74,28 CDM,107790,"Platelets, pheresis, each unit ",3569.1,3569.1,343.82,4121.55,18 CDM,107791,PLASMA CRYO REDUCED,202.02,202.02,12.12,171.72,28 CDM,107791,"Plasma, cryoprecipitate reduced, each unit ",202.02,202.02,50.67,579.65,18 CDM,107792,PRBC,925.94,925.94,55.56,787.05,32 CDM,107792,"Red blood cells, each unit ",925.94,925.94,492.99,665.9,12 CDM,107793,CRYOPRECIPITATE POOLED,449.37,449.37,26.96,381.96,32 CDM,107794,IHC QN/SQN EA AB COMP,1004.91,1004.91,60.29,854.17,23 CDM,107794,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",1004.91,1004.91,313.36,904.08,20 CDM,107804,CULTURE EYE,1038.99,1038.99,62.34,883.14,14 CDM,107805,MERCURY BLD QUANT,873.04,873.04,52.38,742.08,14 CDM,107805,"Mercury, quantitative ",873.04,873.04,13.66,111.86,80 CDM,107806,TRANSGLUTAMIN AB IGG QN,180.94,180.94,10.86,153.8,27 CDM,107807,TRANSGLUTAMIN AB IGA QN,180.94,180.94,10.86,153.8,27 CDM,107808,OCCBLD PEROX 1-3 DIAG,385.09,385.09,23.11,327.33,14 CDM,107809,ENDOMYSIAL FA AB QL,310.65,310.65,18.64,264.05,27 CDM,107809,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",310.65,310.65,10.16,64.67,67 CDM,107811,SCREW SPN 4.5MM 14MM,2633.0,2633.0,342.29,2238.05,28 CDM,107812,SCREW SPN 4.5MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,107813,CRT- DEBIFB CARD DF4,100000.0,100000.0,13000.0,85000.0,28 CDM,107814,BIT DRL 3.0MM,3973.0,3973.0,238.38,3377.05,49 CDM,107815,BLADE SAW 30.5MM 6.5MM,1055.0,1055.0,63.3,896.75,49 CDM,107816,VALVE CAP REPLACEMENT,454.0,454.0,27.24,385.9,49 CDM,107817,INTRO SHTH STRBL SZ SM,67637.0,67637.0,4058.22,57491.45,49 CDM,107818,SEAL CAP RETRACTOR 9.5CM,23110.5,23110.5,1386.63,19643.92,49 CDM,107819,SUTURE UND BRD +1 27IN,93.5,93.5,5.61,79.47,49 CDM,107820,IRRIGATOR ENDO 30.5CM,251.5,251.5,15.09,213.78,49 CDM,107821,NEEDLE INSFL 14GA 120MM,701.0,701.0,42.06,595.85,49 CDM,107822,HEMOSTAT ABS 1X2IN,2589.0,2589.0,155.34,2200.65,49 CDM,107823,SUTURE UND BRD +2-0 27IN,90.5,90.5,5.43,76.92,49 CDM,107824,SUTURE UND MONO +0 27IN,105.0,105.0,6.3,89.25,49 CDM,107825,FORCEPS BX 1.2MM 286CM,17431.0,17431.0,1045.86,14816.35,49 CDM,107827,DILATOR SHEATH PLWY 20FR,3774.5,3774.5,226.47,3208.32,49 CDM,107828,CATH URET 2W 22FR 5CC,194.0,194.0,11.64,164.9,49 CDM,107829,SUTURE ANBCTRL +2-0 27IN,92.5,92.5,5.55,78.63,49 CDM,107830,SUTURE SH 3-0 8X18IN,597.5,597.5,35.85,507.88,49 CDM,107831,SUTURE ANBCTRL 18IN,601.0,601.0,36.06,510.85,49 CDM,107832,SUTURE CT-1 0 8X18IN,599.5,599.5,35.97,509.57,49 CDM,107833,SUTURE UND BRD +4-0 27IN,214.0,214.0,12.84,181.9,49 CDM,107834,SUTURE UND BRD +0 27IN,92.0,92.0,5.52,78.2,49 CDM,107835,GWIRE VASC .035IN 180CM,1641.0,1641.0,98.46,1394.85,49 CDM,107836,GWIRE VASC ANG .035X180,1641.0,1641.0,98.46,1394.85,49 CDM,107837,GWIRE VASC STRT .035X180,1641.0,1641.0,98.46,1394.85,49 CDM,107839,DEV CMPR VASC 26MM,1904.0,1904.0,114.24,1618.4,49 CDM,107840,DEVICE RADIAL CMPR 32CM,1904.0,1904.0,114.24,1618.4,49 CDM,107841,DRILL SURG SM SHRT 2.7MM,2905.5,2905.5,174.33,2469.68,49 CDM,107843,GRAFT AAA 33-34 167MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107844,SNARE POLY MD OVL 240CM,748.5,748.5,44.91,636.23,49 CDM,107845,GRAFT AAA 40-42 179MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107846,SNARE POLY HEX SM,1033.5,1033.5,62.01,878.48,49 CDM,107847,GRAFT AAA 35-36 167MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107848,ADAPTER PEG FD 20FR,489.0,489.0,29.34,415.65,49 CDM,107849,GRAFT AAA 26-27 155MM,100000.0,100000.0,13000.0,85000.0,28 CDM,107850,TUBE TRACH CFLS SIZE 8,1478.5,1478.5,88.71,1256.72,49 CDM,107851,STENT VASC 6X26MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107852,STENT VASC 6X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107853,STENT VASC 7X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107854,STENT VASC 7X37MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107855,STENT VASC 7X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107856,STENT VASC 8X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107857,STENT VASC 8X26MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107858,STENT VASC 8X37MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107859,STENT VASC 10X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107861,STENT VASC 8X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107862,STENT VASC 9X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107863,STENT VASC 9X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107864,STENT VASC 10X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107865,STENT VASC 12X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 CDM,107866,EXPAND BRST 550CC,57562.0,57562.0,7483.06,48927.7,28 CDM,107867,EXPAND BRST 650CC,57562.0,57562.0,7483.06,48927.7,28 CDM,107868,BILIRUBIN TOT FL,840.07,840.07,50.4,714.06,14 CDM,107869,PRO-BNP QT,1958.4,1958.4,117.5,1664.64,14 CDM,107870,INFLUENZA B AG IA,627.74,627.74,37.66,533.58,14 CDM,107871,INFLUENZA A AG IA,627.74,627.74,37.66,533.58,14 CDM,107872,RSV AG IA,958.76,958.76,57.53,814.95,14 CDM,107873,TRIAL LEAD NRSTM 50CM,19633.0,19633.0,2748.62,16688.05,24 CDM,107874,INSERT TIB KN ARTC 15MM,15495.0,15495.0,2014.35,13170.75,28 CDM,107875,SHEATH DIL 12FR 43CM,9508.0,9508.0,570.48,8081.8,49 CDM,107876,SHEATH DIL 12FR 43CM,9508.0,9508.0,570.48,8081.8,49 CDM,107877,DILATOR SHTH 43CM 16FR,9508.0,9508.0,570.48,8081.8,49 CDM,107878,SHEATH DIL 9FR 47.5CM,70410.0,70410.0,4224.6,59848.5,49 CDM,107879,DILATOR SHT 9FR 6.1X15.5,54387.0,54387.0,3263.22,46228.95,49 CDM,107880,SHEATH VASC DIL 15.5CM,54387.0,54387.0,3263.22,46228.95,49 CDM,107881,CATH ULTSND 9FR 90CM,94322.0,94322.0,5659.32,80173.7,49 CDM,107882,BIT DRILL 2.5MM,4767.5,4767.5,286.05,4052.38,49 CDM,107883,BIT DRILL STRL 1.7MM,5520.5,5520.5,331.23,4692.43,49 CDM,107884,PLATE BN CNTR 3HL,27869.0,27869.0,3622.97,23688.65,28 CDM,107885,SCREW BN 3.5MM 12MM,2706.0,2706.0,351.78,2300.1,28 CDM,107886,SCREW BN 3.5MM 14MM,2706.0,2706.0,351.78,2300.1,28 CDM,107887,SCREW BN LOPRO 3.5X20MM,4960.0,4960.0,644.8,4216.0,28 CDM,107888,SCREW BN 2.4MM 20MM,19319.0,19319.0,2511.47,16421.15,28 CDM,107889,SCREW BN 2.4MM 18MM,12557.0,12557.0,1632.41,10673.45,28 CDM,107891,SCREW BN 6.5MM 20MM,2829.0,2829.0,367.77,2404.65,28 CDM,107892,STEM FEM HIP 128D SZ12,53527.0,53527.0,6958.51,45497.95,28 CDM,107894,CANN ARTHSCP 6.5X75MM,988.0,988.0,59.28,839.8,49 CDM,107895,CANNULA ENDO 8X75MM,988.0,988.0,59.28,839.8,49 CDM,107896,SUT WHT/BLU 1.2MM 46IN,2969.5,2969.5,178.17,2524.07,49 CDM,107897,BURR SURG 44.5X4.5X1.6MM,329.5,329.5,19.77,280.07,49 CDM,107898,BLADE SAW 21.8X6.4MM,1383.0,1383.0,82.98,1175.55,49 CDM,107899,BURR SURG RND 54.5MM 3MM,936.0,936.0,56.16,795.6,49 CDM,107900,SUTURE POLY SZ2 40IN,39454.5,39454.5,2367.27,33536.32,49 CDM,107901,CATH GD CRV 7.3FR 55CM,6796.5,6796.5,407.79,5777.02,49 CDM,107902,CATH GD VSC 115D 7F 42CM,7501.0,7501.0,450.06,6375.85,49 CDM,107903,CATH VASC 7FR 55CM,7958.5,7958.5,477.51,6764.73,49 CDM,107904,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,107905,LINER ACTB HIP MF/36MM,15495.0,15495.0,2014.35,13170.75,28 CDM,107906,HEAD FEM HIP SZ36/0.0MM,18312.0,18312.0,2380.56,15565.2,28 CDM,107907,ETHACRYNIC 25 MG PO,7.13,7.13,0.43,6.06,49 CDM,107908,CANDIDA AMP PROBE,187.48,187.48,11.25,159.36,14 CDM,107908,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",187.48,187.48,29.48,241.36,80 CDM,107910,CATH BLN 2.0X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107911,CATH BLNDL 2X40XMM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107912,CATH BLNDL 2X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107913,CATH BLNDL 2X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107914,CATH BLNDL 2X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107915,CATH BLN 2.0X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107916,CATH BLNDL 2X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107917,CATH BLN 2.5X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107918,CATH BLN 2.5X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107919,CATH BLN 2.5X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107920,OCCBLD PEROX 1-3 DIAG,385.09,385.09,23.11,327.33,14 CDM,107921,CATH BLN 2.5X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107922,CATH BLN 2.5X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107923,CATH BLN 2.5X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107924,CATH BLN 2.5X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107925,CATH BLN 3X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107926,CATH BLNDL 3X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107927,CATH BLNDL 3X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107928,CATH BLNDL 3X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107929,CATH BLNDL 3X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107930,CATH BLN 3.0X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107931,CATH BLNDL 3X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107932,CATH BLN 3.5X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107933,CATH BLN 3.5X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107934,CATH BLN 3.5X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107935,CATH BLN 3.5X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107936,CATH BLN 3.5X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107937,CATH BLN 3.5X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107938,CATH BLN 3.5X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107939,CATH BLN 4X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107940,CATH BLNDL 4X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107941,CATH BLNDL 4X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107942,CATH BLNDL 4X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107943,CATH BLN 4X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 CDM,107944,KIT DRN LN VAC BT 1000ML,2244.0,2244.0,134.64,1907.4,49 CDM,107945,FORCEP ENDO ADLT 10IN,582.0,582.0,34.92,494.7,49 CDM,107946,KIT FD TUBE 18FR 45CM,6953.0,6953.0,417.18,5910.05,49 CDM,107947,KIT SYSTEM TRAY,29043.5,29043.5,1742.61,24686.97,49 CDM,107948,BURR RND OSTEON ELTE 3MM,4510.5,4510.5,270.63,3833.93,49 CDM,107949,INSERT TIB KN SZ1 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,107952,CMPNT FEM KN RT SZ7,47048.0,47048.0,6116.24,39990.8,28 CDM,107953,CATH GD KR3S 6FR 2.1MM,2150.5,2150.5,129.03,1827.92,49 CDM,107954,CATH GD 6FR 100CM,2441.0,2441.0,146.46,2074.85,49 CDM,107955,SET CATH URTH 13.35IN,6273.0,6273.0,376.38,5332.05,49 CDM,107956,IMPLANT ACTB HIP CUST,100000.0,100000.0,13000.0,85000.0,28 CDM,107957,ROD SPN 5.5MM 35MM,5265.0,5265.0,684.45,4475.25,28 CDM,107958,BURR SURG OVL 9.5X4.0MM,843.0,843.0,50.58,716.55,49 CDM,107959,BURR SURG 44.5X4.3X1.6MM,263.5,263.5,15.81,223.97,49 CDM,107960,KIT CATH PLR STRT 1000ML,29043.5,29043.5,1742.61,24686.97,49 CDM,107961,CTHGD 6F 90CM M1 KR4H,2150.5,2150.5,129.03,1827.92,49 CDM,107962,CTHGD 6F 90CM M1 KR4S,2150.5,2150.5,129.03,1827.92,49 CDM,107963,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,107964,CTHGD 6F 90CM M1 KR3H,2150.5,2150.5,129.03,1827.92,49 CDM,107965,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,107966,ROSUVASTATIN 5 MG PO,5.4,5.4,0.32,4.59,49 CDM,107967,SCREW SPN 3.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 CDM,107968,LITE Y-NEEDLE 100,1453.0,1453.0,87.18,1235.05,49 CDM,107972,SHELL HIP ACTB SZ24MM,2534.0,2534.0,329.42,2153.9,28 CDM,107973,HEAD FEM HIP -3MM 36MM,24809.0,24809.0,3225.17,21087.65,28 CDM,107974,LINER ACTB HIP SZ24 36MM,33807.0,33807.0,4394.91,28735.95,28 CDM,107975,KWIRE SMTH FX 4IN 0.9MM,152.0,152.0,9.12,129.2,49 CDM,107976,KIT INTRO 21GA 5FR 10CM,1684.0,1684.0,101.04,1431.4,49 CDM,107977,HEXAGONAL PHOSPHOLIPID,191.27,191.27,11.48,162.58,14 CDM,107977,Phospholipid neutralization; hexagonal phospholipid ,191.27,191.27,15.1,123.62,80 CDM,107978,T CELLS CD4 COUNT,212.58,212.58,12.75,180.69,14 CDM,107978,T cells; absolute CD4 count ,212.58,212.58,22.5,184.17,80 CDM,107979,GLUTAMIC ACID DECARB A,318.79,318.79,19.13,270.97,14 CDM,107979,Islet cell antibody ,318.79,318.79,19.8,162.09,80 CDM,107980,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",685.77,685.77,35.01,286.7,80 CDM,107980,MTB AMP PROBE,685.77,685.77,41.15,582.9,14 CDM,107981,ANCA-P ATYPICAL AB TITER,762.38,762.38,45.74,648.02,27 CDM,107982,ANCA PERINUCLEAR TITER,762.38,762.38,45.74,648.02,27 CDM,107983,ANCA CYTOPLASMIC TITER,762.38,762.38,45.74,648.02,27 CDM,107984,Calculus; infrared spectroscopy ,205.21,205.21,10.84,88.69,80 CDM,107984,STONE ANALYSIS INFRARED,205.21,205.21,12.31,174.43,14 CDM,107985,ADAMTS-13,806.87,806.87,48.41,685.84,14 CDM,107985,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",806.87,806.87,25.92,212.22,80 CDM,107986,Infectious agent detection by nucleic acid (DNA or RNA); rubeola (measles) virus ,614.76,614.76,,,0 CDM,107986,RUBEOLA (MEASLES) AMP PR,614.76,614.76,36.89,522.55,48 CDM,107987,STENT VASC 6X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,107988,PACK CATH GD VASC 100CM,100000.0,100000.0,6000.0,85000.0,49 CDM,107989,SHELL HIP CMNTLSS 52MM,25355.0,25355.0,3296.15,21551.75,28 CDM,107990,SCREW BN 6.5MM 25MM,2829.0,2829.0,367.77,2404.65,28 CDM,107991,FORCEPS SURG 5MM,13557.5,13557.5,813.45,11523.88,49 CDM,107992,IPG NRSTM 61X4.95X1.34CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107993,SUTURE VIOL BRD+2-0 27IN,87.5,87.5,5.25,74.38,49 CDM,107994,STENT EPRSTH 8X40MM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,107997,CANNULA ART 17FR 3/8IN,11549.0,11549.0,692.94,9816.65,49 CDM,107998,GWIRE 450CM 45 ANGLE,4511.0,4511.0,270.66,3834.35,49 CDM,107999,SHEATH GD 6FR 119CM,9613.5,9613.5,576.81,8171.48,49 CDM,108000,STENT VASC 6X60MM 200XM,27765.0,27765.0,3609.45,23600.25,28 CDM,108001,DEVICE CLS WND +3-0 30CM,1223.5,1223.5,73.41,1039.97,49 CDM,108004,ENOXAPARIN 150 MG INJ,187.97,187.97,11.28,159.77,24 CDM,108005,BURR SURH MED 4.0MM,854.5,854.5,51.27,726.33,49 CDM,108006,LINER ACTB HIP 10D SZ36,15495.0,15495.0,2014.35,13170.75,28 CDM,108008,SYSTEM URTH MESH 9CM,38332.0,38332.0,4983.16,32582.2,28 CDM,108012,GRAFT EVAS 23MM 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,108013,CAGE SPN 0D 17X22X26-30,76001.0,76001.0,9880.13,64600.85,28 CDM,108014,SCREW SPN 5.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108015,CAGE SPNL 17X22X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108016,PLUG EMBL 12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108017,PLUG EMBL 10MM,35870.0,35870.0,4663.1,30489.5,28 CDM,108018,SPHERE EMBL 100UM 2ML,5440.0,5440.0,707.2,4624.0,28 CDM,108020,SPHERE EMBL 700UM 2ML,5440.0,5440.0,707.2,4624.0,28 CDM,108021,SPHERE EMBL 900UM 2ML,5440.0,5440.0,707.2,4624.0,28 CDM,108022,CATH ANGIO MIK 4F80 .04,627.0,627.0,37.62,532.95,49 CDM,108023,PACK CATH GD VASC 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108024,KIT STAPLE BN 8MM 8MM,61628.0,61628.0,3697.68,52383.8,49 CDM,108025,SYSTEM DLV CATH 1 CLIP,100000.0,100000.0,6000.0,85000.0,49 CDM,108026,SYSTEM DLV CATH 1 CLIP,100000.0,100000.0,13000.0,85000.0,28 CDM,108027,DELFLEX 4.25%DEXT 5L INJ,154.22,154.22,9.25,131.09,33 CDM,108028,HEAD FEM HIP +4MM SZ36,18312.0,18312.0,2380.56,15565.2,28 CDM,108029,FOLLOWER URET 12FR,619.0,619.0,37.14,526.15,49 CDM,108030,SHEATH STRBL 5.7MM 4.2MM,46221.0,46221.0,2773.26,39287.85,49 CDM,108031,CATH RNGR PTCA 2.5X20MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108032,CATH RNGR PTCA 3X20MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108033,CATH RNGR PTCA 3.5X20MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108034,CATH RINGER PTCA 4X20MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108035,CATH RNGR PTCA 4.5X20MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108039,CEPHALEX 250MG/5ML LIQPO,5.4,5.4,0.32,4.59,49 CDM,108040,GRAFT EVAS 26MM 3.3CM,92650.0,92650.0,12044.5,78752.5,28 CDM,108041,PLATE SPN LVL3 75MM,26764.0,26764.0,3479.32,22749.4,28 CDM,108042,STENT VASC 6X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108043,STENT VASC 6X10MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108044,STENT VASC 6X120MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108045,STENT VASC 6X150MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108046,STENT VASC 7X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108047,STENT VASC 7X60MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108048,STENT VASC 7X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108049,STENT VASC 7X100MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108050,STENT VASC 7X120MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108051,STENT VASC 7X150MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108052,STENT VASC 8X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108053,STENT VASC 8X60MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108054,STENT VASC 8X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108055,STENT VASC 8X100MM 200CM,27765.0,27765.0,3609.45,23600.25,28 CDM,108056,VOLUME MEASUREMENT UR,32.7,32.7,1.96,27.8,14 CDM,108056,"Volume measurement for timed collection, each ",32.7,32.7,3.06,25.07,80 CDM,108057,DEF DRUG FENTANYL,247.99,247.99,14.88,210.79,27 CDM,108057,Fentanyl ,247.99,247.99,0.07,127.56,28 CDM,108058,VORICONAZOLE,491.81,491.81,29.51,418.04,15 CDM,108058,Voriconazole ,491.81,491.81,22.77,186.43,79 CDM,108060,MIDAZOLAM 10 MG INJ,17.28,17.28,1.04,14.69,24 CDM,108061,ATROPINE 1 MG/1 ML INJ,38.12,38.12,2.29,32.4,24 CDM,108062,FORMOTEROL 20 MCG INH,14.09,14.09,0.85,11.98,24 CDM,108062,"Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms ",14.09,14.09,1.78,45.93,10 CDM,108063,BUDESONIDE NC 1 MG INH,16.69,16.69,1.0,14.19,24 CDM,108064,METHYLPRED SS 40 MG INJ,20.63,20.63,1.24,17.54,24 CDM,108066,THEOPHY 80MG/15ML LIQ PO,6.48,6.48,0.39,5.51,49 CDM,108068,MAGNESIUM CITR 296ML PO,10.26,10.26,0.62,8.72,49 CDM,108069,AMOX/CLAV250MG/5ML LIQPO,16.65,16.65,1.0,14.15,49 CDM,108070,MORPH ANAL MAN INI PROBE,1021.56,1021.56,61.29,868.33,23 CDM,108070,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",1021.56,1021.56,421.79,904.08,20 CDM,108071,MORPH ANAL CMP INI PROBE,296.53,296.53,17.79,252.05,23 CDM,108071,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",296.53,296.53,337.05,904.08,20 CDM,108072,ISH/FISH EA ADDL PROBE,623.47,623.47,37.41,529.95,28 CDM,108072,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",623.47,623.47,198.75,749.16,20 CDM,108073,CRYPTOCOCCUS AG OIA CSF,1475.73,1475.73,88.54,1254.37,14 CDM,108074,CRYPTOCOCCAL AG IA TIT,213.11,213.11,12.79,181.14,14 CDM,108075,CAMPYLOBACTER AG OIA,3503.26,3503.26,210.2,2977.77,14 CDM,108076,HIV-2 AMP PROBE,239.2,239.2,14.35,203.32,14 CDM,108076,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",239.2,239.2,29.48,241.36,80 CDM,108077,HIV-1 AMP PROBE,239.2,239.2,14.35,203.32,14 CDM,108077,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",239.2,239.2,29.48,241.36,80 CDM,108078,FLU 1ST 2 MPLEX TY SUBTY,736.18,736.18,44.17,625.75,14 CDM,108078,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",736.18,736.18,80.47,658.93,80 CDM,108079,FUNGITELL B-D-GLUCAN IA,187.44,187.44,11.25,159.32,14 CDM,108080,HIV-1AG HIV-1/2AB SINGLE,123.86,123.86,7.43,105.28,14 CDM,108080,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",123.86,123.86,20.23,165.62,80 CDM,108081,INFECT ANTGN DETEC NOS,146.67,146.67,8.8,124.67,14 CDM,108082,ASPERGILLUS AG EIA,330.53,330.53,19.83,280.95,14 CDM,108082,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",330.53,330.53,10.06,82.36,80 CDM,108083,VIRUS DEFINITIVE ID,1052.78,1052.78,63.17,894.86,14 CDM,108083,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",1052.78,1052.78,16.97,138.92,80 CDM,108084,SUSC MACROBROTH EA AGENT,282.87,282.87,16.97,240.44,14 CDM,108084,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",282.87,282.87,5.58,45.7,80 CDM,108085,CULT TYPING AMP PROBE,862.48,862.48,51.75,733.11,14 CDM,108086,CULT W PRESUMPTIVE ID UR,1090.0,1090.0,65.4,926.5,14 CDM,108086,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",1090.0,1090.0,6.8,55.66,80 CDM,108087,CULT QN BRONCH LAVAGE,1090.0,1090.0,65.4,926.5,14 CDM,108087,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",1090.0,1090.0,8.31,68.06,80 CDM,108088,CULT ENVIRON EPIDEMI,1090.0,1090.0,65.4,926.5,14 CDM,108089,PRETREAT SERUM DIL EA,422.02,422.02,25.32,358.72,23 CDM,108089,Pretreatment of serum for use in RBC antibody identification; by dilution ,422.02,422.02,46.44,249.78,20 CDM,108090,PRETREAT RBC'S ENZ EA,422.02,422.02,25.32,358.72,23 CDM,108090,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",422.02,422.02,93.4,904.08,20 CDM,108091,Hemolysins and agglutinins; incubated ,957.45,957.45,10.17,83.26,80 CDM,108091,INCUBATED AUTO SCREEN,957.45,957.45,57.45,813.83,14 CDM,108092,HEMOLYSIN AGGLUTIN AUTO,204.57,204.57,12.27,173.88,14 CDM,108092,"Hemolysins and agglutinins; auto, screen, each ",204.57,204.57,7.37,60.36,80 CDM,108093,Compatibility test each unit; electronic ,265.08,265.08,112.93,457.76,20 CDM,108093,ELECTRONIC XMATCH,265.08,265.08,15.9,225.32,23 CDM,108094,BLOOD TYPE RH PHENOTYPE,561.79,561.79,33.71,477.52,15 CDM,108094,"Blood typing, serologic; Rh phenotyping, complete ",561.79,561.79,6.51,106.64,78 CDM,108095,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",597.41,597.41,4.8,457.76,78 CDM,108095,INDIRECT COOMBS QL EA,597.41,597.41,35.84,507.8,15 CDM,108096,TYPHUS FEVER AB IGG QL,425.08,425.08,25.5,361.32,14 CDM,108097,CHROMATIN AB,499.49,499.49,29.97,424.57,14 CDM,108098,PHOSPHATIDYLSER AB IGA,124.75,124.75,7.49,106.04,14 CDM,108099,MUSK AB,2633.99,2633.99,158.04,2238.89,34 CDM,108099,Muscle-specific kinase (MuSK) antibody ,2633.99,2633.99,15.46,58.7,60 CDM,108100,ACHR RCPT BND AB,145.75,145.75,8.74,123.89,34 CDM,108100,Acetylcholine receptor (AChR); binding antibody ,145.75,145.75,15.46,58.7,60 CDM,108101,GM1 AB IA QN IGM,331.14,331.14,19.87,281.47,14 CDM,108102,GM1 AB IA QN IGG,400.12,400.12,24.01,340.1,14 CDM,108103,FACTOR VIII ANTIGEN IA,532.0,532.0,31.92,452.2,14 CDM,108104,ADAMTS 13 AB IA QN,806.87,806.87,48.41,685.84,14 CDM,108105,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",1047.22,1047.22,20.24,165.71,80 CDM,108105,HPLC MS QUANTITATIVE,1047.22,1047.22,62.83,890.14,14 CDM,108106,CHR HCV 6 BIOCHEM ALG,691.61,691.61,41.5,587.87,22 CDM,108106,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",691.61,691.61,70.75,496.48,64 CDM,108107,CATH VASC GD 17FR 13CM,27733.0,27733.0,1663.98,23573.05,49 CDM,108108,LEAD ENDOCARDIAC 60CM,46682.0,46682.0,6068.66,39679.7,28 CDM,108109,CONTINUOUS EPIDURAL,1080.0,1080.0,64.8,918.0,49 CDM,108110,PATHOGEN TEST PLATELETS,225.84,225.84,13.55,191.96,24 CDM,108110,Pathogen(s) test for platelets ,225.84,225.84,71.71,455.94,20 CDM,108111,PLT CONC LR,486.7,486.7,29.2,413.69,28 CDM,108111,"Platelets, leukocytes reduced, each unit ",486.7,486.7,67.85,1268.99,18 CDM,108112,PRBC WASH,1405.59,1405.59,84.34,1194.75,32 CDM,108112,"Red blood cells, washed, each unit ",1405.59,1405.59,1110.39,1499.86,12 CDM,108113,PLTS CONC,225.84,225.84,13.55,191.96,32 CDM,108113,"Platelets, each unit ",225.84,225.84,1058.26,1429.45,12 CDM,108114,MORPH ANAL CMP MLP PROBE,623.47,623.47,37.41,529.95,23 CDM,108114,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",623.47,623.47,289.87,2042.4,20 CDM,108115,PCMKR CRD 4.45X4.81X0.75,42819.0,42819.0,5566.47,36396.15,28 CDM,108116,PLATE SPN ADJT 6-18MM,30990.0,30990.0,4028.7,26341.5,28 CDM,108117,PLATE SPN LCK 10-18MM,30990.0,30990.0,4028.7,26341.5,28 CDM,108118,RIFAPENTINE 150 MG PO,25.0,25.0,1.5,21.25,49 CDM,108119,DILTIAZEM 125 MG INJ,74.36,74.36,4.46,63.21,24 CDM,108120,DILTIAZEM 25 MG INJ,24.62,24.62,1.48,20.93,24 CDM,108121,CALCIUM CHL 1 G INJ,80.51,80.51,4.83,68.43,25 CDM,108122,CALCIUM CHL 1 G INJ,49.45,49.45,2.97,42.03,25 CDM,108123,VANCO 500 MG INJ,19.77,19.77,1.19,16.8,24 CDM,108125,INDIGOTINDISULF 40MG INJ,1714.99,1714.99,102.9,1457.74,20 CDM,108125,"Injection, indigotindisulfonate sodium, 1 mg ",1714.99,1714.99,19.76,31.82,8 CDM,108126,EPI NOS 1 MG INJ,74.2,74.2,4.45,63.07,24 CDM,108127,EPI NOS 1 MG INJ,55.92,55.92,3.36,47.53,24 CDM,108128,VANCO 1.5 G INJ,73.82,73.82,4.43,62.75,24 CDM,108129,VANCO 1.25 G INJ,73.82,73.82,4.43,62.75,24 CDM,108130,VANCO 5 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,108131,INTRO SHTH VASC 6F 45CM,3131.5,3131.5,187.89,2661.78,49 CDM,108132,INSERT TIB KN SZ3-4 18MM,17397.0,17397.0,2261.61,14787.45,28 CDM,108133,"Injection, metoprolol tartrate, 1 mg ",17.44,17.44,0.13,0.41,10 CDM,108133,METOPROLOL 5 MG INJ,17.44,17.44,1.05,14.82,24 CDM,108134,NALOX NOS 0.4MG INJ,102.55,102.55,6.15,87.17,24 CDM,108135,NALOX NOS 2 MG INJ,213.84,213.84,12.83,181.76,24 CDM,108136,505MY VANCO 750 MG INJ,62.75,62.75,3.77,53.34,24 CDM,108137,VANCO 500 MG INJ,40.77,40.77,2.45,34.65,24 CDM,108138,BSCP DISP SLIM 3.8/1.2,8803.5,8803.5,528.21,7482.98,49 CDM,108139,CTHGD 6F 100CM M1 JL3.5,2150.5,2150.5,129.03,1827.92,49 CDM,108140,STENT EPRSTH 5MM 2.5CM,95062.0,95062.0,12358.06,80802.7,28 CDM,108141,DVC INTLS COR MNRCH 30,1975.0,1975.0,118.5,1678.75,49 CDM,108142,SCREW BN 3.5MM 14MM,1881.0,1881.0,244.53,1598.85,28 CDM,108143,SCREW BN 2.7MM 12MM,10653.0,10653.0,1384.89,9055.05,28 CDM,108144,SCREW BN 2.7MM 14MM,10726.0,10726.0,1394.38,9117.1,28 CDM,108145,SCREW BN 2.7MM 18MM,10653.0,10653.0,1384.89,9055.05,28 CDM,108146,SCREW BN 2.7MM 16MM,10653.0,10653.0,1384.89,9055.05,28 CDM,108147,PLATE BN 2.7MM 3.5MM,55245.0,55245.0,7181.85,46958.25,28 CDM,108150,KIT BONE TAMP,91169.5,91169.5,5470.17,77494.07,49 CDM,108151,SCREW SPN 7.5X45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108152,SCREW SPN 8.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108153,SCREW SPN 8.5MM 80MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108154,NEEDLE PUSHER FEN,17114.0,17114.0,1026.84,14546.9,49 CDM,108155,CAGE SPN 8D 10X34X24MM,95785.0,95785.0,12452.05,81417.25,28 CDM,108156,PLATE SPN GFT CNTN 10MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108160,HEPAR 25000U/D5W250MLINJ,53.6,53.6,3.22,45.56,24 CDM,108161,KIT VALVE HMSTS BORE SM,752.0,752.0,45.12,639.2,49 CDM,108162,KWIRE FX 450MM 2MM,2673.0,2673.0,160.38,2272.05,49 CDM,108163,WIRE EXFIX OLV DMD 2MM,4426.5,4426.5,265.59,3762.53,49 CDM,108164,BOLT EX FIX 1.5-2MM,4056.5,4056.5,243.39,3448.03,49 CDM,108165,BOLT EX FIX 1.5-2MM,4056.5,4056.5,243.39,3448.03,49 CDM,108166,STRUT EXFX 100-125MM,51050.5,51050.5,3063.03,43392.93,49 CDM,108167,GRAFT BONE MATRIX 5CC,40428.0,40428.0,5255.64,34363.8,28 CDM,108168,GRAFT BN 10CC,70076.0,70076.0,9109.88,59564.6,28 CDM,108169,ALPHAGRAFT DBM FIBER 5CC,10969.0,10969.0,1425.97,9323.65,28 CDM,108170,ALPHAGRAFT DBM FIBER 10C,22910.0,22910.0,2978.3,19473.5,28 CDM,108171,HOFFMANN LRF THMBWH,4471.5,4471.5,268.29,3800.78,49 CDM,108172,RING EX FIX 180MM,50362.5,50362.5,3021.75,42808.13,49 CDM,108173,RING EXFX FOOT LNG 180MM,64340.0,64340.0,3860.4,54689.0,49 CDM,108174,ARCH EXFIX FOOT 180MM,55953.5,55953.5,3357.21,47560.47,49 CDM,108175,SHOE EXFX LNG LRG,52337.0,52337.0,3140.22,44486.45,49 CDM,108176,STRUT EX FIX 105-139MM,77651.5,77651.5,4659.09,66003.77,49 CDM,108177,KIT EXFX STRUT MED,16480.5,16480.5,988.83,14008.42,49 CDM,108178,NUT BN ORTH SHRT,1104.5,1104.5,66.27,938.83,49 CDM,108179,BOLT EX FIX 1.5-2MM,4056.5,4056.5,243.39,3448.03,49 CDM,108180,BOLT EX FIX STRUT,1162.5,1162.5,69.75,988.13,49 CDM,108181,WASHER BN UNIV 7MM,2673.0,2673.0,160.38,2272.05,49 CDM,108182,CATH GD 5FR 100CM,2274.5,2274.5,136.47,1933.33,49 CDM,108184,DRESSING WND ADH 8X4IN,307.0,307.0,18.42,260.95,49 CDM,108185,DEVICE CLSR VASC 5FR,6448.0,6448.0,838.24,5480.8,28 CDM,108186,NAIL FEM 125D 12X240MM,52808.0,52808.0,6865.04,44886.8,28 CDM,108187,SCREW BN 10.5MM 115MM,15039.0,15039.0,1955.07,12783.15,28 CDM,108188,DRESSING FOM 6X4IN,225.5,225.5,13.53,191.68,49 CDM,108189,DRESSING FOM 6X8CM,134.0,134.0,8.04,113.9,49 CDM,108190,PCMKR SC MRI SR-T,36784.0,36784.0,4781.92,31266.4,28 CDM,108191,CATH BLNDIL 130CM 6X80MM,35436.5,35436.5,2126.19,30121.03,49 CDM,108192,CELL COUNT CSF,420.7,420.7,25.24,357.6,14 CDM,108193,VANCO 1 G INJ,81.38,81.38,4.88,69.17,24 CDM,108196,INSERT KN ARTC 3-4 11MM,35182.0,35182.0,4573.66,29904.7,28 CDM,108199,CATH 1ST ORDER VEN LT,1215.23,1215.23,72.91,1032.95,37 CDM,108200,CATH 1ST ORDER VEN RT,1215.23,1215.23,72.91,1032.95,37 CDM,108202,CATH 2ND ORDER VEN LT,1374.63,1374.63,82.48,1168.44,37 CDM,108203,CATH 2ND ORDER VEN RT,1374.63,1374.63,82.48,1168.44,37 CDM,108204,CATH 1ST ORDER VEN RT,1215.23,1215.23,157.98,1032.95,29 CDM,108205,CATH 1ST ORDER VEN LT,1215.23,1215.23,157.98,1032.95,29 CDM,108207,CATH 2ND ORDER VEN RT,1374.63,1374.63,178.7,1168.44,29 CDM,108208,CATH 2ND ORDER VEN LT,1374.63,1374.63,178.7,1168.44,29 CDM,108210,CATH 1ST ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CDM,108211,CATH 1ST ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CDM,108212,CATH 2ND ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CDM,108213,CATH 2ND ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CDM,108215,CATH 1ST OD LOW ART RT,5867.05,5867.05,762.72,4986.99,29 CDM,108216,CATH 1ST OD LOW ART LT,5867.05,5867.05,762.72,4986.99,29 CDM,108217,CATH 2ND OD LOW ART RT,8361.52,8361.52,1087.0,7107.29,29 CDM,108218,CATH 2ND OD LOW ART LT,8361.52,8361.52,1087.0,7107.29,29 CDM,108220,CATH 3RD OD LOW ART RT,5864.43,5864.43,762.38,4984.77,29 CDM,108221,CATH 3RD OD LOW ART LT,5864.43,5864.43,762.38,4984.77,29 CDM,108223,CATH 3RD ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CDM,108224,CATH 3RD ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CDM,108225,INJ PERC EXTREM PSEAN RT,19081.62,19081.62,2671.43,16219.38,11 CDM,108226,INJ PERC EXTREM PSEAN LT,19081.62,19081.62,2671.43,16219.38,11 CDM,108227,INJ PERC EXTREM PSEAN BI,28622.44,28622.44,4007.14,24329.07,11 CDM,108228,INJ NEPH NEW ACCESS LT,8584.96,8584.96,1116.04,7297.22,15 CDM,108229,INJ NEPH NEW ACCESS BI,12877.44,12877.44,1674.07,10945.82,15 CDM,108230,INJ NEPH NEW ACCESS RT,8584.96,8584.96,1116.04,7297.22,15 CDM,108231,PLCMT NEPH CATH LT,8907.72,8907.72,1247.08,7571.56,10 CDM,108233,PLCMT NEPH CATH RT,8907.72,8907.72,1247.08,7571.56,10 CDM,108234,PLCMT URETERAL STNT BI,17346.34,17346.34,2428.49,14744.39,10 CDM,108235,PLCMT URETERAL STNT RT,11564.23,11564.23,1618.99,9829.6,10 CDM,108236,PLCMT URETERAL STNT LT,11564.23,11564.23,1618.99,9829.6,10 CDM,108237,PLCMT URETER STNT NEW RT,12268.53,12268.53,1717.59,10428.25,10 CDM,108238,PLCMT URETER STNT NEW LT,12268.53,12268.53,1717.59,10428.25,10 CDM,108239,PLCMT URETER STNT NEW BI,18402.8,18402.8,2576.39,15642.38,10 CDM,108240,XR FINGER(S) 2 + V LT,1655.33,1655.33,99.32,1407.03,17 CDM,108241,XR FINGER(S) 2 + V RT,1655.33,1655.33,99.32,1407.03,17 CDM,108242,XR FINGER(S) 2 + V LT,1533.11,1533.11,91.99,1303.14,17 CDM,108243,XR FINGER(S) 2 + V RT,1533.11,1533.11,91.99,1303.14,17 CDM,108244,CTA UPPER EXTREMITY LT,17259.1,17259.1,1035.55,14670.23,14 CDM,108245,CTA UPPER EXTREMITY RT,17259.1,17259.1,1035.55,14670.23,14 CDM,108246,XR HIP W PEL UNI 1 V LT,1952.93,1952.93,117.18,1659.99,17 CDM,108247,XR HIP W PEL UNI 1 V RT,1952.93,1952.93,117.18,1659.99,17 CDM,108248,XR HIP W PEL UNI 1 V LT,1808.7,1808.7,108.52,1537.39,17 CDM,108250,XR HIP W PEL UN 2-3 V LT,2203.28,2203.28,132.2,1872.79,17 CDM,108251,XR HIP W PEL UN 2-3 V RT,2203.28,2203.28,132.2,1872.79,17 CDM,108252,XR HIP W PEL UN 2-3 V LT,2039.8,2039.8,122.39,1733.83,17 CDM,108253,XR HIP W PEL UN 2-3 V RT,2039.8,2039.8,122.39,1733.83,17 CDM,108254,XR TOE(S) 2 + V LT,1918.45,1918.45,115.11,1630.68,17 CDM,108255,XR TOE(S) 2 + V RT,1918.45,1918.45,115.11,1630.68,17 CDM,108256,XR TOE(S) 2 + V LT,1776.15,1776.15,106.57,1509.73,17 CDM,108257,XR TOE(S) 2 + V RT,1776.15,1776.15,106.57,1509.73,17 CDM,108258,SP ANGIO EXT UNI LT,15268.39,15268.39,916.1,12978.13,17 CDM,108259,SP ANGIO EXT UNI RT,15268.39,15268.39,916.1,12978.13,17 CDM,108260,CATH EA ADDL UP ART RT,14706.34,14706.34,882.38,12500.39,31 CDM,108261,CATH EA ADDL UP ART LT,14706.34,14706.34,882.38,12500.39,31 CDM,108263,SP EX CAROTID ANGIO LT,16814.51,16814.51,2185.89,14292.33,15 CDM,108264,SP EX CAROTID ANGIO RT,16814.51,16814.51,2185.89,14292.33,15 CDM,108265,SP COM CAROTIDANGIO RT,14172.39,14172.39,1842.41,12046.53,15 CDM,108266,SP COM CAROTIDANGIO LT,14172.39,14172.39,1842.41,12046.53,15 CDM,108267,SP VERT ANGIO LT,25511.86,25511.86,3316.54,21685.08,15 CDM,108268,SP VERT ANGIO RT,25511.86,25511.86,3316.54,21685.08,15 CDM,108272,SP INT CAROTID ANGIO RT,25511.86,25511.86,3316.54,21685.08,15 CDM,108273,SP INT CAROTID ANGIO LT,25511.86,25511.86,3316.54,21685.08,15 CDM,108274,SP SUBCL ANGIO LT,14172.39,14172.39,1842.41,12046.53,15 CDM,108275,SP SUBCL ANGIO RT,14172.39,14172.39,1842.41,12046.53,15 CDM,108277,SP EX CARTIDANGIOUNI +RT,1419.07,1419.07,184.48,1206.21,26 CDM,108278,SP EX CARTIDANGIOUNI +LT,1419.07,1419.07,184.48,1206.21,26 CDM,108280,SP INCRAN ANGIO RT,5668.43,5668.43,736.9,4818.17,26 CDM,108281,SP INCRAN ANGIO LT,5668.43,5668.43,736.9,4818.17,26 CDM,108282,CATH 1ST OD LOW ART LT,5867.05,5867.05,352.02,4986.99,37 CDM,108283,CATH 1ST OD LOW ART RT,5867.05,5867.05,352.02,4986.99,37 CDM,108284,CATH 2ND OD LOW ART LT,8361.52,8361.52,501.69,7107.29,37 CDM,108285,CATH 2ND OD LOW ART RT,8361.52,8361.52,501.69,7107.29,37 CDM,108286,CATH 3RD OD LOW ART LT,5864.43,5864.43,351.87,4984.77,37 CDM,108287,CATH 3RD OD LOW ART RT,5864.43,5864.43,351.87,4984.77,37 CDM,108288,ART THRMB NONCOR INI RT,11173.52,11173.52,1564.29,9497.49,10 CDM,108289,ART THRMB NONCOR INI LT,11173.52,11173.52,1564.29,9497.49,10 CDM,108290,VENOUS MECH THROMBECT RT,10509.73,10509.73,1471.36,8933.27,10 CDM,108291,VENOUS MECH THROMBECT LT,10509.73,10509.73,1471.36,8933.27,10 CDM,108292,TRNSCTH TX ART INI DAYRT,5195.4,5195.4,727.36,4416.09,10 CDM,108293,TRNSCTH TX ART INI DAYLT,5195.4,5195.4,727.36,4416.09,10 CDM,108294,TRNSCTH TX VEN INI DAYLT,4556.43,4556.43,637.9,3872.97,10 CDM,108295,TRNSCTH TX VEN INI DAYRT,4556.43,4556.43,637.9,3872.97,10 CDM,108327,TRANSCTH STNT PLC IA BI,88944.57,88944.57,12452.24,75602.88,10 CDM,108328,TRANSCTH STNT PLC IA RT,59296.37,59296.37,8301.49,50401.91,10 CDM,108329,TRANSCTH STNT PLC IA LT,59296.37,59296.37,8301.49,50401.91,10 CDM,108330,TRANSCTH STNT PLC AD BI,43022.85,43022.85,5592.97,36569.42,28 CDM,108331,TRANSCTH STNT PLC AD RT,28681.89,28681.89,3728.65,24379.61,28 CDM,108332,TRANSCTH STNT PLC AD LT,28681.89,28681.89,3728.65,24379.61,28 CDM,108333,TRNSCTH STN PLC IN VN BI,88944.57,88944.57,12452.24,75602.88,10 CDM,108334,TRNSCTH STN PLC IN VN RT,59296.37,59296.37,8301.49,50401.91,10 CDM,108335,TRNSCTH STN PLC IN VN LT,59296.37,59296.37,8301.49,50401.91,10 CDM,108336,TRNSCTH STN PLC EA VN RT,28681.89,28681.89,3728.65,24379.61,28 CDM,108337,TRNSCTH STN PLC EA VN BI,43022.85,43022.85,5592.97,36569.42,28 CDM,108338,TRNSCTH STN PLC EA VN LT,28681.89,28681.89,3728.65,24379.61,28 CDM,108339,INJ NEPH EXIST ACCESS LT,4467.58,4467.58,268.05,3797.44,37 CDM,108341,INJ NEPH EXIST ACCESS RT,7803.56,7803.56,1014.46,6633.03,15 CDM,108342,INJ NEPH EXIST ACCESS LT,7803.56,7803.56,1014.46,6633.03,15 CDM,108343,INJ NEPH EXIST ACCESS BI,11705.34,11705.34,1521.69,9949.54,15 CDM,108344,PLCMT NEPH CATH RT,8907.72,8907.72,534.46,7571.56,37 CDM,108346,NEPHURETERAL CATH PLC BI,13218.51,13218.51,1850.59,11235.73,10 CDM,108347,NEPHURETERAL CATH PLC RT,8812.34,8812.34,1233.73,7490.49,10 CDM,108348,NEPHURETERAL CATH PLC LT,8812.34,8812.34,1233.73,7490.49,10 CDM,108349,NEPH CATH CONV NEPURT BI,14949.22,14949.22,2092.89,12706.84,10 CDM,108350,NEPH CATH CONV NEPURT RT,9966.14,9966.14,1395.26,8471.22,10 CDM,108351,NEPH CATH CONV NEPURT LT,9966.14,9966.14,1395.26,8471.22,10 CDM,108352,NEPH CATH EXCHANGE LT,8719.55,8719.55,1220.74,7411.62,10 CDM,108353,NEPH CATH EXCHANGE RT,8719.55,8719.55,1220.74,7411.62,10 CDM,108354,DIL EX TRCT ENDUR PRC BI,17848.11,17848.11,2498.74,15170.89,11 CDM,108355,DIL EX TRCT ENDUR PRC RT,11898.74,11898.74,1665.82,10113.93,11 CDM,108356,DIL EX TRCT ENDUR PRC LT,11898.74,11898.74,1665.82,10113.93,11 CDM,108357,PLCMT URETER STNT NEW LT,12268.53,12268.53,736.11,10428.25,37 CDM,108358,PLCMT URETER STNT NEW RT,12268.53,12268.53,736.11,10428.25,37 CDM,108359,PLC URTR STNT SEP CTH RT,11850.39,11850.39,1659.05,10072.83,10 CDM,108360,CTA HEAD VIZ AI TECH,14223.78,14223.78,853.43,12090.21,14 CDM,108368,PLC URTR STNT SEP CTH LT,11850.39,11850.39,1659.05,10072.83,10 CDM,108369,PLC URTR STNT SEP CTH BI,17775.58,17775.58,2488.58,15109.24,10 CDM,108370,SP ANGIO EXT UNI RT 59,7459.21,7459.21,447.55,6340.33,17 CDM,108371,SP VENOGRAM EXT UNI LT59,11035.55,11035.55,662.13,9380.22,17 CDM,108372,SP VENOGRAM EXT UNI RT59,11035.55,11035.55,662.13,9380.22,17 CDM,108373,INJ CATH SEL PUL ANG RT,9401.7,9401.7,564.1,7991.45,33 CDM,108374,INJ CATH SEL PUL ANG LT,9401.7,9401.7,564.1,7991.45,33 CDM,108377,VANCO 750 MG INJ,48.11,48.11,2.89,40.89,24 CDM,108378,VANCO 125 MG INJ,13.56,13.56,0.81,11.53,24 CDM,108379,SCREW BN 4MM 3.4MM 14MM,4953.0,4953.0,643.89,4210.05,28 CDM,108381,SPLINT NSL 2.38X1.53IN,846.5,846.5,50.79,719.52,49 CDM,108382,NAIL BN FEM 11MM 440MM,42266.0,42266.0,5494.58,35926.1,28 CDM,108384,SCREW BN 6.5MM 100MM,6479.0,6479.0,842.27,5507.15,28 CDM,108385,SCREW BN LCK F-T6.5X95MM,6479.0,6479.0,842.27,5507.15,28 CDM,108387,TRANEX ACID 1G 100ML INJ,51.84,51.84,3.11,44.06,49 CDM,108391,SPACER FEM KN RT SZ4,40146.0,40146.0,5218.98,34124.1,28 CDM,108392,PLATE BN FULL MAXILLARY,100000.0,100000.0,13000.0,85000.0,28 CDM,108394,DERMACELL AWM PORO 1SQCM,2541.0,2541.0,152.46,2159.85,30 CDM,108395,GRAFT DBM STRIP 100X10MM,27491.0,27491.0,3573.83,23367.35,28 CDM,108396,GRAFT BN CANC 30ML,9050.0,9050.0,1176.5,7692.5,28 CDM,108397,CATHETER GD 9FR 57.5CM,8698.0,8698.0,521.88,7393.3,49 CDM,108398,LEAD PCNG 65CM,6040.0,6040.0,785.2,5134.0,28 CDM,108400,PENCILSMK EVAC SZ3,10388.5,10388.5,623.31,8830.23,49 CDM,108401,DRESSING ANMC GEL 1.5OZ,740.0,740.0,44.4,629.0,49 CDM,108406,CATH BLNDIL 4X20X80,6273.0,6273.0,376.38,5332.05,49 CDM,108407,CATH BLNDIL 5X20X80,6273.0,6273.0,376.38,5332.05,49 CDM,108408,CATH BLNDIL 5.5X20X80,6273.0,6273.0,376.38,5332.05,49 CDM,108409,CATH BLNDIL 6X20X80,6273.0,6273.0,376.38,5332.05,49 CDM,108410,NS 50 ML,51.84,51.84,3.11,44.06,24 CDM,108411,CMPD EPI 5MG 255ML,99.04,99.04,5.94,84.18,30 CDM,108414,SCREW BN 4.5MM 8MM 24MM,922.0,922.0,119.86,783.7,28 CDM,108418,SCREW SPN 7.5MM 45MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108419,SCREW SPN 7.5MM 50MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108420,ROD SPN 5.5MM 400MM,5265.0,5265.0,684.45,4475.25,28 CDM,108421,SCREW SPN 8.5MM 50MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108423,CANNULA CMNT DLV,3555.0,3555.0,213.3,3021.75,49 CDM,108425,SCREW BN 5MM 75MM,4992.0,4992.0,648.96,4243.2,28 CDM,108427,BIT DRL 185MM 4.2MM,5520.5,5520.5,331.23,4692.43,49 CDM,108428,SCREW BN CANN 4MM 40MM,5990.0,5990.0,778.7,5091.5,28 CDM,108429,NAIL BN 10MM 345MM,42266.0,42266.0,5494.58,35926.1,28 CDM,108430,SCREW BN 5MM 37.5MM,4992.0,4992.0,648.96,4243.2,28 CDM,108431,BURR SRG HEURO 5.1MM 4MM,4699.0,4699.0,281.94,3994.15,49 CDM,108432,KNIFE BAYONET STRL 170MM,4182.0,4182.0,250.92,3554.7,49 CDM,108433,SPACER SPN 15D 6X34X24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108434,SPACER SPN 15D 8X34X24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108437,ANCHOR SUT 3.5X10.5MM,19633.0,19633.0,2552.29,16688.05,28 CDM,108438,SCREW SPN 10.5MM 70MM,49301.0,49301.0,6409.13,41905.85,28 CDM,108439,SCREW SPN 10.5MM 60MM,49301.0,49301.0,6409.13,41905.85,28 CDM,108440,SCREW SPN 10.5MM 60MM,49301.0,49301.0,6409.13,41905.85,28 CDM,108442,SHEATH CATH 8FR 65CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108443,SHEATH CATH 8FR 90CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108444,DEVICE THRMB SET,100000.0,100000.0,6000.0,85000.0,49 CDM,108445,CATH THRMB 4-8MM 130CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108446,CATH THRMB 8FR 85CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108447,CATH THRMB 8FR 65CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108449,ROD CONN SPN 0D,10032.0,10032.0,1304.16,8527.2,28 CDM,108454,STEM FEM HIP 132D 111MM,54429.0,54429.0,7075.77,46264.65,28 CDM,108455,SCREW SPN 5.5MM 30MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108456,SCREW SPN 5.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108457,SCREW SPN 6.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108458,SCREW SPN 7.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108459,SCREW SPN 7.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108460,SCREW SPN 4.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108461,SCREW SPN 5.0MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108462,DELIVERY PLUNGER,1453.0,1453.0,87.18,1235.05,49 CDM,108463,LIGHT SURG SPN ILUM SYS,10564.5,10564.5,633.87,8979.83,49 CDM,108464,BOLT SPN FSN 8.5X25MM,9316.0,9316.0,1211.08,7918.6,28 CDM,108465,SCREW SPN 5.0MM 25MM,9316.0,9316.0,1211.08,7918.6,28 CDM,108466,CONN SPN OPN-OPN 11-14MM,10032.0,10032.0,1304.16,8527.2,28 CDM,108467,HANDLE POWER T STRL,20029.5,20029.5,1201.77,17025.08,49 CDM,108468,SCREW SPN 9.5MM 80MM,49301.0,49301.0,6409.13,41905.85,28 CDM,108469,ROD SPN 5.5MM 130MM,5265.0,5265.0,684.45,4475.25,28 CDM,108470,SCREW SPN 8.5MM 80MM,14331.0,14331.0,1863.03,12181.35,28 CDM,108471,CONN SPN OPEN ILIAC 30MM,10032.0,10032.0,1304.16,8527.2,28 CDM,108472,CLEANER GUIDE ALIGNMENT,10564.5,10564.5,633.87,8979.83,49 CDM,108473,SCREW SPN 6.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108474,ROD SPN 6.0MM 500MM,5265.0,5265.0,684.45,4475.25,28 CDM,108475,ROD SPN 5.5MM 500MM,5265.0,5265.0,684.45,4475.25,28 CDM,108476,CMV RAPID CULTURE,145.07,145.07,8.7,123.31,14 CDM,108477,ANCHOR BN 4.75X19.1MM,25415.0,25415.0,3303.95,21602.75,28 CDM,108478,SCREW BN 9MM 20MM,19319.0,19319.0,2511.47,16421.15,28 CDM,108479,SCREW BN 8MM 20MM,12557.0,12557.0,1632.41,10673.45,28 CDM,108480,REAMER CORING CANN 8MM,7817.5,7817.5,469.05,6644.88,49 CDM,108482,PLATE BN COMP 28X13X11MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108483,SCREW BN LCK 5MM 40MM,4992.0,4992.0,648.96,4243.2,28 CDM,108484,BLADE SAW 11MM 40MM,2905.5,2905.5,174.33,2469.68,49 CDM,108485,OSTEOTOME SQUARE,12325.0,12325.0,739.5,10476.25,49 CDM,108486,SCALPEL INSTRMNT,12325.0,12325.0,739.5,10476.25,49 CDM,108487,PLATE TACKS 2.2MM,6273.0,6273.0,376.38,5332.05,49 CDM,108488,OSTEOTOME THIN 1.5MM,12325.0,12325.0,739.5,10476.25,49 CDM,108489,OSTEOTOME HOOKED 1 PC,12325.0,12325.0,739.5,10476.25,49 CDM,108490,SCREW BN 3.5X23 AND 26MM,18770.0,18770.0,2440.1,15954.5,28 CDM,108491,SCREW BN 1.85X5MM,4227.0,4227.0,549.51,3592.95,28 CDM,108492,GWIRE 0.014IN 190CM,3136.5,3136.5,188.19,2666.03,49 CDM,108493,GWIRE VASC 300CM WARRIOR,5436.5,5436.5,326.19,4621.02,49 CDM,108494,GWIRE VASC 200CM BANDIT,4809.5,4809.5,288.57,4088.07,49 CDM,108495,GWIRE 0.014IN 190CM,3345.5,3345.5,200.73,2843.68,49 CDM,108497,SCREW BN 2.7MM 6MM,4416.0,4416.0,574.08,3753.6,28 CDM,108498,KIT INTRATHECAL PUMP SEG,14086.0,14086.0,845.16,11973.1,49 CDM,108499,GUIDEPIN ORTH HIP 3.2MM,8011.5,8011.5,480.69,6809.77,49 CDM,108500,SHELL ACTB HIP MOD 58MM,62964.0,62964.0,8185.32,53519.4,28 CDM,108501,INSERT HIP 28X44MM,14720.0,14720.0,1913.6,12512.0,28 CDM,108502,SCREW BN LCK 20MM,2541.0,2541.0,330.33,2159.85,28 CDM,108504,LINER ACTB HIP 44/58MM,26764.0,26764.0,3479.32,22749.4,28 CDM,108506,ACTI CHAR 50G/240MLLIQPO,127.76,127.76,7.67,108.6,49 CDM,108508,ALBUTERLNC UD 1.25MG INH,5.4,5.4,0.32,4.59,24 CDM,108509,ALBUTEROL 90MCG 8G INH,113.45,113.45,6.81,96.43,33 CDM,108512,CMPD KPHOS 15MM 250B,59.99,59.99,3.6,50.99,30 CDM,108513,CMPD VANCO 2G 500B,170.49,170.49,10.23,144.92,30 CDM,108514,DOXYCYCL HYCL 100 MG PO,5.4,5.4,0.32,4.59,49 CDM,108515,EMTR/TENOF 200/300 MG PO,5.94,5.94,0.36,5.05,49 CDM,108516,LIPID EMUL 20% 500ML INJ,105.56,105.56,6.33,89.73,46 CDM,108517,GUAI/DEX 200/20MG/10MLPO,12.42,12.42,0.75,10.56,49 CDM,108518,HALOPERIDOL 2 MG PO,5.4,5.4,0.32,4.59,49 CDM,108519,AMINOPHYLLIN 250 MG INJ,92.34,92.34,5.54,78.49,24 CDM,108521,CMPD MIDZLM 50MG 50B,43.2,43.2,2.59,36.72,30 CDM,108522,ATORVASTATIN 80 MG PO,5.4,5.4,0.32,4.59,49 CDM,108523,HUMULIN R 20 U INJ,24.98,24.98,1.5,21.23,41 CDM,108524,HUMULIN 70/30 20 U INJ,24.98,24.98,1.5,21.23,41 CDM,108525,HUMULIN N 20 U INJ,38.07,38.07,2.28,32.36,41 CDM,108526,HUMALOG 75/25 20 U INJ,38.07,38.07,2.28,32.36,41 CDM,108527,PROMETH 6.25MG/5ML LIQPO,4.59,4.59,0.28,3.9,49 CDM,108528,BUSPIRONE 15 MG PO,5.4,5.4,0.32,4.59,49 CDM,108529,CARVEDILOL 25 MG PO,5.4,5.4,0.32,4.59,49 CDM,108530,VALSARTAN 80 MG PO,6.86,6.86,0.41,5.83,49 CDM,108533,DEXAMETHASONE 2 MG PO,5.4,5.4,0.32,4.59,24 CDM,108535,LORAZEPAM 2 MG PO,5.4,5.4,0.32,4.59,49 CDM,108538,MORPHINE 30 MG PO,8.59,8.59,0.52,7.3,49 CDM,108539,NAPROXEN 500 MG PO,5.4,5.4,0.32,4.59,49 CDM,108540,OLANZAPINE 10 MG PO,6.05,6.05,0.36,5.14,49 CDM,108542,NINVS CFFR SW ANLYS CTA,13107.5,13107.5,786.45,11141.38,35 CDM,108542,"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and repo",13107.5,13107.5,1753.28,3855.22,5 CDM,108543,EXAM SELEC RETR ARCH MOL,435.03,435.03,26.1,369.78,23 CDM,108543,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",435.03,435.03,46.44,136.84,20 CDM,108544,DRUG SCR DOO MANUAL READ,223.45,223.45,13.41,189.93,14 CDM,108544,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",223.45,223.45,10.58,86.7,80 CDM,108546,INS PICC WO P W IMG=>5Y,6962.06,6962.06,974.69,5917.75,11 CDM,108546,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",6962.06,6962.06,468.58,11153.0,43 CDM,108548,SUTURE VIOL MON+2-0 27IN,134.0,134.0,8.04,113.9,49 CDM,108549,STRUT EX FI X 183-295MM,77651.5,77651.5,4659.09,66003.77,49 CDM,108550,SYSTEM GRAFT STENT CASE,100000.0,100000.0,13000.0,85000.0,23 CDM,108551,SCREW BN 2MM 6MM,2836.0,2836.0,368.68,2410.6,28 CDM,108552,KIT INTRO CATH 5F 40CM,1101.5,1101.5,66.09,936.27,49 CDM,108553,KIT MCR INTRO 5FR 41CM,1275.5,1275.5,76.53,1084.17,49 CDM,108554,DEVICE INSERT HANDPIECE,28318.5,28318.5,1699.11,24070.72,49 CDM,108555,FORCEPS ESURG BIP 11.6IN,21570.0,21570.0,1294.2,18334.5,49 CDM,108556,BOLT SPN GRFT 8.5MM 25MM,9316.0,9316.0,1211.08,7918.6,28 CDM,108557,ROD SPN LRDC 5.5MM 40MM,5265.0,5265.0,684.45,4475.25,28 CDM,108558,ROD SPN 5.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 CDM,108559,SCREW SPN 6.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,108560,SCREW SPN 8.5MM 45MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108561,SCREW SPN 8.5MM 50MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108562,SLING SURG MESH MALE,100000.0,100000.0,13000.0,85000.0,28 CDM,108563,"Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use ",1007.48,1007.48,269.31,800.9,10 CDM,108563,VAXNEUVANCE VAC IM,1007.48,1007.48,60.45,856.36,19 CDM,108566,DAPTACEL < 7 YRS VAC IM,123.61,123.61,7.42,105.07,24 CDM,108566,"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use ",123.61,123.61,32.97,103.4,10 CDM,108568,PNEUMOVAX 23 VAC IMSQ,581.58,581.58,34.89,494.34,19 CDM,108568,"Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use ",581.58,581.58,133.47,409.13,10 CDM,108569,SCREW BN LCK 5MM 47MM,4992.0,4992.0,648.96,4243.2,28 CDM,108570,SUTURE CP 0 TC T-26 48IN,2338.5,2338.5,140.31,1987.72,49 CDM,108571,CAGE SPN 14X11X8MM,22538.0,22538.0,2929.94,19157.3,28 CDM,108572,PLATE SPN 1LVL 14MM,22538.0,22538.0,2929.94,19157.3,28 CDM,108573,PEG GASTRO 24FR,5387.5,5387.5,323.25,4579.38,49 CDM,108574,KIT PEG EVV DISP 20FR,5387.5,5387.5,323.25,4579.38,49 CDM,108575,SCREW SPN 4.0MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,108576,CAGE SPN 10X24X8MM,95785.0,95785.0,12452.05,81417.25,28 CDM,108577,PLATE SPN FLRD LOCK 8MM,30990.0,30990.0,4028.7,26341.5,28 CDM,108578,PLATE SPN FLRD POST 8MM,30990.0,30990.0,4028.7,26341.5,28 CDM,108579,SCREW SET SPN UNIV,10319.0,10319.0,1341.47,8771.15,28 CDM,108580,SCREW SPN 50MM 7.5MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108581,SPACER SPN 10D 8X34X24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108582,LEVONORGESTREL 1.5 MG PO,29.81,29.81,1.79,25.34,49 CDM,108586,FENTANYL CIT 0.05 MG INJ,17.28,17.28,1.04,14.69,24 CDM,108587,METHYLPRED SS 125 MGINJ,32.72,32.72,1.96,27.81,24 CDM,108588,ONDANSETRON 8 MG PO,4.59,4.59,0.28,3.9,25 CDM,108589,SCREW SPN 6.5MM 45MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108590,NUT EXFX LNG M8 15MM,1674.0,1674.0,100.44,1422.9,49 CDM,108591,PHYTONADIONE 5 MG PO,30.78,30.78,1.85,26.16,49 CDM,108593,OXYCODONE 5MG/5ML LIQ PO,12.85,12.85,0.77,10.92,49 CDM,108595,DEXAMETHASONE 6 MG PO,6.05,6.05,0.36,5.14,24 CDM,108598,TROPICAMIDE 1% 15ML OPH,46.76,46.76,2.81,39.75,49 CDM,108599,PREDNISONE 50 MG PO,4.59,4.59,0.28,3.9,24 CDM,108600,PRAVASTATIN 40 MG PO,4.59,4.59,0.28,3.9,49 CDM,108601,KIT IMPLANT ANKLE,80587.0,80587.0,10476.31,68498.95,28 CDM,108602,SCREW BN 3.5MM 10MM,1881.0,1881.0,244.53,1598.85,28 CDM,108603,SCREW BN 1.55X2.65X6MM,3627.0,3627.0,471.51,3082.95,28 CDM,108605,GRAFT CV 30MM 50CM,83797.0,83797.0,10893.61,71227.45,28 CDM,108606,PLUG BNCMNT XL 18-21MM,2541.0,2541.0,330.33,2159.85,28 CDM,108607,PLUG BNCMNT LG 14-17MM,2541.0,2541.0,330.33,2159.85,28 CDM,108608,TUNNLER SHTH 17GA 10IN,1616.0,1616.0,96.96,1373.6,49 CDM,108609,CATHETER BLNDIL 3.5X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,108611,SCREW SPN 6.5MM 25MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108612,CATH BLN 5F 4X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108613,CATH BLN 5F 4X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108614,CATH BLN 5F 4X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108615,CATH BLN 5F 4X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108616,CATH BLN 6F 5X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108617,CATH BLN 6F 5X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108618,CATH BLN 6F 5X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108619,CATH BLN 6F 5X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108620,CATH BLN 6F 80CM 6X40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108621,CATH BLN 6F 6X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108622,CATH BLN 6F 6X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108623,CATH BLN 6F 6X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108624,CATH BLN 7F 7X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108625,CATH BLN 7F 7X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108626,CATH BLN 7F 7X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 CDM,108627,CATH BLN 7F 8X40X80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108628,CATH BLN 7F 8X60X80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108629,CATH BLN 7F 8X80MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108630,CATH BLN 7F 9X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108631,EXPANDER TISSUE 1445CC,67587.0,67587.0,8786.31,57448.95,28 CDM,108632,GRAFT ST TIS 10CM 18CM,1093.0,1093.0,142.09,929.05,28 CDM,108633,CATH BLN 7F 9X60MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108634,CATH BLN 9F 9X80MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108635,CATH BLN 10X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108636,CATH BLN 12X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 CDM,108637,CATH BLNDIL 4MM 200MM,56852.0,56852.0,3411.12,48324.2,49 CDM,108638,CATH BLNDIL 4MM 250MM,62552.5,62552.5,3753.15,53169.63,49 CDM,108639,CATH BLNDIL 5MM 200MM,56852.0,56852.0,3411.12,48324.2,49 CDM,108640,CATH BLNDIL 5MM 250MM,62552.5,62552.5,3753.15,53169.63,49 CDM,108641,CATH BLNDIL 6MM 200MM,56852.0,56852.0,3411.12,48324.2,49 CDM,108642,CATH BLNDIL 6MM 250MM,62552.5,62552.5,3753.15,53169.63,49 CDM,108643,CATH BLN ANGIO 4.0X40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108644,CATH BLN ANGIO 4.0X60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108645,CATH BLN ANGIO 4.0X80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108646,CATH BLN ANGIO 4.0X120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108647,CATH BLN ANGIO 4.0X150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,108648,CATH BLN ANGIO 5.0X40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108649,CATH BLN ANGIO 5.0X60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108650,CATH BLN ANGIO 5.0X80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108651,CATH BLN ANGIO 5.0X120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108652,CATH BLN ANGIO 5.0X150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,108653,CATH BLN ANGIO 6.0X40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108654,CATH BLN ANGIO 6.0X60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108655,CATH BLN ANGIO 6.0X80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108656,CATH BLN ANGIO 6.0X120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108657,CATH BLN ANGIO 6.0X150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,108658,CATH BLN ANGIO 7.0X40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108659,CATH BLN ANGIO 7X60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108660,CATH BLN ANGIO 7.0X80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,108662,CATH GD 5.5FR 0.051IN,13205.5,13205.5,792.33,11224.67,49 CDM,108663,CATH GD 6.0FR 0.056IN,13205.5,13205.5,792.33,11224.67,49 CDM,108664,DEVICE BRST IMPLNT DLVRY,6273.0,6273.0,376.38,5332.05,49 CDM,108676,FIBER DBM 10CC,27488.0,27488.0,3573.44,23364.8,28 CDM,108677,SCREW BN 3.3MM 42MM,29008.0,29008.0,3771.04,24656.8,28 CDM,108678,CAGE SPN 15D 4X42X30MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108679,GWIRE TIP TROCAR 310MM,1453.0,1453.0,87.18,1235.05,49 CDM,108680,SHIM INTRADCA NARROW,7043.0,7043.0,422.58,5986.55,49 CDM,108681,BOLT SPN GRFT 8.5MM 35MM,9316.0,9316.0,1211.08,7918.6,28 CDM,108682,SCREW SPN 5MM 30MM,9316.0,9316.0,1211.08,7918.6,28 CDM,108683,SPACER SPN 10D 6X22X60MM,84516.0,84516.0,10987.08,71838.6,28 CDM,108684,KIT DILATOR CIRCLE,15846.5,15846.5,950.79,13469.52,49 CDM,108685,DEV MEP ACTIVATOR,18488.5,18488.5,1109.31,15715.23,49 CDM,108686,PROBE STIM BALL TIP,6273.0,6273.0,376.38,5332.05,49 CDM,108687,CLIP STIMULATING STRL,6273.0,6273.0,376.38,5332.05,49 CDM,108688,ELCTRD NDL EMG/SSEP/MEP,61628.0,61628.0,3697.68,52383.8,49 CDM,108689,SCREW SPN 6.5MM 55MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108690,PROBE I-PAS III BVL TIP,11061.0,11061.0,663.66,9401.85,49 CDM,108691,SCREW SPN 6.5MM 50MM,7883.0,7883.0,1024.79,6700.55,28 CDM,108692,SCREW BN RELINE MAS SPNE,6449.0,6449.0,838.37,5481.65,28 CDM,108694,CAGE SPN 8D 8X34X24MM,95785.0,95785.0,12452.05,81417.25,28 CDM,108695,PLATE SPN GRAFT CNTN 8MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108696,ROD SPN 40MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,108697,ROD SPN 5.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 CDM,108698,CAP ACCESS PUSHER,7043.0,7043.0,422.58,5986.55,49 CDM,108699,SCREW BN 3.3MM 50MM,29008.0,29008.0,3771.04,24656.8,28 CDM,108700,SCREW BN S/T 2MM 10MM,2836.0,2836.0,368.68,2410.6,28 CDM,108701,CATH GD 8FR 65CM,6273.0,6273.0,376.38,5332.05,49 CDM,108702,CATH BLN 2X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,108703,SCREW BN 2.0MM 5MM,2943.0,2943.0,382.59,2501.55,28 CDM,108704,SCREW BN 2.4MM 5MM,4058.0,4058.0,527.54,3449.3,28 CDM,108708,SCREW BN 5MM 40MM,4992.0,4992.0,648.96,4243.2,28 CDM,108709,GWIRE ORTH 3MM 800MM,17607.0,17607.0,1056.42,14965.95,49 CDM,108710,SCREW SPN 4.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108711,PLATE BN STD RT,39332.0,39332.0,5113.16,33432.2,28 CDM,108714,SCREW BN 2.3MM 22MM,3131.0,3131.0,407.03,2661.35,28 CDM,108718,T CELLS TOTAL,210.68,210.68,12.64,179.08,14 CDM,108718,T cells; total count ,210.68,210.68,31.69,259.46,80 CDM,108719,SCREW BN 4.5MM 36MM,6676.0,6676.0,867.88,5674.6,28 CDM,108720,SCREW BN 4.5MM 48MM,6676.0,6676.0,867.88,5674.6,28 CDM,108721,SCREW BN 4.5MM 26MM,6676.0,6676.0,867.88,5674.6,28 CDM,108722,SCREW BN 4.5MM 22MM,6676.0,6676.0,867.88,5674.6,28 CDM,108723,STYLET SPINE DISP 45MM,1453.0,1453.0,87.18,1235.05,49 CDM,108724,STEM FEM BW 150X11MM,34045.0,34045.0,4425.85,28938.25,28 CDM,108725,SUTURETAPE 1.3MM WH/BL,2905.5,2905.5,174.33,2469.68,49 CDM,108727,CLONIDINE HCL 1 MG INJ,195.36,195.36,11.72,166.06,24 CDM,108727,"Injection, clonidine hydrochloride, 1 mg ",195.36,195.36,17.92,55.13,10 CDM,108728,TRIAMCINO 0.1% 80G TOP,68.47,68.47,4.11,58.2,49 CDM,108729,BISACODYL 5 MG PO,2.16,2.16,0.13,1.84,49 CDM,108730,BISACODYL 10 MG RECTAL,2.16,2.16,0.13,1.84,49 CDM,108731,SOD TETRADECYL 1%2ML MDV,619.1,619.1,37.15,526.24,30 CDM,108732,SENNOSID 8.6-8.8MG PO,2.16,2.16,0.13,1.84,49 CDM,108733,THROMBIN 5000 U TOPICAL,2123.67,2123.67,127.42,1805.12,30 CDM,108733,Unclassified biologics ,2123.67,2123.67,,,0 CDM,108734,NICOTINE 7 MG PATCH,53.54,53.54,3.21,45.51,49 CDM,108735,NICOTINE 21 MG PATCH,55.92,55.92,3.36,47.53,49 CDM,108736,IBUPROF 200MG/10ML LIQPO,6.18,6.18,0.37,5.25,49 CDM,108737,ANTACID/ANTIFLA 4G LIQPO,18.09,18.09,1.09,15.38,49 CDM,108738,E-Z-HD POWD 334GM PO,42.88,42.88,2.57,36.45,33 CDM,108739,BUMETANIDE 2 MG PO,4.59,4.59,0.28,3.9,49 CDM,108741,LEVOTHYROXINE 175 MCG PO,4.59,4.59,0.28,3.9,49 CDM,108742,CMPD DILTZM 125MG 125B,46.76,46.76,2.81,39.75,30 CDM,108743,CMPD OXYTOCIN 30U 500B,43.2,43.2,2.59,36.72,30 CDM,108745,505WG MEROPEN 2 G INJ,136.35,136.35,8.18,115.9,24 CDM,108745,"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg ",136.35,136.35,1.48,5.05,10 CDM,108746,LEVOTHYROXINE 150 MCG PO,4.59,4.59,0.28,3.9,49 CDM,108747,GENTAMI 120MG/NS100MLINJ,51.84,51.84,3.11,44.06,24 CDM,108748,GENTAMI 100MG/NS100MLINJ,51.84,51.84,3.11,44.06,24 CDM,108749,METOPROLOL 12.5 MG PO,4.59,4.59,0.28,3.9,49 CDM,108750,CMPNT TIB KN RS 160X10,65549.0,65549.0,8521.37,55716.65,28 CDM,108751,KIT ANCHOR SUT 4.75MM,14966.0,14966.0,897.96,12721.1,49 CDM,108752,ANCHOR SUT 4.75MM,54813.0,54813.0,7125.69,46591.05,28 CDM,108754,SCREW BN 2X12MM,6240.0,6240.0,811.2,5304.0,28 CDM,108755,SCREW BN 2X14MM,6240.0,6240.0,811.2,5304.0,28 CDM,108756,ANCHOR SUT 3.5MM,28296.0,28296.0,3678.48,24051.6,28 CDM,108757,ANCHOR SUT 4.75MM 22MM,22928.0,22928.0,2980.64,19488.8,28 CDM,108758,KIT STAPLE BN 15MM 15MM,80116.5,80116.5,4806.99,68099.02,49 CDM,108759,SCREW BN NONLCK 3.5X24MM,1017.0,1017.0,132.21,864.45,28 CDM,108760,GUIDEPIN BN 1.4X150MM,2615.0,2615.0,156.9,2222.75,49 CDM,108761,PIN GUIDE 1.6MM 150MM,2615.0,2615.0,156.9,2222.75,49 CDM,108762,REAMER SURG MTRSL 22MM,17431.0,17431.0,1045.86,14816.35,49 CDM,108763,SCREW BN 3.5MM 22MM,1017.0,1017.0,132.21,864.45,28 CDM,108764,SCREW BN 3.5MM 36MM,1017.0,1017.0,132.21,864.45,28 CDM,108765,SCREW BN 3.5X28MM,1017.0,1017.0,132.21,864.45,28 CDM,108766,SCREW BN 3.5MM 20MM,7657.0,7657.0,995.41,6508.45,28 CDM,108767,SCREW BN 3.5MM 26MM,7657.0,7657.0,995.41,6508.45,28 CDM,108768,SCREW BN 3.5X34MM,7657.0,7657.0,995.41,6508.45,28 CDM,108769,SCREW BN 3.5X36MM,8835.0,8835.0,1148.55,7509.75,28 CDM,108770,SCREW BN 3.5MM 44MM,25386.0,25386.0,3300.18,21578.1,28 CDM,108771,CMPD ROP/CLON/EPI/KETOR,131.49,131.49,7.89,111.77,30 CDM,108774,HYDROCORT SUCC 100MG INJ,95.31,95.31,5.72,81.01,24 CDM,108775,KETAMINE 2 MG/ML INJ,17.28,17.28,1.04,14.69,30 CDM,108777,AMOXICILL/CLAV 80 MG PO,16.65,16.65,1.0,14.15,49 CDM,108778,BENZOC/MENTH 15/3.6MG PO,2.16,2.16,0.13,1.84,49 CDM,108779,LIPID EMUL 20% 250ML INJ,305.32,305.32,18.32,259.52,46 CDM,108780,LIDOCAINE 4% 4 ML TOP,195.7,195.7,11.74,166.34,49 CDM,108781,BUPIV5MG/EPI0.005MG 1ML,2.57,2.57,0.15,2.18,46 CDM,108783,POT PHOS 3 MMOL/1ML INJ,17.28,17.28,1.04,14.69,49 CDM,108784,K20/NS 1000 ML INJ,57.11,57.11,3.43,48.54,24 CDM,108786,NICOTINE 14 MG PATCH,22.6,22.6,1.36,19.21,49 CDM,108788,ASPIRIN 325 MG PO,2.16,2.16,0.13,1.84,49 CDM,108789,NOROVIRUS AMP PROBE,691.61,691.61,41.5,587.87,14 CDM,108790,CHLORHEX 4% 118ML TOP,36.4,36.4,2.18,30.94,49 CDM,108792,COLLAGENASE 30 G TOP,1516.37,1516.37,90.98,1288.91,49 CDM,108793,K40/D5NS 1000 ML INJ,374.35,374.35,22.46,318.2,24 CDM,108794,DIGOX 0.125MG/2.5ML LIQ,32.72,32.72,1.96,27.81,49 CDM,108795,MORPHINE EPD/IT PF 5 MG,187.65,187.65,11.26,159.5,24 CDM,108796,SCREW BN 4.0MM 48MM,25386.0,25386.0,3300.18,21578.1,28 CDM,108797,PLATE BN XTN 10HL,77612.0,77612.0,10089.56,65970.2,28 CDM,108799,BLOCK TIBIAL PLATE,100000.0,100000.0,6000.0,85000.0,49 CDM,108800,BRIDGE FOOT EX FIX 180MM,20799.5,20799.5,1247.97,17679.58,49 CDM,108801,STRUT SUPER EX FX LONG,47145.5,47145.5,2828.73,40073.68,49 CDM,108802,NUT SPHERICAL 10MM,2034.0,2034.0,122.04,1728.9,49 CDM,108803,POST EX FX 5 HOLE,17607.0,17607.0,1056.42,14965.95,49 CDM,108804,WIRE SMOOTH 2.0MM,6338.5,6338.5,380.31,5387.73,49 CDM,108805,RAIL WALKER EX FIX,29273.5,29273.5,1756.41,24882.47,49 CDM,108806,BOLT WIRE EX FIX,7043.0,7043.0,422.58,5986.55,49 CDM,108807,BOLT STD EX FX 10X14MM,8874.0,8874.0,532.44,7542.9,49 CDM,108808,POST EX FX 2 HOLE,23295.5,23295.5,1397.73,19801.17,49 CDM,108809,SCREW BN CORT 2MM 8MM,1619.0,1619.0,210.47,1376.15,28 CDM,108810,SCREW BN 2MM 10MM,1619.0,1619.0,210.47,1376.15,28 CDM,108812,KIT PROC SCREW INSTRMNT,17718.5,17718.5,1063.11,15060.73,49 CDM,108813,KIT HMRTOE INST DISP MED,15846.5,15846.5,950.79,13469.52,49 CDM,108814,PACK ANCHOR SUT 4.75MM,24092.0,24092.0,3131.96,20478.2,28 CDM,108815,KIT SUT ANCHOR 4.75MM,49639.0,49639.0,6453.07,42193.15,28 CDM,108816,SCREW BN 35MM 32MM,39291.0,39291.0,5107.83,33397.35,28 CDM,108817,FILLER BN VOID 10CC,37189.0,37189.0,4834.57,31610.65,28 CDM,108818,IMPLANT BN PIN 2.5X16MM,41943.0,41943.0,5452.59,35651.55,28 CDM,108819,SCREW BN 3.5MM 30MM,39291.0,39291.0,5107.83,33397.35,28 CDM,108820,COIL EMBL 55CM 20MM,96691.0,96691.0,12569.83,82187.35,28 CDM,108821,COIL EMBL 15CM,64353.0,64353.0,8365.89,54700.05,28 CDM,108822,COIL EMBL 30CM,83756.0,83756.0,10888.28,71192.6,28 CDM,108823,COIL EMBL 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108824,COIL EMBL 70CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108825,COIL EMBL 6MM 20CM,64353.0,64353.0,8365.89,54700.05,28 CDM,108826,COIL EMBL 6MM 55MM,96691.0,96691.0,12569.83,82187.35,28 CDM,108827,COIL EMBL 8MM 70CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108828,COIL EMBL 12MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108830,SET STD ORT INSTRUMENT,35399.5,35399.5,2123.97,30089.58,49 CDM,108831,BIT DRILL SURG 20MM,12994.0,12994.0,779.64,11044.9,49 CDM,108832,BURR WDG LG 13MM 75MM,12994.0,12994.0,779.64,11044.9,49 CDM,108833,CATH GD 6FR 55CM,2905.5,2905.5,174.33,2469.68,49 CDM,108834,BIT DRILL SURG,17607.0,17607.0,1056.42,14965.95,49 CDM,108835,DRILL MINI 3.7MM,17607.0,17607.0,1056.42,14965.95,49 CDM,108836,ERYTHRO ES 200MG/5ML LIQ,172.79,172.79,10.37,146.87,49 CDM,108838,SARGRAMOSTIM 250 MCG INJ,2038.77,2038.77,122.33,1732.95,19 CDM,108839,COIL EMBL 24MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108840,COIL EMBL 28MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108841,COIL EMBL 32MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108842,COIL EMBL 40MM 70CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108843,COIL EMBL PACKING 45CM,83756.0,83756.0,10888.28,71192.6,28 CDM,108844,COIL EMBL 4MM 10CM,64353.0,64353.0,8365.89,54700.05,28 CDM,108845,COIL EMBL 4MM 30CM,83756.0,83756.0,10888.28,71192.6,28 CDM,108846,COIL EMBL 5MM 10CM,64353.0,64353.0,8365.89,54700.05,28 CDM,108847,COIL EMBL 5MM 30CM,83756.0,83756.0,10888.28,71192.6,28 CDM,108848,COIL EMBL 8MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108849,COIL EMBL 10MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108850,COIL EMBL 14MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108851,COIL EMBL 16MM 55CM,96691.0,96691.0,12569.83,82187.35,28 CDM,108852,CLIP LGTN 50MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108853,BLADE SHAVER 5.5MM,2905.5,2905.5,174.33,2469.68,49 CDM,108854,CARBOXYMET 0.5%0.4 MLOPH,12.12,12.12,0.73,10.3,49 CDM,108855,MILRIN 20MG/D5W100ML INJ,3670.53,3670.53,220.23,3119.95,24 CDM,108856,SCREW BN 2.4MM 10MM,4058.0,4058.0,527.54,3449.3,28 CDM,108857,SCREW BN 2MM 12MM,2836.0,2836.0,368.68,2410.6,28 CDM,108858,SCREW BN 12MM 2.4MM,4058.0,4058.0,527.54,3449.3,28 CDM,108860,MODEL ANTM IPS HLF MNDB,32729.5,32729.5,1963.77,27820.08,49 CDM,108861,MODEL BN CUST HALF ORG,31978.0,31978.0,1918.68,27181.3,49 CDM,108862,BLADE SAW 18.5X9MM,549.0,549.0,32.94,466.65,49 CDM,108864,SCREW DNTL BRDG TEMP,22766.0,22766.0,2959.58,19351.1,28 CDM,108865,BIT DRILL 50 1.1 7 STP,6022.0,6022.0,361.32,5118.7,49 CDM,108866,DRILL TWIST KLS 1.1X50,6022.0,6022.0,361.32,5118.7,49 CDM,108867,SCREW BN 1.5X7MM,2751.0,2751.0,357.63,2338.35,28 CDM,108868,SCREW BN 2X5MM,2630.0,2630.0,341.9,2235.5,28 CDM,108869,SCREW BN 2X7MM,2630.0,2630.0,341.9,2235.5,28 CDM,108870,SCREW BN 2.3X7MM,2968.0,2968.0,385.84,2522.8,28 CDM,108871,IMPLANT CRNL BN CSTM,100000.0,100000.0,13000.0,85000.0,28 CDM,108872,ROD SPN 3.5MM 65MM,5265.0,5265.0,684.45,4475.25,28 CDM,108873,TRANEXAM ACID 650 MG PO,10.5,10.5,0.63,8.93,49 CDM,108874,FONDAPARINUX 10 MG INJ,120.55,120.55,7.23,102.47,24 CDM,108877,DRILL SURG SHRT MINI 2MM,2905.5,2905.5,174.33,2469.68,49 CDM,108878,SCREW BN 2.7MM 13MM,1850.0,1850.0,240.5,1572.5,28 CDM,108879,SCREW BN 4.7MM 14MM,3074.0,3074.0,399.62,2612.9,28 CDM,108880,PLATE BN 8H 3.5MM 94MM,13020.0,13020.0,1692.6,11067.0,28 CDM,108881,MESH SURG 34CM 6CM,100000.0,100000.0,13000.0,85000.0,28 CDM,108882,SUTURE GRN BRD 1 36IN,118.0,118.0,7.08,100.3,49 CDM,108883,SCREW BN LAG 1.4X4X48MM,6911.0,6911.0,898.43,5874.35,28 CDM,108884,GWIRE ORTH TI 100X1.6MM,1395.0,1395.0,83.7,1185.75,49 CDM,108885,DRILL 2.2MM,6064.0,6064.0,363.84,5154.4,49 CDM,108886,COUNTERSINK DISP 4MM,9332.0,9332.0,559.92,7932.2,49 CDM,108887,ICD DEFIB CARD DEVICE,100000.0,100000.0,13000.0,85000.0,28 CDM,108888,LEAD ICD 63CM,84850.0,84850.0,11030.5,72122.5,28 CDM,108889,TOOL TUNNELING ZONE 1,18488.5,18488.5,1109.31,15715.23,49 CDM,108890,TOOL TUNNELING ZONE 2,18488.5,18488.5,1109.31,15715.23,49 CDM,108892,SCREW SPN 5.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108893,SCREW SPN 4.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108894,SCREW SPN 5.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108895,SCREW SPN 6.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108896,SCREW SPN 6.5MM 35MM,15495.0,15495.0,2014.35,13170.75,28 CDM,108897,ROD SPN 5.5MM 300MM,7023.0,7023.0,912.99,5969.55,28 CDM,108898,CONN SPN CROSS VARI28-38,10032.0,10032.0,1304.16,8527.2,28 CDM,108899,LINK SPN X SZ3,10032.0,10032.0,1304.16,8527.2,28 CDM,108900,INSERT TIB KN SZ3 10MM,26764.0,26764.0,3479.32,22749.4,28 CDM,108901,FLUZONE TRI 0.5 ML PF IM,67.8,67.8,4.07,57.63,19 CDM,108901,"Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use ",67.8,67.8,23.22,68.95,10 CDM,108902,SCREW SPN 5.5MM 35MM,28694.0,28694.0,3730.22,24389.9,28 CDM,108904,SCREW SPN 5.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108905,SCREW SPN 6.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108906,MICONAZOLE 2% 85 G TOP,41.4,41.4,2.48,35.19,49 CDM,108908,FLUZONE HD PF IM,273.8,273.8,16.43,232.73,19 CDM,108908,"Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use ",273.8,273.8,84.53,256.34,10 CDM,108909,GRAFT CV 30MM 47CM,47011.0,47011.0,6111.43,39959.35,28 CDM,108910,GRAFT CV 24MM 47CM,87358.0,87358.0,11356.54,74254.3,28 CDM,108911,CANNULA ARTH 8.5MM 45MM,1441.5,1441.5,86.49,1225.28,49 CDM,108912,STENT AAA 16MMX39MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108913,KIT CEMENT 15CC +DLR,46221.0,46221.0,2773.26,39287.85,49 CDM,108914,SCREW SPN 5.0MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108915,SET SHTH INTRO 24FR 65CM,24405.0,24405.0,1464.3,20744.25,49 CDM,108916,GRAFT AAA 40-42 125MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108917,BLADE SAW 18X5.5MM,549.0,549.0,32.94,466.65,49 CDM,108918,BLADE SAW 31X9MM,549.0,549.0,32.94,466.65,49 CDM,108919,NEEDLE NRSTM TIP GD BVL,10564.5,10564.5,633.87,8979.83,49 CDM,108920,CONN SPN OPN-OPN REV11MM,10032.0,10032.0,1304.16,8527.2,28 CDM,108921,DERMAPURE 1SQCM,1906.0,1906.0,114.36,1620.1,30 CDM,108922,DERMAPURE 1SQCM,5103.0,5103.0,306.18,4337.55,30 CDM,108923,DERMAPURE 1SQCM,1644.0,1644.0,98.64,1397.4,30 CDM,108924,DERMAPURE 1SQCM,1652.0,1652.0,99.12,1404.2,30 CDM,108925,CUTTER BN PLATINUM 5.5MM,3638.5,3638.5,218.31,3092.72,49 CDM,108926,KIT INST 1 SPLNT CSTM PT,63659.0,63659.0,3819.54,54110.15,49 CDM,108927,IMPLANT BN MNDBL SML,100000.0,100000.0,13000.0,85000.0,28 CDM,108928,PACK PROC BN MRRW ASP,73800.0,73800.0,4428.0,62730.0,49 CDM,108929,INTRO SHTH 7FR 75CM,2990.0,2990.0,179.4,2541.5,49 CDM,108930,INTRO SHTH 7FR 85CM MLN,2990.0,2990.0,179.4,2541.5,49 CDM,108932,METOPROLOL ER 100 MG PO,4.25,4.25,0.26,3.61,49 CDM,108934,BLADE SAW 25X9MM,549.0,549.0,32.94,466.65,49 CDM,108936,ZINC OXIDE 20% 60 G TOP,15.53,15.53,0.93,13.2,49 CDM,108938,APIXABAN 2.5 MG PO,35.35,35.35,2.12,30.05,49 CDM,108939,CYTO LIQUID BASE NON C/V,564.0,564.0,33.84,479.4,23 CDM,108939,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",564.0,564.0,99.93,281.36,20 CDM,108940,TISS CULT CHROM BLD NM,6819.9,6819.9,409.19,5796.91,14 CDM,108940,Tissue culture for non-neoplastic disorders; lymphocyte ,6819.9,6819.9,97.85,801.2,80 CDM,108941,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",147.15,147.15,10.06,82.36,80 CDM,108941,SHIGA LIKE TOXIN EIA,147.15,147.15,8.83,125.08,14 CDM,108942,MRSA AMP PR TYPING ID,791.27,791.27,47.48,672.58,14 CDM,108943,CULT STREP GROUP A SCR,252.87,252.87,15.17,214.94,14 CDM,108944,Chemiluminescent assay ,171.96,171.96,11.86,97.11,80 CDM,108944,PTH-RELATED PEPTIDE CA,171.96,171.96,10.32,146.17,14 CDM,108945,BIT DRL SHRT DISP 3.0MM,4809.5,4809.5,288.57,4088.07,49 CDM,108946,STAPLE BN 26MM,100000.0,100000.0,13000.0,85000.0,28 CDM,108947,DEVICE ENCORE 26 5PK URO,1624.5,1624.5,97.47,1380.83,49 CDM,108948,PORT ACC 8MM 100MM,14835.5,14835.5,890.13,12610.17,49 CDM,108951,SCREW BN 2X13MM,6240.0,6240.0,811.2,5304.0,28 CDM,108952,SCREW BN 2.3MM 7MM,5791.0,5791.0,752.83,4922.35,28 CDM,108953,KIT SURG GD CUT CSTM,100000.0,100000.0,6000.0,85000.0,49 CDM,108954,MODEL ANTM MXL ACRYL ABL,89203.5,89203.5,5352.21,75822.98,49 CDM,108955,SCREW BN TI SLF DRL 4MM,3629.0,3629.0,471.77,3084.65,28 CDM,108956,SUTURE VIOL MON +5-0 7IN,134.5,134.5,8.07,114.33,49 CDM,108957,Antibody; Leptospira ,335.0,335.0,13.61,111.41,80 CDM,108957,LEPTOSPIRA AB QUAL,335.0,335.0,20.1,284.75,14 CDM,108958,ESMOLOL 2G/NACL100ML INJ,304.9,304.9,18.29,259.16,24 CDM,108959,FLUBLOK TRI PF IM,267.85,267.85,16.07,227.67,19 CDM,108959,"Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use ",267.85,267.85,70.07,256.34,10 CDM,108960,PROCAINAMIDE 8 MG/ML INJ,22.5,22.5,1.35,19.13,19 CDM,108961,SUTURE GUT 6-0 18IN,401.5,401.5,24.09,341.27,49 CDM,108962,SUTURE UND BRD 5-0 18IN,270.5,270.5,16.23,229.93,49 CDM,108971,SYSTEM THRMB 18FR 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,108975,STEM NECK HIP 132D SZ9,54429.0,54429.0,7075.77,46264.65,28 CDM,108979,PIN DRILL 2MM,7571.0,7571.0,454.26,6435.35,49 CDM,108980,CAPSAICIN 0.025% 60G TOP,15.1,15.1,0.91,12.84,49 CDM,108981,BENZOIN 59 ML PO,40.05,40.05,2.4,34.04,49 CDM,108982,READI-CAT 2 450ML PO,16.35,16.35,0.98,13.9,33 CDM,108983,VARIBAR NECTAR 240 ML PO,71.75,71.75,4.3,60.99,33 CDM,108984,VARIBAR PUDDING 230ML PO,258.65,258.65,15.52,219.85,33 CDM,108985,VARIBAR THIN HON 250MLPO,281.65,281.65,16.9,239.4,33 CDM,108986,SCREW SPN 6.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108987,NEEDLE SCORPION KNEE ART,7444.0,7444.0,446.64,6327.4,49 CDM,108988,SCREW SPN 7.5MM 50MM,12898.0,12898.0,1676.74,10963.3,28 CDM,108989,ROD SPN 5.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 CDM,108990,SPACER SPN 10D 6X22X50MM,84516.0,84516.0,10987.08,71838.6,28 CDM,108991,KNIFE ANNULOTOMY,4182.0,4182.0,250.92,3554.7,49 CDM,108992,CLIP STIMULATING TEMG,6273.0,6273.0,376.38,5332.05,49 CDM,108993,SHIM INTRADCA WIDE,7043.0,7043.0,422.58,5986.55,49 CDM,108996,SPACER SPN 10D 6X22X55MM,84516.0,84516.0,10987.08,71838.6,28 CDM,108999,GRAFT BN XS 1.4CC 1X2IN,49862.0,49862.0,6482.06,42382.7,28 CDM,109000,ANCHOR SUT 2-0 1.7MM,17081.0,17081.0,2220.53,14518.85,28 CDM,109001,FOLIC ACID 1 MG INJ,16.0,16.0,0.96,13.6,24 CDM,109007,CMPD KETAMIN 500MG 260ML,40.0,40.0,2.4,34.0,30 CDM,109009,COAG/FIBRIN WB VCA ROTEM,1210.5,1210.5,72.63,1028.92,28 CDM,109009,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",1210.5,1210.5,42.22,139.28,20 CDM,109010,Amphetamines; 1 or 2 ,1168.71,1168.71,0.07,127.56,28 CDM,109010,DEF DRUG AMPHETAM 1 OR 2,1168.71,1168.71,70.12,993.4,27 CDM,109011,Barbiturates ,583.17,583.17,0.07,127.56,28 CDM,109011,DEF DRUG BARBITURATES,583.17,583.17,34.99,495.69,27 CDM,109012,Benzodiazepines; 13 or more ,583.17,583.17,0.07,24.19,25 CDM,109012,DEF DRUG BENZODIAZ 13+,583.17,583.17,34.99,495.69,30 CDM,109013,"Cannabinoids, natural ",583.17,583.17,0.07,127.56,28 CDM,109013,DEF DRUG CANNABINOID NAT,583.17,583.17,34.99,495.69,27 CDM,109014,DEF DRUG MDA MDEA MDMA,624.31,624.31,37.46,530.66,27 CDM,109014,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",624.31,624.31,0.07,127.56,28 CDM,109015,DEF DRUG HEROIN METABOL,583.17,583.17,34.99,495.69,27 CDM,109015,Heroin metabolite ,583.17,583.17,0.07,127.56,28 CDM,109016,DEF DRUG OPIATES 1 OR MR,752.56,752.56,45.15,639.68,27 CDM,109016,"Opiates, 1 or more ",752.56,752.56,0.07,127.56,28 CDM,109017,DEF DRUG METHADONE,624.31,624.31,37.46,530.66,27 CDM,109017,Methadone ,624.31,624.31,0.07,127.56,28 CDM,109018,STENT COR 2.50 X 48MM,8650.0,8650.0,1124.5,7352.5,28 CDM,109019,STENT COR 3X48MM,8650.0,8650.0,1124.5,7352.5,28 CDM,109020,STENT COR 4X48MM,8650.0,8650.0,1124.5,7352.5,28 CDM,109021,STENT COR 3.50X48MM,8650.0,8650.0,1124.5,7352.5,28 CDM,109022,PENCILSMK EVAC #3,12325.0,12325.0,739.5,10476.25,49 CDM,109023,GRAFT AAA 31-32 209MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109024,DEF DRUG OXYCODONE,752.56,752.56,45.15,639.68,27 CDM,109024,Oxycodone ,752.56,752.56,0.07,127.56,28 CDM,109025,DEF DRUG PROPOXYPHENE,752.56,752.56,45.15,639.68,27 CDM,109025,Propoxyphene ,752.56,752.56,0.07,127.56,28 CDM,109026,PHENCYCLIDINE QUANT,752.56,752.56,45.15,639.68,22 CDM,109026,Phencyclidine (PCP) ,752.56,752.56,0.07,195.8,33 CDM,109031,SCREW BN L8 2.7MM,7147.0,7147.0,929.11,6074.95,28 CDM,109033,SCREW BN L9 2.7MM,7147.0,7147.0,929.11,6074.95,28 CDM,109034,Cocaine ,583.17,583.17,0.07,127.56,28 CDM,109034,DEF DRUG COCAINE,583.17,583.17,34.99,495.69,27 CDM,109035,VEGF IA QN,915.0,915.0,54.9,777.75,14 CDM,109036,BIT DRILL DISP 2MM 60MM,6182.5,6182.5,370.95,5255.13,49 CDM,109037,PLATE BN 2.7/3.5MM 72MM,35827.0,35827.0,4657.51,30452.95,28 CDM,109038,PLATE BN 2.7MM 85MM,35827.0,35827.0,4657.51,30452.95,28 CDM,109039,PLATE MED 82MM SS2.7/3.5,34734.0,34734.0,4515.42,29523.9,28 CDM,109040,SCREW BN 2.7MM 38MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,109041,SCREW BN 2.7MM 44MM,4913.0,4913.0,638.69,4176.05,28 CDM,109042,NEEDLE ENDO 19GA 1.73MM,14915.0,14915.0,894.9,12677.75,49 CDM,109043,NEEDLE ASP 22GA 1.83MM,6655.5,6655.5,399.33,5657.18,49 CDM,109044,SPHNTM CANN 20MM 260CM,10371.5,10371.5,622.29,8815.77,49 CDM,109045,CATH BLNDIL 10MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 CDM,109046,CATH BLNDIL 6MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 CDM,109047,DEVICE INFLATION 20ML,1395.0,1395.0,83.7,1185.75,49 CDM,109048,NEEDLE BIOPSY FINE 19GA,17607.0,17607.0,1056.42,14965.95,49 CDM,109049,NEEDLE ENDO BIOP 22GA,13701.5,13701.5,822.09,11646.27,49 CDM,109050,STENT BIL 8FR 8X100MM,49614.0,49614.0,6449.82,42171.9,28 CDM,109051,STENT BIL 8FR 10X60MM,49614.0,49614.0,6449.82,42171.9,28 CDM,109052,STENT BIL 10MM 40MM,49614.0,49614.0,6449.82,42171.9,28 CDM,109053,STENT BIL PGTL 7FR 7CM,2541.0,2541.0,330.33,2159.85,28 CDM,109054,STENT PANC 21MM 146MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109055,STENT ESPH 18X119MM,88529.0,88529.0,11508.77,75249.65,28 CDM,109056,STENT ESPH 18X149MM,88529.0,88529.0,11508.77,75249.65,28 CDM,109057,STENT ESPH 18X59MM,88529.0,88529.0,11508.77,75249.65,28 CDM,109058,STENT ESPH FLCVR 18X97MM,88529.0,88529.0,11508.77,75249.65,28 CDM,109059,STENT ESPH 18X149MM,93781.0,93781.0,12191.53,79713.85,28 CDM,109060,STENT ESPH 18X119MM,88529.0,88529.0,11508.77,75249.65,28 CDM,109061,NEEDLE ENDO NEUR 6F 20GA,7923.5,7923.5,475.41,6734.98,49 CDM,109062,EPI NOS 40MCG/ML INJ,19.05,19.05,1.14,16.19,24 CDM,109063,LEVOTHYROXINE 137 MCG PO,5.0,5.0,0.3,4.25,49 CDM,109064,FAMOTIDINE 2 MG/ML INJ,16.0,16.0,0.96,13.6,24 CDM,109065,HBIG HUMAN 5 ML IM,3145.0,3145.0,188.7,2673.25,19 CDM,109066,GARDASIL 9 2-3 DOSE IM,1430.0,1430.0,85.8,1215.5,24 CDM,109066,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose schedule, for intramuscular use ",1430.0,1430.0,348.38,1074.9,10 CDM,109067,HYDROMORPH 10 MG INJ,34.4,34.4,2.06,29.24,24 CDM,109070,POTASS CL 0.1 MEQ/ML INJ,16.0,16.0,0.96,13.6,24 CDM,109071,CATH THRMB SCTN 7FR,100000.0,100000.0,6000.0,85000.0,49 CDM,109072,CMPNT FEM KN POST RT SZ8,40146.0,40146.0,5218.98,34124.1,28 CDM,109073,BASEPLATE TIB KN RT SZ7,48397.0,48397.0,6291.61,41137.45,28 CDM,109074,STEM FEM KN 120MM 12MM,23341.0,23341.0,3034.33,19839.85,28 CDM,109075,INSERT ARTC KN 7-8 13MM,35182.0,35182.0,4573.66,29904.7,28 CDM,109076,MODEL ANTM MXL ORBIT CLR,96225.0,96225.0,5773.5,81791.25,49 CDM,109077,CATH VASC US 3FR 135CM,21601.0,21601.0,1296.06,18360.85,49 CDM,109078,CATHSND 3.6FR 135CM,21601.0,21601.0,1296.06,18360.85,49 CDM,109084,GRASPER EPTH 5 CRV,1509.5,1509.5,90.57,1283.08,49 CDM,109085,SCREW SPNL 4MM 10MM,2633.0,2633.0,342.29,2238.05,28 CDM,109086,KIT PLS LAV W/SPRAY,1627.5,1627.5,97.65,1383.38,49 CDM,109087,CAGE SPN 0D 14X6X12MM,53527.0,53527.0,6958.51,45497.95,28 CDM,109088,CATH THRMB 8FR 90CM,83198.0,83198.0,4991.88,70718.3,49 CDM,109091,SUTURE CINCH ENDO LNG,6427.0,6427.0,385.62,5462.95,49 CDM,109092,SUTURE CINCH ENDO,6273.0,6273.0,376.38,5332.05,49 CDM,109093,SYTEM ENDO COLONIC,25483.5,25483.5,1529.01,21660.97,49 CDM,109094,DEVICE ENDO TACK 160CM,26744.0,26744.0,3476.72,22732.4,28 CDM,109095,PIN BN 2.5X16MM,48410.0,48410.0,6293.3,41148.5,28 CDM,109096,STENT VASC 9X40X135,19080.0,19080.0,2480.4,16218.0,28 CDM,109098,CULT TYPING SEQ EA ISO,117.3,117.3,7.04,99.7,14 CDM,109098,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",117.3,117.3,96.9,793.41,80 CDM,109099,"Culture, typing; other methods ",97.0,97.0,6.5,53.21,80 CDM,109099,ORGANISM IDENTIFICATION,97.0,97.0,5.82,82.45,14 CDM,109100,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium tuberculosis, rifampin resistance, amplified probe technique ",629.0,629.0,64.49,244.9,56 CDM,109100,MTB RIFAMPIN RST AMP,629.0,629.0,37.74,534.65,35 CDM,109101,DEVICE SLD MOTOR DISP,49272.0,49272.0,2956.32,41881.2,49 CDM,109103,CATH BLNDIL 1.2X12MM,14086.0,14086.0,845.16,11973.1,49 CDM,109104,SCREW BN COMP 6MM 20MM,12094.0,12094.0,1572.22,10279.9,28 CDM,109105,SCREW LOCKING 4.5X20MM,3162.0,3162.0,411.06,2687.7,28 CDM,109106,SCREW VAR ANG 4.5X15MM,2829.0,2829.0,367.77,2404.65,28 CDM,109107,BASPLATE SHLDR 4.5X20MM,2387.0,2387.0,310.31,2028.95,28 CDM,109108,SCREW BN 30MM 4.5MM,2829.0,2829.0,367.77,2404.65,28 CDM,109109,COMP GLENSPHR SHLDR MED,8828.0,8828.0,1147.64,7503.8,28 CDM,109110,BASEPLATE STD SHLDR SHRT,8828.0,8828.0,1147.64,7503.8,28 CDM,109111,BASEPLT GLND 0D 10MM 24M,51865.0,51865.0,6742.45,44085.25,28 CDM,109112,STEM HUM SHLDR 10MM 95MM,71839.0,71839.0,9339.07,61063.15,28 CDM,109113,COMP GLENSP 33MM +3MM,60429.0,60429.0,7855.77,51364.65,28 CDM,109114,SUTURE 2-0 POLY,2905.5,2905.5,174.33,2469.68,49 CDM,109115,COMP BN SHLDR 38MM 6MM,17242.0,17242.0,2241.46,14655.7,28 CDM,109118,EEG CEREB DEATH,3831.31,3831.31,229.88,3256.61,39 CDM,109121,CATH GD IMA 6FR 55CM,2685.0,2685.0,161.1,2282.25,49 CDM,109122,GWIRE VASC 180CM .014IN,3345.5,3345.5,200.73,2843.68,49 CDM,109123,TRACH TUBE 77MM 8MM,1744.5,1744.5,104.67,1482.83,49 CDM,109124,TUBE TRACH 12.7MM 79MM,1744.5,1744.5,104.67,1482.83,49 CDM,109125,TUBE TRACH 8.08MM,2905.5,2905.5,174.33,2469.68,49 CDM,109126,GRAFT ENDOVASC 10X45MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109127,STENT ILIAC 12X45X41MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109128,STENT ILIAC 20FR 12X61MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109129,GRAFT VASC 20FR 10X61MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109130,GRAFT VASC 20FR 10X45MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109131,GRAFT VSC 26X28MM 100MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109132,STENT GRAFT 30X36 100MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109133,GRAFT CV 30MM 38MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109134,STENT GRFT 30X34MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109135,GRAFT CV 28MM 50CM,88768.0,88768.0,11539.84,75452.8,28 CDM,109136,CATH BLNDIL 8MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 CDM,109138,CATH THRMB 16MM 115CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109140,NAIL BN TROCH 10MM 38CM,55518.0,55518.0,7217.34,47190.3,28 CDM,109141,ROD SPNL 35 BN,5265.0,5265.0,684.45,4475.25,28 CDM,109142,CATH THRMB SCTN 7FR,100000.0,100000.0,6000.0,85000.0,49 CDM,109143,SCREW SPN 7.5MM 50MM,7883.0,7883.0,1024.79,6700.55,28 CDM,109144,SPACER SPN 10D 9X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109145,BOLT SPN 8.5MM 30MM,9316.0,9316.0,1211.08,7918.6,28 CDM,109148,CAGE SPN 4D 10X34X24MM,95785.0,95785.0,12452.05,81417.25,28 CDM,109151,STYLET SINGLE STEP 50MM,1453.0,1453.0,87.18,1235.05,49 CDM,109152,KNIFE ANLTMY RETRCT,4182.0,4182.0,250.92,3554.7,49 CDM,109153,STENT ILIAC 20FR 12X58MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109154,STENT ILIAC 20FR 12X58MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109155,STENT ILIAC 20FR 10X58MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109156,PROSTHESIS PENL 27 13MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109157,SCREW BN 5MM 15MM,15511.0,15511.0,2016.43,13184.35,28 CDM,109158,SCREW BN 6.5MM 35MM,11780.0,11780.0,1531.4,10013.0,28 CDM,109159,SCREW BN 5MM 42MM,3120.0,3120.0,405.6,2652.0,28 CDM,109160,SCREW BN 5X46MM,3120.0,3120.0,405.6,2652.0,28 CDM,109161,PIN GUIDE 3MM 75MM,1453.0,1453.0,87.18,1235.05,49 CDM,109162,GUIDE PIN 3.0X100MM,6064.0,6064.0,363.84,5154.4,49 CDM,109163,BSPLT GLND SHLDR15D 25MM,50710.0,50710.0,6592.3,43103.5,28 CDM,109164,HEAD GLND SHLDR STD 39MM,50710.0,50710.0,6592.3,43103.5,28 CDM,109165,INSERT SHD +0 1/2 39MM,47329.0,47329.0,6152.77,40229.65,28 CDM,109166,STEM HUM SHLDR SZ2+,76065.0,76065.0,9888.45,64655.25,28 CDM,109167,STEM HUM PRSFT 9MM,53527.0,53527.0,6958.51,45497.95,28 CDM,109168,CMPNT HUM SHLDR +0MM,47893.0,47893.0,6226.09,40709.05,28 CDM,109169,LINER HUM SHLDR +0 36MM,25355.0,25355.0,3296.15,21551.75,28 CDM,109170,BUMETANIDE 0.5 MG INJ,72.58,72.58,4.35,61.69,24 CDM,109171,CMPD NOREPI 16MG 250B,148.72,148.72,8.92,126.41,30 CDM,109172,DOCUSATE SOD 100 MG PO,11.1,11.1,0.67,9.44,49 CDM,109173,K40 / WFI 100 ML INJ,48.0,48.0,2.88,40.8,24 CDM,109174,LIDOCAINE 4% PATCH,7.5,7.5,0.45,6.38,49 CDM,109175,POT CHL 1.3MEQ/1ML LIQPO,16.47,16.47,0.99,14.0,49 CDM,109176,POT PHOS 45MMOL/15ML INJ,88.74,88.74,5.32,75.43,49 CDM,109177,CMPD NOREPI 16MG 266ML,148.72,148.72,8.92,126.41,30 CDM,109178,ERAVACYCLINE 100 MG INJ,700.0,700.0,42.0,595.0,24 CDM,109179,E-Z-PAQUE 355 ML PO,36.34,36.34,2.18,30.89,33 CDM,109180,OMEGA-3 ACID ESTER 1G PO,10.33,10.33,0.62,8.78,49 CDM,109181,PHENOL 0.5-1.5% ORAL,14.45,14.45,0.87,12.28,49 CDM,109182,TIOTROPIUM 18 MCG 1CAP,97.56,97.56,5.85,82.93,49 CDM,109183,TIOTROPIUM 18 MCG 5CAP,453.75,453.75,27.23,385.69,33 CDM,109184,MYRIAD MORCELLS 4MG,421.0,421.0,25.26,357.85,41 CDM,109185,MYRIAD MORCELLS 4MG,462.0,462.0,27.72,392.7,41 CDM,109186,REAMER CANNULATED 5.0MM,9156.0,9156.0,549.36,7782.6,49 CDM,109187,GRAFT EVAS 179MM 42-46MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109188,PLATE BN 2.7MM,28458.0,28458.0,3699.54,24189.3,28 CDM,109189,SCREW BN 2.7MM 20MM,2704.0,2704.0,351.52,2298.4,28 CDM,109190,SMX/TMP 800/160MG MDV,69.45,69.45,4.17,59.03,24 CDM,109191,FOLIC ACID 50 MG MDV,117.21,117.21,7.03,99.63,24 CDM,109192,ISONIAZID 1000MG MDV,551.43,551.43,33.09,468.72,23 CDM,109192,"Injection, isoniazid, 1 mg ",551.43,551.43,0.57,0.78,5 CDM,109193,ATROPINE NTE 1MG INJ,38.12,38.12,2.29,32.4,27 CDM,109193,"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg ",38.12,38.12,0.1,0.41,7 CDM,109194,CARBOPROST 0.25MG INJ,398.51,398.51,23.91,338.73,23 CDM,109194,"Injection, carboprost tromethamine, 0.1 mg ",398.51,398.51,98.78,136.08,5 CDM,109195,MAG CARB/AL HYDRX LIQ PO,4.25,4.25,0.26,3.61,49 CDM,109196,MANNITOL 100G INJ,809.83,809.83,48.59,688.36,27 CDM,109197,MANNITOL 12.5G INJ,185.6,185.6,11.14,157.76,27 CDM,109198,"Injection, tranexamic acid, 5 mg ",208.95,208.95,0.06,0.08,5 CDM,109198,TRANEXAMIC 1000MG INJ,208.95,208.95,12.54,177.61,28 CDM,109199,505FK LEVOTH100MCG/MLINJ,532.15,532.15,31.93,452.33,19 CDM,109200,CMPD VANCO 1.75G 500B,217.79,217.79,13.07,185.12,30 CDM,109201,OMNIPAQUE 12 500ML PO,52.92,52.92,3.18,44.98,33 CDM,109202,SCREW BN 2.7MM 28MM,2704.0,2704.0,351.52,2298.4,28 CDM,109203,SCREW BN 2.7MM 24MM,2704.0,2704.0,351.52,2298.4,28 CDM,109204,SCREW BN 2.7MM 22MM,2704.0,2704.0,351.52,2298.4,28 CDM,109205,SCREW BN 3.5MM 16MM,6240.0,6240.0,811.2,5304.0,28 CDM,109206,SCREW BN 3.8MM 18MM,6240.0,6240.0,811.2,5304.0,28 CDM,109207,SCREW BN 3.5MM 20MM,1881.0,1881.0,244.53,1598.85,28 CDM,109208,SCREW BN 3.5MM 18MM,1881.0,1881.0,244.53,1598.85,28 CDM,109209,SCREW BN 3.5MM 22MM,1881.0,1881.0,244.53,1598.85,28 CDM,109210,SCREW BN 3.5MM 24MM,1881.0,1881.0,244.53,1598.85,28 CDM,109211,PLATE BN 6HL 3.5MM 164MM,62542.0,62542.0,8130.46,53160.7,28 CDM,109212,SCREW BN 4.5MM 22MM,4160.0,4160.0,540.8,3536.0,28 CDM,109213,TRAY HUM SHLDR +5MM,47893.0,47893.0,6226.09,40709.05,28 CDM,109214,STEM HUM SHLDR 11MM,53527.0,53527.0,6958.51,45497.95,28 CDM,109215,LINER HUM SHLDR 36MM,25355.0,25355.0,3296.15,21551.75,28 CDM,109216,CMPD KETAMIN 2500MG 250B,61.86,61.86,3.71,52.58,30 CDM,109217,DEVICE CATH CONTROLLER,26962.5,26962.5,1617.75,22918.13,49 CDM,109218,SHEATH CATH 7FR 55CM,17718.5,17718.5,1063.11,15060.73,49 CDM,109219,GRAFT EVAS 26MM 96MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109220,KIT HMDIAL 40FR 23CM,7871.5,7871.5,472.29,6690.77,49 CDM,109221,KIT CATH 16CM 13.5FR,2905.5,2905.5,174.33,2469.68,49 CDM,109222,GRAFT AAA 31-32 113MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109225,CMPD VANCO 1.25G 250B,282.02,282.02,16.92,239.72,30 CDM,109226,TIOTROPIUM 2.5MCG 60INH,791.1,791.1,47.47,672.43,33 CDM,109227,PSYLLIUM HUSK 3.4G PO,2.4,2.4,0.14,2.04,49 CDM,109228,GUIDE CRNM PTSPC,25478.0,25478.0,1528.68,21656.3,49 CDM,109229,MATRIDERM PER SQCM,3999.0,3999.0,239.94,3399.15,28 CDM,109229,"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure) ",3999.0,3999.0,198.77,306.17,5 CDM,109230,KWIRE GLND 9IN 2.4MM,872.0,872.0,52.32,741.2,49 CDM,109231,SUTURE BLU MONO 6-0 30IN,875.0,875.0,52.5,743.75,49 CDM,109233,STYLET SINGLE STEP 45MM,1453.0,1453.0,87.18,1235.05,49 CDM,109234,ROD SPN 5.5MM 65MM,5265.0,5265.0,684.45,4475.25,28 CDM,109235,BLADE EXTENDER 26MM,18488.5,18488.5,1109.31,15715.23,49 CDM,109236,SCREW BN CANN 2.5MM 24MM,10406.0,10406.0,1352.78,8845.1,28 CDM,109237,ROD SPN LRDTC 5.5X70MM,5265.0,5265.0,684.45,4475.25,28 CDM,109238,SCREW SPN SHNK 6.5MM45MM,7883.0,7883.0,1024.79,6700.55,28 CDM,109239,SPACER SPN 10D 6X18X55MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109240,SCREW BN 3.5MM 12MM,4950.0,4950.0,643.5,4207.5,28 CDM,109241,SCREW BN 4.7MM 18MM,7328.0,7328.0,952.64,6228.8,28 CDM,109242,PLATE BN 82MM 3.5MM,12480.0,12480.0,1622.4,10608.0,28 CDM,109243,ZONISAM 100MG/5ML LIQ PO,83.9,83.9,5.03,71.32,49 CDM,109244,ROD SPNL 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,28 CDM,109245,KIT PLS LAV W/SPRAY,1627.5,1627.5,97.65,1383.38,49 CDM,109246,STAPLER STD 60MM,14618.5,14618.5,877.11,12425.73,49 CDM,109247,STAPLER LONG 60MM,14148.0,14148.0,848.88,12025.8,49 CDM,109248,RELOAD STAPLER WHT 60MM,6240.0,6240.0,811.2,5304.0,28 CDM,109249,RELOAD STPLR BLUE 60MM,6312.0,6312.0,820.56,5365.2,28 CDM,109250,RELOAD STPLR 60MM,6312.0,6312.0,820.56,5365.2,28 CDM,109251,RELOAD STAPLER BLK 60MM,6312.0,6312.0,820.56,5365.2,28 CDM,109252,HEAD FEM HIP 12/14 +8 28,17397.0,17397.0,2261.61,14787.45,28 CDM,109253,LINER ACTB HIP 46/60MM,26764.0,26764.0,3479.32,22749.4,28 CDM,109254,CATHETER SUP 2.6FR 135CM,6338.5,6338.5,380.31,5387.73,49 CDM,109255,REAMER SURG 18MM,17431.0,17431.0,1045.86,14816.35,49 CDM,109256,PLATE BN 3.5MM 104MM,19633.0,19633.0,2552.29,16688.05,28 CDM,109257,SCREW BN 3.5MM 16MM,1881.0,1881.0,244.53,1598.85,28 CDM,109258,BEARING HUM +3A 0D 33MM,31638.0,31638.0,4112.94,26892.3,28 CDM,109259,PHASE 2 PACU PER MIN,45.0,45.0,2.7,38.25,49 CDM,109260,BASIC PHASE 1 SERVICES,1080.0,1080.0,64.8,918.0,49 CDM,109261,PHASE 1 PER MINUTE,45.0,45.0,2.7,38.25,49 CDM,109262,NEEDLE BX 19G EZSHT 3 PL,10142.0,10142.0,608.52,8620.7,49 CDM,109263,NEEDLE BX 22G EZSHT 3 PL,10142.0,10142.0,608.52,8620.7,49 CDM,109265,SCREW BN 6.5MM 50MM,2541.0,2541.0,330.33,2159.85,28 CDM,109266,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,1337.26,1337.26,10.06,82.36,80 CDM,109266,PNEUMOCYSTIS CARINII IFT,1337.26,1337.26,80.24,1136.67,14 CDM,109267,CARB/LEVO 25/250 MG PO,4.25,4.25,0.26,3.61,49 CDM,109268,CIPROFLOXCN 0.3% 5ML OPH,236.55,236.55,14.19,201.07,49 CDM,109269,CMPD SOD PHOS 15MMOL250B,312.6,312.6,18.76,265.71,30 CDM,109270,GADOBUTROL 15 ML INJ,747.0,747.0,44.82,634.95,24 CDM,109271,PRISMASOL BGK 4/2.5,195.0,195.0,11.7,165.75,46 CDM,109272,CONN SPN CROSS LNK SZ49,10032.0,10032.0,1304.16,8527.2,28 CDM,109273,CONN SPN CROSS VARI35-45,10032.0,10032.0,1304.16,8527.2,28 CDM,109274,ROD SPN STR 5.5MM 300MM,5265.0,5265.0,684.45,4475.25,28 CDM,109275,GRAFT BN 100X20MM,35159.0,35159.0,4570.67,29885.15,28 CDM,109276,SET TUBE SURG IRRIGATION,8803.5,8803.5,528.21,7482.98,49 CDM,109277,SODIUM PHOS 133 ML RECT,5.8,5.8,0.35,4.93,49 CDM,109278,MINERAL OIL 133 ML RECT,10.4,10.4,0.62,8.84,49 CDM,109279,TIOTROPIUM 2.5MCG 10INH,189.16,189.16,11.35,160.79,33 CDM,109280,CAGE SPN 16MM 70-105MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109281,NAIL BN FEM 11.5MM 32CM,55518.0,55518.0,7217.34,47190.3,28 CDM,109282,MRI LW JNT W/O CONT BI,31159.6,31159.6,1869.58,26485.66,14 CDM,109283,CAGE SPN 0D 16X18X55MM,41554.0,41554.0,5402.02,35320.9,28 CDM,109284,ICD DEFIB CARD 7.36CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109285,CATH URET 5FR 70CM,498.5,498.5,29.91,423.73,49 CDM,109286,SCREW SPN 5.5MM 45MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109288,GRAFT STNT VASC 30X150MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109289,SET CLOSURE 50CM,46221.0,46221.0,2773.26,39287.85,49 CDM,109290,SCREW SPN 7.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109291,SPACER SPN 10D 4X22X60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109292,SPACER SPN 10D 6X22X60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109293,SCREW SPN 8.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109294,505FK MORPH 2 MG/ML INJ,51.16,51.16,3.07,43.49,24 CDM,109295,DRESSING WND 10CM 40CM,9966.0,9966.0,597.96,8471.1,49 CDM,109296,GRAVT CV 26MM 10MM 20CM,35579.0,35579.0,4625.27,30242.15,28 CDM,109297,GRAFT CV 28MM 20CM,32298.0,32298.0,4198.74,27453.3,28 CDM,109298,GRAFT CV 30MM 20CM,32298.0,32298.0,4198.74,27453.3,28 CDM,109299,GRAFT CV 26MM 50CM,83797.0,83797.0,10893.61,71227.45,28 CDM,109300,STENT COR 2.5X20MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109301,STENT COR 3.0X26MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109302,STENT COR 3.5X26MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109303,STENT COR 4.0X26MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109304,GRAFT CV 32MM 20CM,32298.0,32298.0,4198.74,27453.3,28 CDM,109305,GRAFT CV 32MM 50CM,83797.0,83797.0,10893.61,71227.45,28 CDM,109306,FORCEP BX 1.8MM 100CM,1685.5,1685.5,101.13,1432.67,49 CDM,109307,SCREW SPN 3.5MM 14MM,2633.0,2633.0,342.29,2238.05,28 CDM,109308,SPACER SPN 10D 6X34X24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109309,ROD SPN 5.5MM 60MM,5265.0,5265.0,684.45,4475.25,28 CDM,109310,SCREW SPN 7.5MM 40MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109311,STENT BIL 7FR 7CM,5286.0,5286.0,687.18,4493.1,28 CDM,109312,PLATE BN MNDB 12H 1.25MM,22936.0,22936.0,2981.68,19495.6,28 CDM,109313,SCREW SPN 3.5X12MM,2633.0,2633.0,342.29,2238.05,28 CDM,109314,PLATE FOOT EXFX 180MM,43140.0,43140.0,2588.4,36669.0,49 CDM,109315,SUT MON0SZ 3-0 27IN,1200.0,1200.0,72.0,1020.0,49 CDM,109316,SCREW BN 1.5X8X1.5MM,4227.0,4227.0,549.51,3592.95,28 CDM,109317,505FK LEVOTHY 100MCGINJ,532.15,532.15,31.93,452.33,19 CDM,109318,505FK MORPHINE 2 MG INJ,51.16,51.16,3.07,43.49,24 CDM,109319,505FK MORPHINE 4 MG INJ,51.16,51.16,3.07,43.49,24 CDM,109320,CMPD LACTULOSE ENEMA,113.4,113.4,6.8,96.39,46 CDM,109322,GRAFT AAA 28-29 155MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109323,SCREW BN 1.85X265X8MM,3629.0,3629.0,471.77,3084.65,28 CDM,109324,CAGE SPN 0D 12X11X28MM,56344.0,56344.0,7324.72,47892.4,28 CDM,109325,CAGE SPN 0D 28X11X11MM,56344.0,56344.0,7324.72,47892.4,28 CDM,109326,SUTURE VIO BRD +1 18IN,725.0,725.0,43.5,616.25,49 CDM,109327,PERC TRANS COR LITH LC,19783.5,19783.5,1187.01,16815.97,34 CDM,109328,PERC TRANS COR LITH RC,19783.5,19783.5,1187.01,16815.97,34 CDM,109329,PERC TRANS COR LITH RI,19783.5,19783.5,1187.01,16815.97,34 CDM,109330,PERC TRANS COR LITH LD,19783.5,19783.5,1187.01,16815.97,34 CDM,109331,PERC TRANS COR LITH LM,19783.5,19783.5,1187.01,16815.97,34 CDM,109332,PLATE BN STAR 6HL,25224.0,25224.0,3279.12,21440.4,28 CDM,109333,PLATE BN ANGLED 4HL,22223.0,22223.0,2888.99,18889.55,28 CDM,109334,SCREW BN L13 2.7MM,70627.0,70627.0,9181.51,60032.95,28 CDM,109335,SCREW BN 2.7MM,35314.0,35314.0,4590.82,30016.9,28 CDM,109336,SPACER SPN 10D 8X22X60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109337,SPACER SPN 10D 8X22X60MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109338,ROD SPN 5.5MM 110MM,5265.0,5265.0,684.45,4475.25,28 CDM,109339,SPACER SPN 10D 8X18X45MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109340,SPACER SPN 10D 6X18X50MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109341,SCREW SPN 7.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109342,SCREW SPN 9.0MM 60MM,49301.0,49301.0,6409.13,41905.85,28 CDM,109343,SCREW SPN 9.0MM 80MM,49301.0,49301.0,6409.13,41905.85,28 CDM,109344,SCREW SPN 5.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109345,CONN SPN OPN-OPN REV15MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109346,ROD SPN 5.5MM 90MM,5265.0,5265.0,684.45,4475.25,28 CDM,109347,CONN SPN OPN-OPN 13-16MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109348,ROD SPN 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,28 CDM,109349,ROD SPN 5.5MM 100MM,5265.0,5265.0,684.45,4475.25,28 CDM,109350,DEVICE HYAL 10MG,1569.0,1569.0,203.97,1333.65,28 CDM,109351,GRAFT STNT VASC 28X150MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109352,STENT VASC 30X150MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109353,CATH BLNDIL 5X200MM,56698.0,56698.0,3401.88,48193.3,49 CDM,109354,BLADE SAW 70X12.5MM,674.5,674.5,40.47,573.33,49 CDM,109355,BLADE SAW 77.5X6.3MM,674.5,674.5,40.47,573.33,49 CDM,109356,RASP SURG 11X5.5MM,3463.0,3463.0,207.78,2943.55,49 CDM,109357,TOOL DSCT 95MM 3.2MM,2905.5,2905.5,174.33,2469.68,49 CDM,109358,BURR SURG OVL 4.0X8.0MM,755.5,755.5,45.33,642.17,49 CDM,109359,BUR NEURO 4.0MM,3136.5,3136.5,188.19,2666.03,49 CDM,109360,BURR ORTHO 3MM,3136.5,3136.5,188.19,2666.03,49 CDM,109361,BLADE SAW 45X42MM,988.0,988.0,59.28,839.8,49 CDM,109362,BIT DRILL 3.2MM 170MM,6273.0,6273.0,376.38,5332.05,49 CDM,109363,BIT DRILL 4.5MM 170MM,6273.0,6273.0,376.38,5332.05,49 CDM,109364,BIT DRILL 2.5X111X86MM,1566.5,1566.5,93.99,1331.53,49 CDM,109365,BIT DRILL 3.5X112X86MM,1253.0,1253.0,75.18,1065.05,49 CDM,109366,KIT MNTRDCR 5FR 21G 40CM,1043.5,1043.5,62.61,886.98,49 CDM,109367,GWIRE VASC .014IN 200CM,9613.5,9613.5,576.81,8171.48,49 CDM,109368,CATH MICRO SYS 165CM,27917.5,27917.5,1675.05,23729.88,49 CDM,109369,KIT DIALTOR INS OP,15846.5,15846.5,950.79,13469.52,49 CDM,109370,SPACER SPN 10D10X18X55MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109371,SPACER SPN 10D10X18X60MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109372,CLIP STIMULATING STRL,6273.0,6273.0,376.38,5332.05,49 CDM,109373,PROBE STIM BALL TIP,6273.0,6273.0,376.38,5332.05,49 CDM,109374,KIT ELECTRODE EMG SSEP,46221.0,46221.0,2773.26,39287.85,49 CDM,109375,CEMENT BN PMMA,18063.0,18063.0,2348.19,15353.55,28 CDM,109376,KIT BNCMNT VRTBPL,22340.5,22340.5,1340.43,18989.42,49 CDM,109377,SCREW SPN 5.5/6MM,2201.0,2201.0,286.13,1870.85,28 CDM,109381,SCREW BN SPN 6.5MM 45MM,16904.0,16904.0,2197.52,14368.4,28 CDM,109382,SCREW BN SPN 6.5MM 50MM,16904.0,16904.0,2197.52,14368.4,28 CDM,109383,ROD SPNL 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,28 CDM,109385,ANCHOR SUT 5.5MM 22MM,22928.0,22928.0,2980.64,19488.8,28 CDM,109386,ANCHOR KNTLS 4.75MM,85696.0,85696.0,11140.48,72841.6,28 CDM,109387,SCREW BN 3.5MM 24MM,24254.0,24254.0,3153.02,20615.9,28 CDM,109388,HEAD FEM HIP SZ12/14,18312.0,18312.0,2380.56,15565.2,28 CDM,109389,CMPNT FEM HIP SZ6,47893.0,47893.0,6226.09,40709.05,28 CDM,109390,SYSTEM STENT,100000.0,100000.0,13000.0,85000.0,28 CDM,109391,TRAY CATH 20GA 10CM,4736.0,4736.0,284.16,4025.6,49 CDM,109392,CATHETER ART 25FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109393,CANNULA ORTHO VIS 8MM,30118.0,30118.0,1807.08,25600.3,49 CDM,109394,MESH HRN SFT 12X12IN,23892.0,23892.0,3105.96,20308.2,28 CDM,109395,505FK MORPHINE 10 MG INJ,18.3,18.3,1.1,15.55,24 CDM,109396,BENZOCAINE 20% 60ML TOP,163.25,163.25,9.79,138.76,49 CDM,109397,RETRACTOR CHEEK DISP,17607.0,17607.0,1056.42,14965.95,49 CDM,109398,K-WIRE SHRT THRD 3.2MM,5855.0,5855.0,351.3,4976.75,49 CDM,109399,INSERT TIB 3-8MM,26764.0,26764.0,3479.32,22749.4,28 CDM,109400,PACEMAKER DUAL CHMBR,100000.0,100000.0,13000.0,85000.0,18 CDM,109400,"Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation ",100000.0,100000.0,342.64,527.77,5 CDM,109401,SHELL ACTB HIP 3H 62MM,24088.0,24088.0,3131.44,20474.8,28 CDM,109402,LINER ACTB 20D 36MM 62MM,14720.0,14720.0,1913.6,12512.0,28 CDM,109403,KIT CATH 14.5FR 36CM,11374.5,11374.5,682.47,9668.33,49 CDM,109405,AUG ACTB HIP 15MM45MM,44802.0,44802.0,5824.26,38081.7,28 CDM,109406,SCREW BN 6.5X15MM,2541.0,2541.0,330.33,2159.85,28 CDM,109407,LINER FEM HIP D 36MM,42258.0,42258.0,5493.54,35919.3,28 CDM,109408,HEAD FEM HIP 36MM,24809.0,24809.0,3225.17,21087.65,28 CDM,109409,SHELL ACTB HIP 56MM,60700.0,60700.0,7891.0,51595.0,28 CDM,109410,SCREW BN 6.5X50MM,2541.0,2541.0,330.33,2159.85,28 CDM,109411,SCREW SPN 4.5MM 35MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109412,SCREW SPN 6.5MM 35MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109413,SCREW BN 2.5MM 22MM,6240.0,6240.0,811.2,5304.0,28 CDM,109414,SCREW FT ANKL 2.5X12MM,6240.0,6240.0,811.2,5304.0,28 CDM,109415,OCCLUDER CV 12FR 44MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109416,SCREW SPN 4.0MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109418,SCREW BN LCK 30MM,2541.0,2541.0,330.33,2159.85,28 CDM,109419,CATH BLN 1.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109420,CATH BLNL 1.5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109421,SCREW BN 6.5MM 45MM,2541.0,2541.0,330.33,2159.85,28 CDM,109422,CATH BLN 1.5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109423,SCREW BN 3.5MM 12MM,6240.0,6240.0,811.2,5304.0,28 CDM,109424,CATH BLDL 2X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109425,PLATE BN 3.5MM,27488.0,27488.0,3573.44,23364.8,28 CDM,109426,SHELL ACTB HIP MOD 60MM,62964.0,62964.0,8185.32,53519.4,28 CDM,109427,SCREW BN 2.7MM 8MM,2704.0,2704.0,351.52,2298.4,28 CDM,109428,SCREW BN 2.7MM 10MM,2704.0,2704.0,351.52,2298.4,28 CDM,109429,BIT DRILL FLX 50MM,7043.0,7043.0,422.58,5986.55,49 CDM,109430,SCREW BN 3.5MM 12MM,1881.0,1881.0,244.53,1598.85,28 CDM,109431,CATH BLDL 2X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109432,CATH BLDL 2X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,109433,STEM FEM HIP SZ18,50851.0,50851.0,6610.63,43223.35,28 CDM,109434,ROD SPN 5.5MM 500MM,10319.0,10319.0,1341.47,8771.15,28 CDM,109435,CEMENT BN PMMA FULL DOSE,2541.0,2541.0,330.33,2159.85,28 CDM,109436,ANCHOR FX BLK 4.75MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109437,SUTURE NDL HD W/MGELDR,11445.0,11445.0,686.7,9728.25,49 CDM,109438,CANNULA BTN 8MM 3CM,2905.5,2905.5,174.33,2469.68,49 CDM,109439,SYSTEM IMPLNT TNPDSIS,36381.0,36381.0,4729.53,30923.85,28 CDM,109440,ANCHOR SUT 4.75X19.1MMM,93781.0,93781.0,12191.53,79713.85,28 CDM,109441,LINER ACTB HIP SZF 40MM,21129.0,21129.0,2746.77,17959.65,28 CDM,109442,BUR 6.0 RND FLU LG,3432.0,3432.0,205.92,2917.2,49 CDM,109443,SCREW BN 4.75MM 45MM,2541.0,2541.0,330.33,2159.85,28 CDM,109444,PLATE MDFC 3D SMALL,100000.0,100000.0,13000.0,85000.0,28 CDM,109445,SCREW BN 1.55X1.22X10MM,3521.0,3521.0,457.73,2992.85,28 CDM,109446,SPACER SPN 10D 6X22X50MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109447,SCREW SPN 9.0MM 70MM,49301.0,49301.0,6409.13,41905.85,28 CDM,109448,SCREW SPN 7.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109449,ROD SPN 5.5MM 110MM,5265.0,5265.0,684.45,4475.25,28 CDM,109450,SUTURE TAPE W/B 1.3MM,5938.5,5938.5,356.31,5047.73,49 CDM,109451,LINER ACTB HIP 52MM 40MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109453,KIT ACHL REPAIR 4.5MM,58047.0,58047.0,7546.11,49339.95,28 CDM,109454,REVSC LOW EXT IVL ANG BI,42771.6,42771.6,2566.3,36355.86,23 CDM,109455,REVSC LOW EXT IVL ANG LT,28514.4,28514.4,1710.86,24237.24,23 CDM,109456,REVSC LOW EXT IVL ANG RT,28514.4,28514.4,1710.86,24237.24,23 CDM,109457,TRANS BAL ANGIO EA IN LT,31226.02,31226.02,4371.64,26542.12,11 CDM,109458,TRANS BAL ANGIO EA IN RT,31226.02,31226.02,4371.64,26542.12,11 CDM,109459,SET INTRO 14FR 13CM,2556.5,2556.5,153.39,2173.03,49 CDM,109460,TUBE GSTRM LP 20FR 3.5CM,3790.5,3790.5,227.43,3221.93,49 CDM,109461,TUBE JJNSTM 20FR,4821.5,4821.5,289.29,4098.27,49 CDM,109462,TUBE JJNSTM 24FR,4821.5,4821.5,289.29,4098.27,49 CDM,109463,PLATE BNPLNTR REPAIR SYS,24448.0,24448.0,3178.24,20780.8,28 CDM,109464,PLATE BN PLNTR REPR SYS,24448.0,24448.0,3178.24,20780.8,28 CDM,109465,NEEDLE SUT MF SCRPN STRL,11445.0,11445.0,686.7,9728.25,49 CDM,109466,ROD SPN CONN 12-15MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109467,CMPNT KN FEM ELP LT 7CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109468,PACEMAKR LDLS DR 32.2MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109469,HEAD FEM HIP 28MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109470,HEAD HIP TPR NK+6X28MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109471,RVSC IVT ANG SFL IN LT,80747.03,80747.03,10497.11,68634.98,27 CDM,109472,RVSC IVT ANG SFL IN RT,80747.03,80747.03,10497.11,68634.98,27 CDM,109473,RVSC IVT ANG SFL IN BI,121120.55,121120.55,15745.67,102952.47,27 CDM,109474,RVSC IVT ANG SFL EA LT,25783.65,25783.65,3351.87,21916.1,32 CDM,109475,RVSC IVT ANG SFL EA RT,25783.65,25783.65,3351.87,21916.1,32 CDM,109476,RVSC IVT STN SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CDM,109477,RVSC IVT STN SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CDM,109478,RVSC IVT STN SFL IN BI,110293.29,110293.29,14338.13,93749.3,27 CDM,109479,RVSC IVT STNT SFL EA LT,49356.37,49356.37,6416.33,41952.91,32 CDM,109480,RVSC IVT STNT SFL EA RT,49356.37,49356.37,6416.33,41952.91,32 CDM,109481,RVSC FPVT ANG SFL IN LT,82291.54,82291.54,10697.9,69947.81,27 CDM,109482,RVSC FPVT ANG SFL IN RT,82291.54,82291.54,10697.9,69947.81,27 CDM,109483,RVSC FPVT ANG SFL IN BI,123437.31,123437.31,16046.85,104921.71,27 CDM,109484,RVSC FPVT ANG SFL EA LT,55135.33,55135.33,7167.59,46865.03,32 CDM,109485,RVSC FPVT ANG SFL EA RT,55135.33,55135.33,7167.59,46865.03,32 CDM,109486,RVSC FPVT STN SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CDM,109487,RVSC FPVT STN SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CDM,109488,RVSC FPVT STN SFL IN BI,110293.29,110293.29,14338.13,93749.3,27 CDM,109489,RVSC FPVT STN SFL EA LT,49264.34,49264.34,6404.36,41874.69,32 CDM,109490,RVSC FPVT STN SFL EA RT,49264.34,49264.34,6404.36,41874.69,32 CDM,109491,RVSC FPVT ATH SFL IN LT,48936.92,48936.92,6361.8,41596.38,27 CDM,109492,RVSC FPVT ATH SFL IN RT,48936.92,48936.92,6361.8,41596.38,27 CDM,109493,RVSC FPVT ATH SFL IN BI,73405.38,73405.38,9542.7,62394.57,27 CDM,109494,RVSC FPVT ATH SFL EA LT,32787.74,32787.74,4262.41,27869.58,32 CDM,109495,RVSC FPVT ATH SFL EA RT,32787.74,32787.74,4262.41,27869.58,32 CDM,109496,RV FPVT ST/ATH SFL IN LT,85590.94,85590.94,11126.82,72752.3,27 CDM,109497,RV FPVT ST/ATH SFL IN RT,85590.94,85590.94,11126.82,72752.3,27 CDM,109498,RV FPVT ST/ATH SFL IN BI,128386.41,128386.41,16690.23,109128.45,27 CDM,109499,RV FPVT ST/ATH SFL EA LT,57345.93,57345.93,7454.97,48744.04,32 CDM,109500,RV FPVT ST/ATH SFL EA RT,57345.93,57345.93,7454.97,48744.04,32 CDM,109501,RVSC TPVT ANG SFL IN LT,73125.09,73125.09,9506.26,62156.33,27 CDM,109502,RVSC TPVT ANG SFL IN RT,73125.09,73125.09,9506.26,62156.33,27 CDM,109503,RVSC TPVT ANG SFL IN BI,109687.64,109687.64,14259.39,93234.49,27 CDM,109504,RVSC TPVT ANG SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CDM,109505,RVSC TPVT ANG SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CDM,109506,RVSC TPVT STNT SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CDM,109507,RVSC TPVT STNT SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CDM,109508,RVSC TPVT STNT SFL IN BL,110293.29,110293.29,14338.13,93749.3,27 CDM,109509,RVSC TPVT STNT SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CDM,109510,RVSC TPVT STNT SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CDM,109511,RVSC TPVT ATH SFL IN LT,160928.26,160928.26,20920.67,136789.02,27 CDM,109512,RVSC TPVT ATH SFL IN RT,160928.26,160928.26,20920.67,136789.02,27 CDM,109513,RVSC TPVT ATH SFL IN BI,241392.4,241392.4,31381.01,205183.54,27 CDM,109514,RVSC TPVT ATH SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CDM,109515,RVSC TPVT ATH SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CDM,109516,RV TPVT ST/ATH SFL IN LT,85590.94,85590.94,11126.82,72752.3,27 CDM,109517,RV TPVT ST/ATH SFL IN RT,85590.94,85590.94,11126.82,72752.3,27 CDM,109518,RV TPVT ST/ATH SFL IN BI,128386.41,128386.41,16690.23,109128.45,27 CDM,109519,RV TPVT ST/ATH SFL EA LT,49356.37,49356.37,6416.33,41952.91,32 CDM,109520,RV TPVT ST/ATH SFL EA RT,49356.37,49356.37,6416.33,41952.91,32 CDM,109521,RVSC IMVT ANG SFL IN LT,73125.09,73125.09,9506.26,62156.33,27 CDM,109522,RVSC IMVT ANG SFL IN RT,73125.09,73125.09,9506.26,62156.33,27 CDM,109523,RVSC IMVT ANG SFL IN BI,109687.64,109687.64,14259.39,93234.49,27 CDM,109524,RVSC IMVT ANG SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CDM,109525,RVSC IMVT ANG SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CDM,109526,PTCA NCOR ST WANG 2+LSLD,133308.06,133308.06,17330.05,113311.85,20 CDM,109527,PTCA NCOR ST WANG 2+LSLC,133308.06,133308.06,17330.05,113311.85,20 CDM,109528,PTCA NCOR ST WANG 2+LSRC,133308.06,133308.06,17330.05,113311.85,20 CDM,109529,PTCA NCOR ST WANG 2+LSLM,133308.06,133308.06,17330.05,113311.85,20 CDM,109530,PTCA NCOR ST WANG 2+LSRI,133308.06,133308.06,17330.05,113311.85,20 CDM,109531,CMV AB QL SQN,75.0,75.0,4.5,63.75,14 CDM,109532,IMAGE GUIDE VASC ACCESS,4596.91,4596.91,275.81,3907.37,28 CDM,109533,BUPIVAC LIPO 266MG INJ,2392.1,2392.1,143.53,2033.29,19 CDM,109534,DIPHEN 12.5MG/5ML LIQ PO,12.35,12.35,0.74,10.5,49 CDM,109535,FENOFIBRATE 145 MG PO,4.25,4.25,0.26,3.61,49 CDM,109536,FENOFIBRATE 48 MG PO,4.25,4.25,0.26,3.61,49 CDM,109537,TRIFLUOPERAZINE 5 MG PO,8.1,8.1,0.49,6.88,49 CDM,109538,"Injection, pentamidine isethionate, 1 mg ",1727.48,1727.48,0.16,0.7,7 CDM,109538,PENTAMIDINE 300MG INJ,1727.48,1727.48,103.65,1468.36,27 CDM,109539,POSACONAZOLE 300MG INJ,1500.71,1500.71,90.04,1275.6,27 CDM,109540,VALPROATE 30MG/ML INJ,17.28,17.28,1.04,14.69,27 CDM,109541,VALPROATE 500MG INJ,164.44,164.44,9.87,139.77,27 CDM,109542,GWIRE 3.2MM 400MM,2905.5,2905.5,174.33,2469.68,49 CDM,109543,PIN TEMP 3.2.9X450MM,7501.0,7501.0,450.06,6375.85,49 CDM,109544,GWIRE ORT 1000MM,9843.0,9843.0,590.58,8366.55,49 CDM,109545,SCREW BN 5MM 47.5MM,4992.0,4992.0,648.96,4243.2,28 CDM,109546,SCREW BN 10.5MM 100MM,15039.0,15039.0,1955.07,12783.15,28 CDM,109547,NAIL BN 130D 12X460MM,52808.0,52808.0,6865.04,44886.8,28 CDM,109548,CMPD FTBP5MCG-0.0625250B,186.75,186.75,11.21,158.74,30 CDM,109549,DELFLEX 1.5%DEX 5L INJ,142.8,142.8,8.57,121.38,33 CDM,109550,DELFLEX 2.5%DEXT 5L INJ,142.8,142.8,8.57,121.38,33 CDM,109551,ALBUMIN INF 25% 50ML JW,1637.06,1637.06,98.22,1391.5,20 CDM,109552,FLUTIC/SAL 250/50 PUFF,2245.4,2245.4,134.72,1908.59,49 CDM,109553,GLYCERIN ADULT RECT,5.0,5.0,0.3,4.25,49 CDM,109554,EPTIFIBATIDE 5 MG INJ,683.95,683.95,41.04,581.36,25 CDM,109555,EPTIFIBATIDE 5 MG INJ JW,683.95,683.95,41.04,581.36,25 CDM,109556,FOSPHEN PE 50 MG INJ,330.15,330.15,19.81,280.63,25 CDM,109557,FOSPHEN PE 50 MG INJJW,330.15,330.15,19.81,280.63,25 CDM,109558,SCREW BN 3.0X16MM,6240.0,6240.0,811.2,5304.0,28 CDM,109559,SPACER SPN 10D 6X22X55MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109560,SCREW SPN 6.5MM 50MM,14331.0,14331.0,1863.03,12181.35,28 CDM,109561,STENT VASC 5FR 5X40MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109562,STENT VASC 5FR 5X60MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109564,STENT VASC 5FR 5X10MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109565,SCREW BN 3.5MM 18MM,4160.0,4160.0,540.8,3536.0,28 CDM,109566,PLATE BN 3HL,42848.0,42848.0,5570.24,36420.8,28 CDM,109567,GRAFT EVAS 79MM 24MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109568,SCREW BN 2.4X30MM,7225.0,7225.0,939.25,6141.25,28 CDM,109569,SCREW BN TI 2.4X26MM,19319.0,19319.0,2511.47,16421.15,28 CDM,109570,SCREW BN TI 2.4X28MM,19319.0,19319.0,2511.47,16421.15,28 CDM,109571,SCREW BN 3.0MM 16MM,19319.0,19319.0,2511.47,16421.15,28 CDM,109573,SCREW BN TI 2.4X30MM,19319.0,19319.0,2511.47,16421.15,28 CDM,109574,PROS PNL NRW 0 ANG 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109575,SUTURE ENDO DISP,7600.5,7600.5,456.03,6460.43,49 CDM,109576,SPACER SPN 10D 8X18X55MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109577,SCREW BN 2.4MM 4MM 22MM,2366.0,2366.0,307.58,2011.1,28 CDM,109578,PIN SPN FX TEMPORARY,1453.0,1453.0,87.18,1235.05,49 CDM,109579,BIT DRIL 2.3MM 12MM,1453.0,1453.0,87.18,1235.05,49 CDM,109580,BIT DRIL 2.3MM 14MM,1453.0,1453.0,87.18,1235.05,49 CDM,109581,CAGE SPN 7D 12X14X6MM,22538.0,22538.0,2929.94,19157.3,28 CDM,109582,SCREW SPN 6.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109583,SPACER SPN 24X8MM,56344.0,56344.0,7324.72,47892.4,28 CDM,109584,GRAFT BN DBF PTTY 6CC,14959.0,14959.0,1944.67,12715.15,28 CDM,109585,STENT VASC 5FR 5X120MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109586,KIT DRILL CANN 3.5/3.6MM,14438.0,14438.0,866.28,12272.3,49 CDM,109587,SYSTEM IMPL SYNDSMS FX,43560.0,43560.0,5662.8,37026.0,28 CDM,109588,KIT ANCH BN 3.5MM 4.5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109589,GWIRE OLV BN FX .062X3IN,6147.5,6147.5,368.85,5225.38,49 CDM,109590,BIT DRILL ORTH 2.5X60MM,6273.0,6273.0,376.38,5332.05,49 CDM,109591,SCREW BN CORT 3.5X14MM,6115.0,6115.0,794.95,5197.75,28 CDM,109592,SCREW BN ANKL 3.5X18MM,6115.0,6115.0,794.95,5197.75,28 CDM,109593,PLATE BN 1/3 TUBLR 4H,30625.0,30625.0,3981.25,26031.25,28 CDM,109594,DRILL SOLID 3.5MM,7923.5,7923.5,475.41,6734.98,49 CDM,109595,ANCHOR SUTURE #2 1.3MM,17081.0,17081.0,2220.53,14518.85,28 CDM,109596,CATHETER ART 15FR 18CM,15846.5,15846.5,950.79,13469.52,49 CDM,109597,CATHETER ART 17FR 18CM,15846.5,15846.5,950.79,13469.52,49 CDM,109598,CATH DRN 21FR,17607.0,17607.0,1056.42,14965.95,49 CDM,109599,CATHETER DRN 23FR 61CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109600,CATH DRN 25FR,17607.0,17607.0,1056.42,14965.95,49 CDM,109601,CATH DRN 27FR,17607.0,17607.0,1056.42,14965.95,49 CDM,109602,CATH GUIDE 9FR 10CM,13596.5,13596.5,815.79,11557.02,49 CDM,109603,CATH DRAIN 11FR 10.5CM,13596.5,13596.5,815.79,11557.02,49 CDM,109604,CATH DRAIN 13FR 11CM,13596.5,13596.5,815.79,11557.02,49 CDM,109605,CATH DRAIN 13FR 11.5CM,13596.5,13596.5,815.79,11557.02,49 CDM,109606,CATH DRN 9FR,13596.5,13596.5,815.79,11557.02,49 CDM,109607,CATH DRN 11FR,13596.5,13596.5,815.79,11557.02,49 CDM,109608,CATH DRN 13FR,13596.5,13596.5,815.79,11557.02,49 CDM,109609,CATH DRAIN 15FR 11.5CM,13596.5,13596.5,815.79,11557.02,49 CDM,109610,CATH DRN 21FR 38CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109611,CATH DRAIN 23FR 38CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109612,CATH DRAIN 25FR 38CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109613,PLATE MNDB TRUMATCH 3D,100000.0,100000.0,13000.0,85000.0,28 CDM,109614,GRAFT VASC STD 60CM 8MM,69877.0,69877.0,9084.01,59395.45,28 CDM,109615,STENT VASC 5FR 6X10MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109616,GRAFT EVAS 90MM 16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109617,CANNULA ARTH 7CM 8.25MM,2905.5,2905.5,174.33,2469.68,49 CDM,109618,SYSTEM KNOTLES AC REPAIR,100000.0,100000.0,13000.0,85000.0,28 CDM,109619,SUTURE FBSNR #2 26IN,6273.0,6273.0,376.38,5332.05,49 CDM,109620,GRAFT EVAS 7CMX14.5MM,96679.0,96679.0,12568.27,82177.15,28 CDM,109621,GRAFT EVAS 10CM 12MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109623,CATH DRN 29FR,17607.0,17607.0,1056.42,14965.95,49 CDM,109624,CANNULA ART 15F 3/8IN 23,11549.0,11549.0,692.94,9816.65,49 CDM,109625,SPACER SPN 10D 8X18X60MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109626,SCREW SPN 6.5MM 50MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109627,LEAD ICD 52CM,84850.0,84850.0,11030.5,72122.5,28 CDM,109628,GRAFT CV 4MM 40CM,82430.0,82430.0,10715.9,70065.5,28 CDM,109629,STENT VASC 5FR 6X120MM,18317.0,18317.0,2381.21,15569.45,28 CDM,109630,CANNULA VEN 19FR 38CM,15778.0,15778.0,946.68,13411.3,49 CDM,109632,GRAFT VASC 45CM 4-7MM,47592.0,47592.0,6186.96,40453.2,28 CDM,109633,DRESSING GELING FBR 1X18,401.0,401.0,24.06,340.85,49 CDM,109634,RING ANULPSTY MITRL 24MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109635,RING ANULPSTY MITRL 24MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109636,RING ANULPSTY MITRL 28MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109637,RING ANNULOPLASTY 30MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109638,RING ANULPSTY MITRL 32MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109639,RING ANULPSTY MITRL 34MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109640,RING ANULPSTY MITRL 36MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109641,RING ANULPSTY MITRL 38MM,63283.0,63283.0,8226.79,53790.55,28 CDM,109642,RING ANLPLSTY 40MM,63306.0,63306.0,8229.78,53810.1,28 CDM,109643,TEMPLATE BN/ORGN CUSTOM,30280.5,30280.5,1816.83,25738.42,49 CDM,109644,CANNULA ARTHSCP 7CM,2441.0,2441.0,146.46,2074.85,49 CDM,109645,PASSER SUT 45D CRV LT,9402.5,9402.5,564.15,7992.13,49 CDM,109646,SCREW SPN SET,2201.0,2201.0,286.13,1870.85,28 CDM,109647,SCREW SPN 4.0MM 16MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109648,SCREW SPN 4.0MM 14MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109649,SCREW SPN 5.0MM 28MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109650,SCREW SPN 3.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109651,SCREW SPN 3.5MM 22MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109652,SCREW SPN 3.5MM 28MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109653,ANCHOR SUT KNTLSS 1.8MM,88930.0,88930.0,11560.9,75590.5,28 CDM,109654,CONN SPN OPN-OPN 3.5-5.5,10032.0,10032.0,1304.16,8527.2,28 CDM,109655,SCREW SPN 4.5MM 28MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109656,SCREW SPN 4.0MM 18MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109657,SUTURE ENDO DISP,39288.0,39288.0,2357.28,33394.8,49 CDM,109658,PLATE BN TI LOCK 4HL,14725.0,14725.0,1914.25,12516.25,28 CDM,109659,BIT DRILL 2.5MM,5938.5,5938.5,356.31,5047.73,49 CDM,109660,BIT DRILL DIST ANKL 2.5M,5938.5,5938.5,356.31,5047.73,49 CDM,109661,SCREW BN 3.5MM 14MM,12557.0,12557.0,1632.41,10673.45,28 CDM,109662,GWIRE ORTH 150MM .053IN,1260.0,1260.0,75.6,1071.0,49 CDM,109663,"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure) ",150.0,150.0,226.42,348.77,5 CDM,109663,SKIN SUB FDA DEVICE NOC,150.0,150.0,19.5,127.5,23 CDM,109664,CATH ABL 25-35MM,100000.0,100000.0,6000.0,85000.0,49 CDM,109665,505HP NA THIOS 100MG JW,4.28,4.28,0.26,3.64,25 CDM,109666,505HP NA THIOS 100MGINJ,4.28,4.28,0.26,3.64,25 CDM,109667,ERAVACYCLINE 1 MG INJ,7.57,7.57,0.45,6.43,24 CDM,109668,ERAVACYCLINE 1 MG INJ JW,7.57,7.57,0.45,6.43,24 CDM,109669,POSACONAZOLE 1MG INJ,5.0,5.0,0.3,4.25,27 CDM,109670,POSACONAZOLE 1MG INJ JW,5.0,5.0,0.3,4.25,27 CDM,109671,"Injection, tranexamic acid in sodium chloride, 5 mg ",208.95,208.95,0.2,0.27,5 CDM,109671,TRANEX NACL 1000MG INJ,208.95,208.95,12.54,177.61,28 CDM,109672,ZIDOVUDINE 10 MG INJ,11.66,11.66,0.7,9.91,24 CDM,109673,ZIDOVUDINE 10 MG INJ JW,11.66,11.66,0.7,9.91,24 CDM,109674,CHLM TRCH&NEISR GONO MUL,51.0,51.0,3.06,43.35,37 CDM,109674,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique ",51.0,51.0,68.78,223.87,49 CDM,109675,CYTOG ALYS CHRML ABN OGM,227.45,227.45,13.65,193.33,37 CDM,109675,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (OGM) ",227.45,227.45,1238.26,4030.66,49 CDM,109676,"Infectious agent detection by nucleic acid (DNA or RNA); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets ",19.15,19.15,666.17,2168.47,49 CDM,109676,JT SPC PTHGN&RX RES 26+,19.15,19.15,1.15,16.28,37 CDM,109677,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influe",143.0,143.0,72.99,237.59,49 CDM,109677,SARSCOV2&INF TYP AB OPTI,143.0,143.0,8.58,121.55,37 CDM,109678,SC STD CARBAPENE RES GEN,52.8,52.8,3.17,44.88,37 CDM,109678,"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP), amplified probe technique, per isolate ",52.8,52.8,34.39,111.94,49 CDM,109679,SC STD CARBAPENE NZM DET,52.8,52.8,3.17,44.88,42 CDM,109679,"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, Klebsiella pneumoniae carbapenemase ºKPC», New Delhi metallo-beta-lactamase ºNDM», Verona integron-encoded metallo-beta",52.8,52.8,9.6,15.15,5 CDM,109680,ONC CNS TUM DNA MTH10000,1950.0,1950.0,117.0,1657.5,42 CDM,109680,"Oncology (central nervous system tumor), DNA methylation analysis of at least 10,000 methylation sites, utilizing DNA extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability o",1950.0,1950.0,251.77,397.6,5 CDM,109681,CMPD PHENYLEPN 0.5MG 5S,30.0,30.0,1.8,25.5,30 CDM,109682,CATH THRMB SCTN 7FR,100000.0,100000.0,6000.0,85000.0,49 CDM,109683,ANCHOR SUT 5.5MM,37642.0,37642.0,4893.46,31995.7,28 CDM,109684,IMPLANT SPN CERV SYS 4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109685,RETRACTOR COLLAR DIS LNG,4394.5,4394.5,263.67,3735.32,49 CDM,109686,IMPLANT SPN CERV SYS 4MM,78882.0,78882.0,10254.66,67049.7,28 CDM,109687,FIBER LASER 272UM,8980.0,8980.0,538.8,7633.0,49 CDM,109688,GRAFT CV 4MM 35CM,79645.0,79645.0,10353.85,67698.25,28 CDM,109689,PROSTH PENL PUMP PL 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109690,PURAPLY 1SQCM,2829.0,2829.0,169.74,2404.65,25 CDM,109691,INSERT KN BRNG SZ2 10MM,26764.0,26764.0,3479.32,22749.4,28 CDM,109692,FIBER LASER 200UM,8980.0,8980.0,538.8,7633.0,49 CDM,109693,INSTRMNT PLVC SCRW 80MM,10142.0,10142.0,608.52,8620.7,49 CDM,109694,GRAFT BN PUTTY 2.5CC,35712.0,35712.0,4642.56,30355.2,28 CDM,109695,BONE GRAFT 10.0CC,100000.0,100000.0,13000.0,85000.0,28 CDM,109696,INSTRMNT PLVC SCRW 130MM,9860.0,9860.0,591.6,8381.0,49 CDM,109697,INSTRMNT PLVC NAIL 80MM,7395.0,7395.0,443.7,6285.75,49 CDM,109698,INSTRMNT PLVC NAIL 130MM,6831.5,6831.5,409.89,5806.77,49 CDM,109699,INSTRMNT FX ARROW 125MM,15142.0,15142.0,908.52,12870.7,49 CDM,109700,GRAFT BN 5X1.75CM,59295.0,59295.0,7708.35,50400.75,28 CDM,109702,CAGE SPN 5.0X25MM,2633.0,2633.0,342.29,2238.05,28 CDM,109703,LINER ACTB HIP 28MM 56MM,38737.0,38737.0,5035.81,32926.45,28 CDM,109704,PRIMATRIX 1SQCM,2467.0,2467.0,148.02,2096.95,25 CDM,109705,PRIMATRIX 1SQCM,2050.0,2050.0,123.0,1742.5,25 CDM,109706,PRIMATRIX 1SQCM,1747.0,1747.0,104.82,1484.95,25 CDM,109707,CAGE SPN 10D 8X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109708,CAGE SPNL 5X20MM,2633.0,2633.0,342.29,2238.05,28 CDM,109709,PLATE BN RT 0DEG XSML,58209.0,58209.0,7567.17,49477.65,28 CDM,109710,SCREW BN 2.7MM 16MM,7657.0,7657.0,995.41,6508.45,28 CDM,109711,SCREW BN 2.7MM 20MM,1017.0,1017.0,132.21,864.45,28 CDM,109712,SCREW BN LCK 2.7X24MM,7657.0,7657.0,995.41,6508.45,28 CDM,109714,SCREW BN 2.7MM 22MM,1017.0,1017.0,132.21,864.45,28 CDM,109715,NAIL BN TIB 9MM 330MM,42266.0,42266.0,5494.58,35926.1,28 CDM,109716,SCREW BN 5MM 32MM,4992.0,4992.0,648.96,4243.2,28 CDM,109717,SCREW BN 5MM 42MM,4992.0,4992.0,648.96,4243.2,28 CDM,109718,ROD SPN 3.5-5.5MM 500MM,5265.0,5265.0,684.45,4475.25,28 CDM,109720,CATH BLN 5X200MM 200CM,83044.0,83044.0,4982.64,70587.4,49 CDM,109721,TUBE TRACH 8.5MM,1758.0,1758.0,105.48,1494.3,49 CDM,109722,VLVLTM SURG 94CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109723,SPADE BLADES DISP,7043.0,7043.0,422.58,5986.55,49 CDM,109724,HIP PIN FIXATION 80MM,15142.0,15142.0,908.52,12870.7,49 CDM,109725,HEAD HIP 45MM 28MM,11465.0,11465.0,1490.45,9745.25,28 CDM,109726,STEM HIP 132D SZ2 124MM,39441.0,39441.0,5127.33,33524.85,28 CDM,109727,SPACER FEM HIP SM 10MM,2541.0,2541.0,330.33,2159.85,28 CDM,109728,HEAD FEM HIP 0MM 28MM,19721.0,19721.0,2563.73,16762.85,28 CDM,109729,SCREW SPN 3.5MM 22MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109730,MYRIAD MORCELLS 4MG,421.0,421.0,25.26,357.85,41 CDM,109731,SCREW SPN 7.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,109732,ROD SPNL 35MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,109733,CANNULA D-LUMN 29FR 46CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109734,CANNULA D-LUMN 31FR 51CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109735,STEM HIP SZ4 103X32.5MM,54429.0,54429.0,7075.77,46264.65,28 CDM,109736,HEAD FEM HIP BIP 28X46MM,11465.0,11465.0,1490.45,9745.25,28 CDM,109737,ELECTRODE CAUTRY 4IN,221.5,221.5,13.29,188.28,49 CDM,109738,ELECTRODE ESURG BLUE,191.0,191.0,11.46,162.35,49 CDM,109739,ELECTRODE ENDO BLDE 6IN,194.0,194.0,11.64,164.9,49 CDM,109740,ELECTRODE SURG 20X12MM,491.0,491.0,29.46,417.35,49 CDM,109741,ELECTRODE BLDE XTN 2.5IN,194.0,194.0,11.64,164.9,49 CDM,109742,BLADE PTFE COATED 6IN,242.0,242.0,14.52,205.7,49 CDM,109743,ELECTRODE ENDO BLDE 4IN,204.0,204.0,12.24,173.4,49 CDM,109744,SHEATH GD 4FR 45CM,2905.5,2905.5,174.33,2469.68,49 CDM,109745,CLIP LIGATING SM,146.0,146.0,18.98,124.1,28 CDM,109746,STYLET CATH 60CM,2499.0,2499.0,149.94,2124.15,49 CDM,109747,CAP LD 26MM 6.4MM 3.4MM,952.0,952.0,123.76,809.2,28 CDM,109748,STYLET LD ICD 60CM,2499.0,2499.0,149.94,2124.15,49 CDM,109749,TOOL LD FIXATION IS-1,2499.0,2499.0,149.94,2124.15,49 CDM,109750,SCREW SPN 5.5MM 40MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109751,PENCIL CAUT ESURG DISP,258.5,258.5,15.51,219.72,49 CDM,109752,CATH ABL 7FR 115CM,11585.0,11585.0,695.1,9847.25,49 CDM,109753,TIP PLS LAV 22.86X.89CM,774.0,774.0,46.44,657.9,49 CDM,109754,KIT INTRO 4FR 10CM,1293.0,1293.0,77.58,1099.05,49 CDM,109755,SCREW SPN 9.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109756,SCREW SPN 8.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109757,SCREW SPN 9.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109758,SCREW SPN 9.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109759,CONN SPN OPEN ILIAC 20MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109760,SCREW SPN 9.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109761,KIT PLS LAV W/HIP,1830.5,1830.5,109.83,1555.92,49 CDM,109762,INSERT SHLDR +6MM 36MM,14331.0,14331.0,1863.03,12181.35,28 CDM,109763,SCREW BN 5MM 30MM,3120.0,3120.0,405.6,2652.0,28 CDM,109764,SCREW BN 5MM 22MM,3120.0,3120.0,405.6,2652.0,28 CDM,109765,STEM SHLDR 9MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109766,HEAD SHOULDER 36MM,50710.0,50710.0,6592.3,43103.5,28 CDM,109767,FLEX HUM SHLDR +6MM 0MM,16904.0,16904.0,2197.52,14368.4,28 CDM,109768,SCREW BN SHLDR 30MM,23446.0,23446.0,3047.98,19929.1,28 CDM,109769,SPACER SHLDR HUM 9X30MM,69388.0,69388.0,9020.44,58979.8,28 CDM,109770,CAP BN LOCKING FLEX,15746.0,15746.0,2046.98,13384.1,28 CDM,109771,STEM HUM SHLDR 9MM 90MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109772,CATHETER DUAL LUMEN 30FR,75494.5,75494.5,4529.67,64170.32,49 CDM,109773,CATH CV DUAL LUMEN 32FR,75494.5,75494.5,4529.67,64170.32,49 CDM,109774,SET DBF WITH DEL TUBES,19633.0,19633.0,2552.29,16688.05,28 CDM,109775,SCREW SPN 5.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109776,STENT BIL 8X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,109777,SYS DRN BAL WET SEAL SGL,56852.0,56852.0,3411.12,48324.2,49 CDM,109778,TRAY CATH PICC 3FR 55CM,9379.0,9379.0,562.74,7972.15,49 CDM,109779,STENT EPRSTH RX 10MM 6CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109780,CATH BLNDIL 4X120MM,38209.5,38209.5,2292.57,32478.08,49 CDM,109781,ROD SPN 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,28 CDM,109782,GRAFT EVAS 36MM 113MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109783,GRAFT EVAS 20F 50X36MM,75891.0,75891.0,9865.83,64507.35,28 CDM,109784,SCREW SPN 5.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109785,SCREW SPN 5.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109786,CATH BLN URTH RX 24F 5CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109787,CATH BLN URTH RX 18F 5CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109788,CATH BLN W/INFL DEV 30FR,100000.0,100000.0,6000.0,85000.0,49 CDM,109789,CATH THRMB 6FR 137CM,68561.5,68561.5,4113.69,58277.28,49 CDM,109792,GRAFT VASC 45CM 4-6MM,47592.0,47592.0,6186.96,40453.2,28 CDM,109793,RETRACTOR SURG DISP,20839.5,20839.5,1250.37,17713.58,49 CDM,109794,SCREW SPN 5.5MM 25MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109795,LEAD ICD SC DF4 64CM,59127.0,59127.0,7686.51,50257.95,28 CDM,109796,CATH GD 7FR 42CM,15529.5,15529.5,931.77,13200.08,49 CDM,109797,KIT ANCHORING 2 STITCH,23275.0,23275.0,3025.75,19783.75,28 CDM,109798,SHELL ACTB HIP 3HL 50MM,24088.0,24088.0,3131.44,20474.8,28 CDM,109801,CATH THRMB 8FR 50CM,83198.0,83198.0,4991.88,70718.3,49 CDM,109802,INSERT SFJW FGRTY SPRG,616.5,616.5,36.99,524.02,49 CDM,109803,SYSTEM IMPL ACL 11MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109804,DRILL ASSEMBLY 3MM,8522.0,8522.0,511.32,7243.7,49 CDM,109805,BLADE STRPR TNDN 9MM,10282.5,10282.5,616.95,8740.13,49 CDM,109806,CUTTER SURG RETRO 9.5MM,11445.0,11445.0,686.7,9728.25,49 CDM,109807,ANCHOR SUT 24D 1.5MM,29654.0,29654.0,3855.02,25205.9,28 CDM,109808,SCREW BN 6.5MM 25MM,9817.0,9817.0,1276.21,8344.45,28 CDM,109809,PUSHER CUTTER SUT KNOT,12924.0,12924.0,775.44,10985.4,49 CDM,109810,ROD SPN CRVD 55MM,5265.0,5265.0,684.45,4475.25,28 CDM,109811,ROD SAVNNH-T CRV 65MM,5265.0,5265.0,684.45,4475.25,28 CDM,109812,ANCHOR SUT SFT 2.6,24254.0,24254.0,3153.02,20615.9,28 CDM,109813,CANNULA ARTH 2.6X 305MM,2905.5,2905.5,174.33,2469.68,49 CDM,109814,SET FD PUMP 1000ML,173.5,173.5,10.41,147.47,49 CDM,109815,CATH SYS THRMB 154CM,31584.5,31584.5,1895.07,26846.83,49 CDM,109816,STENT EPRSTH 22FR 31MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109817,PLATE BN HUM LT3.5X198MM,69107.0,69107.0,8983.91,58740.95,28 CDM,109818,ROD SPN 5.5X7.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,109819,SCREW BN 3.5MM 14MM,6240.0,6240.0,811.2,5304.0,28 CDM,109820,DEVICE CLS WND +4-0 45CM,1199.5,1199.5,71.97,1019.58,49 CDM,109821,STENT BIL 8X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,109822,STENT BIL 8X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,109823,STENT BIL 8X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,109824,SPONGE ABS HEMO 6X2CM,244.0,244.0,14.64,207.4,49 CDM,109825,CATH HEMO 28FR 45CM,7871.5,7871.5,472.29,6690.77,49 CDM,109826,KIT HMDIAL CATH 24CM,4893.0,4893.0,293.58,4159.05,49 CDM,109827,STENT COR 3MM 40MM,18164.0,18164.0,2361.32,15439.4,28 CDM,109828,SPACER SPN 0D 18X50X16MM,41554.0,41554.0,5402.02,35320.9,28 CDM,109829,CATH ANGIO 5FR 65CM,32355.0,32355.0,1941.3,27501.75,49 CDM,109830,DEVICE CLSR FEM 5FR,7854.0,7854.0,1021.02,6675.9,28 CDM,109831,SCREW BN 2.7MM 16MM,1943.0,1943.0,252.59,1651.55,28 CDM,109832,ANCHOR BN SHDR 1.8,17277.0,17277.0,2246.01,14685.45,28 CDM,109833,SEALER VESSL CRV,23573.0,23573.0,1414.38,20037.05,49 CDM,109834,BAG SPEC RETRVL 1850ML,5512.5,5512.5,330.75,4685.63,49 CDM,109835,SCREW SPN 3.5MM 12MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109836,SCREW SPN CLOSURE TOP,2201.0,2201.0,286.13,1870.85,28 CDM,109837,ROD SPN 3.5MM 30MM,5265.0,5265.0,684.45,4475.25,28 CDM,109838,PRIMATRIX 1SQCM,2541.0,2541.0,152.46,2159.85,25 CDM,109839,CAGE SPN 15D 5X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109840,SCREW SPN 5.0MM 25MM,9316.0,9316.0,1211.08,7918.6,28 CDM,109841,ROD SPN 5.5MM 35MM,5265.0,5265.0,684.45,4475.25,28 CDM,109842,NAIL TIB 10MM 31CM,38774.0,38774.0,5040.62,32957.9,28 CDM,109843,INSTR HRVST BN 6MM,17607.0,17607.0,1056.42,14965.95,49 CDM,109844,SUTURE SURG 4-0 36IN,500.0,500.0,30.0,425.0,49 CDM,109845,STENT EPRSTH 7MM 2.5CM,95062.0,95062.0,12358.06,80802.7,28 CDM,109846,STENT EPRSTH 8MM 25CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109847,POWDER COLGN TYPE1 5GM,41599.0,41599.0,2495.94,35359.15,49 CDM,109848,STENT EPRSTH 7MM 25CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109849,STENT EPRSTH 6MM 2.5CM,95062.0,95062.0,12358.06,80802.7,28 CDM,109850,CMPNT FEM NAR KN RT SZ5,50710.0,50710.0,6592.3,43103.5,28 CDM,109851,COMP TIB KN RT 0D SZC,30990.0,30990.0,4028.7,26341.5,28 CDM,109852,INSERT TIB KN SZ4/5 13MM,21129.0,21129.0,2746.77,17959.65,28 CDM,109853,HEAD FEM HIP 12/14MM,18312.0,18312.0,2380.56,15565.2,28 CDM,109854,CMPNT FEM HIP SZ 7,47893.0,47893.0,6226.09,40709.05,28 CDM,109855,SCREW SPN P-AX 05.5X45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109856,CAGE SPN 10D 7X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109857,SCREW SPN 5.0MM 30MM,9316.0,9316.0,1211.08,7918.6,28 CDM,109858,ROD SPN 5.5MM 55MM,5265.0,5265.0,684.45,4475.25,28 CDM,109859,ROD SPN 5.5MM 50MM,5265.0,5265.0,684.45,4475.25,28 CDM,109860,SCREW BN 2.0MM 8MM,2545.0,2545.0,330.85,2163.25,28 CDM,109861,CATH THRMB 5FR 160CM,68561.5,68561.5,4113.69,58277.28,49 CDM,109862,CATH SYS THRMB 177CM,31584.5,31584.5,1895.07,26846.83,49 CDM,109863,CATH SYS THRMB 107CM,31584.5,31584.5,1895.07,26846.83,49 CDM,109864,CATH SYS THRMB 67CM,31584.5,31584.5,1895.07,26846.83,49 CDM,109865,CATH BLNDIL OTW 1.5X6MM,8803.5,8803.5,528.21,7482.98,49 CDM,109866,STENT URET 8FR 24CM,4908.0,4908.0,638.04,4171.8,28 CDM,109867,STABILIZER HRT OF/PMPSYS,31570.5,31570.5,1894.23,26834.92,49 CDM,109868,GRAFT TENDON 26CM,59826.0,59826.0,7777.38,50852.1,28 CDM,109869,SCREW SPN PLVC 10.5X60MM,82404.0,82404.0,10712.52,70043.4,28 CDM,109870,SCREW SPN PLVC 10.5X70MM,82404.0,82404.0,10712.52,70043.4,28 CDM,109871,CATH BLN 6X120MM 150CM,46221.0,46221.0,2773.26,39287.85,49 CDM,109872,STENT VASC 6X150MM 130CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109873,CATH BLNDIL 6.0MM 35MM,11938.0,11938.0,716.28,10147.3,49 CDM,109874,SCREW BN 2.4MM 22MM,4960.0,4960.0,644.8,4216.0,28 CDM,109875,SCREW BN 3.5MM 16MM,2706.0,2706.0,351.78,2300.1,28 CDM,109876,PLATE BN TI 3HL,27869.0,27869.0,3622.97,23688.65,28 CDM,109877,CERCLAGE TAPE W/O NEEDLE,25612.0,25612.0,3329.56,21770.2,28 CDM,109878,INST PASSR SUT DISP MD,13205.5,13205.5,792.33,11224.67,49 CDM,109879,DEVICE INFL 30ML 35ATM,2449.0,2449.0,146.94,2081.65,49 CDM,109880,KIT HMSTC MTRX THRMB,30213.0,30213.0,1812.78,25681.05,49 CDM,109881,DEVICE IPG SLEEP APENA,100000.0,100000.0,13000.0,85000.0,28 CDM,109882,PENCIL ESURG SMOKE EVAC,143.0,143.0,8.58,121.55,49 CDM,109883,BASKET RET 2.5CM 3.2MM,8845.5,8845.5,530.73,7518.68,49 CDM,109884,SHEARS ESURG 5MM 45CM,7095.0,7095.0,425.7,6030.75,49 CDM,109885,KIT ARTER CATH 20G 12CM,3722.0,3722.0,223.32,3163.7,49 CDM,109886,PLATE BN 5MM,56592.0,56592.0,7356.96,48103.2,28 CDM,109887,SCREW BN 5MM 10MM,6240.0,6240.0,811.2,5304.0,28 CDM,109888,SCREW BN CORT 4.5X20MM,2135.0,2135.0,277.55,1814.75,28 CDM,109889,MICROCATH COX 2.4FR 130C,19320.5,19320.5,1159.23,16422.42,49 CDM,109890,COIL EMBL 2.8FR 20CM,40617.0,40617.0,5280.21,34524.45,28 CDM,109891,COIL EMBL 6MM 20CM,31692.0,31692.0,4119.96,26938.2,28 CDM,109893,STENT PANC 24MM 146MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109894,SNARE RETR 9MM 286CM,17431.0,17431.0,1045.86,14816.35,49 CDM,109895,COMPNT FEM KN RT SZ7,32398.0,32398.0,4211.74,27538.3,28 CDM,109896,BASEPLATE TIB KN SZ6,29581.0,29581.0,3845.53,25143.85,28 CDM,109897,INSERT TIB KN RT SZ7 5MM,21129.0,21129.0,2746.77,17959.65,28 CDM,109898,CEMENT BN PMMA GMV 40GM,6240.0,6240.0,811.2,5304.0,28 CDM,109899,SYSTEM BNCMNT MIXER,3680.5,3680.5,220.83,3128.43,49 CDM,109900,SCREW BN LCK 5X57.5MM,4992.0,4992.0,648.96,4243.2,28 CDM,109901,SCREW BN 10.5MM 90MM,15039.0,15039.0,1955.07,12783.15,28 CDM,109902,NAIL BN FEM RT 11X380MM,52808.0,52808.0,6865.04,44886.8,28 CDM,109903,STENT ENDO 9X79MM 135CM,100000.0,100000.0,13000.0,85000.0,28 CDM,109904,DERMACELL AWM PORO 1SQCM,2541.0,2541.0,152.46,2159.85,30 CDM,109905,DERMACELL AWM PORO 1SQCM,2541.0,2541.0,152.46,2159.85,30 CDM,109906,DERMACELL AWM PORO 1SQCM,2541.0,2541.0,152.46,2159.85,30 CDM,109907,DERMACELL AWM PORO 1SQCM,1992.0,1992.0,119.52,1693.2,30 CDM,109908,SCREW BN 2.0MM 14MM,2541.0,2541.0,330.33,2159.85,28 CDM,109909,SCREW SPN 5.5MM 40MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109910,SCREW SPN 5.5MM 35MM,15495.0,15495.0,2014.35,13170.75,28 CDM,109911,CATH BLNDIL 2MM 8MM,5102.0,5102.0,306.12,4336.7,49 CDM,109912,CATHETER PTCA 5F 145CM,5102.0,5102.0,306.12,4336.7,49 CDM,109913,BIT DRIVER DISP,1104.5,1104.5,66.27,938.83,49 CDM,109914,SCREW BN 3MM 13MM,8639.0,8639.0,1123.07,7343.15,28 CDM,109915,DEVICE FX PLATE BOX,18024.0,18024.0,2343.12,15320.4,28 CDM,109916,CATHETER DUAL LUMEN 28FR,69832.5,69832.5,4189.95,59357.63,49 CDM,109917,PLATE BN THOR FXTN STRL,15668.0,15668.0,2036.84,13317.8,28 CDM,109918,SCREW BN 3MM 13MM,8482.0,8482.0,1102.66,7209.7,28 CDM,109919,PROBE ABL 30CM,94899.5,94899.5,5693.97,80664.57,49 CDM,109920,LEAD PCNG RT VNTRC 52CM,5587.0,5587.0,726.31,4748.95,28 CDM,109921,GRAFT STNT 10FR 14X100MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109922,GRAFT STNT 14FR 22X45MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109923,CATH URET 2W 14FR 5CC,194.0,194.0,11.64,164.9,49 CDM,109924,PLATE ADJ BN SPNE OCT,42258.0,42258.0,5493.54,35919.3,28 CDM,109925,STYLET LD 75CM .014IN,1505.0,1505.0,90.3,1279.25,49 CDM,109926,CATH GD VASC 45CM,10130.5,10130.5,607.83,8610.92,49 CDM,109927,SCREW BN SPN 4.5MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,109928,ROD SPN 200MM 3.5MM,8599.0,8599.0,1117.87,7309.15,28 CDM,109929,SCREW SPN 4.0MM 24MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109930,SCREW SPN 3.5MM 14MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109931,SCREW SPN 3.5MM 18MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109932,CONN SPN RD-RD 3.5X40MM,10032.0,10032.0,1304.16,8527.2,28 CDM,109933,SHEATH STRBL 13FR 91CM,40058.5,40058.5,2403.51,34049.72,49 CDM,109934,CATH EP ABL PFA 35MM,100000.0,100000.0,6000.0,85000.0,49 CDM,109935,CATH VASC GD 17F 65CM,27733.0,27733.0,1663.98,23573.05,49 CDM,109936,CATH EP ABL PFA 31MM,100000.0,100000.0,6000.0,85000.0,49 CDM,109937,FIBER LASER HOLMIUM 200,6273.0,6273.0,376.38,5332.05,49 CDM,109938,CATH BLNDL 9MM 75CM 80MM,44680.5,44680.5,2680.83,37978.43,49 CDM,109939,CATHETER BLNDIL 8MM 80M,44680.5,44680.5,2680.83,37978.43,49 CDM,109940,CATH IVL 3X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109941,PLATE BN 8H 97MM,30851.0,30851.0,4010.63,26223.35,28 CDM,109942,CATH EP ABL NAV PFA 35MM,100000.0,100000.0,6000.0,85000.0,49 CDM,109943,CATH EP ABL NAV PFA 31MM,100000.0,100000.0,6000.0,85000.0,49 CDM,109944,EXTENDER XTRT LD 70CM,13211.0,13211.0,792.66,11229.35,49 CDM,109945,COIL CMPR LD RTRVL,9457.0,9457.0,567.42,8038.45,49 CDM,109946,SPACER SPN 10D 8X22X55MM,84516.0,84516.0,10987.08,71838.6,28 CDM,109947,SCREW SPN 6.5MM 35MM,5265.0,5265.0,684.45,4475.25,28 CDM,109948,PLATE SPN 1 SCREW SZ08,30285.0,30285.0,3937.05,25742.25,28 CDM,109949,PLATE BN SLM 6HL,20664.0,20664.0,2686.32,17564.4,28 CDM,109950,SET SHTH DIL 11FR 13.6CM,56062.5,56062.5,3363.75,47653.13,49 CDM,109951,SET SHTH DIL 9FR 40.6CM,46067.0,46067.0,2764.02,39156.95,49 CDM,109952,SET SHTH DIL 11FR 40.6CM,69486.0,69486.0,4169.16,59063.1,49 CDM,109953,SET SHTH DIL 13FR 40.6CM,69486.0,69486.0,4169.16,59063.1,49 CDM,109954,SNARE VASC 12F 13MM 94CM,59410.5,59410.5,3564.63,50498.93,49 CDM,109955,CATH IVL 3.5X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109956,CATH IVL 4X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109957,CATH IVL 2.5X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 CDM,109958,CATH BLNDL 7MM 75CM 80MM,35436.5,35436.5,2126.19,30121.03,49 CDM,109959,CATH BLNDL7MM 75CM 100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,109960,CATH BLNDL 8MM 75CM 80MM,44680.5,44680.5,2680.83,37978.43,49 CDM,109961,CATH BLNDL8MM 75CM 100MM,44680.5,44680.5,2680.83,37978.43,49 CDM,109962,CEMENT BN 40GM 20ML,2541.0,2541.0,330.33,2159.85,28 CDM,109964,SUB BNGF FOAM 2.5CC,8666.0,8666.0,1126.58,7366.1,28 CDM,109965,ADAPTER CATH 14F 15CM,2586.0,2586.0,155.16,2198.1,49 CDM,109966,DRESSING FOM 6X6IN,868.5,868.5,52.11,738.23,49 CDM,109967,BASEPLATE GLND +3MM 24MM,59162.0,59162.0,7691.06,50287.7,28 CDM,109968,SCREW BN CMPR 4.5MM 35MM,3120.0,3120.0,405.6,2652.0,28 CDM,109969,SPHERE GLND SHLDR 36MM,33807.0,33807.0,4394.91,28735.95,28 CDM,109970,SCREW BN 4.5MM 30MM,3120.0,3120.0,405.6,2652.0,28 CDM,109971,STEM HUM SHLDR 120MM,76065.0,76065.0,9888.45,64655.25,28 CDM,109972,SCREW BN 4.5MM 32MM,3120.0,3120.0,405.6,2652.0,28 CDM,109973,CUP HUMERAL 36 +9,28172.0,28172.0,3662.36,23946.2,28 CDM,109974,GRAFT EVAS 22MM 96MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109975,GRAFT EVAS 11MM 107MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109976,GRAFT EVAS 11X11X122MM,100000.0,100000.0,13000.0,85000.0,28 CDM,109977,ADAPTER INST URLK2 BALL,705.5,705.5,42.33,599.67,49 CDM,109978,CLIP LIGATION 40MM,72761.0,72761.0,9458.93,61846.85,28 CDM,109979,SUTURE CT-2 2-0 1X27IN,90.0,90.0,5.4,76.5,49 CDM,109980,SCREW SPN 7.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109981,SCREW SPN 8.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 CDM,109982,BLADE SAW 90X25MM,1511.0,1511.0,90.66,1284.35,49 CDM,109983,BLADE SAW 90X25MM,1441.5,1441.5,86.49,1225.28,49 CDM,109984,PROBE CRYO 11IN,86279.5,86279.5,5176.77,73337.57,49 CDM,109985,CATH VASC 6FR 110CM,9332.0,9332.0,559.92,7932.2,49 CDM,109986,SET INTRO 16FR 27IN,23120.0,23120.0,1387.2,19652.0,49 CDM,109987,CAGE XPND 4D 8X34X24MM,95785.0,95785.0,12452.05,81417.25,28 CDM,109988,TOOL COID XPNDR STR,5615.5,5615.5,336.93,4773.18,49 CDM,109989,MESH CIR LRG WSTRP 3.2IN,20386.0,20386.0,2650.18,17328.1,28 CDM,109990,SHEATH CATH 8.5FR 45CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109991,SHEATH CATH 8.5FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109992,SHEATH CATH 8.5FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109993,SHEATH CATH 8.5FR 90CM,17607.0,17607.0,1056.42,14965.95,49 CDM,109994,PROTECTOR TNDN 2X2IN,88122.0,88122.0,11455.86,74903.7,28 CDM,109995,BONE GRAFT 5.0CC,100000.0,100000.0,13000.0,85000.0,28 CDM,109996,DEVICE SYS CLSR 35MM,72761.0,72761.0,9458.93,61846.85,28 CDM,109997,STENT ENDO 7X19MM 135CM,85955.0,85955.0,11174.15,73061.75,28 CDM,109998,CMPNT FEM KN RT SZ7,32398.0,32398.0,4211.74,27538.3,28 CDM,109999,INSERT TIB KN STAB 7 5MM,21129.0,21129.0,2746.77,17959.65,28 CDM,110000,STEM FEM HIP LT 3 150MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110001,HEAD FEM 28MM +8.5MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110002,MESH SURG 7.5CM 15CM,2384.0,2384.0,309.92,2026.4,28 CDM,110003,K-WIRE 2MM 180MM,1220.5,1220.5,73.23,1037.42,49 CDM,110004,BIT DRILL AO 3.2MM,6064.0,6064.0,363.84,5154.4,49 CDM,110005,ELECTRODE ESURG CTD NDL,276.5,276.5,16.59,235.03,49 CDM,110006,CATH HMDIAL 14.5FR 72CM,7871.5,7871.5,472.29,6690.77,49 CDM,110007,CATH HMDIAL 13.5F 30CM,2905.5,2905.5,174.33,2469.68,49 CDM,110008,STAPLER LONG 45MM,12019.0,12019.0,721.14,10216.15,49 CDM,110009,SHELL ACTB HIP 56MM,71839.0,71839.0,9339.07,61063.15,28 CDM,110010,CAGE SPN 10D 6X10X30MM,84516.0,84516.0,10987.08,71838.6,28 CDM,110011,SCREW BN 2.5MM 26MM,6872.0,6872.0,893.36,5841.2,28 CDM,110012,SCREW BN LCK 2.5X22MM,6872.0,6872.0,893.36,5841.2,28 CDM,110013,SCREW BN NLCK 2.5X16MM,4243.0,4243.0,551.59,3606.55,28 CDM,110014,SCREW BN 2.5X26MM,3580.0,3580.0,465.4,3043.0,28 CDM,110015,RELOAD STPLR 45MM,5028.0,5028.0,653.64,4273.8,28 CDM,110016,CONN SPN CROSS 56-66MM,10032.0,10032.0,1304.16,8527.2,28 CDM,110018,CATH PTA 8X100MM-100CM,44680.5,44680.5,2680.83,37978.43,49 CDM,110019,SHEATH CATH 6.5FR 55CM,17607.0,17607.0,1056.42,14965.95,49 CDM,110020,SHEATH CATH 6.5FR 70CM,17607.0,17607.0,1056.42,14965.95,49 CDM,110021,SHEATH ENDO 5FR 2.2MM,17607.0,17607.0,1056.42,14965.95,49 CDM,110022,CAGE SPN 7D 7X11X14,22538.0,22538.0,2929.94,19157.3,28 CDM,110023,PLATE SPN 4LVL 72MM,26764.0,26764.0,3479.32,22749.4,28 CDM,110024,SCREW SPNL 4X16MM FXANG,2633.0,2633.0,342.29,2238.05,28 CDM,110025,SCREW SPN SLFDRL 4X14MM,2633.0,2633.0,342.29,2238.05,28 CDM,110026,SCREW SPN 4MM 14MM,2633.0,2633.0,342.29,2238.05,28 CDM,110027,PIN TEMP EX FIXATION,1453.0,1453.0,87.18,1235.05,49 CDM,110028,SCREW SPN 3.5MM 14MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110029,SCREW SPN P-AX 4X22MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110030,ROD LORDOSED 3.5X70MM,5265.0,5265.0,684.45,4475.25,28 CDM,110031,SCREW SPN ST THRD CAP,2201.0,2201.0,286.13,1870.85,28 CDM,110032,CONN SPN 35-42MM,10032.0,10032.0,1304.16,8527.2,28 CDM,110033,CONNECTOR SPN 41-50MM,10032.0,10032.0,1304.16,8527.2,28 CDM,110034,DRILL SURG 12MM,1453.0,1453.0,87.18,1235.05,49 CDM,110035,CATH BLN 2MM 150CM 40MM,8101.0,8101.0,486.06,6885.85,49 CDM,110036,CATH BLNDIL 2.5MM 150CM,8101.0,8101.0,486.06,6885.85,49 CDM,110037,CATH BLN 1.5X120MM 150CM,8101.0,8101.0,486.06,6885.85,49 CDM,110039,STAPLER STRAIGHT 45MM,100000.0,100000.0,6000.0,85000.0,49 CDM,110040,INSTRUMENT PORT ACCESS,92226.5,92226.5,5533.59,78392.52,49 CDM,110041,GWIRE TROCAR 18IN,1453.0,1453.0,87.18,1235.05,49 CDM,110042,SCREW SPN SHNK 8.5MM45MM,7883.0,7883.0,1024.79,6700.55,28 CDM,110043,LINER ACTB HIP 36X50MM,14720.0,14720.0,1913.6,12512.0,28 CDM,110044,MESH HRN PLGLY 20X16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,110045,MESH SURG 12CM 10CM,31045.0,31045.0,4035.85,26388.25,28 CDM,110046,MESH HRN PLGLY 12X10CM,59373.0,59373.0,7718.49,50467.05,28 CDM,110047,MESH HRN RSRB 20X20CM,100000.0,100000.0,13000.0,85000.0,28 CDM,110048,MESH HRN PLGLY 20X20IN,100000.0,100000.0,13000.0,85000.0,28 CDM,110049,SHEATH INTRO 9FR 25CM,2471.0,2471.0,148.26,2100.35,49 CDM,110050,SHEATH URET 12/14FR 40CM,11445.0,11445.0,686.7,9728.25,49 CDM,110051,SHEATH URET 11/13FR 40CM,11445.0,11445.0,686.7,9728.25,49 CDM,110052,SHEATH URET 12-14FR 46CM,11445.0,11445.0,686.7,9728.25,49 CDM,110053,CATH THRM 6-16MM 80CM,100000.0,100000.0,6000.0,85000.0,49 CDM,110054,HEAD FEM HIP +7MM 36MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110055,SCREW BN 2.5MM 12MM,3786.0,3786.0,492.18,3218.1,28 CDM,110056,SCREW BN HAND 2.5MM 12MM,3786.0,3786.0,492.18,3218.1,28 CDM,110057,SCREW BN 2.5MM 14MM,3786.0,3786.0,492.18,3218.1,28 CDM,110058,SCREW BN 2.5MM 15MM,3786.0,3786.0,492.18,3218.1,28 CDM,110059,SCREW BN 2.5MM 16MM,3786.0,3786.0,492.18,3218.1,28 CDM,110060,SCREW BN 2.5MM 14MM,6198.0,6198.0,805.74,5268.3,28 CDM,110061,SCREW BN 2.5MM 16MM,6198.0,6198.0,805.74,5268.3,28 CDM,110062,SCREW BN 2.5MM 20MM,6198.0,6198.0,805.74,5268.3,28 CDM,110063,SCREW BN 2.5MM 24MM,6198.0,6198.0,805.74,5268.3,28 CDM,110064,PLATE BN 62X23X2MM,42622.0,42622.0,5540.86,36228.7,28 CDM,110065,DRILL TWIST 2MM 91MM,4475.0,4475.0,268.5,3803.75,49 CDM,110066,KWIRE FX 1.6MM 150MM,1511.0,1511.0,90.66,1284.35,49 CDM,110067,DRESSING WND 2X2IN,1046.0,1046.0,62.76,889.1,49 CDM,110068,PAD MNSTC AG 2X2IN,814.0,814.0,48.84,691.9,49 CDM,110069,SCREW BN 10.5MM 95MM,15039.0,15039.0,1955.07,12783.15,28 CDM,110070,NAIL BN 130D 11MM 400MM,52808.0,52808.0,6865.04,44886.8,28 CDM,110071,SCREW BN 5MM 50MM,4992.0,4992.0,648.96,4243.2,28 CDM,110072,SUTURE BLU MON 5-0 24IN,265.0,265.0,15.9,225.25,49 CDM,110073,SUTURE PRLN 5-0 30IN,639.0,639.0,38.34,543.15,49 CDM,110074,ROD SPNL OCC 100MM 3.5MM,8599.0,8599.0,1117.87,7309.15,28 CDM,110080,SUTURE TGRLNK 0.9MM,6244.0,6244.0,811.72,5307.4,28 CDM,110081,SUTURE ANCH 14.5X1.3MM,19633.0,19633.0,2552.29,16688.05,28 CDM,110082,KIT INS 1.1MM STEP DRL,11445.0,11445.0,686.7,9728.25,49 CDM,110083,PLATE BN 5MM 143MM,56592.0,56592.0,7356.96,48103.2,28 CDM,110084,SCREW BN 4.5MM 26MM,2135.0,2135.0,277.55,1814.75,28 CDM,110085,SCREW BN 4.5MM 32M,2135.0,2135.0,277.55,1814.75,28 CDM,110086,SCREW SPN 4.5MM 18MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110087,SCREW SPN 4.5MM 14MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110088,SCREW SPN 4.5MM 26MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110089,ROD SPN 5.5MM 50MM,5265.0,5265.0,684.45,4475.25,28 CDM,110090,SCREW SPN 4.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110091,SCREW SPN 5.5MM 25MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110092,SYS IMPLANT BN,100000.0,100000.0,13000.0,85000.0,28 CDM,110093,PROBE CRYO 17IN,89361.0,89361.0,5361.66,75956.85,49 CDM,110094,TRAY CATH DRN 8FR,1418.5,1418.5,85.11,1205.72,49 CDM,110095,TAPE SUTURE 1.3MM 20IN,4867.0,4867.0,632.71,4136.95,28 CDM,110096,SHELL ACTB HIP 50MM,22538.0,22538.0,2929.94,19157.3,28 CDM,110097,SCREW BN 3MM 16MM,10406.0,10406.0,1352.78,8845.1,28 CDM,110098,BIT DRILL CANN AO QC 2.0,6273.0,6273.0,376.38,5332.05,49 CDM,110099,STEM FEM REV135D18X190MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110100,SET SCREW BN 2.0X12MM,2541.0,2541.0,330.33,2159.85,28 CDM,110101,LNR ACTB COC HIP G7D40MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110102,KIT CATH 9FR 11.5CM,6402.0,6402.0,384.12,5441.7,49 CDM,110103,HEAD FEM HIP 12/14 28MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110104,SHEATH 12F 20MM,33094.5,33094.5,1985.67,28130.33,49 CDM,110105,SCREW BN ANCH 4.0MM 30MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110106,SCREW BN ANCH 4.0MM 20MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110107,HEAD FEM HIP 28MM +1.5MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110108,HEAD ACTB HIP 44MM 28MM,15495.0,15495.0,2014.35,13170.75,28 CDM,110109,STEM FEM SZ8 12/14 139MM,39441.0,39441.0,5127.33,33524.85,28 CDM,110110,LINER ACTB HIP 54MM 44MM,30990.0,30990.0,4028.7,26341.5,28 CDM,110111,SCREW BN 6.5MM 35MM,2541.0,2541.0,330.33,2159.85,28 CDM,110112,SHELL ACTB HIP 54MM,42258.0,42258.0,5493.54,35919.3,28 CDM,110113,PATCH VASC 1CM X 6CM,5440.0,5440.0,707.2,4624.0,28 CDM,110114,GRAFT EVAS 12FR 76MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110115,LINER ACTB HIP 28X40MM,21129.0,21129.0,2746.77,17959.65,28 CDM,110116,SHEARS ESURG 5MM 20CM,7556.0,7556.0,453.36,6422.6,49 CDM,110117,BAG DRN 500ML,115.5,115.5,6.93,98.17,49 CDM,110118,PLATE BN LT 4HL 57MM,53682.0,53682.0,6978.66,45629.7,28 CDM,110119,CLIPPER LEAD EXTRCT,5615.5,5615.5,336.93,4773.18,49 CDM,110120,SCREW SPN 8.5MM 50MM,9316.0,9316.0,1211.08,7918.6,28 CDM,110121,SCREW SPN 7.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110122,SCREW SPN 10.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110123,SCREW SPN 9.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110124,SCREW SPN 8.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110125,CAGE SPN 0D 18X45X16MM,41554.0,41554.0,5402.02,35320.9,28 CDM,110129,INTBDY SPN 16X40-60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110131,SCREW BN 3MM 13MM(4/4EA),27940.0,27940.0,3632.2,23749.0,28 CDM,110134,SHEATH URET 11/13FR 46CM,11445.0,11445.0,686.7,9728.25,49 CDM,110136,DRIVER POWER DISP,6273.0,6273.0,376.38,5332.05,49 CDM,110139,CAUTERY FINE TIP LO TEMP,440.5,440.5,26.43,374.43,49 CDM,110140,STENT BIL DB 7FR 5CM,2541.0,2541.0,330.33,2159.85,28 CDM,110141,STENT PANC 5FR 3CM,3074.0,3074.0,399.62,2612.9,28 CDM,110142,SYSTEM URTH SUPP 9CM,38332.0,38332.0,4983.16,32582.2,28 CDM,110143,GRAFT BN 5ML,12683.0,12683.0,1648.79,10780.55,28 CDM,110144,BUR 6.0 RND FLUT,3432.0,3432.0,205.92,2917.2,49 CDM,110145,BLADE SAW 25MM DUAL CUT,2532.5,2532.5,151.95,2152.63,49 CDM,110146,GRAFT VASC 26MM 50CM,55376.0,55376.0,7198.88,47069.6,28 CDM,110147,SCREW BN COMP 6MM 15MM,12094.0,12094.0,1572.22,10279.9,28 CDM,110148,SCREW BN LCK 4.5MM 15MM,3162.0,3162.0,411.06,2687.7,28 CDM,110149,STENT VASC 7MM 150MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110150,CATH ANGIO AL2 6FR 100CM,434.5,434.5,26.07,369.32,49 CDM,110151,CATH HMDIAL 33CM 14.5FR,7931.0,7931.0,475.86,6741.35,49 CDM,110152,CATH HMDIAL 13.5FR 24CM,2905.5,2905.5,174.33,2469.68,49 CDM,110153,PATCH WND GEL 4X2.8IN,2905.5,2905.5,174.33,2469.68,49 CDM,110154,STEM FEM HIP ACT SZ6,53527.0,53527.0,6958.51,45497.95,28 CDM,110155,SHELL ACTB HIP 3H 52MM,28172.0,28172.0,3662.36,23946.2,28 CDM,110156,LINER ACTB HIP52MM 40MM,15495.0,15495.0,2014.35,13170.75,28 CDM,110157,GWIRE VASC .035IN 145CM,2905.5,2905.5,174.33,2469.68,49 CDM,110158,SCREW BN 2.7MM 9MM,8149.0,8149.0,1059.37,6926.65,28 CDM,110159,PLATE BN 17HL 1.5MM,38783.0,38783.0,5041.79,32965.55,28 CDM,110160,PLATE BN 16H,38783.0,38783.0,5041.79,32965.55,28 CDM,110161,PLATE BN RT 15HL,38783.0,38783.0,5041.79,32965.55,28 CDM,110162,HEAD FEM HIP 40MM +5MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110163,DEVICE FLW CTRL BLUE,268.5,268.5,16.11,228.22,49 CDM,110164,SCREW BN LCK SD 2.7X11MM,8149.0,8149.0,1059.37,6926.65,28 CDM,110165,SCREW BN 2.7MM 10MM,8149.0,8149.0,1059.37,6926.65,28 CDM,110166,ANCHOR BN TNDN 15 REV,16689.0,16689.0,2169.57,14185.65,28 CDM,110167,CATH THRMB 16F 117CM,100000.0,100000.0,6000.0,85000.0,49 CDM,110168,CATH SYS THRMB 16F 82CM,100000.0,100000.0,6000.0,85000.0,49 CDM,110169,CATH THRMB 24F 85CM,100000.0,100000.0,6000.0,85000.0,49 CDM,110170,RETRACTOR 135MM 20MM,7923.5,7923.5,475.41,6734.98,49 CDM,110171,BUR SNGLUSE RND FLUT 9MM,3276.0,3276.0,196.56,2784.6,49 CDM,110172,TOOL DSCT 22MMX2.3MM,3618.5,3618.5,217.11,3075.72,49 CDM,110173,MESH ABDOMINAL 2-4 X6 EL,100000.0,100000.0,13000.0,85000.0,28 CDM,110174,CMPNT FEM KN NAR RT SZ5,42258.0,42258.0,5493.54,35919.3,28 CDM,110175,CMPNT TIB KN 14MM SZ3,22538.0,22538.0,2929.94,19157.3,28 CDM,110176,STENT THORAC 22FR 34X28,100000.0,100000.0,13000.0,85000.0,28 CDM,110177,STENT GRFT 23MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,110178,GRAFT AAA 20-24 105MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110179,GWIRE VASC .035IN 300CM,6273.0,6273.0,376.38,5332.05,49 CDM,110180,GWIRE VASC .035IN 200CM,6273.0,6273.0,376.38,5332.05,49 CDM,110181,FILTER EMBL NAVALIGN DLV,30074.0,30074.0,3909.62,25562.9,28 CDM,110182,SCREW BN SLFDRL 2.7X8MM,8067.0,8067.0,1048.71,6856.95,28 CDM,110183,PROSTHESIS PENILE INFLT,21441.0,21441.0,2787.33,18224.85,28 CDM,110184,PICK SURG 13CM 45D 1.5MM,6273.0,6273.0,376.38,5332.05,49 CDM,110185,GRAFT BN DBM 1.75X10CM,46072.0,46072.0,5989.36,39161.2,28 CDM,110186,CANNULA W/GD 30CM,78576.0,78576.0,4714.56,66789.6,49 CDM,110187,D10/0.45NS 1000ML INJ,48.0,48.0,2.88,40.8,49 CDM,110189,D5W 150 ML INJ,48.0,48.0,2.88,40.8,24 CDM,110190,OCTREOT 25MCG ND SQIV,25.73,25.73,1.54,21.87,40 CDM,110191,DORZ/TIM 2.23/0.68% 10ML,125.0,125.0,7.5,106.25,49 CDM,110193,CMPD EPI 5 MG 250B,186.75,186.75,11.21,158.74,30 CDM,110194,FLUTI/SAL250/50MCG 60INH,1174.7,1174.7,70.48,998.5,33 CDM,110195,HYDROMORPH 0.2 MG INJ,16.0,16.0,0.96,13.6,24 CDM,110196,RVSCTPVT ANG CL IN BI,137778.63,137778.63,17911.22,117111.84,27 CDM,110197,RVSC TPVT ANG CL IN LT,91852.42,91852.42,11940.81,78074.56,27 CDM,110198,RVSC TPVT ANG CL IN RT,91852.42,91852.42,11940.81,78074.56,27 CDM,110199,ANTACID PO,2.83,2.83,0.17,2.41,49 CDM,110200,BENZOCAINE 20% 57G TOP,163.25,163.25,9.79,138.76,49 CDM,110201,BENZOCAINE 20% 60ML PO,163.25,163.25,9.79,138.76,49 CDM,110202,DOBUTAMINE 1000 MG INJ,77.98,77.98,4.68,66.28,24 CDM,110203,METRONIDAZOLE 250 MG INJ,48.0,48.0,2.88,40.8,24 CDM,110204,HYDROMORPH 50 MG INJ,34.4,34.4,2.06,29.24,24 CDM,110205,CAR MRI MRP FN WO/W CM,27685.0,27685.0,1661.1,23532.25,14 CDM,110205,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",27685.0,27685.0,366.42,2739.0,33 CDM,110206,CAR MRI MORPH FUNC WO CM,25316.0,25316.0,1518.96,21518.6,14 CDM,110206,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,25316.0,25316.0,233.47,2739.0,33 CDM,110207,CAR MRI MR FN WO/W CM ST,8285.0,8285.0,497.1,7042.25,14 CDM,110207,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",8285.0,8285.0,436.71,2739.0,33 CDM,110208,CAR MRI MRP FN WO CM STR,12856.0,12856.0,771.36,10927.6,14 CDM,110208,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,12856.0,12856.0,385.59,2739.0,33 CDM,110209,CAR MRI VELOCITY FLW MAP,5692.0,5692.0,341.52,4838.2,25 CDM,110209,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,5692.0,5692.0,73.59,2739.0,20 CDM,110210,CMPD HYMOR 10MG 50ML,47.58,47.58,2.85,40.44,30 CDM,110211,CMPD HYMOR 25MG 50ML,204.64,204.64,12.28,173.94,30 CDM,110212,"Cocaine hydrochloride nasal solution (numbrino), 1 mg ",1684.4,1684.4,2.37,7.14,8 CDM,110212,NUMBRINO 160 MG NASAL,1684.4,1684.4,101.06,1431.74,25 CDM,110213,DIPHENYDRAMINE 12.5MG PO,12.35,12.35,0.74,10.5,49 CDM,110214,TENECTEPLASE 25 MG INJ,41186.1,41186.1,2471.17,35008.18,19 CDM,110215,ADENOVIRUS AMP QN,617.05,617.05,37.02,524.49,14 CDM,110216,Alcohols ,200.0,200.0,0.07,127.56,28 CDM,110216,DEF DRUG ALCOHOLS,200.0,200.0,12.0,170.0,27 CDM,110217,PARVO VIRUS AMP PROBE,617.05,617.05,37.02,524.49,14 CDM,110218,Receptor assay; non-endocrine (specify receptor) ,400.0,400.0,30.72,251.5,80 CDM,110218,SOLUBLE TRANSFER REC QN,400.0,400.0,24.0,340.0,14 CDM,110219,CTA H&N W/CON+NONCON IMG,31670.0,31670.0,1900.2,26919.5,40 CDM,110220,CTA H&N W/CON+NONCON IMG,31670.0,31670.0,1900.2,26919.5,40 CDM,110221,PAXLOVID 300/100 MG PO,239.8,239.8,14.39,203.83,30 CDM,110222,KOH PREP WET MOUNT,50.0,50.0,3.0,42.5,14 CDM,110223,ICU-W/ECMO ED HOLD,58839.51,58839.51,,,0 CDM,110224,POSACONAZOLE 200 MG PO,225.3,225.3,13.52,191.5,49 CDM,110225,POSACONAZOLE ER 100MG PO,8.25,8.25,0.49,7.01,30 CDM,110226,MAG IGM AB IA QN,50.0,50.0,3.0,42.5,14 CDM,110227,MULTIHANCE 15 ML INJ,111.45,111.45,6.69,94.73,24 CDM,110228,MULTIHANCE 20 ML INJ,148.6,148.6,8.92,126.31,24 CDM,110229,AFP-L3 FRA ISO + TOT AFP,300.0,300.0,18.0,255.0,14 CDM,110229,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,300.0,300.0,54.1,443.0,80 CDM,110230,NEOSTIG METH 0.5 MG INJ,6.2,6.2,0.37,5.27,25 CDM,110231,RVSC FPVT ANG CL IN LT,111488.57,111488.57,14493.51,94765.28,27 CDM,110232,STRPTCS PNEUM AB IA,190.0,190.0,11.4,161.5,35 CDM,110232,"Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative ",190.0,190.0,29.68,265.97,56 CDM,110233,RVSCFPVT ANG CL IN BI,167232.85,167232.85,21740.27,142147.92,27 CDM,110234,NO COST DEVICE,1.0,1.0,0.13,0.85,28 CDM,110235,NO COST IMPLANT,1.0,1.0,0.13,0.85,28 CDM,110236,SENT NODE RAD TR INJ,6622.31,6622.31,397.34,5628.96,37 CDM,110237,RVSC FPVT ANG CL IN RT,111488.57,111488.57,14493.51,94765.28,27 CDM,110238,OXYGEN PER HOUR,144.72,144.72,8.68,123.01,49 CDM,110239,INH TX AC AWY OBST,164.15,164.15,9.85,139.53,33 CDM,110240,RVSC LOW EXT IVL/STNT BI,53074.04,53074.04,3184.44,45112.93,23 CDM,110241,RVSC LOW EXT IVL/STNT LT,35382.69,35382.69,2122.96,30075.29,23 CDM,110242,RVSC LOW EXT IVL/STNT RT,35382.69,35382.69,2122.96,30075.29,23 CDM,110243,ACETONE BLD QL,6.0,6.0,0.36,5.1,14 CDM,110243,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",6.0,6.0,3.8,31.13,80 CDM,110244,ANTI-TIF-1GAMMA AB,30.0,30.0,1.8,25.5,14 CDM,110245,ANTI-U3 RNP FIBRILLARIN,30.0,30.0,1.8,25.5,14 CDM,110246,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",100.0,100.0,0.07,127.56,28 CDM,110246,DEF DRUG ANTIDEP TRI 1-2,100.0,100.0,6.0,85.0,27 CDM,110247,FUROSEMIDE LASIX QN,57.0,57.0,3.42,48.45,14 CDM,110248,HEPATITIS E AB QL IGG,45.0,45.0,2.7,38.25,14 CDM,110249,HEPATITIS E AB QL IGM,55.0,55.0,3.3,46.75,14 CDM,110250,ISOSORBIDE MONO 10MG PO,11.12,11.12,0.67,9.45,49 CDM,110251,LOSARTAN 100 MG PO,4.86,4.86,0.29,4.13,49 CDM,110252,MDA5 (CADM-140) AB IA QL,30.0,30.0,1.8,25.5,14 CDM,110253,MIDAZOL/0.9NS 100 MG IV,152.95,152.95,9.18,130.01,24 CDM,110254,MYOSITIS EJ AB QL IA,595.0,595.0,35.7,505.75,14 CDM,110255,MYOSITIS KU AB QL IA,595.0,595.0,35.7,505.75,14 CDM,110256,MYOSITIS MI-2 AB QL IA,595.0,595.0,35.7,505.75,14 CDM,110257,MYOSITIS NXP-2 AB QL IA,595.0,595.0,35.7,505.75,14 CDM,110258,MYOSITIS OJ AB QL IA,595.0,595.0,35.7,505.75,14 CDM,110259,NEURON SPEC ENOLASE QN,24.73,24.73,1.48,21.02,14 CDM,110260,OMNIPAQUE 240 50 ML INJ,235.05,235.05,14.1,199.79,24 CDM,110261,OMNIPAQUE 300 50 ML INJ,277.35,277.35,16.64,235.75,24 CDM,110262,SAE1 (SUMO ACT ENZ) AB,140.0,140.0,8.4,119.0,14 CDM,110263,SRP AB QL RIPA IA,39.12,39.12,2.35,33.25,14 CDM,110264,SSA-52 (RO52) ENA IGG AB,65.0,65.0,3.9,55.25,14 CDM,110265,U1 RNP ENA IGG AB,34.0,34.0,2.04,28.9,14 CDM,110266,U2 RNP ENA AB,36.97,36.97,2.22,31.42,14 CDM,110267,VISIPAQUE 270 100 ML INJ,490.2,490.2,29.41,416.67,24 CDM,110268,VISIPAQUE 270 50 ML INJ,291.9,291.9,17.51,248.11,24 CDM,110269,VISIPAQUE 320 50 ML INJ,317.9,317.9,19.07,270.21,24 CDM,110270,PM SCL (PM1) AB,34.43,34.43,2.07,29.27,14 CDM,110272,BX PRS TR USG,9010.0,9010.0,540.6,7658.5,37 CDM,110273,505EN EPI NACL 5MG INJ,300.0,300.0,18.0,255.0,27 CDM,110273,"Injection, epinephrine in sodium chloride (endo), 0.1 mg ",300.0,300.0,0.3,2.94,7 CDM,110274,505MY VANCO 1.5 G INJ,144.7,144.7,8.68,122.99,24 CDM,110275,ADRENALIN 1 MG INJ,49.2,49.2,2.95,41.82,24 CDM,110275,"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg ",49.2,49.2,0.87,6.83,10 CDM,110276,505MY VANCO 1.25 G INJ,120.6,120.6,7.24,102.51,24 CDM,110277,COXSACKIE A AB QL,177.35,177.35,10.64,150.75,14 CDM,110278,COXSACKIE B AB QL,235.0,235.0,14.1,199.75,14 CDM,110279,HERPES 6 AMP PROBE,71.68,71.68,4.3,60.93,14 CDM,110280,KETAMINE 500 MG MDV,272.1,272.1,16.33,231.29,30 CDM,110281,KOH PREP WET MOUNT,18.0,18.0,1.08,15.3,14 CDM,110282,MYOSITIS PL-12 AB QL IA,30.0,30.0,1.8,25.5,14 CDM,110283,MYOSITIS PL-7 AB QL IA,36.97,36.97,2.22,31.42,14 CDM,110284,PHEN/MINER/PETR 57G RECT,14.7,14.7,0.88,12.49,49 CDM,110285,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",51.0,51.0,29.48,241.36,80 CDM,110285,TRICH VAGINALIS AMP PRBE,51.0,51.0,3.06,43.35,14 CDM,110286,IVIG PRIVIGEN 10G,10556.4,10556.4,633.38,8972.94,19 CDM,110287,IVIG PRIVIGEN 20G,21112.8,21112.8,1266.77,17945.88,19 CDM,110288,IVIG PRIVIGEN 40G,8445.12,8445.12,506.71,7178.35,19 CDM,110289,IVIG PRIVIGEN 5G,5278.2,5278.2,316.69,4486.47,19 CDM,110290,PROFILNINE 1 U INJ,9.35,9.35,0.56,7.95,19 CDM,110291,IDE-NO COST,1.0,1.0,0.06,0.85,49 CDM,110292,ISOSORBIDE MONO 20MG PO,20.95,20.95,1.26,17.81,49 CDM,110293,SOD POLYSTYRENE 15 G PO,211.42,211.42,12.69,179.71,49 CDM,110294,CMPD INDOMET 100MG SUPP,1200.0,1200.0,72.0,1020.0,46 CDM,110295,INJ PERITONEAL CAVITY,1140.11,1140.11,68.41,969.09,37 CDM,110296,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",1352.5,1352.5,81.04,5338.91,33 CDM,110296,XR PERITONEOGRAM,1352.5,1352.5,81.15,1149.63,17 CDM,110297,NALBUPHINE 20 MG INJ,67.08,67.08,4.02,57.02,24 CDM,110298,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",71.68,71.68,252.0,2063.4,78 CDM,110298,ABL1 VARS KINASE DOMAIN,71.68,71.68,4.3,60.93,15 CDM,110299,CURETTE DERMAL 7MM,132.5,132.5,7.95,112.63,49 CDM,110300,GRAFT TNDN LAT CONNECT,39527.0,39527.0,5138.51,33597.95,28 CDM,110301,UL PROC URINARY,1560.0,1560.0,93.6,1326.0,37 CDM,110302,AMPA-R-1 IF TITER,40.0,40.0,2.4,34.0,14 CDM,110303,AMPA-R-2 IF TITER,40.0,40.0,2.4,34.0,14 CDM,110304,ANTI-GAD65 AB TITER,50.0,50.0,3.0,42.5,14 CDM,110305,BIORPHEN 500 MCG INJ,30.0,30.0,1.8,25.5,24 CDM,110306,AMPA-R-1 CBA,1550.0,1550.0,93.0,1317.5,14 CDM,110307,AMPA-R-2 CBA,1550.0,1550.0,93.0,1317.5,14 CDM,110308,DNER LINE BLOT,720.0,720.0,43.2,612.0,14 CDM,110309,IGLON5 AB,2900.0,2900.0,174.0,2465.0,14 CDM,110310,ITPR1 AB,1550.0,1550.0,93.0,1317.5,14 CDM,110311,ITPR1 CB IFA,1550.0,1550.0,93.0,1317.5,14 CDM,110312,ITPR1 IF TITER,1550.0,1550.0,93.0,1317.5,14 CDM,110313,MA2-TA AB,450.0,450.0,27.0,382.5,14 CDM,110314,BASE ANCHOR SHLDR 38MM,76065.0,76065.0,9888.45,64655.25,28 CDM,110315,GLENOID 3-4PEG CMNT SZXS,28172.0,28172.0,3662.36,23946.2,28 CDM,110316,INSERT SHLDR +0MM 19MM,5265.0,5265.0,684.45,4475.25,28 CDM,110317,HEAD HUM SHLDR 20X48MM,18312.0,18312.0,2380.56,15565.2,28 CDM,110318,KWIRE 2.0 L 150MM,1220.5,1220.5,73.23,1037.42,49 CDM,110319,SPACER SPN 32-46MM 16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110320,CATH ARTHCTMY 5F 146CM,50535.0,50535.0,3032.1,42954.75,49 CDM,110321,SHEARS ESURG 5MM 36CM,6736.0,6736.0,404.16,5725.6,49 CDM,110322,CATH VASC 6FR 110CM,9332.0,9332.0,559.92,7932.2,49 CDM,110323,BASIC CARE NP,330.0,330.0,19.8,280.5,38 CDM,110324,CAT 1 CLINIC PROCEDURE,395.0,395.0,23.7,335.75,37 CDM,110325,CAT 2 CLINIC PROCEDURE,495.0,495.0,29.7,420.75,37 CDM,110326,CAT 3 CLINIC PROCEDURE,620.0,620.0,37.2,527.0,37 CDM,110327,FOLLOW UP VISIT ONLY NP,775.0,775.0,46.5,658.75,38 CDM,110328,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,110329,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,110330,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,110331,IV EACH ADD HOUR,201.55,201.55,12.09,171.32,39 CDM,110332,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,110333,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,110334,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,110335,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,110336,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,110337,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,110338,OP VISIT LEVEL 5 NP,695.0,695.0,41.7,590.75,38 CDM,110339,OP VISIT LEVEL 1 EST,330.0,330.0,19.8,280.5,38 CDM,110340,OP VISIT LEVEL 2 EST,380.0,380.0,22.8,323.0,38 CDM,110341,OP VISIT LEVEL 2 NP,455.0,455.0,27.3,386.75,38 CDM,110342,OP VISIT LEVEL 3 EST,437.0,437.0,26.22,371.45,38 CDM,110343,OP VISIT LEVEL 3 NP,525.0,525.0,31.5,446.25,38 CDM,110344,OP VISIT LEVEL 4 EST,502.0,502.0,30.12,426.7,38 CDM,110345,OP VISIT LEVEL 4 NP,604.0,604.0,36.24,513.4,38 CDM,110346,OP VISIT LEVEL 5 EST,580.0,580.0,34.8,493.0,38 CDM,110347,LACTIC ACID BODY FL,905.0,905.0,54.3,769.25,14 CDM,110348,IODINE MS QN EACH SPEC,1908.0,1908.0,114.48,1621.8,14 CDM,110348,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",1908.0,1908.0,20.25,165.8,80 CDM,110349,FDP SEMIQUANT,1194.0,1194.0,71.64,1014.9,14 CDM,110349,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",1194.0,1194.0,5.79,47.42,80 CDM,110350,HANTAVIRUS AB QL,1113.0,1113.0,66.78,946.05,14 CDM,110351,SMEAR FUNGI FLUOR STAIN,513.0,513.0,30.78,436.05,14 CDM,110352,HERPES 6 AMP PROBE,2714.0,2714.0,162.84,2306.9,14 CDM,110353,AGNA-1 AB BY FA,35.0,35.0,2.1,29.75,14 CDM,110354,AMPHIPHYSIN AB FA,245.0,245.0,14.7,208.25,14 CDM,110355,ANNA-1 (ANTI-HU) SCR FA,175.0,175.0,10.5,148.75,14 CDM,110356,ANNA-3 SCR BY IFA,175.0,175.0,10.5,148.75,14 CDM,110357,ANTI-LGI1 AB TIT,2900.0,2900.0,174.0,2465.0,14 CDM,110358,CASPR2 IGG AB TITER IFA,595.0,595.0,35.7,505.75,14 CDM,110359,CASPR2-IGG AB CBA-IF,300.0,300.0,18.0,255.0,14 CDM,110360,CRMP-5 IGG BY FA,450.0,450.0,27.0,382.5,14 CDM,110361,CRMP5 IGG BY WB,170.0,170.0,10.2,144.5,14 CDM,110362,DNER AB,720.0,720.0,43.2,612.0,14 CDM,110363,ANTI-RI AB FA QL,175.0,175.0,10.5,148.75,14 CDM,110364,DPPX AB BY CBA-IFA,1550.0,1550.0,93.0,1317.5,14 CDM,110365,DPPX AB BY IFA,1550.0,1550.0,93.0,1317.5,14 CDM,110366,DPPX AB BY IFA TIT,1550.0,1550.0,93.0,1317.5,14 CDM,110367,GABA-B-R AB CBA-IFA,450.0,450.0,27.0,382.5,14 CDM,110368,IGLON5-IGG AB BY CBA,2900.0,2900.0,174.0,2465.0,14 CDM,110369,LGI1-IGG AB CBA-IFA,2900.0,2900.0,174.0,2465.0,14 CDM,110370,MA TA AB WB-BD,425.0,425.0,25.5,361.25,14 CDM,110371,MGLUR1-IGG AB CBA-IF,1550.0,1550.0,93.0,1317.5,14 CDM,110372,MGLUR1-IGG IFA,1550.0,1550.0,93.0,1317.5,14 CDM,110373,MGLUR1-IGGAB IFA TIT,1550.0,1550.0,93.0,1317.5,14 CDM,110374,NEUR NUC AB 1 HU WB&BAND,100.0,100.0,6.0,85.0,14 CDM,110375,NMDA RECEPTOR AB TIT FA,2900.0,2900.0,174.0,2465.0,14 CDM,110376,NMDA-RCPT AB CBA,2900.0,2900.0,174.0,2465.0,14 CDM,110377,PCA-2 AB BY FA,450.0,450.0,27.0,382.5,14 CDM,110378,PCA-TR AB BY FA,450.0,450.0,27.0,382.5,14 CDM,110379,PCA-TR/DNER AB IB,720.0,720.0,43.2,612.0,14 CDM,110380,PURK CELL (YO) FA AB QL,450.0,450.0,27.0,382.5,14 CDM,110381,RI AB WB BAND ID,175.0,175.0,10.5,148.75,14 CDM,110382,YO AB WB BAND ID,175.0,175.0,10.5,148.75,14 CDM,110383,ZIC4 AB,720.0,720.0,43.2,612.0,14 CDM,110384,ZIC4 AB WB BAND ID,720.0,720.0,43.2,612.0,14 CDM,110385,GABA-B-R AB IFA TIT,35.0,35.0,2.1,29.75,14 CDM,110386,AMPHIPHYSIN AB IB,250.0,250.0,15.0,212.5,14 CDM,110387,AGNA-1/SOX1 AB IB,525.0,525.0,31.5,446.25,14 CDM,110388,IGLON5 AB BY IFA TIT,2900.0,2900.0,174.0,2465.0,14 CDM,110389,PAXLOVID 150/100 MG PO,462.3,462.3,27.74,392.95,30 CDM,110390,SULFAMET/TMP 200/40MG PO,5.95,5.95,0.36,5.06,49 CDM,110391,STENT BIL 9X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110392,STENT BIL 9X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110393,STENT BIL 9X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110394,STENT BIL 9X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110395,STENT BIL 10X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110396,STENT BIL 10X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110397,STENT BIL 10X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110398,STENT BIL 10X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110399,STENT BIL 12X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110400,STENT BIL 12X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110401,STENT BIL 12X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110402,STENT BIL 12X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110403,STENT BIL 14X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110404,STENT CIL 14X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110405,STENT BIL 14X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 CDM,110406,SCREW BN 4.5MM 30MM,27164.0,27164.0,3531.32,23089.4,28 CDM,110407,SCREW BN 3.7MM 36MM,27164.0,27164.0,3531.32,23089.4,28 CDM,110408,ATTACHMENT SWVL EXFX,24266.5,24266.5,1455.99,20626.53,49 CDM,110409,CLAMP EXFX 5-6MM 11MM,15846.5,15846.5,950.79,13469.52,49 CDM,110410,PIN HLF EXFX 5X55X160MM,6735.0,6735.0,404.1,5724.75,49 CDM,110411,DRILL MEDIUM 4MM,10151.5,10151.5,609.09,8628.77,49 CDM,110412,DEVICE SYS CLSR CLP 45MM,72761.0,72761.0,9458.93,61846.85,28 CDM,110413,CAGE SPN 14X12X17-25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110414,PIN EXFX 5MM 275MM,7527.0,7527.0,451.62,6397.95,49 CDM,110415,CLAMP MLTI-PIN EXFX 75MM,12325.0,12325.0,739.5,10476.25,49 CDM,110416,BAR EXFX 11MM 300MM,9860.0,9860.0,591.6,8381.0,49 CDM,110417,BAR EXFX 11MM 250MM,9860.0,9860.0,591.6,8381.0,49 CDM,110418,CLAMP EXFX 11MM 5-6MM,12325.0,12325.0,739.5,10476.25,49 CDM,110419,POST EXFIX 90DEG,11319.5,11319.5,679.17,9621.58,49 CDM,110420,SCREW SPN 4MM 16MM,2633.0,2633.0,342.29,2238.05,28 CDM,110421,PLATE SPN 32X16X2MM 2LVL,25355.0,25355.0,3296.15,21551.75,28 CDM,110422,MONITOR CARDIAC INSERT,70839.0,70839.0,9209.07,60213.15,28 CDM,110423,SPONGE ABS 8X12.5CMX10MM,1096.5,1096.5,65.79,932.02,49 CDM,110424,SCREW SPN 4.0MM 18MM,2633.0,2633.0,342.29,2238.05,28 CDM,110425,SCREW BN 2.7 4.5MM 22MM,1493.0,1493.0,194.09,1269.05,28 CDM,110426,GRAFT AAA 33-34 178MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110427,PLUG TRULOCK PENILE IMPL,6240.0,6240.0,811.2,5304.0,28 CDM,110428,INS SUT HLD OCTOUS SYS,2278.0,2278.0,136.68,1936.3,49 CDM,110429,STEM HIP SZ6 107MM 35MM,54429.0,54429.0,7075.77,46264.65,28 CDM,110431,SCREW BN 2.5MM 22MM,6198.0,6198.0,805.74,5268.3,28 CDM,110432,INSERT ACTB HIP 10D 32MM,21129.0,21129.0,2746.77,17959.65,28 CDM,110435,CAGE SPN 15D 8X42 32MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110436,CAGE SPNL 15D 6X42X32MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110437,CAGE SPN 10D 6X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110438,FORCEP GRASP DISP,3546.5,3546.5,212.79,3014.53,49 CDM,110439,SCREW SPN 5.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110440,SCREW SPN 8.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110441,SCREW SPN 5.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110442,ROD SPN 6MM,38737.0,38737.0,5035.81,32926.45,28 CDM,110443,ROD SPN 5.5MM 400MM,38737.0,38737.0,5035.81,32926.45,28 CDM,110444,SCREW SPN 6.5MM 45MM,13866.0,13866.0,1802.58,11786.1,28 CDM,110445,ROD SPN 5.5MMM 50M,5265.0,5265.0,684.45,4475.25,28 CDM,110446,SCREW SPN 7.5MM 55MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110447,CAGE SPN 10D 8X18X55MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110448,SUT TAPE DKBL 1.3MM 40IN,2990.5,2990.5,179.43,2541.93,49 CDM,110449,CAGE SPN 8X22X60MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110450,SCREW SPN 7.5MM 50MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110451,SCREW SPN 7.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110452,RESTRATA 1SQCM,1982.0,1982.0,118.92,1684.7,25 CDM,110452,"Restrata, per square centimeter (add-on, list separately in addition to primary procedure) ",1982.0,1982.0,11.74,641.78,8 CDM,110453,RESTRATA MINIMATRIX 5MG,1266.0,1266.0,75.96,1076.1,44 CDM,110453,"Restrata minimatrix, 5 mg ",1266.0,1266.0,9.4,14.48,5 CDM,110454,DISTRACTION PIN - 14MM,1453.0,1453.0,87.18,1235.05,49 CDM,110455,CAGE SPN 7D 6X16X19MM,22538.0,22538.0,2929.94,19157.3,28 CDM,110456,CAGE SPN 7D 8X16X19MM,22538.0,22538.0,2929.94,19157.3,28 CDM,110457,PLATE SPN 3LVL 1.9H 50MM,26764.0,26764.0,3479.32,22749.4,28 CDM,110458,SCREW SPN SLFDRL3.5X19MM,2633.0,2633.0,342.29,2238.05,28 CDM,110459,CAGE SPN 15D 5X38X28MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110460,TUBE JJNSTM 16FR,4857.5,4857.5,291.45,4128.88,49 CDM,110461,CATH EP 8FR 115CM,75125.0,75125.0,4507.5,63856.25,49 CDM,110462,CATH ABL MAP 8FR 4MM,84738.5,84738.5,5084.31,72027.73,49 CDM,110463,CATH ABL MAP 8FR 4MM,84738.5,84738.5,5084.31,72027.73,49 CDM,110464,PATCH LOC REF CATH MAP,15388.5,15388.5,923.31,13080.23,49 CDM,110465,CLIP LGTN 35MM,100000.0,100000.0,13000.0,85000.0,28 CDM,110466,SHELL ACTB HIP 52MM,42258.0,42258.0,5493.54,35919.3,28 CDM,110467,SCREW BN 6.5MM 40MM,2541.0,2541.0,330.33,2159.85,28 CDM,110468,LINER ACTB HIP 42MM 52MM,30990.0,30990.0,4028.7,26341.5,28 CDM,110469,STEM FEM HIP LNG SZ 20,100000.0,100000.0,13000.0,85000.0,28 CDM,110470,LINER ACTB HIP 42MM 28MM,15495.0,15495.0,2014.35,13170.75,28 CDM,110471,DEVICE HRN FX TACKS 5MM,19549.0,19549.0,2541.37,16616.65,28 CDM,110472,SCREW SPN 6.5X45MM,7883.0,7883.0,1024.79,6700.55,28 CDM,110473,ROD SPN LORDTC 5.5X35MM,5265.0,5265.0,684.45,4475.25,28 CDM,110474,PUTTY BN 10CC,24254.0,24254.0,3153.02,20615.9,28 CDM,110475,STENT COR 5X12MM,3083.0,3083.0,400.79,2620.55,28 CDM,110476,STENT COR 5X15MM,3083.0,3083.0,400.79,2620.55,28 CDM,110477,STENT COR 5X18MM,3083.0,3083.0,400.79,2620.55,28 CDM,110478,STENT COR 5X23MM,3083.0,3083.0,400.79,2620.55,28 CDM,110479,OMNIPAQUE 9 500ML PO,51.78,51.78,3.11,44.01,33 CDM,110480,STENT COR 5X28MM,3083.0,3083.0,400.79,2620.55,28 CDM,110481,STENT COR 5X33MM,3083.0,3083.0,400.79,2620.55,28 CDM,110482,CATH EP MAP D-F,100000.0,100000.0,6000.0,85000.0,49 CDM,110483,GWIRE VASC .035IN 260CM,697.5,697.5,41.85,592.88,49 CDM,110484,INRO SHTH ACCESS 180P,30660.0,30660.0,1839.6,26061.0,49 CDM,110485,CATH EP PFA 2.7MM,100000.0,100000.0,6000.0,85000.0,49 CDM,110486,GRAFT BN PUTTY 5CC,70076.0,70076.0,9109.88,59564.6,28 CDM,110487,CATHETER BIL ULTSND BLN,1203.0,1203.0,72.18,1022.55,49 CDM,110488,BALLOON ENDO LTX STRL,1229.0,1229.0,73.74,1044.65,49 CDM,110489,CATH HMST 2.8MM 210CM,6861.0,6861.0,411.66,5831.85,49 CDM,110492,SUB BNGF CAPHS 10CC,74684.0,74684.0,9708.92,63481.4,28 CDM,110493,SCREW SPN 5MM 12MM,2633.0,2633.0,342.29,2238.05,28 CDM,110495,CATH ULTSND 3.4FR 135CM,20029.5,20029.5,1201.77,17025.08,49 CDM,110497,SPACER SPN BN 10MM 14X2D,23348.0,23348.0,3035.24,19845.8,28 CDM,110499,NEEDLE SUT T-5 26.5MM,8705.0,8705.0,522.3,7399.25,49 CDM,110500,CATH ART SET 18GA 16CM,1354.0,1354.0,81.24,1150.9,49 CDM,110501,SHEARS ESURG 5MM 23CM,5720.0,5720.0,343.2,4862.0,49 CDM,110502,CATH BALLOON2.5X120MM,46221.0,46221.0,2773.26,39287.85,49 CDM,110504,SCREW SPN 5.5MM 24MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110505,SCREW SPN 4.5MM 24MM,12898.0,12898.0,1676.74,10963.3,28 CDM,110506,CONN SPN RD-RD 3.5X45MM,10032.0,10032.0,1304.16,8527.2,28 CDM,110507,ROD SPN STR 3.5MM 300MM,3159.0,3159.0,410.67,2685.15,28 CDM,110508,ROD SPN HINGED 3.5X3.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,110509,ROD SPN OC PREBENT 3.5MM,5265.0,5265.0,684.45,4475.25,28 CDM,110514,STEM HIP SZ5 38.5X105MM,52823.0,52823.0,6866.99,44899.55,28 CDM,110515,INTRO SHEATH 22FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,110516,SCREW SPN 5.5MM 45MM,14331.0,14331.0,1863.03,12181.35,28 CDM,110517,ROD SPN 5.5MM 75MM,5265.0,5265.0,684.45,4475.25,28 CDM,110518,INSERT KIT PERC FT 1.8MM,8589.0,8589.0,515.34,7300.65,49 CDM,110519,GRAFT CV 7MM 50CM,85446.0,85446.0,11107.98,72629.1,28 CDM,110520,LINE ANGIO 1.8MM 3.6MM,290.0,290.0,17.4,246.5,49 CDM,110521,CONNECTOR SPN OFST 20MM,10032.0,10032.0,1304.16,8527.2,28 CDM,110903,IMMPHENTIV 500 MCG INJ,30.0,30.0,1.8,25.5,24 CDM,110903,"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms ",30.0,30.0,0.13,0.65,10 CDM,110904,BASIC CARE NP,330.0,330.0,19.8,280.5,38 CDM,110905,CAT 1 CLINIC PROCEDURE,395.0,395.0,23.7,335.75,37 CDM,110906,CAT 2 CLINIC PROCEDURE,495.0,495.0,29.7,420.75,37 CDM,110907,CAT 3 CLINIC PROCEDURE,620.0,620.0,37.2,527.0,37 CDM,110908,FOLLOW UP VISIT ONLY NP,775.0,775.0,46.5,658.75,38 CDM,110909,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,110910,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,110911,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,110912,IV EACH ADD HOUR,201.55,201.55,12.09,171.32,39 CDM,110913,IV HYDRAT EA ADD HR,201.55,201.55,12.09,171.32,39 CDM,110914,IV HYDRAT INIT UP TO 1HR,624.69,624.69,37.48,530.99,39 CDM,110915,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,110916,IVP EA ADD SEQ NEW DRUG,339.57,339.57,20.37,288.63,39 CDM,110917,IVP EA ADD SEQ SAME DRUG,339.57,339.57,20.37,288.63,44 CDM,110918,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,110919,OP VISIT LEVEL 5 NP,695.0,695.0,41.7,590.75,38 CDM,110920,OP VISIT LEVEL 1 EST,330.0,330.0,19.8,280.5,38 CDM,110921,OP VISIT LEVEL 2 EST,380.0,380.0,22.8,323.0,38 CDM,110922,OP VISIT LEVEL 2 NP,455.0,455.0,27.3,386.75,38 CDM,110923,OP VISIT LEVEL 3 EST,437.0,437.0,26.22,371.45,38 CDM,110924,OP VISIT LEVEL 3 NP,525.0,525.0,31.5,446.25,38 CDM,110925,OP VISIT LEVEL 4 EST,502.0,502.0,30.12,426.7,38 CDM,110926,OP VISIT LEVEL 4 NP,604.0,604.0,36.24,513.4,38 CDM,110927,OP VISIT LEVEL 5 EST,580.0,580.0,34.8,493.0,38 CDM,110928,INTEROGT VAD INC PROGRAM,291.0,291.0,17.46,247.35,39 CDM,110928,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",291.0,291.0,111.31,153.65,5 CDM,110929,REMMON INTL DEVC EA 30 D,115.0,115.0,6.9,97.75,33 CDM,110929,"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 d",115.0,115.0,84.82,117.09,5 CDM,110931,REVSC TIB/PER IVL/ATH,37457.0,37457.0,2247.42,31838.45,17 CDM,110931,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",37457.0,37457.0,2996.0,43854.72,34 CDM,110932,RVSC TIB/PR IVL ST/AT LT,37457.0,37457.0,2247.42,31838.45,17 CDM,110933,RVSC TIB/PR IVL ST/AT RT,37457.0,37457.0,2247.42,31838.45,17 CDM,110934,RVSC TIB/PR IVL ST/AT BI,56185.5,56185.5,3371.13,47757.68,17 CDM,110935,RVSC TIB/PER IVL/STNT RT,37457.0,37457.0,2247.42,31838.45,17 CDM,110936,RVSC TIB/PER IVL/STNT BI,56185.5,56185.5,3371.13,47757.68,17 CDM,110937,REVSC TIB/PER IVL ANG BI,35382.0,35382.0,2122.92,30074.7,17 CDM,110938,RVSC TIB/PER IVL/STNT LT,37457.0,37457.0,2247.42,31838.45,17 CDM,110939,REVSC TIB/PER IVL ANG LT,23588.0,23588.0,1415.28,20049.8,17 CDM,110940,REVSC TIB/PER IVL ANG RT,23588.0,23588.0,1415.28,20049.8,17 CDM,110941,CT GUIDANCE TISSUE ABLAT,6267.0,6267.0,376.02,5326.95,28 CDM,110941,"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation ",6267.0,6267.0,346.32,1361.0,17 CDM,110942,PHOXILLUM B22K 4/0,194.45,194.45,11.67,165.28,30 CDM,110943,RV FPVT ST/ATH CL IN BI,175067.7,175067.7,22758.8,148807.55,27 CDM,110944,RV FPVT ST/ATH CL IN LT,116711.8,116711.8,15172.53,99205.03,27 CDM,110945,RV FPVT ST/ATH CL IN RT,116711.8,116711.8,15172.53,99205.03,27 CDM,110946,INJ NEPH EXIST ACCESS RT,4467.58,4467.58,268.05,3797.44,37 CDM,110947,INJ NEPH EXIST ACCESS BI,11705.34,11705.34,702.32,9949.54,37 CDM,110948,PLCMT NEPH CATH LT,8907.72,8907.72,534.46,7571.56,37 CDM,110949,PLCMT NEPH CATH BI,13361.59,13361.59,801.7,11357.35,37 CDM,110950,IVERMECTIN 3 MG PO,24.85,24.85,1.49,21.12,30 CDM,110951,SP ANGIO PULM SEL UNI LT,6138.0,6138.0,368.28,5217.3,17 CDM,110952,SP ANGIO PULM SEL UNI RT,6138.0,6138.0,368.28,5217.3,17 CDM,110953,SP VENOGM RENAL UNI LT,6138.0,6138.0,368.28,5217.3,17 CDM,110954,SP VENOGM RENAL UNI RT,6138.0,6138.0,368.28,5217.3,17 CDM,110955,SUGAMMADEX 200MG INJ,633.37,633.37,38.0,538.36,49 CDM,110956,SUGAMMADEX 500MG INJ,1160.04,1160.04,69.6,986.03,49 CDM,110958,DAPTOMYCIN 350MG INJ,390.0,390.0,23.4,331.5,24 CDM,111121,CATH URTH INTRMT 18FR,41.0,41.0,2.46,34.85,49 CDM,111131,HYDROXYZINE PAM 25 MG PO,9.51,9.51,0.57,8.08,49 CDM,111133,NS 100 ML,52.88,52.88,3.17,44.95,24 CDM,111144,ALTEPLASE RECOM 1MG INJ,849.46,849.46,50.97,722.04,19 CDM,111145,ALTEPLASE RECOMB 1 MGJW,740.02,740.02,44.4,629.02,19 CDM,1123,PCMKR 46.6X50.8X7.4MM,84428.0,84428.0,10975.64,71763.8,28 CDM,112736,SYSTEM PCNG LEADLESS,100000.0,100000.0,13000.0,85000.0,28 CDM,114382,PROSTHESIS PENILE 9.5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,11452,BISMUTH 525 MG PO,9.51,9.51,0.57,8.08,49 CDM,11540,KIT DCMPRS 14FR 175CM,5436.5,5436.5,326.19,4621.02,49 CDM,117,KIT CATH CHLGM 4FR 60CM,4078.5,4078.5,244.71,3466.72,49 CDM,1260,CATH URTH INTRMT 8FR,197.0,197.0,11.82,167.45,49 CDM,1330,CATHETER S TIP 7FR 110CM,5058.0,5058.0,303.48,4299.3,49 CDM,13600,SUTURE SS 6 18IN,633.5,633.5,38.01,538.48,49 CDM,13666,SUTURE UND MONO 4-0 27IN,90.5,90.5,5.43,76.92,49 CDM,13667,SUTURE SH 3-0 1X27IN,90.5,90.5,5.43,76.92,49 CDM,13915,CATH HMST 2.8MM 350CM,5768.5,5768.5,346.11,4903.23,49 CDM,14000,SUT CHRM 3-0CTI ABS 36IN,153.0,153.0,9.18,130.05,49 CDM,140503,CMPD HYMOR 25MG 50B,204.64,204.64,12.28,173.94,30 CDM,140506,CMPD HEP 30000U 1000ML,99.93,99.93,6.0,84.94,30 CDM,140507,CMPD CARDIOPLEGIA,333.13,333.13,19.99,283.16,30 CDM,140509,BRIMONID 0.2% 10 ML OPH,16.65,16.65,1.0,14.15,49 CDM,140513,DAPAGLIFLOZIN 5 MG PO,98.74,98.74,5.92,83.93,30 CDM,140515,MYXREDLIN 100U/100ML INJ,70.29,70.29,4.22,59.75,41 CDM,140520,PEG/PG 0.4/0.3% 15ML OPH,64.25,64.25,3.85,54.61,49 CDM,140522,FLUVOXAMINE 50 MG PO,17.84,17.84,1.07,15.16,49 CDM,1420,CATH PERI 18GA 1.75IN,778.0,778.0,46.68,661.3,49 CDM,14410,SUTURE RB-1 4-0 1X36IN,269.0,269.0,16.14,228.65,49 CDM,150006,ETHYL ALCOHOL 99%5ML INJ,5037.3,5037.3,302.24,4281.7,49 CDM,150007,TOBRAMYCIN NC 300 MG INH,107.07,107.07,6.42,91.01,24 CDM,150007,"Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams ",107.07,107.07,7.77,150.2,10 CDM,150011,PRISMASOL BGK 2/3.5,231.99,231.99,13.92,197.19,30 CDM,150014,OXYCODONE 10 MG PO,8.33,8.33,0.5,7.08,49 CDM,150017,KETAMINE 50 MG INJ,27.21,27.21,1.63,23.13,46 CDM,150051,PROCHLORPERAZINE 10MG PO,5.95,5.95,0.36,5.06,25 CDM,150057,VALGANCIC 50MG/ML LIQ PO,40.67,40.67,2.44,34.57,49 CDM,150058,CEFIDEROCOL 10 MG INJJW,11.9,11.9,0.71,10.12,19 CDM,150059,CEFIDEROCOL 10 MG INJ,11.9,11.9,0.71,10.12,19 CDM,150060,CEFIDEROCOL 1 G INJ,1137.38,1137.38,68.24,966.77,19 CDM,150065,LIDOC VIS 2% 15ML LIQ PO,5.95,5.95,0.36,5.06,49 CDM,150074,CALCITONIN SALMON 400 U,24370.38,24370.38,1462.22,20714.82,41 CDM,150074,"Injection, calcitonin salmon, up to 400 units ",24370.38,24370.38,1974.72,7298.29,8 CDM,150080,TBO-FILGRASTIM 1MCGINJJW,5.95,5.95,0.36,5.06,19 CDM,150081,TBO-FILGRASTIM 1 MCG INJ,5.95,5.95,0.36,5.06,19 CDM,150088,SEMGLEE 20 U INJ,82.09,82.09,4.93,69.78,41 CDM,150091,CMPD LANSOPRAZ 3MG/ML PO,13.09,13.09,0.79,11.13,46 CDM,150096,DAPAGLIFLOZIN 10 MG PO,89.23,89.23,5.35,75.85,30 CDM,150098,NALOXEGOL 25 MG PO,73.76,73.76,4.43,62.7,30 CDM,150099,ANASTROZOLE 1 MG PO,12.31,12.31,0.74,10.46,25 CDM,150099,"Anastrozole, oral, 1 mg ",12.31,12.31,1.19,5.18,8 CDM,150099,"Anastrozole, oral, 1 mg Chemotherapy Drugs",12.31,12.31,,,0 CDM,150102,OMALIZUMAB 5 MG INJ,227.24,227.24,13.63,193.15,19 CDM,150103,OMALIZUMAB 75 MG INJ,3403.81,3403.81,204.23,2893.24,19 CDM,150104,BUDESONIDE NC 0.5 MG INH,19.87,19.87,1.19,16.89,24 CDM,150111,ISOLYTE S PH 7.4 INJ,39.56,39.56,2.37,33.63,49 CDM,150112,CEFTA/AVI 0.5/0.125G JW,1130.24,1130.24,67.81,960.7,19 CDM,150113,CEFTA/AVI 0.5/0.125G INJ,1130.24,1130.24,67.81,960.7,19 CDM,150115,CEFAZOLIN 2 G INJ,23.63,23.63,1.42,20.09,24 CDM,150117,DOPAMINE 3200 MCG/ML INJ,11.9,11.9,0.71,10.12,20 CDM,150119,PROCAINAMIDE 1 G MDV,312.9,312.9,18.77,265.96,19 CDM,150120,EYE WASH 118 ML OPH IRR,14.28,14.28,0.86,12.14,49 CDM,150134,SIROLIMUS 1 MG/ML LIQ PO,46.95,46.95,2.82,39.91,24 CDM,150135,ESCITALOPRAM 5 MG PO,5.95,5.95,0.36,5.06,49 CDM,150139,RIG KEDRAB 150 U IMSQ,1304.97,1304.97,78.3,1109.22,19 CDM,150140,RIG KEDRAB 300 U IMSQ,2609.97,2609.97,156.6,2218.47,19 CDM,150141,RIG KEDRAB 150 U IMSQJW,1304.97,1304.97,78.3,1109.22,19 CDM,150142,RIG KEDRAB 1500 U IMSQ,13049.83,13049.83,782.99,11092.36,19 CDM,150149,BORTEZOMIB 0.1 MG INJ,395.59,395.59,23.74,336.25,24 CDM,150150,BORTEZOMIB 3.5 MG INJ,13845.79,13845.79,830.75,11768.92,24 CDM,150153,"Injection, amiodarone hydrochloride (nexterone), 30 mg ",109.27,109.27,2.49,10.34,10 CDM,150153,NEXTERONE AMIO 150MG INJ,109.27,109.27,6.56,92.88,24 CDM,150159,ROSUVASTATIN 10 MG PO,5.95,5.95,0.36,5.06,49 CDM,150161,LIDOCAINE 2% 6 ML TOP,36.3,36.3,2.18,30.85,49 CDM,150162,LIDOCAINE 2% 11 ML TOP,27.31,27.31,1.64,23.21,49 CDM,150167,CMPD HYMOR 10MG 50B,47.58,47.58,2.85,40.44,30 CDM,150172,NON RAD/CONTRAS 1MGINJJW,22.81,22.81,1.37,19.39,20 CDM,150173,NON RAD/CONTRAST 1MG INJ,22.81,22.81,1.37,19.39,20 CDM,150174,METHYLENE BLUE 50 MG INJ,1140.94,1140.94,68.46,969.8,20 CDM,150185,MORPHINE 1MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,150192,MUPIROCIN 2% 22G TOP,21.54,21.54,1.29,18.31,49 CDM,150195,GENTAMI 100MG/NS 50MLINJ,17.63,17.63,1.06,14.99,24 CDM,150199,CEFAZOLIN 1 G INJ,17.63,17.63,1.06,14.99,24 CDM,150200,CMPD ACYCLOV 500MG/100ML,17.63,17.63,1.06,14.99,30 CDM,150201,"Injection, regadenoson, 0.1 mg ",346.15,346.15,2.9,164.0,10 CDM,150201,REGADENOSON 0.4 MG INJ,346.15,346.15,20.77,294.23,24 CDM,16020,SUTURE CTX SZ0 1X36IN,86.5,86.5,5.19,73.53,49 CDM,16070,SUTURE P-3 5-0 1X18IN,3110.0,3110.0,186.6,2643.5,49 CDM,16080,SUTURE BLK MONO 2-0 30IN,160.0,160.0,9.6,136.0,49 CDM,16100,SUTURE UND MONO 5-0 18IN,242.0,242.0,14.52,205.7,49 CDM,16105,SUTURE UND MONO 2-0 36IN,124.0,124.0,7.44,105.4,49 CDM,16130,SUTURE SH 2-0 1X27IN,116.0,116.0,6.96,98.6,49 CDM,16170,SUTURE BLU MONO 7-0 18IN,245.5,245.5,14.73,208.68,49 CDM,16180,SUTURE SH 3-0 8X18IN,375.0,375.0,22.5,318.75,49 CDM,16193,SUTURE BLK BRD 0 30IN,201.0,201.0,12.06,170.85,49 CDM,1620,KIT CATH CHLGM 4FR 60CM,4079.0,4079.0,244.74,3467.15,49 CDM,16200,SUTURE SH 2-0 1X30IN,114.5,114.5,6.87,97.33,49 CDM,16201,SUTURE SH 0 1X30IN,59.0,59.0,3.54,50.15,49 CDM,16250,SUTURE TP-1 SZ2 4X27IN,5316.5,5316.5,318.99,4519.02,49 CDM,16260,SUTURE PS-1 4-0 1X27IN,211.0,211.0,12.66,179.35,49 CDM,16379,SUTURE VIO BRD 0 36IN,86.0,86.0,5.16,73.1,49 CDM,17442,MESH SURG 4IN 6IN,6240.0,6240.0,811.2,5304.0,28 CDM,17443,MESH SURG 4IN 6IN,6240.0,6240.0,811.2,5304.0,28 CDM,17490,HOOK RETR LNSTR 5MM,18087.0,18087.0,1085.22,15373.95,49 CDM,17557,GWIRE VASC .035IN 260CM,2790.5,2790.5,167.43,2371.93,49 CDM,1760,SYST THERM INJ RTEMP10ML,861.5,861.5,51.69,732.27,49 CDM,180069,RENAL FUNCTION PANEL,2686.0,2686.0,161.16,2283.1,14 CDM,180069,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",2686.0,2686.0,6.01,59.73,80 CDM,180074,ACUTE HEPATITIS PANEL,1547.0,1547.0,92.82,1314.95,14 CDM,180074,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",1547.0,1547.0,8.08,327.61,80 CDM,180113,LEVETIRACETAM QN,591.0,591.0,35.46,502.35,14 CDM,180113,Levetiracetam ,591.0,591.0,11.13,91.13,80 CDM,180176,LIDOCAINE QN,377.17,377.17,22.63,320.59,14 CDM,180176,Lidocaine ,377.17,377.17,12.34,101.0,80 CDM,18108,GFT CV HMSH MCVL18X9X40,17229.0,17229.0,2239.77,14644.65,28 CDM,182024,ACTH QN,2142.0,2142.0,128.52,1820.7,14 CDM,182024,Adrenocorticotropic hormone (ACTH) ,2142.0,2142.0,32.44,265.62,80 CDM,182043,"Albumin; urine (eg, microalbumin), quantitative ",146.0,146.0,4.86,39.73,80 CDM,182043,MICROALBUMIN QN,146.0,146.0,8.76,124.1,14 CDM,182088,ALDOSTERONE UR QN,2530.76,2530.76,151.85,2151.15,14 CDM,182133,HOMOCYSTEINE QN,1569.0,1569.0,94.14,1333.65,14 CDM,182133,Homocysteine ,1569.0,1569.0,15.05,123.26,80 CDM,182627,DHEA-S,1569.0,1569.0,94.14,1333.65,14 CDM,182627,Dehydroepiandrosterone-sulfate (DHEA-S) ,1569.0,1569.0,18.67,152.85,80 CDM,182784,IGG CSF EA,1027.0,1027.0,61.62,872.95,14 CDM,182810,PYRIDOXAL 5 PHOS VIT B6,4045.0,4045.0,242.7,3438.25,14 CDM,182810,Pyridoxal phosphate (Vitamin B-6) ,4045.0,4045.0,23.6,193.31,80 CDM,182952,GTT EA ADDTL >3 SPEC,257.16,257.16,15.43,218.59,14 CDM,182952,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",257.16,257.16,3.29,26.97,80 CDM,183521,FLECAINIDE TAMBOCOR QN,357.39,357.39,21.44,303.78,27 CDM,183521,Flecainide ,357.39,357.39,15.66,98.82,67 CDM,184153,PROS SPEC AG FREE,798.0,798.0,47.88,678.3,14 CDM,184153,Prostate specific antigen (PSA); free ,798.0,798.0,15.45,126.52,80 CDM,184155,TOTAL PROTEIN CSF QN,797.87,797.87,47.87,678.19,14 CDM,184252,Riboflavin (Vitamin B-2) ,3272.0,3272.0,17.0,139.19,80 CDM,184252,VITAMIN B2 (RIBOFL),3272.0,3272.0,196.32,2781.2,14 CDM,185000,CARDIOVERSION EXTERNAL,3332.23,3332.23,199.93,2832.4,43 CDM,185004,MESH SURG 6X4IN,89130.0,89130.0,11586.9,75760.5,28 CDM,185006,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,44 CDM,185011,INSERT TIB KN SZ5 12MM,28694.0,28694.0,3730.22,24389.9,28 CDM,185018,PROGRAMMER NRSTM VRF 4,9133.0,9133.0,547.98,7763.05,49 CDM,185020,BX TRANSCATH,6805.25,6805.25,408.31,5784.46,37 CDM,185021,LUNG CA SCREEN WO CON,1363.23,1363.23,81.79,1158.75,17 CDM,185022,CBC AUTOMATED,901.0,901.0,54.06,765.85,14 CDM,185026,TTVR - INITIAL DEVICE,122226.67,122226.67,7333.6,103892.67,37 CDM,185041,"Blood count; red blood cell (RBC), automated ",203.09,203.09,2.54,20.82,80 CDM,185041,RBC COUNT BLD AUTO,203.09,203.09,12.19,172.63,14 CDM,185300,ANTITHROMBIN 3 ACT,1395.28,1395.28,83.72,1185.99,14 CDM,185300,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",1395.28,1395.28,9.95,81.54,80 CDM,185303,"Clotting inhibitors or anticoagulants; protein C, activity ",1540.34,1540.34,11.63,95.21,80 CDM,185303,PROTEIN C ACTIVITY,1540.34,1540.34,92.42,1309.29,14 CDM,185305,"Clotting inhibitors or anticoagulants; protein S, total ",1540.0,1540.0,9.75,79.82,80 CDM,185305,PROTEIN S ANTIGEN TOTAL,1540.0,1540.0,92.4,1309.0,14 CDM,185306,PROTEIN S FREE,1540.34,1540.34,92.42,1309.29,14 CDM,186147,CARDIOLIPIN AB IGM,1284.0,1284.0,77.04,1091.4,14 CDM,186148,PHOSPHATIDYLSER AB IGG,688.41,688.41,41.3,585.15,14 CDM,186230,SMITH ANTIBODY,574.0,574.0,34.44,487.9,14 CDM,186235,JO-1 ANTIBODY,1283.0,1283.0,76.98,1090.55,14 CDM,186236,SCLERODERMA 70 AB,1283.0,1283.0,76.98,1090.55,14 CDM,186360,T CELLS CD4 8 RATIO,1966.0,1966.0,117.96,1671.1,14 CDM,186360,"T cells; absolute CD4 and CD8 count, including ratio ",1966.0,1966.0,39.46,323.09,80 CDM,186376,LIVER-KIDNEY MICRO AB,878.0,878.0,52.68,746.3,14 CDM,186431,RA QN,669.95,669.95,40.2,569.46,14 CDM,186431,Rheumatoid factor; quantitative ,669.95,669.95,4.76,39.01,80 CDM,186593,VDRL CSF QN,924.47,924.47,55.47,785.8,14 CDM,186594,VDRL CSF QUAL,659.0,659.0,39.54,560.15,14 CDM,186651,"Antibody; encephalitis, California (La Crosse) ",510.37,510.37,11.08,90.68,80 CDM,186651,ENCEPH LACROSSE AB QUAL,510.37,510.37,30.62,433.81,14 CDM,186652,"Antibody; encephalitis, Eastern equine ",510.37,510.37,11.08,90.68,80 CDM,186652,ENCEPH E EQUINE AB QUAL,510.37,510.37,30.62,433.81,14 CDM,186653,"Antibody; encephalitis, St. Louis ",510.37,510.37,11.08,90.68,80 CDM,186653,ENCEPH ST LOUIS AB QUAL,510.37,510.37,30.62,433.81,14 CDM,186654,"Antibody; encephalitis, Western equine ",510.37,510.37,11.08,90.68,80 CDM,186654,ENCEPH W EQUINE AB QUAL,510.37,510.37,30.62,433.81,14 CDM,186692,"Antibody; hepatitis, delta agent ",2673.19,2673.19,14.41,118.01,80 CDM,186692,HEPATITIS DELTA AB QUAL,2673.19,2673.19,160.39,2272.21,14 CDM,186698,Antibody; histoplasma ,873.04,873.04,11.58,94.84,80 CDM,186698,HISTOPLASMA AB QL,873.04,873.04,52.38,742.08,14 CDM,186702,Antibody; HIV-2 ,1255.0,1255.0,11.36,93.03,80 CDM,186702,HIV-2 AB QUAL,1255.0,1255.0,75.3,1066.75,14 CDM,186704,HEP B CORE AB TOTAL,1232.0,1232.0,73.92,1047.2,14 CDM,186704,Hepatitis B core antibody (HBcAb); total ,1232.0,1232.0,10.12,82.9,80 CDM,186709,HEP A AB IGM QUAL,197.0,197.0,11.82,167.45,14 CDM,186709,"Hepatitis A antibody (HAAb), IgM antibody ",197.0,197.0,9.46,77.47,80 CDM,186738,MYCOPLASMA AB IGM QL,811.0,811.0,48.66,689.35,14 CDM,186765,RUBEOLA IGM,987.78,987.78,59.27,839.61,14 CDM,186903,AG SC DON BLD REA SER EA,229.22,229.22,13.75,194.84,15 CDM,186903,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",229.22,229.22,5.33,904.08,78 CDM,187060,CULT THROAT,1039.0,1039.0,62.34,883.15,14 CDM,187071,CULTURE CATHETER TIP,833.0,833.0,49.98,708.05,14 CDM,187103,CULT FUNGUS BLOOD,1208.0,1208.0,72.48,1026.8,14 CDM,187103,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",1208.0,1208.0,17.19,140.73,80 CDM,187116,CULT AFB,873.0,873.0,52.38,742.05,14 CDM,187116,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",873.0,873.0,9.07,74.3,80 CDM,187181,SUSC AGAR DIL EACH AGENT,253.21,253.21,15.19,215.23,14 CDM,18720,SUTURE PS-2 5-0 1X18IN,1567.0,1567.0,94.02,1331.95,49 CDM,187205,SMEAR EOSINOPHILS STAIN,257.16,257.16,15.43,218.59,14 CDM,187278,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,592.0,592.0,13.1,107.33,80 CDM,187278,LEG PNEUMOPHILIA AG IFT,592.0,592.0,35.52,503.2,14 CDM,189051,CELL CT & DIFF CSF,840.07,840.07,50.4,714.06,14 CDM,19115,CLIP LIGATING MED,420.0,420.0,54.6,357.0,28 CDM,19120,GRAFT CV 20X10MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,19205,INSTR BX 18GA 20CM,1860.5,1860.5,111.63,1581.42,49 CDM,197030,BLADE BN SGTL SAW NAR,17607.0,17607.0,1056.42,14965.95,49 CDM,197031,BLADE BN SAW STD,17607.0,17607.0,1056.42,14965.95,49 CDM,197036,MARKER SURG FEM STRL,2905.5,2905.5,174.33,2469.68,49 CDM,200002,GWIRE ORTHO .062IN 6IN,1685.5,1685.5,101.13,1432.67,49 CDM,200020,BORTEZOMIB 0.1 MG INJJW,395.59,395.59,23.74,336.25,24 CDM,20015,EVACUATR WND DRN 100CC,229.0,229.0,13.74,194.65,49 CDM,2008,SUTURE OS-4 1 1X30IN,118.0,118.0,7.08,100.3,49 CDM,20980,DISSECTOR BLNT TIP 5MM,582.0,582.0,34.92,494.7,49 CDM,2119,RIBAVIRIN 200 MG PO,5.51,5.51,0.33,4.68,49 CDM,211901,"Injection, remdesivir, 1 mg ",3708.39,3708.39,6.9,21.0,10 CDM,211901,REMDESIVIR 100 MG INJ,3708.39,3708.39,222.5,3152.13,19 CDM,2140,LOOP ENDO .012IN 24FR,2905.5,2905.5,174.33,2469.68,49 CDM,2151,THEOPHYLL ER 400 MG PO,5.95,5.95,0.36,5.06,49 CDM,2153,THEOPHYLL ER 600 MG PO,5.95,5.95,0.36,5.06,49 CDM,216434,OLUMIANT 1 MG PO,565.12,565.12,33.91,480.35,30 CDM,216436,OLUMIANT 2 MG PO,565.12,565.12,33.91,480.35,30 CDM,219711,PRIMAQUINE 26.3 MG PO,11.9,11.9,0.71,10.12,49 CDM,219715,ROPIVACAINE 150 MG INJ,230.81,230.81,13.85,196.19,24 CDM,219726,AMIODARONE 450 MG INJ,28.56,28.56,1.71,24.28,24 CDM,221919,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,221920,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,221921,INTENSIVE CARE UNIT,11767.9,11767.9,,,0 CDM,221922,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,44 CDM,221923,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,44 CDM,221927,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,44 CDM,221931,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,44 CDM,221950,ERGOCALCIFERO 1.25 MG PO,10.7,10.7,0.64,9.09,49 CDM,221952,TALC STERILE POWD 4GM,1215.91,1215.91,72.95,1033.52,30 CDM,221954,POTASSIUM 20MEQ LIQ PO,201.06,201.06,12.06,170.9,49 CDM,221955,ESCITALOPRAM 10 MG PO,84.47,84.47,5.07,71.8,49 CDM,221957,RITUXIMAB 10 MG INJJW,141.58,141.58,8.49,120.34,19 CDM,221961,"Injection, minocycline hydrochloride, 1 mg ",1688.22,1688.22,3.18,8.24,8 CDM,221961,MINOCYCLINE HCL 100 MG,1688.22,1688.22,101.29,1434.99,20 CDM,221962,MINOCYCLINE 50 MG PO,86.85,86.85,5.21,73.82,49 CDM,221965,MEDROXYPROGEST 10 MG PO,10.7,10.7,0.64,9.09,49 CDM,221966,RIFABUTIN 150 MG PO,345.02,345.02,20.7,293.27,49 CDM,221968,MOXIFLOXACIN 400 MG PO,409.27,409.27,24.56,347.88,49 CDM,221970,ISONIAZID 1000 MG MDV,551.43,551.43,33.09,468.72,49 CDM,22310,SUTURE BLK BRD 2-0 18IN,165.0,165.0,9.9,140.25,49 CDM,229888,HEATED HIGH FLOW O2 HR,144.72,144.72,8.68,123.01,49 CDM,2493,ELCTRODE ESURG 2.75IN,182.0,182.0,10.92,154.7,49 CDM,2494,ELECTRD ESURG BLDE 2.5IN,219.5,219.5,13.17,186.57,49 CDM,2500,DRESSING ABD 8X10IN,7.5,7.5,0.45,6.38,49 CDM,2540,DRESSING PETRO 3INX16IN,39.0,39.0,2.34,33.15,49 CDM,264655,IRON SUCROSE 100 MG INJ,471.13,471.13,28.27,400.46,24 CDM,264655,"Injection, iron sucrose, 1 mg ",471.13,471.13,0.22,0.94,10 CDM,2675,BUPIV125MG/EPI0.25MG MDV,82.84,82.84,4.97,70.41,30 CDM,272398,LIDO 300MG/EPI0.15MG INJ,46.98,46.98,2.82,39.93,25 CDM,2740,PACKING WND .5IN 5YD,107.0,107.0,6.42,90.95,49 CDM,2770,PACKING WND 1IN 5YD,117.0,117.0,7.02,99.45,49 CDM,285001,INS CVAD W PORT CENT=>5Y,24804.93,24804.93,1488.3,21084.19,37 CDM,285006,CATH 1ST OD RENAL RT,10816.79,10816.79,649.01,9194.27,37 CDM,285007,CMPNT KN HINGED ROTATE,5717.0,5717.0,743.21,4859.45,28 CDM,285009,OBS PER HOUR,484.82,484.82,67.87,412.1,15 CDM,286595,Bone and/or joint imaging; limited area ,6338.63,6338.63,212.18,2091.27,30 CDM,286595,NM BONE LIMITED,6338.63,6338.63,380.32,5387.84,17 CDM,286600,NM TUMOR LOCAL MULT,6338.63,6338.63,380.32,5387.84,17 CDM,286600,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",6338.63,6338.63,255.61,2544.21,30 CDM,286601,NM TUMOR LC WHBD SGL DAY,11076.14,11076.14,664.57,9414.72,17 CDM,286601,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",11076.14,11076.14,288.69,2877.49,30 CDM,286602,NM TUMOR LCL SPECT,8761.29,8761.29,525.68,7447.1,17 CDM,286602,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",8761.29,8761.29,355.19,3513.57,30 CDM,286624,PARACENTESIS W IMAGE,7251.0,7251.0,435.06,6163.35,37 CDM,288505,ONDANSETRON 4 MG PO,5.95,5.95,0.36,5.06,25 CDM,288509,TRIAMCINO 0.1%453.6G TOP,98.45,98.45,5.91,83.68,49 CDM,288516,MEROPENEM 50 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,288519,BUPIVACAINE 75 MG INJ,7.56,7.56,0.45,6.43,24 CDM,288520,ESMOLO 2.5G/NACL250MLINJ,503.87,503.87,30.23,428.29,24 CDM,288521,ESMOLOL 100 MG INJ,19.04,19.04,1.14,16.18,24 CDM,288522,LABETALOL 20 MG INJ,19.21,19.21,1.15,16.33,24 CDM,288523,CLINDAMYCIN 900 MG INJ,19.04,19.04,1.14,16.18,24 CDM,288525,CLINDAMYCIN 600 MG INJ,19.04,19.04,1.14,16.18,24 CDM,288534,BUPIVACAINE 25 MG INJ,19.04,19.04,1.14,16.18,24 CDM,288535,PHENYLEPHRINE 10 MG INJ,23.25,23.25,1.4,19.76,24 CDM,288536,"Injection, vasopressin, 1 unit ",127.47,127.47,0.53,8.78,10 CDM,288536,VASOPRESSIN 20 UNIT INJ,127.47,127.47,7.65,108.35,24 CDM,288538,BUPIVACAINE 50 MG INJ,19.04,19.04,1.14,16.18,24 CDM,288540,AZTREONAM 2 G INJ,297.13,297.13,17.83,252.56,24 CDM,288541,AZTREONAM 1 G INJ,148.54,148.54,8.91,126.26,24 CDM,288546,NITROGLYCERIN 50 MG INJ,65.73,65.73,3.94,55.87,24 CDM,288547,PHENYLEPHRINE 500MCG INJ,22.01,22.01,1.32,18.71,24 CDM,288551,NITROG 50MG/D5W 250MLINJ,36.23,36.23,2.17,30.8,24 CDM,288553,TACROLIMUS IMM 5 MG PO,50.68,50.68,3.04,43.08,24 CDM,288563,DORNASEALFA UD 2.5MG INH,720.92,720.92,43.26,612.78,24 CDM,288563,"Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram ",720.92,720.92,55.17,172.1,10 CDM,288566,SELE SULFIDE 1% 207MLTOP,18.03,18.03,1.08,15.33,49 CDM,288576,HYDROCORT 2.5% 30G TOP,12.83,12.83,0.77,10.91,30 CDM,288579,FLUOCINOND 0.05% 15G TOP,93.14,93.14,5.59,79.17,30 CDM,288580,CLOBETASOL 0.05% 15G TOP,78.11,78.11,4.69,66.39,49 CDM,288581,LITHIUM CARB 300 MG PO,5.51,5.51,0.33,4.68,49 CDM,288600,IVIG GAMUNEX-C 20G,7258.94,7258.94,435.54,6170.1,19 CDM,288601,IVIG GAMUNEX-C 10G,3629.44,3629.44,217.77,3085.02,19 CDM,288604,REZAFUNGIN 1 MG INJ,53.71,53.71,3.22,45.65,19 CDM,288605,REZAFUNGIN 200 MG INJ,10740.6,10740.6,644.44,9129.51,19 CDM,288606,IVIG GAMUNEX-C 40G,14517.88,14517.88,871.07,12340.2,19 CDM,288607,ANIDULAFUNGIN 100 MG INJ,775.42,775.42,46.53,659.11,24 CDM,288607,"Injection, anidulafungin, 1 mg ",775.42,775.42,0.49,4.86,10 CDM,288615,AZTREONAM 20 MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288616,METRONIDAZOL 5 MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288617,PHENYLEPHN 20 MCG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288618,AZITHROMYCIN 500 MG PO,5.3,5.3,0.32,4.5,41 CDM,288623,ROCURONIUM 10 MG/ML INJ,17.63,17.63,1.06,14.99,30 CDM,288627,CARBOPROST 250 MCG IM,398.51,398.51,23.91,338.73,30 CDM,288630,POSACONAZOLE 300 MG INJ,1500.71,1500.71,90.04,1275.6,30 CDM,288632,BUMETANIDE 1 MG INJ,17.63,17.63,1.06,14.99,24 CDM,288633,GLYCOPYRROL 0.2 MG INJ,69.9,69.9,4.19,59.42,24 CDM,288634,GLYCOPYRROL 0.4 MG INJ,117.98,117.98,7.08,100.28,24 CDM,288637,NICARDIPIN 25MG/10ML INJ,50.89,50.89,3.05,43.26,24 CDM,288638,NICARDIP 40MG/200ML INJ,305.25,305.25,18.32,259.46,24 CDM,288640,NICARDIPINE 0.2MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288641,BRIDION 200 MG INJ,633.37,633.37,38.0,538.36,30 CDM,288642,BRIDION 500 MG INJ,1160.04,1160.04,69.6,986.03,30 CDM,288647,LEVETIRACTM 15 MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288653,IMIPEN/CILAS/RELEB 1.25G,35918.27,35918.27,2155.1,30530.53,24 CDM,288654,IMIPEN4/CILAS4/RELE2 INJ,287.3,287.3,17.24,244.21,24 CDM,288655,IMIPEN4/CILA4/REL2 INJJW,287.3,287.3,17.24,244.21,24 CDM,288658,LACOSAM 100MG/10ML LIQPO,111.5,111.5,6.69,94.78,30 CDM,288660,TOLVAPTAN 30 MG PO,594.1,594.1,35.65,504.99,30 CDM,288673,OXCARBA 300MG 5ML LIQ PO,74.95,74.95,4.5,63.71,49 CDM,288674,LIDO 1% 200MG/20ML MDV,18.32,18.32,1.1,15.57,25 CDM,288684,PROPAFENONE 225 MG PO,5.51,5.51,0.33,4.68,49 CDM,288685,LITHIUM CARB 150 MG PO,5.51,5.51,0.33,4.68,49 CDM,288687,DEXTROSE 25% 10 ML INJ,80.88,80.88,4.85,68.75,49 CDM,288690,MICONAZOLE 2% 45 G VAG,22.74,22.74,1.36,19.33,49 CDM,288697,GIAPREZA 2.5 MG INJ,8922.96,8922.96,535.38,7584.52,30 CDM,288698,HYDROXYZINE HCL 25 MG PO,5.51,5.51,0.33,4.68,49 CDM,288703,505HP NA THIOS 12.5GINJ,534.28,534.28,32.06,454.14,25 CDM,288707,HYDROXOCOBALAM 5 G IV,4984.47,4984.47,299.07,4236.8,20 CDM,288707,"Injection, hydroxocobalamin, intravenous, 25 mg ",4984.47,4984.47,9.56,15.88,8 CDM,288708,METHYLPRED ACE 40 MG INJ,361.68,361.68,21.7,307.43,24 CDM,288709,METHYLPRED ACE 80 MG INJ,631.75,631.75,37.91,536.99,24 CDM,288710,METHYLPRED SS 2.5MG/ML,17.63,17.63,1.06,14.99,24 CDM,288711,METHYLPRED SS 125 MGINJ,117.73,117.73,7.06,100.07,24 CDM,288712,METHYLPRED SS 40 MG INJ,146.34,146.34,8.78,124.39,24 CDM,288713,METHYLPRED SS 1 G MDV,1049.34,1049.34,62.96,891.94,24 CDM,288719,CA GLUC NOS 20MG/ML INJ,17.63,17.63,1.06,14.99,24 CDM,288723,LEVOTHY NOS 10MCG/MLINJ,17.63,17.63,1.06,14.99,24 CDM,288724,LEVOTHY NOS 100 MCG INJ,546.5,546.5,32.79,464.52,24 CDM,288729,HYDROCORTIS 1% 28G TOP,8.92,8.92,0.54,7.58,49 CDM,288737,SOD PHOS 15 MMOL INJ,104.4,104.4,6.26,88.74,49 CDM,288747,BENZOCAINE 20% 0.5ML TOP,59.49,59.49,3.57,50.57,49 CDM,300000,BORD PERTUSSIS AMP PR,265.08,265.08,15.9,225.32,14 CDM,300017,ISORSOR/HYDRAL 20/37.5PO,26.18,26.18,1.57,22.25,49 CDM,300018,DRSG WND AG 4X10IN,2670.5,2670.5,160.23,2269.93,49 CDM,300041,BLADE REAMER 38MM,4182.0,4182.0,250.92,3554.7,49 CDM,300042,SCREW BN HIP 6.5MM 20MM,2541.0,2541.0,330.33,2159.85,28 CDM,300043,SCREW BN 6.5MM 25MM,2541.0,2541.0,330.33,2159.85,28 CDM,300048,STEM FEM BW 225X14.5MM,37976.0,37976.0,4936.88,32279.6,28 CDM,300049,CMPNT TIB KN 63MM,66767.0,66767.0,8679.71,56751.95,28 CDM,300052,CMPNT KN YOKE REINFC,19937.0,19937.0,2591.81,16946.45,28 CDM,300070,VERTEBRO LUMBOSACRAL,5690.64,5690.64,341.44,4837.04,37 CDM,300090,PORT XI SGL SITE 8.5MM,6273.0,6273.0,376.38,5332.05,49 CDM,300095,SEALER VESSEL EXTEND,60717.0,60717.0,3643.02,51609.45,49 CDM,300104,PLATE BN FSN WRST,62514.0,62514.0,8126.82,53136.9,28 CDM,300106,SCREW BN NLCK 3.5MM 16MM,5658.0,5658.0,735.54,4809.3,28 CDM,300117,PIN FX INSTR THRD HIP,5125.5,5125.5,307.53,4356.68,49 CDM,300127,CMPNT FEM HIP 13MM,2201.0,2201.0,286.13,1870.85,28 CDM,300130,BASEPLATE TIB KN SZ8,29581.0,29581.0,3845.53,25143.85,28 CDM,300132,OBTURATOR BLDLSS 8MM,1830.5,1830.5,109.83,1555.92,49 CDM,300133,BLADE SHVR 3.5MM 13CM,2150.5,2150.5,129.03,1827.92,49 CDM,300137,DEVICE CLSR WND 2-0 15CM,1425.5,1425.5,85.53,1211.67,49 CDM,300138,CATH 3RD OD LOW ART,5864.43,5864.43,351.87,4984.77,37 CDM,300140,DIALYSIS CIRC THRMB/STNT,97747.1,97747.1,5864.83,83085.04,37 CDM,300344,RNG ANLPLS TRCSPD 30,59925.0,59925.0,7790.25,50936.25,28 CDM,300501,AMOXICILLIN 500 MG PO,9.51,9.51,0.57,8.08,49 CDM,300503,AMPHOTERICN B 50 MG INJ,302.19,302.19,18.13,256.86,24 CDM,300503,"Injection, amphotericin b, 50 mg ",302.19,302.19,44.33,106.45,10 CDM,300506,BENZTROPINE 0.5 MG PO,9.51,9.51,0.57,8.08,49 CDM,300509,BUMETANIDE 0.5 MG PO,15.47,15.47,0.93,13.15,49 CDM,300512,BUPIV2.5/EPI0.005MG 30ML,74.19,74.19,4.45,63.06,46 CDM,300513,BUPIV5MG/EPI0.005MG 10ML,48.22,48.22,2.89,40.99,46 CDM,300514,BUPIV5MG/EPI0.005MG 30ML,80.36,80.36,4.82,68.31,46 CDM,300515,BUPRENORPHINE 2 MG PO,9.51,9.51,0.57,8.08,25 CDM,300516,BUPRENORPHINE 8 MG PO,17.84,17.84,1.07,15.16,25 CDM,300518,BUSULFAN 2 MG PO,185.6,185.6,11.14,157.76,20 CDM,300518,"Busulfan; oral, 2 mg ",185.6,185.6,47.29,437.14,8 CDM,300521,CEFDINIR 300 MG PO,9.51,9.51,0.57,8.08,49 CDM,300523,CEPHALEXIN 500 MG PO,9.51,9.51,0.57,8.08,49 CDM,300524,CHLORAMBUCIL 2 MG PO,159.42,159.42,9.57,135.51,25 CDM,300524,"Chlorambucil, oral, 2 mg ",159.42,159.42,40.92,840.62,8 CDM,300524,"Chlorambucil, oral, 2 mg Chemotherapy Drugs",159.42,159.42,,,0 CDM,300526,CILOSTAZOL 100 MG PO,9.51,9.51,0.57,8.08,49 CDM,300532,CYCLOPHOSPHAMIDE 25MG PO,59.49,59.49,3.57,50.57,24 CDM,300533,CYCLOPHOSPHAMIDE 50MG PO,102.32,102.32,6.14,86.97,24 CDM,300534,DEMECLOCYCLINE 150 MG PO,27.37,27.37,1.64,23.26,49 CDM,300535,DEXAMETHASONE 0.5 MG PO,9.51,9.51,0.57,8.08,24 CDM,300536,DEXAMETHASONE 0.75 MG PO,9.51,9.51,0.57,8.08,24 CDM,300539,DOXAZOSIN 1 MG PO,19.04,19.04,1.14,16.18,49 CDM,300540,DOXEPIN 100 MG PO,13.09,13.09,0.79,11.13,49 CDM,300547,ESTRADIOL 0.5 MG PO,9.51,9.51,0.57,8.08,49 CDM,300548,ESTROGEN CON 0.45 MG PO,42.83,42.83,2.57,36.41,49 CDM,300549,ESTROGEN CON 1.25 MG PO,42.83,42.83,2.57,36.41,49 CDM,300553,ETOPOSIDE 50 MG PO,600.81,600.81,36.05,510.69,24 CDM,300553,"Etoposide; oral, 50 mg ",600.81,600.81,86.84,236.37,10 CDM,300553,"Etoposide; oral, 50 mg Chemotherapy Drugs",600.81,600.81,,,0 CDM,300562,HEPAR 10000U/10ML MDV,28.56,28.56,1.71,24.28,24 CDM,300564,INDOMETHACIN 50 MG PO,9.51,9.51,0.57,8.08,49 CDM,300565,ISONIAZID 100 MG PO,15.47,15.47,0.93,13.15,49 CDM,300569,LACOSAMIDE 100 MG PO,97.56,97.56,5.85,82.93,49 CDM,300572,LEVOTHYROXINE 125 MCG PO,10.7,10.7,0.64,9.09,49 CDM,300575,LIDO 200MG/EPI0.05MG INJ,25.91,25.91,1.55,22.02,25 CDM,300588,PANCRELIPASE 12000 U PO,24.98,24.98,1.5,21.23,49 CDM,300589,MEDROXYPROGEST 2.5 MG PO,9.51,9.51,0.57,8.08,49 CDM,300590,"Injection, mepivacaine hydrochloride, per 10 ml ",41.64,41.64,2.59,11.92,10 CDM,300590,MEPIVACAIN 1% 30 ML INJ,41.64,41.64,2.5,35.39,24 CDM,300594,NITROFUR MACRO 50 MG PO,13.09,13.09,0.79,11.13,49 CDM,300605,KETOROLAC 15 MG INJ,28.56,28.56,1.71,24.28,19 CDM,300609,"Injection, leucovorin calcium, per 50 mg ",42.83,42.83,3.59,12.32,10 CDM,300609,LEUCOVORIN CA 50 MG INJ,42.83,42.83,2.57,36.41,24 CDM,300614,PHENYLEPHRIN 10% 5ML OPH,297.97,297.97,17.88,253.27,49 CDM,300615,PHENYLEPHRI 2.5% 2ML OPH,242.33,242.33,14.54,205.98,49 CDM,300624,ISOPROTERENOL 1MG INJ,10186.45,10186.45,611.19,8658.48,30 CDM,300628,"Injection, methocarbamol, up to 10 ml ",528.24,528.24,4.2,33.99,10 CDM,300628,METHOCARBAM 1G/10ML INJ,528.24,528.24,31.69,449.0,24 CDM,300632,PREDNISONE 1MG/1ML LIQPO,9.51,9.51,0.57,8.08,24 CDM,300634,ACETAMINO NOS 1000MG INJ,35.15,35.15,2.11,29.88,24 CDM,300634,"Injection, acetaminophen, not otherwise specified,10 mg ",35.15,35.15,0.05,0.81,10 CDM,300635,ACETYLCHOLINE 1% 2 ML OP,515.57,515.57,30.93,438.23,49 CDM,300636,ALBUTEROL 2MG/5ML LIQ PO,9.51,9.51,0.57,8.08,49 CDM,300646,CEFUROXIME 750 MG INJ,69.0,69.0,4.14,58.65,24 CDM,300647,CEFUROXIME 1.5 G INJ,69.0,69.0,4.14,58.65,24 CDM,300654,CHOLESTYRAMINE 4 G PO,14.28,14.28,0.86,12.14,49 CDM,300661,DABIGATRAN 150 MG PO,47.58,47.58,2.85,40.44,49 CDM,300662,DABIGATRAN 75 MG PO,47.58,47.58,2.85,40.44,49 CDM,300664,TBO-FILGRASTM 300MCG INJ,1944.01,1944.01,116.64,1652.41,19 CDM,300668,DOBUTAM 250MG/250ML INJ,74.95,74.95,4.5,63.71,24 CDM,300677,FLUOROURACIL 500 MG INJ,69.0,69.0,4.14,58.65,24 CDM,300677,"Injection, fluorouracil, 500 mg ",69.0,69.0,2.06,5.83,10 CDM,300677,"Injection, fluorouracil, 500 mg Chemotherapy Drugs",69.0,69.0,,,0 CDM,300680,MOMET/FOR 100/5MCG 60INH,841.14,841.14,50.47,714.97,33 CDM,300681,MOMET/FOR 200/5MCG 60INH,841.14,841.14,50.47,714.97,33 CDM,300684,"Injection, testosterone cypionate, 1 mg ",111.83,111.83,0.02,0.09,10 CDM,300684,TESTOSTERNE CY 200MG INJ,111.83,111.83,6.71,95.06,24 CDM,300688,VENLAFAXINE 25 MG PO,9.51,9.51,0.57,8.08,49 CDM,300691,ALTEPLASE RECOMB 50 MG,37026.72,37026.72,2221.6,31472.71,19 CDM,301425,AMIODARONE 1.8 MG/ML INJ,10.7,10.7,0.64,9.09,24 CDM,301429,CEFEPIME 280 MG/ML INJ,241.51,241.51,14.49,205.28,24 CDM,301430,CEFEPIME 40 MG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301431,CEFOTAXIME 300 MG/ML INJ,207.01,207.01,12.42,175.96,25 CDM,301431,"Injection, cefotaxime sodium, per gm ",207.01,207.01,4.06,31.2,8 CDM,301436,CLINDAMYCIN 12 MG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301441,DEXAMTH NAP 4MG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301451,FENTANYL 10 MCG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301452,FENTANYL 50 MCG/ML INJ,69.0,69.0,4.14,58.65,24 CDM,301457,GANCICLOVIR 5 MG/ML INJ,114.21,114.21,6.85,97.08,24 CDM,301466,LEVOFLOXACIN 5 MG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301469,LIDO 8000 MCG/ML INJ,4.76,4.76,0.29,4.05,25 CDM,301472,MAG SULFATE 40 MG/ML INJ,16.65,16.65,1.0,14.15,24 CDM,301479,MIDAZOLAM 1 MG/ML INJ,33.31,33.31,2.0,28.31,24 CDM,301480,MILRINONE 200 MCG/ML INJ,4.76,4.76,0.29,4.05,24 CDM,301490,NOREPI 16MCG/ML INJ,69.0,69.0,4.14,58.65,30 CDM,301501,VIT K PHYTON 1 MG/ML INJ,140.39,140.39,8.42,119.33,24 CDM,301502,POTASS CL 0.08MEQ/ML INJ,16.65,16.65,1.0,14.15,24 CDM,301504,POT PHOS 0.05MMOL/ML INJ,16.65,16.65,1.0,14.15,30 CDM,301506,PROPRANOL 0.2 MG/ML INJ,16.07,16.07,0.96,13.66,25 CDM,301508,PROPOFOL 10 MG/ML INJ,16.65,16.65,1.0,14.15,24 CDM,301516,NA BICARB 0.5 MEQ/ML INJ,17.31,17.31,1.04,14.71,30 CDM,301521,ZIDOVUDINE 4 MG/ML INJ,16.65,16.65,1.0,14.15,24 CDM,301522,MESALAMINE ER 250 MG PO,24.98,24.98,1.5,21.23,49 CDM,301528,0.9% NACL 3000 ML IRR,86.55,86.55,5.19,73.57,49 CDM,301529,0.9% NACL 250 ML IRR,83.28,83.28,5.0,70.79,49 CDM,301530,ALBUTEROL 90MCG 6.7G INH,166.56,166.56,9.99,141.58,33 CDM,301533,POVIDONE IOD 5% 30ML OPH,51.16,51.16,3.07,43.49,49 CDM,301534,BSS 15ML OPH,25.96,25.96,1.56,22.07,49 CDM,301535,D5NS 500 ML,83.28,83.28,5.0,70.79,24 CDM,301539,CARBACH 0.01% 1.5 ML INJ,106.33,106.33,6.38,90.38,49 CDM,301545,OCTREOT 500MCG ND SQIV,152.28,152.28,9.14,129.44,40 CDM,301548,POTASS CL 20 MEQ INJ,69.0,69.0,4.14,58.65,24 CDM,301550,MERCAPTOPURINE 50 MG PO,28.56,28.56,1.71,24.28,25 CDM,301550,"Mercaptopurine, oral, 50 mg ",28.56,28.56,4.63,9.83,8 CDM,301550,"Mercaptopurine, oral, 50 mg Chemotherapy Drugs",28.56,28.56,,,0 CDM,301552,LIDOCAINE 4% 50 ML TOP,263.35,263.35,15.8,223.85,49 CDM,301555,HEPARIN 1000U / 1 ML INJ,28.56,28.56,1.71,24.28,24 CDM,306018,OBS PER HOUR,110.19,110.19,15.43,93.66,15 CDM,30677,WASHER BN 13.0MM,1196.0,1196.0,155.48,1016.6,28 CDM,307010,RM & BD ADJ,14157.35,14157.35,849.44,12033.75,49 CDM,3089,MESH SURG 1X4IN,1367.0,1367.0,177.71,1161.95,28 CDM,310018,OBS PER HOUR,242.41,242.41,33.94,206.05,15 CDM,310379,DIRECT REFERRAL TO OBS,606.02,606.02,84.84,515.12,10 CDM,310430,BLOOD TRANSFUSION,3726.0,3726.0,223.56,3167.1,40 CDM,310430,"Transfusion, blood or blood components ",3726.0,3726.0,33.8,445.4,10 CDM,310950,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,311379,DIRECT REFERRAL TO OBS,441.97,441.97,61.88,375.67,10 CDM,311772,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,311950,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,311952,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,312379,DIRECT REFERRAL TO OBS,220.38,220.38,30.85,187.32,10 CDM,312772,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,312950,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,312952,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,313379,DIRECT REFERRAL TO OBS,220.38,220.38,30.85,187.32,10 CDM,313772,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,313774,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,319916,ESG PLSMB 24F OVL 24-30D,16801.5,16801.5,1008.09,14281.27,49 CDM,331783,CILASTATN/IMIPINM 500 MG,53.92,53.92,3.24,45.83,24 CDM,331783,"Injection, cilastatin sodium; imipenem, per 250 mg ",53.92,53.92,6.32,21.75,10 CDM,331784,BSS 500ML OPH,416.66,416.66,25.0,354.16,49 CDM,331785,BETAMETH DIP 0.05%15GTOP,329.55,329.55,19.77,280.12,49 CDM,331802,CYSTOGRAFIN 30% 300 ML,296.24,296.24,17.77,251.8,24 CDM,331802,"High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml ",296.24,296.24,0.08,0.24,10 CDM,331810,ISOVUE 370 150 ML INJ,254.6,254.6,15.28,216.41,24 CDM,331811,ISOVUE-M 200 10 ML INJ,186.79,186.79,11.21,158.77,24 CDM,331813,ISOVUE-M 200 20 ML INJ,255.79,255.79,15.35,217.42,24 CDM,331814,ISOVUE 250 100 ML INJ,176.08,176.08,10.56,149.67,24 CDM,331815,ISOVUE 250 50 ML INJ,76.14,76.14,4.57,64.72,24 CDM,331816,ISOVUE 300 100 ML INJ,166.56,166.56,9.99,141.58,24 CDM,331817,ISOVUE 300 50 ML INJ,83.28,83.28,5.0,70.79,24 CDM,331818,ISOVUE-M 300 15 ML INJ,246.27,246.27,14.78,209.33,24 CDM,331819,ISOVUE 370 100 ML INJ,184.41,184.41,11.06,156.75,24 CDM,331820,ISOVUE 370 50 ML INJ,90.42,90.42,5.43,76.86,24 CDM,334973,ABL 1/MORE LIV TU PC RAD,29256.83,29256.83,1755.41,24868.31,37 CDM,334974,ABL 1/MORE PULM TU PC RF,29256.83,29256.83,1755.41,24868.31,37 CDM,3357,STAPLER INT VASC 35MM,10173.5,10173.5,610.41,8647.48,49 CDM,344748,LVL 1 BEDSIDE PROC,438.0,438.0,26.28,372.3,37 CDM,344749,LVL 2 BEDSIDE PROC,875.0,875.0,52.5,743.75,37 CDM,344751,LVL 3 BEDSIDE PROC,2253.0,2253.0,135.18,1915.05,37 CDM,344752,LVL 4 BEDSIDE PROC,6778.0,6778.0,406.68,5761.3,37 CDM,344755,LVL 5 BEDSIDE PROC,17200.0,17200.0,1032.0,14620.0,37 CDM,3483,RELOAD STPLR 35MM,6021.5,6021.5,782.79,5118.27,28 CDM,351020,RM & BD ADJ,14402.62,14402.62,864.16,12242.23,49 CDM,3540,DEVICE ENDO SZ0 48IN,3046.5,3046.5,182.79,2589.53,49 CDM,3660,EVACUATOR BLADDER ADPT,920.5,920.5,55.23,782.42,49 CDM,3662,APPLIER CLP PRLD 9.375IN,7008.0,7008.0,911.04,5956.8,28 CDM,3663,APPLIER CLP PRLD 9.375IN,2008.5,2008.5,261.11,1707.22,28 CDM,400061,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",56697.36,56697.36,3673.0,55788.29,29 CDM,400061,EP REPOS ELE VT 3D MAP,56697.36,56697.36,7370.66,48192.76,19 CDM,400062,EP INTRACARD DX TX,80130.69,80130.69,10416.99,68111.09,20 CDM,400062,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",80130.69,80130.69,1045.7,43890.0,21 CDM,400063,COM EP REPO CTH TX AFIB,44953.56,44953.56,5843.96,38210.53,19 CDM,400063,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",44953.56,44953.56,5591.0,55788.29,17 CDM,400064,ADD INTRACRD AFIB/PV ISO,58277.11,58277.11,7576.02,49535.54,20 CDM,400064,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,58277.11,58277.11,1044.01,43890.0,21 CDM,400125,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",48555.75,48555.75,5591.0,55788.29,17 CDM,400125,EP REPOS ELE SVT SGL,48555.75,48555.75,6312.25,41272.39,19 CDM,400159,GWIRE STRAIT 190CM,3053.0,3053.0,183.18,2595.05,49 CDM,403184,CMPD NITROGL1000MCG 10ML,52.35,52.35,3.14,44.5,30 CDM,403185,IVIG GAMUNEX-C 5G,1814.72,1814.72,108.88,1542.51,19 CDM,404209,505MY VANCOMY 1.25 G INJ,68.35,68.35,4.1,58.1,33 CDM,404358,505AC ARGAT 50MG ESRDINJ,1081.88,1081.88,64.91,919.6,25 CDM,404359,505AC ARGAT 1MG NESRDINJ,21.62,21.62,1.3,18.38,20 CDM,404360,505AC ARGAT 50MG NESRD,1081.88,1081.88,64.91,919.6,20 CDM,404361,505PP MICAFUN 50 MG INJ,408.67,408.67,24.52,347.37,24 CDM,404361,"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg ",408.67,408.67,0.22,1.12,10 CDM,404364,505FK GLUCAGON 1 MG INJ,1174.74,1174.74,70.48,998.53,19 CDM,404364,"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg ",1174.74,1174.74,135.0,486.94,10 CDM,404365,MIDAZOL/0.9NS 50 MG IV,117.19,117.19,7.03,99.61,24 CDM,404371,505FK MORPHINE 5 MG INJ,19.04,19.04,1.14,16.18,24 CDM,404372,505TV FULVES 25 MG INJ,41.64,41.64,2.5,35.39,20 CDM,404373,505TV FULVES 250 MG INJ,417.3,417.3,25.04,354.7,20 CDM,404374,505PF HEPARIN 1000 U INJ,19.04,19.04,1.14,16.18,24 CDM,404374,"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units ",19.04,19.04,0.65,9.39,10 CDM,404376,505BX CEFEP 1 G INJ,246.22,246.22,14.77,209.29,24 CDM,404377,505BX CEFEP 2G/100ML INJ,246.22,246.22,14.77,209.29,24 CDM,404379,505BXCEFAZ 1G/D5W50MLINJ,40.58,40.58,2.43,34.49,24 CDM,404379,"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg ",40.58,40.58,1.24,4.15,10 CDM,404421,505AU ARGAT 1MG ESRD INJ,21.31,21.31,1.28,18.11,24 CDM,404422,505AU ARGAT 50MG ESRD,1065.45,1065.45,63.93,905.63,24 CDM,404423,505AU ARGAT1MGNESRDINJJW,21.31,21.31,1.28,18.11,24 CDM,404424,505AU ARGAT 1MG NESRDINJ,21.31,21.31,1.28,18.11,24 CDM,404425,505AU ARGAT 50MG NESRD,1065.45,1065.45,63.93,905.63,24 CDM,404428,505BB ACETAMIN 1000MGINJ,33.31,33.31,2.0,28.31,24 CDM,404428,"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg ",33.31,33.31,0.05,0.16,10 CDM,404429,505FK ACETAMIN 1000MGINJ,32.78,32.78,1.97,27.86,24 CDM,404429,"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg ",32.78,32.78,0.05,0.41,10 CDM,404430,505HS DAPTOMY 350 MG INJ,169.42,169.42,10.17,144.01,24 CDM,404430,"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg ",169.42,169.42,0.05,0.19,10 CDM,404432,505SP DECITABIN 50MG INJ,272.57,272.57,16.35,231.68,25 CDM,404432,"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg ",272.57,272.57,1.89,4.75,8 CDM,404433,505ACARGAT1MG NESRDINJJW,21.62,21.62,1.3,18.38,20 CDM,404434,TOBRAMYCIN 1200 MG MDV,300.53,300.53,18.03,255.45,24 CDM,404435,505BB CEFEPI 2G/50ML INJ,155.21,155.21,9.31,131.93,24 CDM,404435,"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg ",155.21,155.21,4.89,15.82,10 CDM,404436,505BB MEROPEN 1 G INJ,159.25,159.25,9.55,135.36,24 CDM,404436,"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg ",159.25,159.25,1.97,6.49,10 CDM,404437,505AC ARGAT 1MGESRDINJJW,21.62,21.62,1.3,18.38,25 CDM,404438,505AC ARGAT 1MG ESRD INJ,21.62,21.62,1.3,18.38,25 CDM,409568,505WG CAGLUC 2G/100MLINJ,98.57,98.57,5.91,83.78,24 CDM,409569,505WGCAGL1G/NACL 50MLINJ,46.75,46.75,2.81,39.74,24 CDM,409572,CA GLUC NOS 2 G INJ,215.82,215.82,12.95,183.45,24 CDM,409574,CA GLUC NOS 1 G INJ,52.23,52.23,3.13,44.4,24 CDM,409581,505BX CLINDA 600MG NS 50,43.17,43.17,2.59,36.69,24 CDM,409583,CLINDAMY/D5W 600MG/50ML,90.13,90.13,5.41,76.61,24 CDM,409585,505BX CLINDA 900MG NS 50,53.97,53.97,3.24,45.87,24 CDM,409586,505BX CLINDA 300MG NS 50,31.1,31.1,1.87,26.43,24 CDM,412020,ACETAMINOPH 120 MG RECT,2.47,2.47,0.15,2.1,49 CDM,412040,ACETAMINOPHEN 325MG RECT,2.47,2.47,0.15,2.1,49 CDM,412080,ACETAMINOPH 650 MG RECT,2.47,2.47,0.15,2.1,49 CDM,412100,ACETAZOLAMIDE 250 MG PO,19.79,19.79,1.19,16.82,49 CDM,412115,ACETAZOLAMIDE 500 MG INJ,1273.01,1273.01,76.38,1082.06,24 CDM,412115,"Injection, acetazolamide sodium, up to 500 mg ",1273.01,1273.01,24.36,67.96,10 CDM,412170,ACETYLCYSTN 10% 4 ML INH,204.64,204.64,12.28,173.94,24 CDM,412200,ACETYLCYSTN 20% 4 ML INH,296.24,296.24,17.77,251.8,24 CDM,412260,ACYCLOVIR 200 MG PO,115.41,115.41,6.92,98.1,49 CDM,412263,ACYCLOVIR 800 MG PO,123.64,123.64,7.42,105.09,49 CDM,412280,ACYCLOV 200MG/5ML LIQ PO,109.46,109.46,6.57,93.04,49 CDM,412290,ACYCLOVIR 500 MG INJ,1961.86,1961.86,117.71,1667.58,24 CDM,412293,ACYCLOVIR 5 MG/ML INJ,46.4,46.4,2.78,39.44,24 CDM,412301,ADENOSINE 6 MG INJ,4247.33,4247.33,254.84,3610.23,24 CDM,412307,ADENOSINE 90 MG INJ,6272.25,6272.25,376.33,5331.41,24 CDM,412350,ALBUTERL NC UD 2.5MG INH,46.4,46.4,2.78,39.44,24 CDM,412430,ALLOPURINOL 100 MG PO,11.12,11.12,0.67,9.45,49 CDM,412440,ALLOPURINOL 300 MG PO,28.44,28.44,1.71,24.17,49 CDM,412451,ALPRAZOLAM 0.25 MG PO,28.44,28.44,1.71,24.17,49 CDM,412461,ALPRAZOLAM 0.5 MG PO,32.14,32.14,1.93,27.32,49 CDM,412471,ALPRAZOLAM 1 MG PO,42.03,42.03,2.52,35.73,49 CDM,412481,ALPROSTADIL 500 MCG INJ,1988.03,1988.03,119.28,1689.83,41 CDM,412481,"Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",1988.03,1988.03,0.37,32.7,8 CDM,412512,ALUM HYDRO 1920MG LIQ PO,2.47,2.47,0.15,2.1,49 CDM,412561,AMANTADINE 100 MG PO,28.44,28.44,1.71,24.17,49 CDM,412580,AMIKACIN SULFATE 500 MG,185.6,185.6,11.14,157.76,24 CDM,412581,AMIKACIN 10 MG/ML INJ,82.09,82.09,4.93,69.78,24 CDM,412640,AMINOPHYLLIN 500 MG INJ,71.39,71.39,4.28,60.68,24 CDM,412649,AMIODARONE 100 MG PO,5.95,5.95,0.36,5.06,49 CDM,412650,AMIODARONE 200 MG PO,134.76,134.76,8.09,114.55,49 CDM,412660,AMITRIPTYLINE 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,412680,AMITRIPTYLINE 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,412729,AMLODIPINE 2.5 MG PO,92.73,92.73,5.56,78.82,49 CDM,412730,AMLODIPINE 5 MG PO,92.73,92.73,5.56,78.82,49 CDM,412731,AMLODIPINE 10 MG PO,126.11,126.11,7.57,107.19,49 CDM,412750,AMMON LAC12% 225-226GTOP,1470.06,1470.06,88.2,1249.55,49 CDM,412780,AMOXICILL/CLAV 500 MG PO,260.87,260.87,15.65,221.74,49 CDM,412785,AMOXICILL/CLAV 875 MG PO,337.53,337.53,20.25,286.9,49 CDM,412810,AMOXICILLIN 250 MG PO,11.12,11.12,0.67,9.45,49 CDM,412831,AMOXICI 250MG/5ML LIQ PO,11.12,11.12,0.67,9.45,49 CDM,412910,AMPICILLIN 500 MG INJ,159.42,159.42,9.57,135.51,24 CDM,412920,AMPICIL/SULBAC 1.5 G INJ,429.49,429.49,25.77,365.07,24 CDM,412930,AMPICIL/SULBAC 3 G INJ,659.11,659.11,39.55,560.24,24 CDM,415000,ACETIC ACID 0.25% 1L IRR,147.13,147.13,8.83,125.06,49 CDM,415100,K20/D5/0.2NACL 1L INJ,404.3,404.3,24.26,343.65,24 CDM,415110,K20/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415111,K10/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415112,K40/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415120,K20/D5NS 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415130,K20/D5 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415140,DEXTROSE 10% 1000 ML INJ,404.3,404.3,24.26,343.65,49 CDM,415150,DEXTROSE 10% 250 ML INJ,54.95,54.95,3.3,46.71,49 CDM,415161,DEXTROSE 70% 500 ML INJ,101.38,101.38,6.08,86.17,49 CDM,415170,DEXTROSE 20% 500 ML INJ,380.81,380.81,22.85,323.69,49 CDM,415180,D5/0.225NACL 1000ML INJ,404.3,404.3,24.26,343.65,49 CDM,415230,"5% dextrose and 0.45% normal saline, 1000 ml ",285.53,285.53,10.25,25.02,8 CDM,415230,D5/0.45NS 1000 ML INJ,285.53,285.53,17.13,242.7,25 CDM,415240,"5% dextrose in lactated ringers infusion, up to 1000 cc ",389.04,389.04,9.7,25.4,8 CDM,415240,D5 LR 1000 ML,389.04,389.04,23.34,330.68,25 CDM,415245,K20/D5LR 1000 ML INJ,404.3,404.3,24.26,343.65,24 CDM,415260,D5NS 1000 ML,55.31,55.31,3.32,47.01,24 CDM,415270,D5W 100 ML INJ,192.88,192.88,11.57,163.95,24 CDM,415290,D5W 1000ML,404.3,404.3,24.26,343.65,24 CDM,415290,"Infusion, d5w, 1000 cc ",404.3,404.3,3.07,40.93,10 CDM,415300,D5W 250 ML INJ,192.88,192.88,11.57,163.95,24 CDM,415305,D5W 250 ML INJ,281.89,281.89,16.91,239.61,24 CDM,415310,D5W 50 ML INJ,58.3,58.3,3.5,49.55,24 CDM,415320,D5W 50 ML INJ,192.88,192.88,11.57,163.95,24 CDM,415356,DEXTROSE 40% 500 ML INJ,73.07,73.07,4.38,62.11,49 CDM,415359,DOBUTAM 500MG/250ML INJ,580.59,580.59,34.84,493.5,24 CDM,415366,DOPAMINE 400 MG INJ,46.4,46.4,2.78,39.44,20 CDM,415367,DOPA 800MG/D5W 250ML INJ,46.4,46.4,2.78,39.44,20 CDM,415375,PLASMA-LYTE A 1L INJ,404.3,404.3,24.26,343.65,46 CDM,415510,MANNITOL 20% 100 G INJ,809.83,809.83,48.59,688.36,49 CDM,415521,K20/NS0.45 1000 ML INJ,479.46,479.46,28.77,407.54,24 CDM,415522,K40/NS 1000 ML INJ,361.68,361.68,21.7,307.43,24 CDM,415540,LACTATED RINGERS 500 ML,320.22,320.22,19.21,272.19,24 CDM,415550,0.45% NACL 1000 ML INJ,404.3,404.3,24.26,343.65,49 CDM,415560,0.45% NACL 500 ML INJ,200.3,200.3,12.02,170.25,49 CDM,415580,NS 100 ML,338.77,338.77,20.33,287.95,24 CDM,415630,"Infusion, normal saline solution, sterile (500 ml = 1 unit) ",200.3,200.3,1.36,20.12,10 CDM,415630,NS 500 ML,200.3,200.3,12.02,170.25,24 CDM,415640,3% NACL 500 ML INJ,290.55,290.55,17.43,246.97,25 CDM,415645,0.9% NACL 1000 ML IRR,103.85,103.85,6.23,88.27,49 CDM,415662,NS 50 ML,338.77,338.77,20.33,287.95,24 CDM,415664,NS 250 ML,208.2,208.2,12.49,176.97,24 CDM,415665,"Infusion, normal saline solution , 1000 cc ",441.39,441.39,2.19,40.23,10 CDM,415665,NS 1000 ML,441.39,441.39,26.48,375.18,24 CDM,415666,LACTATED RINGERS 1000 ML,441.39,441.39,26.48,375.18,24 CDM,415667,DOPAM 400MG/D5W250ML INJ,731.68,731.68,43.9,621.93,20 CDM,415668,D5W 500 ML INJ,302.19,302.19,18.13,256.86,24 CDM,4250,GRAFT CV 16X8MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,425954,BLADE SHAVER SOFT MINI,17607.0,17607.0,1056.42,14965.95,49 CDM,4260,MESH HRN GRN 10X14IN,6676.0,6676.0,867.88,5674.6,28 CDM,426008,CT MAXIFAC W&W/O CONT,13889.58,13889.58,833.37,11806.14,14 CDM,426009,CT NECK W&W/O CONT,15820.23,15820.23,949.21,13447.2,14 CDM,426011,CT CHEST W&W/O CONT,13798.22,13798.22,827.89,11728.49,14 CDM,426013,CT T-SPINE W&W/O CONT,18492.6,18492.6,1109.56,15718.71,14 CDM,426015,CT CHEST W/CONTRAST,13662.38,13662.38,819.74,11613.02,14 CDM,426017,CTA ABD&PEL W CONT,25742.73,25742.73,1544.56,21881.32,14 CDM,426020,CT L-SPINE W/CONTRAST,15400.68,15400.68,924.04,13090.58,14 CDM,426022,RAD WOUND PROCEDURE,8937.78,8937.78,536.27,7597.11,37 CDM,426023,CTA LOW EXTREMITY BI,19079.24,19079.24,1144.75,16217.35,14 CDM,426024,CTA LOW EXTREMITY LT,19079.24,19079.24,1144.75,16217.35,14 CDM,426026,CTA LOW EXTREMITY RT,19079.24,19079.24,1144.75,16217.35,14 CDM,426030,CT ABDOMEN W/CONT,17161.83,17161.83,1029.71,14587.56,14 CDM,426035,CT ABDOMEN W/O CONT,16054.64,16054.64,963.28,13646.44,14 CDM,426040,CT C-SPINE W/CONTRAST,18746.25,18746.25,1124.78,15934.31,14 CDM,426045,CT CHEST W/O CONTRAST,12981.97,12981.97,778.92,11034.67,14 CDM,426060,CT HEAD/BRAIN W/CONT,15400.68,15400.68,924.04,13090.58,14 CDM,426061,IMG GD FLD COLL PERI/RET,12908.81,12908.81,774.53,10972.49,37 CDM,426065,CT HEAD/BRAIN W/O CONT,10013.87,10013.87,600.83,8511.79,14 CDM,426070,CT HD/BR W&W/O CONT,17300.07,17300.07,1038.0,14705.06,14 CDM,426075,CT ORBIT/SELLA/IAC W,17005.54,17005.54,1020.33,14454.71,14 CDM,426080,CT ORBIT/SELLA/IAC WO,15775.75,15775.75,946.54,13409.39,14 CDM,426080,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",15775.75,15775.75,104.75,1361.0,29 CDM,426081,BX ABD/RETROPERITO,12908.81,12908.81,774.53,10972.49,37 CDM,426089,CT L-SPINE W&W/O CONT,19845.01,19845.01,1190.7,16868.26,14 CDM,426090,CT L-SPINE W/O CONTRAST,13908.82,13908.82,834.53,11822.5,14 CDM,426095,CT NECK W/O CONTRAST,14652.94,14652.94,879.18,12455.0,14 CDM,426103,CT LW EXTRM W&W/O CON LT,12653.78,12653.78,759.23,10755.71,14 CDM,426104,CT LW EXTRM W&W/O CON RT,12653.78,12653.78,759.23,10755.71,14 CDM,426105,CT GUID NDL PLCMT,10480.3,10480.3,628.82,8908.25,28 CDM,426105,"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation ",10480.3,10480.3,137.63,1361.0,17 CDM,426107,CT LOWER EXTRM W/O C LT,6515.63,6515.63,390.94,5538.29,14 CDM,426108,CT LOWER EXTRM W/O C RT,6515.63,6515.63,390.94,5538.29,14 CDM,426120,CT PELVIS W/CONTRAST,16066.67,16066.67,964.0,13656.67,14 CDM,426125,CT PELVIS W/O CONTRAST,12264.29,12264.29,735.86,10424.65,14 CDM,426126,CT PELVIS W&W/O CONT,16922.6,16922.6,1015.36,14384.21,14 CDM,426129,DUP AB/PEL/SC LTD,3033.49,3033.49,182.01,2578.47,33 CDM,426129,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",3033.49,3033.49,106.88,363.18,18 CDM,426135,CT MAXIFAC W/CONTRAST,13169.5,13169.5,790.17,11194.08,14 CDM,426137,CT LOWER EXTRM W/CON RT,10985.2,10985.2,659.11,9337.42,14 CDM,426140,CT T-SPINE W/O CONTRAST,17524.87,17524.87,1051.49,14896.14,14 CDM,426145,CT T-SPINE W/CONTRAST,15868.31,15868.31,952.1,13488.06,14 CDM,426145,"Computed tomography, thoracic spine; with contrast material ",15868.31,15868.31,174.75,1361.0,29 CDM,426150,CT ABDOMEN W&WO CONT,18010.54,18010.54,1080.63,15308.96,14 CDM,426190,CT NECK W/CONTRAST,15677.17,15677.17,940.63,13325.59,14 CDM,426191,CTA PELVIS,20535.04,20535.04,1232.1,17454.78,14 CDM,426201,CT UP EXTREM W/CONT LT,6515.63,6515.63,390.94,5538.29,14 CDM,426202,CT UP EXTREM W/CONT RT,6515.63,6515.63,390.94,5538.29,14 CDM,426204,CT UP EXTREM W/O CONT LT,12008.22,12008.22,720.49,10206.99,14 CDM,426206,CT UP EXTREM W/O CONT RT,12008.22,12008.22,720.49,10206.99,14 CDM,426208,CT UP EXTRM W&W/O CON LT,12653.78,12653.78,759.23,10755.71,14 CDM,426209,CT UP EXTRM W&W/O CON RT,12653.78,12653.78,759.23,10755.71,14 CDM,426211,BX ASP BONE MARROW DX,5980.73,5980.73,358.84,5083.62,37 CDM,426219,CT ORBIT/SELLA/IAC W&WO,18451.72,18451.72,1107.1,15683.96,14 CDM,426220,CT MAXIFAC W/O CNT,12010.63,12010.63,720.64,10209.04,14 CDM,426230,CT C-SPINE W/O CONTRAST,15400.68,15400.68,924.04,13090.58,14 CDM,426240,ASP ONLY BONE MARROW DX,6998.64,6998.64,419.92,5948.84,37 CDM,426247,BX BONE MARROW DX,7167.2,7167.2,430.03,6092.12,37 CDM,426249,BX BONE SUPERFICIAL,7167.0,7167.0,430.02,6091.95,37 CDM,426275,CTA CHEST,20535.04,20535.04,1232.1,17454.78,14 CDM,426313,BX/EXC LYMPH NODE NDL,8756.14,8756.14,525.37,7442.72,37 CDM,426370,CT LOWER EXTRM W/CON BI,21966.8,21966.8,1318.01,18671.78,14 CDM,426371,CT LOWER EXTRM W/CON LT,10985.2,10985.2,659.11,9337.42,14 CDM,426376,CT HEART W CN ART/GRAFTS,1603.66,1603.66,96.22,1363.11,14 CDM,426376,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",1603.66,1603.66,175.06,1361.0,29 CDM,426377,CTHEART W CN STR MOR FNC,24558.62,24558.62,1473.52,20874.83,14 CDM,426377,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",24558.62,24558.62,175.06,1361.0,29 CDM,426378,CTHEART CONGENITL DISEAS,24558.62,24558.62,1473.52,20874.83,14 CDM,426378,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",24558.62,24558.62,175.06,1361.0,29 CDM,426379,CT HEART WO CN W QUAN CA,818.66,818.66,49.12,695.86,14 CDM,426379,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",818.66,818.66,86.58,1361.0,29 CDM,426402,ABL RENL TUMRS PC CRYO,21813.92,21813.92,1308.84,18541.83,37 CDM,426496,CTA HEAD,12961.53,12961.53,777.69,11017.3,14 CDM,426498,CTA NECK,12961.53,12961.53,777.69,11017.3,14 CDM,426502,BX RENAL,10465.0,10465.0,627.9,8895.25,37 CDM,426700,BX LIVER,8938.0,8938.0,536.28,7597.3,37 CDM,426701,IMG GD FLD COLL VISCERAL,8937.78,8937.78,536.27,7597.11,37 CDM,426741,CTA ABDOMEN,1603.66,1603.66,96.22,1363.11,14 CDM,426742,CTA ABD AORTA IF LWEX RO,18984.27,18984.27,1139.06,16136.63,14 CDM,427025,SP AORTOGM ABD W/RNF,12082.9,12082.9,724.97,10270.47,17 CDM,427027,INJ CHOLANGIO EXST ACCES,667.72,667.72,40.06,567.56,37 CDM,427040,XR ARTHROGRAM SHLDR LT,4580.26,4580.26,274.82,3893.22,17 CDM,427041,INJ CHOLANGIO NEW ACCES,5019.01,5019.01,301.14,4266.16,37 CDM,427069,INJ ARTHRO ELBOW LT,2140.37,2140.37,128.42,1819.31,37 CDM,427070,INJ ARTHRO ELBOW RT,2140.37,2140.37,128.42,1819.31,37 CDM,427085,XR ARTHROGRAM ELBOW LT,3047.54,3047.54,182.85,2590.41,17 CDM,427115,XR ARTHROGRAM WRIST LT,4580.26,4580.26,274.82,3893.22,17 CDM,427186,SEC ART THRMB NONCOR,6145.37,6145.37,368.72,5223.56,37 CDM,427252,XR ARTHROGRAM HIP RT,4580.26,4580.26,274.82,3893.22,17 CDM,427270,PUNCTURE LUMBAR DX,3739.75,3739.75,224.38,3178.79,37 CDM,427284,INJ MYELOGRAM SPINE,1276.64,1276.64,76.6,1085.14,37 CDM,427304,XR ARTHROGRAM SHLDR RT,4580.26,4580.26,274.82,3893.22,17 CDM,427308,XR ARTHROGRAM ELBOW RT,3047.54,3047.54,182.85,2590.41,17 CDM,427350,INJ ARTHRO SHOULDER,4261.12,4261.12,255.67,3621.95,37 CDM,427352,XR ARTHROGRAM HIP LT,4580.26,4580.26,274.82,3893.22,17 CDM,427358,XR ARTHROGRAM KNEE RT,4580.26,4580.26,274.82,3893.22,17 CDM,427421,TRNSCTH TX ART INI DAY,2673.5,2673.5,160.41,2272.47,37 CDM,427431,ASP/INJ CYST REN/PEL,7949.91,7949.91,476.99,6757.42,37 CDM,427465,SP VENOGRAM EXT UNI LT,11035.55,11035.55,662.13,9380.22,17 CDM,427466,SP VENOGRAM EXT UNI RT,11035.55,11035.55,662.13,9380.22,17 CDM,427500,INJ VENOGRAM LT,1577.18,1577.18,94.63,1340.6,37 CDM,427501,INJ VENOGRAM RT,1577.18,1577.18,94.63,1340.6,37 CDM,427502,INJ VENOGRAM BI,2238.36,2238.36,134.3,1902.61,37 CDM,427503,NEPH CATH EXCHANGE BI,7146.3,7146.3,428.78,6074.35,37 CDM,427504,NEPH CATH EXCHANGE LT,5829.15,5829.15,349.75,4954.78,37 CDM,427505,NEPH CATH EXCHANGE RT,5829.15,5829.15,349.75,4954.78,37 CDM,427523,VERT W FRAC RED & BB TH,41661.26,41661.26,2499.68,35412.07,37 CDM,427524,VERT W FRAC RED & BB LU,38312.21,38312.21,2298.73,32565.38,37 CDM,427530,SP AORTOGM TH W/O FILM,7599.71,7599.71,455.98,6459.75,17 CDM,427568,INS PICC WO PORT/IMG<5Y,4406.16,4406.16,264.37,3745.24,37 CDM,427570,INJ ARTHRO HIP W/O AN LT,1276.64,1276.64,76.6,1085.14,37 CDM,427571,INJ ARTHRO HIP W/O AN RT,1276.64,1276.64,76.6,1085.14,37 CDM,427572,INJ ARTHRO HIP W/O AN BI,1616.38,1616.38,96.98,1373.92,37 CDM,427580,XR ARTHROGRAM KNEE LT,4580.26,4580.26,274.82,3893.22,17 CDM,427581,XR ARTHROGRAM KNEE BI,8796.5,8796.5,527.79,7477.02,17 CDM,427600,SP AORTOGM ABD W/FILM,12082.9,12082.9,724.97,10270.47,17 CDM,427603,INJ ARTHRO HIP W/ANS,1841.13,1841.13,110.47,1564.96,37 CDM,427731,XR ARTHROGRAM WRIST RT,4580.26,4580.26,274.82,3893.22,17 CDM,427809,SP SHUNTOGM NONVASC,2550.69,2550.69,153.04,2168.09,17 CDM,427809,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",2550.69,2550.69,81.86,666.03,29 CDM,428010,XR ABD ACUTE W/CHEST,3507.36,3507.36,210.44,2981.26,17 CDM,428013,XR HAND 2 V RT,1891.62,1891.62,113.5,1607.88,17 CDM,428021,XR HAND 2 V LT,1891.62,1891.62,113.5,1607.88,17 CDM,428025,XR ANKLE 3 + V RT,2315.67,2315.67,138.94,1968.32,17 CDM,428027,XR ANKLE 2 VIEWS RT,1890.35,1890.35,113.42,1606.8,17 CDM,428037,XR SHOULDER 2 + V BI,4784.63,4784.63,287.08,4066.94,17 CDM,428047,DILATE URETERAL STR BLN,23481.25,23481.25,1408.88,19959.06,37 CDM,428052,XR C-SPINE 6 + V,4506.18,4506.18,270.37,3830.25,17 CDM,428058,XR RIBS UNI W/CXR 3+V LT,4877.86,4877.86,292.67,4146.18,17 CDM,428059,XR RIBS UNI W/CXR 3+V RT,4877.86,4877.86,292.67,4146.18,17 CDM,428068,"Radiologic examination, eye, for detection of foreign body ",1687.26,1687.26,32.75,308.86,29 CDM,428068,XR EYE FOREIGN BODY RT,1687.26,1687.26,101.24,1434.17,17 CDM,428086,"Radiologic examination, spine, single view, specify level ",890.25,890.25,24.39,308.86,29 CDM,428086,XR SPINE 1 V SPEC LEVEL,890.25,890.25,53.41,756.71,17 CDM,428100,"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation ",5190.79,5190.79,32.98,267.66,17 CDM,428100,XR CHOLANG INTRAOP,5190.79,5190.79,311.45,4412.17,31 CDM,428108,XR HIP W PEL BI MIN5 VW,3001.57,3001.57,180.09,2551.33,17 CDM,428109,XR HIP W PEL BI 3-4 VIEW,2429.35,2429.35,145.76,2064.95,17 CDM,428114,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",931.12,931.12,42.78,336.48,29 CDM,428114,XR SPINE 1 VIEW,931.12,931.12,55.87,791.45,17 CDM,428116,XR SPINE 2 OR 3 VIEWS,1913.34,1913.34,114.8,1626.34,17 CDM,428117,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",3523.96,3523.96,79.19,688.53,29 CDM,428117,XR SPINE 4 OR 5 VIEWS,3523.96,3523.96,211.44,2995.37,17 CDM,428121,XR FEMUR 1 VIEW LT,1449.69,1449.69,86.98,1232.24,17 CDM,428122,XR FEMUR 1 VIEW RT,1449.69,1449.69,86.98,1232.24,17 CDM,428123,XR FEMUR MIN 2 V LT,1952.93,1952.93,117.18,1659.99,17 CDM,428124,XR FEMUR MIN 2 V RT,1952.93,1952.93,117.18,1659.99,17 CDM,428125,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5055.4,5055.4,153.7,1223.99,29 CDM,428125,XR CONT ENEMA W/WO KUB,5055.4,5055.4,303.32,4297.09,17 CDM,428126,XR ANKLE 3 + V LT,2315.67,2315.67,138.94,1968.32,17 CDM,428127,XR ANKLE 2 VIEWS LT,1890.35,1890.35,113.42,1606.8,17 CDM,428130,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",6608.55,6608.55,175.06,1886.69,29 CDM,428130,XR ENEMA W/ AIR,6608.55,6608.55,396.51,5617.27,17 CDM,428145,"Cystography, minimum of 3 views, radiological supervision and interpretation ",5539.48,5539.48,41.44,1477.76,29 CDM,428145,XR CYSTOGRAM 3 + V,5539.48,5539.48,332.37,4708.56,17 CDM,428154,XR ELBOW 2 VIEWS RT,1774.12,1774.12,106.45,1508.0,17 CDM,428155,XR ELBOW 3 + V RT,2042.34,2042.34,122.54,1735.99,17 CDM,428156,XR ELBOW 3 + V LT,2042.34,2042.34,122.54,1735.99,17 CDM,428170,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",4121.72,4121.72,97.56,808.32,29 CDM,428170,XR ESOPHAGUS,4121.72,4121.72,247.3,3503.46,17 CDM,428185,XR FACIAL BONES < 3 V,2908.32,2908.32,174.5,2472.07,17 CDM,428207,XR FLUORO NDL,4372.07,4372.07,262.32,3716.26,31 CDM,428210,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",3789.63,3789.63,42.78,310.26,29 CDM,428210,XR FLUOROSCOPY 0-60 MIN,3789.63,3789.63,227.38,3221.19,17 CDM,428214,XR FOOT 2 VIEWS RT,1975.92,1975.92,118.56,1679.53,17 CDM,428215,XR FOOT 3 + V RT,2383.37,2383.37,143.0,2025.86,17 CDM,428219,"Radiologic examination, pelvis; complete, minimum of 3 views ",2585.17,2585.17,42.44,433.75,29 CDM,428219,XR PELVIS 3 + V,2585.17,2585.17,155.11,2197.39,17 CDM,428220,XR FOREARM 2 VIEWS RT,2038.51,2038.51,122.31,1732.73,17 CDM,428240,XR HAND 3 + V RT,2066.61,2066.61,124.0,1756.62,17 CDM,428241,XR WRIST 2 VIEWS RT,2859.79,2859.79,171.59,2430.82,17 CDM,428251,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",6404.19,6404.19,175.06,1976.54,29 CDM,428251,XR SMALL BOWEL/ENTERO,6404.19,6404.19,384.25,5443.56,17 CDM,428254,XR ELBOW 2 VIEWS LT,1774.12,1774.12,106.45,1508.0,17 CDM,428255,XR HUMERUS 2 + V RT,1922.28,1922.28,115.34,1633.94,17 CDM,428264,XR KNEE 1 OR 2 V RT,1837.98,1837.98,110.28,1562.28,17 CDM,428265,XR KNEE 3 V RT,2246.7,2246.7,134.8,1909.69,17 CDM,428266,XR KNEE 4 + V RT,2919.82,2919.82,175.19,2481.85,17 CDM,428267,XR KNEE AP STAND BI,4025.93,4025.93,241.56,3422.04,17 CDM,428280,XR TIBIA/FIBULA 2 V RT,2185.39,2185.39,131.12,1857.58,17 CDM,428295,PUNCTURE LUMBAR DX,3739.75,3739.75,224.38,3178.79,37 CDM,428305,XR TIB/FIB INFNT 2V RT,1711.53,1711.53,102.69,1454.8,17 CDM,428310,XR MANDIBLE < 4 V,1504.61,1504.61,90.28,1278.92,17 CDM,428314,XR FOOT 2 VIEWS LT,1975.92,1975.92,118.56,1679.53,17 CDM,428315,XR MANDIBLE 4 + V,2702.69,2702.69,162.16,2297.29,17 CDM,428316,XR FOOT 3 + V LT,2383.37,2383.37,143.0,2025.86,17 CDM,428321,XR FOREARM 2 VIEWS LT,2038.51,2038.51,122.31,1732.73,17 CDM,428325,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",6065.71,6065.71,99.9,819.5,29 CDM,428325,XR BONE SURVEY COMP,6065.71,6065.71,363.94,5155.85,17 CDM,428326,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",3925.02,3925.02,124.96,1175.27,29 CDM,428326,XR SWLW FUNC W/C&V,3925.02,3925.02,235.5,3336.27,17 CDM,428335,CONT INJ GS/ DU/ JJ/ GJ/,3624.76,3624.76,217.49,3081.05,37 CDM,428341,XR HAND 3 + V LT,2066.61,2066.61,124.0,1756.62,17 CDM,428345,XR NASAL BONES COMP,1821.38,1821.38,109.28,1548.17,17 CDM,428350,XR NECK SOFT TISSUE,1729.41,1729.41,103.76,1470.0,17 CDM,428359,XR TIB/FIB INFANT 2V BI,2098.54,2098.54,125.91,1783.76,17 CDM,428375,"Radiologic examination; orbits, complete, minimum of 4 views ",2771.66,2771.66,48.11,433.75,29 CDM,428375,XR ORBITS 4 + V,2771.66,2771.66,166.3,2355.91,17 CDM,428376,XR KNEE 3 V LT,2246.7,2246.7,134.8,1909.69,17 CDM,428377,XR KNEE 4 + V LT,2919.82,2919.82,175.19,2481.85,17 CDM,428380,XR CALCANEUS 2 + V LT,1891.62,1891.62,113.5,1607.88,17 CDM,428387,"Radiologic examination from nose to rectum for foreign body, single view, child ",2125.36,2125.36,80.9,308.86,29 CDM,428387,XR WHOLE BODY FB 1 V,2125.36,2125.36,127.52,1806.56,17 CDM,428390,XR PELVIS 1/2 VIEWS,2004.03,2004.03,120.24,1703.43,17 CDM,428410,"Urography, retrograde, with or without KUB ",10289.62,10289.62,77.19,587.37,29 CDM,428410,XR UROGRAM RETRO,10289.62,10289.62,617.38,8746.18,17 CDM,428435,XR RIBS BI 3 V,4877.86,4877.86,292.67,4146.18,17 CDM,428445,"Radiologic examination, sacroiliac joints; 3 or more views ",2246.7,2246.7,39.43,433.75,29 CDM,428445,XR SI JOINTS 3 + V,2246.7,2246.7,134.8,1909.69,17 CDM,428450,XR SACRUM/COCCYX 2 + V,2075.55,2075.55,124.53,1764.22,17 CDM,428455,"Hysterosalpingography, radiological supervision and interpretation ",4658.17,4658.17,66.83,901.86,29 CDM,428455,XR HYSTROSALPNGOGRAM,4658.17,4658.17,279.49,3959.44,17 CDM,428463,XR WRIST 2 VIEWS LT,2859.79,2859.79,171.59,2430.82,17 CDM,428466,XR HUMERUS 2 + V LT,1922.28,1922.28,115.34,1633.94,17 CDM,428474,XR SHOULDER 1 V RT,1871.19,1871.19,112.27,1590.51,17 CDM,428475,XR SHOULDER 2 + V RT,2393.59,2393.59,143.62,2034.55,17 CDM,428481,XR TIBIA/FIBULA 2 V LT,2185.39,2185.39,131.12,1857.58,17 CDM,428485,XR SINUSES < 3 V,2185.39,2185.39,131.12,1857.58,17 CDM,428490,XR SINUSES 3 + V,3569.95,3569.95,214.2,3034.46,17 CDM,428495,XR SKULL < 4 V,2140.69,2140.69,128.44,1819.59,17 CDM,428500,XR SKULL 4 + V,3995.28,3995.28,239.72,3395.99,17 CDM,428505,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",5600.79,5600.79,121.96,980.55,29 CDM,428505,XR SMALL INTESTINE,5600.79,5600.79,336.05,4760.67,17 CDM,428510,XR C-SPINE 2-3 VIEWS,2172.63,2172.63,130.36,1846.74,17 CDM,428515,"Radiologic examination, spine, cervical; 4 or 5 views ",4062.97,4062.97,53.46,448.81,29 CDM,428515,XR C-SPINE 4-5 V,4062.97,4062.97,243.78,3453.52,17 CDM,428516,INJ CYSTO/URETH,1024.44,1024.44,61.47,870.77,37 CDM,428520,XR T-SPINE 3 VIEWS,3563.56,3563.56,213.81,3029.03,17 CDM,428525,XR L-SPINE 4 + VIEWS,4139.61,4139.61,248.38,3518.67,17 CDM,428535,XR L-SPINE 2/3 VIEWS,2222.43,2222.43,133.35,1889.07,17 CDM,428545,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",2290.13,2290.13,41.44,347.79,29 CDM,428545,XR SC JOINTS 3 + V,2290.13,2290.13,137.41,1946.61,17 CDM,428550,XR STERNUM 2 + V,2136.86,2136.86,128.21,1816.33,17 CDM,428555,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",3263.4,3263.4,53.13,471.31,29 CDM,428555,XR TMJ BI,3263.4,3263.4,195.8,2773.89,17 CDM,428576,XR KNEE 1 OR 2 V LT,1837.98,1837.98,110.28,1562.28,17 CDM,428580,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",6364.59,6364.59,139.34,1137.87,29 CDM,428580,XR UGI DBL CONTRAST,6364.59,6364.59,381.88,5409.9,17 CDM,428590,"Urethrocystography, voiding, radiological supervision and interpretation ",5086.05,5086.05,104.25,1021.68,29 CDM,428590,XR CYSTOURETHRO VDNG,5086.05,5086.05,305.16,4323.14,17 CDM,428600,XR TIB/FIB INFNT 2V LT,1711.53,1711.53,102.69,1454.8,17 CDM,428602,XR UP EXTREM INFANT2V LT,1899.29,1899.29,113.96,1614.4,17 CDM,428603,XR UP EXTREM INFANT2V RT,1899.29,1899.29,113.96,1614.4,17 CDM,428605,XR CLAVICLE COMP LT,1922.28,1922.28,115.34,1633.94,17 CDM,428606,XR WRIST 3 + V RT,1915.9,1915.9,114.95,1628.52,17 CDM,428608,XR CLAVICLE COMP RT,1922.28,1922.28,115.34,1633.94,17 CDM,428609,XR SCAPULA COMP LT,2044.89,2044.89,122.69,1738.16,17 CDM,428610,ARTH JNTBRS MJR WO US,1886.0,1886.0,113.16,1603.1,37 CDM,428611,XR SCAPULA COMP RT,2044.89,2044.89,122.69,1738.16,17 CDM,428612,XR RIBS UNI 2 V LT,2356.55,2356.55,141.39,2003.07,17 CDM,428613,XR RIBS UNI 2 V RT,2356.55,2356.55,141.39,2003.07,17 CDM,428648,I123 SOD DX 100-999 UCI,2768.75,2768.75,166.13,2353.44,41 CDM,428648,"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries ",2768.75,2768.75,262.23,486.35,8 CDM,428653,XR CALCANEUS 2 + V RT,1891.62,1891.62,113.5,1607.88,17 CDM,428660,Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code,6824.41,6824.41,121.14,864.48,17 CDM,428660,XR FLUORO FOR SPINE INJ,6824.41,6824.41,409.46,5800.75,31 CDM,428685,XR SHOULDER 1 V LT,1871.19,1871.19,112.27,1590.51,17 CDM,428686,XR SHOULDER 2 + V LT,2393.59,2393.59,143.62,2034.55,17 CDM,428701,XR FACIAL BONES 3 + V,2213.49,2213.49,132.81,1881.47,17 CDM,428720,XR T-L-SPINE 2 VIEWS,3997.83,3997.83,239.87,3398.16,17 CDM,428740,INJ CHOLANGIO EXST ACCES,667.72,667.72,40.06,567.56,37 CDM,428742,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5225.28,5225.28,122.96,988.0,29 CDM,428742,XR UGI SNGL CONTRAST,5225.28,5225.28,313.52,4441.49,17 CDM,428759,XR TIBIA/FIBULA 2 V BI,4368.23,4368.23,262.09,3713.0,17 CDM,428760,"Bone length studies (orthoroentgenogram, scanogram) ",2628.6,2628.6,45.11,433.75,29 CDM,428760,XR BONE LENGTH STUDIES,2628.6,2628.6,157.72,2234.31,17 CDM,428818,XR WRIST 3 + V LT,1915.9,1915.9,114.95,1628.52,17 CDM,428900,RADIOPHM THPY ORAL ADMIN,1373.03,1373.03,82.38,1167.08,17 CDM,428900,"Radiopharmaceutical therapy, by oral administration ",1373.03,1373.03,89.44,564.48,29 CDM,428902,XR FLUORO NDL,12759.84,12759.84,765.59,10845.86,31 CDM,428998,FLUORO GUID CTRL ACC DEV,13882.56,13882.56,832.95,11800.18,31 CDM,428998,"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any",13882.56,13882.56,128.13,950.6,17 CDM,429000,US ABDOMEN COMPLETE,5487.71,5487.71,329.26,4664.55,16 CDM,429006,PARACENTESIS W IMAGE,7251.0,7251.0,435.06,6163.35,37 CDM,429023,FINE NDL ASP WUS 1ST LSN,11548.55,11548.55,692.91,9816.27,37 CDM,429031,US EXTREM NON VASC LTD,2870.09,2870.09,172.21,2439.58,16 CDM,429033,US JOINT COMP,3435.78,3435.78,206.15,2920.41,16 CDM,429033,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",3435.78,3435.78,96.28,317.84,30 CDM,429035,Fetal biophysical profile; with non-stress testing ,4989.91,4989.91,104.75,721.67,30 CDM,429035,US FETAL BIOPHYS PROF,4989.91,4989.91,299.39,4241.42,16 CDM,429042,USG NDL PLACEMENT,11055.22,11055.22,663.31,9396.94,28 CDM,429042,"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation ",11055.22,11055.22,44.4,306.53,17 CDM,429046,US INTRAOPERATIVE,2346.09,2346.09,140.77,1994.18,28 CDM,429046,"Ultrasonic guidance, intraoperative ",2346.09,2346.09,114.8,669.23,17 CDM,429050,US RETRO LTD,4926.79,4926.79,295.61,4187.77,16 CDM,429051,US PREGNANCY LTD,3022.53,3022.53,181.35,2569.15,16 CDM,429054,US BRST BI W AX LTD,5958.12,5958.12,357.49,5064.4,16 CDM,429057,US BRST UNI LT W AX LTD,5892.62,5892.62,353.56,5008.73,16 CDM,429059,US BRST UNI RT W AX LTD,5892.62,5892.62,353.56,5008.73,16 CDM,429065,US PELVIC COMPLETE,4793.42,4793.42,287.61,4074.41,16 CDM,429066,US PELVIC LTD OR FU,1050.39,1050.39,63.02,892.83,16 CDM,429080,US PREG AFTER 1ST TRI,4311.09,4311.09,258.67,3664.43,16 CDM,429085,US RETROPERITONEAL COM,4506.4,4506.4,270.38,3830.44,16 CDM,429095,US SCROTUM AND CNTS,3666.82,3666.82,220.01,3116.8,16 CDM,429100,US CHST W/MEDIASTINUM,5319.79,5319.79,319.19,4521.82,16 CDM,429103,THORACENTESIS W/ IMAG,6504.0,6504.0,390.24,5528.4,37 CDM,429105,US HEAD AND NECK,3587.03,3587.03,215.22,3048.98,16 CDM,429106,BX SALIVARY GLAND NDL,3402.63,3402.63,204.16,2892.24,37 CDM,429108,BX ABD/RETROPERITO,10334.63,10334.63,620.08,8784.44,37 CDM,429109,US GUIDANCE VASC ACCESS,4596.91,4596.91,275.81,3907.37,28 CDM,429110,US TRANSVAGINAL,2568.79,2568.79,154.13,2183.47,16 CDM,429111,ASP/INJ THYROID CYST,5448.9,5448.9,326.93,4631.56,37 CDM,429112,BX SOFT TISS NECK/THORAX,11261.07,11261.07,675.66,9571.91,37 CDM,429115,US ABDOMEN LTD,2624.76,2624.76,157.49,2231.05,16 CDM,429116,BX THYROID,13275.99,13275.99,796.56,11284.59,37 CDM,429118,BX RENAL,10465.0,10465.0,627.9,8895.25,37 CDM,429130,BX LIVER,13275.99,13275.99,796.56,11284.59,37 CDM,429160,RAD WOUND PROCEDURE,8938.0,8938.0,536.28,7597.3,37 CDM,429800,US SPINAL CANAL,4966.09,4966.09,297.97,4221.18,16 CDM,429800,"Ultrasound, spinal canal and contents ",4966.09,4966.09,104.75,984.27,30 CDM,429802,US PRG 1ST TRI EA ADD,3071.36,3071.36,184.28,2610.66,21 CDM,429802,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",3071.36,3071.36,38.68,239.58,30 CDM,429803,US PREG 1ST TRIMTR,3818.06,3818.06,229.08,3245.35,16 CDM,429817,US PREG UT TRANSVAGINAL,2992.76,2992.76,179.57,2543.85,16 CDM,429975,DUP AB/PEL/SC COMP,3782.02,3782.02,226.92,3214.72,33 CDM,429975,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",3782.02,3782.02,230.13,726.36,18 CDM,432025,TISS CULT NEOPLAS BM BLD,5892.35,5892.35,353.54,5008.5,14 CDM,432025,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",5892.35,5892.35,120.75,988.71,76 CDM,432035,CHROM & KARY 15-20 2 KAR,9625.86,9625.86,577.55,8181.98,14 CDM,432035,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",9625.86,9625.86,105.41,863.1,76 CDM,432037,CHROM ANAL 20-25 CELLS,1192.19,1192.19,71.53,1013.36,14 CDM,432037,Chromosome analysis; analyze 20-25 cells ,1192.19,1192.19,121.47,994.6,76 CDM,432088,IHC EA MULTIPLEX AB PROC,4335.0,4335.0,260.1,3684.75,23 CDM,432088,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",4335.0,4335.0,572.49,954.87,17 CDM,432145,FC 1ST MARK,799.19,799.19,47.95,679.31,23 CDM,432145,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",799.19,799.19,362.2,904.08,17 CDM,432160,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,702.0,702.0,18.2,60.91,17 CDM,432160,PATH DECALCIFICATION,702.0,702.0,42.12,596.7,28 CDM,432175,IHC AB STAIN,4109.0,4109.0,246.54,3492.65,23 CDM,432175,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",4109.0,4109.0,289.87,479.74,17 CDM,432185,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",1039.0,1039.0,99.93,630.69,17 CDM,432185,FNA INTERP & REPORT,1039.0,1039.0,62.34,883.15,23 CDM,432190,PATH CONSULT FS 1 SPEC,2246.0,2246.0,134.76,1909.1,23 CDM,432190,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",2246.0,2246.0,217.35,457.76,17 CDM,432195,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",808.0,808.0,103.11,457.76,17 CDM,432195,FNA SAMPLE ADEQUACY IMM,808.0,808.0,48.48,686.8,23 CDM,432230,"Level I - Surgical pathology, gross examination only ",597.0,597.0,46.44,78.1,17 CDM,432230,SURG PATH LEVEL 1,597.0,597.0,35.82,507.45,23 CDM,432240,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",1452.0,1452.0,46.44,178.47,17 CDM,432240,SURG PATH LEVEL 2,1452.0,1452.0,87.12,1234.2,23 CDM,432250,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",1452.0,1452.0,99.93,217.65,17 CDM,432250,SURG PATH LEVEL 3,1452.0,1452.0,87.12,1234.2,23 CDM,432260,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",1853.0,1853.0,99.93,244.62,17 CDM,432260,SURG PATH LEVEL 4,1853.0,1853.0,111.18,1575.05,23 CDM,432270,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",2555.0,2555.0,572.49,1473.25,17 CDM,432270,SURG PATH LEVEL 5,2555.0,2555.0,153.3,2171.75,23 CDM,432280,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",2751.0,2751.0,1268.96,2100.23,17 CDM,432280,SURG PATH LEVEL 6,2751.0,2751.0,165.06,2338.35,23 CDM,432285,CYTO FWB SMEAR & INTERP,1039.0,1039.0,62.34,883.15,23 CDM,432285,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",1039.0,1039.0,67.53,288.69,17 CDM,432350,PATH STAIN GROUP 1,895.0,895.0,53.7,760.75,23 CDM,432350,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",895.0,895.0,99.93,624.27,17 CDM,432360,PATH STAIN GROUP 2,1112.0,1112.0,66.72,945.2,23 CDM,432360,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",1112.0,1112.0,67.53,496.85,17 CDM,432415,PATH CONSULT FS EA ADDTL,675.0,675.0,40.5,573.75,28 CDM,432415,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,675.0,675.0,44.4,173.58,17 CDM,432455,CHROM ADDTL KARYOTYPE,1528.47,1528.47,91.71,1299.2,14 CDM,432455,"Chromosome analysis; additional karyotypes, each study ",1528.47,1528.47,28.11,230.23,76 CDM,432890,FC ADD,109.46,109.46,6.57,93.04,28 CDM,432890,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",109.46,109.46,50.24,156.75,17 CDM,432891,BORRELIA BURGDORFERI AMP,1746.0,1746.0,104.76,1484.1,14 CDM,432891,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",1746.0,1746.0,29.48,241.36,76 CDM,432892,METANEPHRINES FRACT,1580.0,1580.0,94.8,1343.0,14 CDM,432892,Metanephrines ,1580.0,1580.0,14.23,116.47,76 CDM,432895,AMINO ACIDS QN 6 OR MORE,1772.46,1772.46,106.35,1506.59,14 CDM,432895,"Amino acids, 6 or more amino acids, quantitative, each specimen ",1772.46,1772.46,14.17,116.02,76 CDM,434001,MRI ABDOMEN W&WO CONT,28516.08,28516.08,1710.96,24238.67,14 CDM,434001,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",28516.08,28516.08,348.5,2739.0,33 CDM,434003,INJ ARTHRO WRIST LT,2140.37,2140.37,128.42,1819.31,37 CDM,434004,INJ ARTHRO WRIST RT,2140.37,2140.37,128.42,1819.31,37 CDM,434006,INJ ARTHRO WRIST BI,3099.47,3099.47,185.97,2634.55,37 CDM,434010,MRI ABDOMEN W/O CONT,26401.51,26401.51,1584.09,22441.28,14 CDM,434010,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",26401.51,26401.51,201.81,2739.0,33 CDM,434015,MRI BRAIN W/O CONTRAST,17453.95,17453.95,1047.24,14835.86,14 CDM,434015,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",17453.95,17453.95,202.15,2739.0,33 CDM,434022,MRI UP EX W&WO CONT RT,14543.55,14543.55,872.61,12362.02,14 CDM,434035,MRI C-SPINE W&W/O CONT,34340.47,34340.47,2060.43,29189.4,14 CDM,434035,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",34340.47,34340.47,329.79,2739.0,33 CDM,434040,MRI C-SPINE W/O CONT,18977.06,18977.06,1138.62,16130.5,14 CDM,434040,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",18977.06,18977.06,196.48,2739.0,33 CDM,434045,MRI CHEST W/O CONT,18791.93,18791.93,1127.52,15973.14,14 CDM,434045,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",18791.93,18791.93,233.47,2739.0,33 CDM,434055,MRI OR/FCE/NCK W/O CONT,17691.97,17691.97,1061.52,15038.17,14 CDM,434055,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",17691.97,17691.97,233.23,2739.0,33 CDM,434090,MRI L-SPINE W/O CONT,18235.34,18235.34,1094.12,15500.04,14 CDM,434090,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",18235.34,18235.34,197.14,2739.0,33 CDM,434095,MRI L-SPINE W&W/O CONT,33304.22,33304.22,1998.25,28308.59,14 CDM,434095,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",33304.22,33304.22,329.13,2739.0,33 CDM,434111,MRI UP JNT W&WO CONT LT,21415.01,21415.01,1284.9,18202.76,14 CDM,434122,MRI UP JNT W/O CONT LT,19145.36,19145.36,1148.72,16273.56,14 CDM,434123,MRI UP JNT W&WO CONT RT,21415.01,21415.01,1284.9,18202.76,14 CDM,434126,MRI BRAIN W&WO CONT,32201.85,32201.85,1932.11,27371.57,14 CDM,434126,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",32201.85,32201.85,328.11,2739.0,33 CDM,434140,MRI T-SPINE W/O CONT,18442.1,18442.1,1106.53,15675.78,14 CDM,434140,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",18442.1,18442.1,196.14,2739.0,33 CDM,434145,MRI T-SPINE W&W/O CONT,33586.73,33586.73,2015.2,28548.72,14 CDM,434145,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",33586.73,33586.73,330.45,2739.0,33 CDM,434150,MRI TMJ,16191.69,16191.69,971.5,13762.94,14 CDM,434150,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",16191.69,16191.69,233.47,2739.0,33 CDM,434182,MRI UPPER EX W/O CONT LT,10003.04,10003.04,600.18,8502.58,14 CDM,434200,MRA WO FOL W CONT PELVIS,26401.51,26401.51,1584.09,22441.28,32 CDM,434200,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",26401.51,26401.51,672.06,2739.0,8 CDM,434205,MRA HD W&WO CONTRAST,21079.61,21079.61,1264.78,17917.67,14 CDM,434205,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",21079.61,21079.61,340.15,2739.0,33 CDM,434210,MRA HD W/O CONT,18939.79,18939.79,1136.39,16098.82,14 CDM,434210,"Magnetic resonance angiography, head; without contrast material(s) ",18939.79,18939.79,222.2,2739.0,33 CDM,434212,MRI UP JNT W/O CONT RT,19145.36,19145.36,1148.72,16273.56,14 CDM,434215,MRA NECK W&WO CONT,28512.47,28512.47,1710.75,24235.6,14 CDM,434215,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",28512.47,28512.47,356.19,2739.0,33 CDM,434219,MRI PELVIS W/O CONT,15576.19,15576.19,934.57,13239.76,14 CDM,434219,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",15576.19,15576.19,233.47,2739.0,33 CDM,434222,MRI UP EX W&WO CONT LT,14543.55,14543.55,872.61,12362.02,14 CDM,434235,MRA W/O FOL W/CONT ABD,28516.08,28516.08,1710.96,24238.67,32 CDM,434235,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",28516.08,28516.08,672.06,2739.0,8 CDM,434265,MRA NECK W/O CONT,18939.79,18939.79,1136.39,16098.82,14 CDM,434265,"Magnetic resonance angiography, neck; without contrast material(s) ",18939.79,18939.79,222.54,2739.0,33 CDM,434273,MRI LW JNT W/O CONT LT,18384.41,18384.41,1103.06,15626.75,14 CDM,434281,MRI UPPER EX W/O CONT RT,10003.04,10003.04,600.18,8502.58,14 CDM,434297,MRI PELVIS W&WO CONT,21416.21,21416.21,1284.97,18203.78,14 CDM,434297,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",21416.21,21416.21,347.16,2739.0,33 CDM,434372,MRI LOW EXT W&WO CONT LT,14024.22,14024.22,841.45,11920.59,14 CDM,434378,MRI BRAIN W/CONTRAST,18326.7,18326.7,1099.6,15577.69,14 CDM,434378,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",18326.7,18326.7,278.66,2739.0,33 CDM,434472,MRI LW JNT W&WO CONT RT,19719.98,19719.98,1183.2,16761.98,14 CDM,434543,MRI OR/FCE/NCK W&WO,26021.63,26021.63,1561.3,22118.39,14 CDM,434543,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",26021.63,26021.63,349.16,2739.0,33 CDM,434552,MRI CHEST W&WO CONT,23100.42,23100.42,1386.03,19635.36,14 CDM,434552,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",23100.42,23100.42,366.42,2739.0,33 CDM,434718,MRI LOW EXT W/O CONT LT,10003.04,10003.04,600.18,8502.58,14 CDM,434721,MRI LOW EXT W&WO CONT RT,14024.22,14024.22,841.45,11920.59,14 CDM,434723,MRI LW JNT W&WO CONT LT,19719.98,19719.98,1183.2,16761.98,14 CDM,434737,MRI LW JNT W/O CONT RT,18384.41,18384.41,1103.06,15626.75,14 CDM,434781,MRI LOW EXT W/O CONT RT,10003.04,10003.04,600.18,8502.58,14 CDM,434896,MRA W/O FOL W/CONT CHEST,26264.47,26264.47,1575.87,22324.8,32 CDM,434896,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",26264.47,26264.47,672.06,2739.0,8 CDM,436001,STREP PNEUMO AG OIA,701.6,701.6,42.1,596.36,14 CDM,436006,CULTURE EAR,899.0,899.0,53.94,764.15,14 CDM,436008,CULTURE RESPIRATORY,915.0,915.0,54.9,777.75,14 CDM,436009,CULTURE GENITAL,900.0,900.0,54.0,765.0,14 CDM,436010,5 HIAA,754.0,754.0,45.24,640.9,14 CDM,436010,"Hydroxyindolacetic acid, 5-(HIAA) ",754.0,754.0,10.84,88.69,76 CDM,436022,AMIODARONE QN,1547.0,1547.0,92.82,1314.95,27 CDM,436022,Amiodarone ,1547.0,1547.0,15.66,59.46,63 CDM,436028,BARTONELLA Q IGG,98.91,98.91,5.93,84.07,14 CDM,436029,BARTONELLA Q IGM,98.91,98.91,5.93,84.07,14 CDM,436031,PHOSPHATIDYLSER AB IGM,526.2,526.2,31.57,447.27,14 CDM,436037,Antibody; Coxiella burnetii (Q fever) ,1325.39,1325.39,10.18,83.35,76 CDM,436037,Q FEVER AB QUAL,1325.39,1325.39,79.52,1126.58,14 CDM,436040,ABO TYPE,347.0,347.0,20.82,294.95,15 CDM,436040,"Blood typing, serologic; ABO ",347.0,347.0,2.51,347.81,74 CDM,436043,BARTONELLA H IGG,98.91,98.91,5.93,84.07,14 CDM,436044,BARTONELLA H IGM,98.91,98.91,5.93,84.07,14 CDM,436058,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",2216.0,2216.0,61.63,504.63,76 CDM,436058,F5 GENE LEIDEN VARIANT,2216.0,2216.0,132.96,1883.6,14 CDM,436062,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",2215.57,2215.57,55.18,451.78,76 CDM,436062,F2 GENE 20210G>A VARIANT,2215.57,2215.57,132.93,1883.23,14 CDM,436067,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",1747.0,1747.0,76.99,630.42,74 CDM,436067,JAK2 V617F VARIANT,1747.0,1747.0,104.82,1484.95,15 CDM,436068,TACROLIMUS QUANT,736.0,736.0,44.16,625.6,14 CDM,436068,Tacrolimus ,736.0,736.0,11.53,94.39,76 CDM,436072,Antibody; Borrelia burgdorferi (Lyme disease) ,495.86,495.86,14.31,117.11,76 CDM,436072,LYME DISEASE AB QL,495.86,495.86,29.75,421.48,14 CDM,436073,T GONDII AMP PROBE,1962.36,1962.36,117.74,1668.01,14 CDM,436075,FUNGAL MIC,624.0,624.0,37.44,530.4,14 CDM,436079,ACETAMINOPHEN QN,1304.28,1304.28,78.26,1108.64,27 CDM,436079,Acetaminophen ,1304.28,1304.28,15.66,59.46,63 CDM,436085,SUSC MIC,930.0,930.0,55.8,790.5,14 CDM,436086,"Clotting; factor VIII, VW factor antigen ",1515.3,1515.3,19.27,157.74,76 CDM,436086,FACTOR 8 VW AG,1515.3,1515.3,90.92,1288.01,14 CDM,436089,"Alkaloids, not otherwise specified ",494.54,494.54,0.07,21.36,24 CDM,436089,NICOTINE BLD,494.54,494.54,29.67,420.36,27 CDM,436095,CULTURE BONE MARROW,987.78,987.78,59.27,839.61,14 CDM,436121,CA 27-29 QN,1152.62,1152.62,69.16,979.73,14 CDM,436130,AFB IDENTIFICATION,1208.01,1208.01,72.48,1026.81,14 CDM,436130,"Culture, mycobacterial, definitive identification, each isolate ",1208.01,1208.01,12.27,100.45,76 CDM,436135,MACRO EXAM PARASITE,257.16,257.16,15.43,218.59,14 CDM,436135,Macroscopic examination; parasite ,257.16,257.16,3.62,29.68,76 CDM,436140,SUSC AFB PROP EA AGENT,978.55,978.55,58.71,831.77,14 CDM,436140,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",978.55,978.55,6.14,50.32,76 CDM,436150,SMEAR AFB,241.34,241.34,14.48,205.14,14 CDM,436160,ALBUMIN SERUM QN,346.0,346.0,20.76,294.1,14 CDM,436160,"Albumin; serum, plasma or whole blood ",346.0,346.0,4.16,34.03,76 CDM,436166,IHC AB STAIN EA ADD,1005.0,1005.0,60.3,854.25,28 CDM,436166,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",1005.0,1005.0,130.31,435.94,17 CDM,436170,CULTURE SPUTUM,1304.28,1304.28,78.26,1108.64,14 CDM,436176,CYTOLOGY CONC & INTERP,226.0,226.0,13.56,192.1,23 CDM,436176,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",226.0,226.0,67.53,303.36,17 CDM,436181,ETHYLENE GLYCOL,658.08,658.08,39.48,559.37,14 CDM,436181,Ethylene glycol ,658.08,658.08,12.52,102.45,76 CDM,436190,INF AGENT CONCENTRATION,146.39,146.39,8.78,124.43,14 CDM,436200,ALDOLASE,992.0,992.0,59.52,843.2,14 CDM,436200,Aldolase ,992.0,992.0,8.16,66.79,76 CDM,436204,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",1883.0,1883.0,34.22,137.2,17 CDM,436204,TOUCH PREP EA ADD SITE,1883.0,1883.0,112.98,1600.55,28 CDM,436206,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",3242.0,3242.0,172.06,2003.96,17 CDM,436206,TOUCH PREP INITIAL SITE,3242.0,3242.0,194.52,2755.7,23 CDM,436210,ALDOSTERONE QN,2531.0,2531.0,151.86,2151.35,14 CDM,436214,BONE MARROW TECH ASSIST,1499.0,1499.0,89.94,1274.15,23 CDM,436214,"Bone marrow, smear interpretation ",1499.0,1499.0,253.19,2003.96,17 CDM,436217,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",377.17,377.17,82.41,674.77,76 CDM,436217,PAMG-1 CVS QL,377.17,377.17,22.63,320.59,14 CDM,436220,ALK PHOS ISOENZYMES,1612.88,1612.88,96.77,1370.95,14 CDM,436220,"Phosphatase, alkaline; isoenzymes ",1612.88,1612.88,12.42,101.63,76 CDM,436225,CULTURE BODY FLUID,988.0,988.0,59.28,839.8,14 CDM,436230,ALK PHOS (ALP),808.0,808.0,48.48,686.8,14 CDM,436230,"Phosphatase, alkaline; ",808.0,808.0,4.35,35.66,76 CDM,436250,A-1-ANTITRYPSIN TOT,410.0,410.0,24.6,348.5,14 CDM,436250,Alpha-1-antitrypsin; total ,410.0,410.0,11.29,92.4,76 CDM,436260,ALPHA FETOPROT SERUM,1401.0,1401.0,84.06,1190.85,14 CDM,436260,Alpha-fetoprotein (AFP); serum ,1401.0,1401.0,14.09,115.39,76 CDM,436280,AMIKACIN QUANT,736.0,736.0,44.16,625.6,14 CDM,436320,AMMONIA,597.0,597.0,35.82,507.45,14 CDM,436320,Ammonia ,597.0,597.0,12.24,100.18,76 CDM,436330,AMOEBIC AB,410.15,410.15,24.61,348.63,14 CDM,436330,"Antibody; protozoa, not elsewhere specified ",410.15,410.15,10.41,85.25,76 CDM,436360,AMYLASE BLD,1033.93,1033.93,62.04,878.84,14 CDM,436380,AMYLASE UR,625.1,625.1,37.51,531.34,14 CDM,436385,HISTOPLASMA CAPS AG EIA,733.0,733.0,43.98,623.05,14 CDM,436385,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",733.0,733.0,11.13,91.13,76 CDM,436410,ANGIOTENSIN I CONV ENZ,1350.44,1350.44,81.03,1147.87,14 CDM,436410,Angiotensin I - converting enzyme (ACE) ,1350.44,1350.44,12.26,100.45,76 CDM,436420,ANTISTREPTOLYSIN O QN,716.11,716.11,42.97,608.69,14 CDM,436420,Antistreptolysin 0; titer ,716.11,716.11,6.13,50.23,76 CDM,436480,RNP ANTIBODY,958.76,958.76,57.53,814.95,14 CDM,436510,ANTIBODY SCREEN EA,597.41,597.41,35.84,507.8,21 CDM,436510,"Antibody screen, RBC, each serum technique ",597.41,597.41,9.57,157.81,62 CDM,436520,ANTI-CCP,454.0,454.0,27.24,385.9,14 CDM,436520,"Cyclic citrullinated peptide (CCP), antibody ",454.0,454.0,10.88,89.05,76 CDM,436529,HERPES SIMP AMP PROBE,1099.0,1099.0,65.94,934.15,14 CDM,436529,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",1099.0,1099.0,29.48,241.36,76 CDM,436530,ADH (VASOPRESSIN),498.5,498.5,29.91,423.73,14 CDM,436530,"Vasopressin (antidiuretic hormone, ADH) ",498.5,498.5,28.51,233.4,76 CDM,436540,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",347.0,347.0,3.22,904.08,74 CDM,436540,RBC ANTIGEN TYPING EA,347.0,347.0,20.82,294.95,15 CDM,436560,ANA QUAL SCREEN,1170.0,1170.0,70.2,994.5,14 CDM,436560,Antinuclear antibodies (ANA); ,1170.0,1170.0,10.16,83.17,76 CDM,436590,ARSENIC BLD,873.04,873.04,52.38,742.08,14 CDM,436590,Arsenic ,873.04,873.04,15.93,130.5,76 CDM,436602,Antibody identification; leukocyte antibodies ,895.46,895.46,12.64,103.53,76 CDM,436602,NEUTROPHIL AB,895.46,895.46,53.73,761.14,14 CDM,436614,C-REACTIVE PROTEIN HS,298.0,298.0,17.88,253.3,14 CDM,436614,C-reactive protein; high sensitivity (hsCRP) ,298.0,298.0,10.88,89.05,76 CDM,436615,HYDROXYPROG 17D,466.85,466.85,28.01,396.82,14 CDM,436615,"Hydroxyprogesterone, 17-d ",466.85,466.85,22.82,186.88,76 CDM,436616,CHROMOGRANIN A IA QN,680.5,680.5,40.83,578.42,14 CDM,436730,BILIRUBIN DIRECT,702.0,702.0,42.12,596.7,14 CDM,436730,Bilirubin; direct ,702.0,702.0,4.22,34.57,76 CDM,436735,HEP BE AG EIA,70.0,70.0,4.2,59.5,14 CDM,436735,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",70.0,70.0,9.69,79.28,76 CDM,436750,Antibody; Blastomyces ,775.0,775.0,10.84,88.69,76 CDM,436750,BLASTOMYCES AB QUAL,775.0,775.0,46.5,658.75,14 CDM,436780,BUN,622.47,622.47,37.35,529.1,14 CDM,436798,EBV AMP PROBE,1102.51,1102.51,66.15,937.13,14 CDM,436801,NATRIURETIC PEPTIDE,1958.0,1958.0,117.48,1664.3,14 CDM,436805,C DIFFICILE TOXIN AG EIA,1297.69,1297.69,77.86,1103.04,14 CDM,436805,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",1297.69,1297.69,10.06,82.36,76 CDM,436810,C-PEPTIDE,673.0,673.0,40.38,572.05,14 CDM,436810,C-peptide ,673.0,673.0,17.48,143.17,76 CDM,436820,C-REACTIVE PROTEIN,253.0,253.0,15.18,215.05,14 CDM,436820,C-reactive protein; ,253.0,253.0,4.35,35.66,76 CDM,436850,CA 125 QN,960.0,960.0,57.6,816.0,14 CDM,436850,"Immunoassay for tumor antigen, quantitative; CA 125 ",960.0,960.0,17.48,143.17,76 CDM,436860,CA 15-3 QN,688.0,688.0,41.28,584.8,14 CDM,436870,CA 19-9 QN,1423.0,1423.0,85.38,1209.55,14 CDM,436870,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",1423.0,1423.0,17.48,143.17,76 CDM,436880,CALCITONIN,1001.0,1001.0,60.06,850.85,14 CDM,436880,Calcitonin ,1001.0,1001.0,22.5,184.26,76 CDM,436890,CALCIUM TOTAL,636.0,636.0,38.16,540.6,14 CDM,436900,CALCIUM UR TIMED QN,532.79,532.79,31.97,452.87,14 CDM,436900,"Calcium; urine quantitative, timed specimen ",532.79,532.79,5.07,41.45,76 CDM,436901,HIV 1 GENOTYPE RT & PROT,2498.0,2498.0,149.88,2123.3,14 CDM,436901,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",2498.0,2498.0,216.26,1770.72,76 CDM,436910,CALCIUM IONIZED,1817.0,1817.0,109.02,1544.45,14 CDM,436910,Calcium; ionized ,1817.0,1817.0,11.49,94.12,76 CDM,436921,METHYLMALONIC ACID QN,1906.98,1906.98,114.42,1620.93,14 CDM,436921,"Organic acid, single, quantitative ",1906.98,1906.98,17.82,145.89,76 CDM,436940,CARBAMAZEPINE TOTAL,1109.0,1109.0,66.54,942.65,14 CDM,436940,Carbamazepine; total ,1109.0,1109.0,12.24,100.18,76 CDM,436960,CARBOXYHEMOGLOBIN QN,1024.7,1024.7,61.48,871.0,14 CDM,436960,Carboxyhemoglobin; quantitative ,1024.7,1024.7,10.35,84.71,76 CDM,436970,CEA,1252.0,1252.0,75.12,1064.2,14 CDM,436970,Carcinoembryonic antigen (CEA) ,1252.0,1252.0,15.93,130.41,76 CDM,436980,CARDIOLIPIN AB IGA,1284.0,1284.0,77.04,1091.4,14 CDM,436990,CARDIOLIPIN AB IGG,1284.0,1284.0,77.04,1091.4,14 CDM,436995,GABAPENTIN NEURONTIN QN,900.73,900.73,54.04,765.62,14 CDM,436995,"Gabapentin, whole blood, serum, or plasma ",900.73,900.73,18.2,149.05,76 CDM,436996,DRUG SCR ANY NBR PER DOS,2822.0,2822.0,169.32,2398.7,14 CDM,437000,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",534.11,534.11,4.68,38.28,76 CDM,437000,RETIC CT AUTO W/RET-HE,534.11,534.11,32.05,453.99,14 CDM,444145,EKG TRACING ONLY,1781.9,1781.9,106.91,1514.62,39 CDM,444145,"Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report ",1781.9,1781.9,128.72,177.68,5 CDM,444290,RHYTHM STRIP TRACE,1205.41,1205.41,72.32,1024.6,39 CDM,444290,"Rhythm ECG, 1-3 leads; tracing only without interpretation and report ",1205.41,1205.41,128.72,177.68,5 CDM,444360,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an",12373.98,12373.98,592.25,817.51,5 CDM,444360,STRESS TEST,12373.98,12373.98,742.44,10517.88,39 CDM,4444,INS ECMO PERC PERIPH=>6Y,25490.95,25490.95,1529.46,21667.31,37 CDM,446000,SP AORTOGM ABD W/FILM,12082.9,12082.9,724.97,10270.47,17 CDM,446008,AICD LEAD/GEN TEST INIT,18072.76,18072.76,2349.46,15361.85,20 CDM,446008,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",18072.76,18072.76,767.43,43890.0,31 CDM,446018,CATH 2ND OD LOW ART,5864.43,5864.43,351.87,4984.77,37 CDM,446020,SP TRANSCATH ANGIO F/U,4877.86,4877.86,292.67,4146.18,17 CDM,446024,SP VENOGRAM EXT BI,7302.11,7302.11,438.13,6206.79,17 CDM,446025,SP AORTOGM ABD W/RNF,12082.9,12082.9,724.97,10270.47,17 CDM,446031,SP CHG TUBE/DRN W/C,4922.56,4922.56,295.35,4184.18,31 CDM,446035,SP ANGIO EXT UNI LT,7459.21,7459.21,447.55,6340.33,17 CDM,446110,SP ANGIO ADDL VESSEL,2766.55,2766.55,165.99,2351.57,31 CDM,446190,SP ANG VISC SEL W/WO F,7599.71,7599.71,455.98,6459.75,17 CDM,446197,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",2454.89,2454.89,136.66,10724.85,29 CDM,446197,SP PORTOGM W/HEMODYN,2454.89,2454.89,147.29,2086.66,17 CDM,446210,SP AORTOGM TH W/FILM,8951.05,8951.05,537.06,7608.39,17 CDM,446230,SP VENOCAVAGM INF,10492.71,10492.71,629.56,8918.8,17 CDM,446237,SP VENOCAVAGM SUP,1071.62,1071.62,64.3,910.88,17 CDM,446260,SP ANGIO EXT BI,11142.84,11142.84,668.57,9471.41,17 CDM,446265,SP ANGIO EXT UNI RT,7459.21,7459.21,447.55,6340.33,17 CDM,446370,SP TRANSCTH THPY EMBL,27141.81,27141.81,1628.51,23070.54,31 CDM,446395,SP ANGIO PULM SEL BI,12492.9,12492.9,749.57,10618.97,17 CDM,446530,SP AORTOGM TH W/O FILM,7599.71,7599.71,455.98,6459.75,17 CDM,446967,INSERTION IABP PERC,14343.56,14343.56,860.61,12192.03,37 CDM,446968,REM IABP PERC,14343.56,14343.56,860.61,12192.03,37 CDM,447000,BUNDLE OF HIS RECORDING,10799.87,10799.87,1403.98,9179.89,19 CDM,447000,Bundle of His recording ,10799.87,10799.87,3673.0,43890.0,19 CDM,447000,Bundle of His recording with Cardiac Cath,10799.87,10799.87,7818.0,7818.0,5 CDM,447000,Bundle of His recording without Cardiac Cath,10799.87,10799.87,5591.0,5591.0,5 CDM,447001,INTRA ATRIAL RECORDING,12960.92,12960.92,1684.92,11016.78,19 CDM,447001,Intra-atrial recording ,12960.92,12960.92,16024.0,43890.0,7 CDM,447001,Intra-atrial recording with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CDM,447001,Intra-atrial recording without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CDM,447004,IA PACING,18072.76,18072.76,2349.46,15361.85,19 CDM,447004,Intra-atrial pacing ,18072.76,18072.76,16024.0,43890.0,7 CDM,447004,Intra-atrial pacing with Cardiac Cath,18072.76,18072.76,7818.0,7818.0,5 CDM,447004,Intra-atrial pacing without Cardiac Cath,18072.76,18072.76,5591.0,5591.0,5 CDM,447005,IV PACING,12960.92,12960.92,1684.92,11016.78,19 CDM,447005,Intraventricular pacing ,12960.92,12960.92,16024.0,43890.0,7 CDM,447005,Intraventricular pacing with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CDM,447005,Intraventricular pacing without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CDM,447006,INTRACARD EP 3D MAPPING,12960.92,12960.92,1684.92,11016.78,20 CDM,447006,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,12960.92,12960.92,727.79,43890.0,11 CDM,447006,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CDM,447006,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CDM,447009,ARRHYTHMIA INDUCE ELECT,12960.92,12960.92,1684.92,11016.78,30 CDM,447009,Induction of arrhythmia by electrical pacing ,12960.92,12960.92,2310.89,43890.0,9 CDM,447009,Induction of arrhythmia by electrical pacing with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CDM,447009,Induction of arrhythmia by electrical pacing without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CDM,447010,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",40464.92,40464.92,3673.0,43890.0,33 CDM,447010,EP W/O ARRHYTHMIA,40464.92,40464.92,5260.44,34395.18,15 CDM,447011,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,40464.92,40464.92,3673.0,43890.0,29 CDM,447011,EP W/ARRHYTHMIA,40464.92,40464.92,5260.44,34395.18,19 CDM,447012,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,38486.54,38486.54,285.88,43890.0,32 CDM,447012,EP W/LA REC W/ARRHYTHMIA,38486.54,38486.54,5003.25,32713.56,21 CDM,447013,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,46065.65,46065.65,423.35,43890.0,32 CDM,447013,EP W/LVREC W/ARRHYTHMIA,46065.65,46065.65,5988.53,39155.8,21 CDM,447014,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,12496.2,12496.2,388.77,43890.0,10 CDM,447014,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) with Cardiac Cath,12496.2,12496.2,7818.0,7818.0,5 CDM,447014,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) without Cardiac Cath,12496.2,12496.2,5591.0,5591.0,5 CDM,447014,STIM & PACE AFTER IV INF,12496.2,12496.2,1624.51,10621.77,21 CDM,447017,ABLATION AV NODE W/WO,27383.13,27383.13,3559.81,23275.66,19 CDM,447017,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",27383.13,27383.13,16067.99,43890.0,7 CDM,447017,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement with Cardiac Cath",27383.13,27383.13,7818.0,7818.0,5 CDM,447017,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement without Cardiac Cath",27383.13,27383.13,5591.0,5591.0,5 CDM,447021,INTRACARDIAC ECHO,15827.09,15827.09,2057.52,13453.03,20 CDM,447027,3D OTH W POST IMG IND,516.01,516.01,30.96,438.61,31 CDM,448005,EEG COMA OR SLEEP ONLY,5517.91,5517.91,331.07,4690.22,39 CDM,448005,Electroencephalogram (EEG); recording in coma or sleep only ,5517.91,5517.91,779.22,1075.59,5 CDM,448025,EEG REC AW & DROWSY,7288.59,7288.59,437.32,6195.3,39 CDM,448025,Electroencephalogram (EEG); including recording awake and drowsy ,7288.59,7288.59,726.94,1003.43,5 CDM,448035,EEG REC AW & ASLEEP,6104.4,6104.4,366.26,5188.74,39 CDM,448035,Electroencephalogram (EEG); including recording awake and asleep ,6104.4,6104.4,879.58,1214.12,5 CDM,448100,EEG CEREB DEATH,4137.81,4137.81,248.27,3517.14,39 CDM,449257,EMERGENT DIALYSIS ESRD,4627.0,4627.0,601.51,3932.95,33 CDM,450501,BLEOMYCIN SULF 15 U INJ,299.81,299.81,17.99,254.84,24 CDM,450501,"Injection, bleomycin sulfate, 15 units ",299.81,299.81,16.6,86.08,10 CDM,450501,"Injection, bleomycin sulfate, 15 units Chemotherapy Drugs",299.81,299.81,,,0 CDM,450504,CLINDAMYCIN 75MG PO,16.65,16.65,1.0,14.15,49 CDM,450509,EFAVIRENZ 600 MG PO,182.02,182.02,10.92,154.72,49 CDM,450510,TETRAHYDROZ 0.05%15ML OP,13.09,13.09,0.79,11.13,49 CDM,450511,ZIPRASIDONE 80 MG PO,9.51,9.51,0.57,8.08,49 CDM,450513,CMPD MORPH 30MG 30B,82.73,82.73,4.96,70.32,30 CDM,450515,QUETIAPINE 200 MG PO,9.51,9.51,0.57,8.08,49 CDM,450517,SELEGILINE 5 MG PO,10.7,10.7,0.64,9.09,49 CDM,450519,STERILE WATER 1 L IRRIG,24.98,24.98,1.5,21.23,49 CDM,450520,RIVASTIGMINE 3 MG PO,9.51,9.51,0.57,8.08,49 CDM,450521,TETRACAINE 0.5% 4 ML OPH,30.93,30.93,1.86,26.29,49 CDM,450525,NOVOLIN R 5 U INJ,16.65,16.65,1.0,14.15,41 CDM,450530,CARBAMAZ 100MG/5ML LIQPO,9.51,9.51,0.57,8.08,49 CDM,450540,SOD PHOS 0.12MMOL/ML INJ,53.54,53.54,3.21,45.51,30 CDM,450543,FOMEPIZOLE 15 MG INJ,74.95,74.95,4.5,63.71,20 CDM,450544,FOMEPIZOLE 15 MG INJJW,74.95,74.95,4.5,63.71,20 CDM,454003,PLETHYSMOGRAPHY,1026.52,1026.52,61.59,872.54,39 CDM,454003,"Plethysmography for determination of lung volumes and, when performed, airway resistance ",1026.52,1026.52,592.25,817.51,5 CDM,454006,GAS DILUTION/WASHOUT,2678.13,2678.13,160.69,2276.41,39 CDM,454006,"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes ",2678.13,2678.13,323.74,446.87,5 CDM,454008,DIFFUSING CAPACITY,2000.7,2000.7,120.04,1700.6,44 CDM,454008,"Diffusing capacity (eg, carbon monoxide, membrane) (List separately in addition to code for primary procedure) ",2000.7,2000.7,109.63,151.33,5 CDM,454015,BG WITH MEAS O2 SAT,2650.0,2650.0,159.0,2252.5,14 CDM,454015,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",2650.0,2650.0,66.17,541.82,76 CDM,454060,CPAP VENT INT&MGMT,713.07,713.07,42.78,606.11,33 CDM,454060,"Continuous positive airway pressure ventilation (CPAP), initiation and management ",713.07,713.07,430.47,594.19,5 CDM,454090,CPR,2664.71,2664.71,159.88,2265.0,34 CDM,454095,CHEST WALL INITIAL,171.85,171.85,10.31,146.07,33 CDM,454095,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation ",171.85,171.85,255.13,352.17,5 CDM,454096,CHEST WALL SUBSEQUENT,130.81,130.81,7.85,111.19,33 CDM,454096,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent ",130.81,130.81,255.13,352.17,5 CDM,454180,CONT INHAL TRMT 1ST HOUR,498.89,498.89,29.93,424.06,33 CDM,454180,Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour ,498.89,498.89,255.13,352.17,5 CDM,454188,CONT IN TRMT EA ADD HOUR,355.25,355.25,21.32,301.96,38 CDM,454188,Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure) ,355.25,355.25,39.64,54.72,5 CDM,454192,INH TX AC AWY OBST,164.15,164.15,9.85,139.53,33 CDM,454195,SPUTIND,76.52,76.52,4.59,65.04,39 CDM,454220,OXYGEN PER HOUR,144.72,144.72,8.68,123.01,49 CDM,454310,Noninvasive ear or pulse oximetry for oxygen saturation; single determination ,343.74,343.74,5.9,8.14,5 CDM,454310,SINGLE DX PULSE OX,343.74,343.74,20.62,292.18,44 CDM,454340,BRONCH EV SPIR PRE/POST,4215.55,4215.55,252.93,3583.22,39 CDM,454340,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration ",4215.55,4215.55,110.47,152.49,5 CDM,454400,VENT MGMT INITIAL IP/OBS,2003.26,2003.26,120.2,1702.77,33 CDM,454400,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day ",2003.26,2003.26,1087.0,1500.43,5 CDM,454410,VENT MGMT IP/OBS SUB DAY,1705.72,1705.72,102.34,1449.86,33 CDM,454410,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day ",1705.72,1705.72,1087.0,1500.43,5 CDM,454415,INOMAX PER HOUR INH,1554.97,1554.97,93.3,1321.72,30 CDM,454415,"Prescription drug, brand name ",1554.97,1554.97,,,0 CDM,454420,VITAL CAPACITY,503.84,503.84,30.23,428.26,39 CDM,454420,"Vital capacity, total (separate procedure) ",503.84,503.84,323.74,446.87,5 CDM,457570,STAPLER INT 65MM,10956.5,10956.5,657.39,9313.02,49 CDM,457850,BG DRN W/GRVTY 600ML,596.0,596.0,35.76,506.6,49 CDM,457950,BLADE DRMTN 1.25-4.25,1697.5,1697.5,101.85,1442.88,49 CDM,458040,ANTIBODY TITER EA INDIR,497.18,497.18,29.83,422.6,15 CDM,458040,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",497.18,497.18,4.35,457.76,74 CDM,458050,IRRADIATION BLD EA,257.16,257.16,15.43,218.59,26 CDM,458050,"Irradiation of blood product, each unit ",257.16,257.16,67.53,208.15,17 CDM,458073,PRBC LR,926.0,926.0,55.56,787.1,32 CDM,458073,"Red blood cells, leukocytes reduced, each unit ",926.0,926.0,1609.21,2173.63,12 CDM,458076,PLTS PHERESIS LR EA UNIT,3569.1,3569.1,214.15,3033.74,28 CDM,458076,"Platelets, pheresis, leukocytes reduced, each unit ",3569.1,3569.1,480.75,5011.53,18 CDM,459000,EVAL ORAL/PHARYNG SWL SP,483.13,483.13,28.99,410.66,32 CDM,459000,Evaluation of oral and pharyngeal swallowing function ,483.13,483.13,83.32,239.8,50 CDM,459001,APHASIA INT&RPT/HR SP,921.75,921.75,55.3,783.49,37 CDM,459001,"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagno",921.75,921.75,96.07,210.76,45 CDM,459003,"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); ",1164.59,1164.59,110.33,662.42,62 CDM,459003,SP/EVAL SOUND PRODUCTION,1164.59,1164.59,69.88,989.9,20 CDM,459004,"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) ",1164.59,1164.59,222.38,1348.56,62 CDM,459004,SP/EVAL SND W/ LANG EVAL,1164.59,1164.59,69.88,989.9,20 CDM,459007,EVAL USE/FIT VOICE PR SP,409.38,409.38,24.56,347.97,32 CDM,459007,Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech ,409.38,409.38,70.09,239.8,50 CDM,459009,COGNITIV PERFORM TEST SP,638.23,638.23,38.29,542.5,32 CDM,459009,"Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patie",638.23,638.23,101.45,363.18,50 CDM,459045,TX SWAL/ORAL FUNCTION SP,559.41,559.41,33.56,475.5,32 CDM,459045,Treatment of swallowing dysfunction and/or oral function for feeding ,559.41,559.41,82.69,284.05,50 CDM,459060,FLUORO EVAL OF SWALW SP,1823.15,1823.15,109.39,1549.68,32 CDM,459060,Motion fluoroscopic evaluation of swallowing function by cine or video recording ,1823.15,1823.15,90.33,296.84,50 CDM,459090,TX SPEECH INDIVIDUAL SP,994.22,994.22,59.65,845.09,20 CDM,459090,"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual ",994.22,994.22,74.87,455.33,62 CDM,462003,EVAL PT LOW COMPLEX,741.21,741.21,44.47,630.03,20 CDM,462005,WHEELCHAIR MGT 15M PT,282.25,282.25,16.93,239.91,20 CDM,462007,EL ST UN IND NOT WC PT,326.74,326.74,19.6,277.73,32 CDM,462007,"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care ",326.74,326.74,11.06,46.58,136 CDM,462008,EVAL PT MOD COMPLEX,1059.06,1059.06,63.54,900.2,20 CDM,462011,EVAL PT HIGH COMPLEX,1376.9,1376.9,82.61,1170.37,20 CDM,462013,RE-EVALUATION PT,741.21,741.21,44.47,630.03,20 CDM,462015,SELF/HOME ONE/ONE 15M PT,429.72,429.72,25.78,365.26,20 CDM,462070,DEBRIDE WND IN 20SQCM PT,328.02,328.02,19.68,278.82,33 CDM,462070,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",328.02,328.02,57.35,218.96,48 CDM,462115,GAIT TRAINING 15 MIN PT,218.68,218.68,13.12,185.88,20 CDM,462117,NEUROMUSC REEDUCT 15M PT,282.25,282.25,16.93,239.91,20 CDM,462135,TRACTION MECHANICAL PT,507.28,507.28,30.44,431.19,20 CDM,462200,ORTH MGT TRAIN EA 15M PT,274.62,274.62,16.48,233.43,32 CDM,462265,THER ACTIV DIR 15 MIN PT,244.1,244.1,14.65,207.49,20 CDM,462315,THER EXERCISES 15 MIN PT,336.92,336.92,20.22,286.38,20 CDM,462370,MANUAL THER TECH 15M PT,395.4,395.4,23.72,336.09,20 CDM,462370,"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes ",395.4,395.4,24.04,151.07,148 CDM,463000,Acute gastrointestinal blood loss imaging ,3376.98,3376.98,324.78,3176.56,29 CDM,463000,NM ACUTE GI BLOOD LOSS,3376.98,3376.98,202.62,2870.43,17 CDM,463004,IN111 PENTETREOT DX 6MCI,1116.58,1116.58,66.99,949.09,36 CDM,463004,"Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries ",1116.58,1116.58,11080.47,15263.91,5 CDM,463006,HEPA IMAG INCL GB,9898.29,9898.29,593.9,8413.55,17 CDM,463006,"Hepatobiliary system imaging, including gallbladder when present; ",9898.29,9898.29,303.06,3060.5,29 CDM,463007,HEPA IMAG INCL GB W PHA,12147.34,12147.34,728.84,10325.24,17 CDM,463007,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",12147.34,12147.34,407.3,4167.89,29 CDM,463008,PULM VENT IMAGING,8596.76,8596.76,515.81,7307.25,17 CDM,463008,"Pulmonary ventilation imaging (eg, aerosol or gas) ",8596.76,8596.76,176.43,1731.76,29 CDM,463009,PULM VENT & PERF IMAG,6864.01,6864.01,411.84,5834.41,17 CDM,463009,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",6864.01,6864.01,309.4,2970.66,29 CDM,463011,QUANT DIF PULM PERF,15331.41,15331.41,919.88,13031.7,17 CDM,463011,"Quantitative differential pulmonary perfusion, including imaging when performed ",15331.41,15331.41,188.11,1765.44,29 CDM,463015,Bone and/or joint imaging; whole body ,8663.7,8663.7,275.66,2697.8,29 CDM,463015,NM BONE WHOLE BODY,8663.7,8663.7,519.82,7364.15,17 CDM,463019,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",6225.16,6225.16,314.09,3225.28,29 CDM,463019,NM CISTERNOGRAM,6225.16,6225.16,373.51,5291.39,17 CDM,463024,THORACENTESIS W/ IMAG,6504.0,6504.0,390.24,5528.4,37 CDM,463026,PERC PLEUR DRN W/ IMG,6768.66,6768.66,406.12,5753.36,37 CDM,463029,NM THYROID SCN UP/STIM V,7601.59,7601.59,456.1,6461.35,17 CDM,463029,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",7601.59,7601.59,218.19,2267.23,29 CDM,463030,GA67 CITRATE DX 1 MCI,2582.66,2582.66,154.96,2195.26,41 CDM,463030,"Gallium ga-67 citrate, diagnostic, per millicurie ",2582.66,2582.66,234.59,429.69,8 CDM,463034,GASTRIC EMPTY W SB MULT,6798.2,6798.2,407.89,5778.47,17 CDM,463034,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",6798.2,6798.2,414.33,4115.05,29 CDM,463050,TC99M EXAMETAZM DX 25MCI,5585.17,5585.17,335.11,4747.39,41 CDM,463050,"Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries ",5585.17,5585.17,2842.27,5454.54,8 CDM,463052,TC99M AUTO WBC DX DOSE,1081.41,1081.41,64.88,919.2,36 CDM,463052,"Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose ",1081.41,1081.41,2842.27,5454.54,8 CDM,463055,IN111 OXYQUINO DX 0.5MCI,7955.63,7955.63,477.34,6762.29,36 CDM,463055,"Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie ",7955.63,7955.63,3490.7,6698.89,8 CDM,463059,TC99M PERTECHNETA DX MCI,203.12,203.12,12.19,172.65,41 CDM,463059,"Technetium tc-99m pertechnetate, diagnostic, per millicurie ",203.12,203.12,4.19,10.61,8 CDM,463060,TC99M LABEL RBC DX 30MCI,2221.81,2221.81,133.31,1888.54,41 CDM,463060,"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries ",2221.81,2221.81,182.34,297.24,8 CDM,463065,Liver and spleen imaging; with vascular flow ,5721.34,5721.34,126.98,1132.68,29 CDM,463065,NM LVR & SPLN W/FLOW,5721.34,5721.34,343.28,4863.14,17 CDM,463070,Liver and spleen imaging; static only ,6742.6,6742.6,184.44,1829.06,29 CDM,463070,NM LIVER & SPLEEN,6742.6,6742.6,404.56,5731.21,17 CDM,463103,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",6689.26,6689.26,307.74,3139.16,29 CDM,463103,NM INTESTINE IMAGING,6689.26,6689.26,401.36,5685.87,17 CDM,463105,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",7418.89,7418.89,212.84,1915.18,29 CDM,463105,NM MUGA R/S SINGLE,7418.89,7418.89,445.13,6306.06,17 CDM,463114,TC99M MEBROFEN DX 15MCI,1099.56,1099.56,65.97,934.63,41 CDM,463114,"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries ",1099.56,1099.56,108.0,176.03,8 CDM,463118,TC99M PYROPHOS DX 25MCI,1099.56,1099.56,65.97,934.63,41 CDM,463118,"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries ",1099.56,1099.56,97.61,203.83,8 CDM,463119,TC99M MACRO ALB DX 10MCI,1099.56,1099.56,65.97,934.63,41 CDM,463119,"Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries ",1099.56,1099.56,58.56,95.47,8 CDM,463121,TC99M SULFUR CO DX 20MCI,1099.56,1099.56,65.97,934.63,41 CDM,463121,"Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries ",1099.56,1099.56,104.39,850.86,8 CDM,463122,XENON XE133 GAS DX 10MCI,1099.56,1099.56,65.97,934.63,41 CDM,463122,"Xenon xe-133 gas, diagnostic, per 10 millicuries ",1099.56,1099.56,409.39,811.82,8 CDM,463125,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",5060.92,5060.92,218.53,1975.07,29 CDM,463125,NM KDNEY SCAN FLW&FNC,5060.92,5060.92,303.66,4301.78,17 CDM,463140,TC99M PENTETATE DX 25MCI,1338.99,1338.99,80.34,1138.14,41 CDM,463140,"Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries ",1338.99,1338.99,61.17,99.72,8 CDM,463151,TC99M MEDRONATE DX 30MCI,1099.56,1099.56,65.97,934.63,41 CDM,463151,"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries ",1099.56,1099.56,25.38,41.37,8 CDM,463166,TC99M SESTAMIBI DX DOSE,5135.81,5135.81,308.15,4365.44,41 CDM,463166,"Technetium tc-99m sestamibi, diagnostic, per study dose ",5135.81,5135.81,240.23,367.55,8 CDM,463170,TC99M MERTIATID DX 15MCI,2162.8,2162.8,129.77,1838.38,41 CDM,463170,"Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries ",2162.8,2162.8,1512.49,2083.54,5 CDM,463185,NM PLANAR PARATHYROID,7185.14,7185.14,431.11,6107.37,17 CDM,463185,"Parathyroid planar imaging (including subtraction, when performed); ",7185.14,7185.14,273.65,2690.35,29 CDM,463195,TL201 THALLOUS CL DX MCI,5060.92,5060.92,303.66,4301.78,41 CDM,463195,"Thallium tl-201 thallous chloride, diagnostic, per millicurie ",5060.92,5060.92,80.61,409.86,8 CDM,463240,Kidney imaging morphology; with vascular flow ,8305.13,8305.13,211.18,2091.27,29 CDM,463240,NM KIDNEY SCAN W/FLOW,8305.13,8305.13,498.31,7059.36,17 CDM,463250,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",12267.62,12267.62,173.41,1315.69,29 CDM,463250,NM KDNEY FLW&FNC W/RX,12267.62,12267.62,736.06,10427.48,17 CDM,46351,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",16883.73,16883.73,315.75,2892.0,29 CDM,46351,NM MYOCRD SPECT R/S SGL,16883.73,16883.73,1013.02,14351.17,17 CDM,46353,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",16883.73,16883.73,272.65,2611.69,29 CDM,46353,NM MYOCRD PERF R/S SGL,16883.73,16883.73,1013.02,14351.17,17 CDM,46354,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",17522.58,17522.58,406.64,3894.51,29 CDM,46354,NM MYOCRD PERF R/S MULT,17522.58,17522.58,1051.35,14894.19,17 CDM,463605,"Brain imaging, minimum 4 static views; ",9961.84,9961.84,189.11,1847.83,29 CDM,463605,NM BRAIN MIN 4 STATIC,9961.84,9961.84,597.71,8467.56,17 CDM,463819,Lymphatics and lymph nodes imaging ,6123.03,6123.03,329.79,3135.44,29 CDM,463819,NM LYMPHIMAG,6123.03,6123.03,367.38,5204.58,17 CDM,466003,EVAL OT LOW COMPLEX,797.15,797.15,47.83,677.58,20 CDM,466003,"Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or ",797.15,797.15,86.87,562.68,105 CDM,466007,EVAL OT MOD COMPLEX,1187.46,1187.46,71.25,1009.34,20 CDM,466007,"Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy r",1187.46,1187.46,86.87,562.68,105 CDM,466008,EVAL OT HIGH COMPLEX,1543.45,1543.45,92.61,1311.93,20 CDM,466008,"Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and exten",1543.45,1543.45,86.87,562.68,105 CDM,466012,RE-EVALUATION OT,741.21,741.21,44.47,630.03,20 CDM,466012,"Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the",741.21,741.21,59.16,387.19,105 CDM,466045,SELF/HOME ONE/ONE 15M OT,218.68,218.68,13.12,185.88,20 CDM,466052,SENSORY INTEGRATN 15M OT,63.57,63.57,3.81,54.03,20 CDM,466052,"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes ",63.57,63.57,52.37,360.99,105 CDM,466070,THER ACTIV DIR 15 MIN OT,222.49,222.49,13.35,189.12,20 CDM,466166,NEUROMUSC REEDUCT 15M OT,282.25,282.25,16.93,239.91,20 CDM,466211,THER EXERCISES 15 MIN OT,358.53,358.53,21.51,304.75,20 CDM,4747,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,4748,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,4749,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,480257,EMERGENT DIALYSIS ESRD,3316.59,3316.59,431.16,2819.1,33 CDM,481017,IMMUNIZ ADMIN SGL,329.65,329.65,19.78,280.2,39 CDM,481110,CAT 1 ED PROCEDURE,1739.71,1739.71,226.16,1478.75,44 CDM,481477,IMMUNIZ ADMIN EA ADDTL,300.98,300.98,18.06,255.83,44 CDM,484032,CRIT CARE 1ST 30-74 MINS,4396.96,4396.96,571.6,3737.42,15 CDM,485002,NITAZOXANIDE 500 MG PO,604.68,604.68,36.28,513.98,30 CDM,485009,ACD A/ANTICO-CIT-DEX1000,108.8,108.8,6.53,92.48,46 CDM,485010,BACITRACIN 28.4 G TOP,27.37,27.37,1.64,23.26,49 CDM,485013,HYDROCO/APAP 15ML LIQ PO,39.26,39.26,2.36,33.37,49 CDM,485019,CARDIOPLEGIC INST,547.72,547.72,32.86,465.56,49 CDM,485023,AMITRIPTYLINE 50 MG PO,10.7,10.7,0.64,9.09,49 CDM,485029,SILVER SULFAD 1% 50G TOP,129.68,129.68,7.78,110.23,49 CDM,485030,"Injection, oxaliplatin, 0.5 mg ",1036.25,1036.25,0.08,0.78,10 CDM,485030,"Injection, oxaliplatin, 0.5 mg Chemotherapy Drugs",1036.25,1036.25,,,0 CDM,485030,OXALIPLATIN 100 MG INJ,1036.25,1036.25,62.17,880.81,24 CDM,485034,ZIDOVUDINE 200 MG INJ,233.18,233.18,13.99,198.2,24 CDM,485035,MEROPNM/VABORB 2G INJ,1845.27,1845.27,110.72,1568.48,20 CDM,485036,DICYCLOM 10MG/5ML LIQ PO,22.6,22.6,1.36,19.21,49 CDM,485044,GENTAMICIN 0.1% 15 G TOP,98.74,98.74,5.92,83.93,49 CDM,485045,ZIPRASIDONE 40 MG PO,302.19,302.19,18.13,256.86,49 CDM,485047,PREGABALIN 100 MG PO,117.78,117.78,7.07,100.11,49 CDM,485048,DRONABINOL 5 MG PO,486.59,486.59,29.2,413.6,49 CDM,485049,METHYLPHENIDATE 10 MG PO,19.04,19.04,1.14,16.18,49 CDM,485050,NYSTATIN 15 G TOP,963.68,963.68,57.82,819.13,49 CDM,485052,VINCRISTINE SULF 1MG INJ,229.62,229.62,13.78,195.18,24 CDM,485052,"Vincristine sulfate, 1 mg ",229.62,229.62,7.45,24.52,10 CDM,485052,"Vincristine sulfate, 1 mg Chemotherapy Drugs",229.62,229.62,,,0 CDM,485054,CYPROHEPTADINE 4 MG PO,10.7,10.7,0.64,9.09,49 CDM,485055,CYPROHEP 2MG/5ML LIQ PO,10.7,10.7,0.64,9.09,49 CDM,485056,MEMANTINE 10 MG PO,123.74,123.74,7.42,105.18,49 CDM,485062,ESTROGEN CON 0.3 MG PO,51.16,51.16,3.07,43.49,49 CDM,485063,ESTROGEN CON 0.625 MG PO,72.58,72.58,4.35,61.69,49 CDM,485064,"Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use ",1020.6,1020.6,75.15,240.46,10 CDM,485064,RECOMBIVAX ADLT 10MCG IM,1020.6,1020.6,61.24,867.51,19 CDM,485065,"Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use ",942.84,942.84,33.2,97.53,10 CDM,485065,RECOMBIVAX PED 5MCG IM,942.84,942.84,56.57,801.41,19 CDM,485068,OCTREOT 100MCG ND SQIV,311.71,311.71,18.7,264.95,40 CDM,485070,CLARITHROMYCIN 500 MG PO,254.6,254.6,15.28,216.41,49 CDM,485071,GLIMEPIRIDE 4 MG PO,72.58,72.58,4.35,61.69,49 CDM,485074,ERYTHROMYC DR 250 MG PO,10.7,10.7,0.64,9.09,49 CDM,485077,TORSEMIDE 20 MG PO,10.7,10.7,0.64,9.09,49 CDM,485089,OLANZAPINE 5 MG PO,111.83,111.83,6.71,95.06,49 CDM,485094,DOLUTEGRAVIR 50 MG PO,600.81,600.81,36.05,510.69,49 CDM,485098,BUSPIRONE 10 MG PO,27.37,27.37,1.64,23.26,49 CDM,485106,RETACRIT BS 4000U ESRD,299.81,299.81,17.99,254.84,24 CDM,485107,RETACRIT BS 3000U ESRD,224.86,224.86,13.49,191.13,24 CDM,485108,RETACRIT BS 2000U ESRD,189.16,189.16,11.35,160.79,24 CDM,485109,RETACRIT BS 10000U ESRD,750.72,750.72,45.04,638.11,24 CDM,485110,FENOFIBRATE 200 MG PO,27.37,27.37,1.64,23.26,49 CDM,485112,FLECAINIDE 100MG PO,5.95,5.95,0.36,5.06,49 CDM,485113,ESTRADIOL 42.5 G VAGINAL,1524.04,1524.04,91.44,1295.43,30 CDM,485114,NEBIVOLOL 10 MG PO,51.16,51.16,3.07,43.49,49 CDM,485118,LEVETIRACET ER 500 MG PO,38.07,38.07,2.28,32.36,49 CDM,485119,LEUPRO 7.5 MG DEPO INJ,4678.01,4678.01,280.68,3976.31,19 CDM,485119,"Leuprolide acetate (for depot suspension), 7.5 mg ",4678.01,4678.01,176.2,1185.3,10 CDM,485119,"Leuprolide acetate (for depot suspension), 7.5 mg Chemotherapy Drugs",4678.01,4678.01,,,0 CDM,485121,EMTRICITABINE 200 MG PO,185.6,185.6,11.14,157.76,49 CDM,485124,SERTRALINE 25 MG PO,10.7,10.7,0.64,9.09,49 CDM,485127,CHLORHEX 0.12% 15ML PO,17.84,17.84,1.07,15.16,49 CDM,485128,PILOCARPINE 4% 15ML OPH,878.02,878.02,52.68,746.32,49 CDM,485129,DIPHEN 25MG/10 ML LIQ PO,29.74,29.74,1.78,25.28,49 CDM,485130,"Injection, pyridoxine hcl, 100 mg ",42.07,42.07,14.9,39.94,10 CDM,485130,PYRIDOXINE 100 MG INJ,42.07,42.07,2.52,35.76,24 CDM,485133,FLUOCINOND 0.05% 15G TOP,393.8,393.8,23.63,334.73,30 CDM,485135,ARGATROB 50MG NESRD INJ,357.1,357.1,21.43,303.54,19 CDM,485136,"Injection, pentamidine isethionate, 300 mg ",1727.48,1727.48,241.15,310.91,3 CDM,485136,PENTAMIDINE 300 MG INJ,1727.48,1727.48,103.65,1468.36,30 CDM,485138,LEVETIRACET ER 750 MG PO,58.3,58.3,3.5,49.55,49 CDM,485139,LOPERAMIDE 2 MG PO,10.7,10.7,0.64,9.09,49 CDM,485140,TRIAMCINOLON 0.1% 5G TOP,723.35,723.35,43.4,614.85,49 CDM,485142,PROPRANOLOL 60 MG PO,11.9,11.9,0.71,10.12,49 CDM,485145,GASTROGRAFIN 37% 30 ML,239.13,239.13,14.35,203.26,24 CDM,485146,FOSCARNET 1000 MG INJJW,816.16,816.16,48.97,693.74,24 CDM,485147,FOSCARNET 1000 MG INJ,816.16,816.16,48.97,693.74,24 CDM,485148,FOSCARNET 6000 MG INJ,4895.73,4895.73,293.74,4161.37,24 CDM,485157,ACETYLCY 20% 30ML LIQ PO,492.54,492.54,29.55,418.66,49 CDM,485161,CARBOPLATIN 50 MG INJ,36.88,36.88,2.21,31.35,24 CDM,485161,"Injection, carboplatin, 50 mg ",36.88,36.88,2.94,7.24,10 CDM,485161,"Injection, carboplatin, 50 mg Chemotherapy Drugs",36.88,36.88,,,0 CDM,485165,MORPHINE EPD/IT PF 10 MG,51.16,51.16,3.07,43.49,24 CDM,485166,CMPD FENTPF 1000MCG 100B,1092.17,1092.17,65.53,928.34,30 CDM,485168,"Injection, thiamine hcl, 100 mg ",52.35,52.35,1.55,8.29,10 CDM,485168,THIAMINE 100 MG INJ,52.35,52.35,3.14,44.5,24 CDM,485173,HEPAR 1000U/NS 500ML INJ,83.28,83.28,5.0,70.79,24 CDM,485175,BUDESON NC UD 0.25MG INH,186.79,186.79,11.21,158.77,24 CDM,485176,CEFTRIAXONE 40 MG/ML INJ,28.56,28.56,1.71,24.28,24 CDM,485178,HYDROCORT SUCC 250MG INJ,449.71,449.71,26.98,382.25,24 CDM,485179,HYDROMORPHONE 2 MG PO,10.7,10.7,0.64,9.09,49 CDM,485180,LIDO 2% 400MG/20ML MDV,29.68,29.68,1.78,25.23,25 CDM,485181,MIDAZOLAM 2 MG INJ,28.56,28.56,1.71,24.28,24 CDM,485182,MYCOPHENOLATE 250 MG PO,78.53,78.53,4.71,66.75,24 CDM,485183,NITROGLYCERIN 2% 1G TOP,55.92,55.92,3.36,47.53,49 CDM,485187,VALPROATE 500 MG INJ,164.44,164.44,9.87,139.77,49 CDM,485189,RETACRIT BS1000U NESRDJW,95.18,95.18,5.71,80.9,19 CDM,485198,TENECTEPLASE 1 MG INJ,986.29,986.29,59.18,838.35,19 CDM,485207,RETACRIT BS 100U ESRD,9.51,9.51,0.57,8.08,24 CDM,485209,RETACRIT BS 1000U NESRD,95.18,95.18,5.71,80.9,19 CDM,485210,RETACRIT BS 10000U NESRD,750.72,750.72,45.04,638.11,19 CDM,485211,RETACRIT BS 2000U NESRD,189.16,189.16,11.35,160.79,19 CDM,485212,RETACRIT BS 3000U NESRD,224.86,224.86,13.49,191.13,19 CDM,485213,RETACRIT BS 4000U NESRD,299.81,299.81,17.99,254.84,19 CDM,485218,ZIPRASIDONE 60 MG PO,95.18,95.18,5.71,80.9,49 CDM,485220,PAMIDRONATE 90 MG INJ,584.16,584.16,35.05,496.54,24 CDM,485227,INDOMETHACIN 50 MG SUPP,1759.61,1759.61,105.58,1495.67,30 CDM,485229,ARGATROB 250MG NESRD INJ,2584.33,2584.33,155.06,2196.68,19 CDM,485234,ETHAMBUTOL 100 MG PO,10.7,10.7,0.64,9.09,49 CDM,485235,KALETRA 400/100MG LIQPO,141.58,141.58,8.49,120.34,30 CDM,485236,NEO/POLY B/DEX 5ML OPHTH,171.32,171.32,10.28,145.62,30 CDM,485237,NEO/POLY B/DEX 3.5G OPH,129.68,129.68,7.78,110.23,30 CDM,485241,"Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use ",1085.03,1085.03,229.61,724.46,10 CDM,485241,TRUMENBA VAC IM,1085.03,1085.03,65.1,922.28,24 CDM,485247,MEROPNM/VABORB 20MGINJJW,92.79,92.79,5.57,78.87,20 CDM,485248,MEROPNM/VABORB 20MG INJ,92.79,92.79,5.57,78.87,20 CDM,485253,CMPD CARDIOPLEGIA,490.17,490.17,29.41,416.64,30 CDM,485254,RASBURICASE 1.5 MG INJ,5918.4,5918.4,355.1,5030.64,19 CDM,485256,NOVOSEVEN RT 2 MG INJ,38662.6,38662.6,2319.76,32863.21,19 CDM,485257,NOVOSEVEN RT 1 MCGJW,17.84,17.84,1.07,15.16,19 CDM,485258,NOVOSEVEN RT 1 MICROGRAM,17.84,17.84,1.07,15.16,19 CDM,485260,NOVOSEVEN RT 1 MG INJ,19331.89,19331.89,1159.91,16432.11,19 CDM,485261,DOTAREM 20 ML INJ,1041.01,1041.01,62.46,884.86,24 CDM,485265,AMILORIDE 5 MG PO,10.7,10.7,0.64,9.09,49 CDM,485268,"Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use ",517.55,517.55,164.42,652.7,10 CDM,485268,RECOMBIVAX DIAL 40MCG IM,517.55,517.55,31.05,439.92,19 CDM,485272,LAMIVUD 50 MG/5ML LIQPO,10.7,10.7,0.64,9.09,49 CDM,485286,PYRIMETHAMINE 25 MG PO,7767.74,7767.74,466.06,6602.58,30 CDM,485287,FENTANYL CIT 1 MG INJ,66.63,66.63,4.0,56.64,24 CDM,485289,AMPICILLIN 100 MG/ML INJ,69.0,69.0,4.14,58.65,24 CDM,485290,PIP/TAZ60MG/7.5MG PER ML,26.18,26.18,1.57,22.25,24 CDM,485291,PROCHLORPERAZ 25 MG SUPP,104.7,104.7,6.28,89.0,49 CDM,485292,METHACHOLINE 100 MG INH,778.09,778.09,46.69,661.38,25 CDM,485292,"Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg ",778.09,778.09,1.47,5.4,8 CDM,485294,SULFADIAZINE 500 MG PO,46.4,46.4,2.78,39.44,49 CDM,485295,OXYMETAZO 0.05% 30ML NAS,38.07,38.07,2.28,32.36,49 CDM,485296,"Injection, perflutren lipid microspheres, per ml ",510.4,510.4,39.96,257.42,10 CDM,485296,PERFLUT LPDMCS 1.5ML INJ,510.4,510.4,30.62,433.84,24 CDM,485307,MAG SULFATE 5G/10ML INJ,28.56,28.56,1.71,24.28,24 CDM,485309,POTASSI CHL ER 10 MEQ PO,10.7,10.7,0.64,9.09,49 CDM,485313,DESMOPRESSIN 1 MCG INJJW,140.39,140.39,8.42,119.33,24 CDM,485316,BUPIV7.5/EPI0.005MG 30ML,100.15,100.15,6.01,85.13,46 CDM,485317,CMPD MORPH 100MG 100B,198.69,198.69,11.92,168.89,30 CDM,485322,RENFLEXIS BS 10 MG INJJW,399.5,399.5,23.97,339.57,19 CDM,485323,RENFLEXIS BS 10 MG INJ,399.5,399.5,23.97,339.57,19 CDM,485324,RENFLEXIS BS 100 MG INJ,3995.35,3995.35,239.72,3396.05,19 CDM,485325,RISPERID 1MG/ML LIQ PO,44.02,44.02,2.64,37.42,49 CDM,485326,OXYCOD/APAP 7.5/325MG PO,22.6,22.6,1.36,19.21,49 CDM,485328,PRAZOSIN 1 MG PO,9.51,9.51,0.57,8.08,49 CDM,485331,IVIG PRIVIGEN 500 MGJW,817.34,817.34,49.04,694.74,19 CDM,485332,IVIG PRIVIGEN 500MG,817.34,817.34,49.04,694.74,19 CDM,485345,CLOTRIMAZOL 1% 28.4G TOP,16.65,16.65,1.0,14.15,49 CDM,485346,HYDRALAZINE 50 MG PO,9.51,9.51,0.57,8.08,49 CDM,485350,TRUXIMA BS 500 MG INJ,39802.35,39802.35,2388.14,33832.0,19 CDM,485351,TRUXIMA BS 100 MG INJ,7961.66,7961.66,477.7,6767.41,19 CDM,485365,RITUXIMAB 10 MG INJ,141.58,141.58,8.49,120.34,19 CDM,485366,FOSPHEN PE 25 MG/ML INJ,61.86,61.86,3.71,52.58,25 CDM,485378,PRAMIPEXOLE 0.5 MG PO,23.79,23.79,1.43,20.22,49 CDM,485379,CEFTRIAXONE 250 MG INJ,17.63,17.63,1.06,14.99,24 CDM,485381,"Cocaine hydrochloride nasal solution (goprelto), 1 mg ",2306.88,2306.88,2.37,5.37,8 CDM,485381,GOPRELTO 160 MG NASAL,2306.88,2306.88,138.41,1960.85,25 CDM,485386,PAROMOMYCIN 250 MG PO,44.02,44.02,2.64,37.42,49 CDM,485388,DEXMED 400MCG/NS100MLINJ,79.28,79.28,4.76,67.39,46 CDM,485389,IG RHOPHYLAC 1500 IU,423.54,423.54,25.41,360.01,24 CDM,485389,"Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu ",423.54,423.54,4.85,26.24,10 CDM,485391,LINEZOL 100MG/5ML LIQPO,214.15,214.15,12.85,182.03,30 CDM,485394,CANGRELOR 1 MG INJJW,141.58,141.58,8.49,120.34,25 CDM,485395,CANGRELOR 1 MG INJ,141.58,141.58,8.49,120.34,25 CDM,485396,CANGRELOR 50 MG INJ,7050.33,7050.33,423.02,5992.78,25 CDM,485398,HYDROXYCHLOROQN 200MG PO,81.6,81.6,4.9,69.36,30 CDM,485401,CYTARABINE 100 MG INJ,58.3,58.3,3.5,49.55,24 CDM,485401,"Injection, cytarabine, 100 mg ",58.3,58.3,0.8,2.53,10 CDM,485401,"Injection, cytarabine, 100 mg Chemotherapy Drugs",58.3,58.3,,,0 CDM,485405,TOCILIZUMAB 1 MG INJJW,54.72,54.72,3.28,46.51,19 CDM,485406,TOCILIZUMAB 1 MG INJ,54.72,54.72,3.28,46.51,19 CDM,485407,TOCILIZUMAB 400MG INJ,21708.97,21708.97,1302.54,18452.62,19 CDM,485408,TOCILIZUMAB 200MG INJ,9867.6,9867.6,592.06,8387.46,19 CDM,485409,EPOPROSTENOL 0.5 MG INJ,138.95,138.95,8.34,118.11,24 CDM,485410,EPOPROSTENOL 1.5 MG INJ,310.81,310.81,18.65,264.19,24 CDM,485415,MOMETASONE 220MCG PUFF,1639.44,1639.44,98.37,1393.52,49 CDM,485416,MOMETASONE 110MCG 30INH,747.14,747.14,44.83,635.07,33 CDM,485422,"Injection, penicillin g potassium, up to 600,000 units ",118.97,118.97,0.68,4.0,10 CDM,485422,PCNG K 5 MILLION U INJ,118.97,118.97,7.14,101.12,24 CDM,485425,"Injection, methotrexate sodium, 50 mg ",19.04,19.04,2.33,7.05,10 CDM,485425,"Injection, methotrexate sodium, 50 mg Chemotherapy Drugs",19.04,19.04,,,0 CDM,485425,METHOTREXATE 50 MG INJ,19.04,19.04,1.14,16.18,24 CDM,485431,RITONAVIR 100 MG PO,72.58,72.58,4.35,61.69,30 CDM,485432,NIMODIP 30MG/5ML LIQ PO,400.59,400.59,24.04,340.5,49 CDM,485440,BACLOFEN 5 MG PO,5.4,5.4,0.32,4.59,49 CDM,485442,ENALAPRILAT 25MCG/ML INJ,15.47,15.47,0.93,13.15,30 CDM,485446,RUXIENCE BS 500 MG INJ,33741.88,33741.88,2024.51,28680.6,19 CDM,485447,RUXIENCE BS 100 MG INJ,6748.14,6748.14,404.89,5735.92,19 CDM,485454,EPHEDRINE 50 MG INJ,258.4,258.4,15.5,219.64,46 CDM,485455,CISATRACURIUM 10 MG INJ,123.64,123.64,7.42,105.09,46 CDM,485456,CEFTRIAXONE 350MG/ML INJ,14.28,14.28,0.86,12.14,24 CDM,485457,ROPIVACA 200MG/100ML INJ,347.4,347.4,20.84,295.29,24 CDM,487004,BETAMETHSN 6 MG INJ,97.56,97.56,5.85,82.93,24 CDM,487004,"Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg ",97.56,97.56,6.97,21.5,10 CDM,4896,DILATOR BLN 8X180CM,5546.5,5546.5,332.79,4714.52,49 CDM,491690,DIALYSIS CIRC BLN ANGIOP,23570.11,23570.11,1414.21,20034.59,37 CDM,493111,DUP UE ART BIL,2123.58,2123.58,127.41,1805.04,33 CDM,493111,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,2123.58,2123.58,196.14,545.93,18 CDM,493120,DUP UE ART UNI/LTD,1066.23,1066.23,63.97,906.3,33 CDM,493120,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,1066.23,1066.23,106.88,341.06,18 CDM,493145,DUP VEIN UNI/LTD,5543.4,5543.4,332.6,4711.89,33 CDM,500101,CIDOFOVIR 375 MG INJ,6965.86,6965.86,417.95,5920.98,19 CDM,500101,"Injection, cidofovir, 375 mg ",6965.86,6965.86,560.79,1651.67,10 CDM,500119,OMALIZUMAB 150 MG INJ,6807.63,6807.63,408.46,5786.49,19 CDM,501216,GADOXETATE 10 ML INJ,1139.76,1139.76,68.39,968.8,24 CDM,501216,"Injection, gadoxetate disodium, 1 ml ",1139.76,1139.76,14.73,45.86,10 CDM,501217,GADOBUTROL 7.5 ML INJ,429.49,429.49,25.77,365.07,24 CDM,501218,GADOBUTROL 10 ML INJ,574.64,574.64,34.48,488.44,24 CDM,501222,MIDODRINE 5 MG PO,10.7,10.7,0.64,9.09,49 CDM,501224,OMNIPAQUE 350 100 ML INJ,259.36,259.36,15.56,220.46,24 CDM,5152,DEVICE INFL 30ML,2905.5,2905.5,174.33,2469.68,49 CDM,5153,INJ ILEAL CONDUIT,172.49,172.49,10.35,146.62,37 CDM,5155,CHMODENERVAT NECK UNI,1382.48,1382.48,82.95,1175.11,37 CDM,5156,ASPR BLDDR INSRT SUPRCTH,2988.4,2988.4,179.3,2540.14,37 CDM,5158,INJ CYSTO/URETH,1024.44,1024.44,61.47,870.77,37 CDM,5159,DELAY PLC EXT PROSTH INI,51453.61,51453.61,3087.22,43735.57,37 CDM,5160,REPL G TUBE WO REV/IMG,1292.32,1292.32,77.54,1098.47,37 CDM,5161,SPINE PUNC DX W FLUR CT,7820.55,7820.55,469.23,6647.47,37 CDM,5162,CORE NDL BX LG/MED PERC,7857.14,7857.14,471.43,6678.57,37 CDM,5164,REPL TUN CV CATH W/O P-P,11587.74,11587.74,695.26,9849.58,37 CDM,5165,INJ SCLEROSANT MULT VEIN,2097.24,2097.24,125.83,1782.65,37 CDM,5167,INS TUN IP CTH COMP PERC,17776.24,17776.24,1066.57,15109.8,37 CDM,5294,SOLUTION IRR 1.5% 3000CC,627.0,627.0,37.62,532.95,49 CDM,5330,DRAIN WND 10IN 20IN,473.0,473.0,28.38,402.05,49 CDM,5414,GWIRE VASC .035IN 180CM,2559.0,2559.0,153.54,2175.15,49 CDM,5648,RELOAD STPLR 60 2.5MM,8938.0,8938.0,1161.94,7597.3,28 CDM,5653,KWIRE FX 285MM 3MM,3847.5,3847.5,230.85,3270.38,49 CDM,5657,SP EX CARTIDANGIOUNI ADD,8057.06,8057.06,483.42,6848.5,37 CDM,5658,SP COM CAROTIDANGIO UNIL,12130.02,12130.02,727.8,10310.52,37 CDM,5660,SP EX CAROTID ANGIO UNIL,12130.02,12130.02,727.8,10310.52,37 CDM,5661,NSP THOR AORT W/ ANGIO,12885.29,12885.29,773.12,10952.5,37 CDM,5662,PERC PLEUR DRN W/ IMG,6768.66,6768.66,406.12,5753.36,37 CDM,5665,REMVL PLEURL CATH W/CUFF,6945.07,6945.07,416.7,5903.31,37 CDM,5667,INJ SACIL JOINT ARTHRO,14500.36,14500.36,870.02,12325.31,37 CDM,5669,BX BONE DEEP,4952.36,4952.36,297.14,4209.51,37 CDM,5677,TRNSCTH TX VEN INI DAY,4556.43,4556.43,273.39,3872.97,37 CDM,5678,PERIPH ATH ILI ART EACH,5195.4,5195.4,311.72,4416.09,37 CDM,5681,TRANSCATH RTRV FB S&I,15876.31,15876.31,952.58,13494.86,37 CDM,5683,REPOS IVC FILTER W IMG,24333.22,24333.22,1459.99,20683.24,37 CDM,5685,VENOUS MECH THROMBECTOMY,10509.73,10509.73,630.58,8933.27,37 CDM,5686,ART THRMB NONCOR INI VSL,11173.52,11173.52,670.41,9497.49,37 CDM,5687,INS TRNVEN INTRHEP SHUNT,37351.79,37351.79,2241.11,31749.02,37 CDM,5688,REM TUN CVAD W/P-P,10921.33,10921.33,655.28,9283.13,37 CDM,5691,CATH 1ST OD RENAL LT,10816.79,10816.79,649.01,9194.27,37 CDM,5692,REPL PICC W/O PUMP/PORT,19022.82,19022.82,1141.37,16169.4,37 CDM,5693,REPL NON-TUN CVC W/O P-P,3155.66,3155.66,189.34,2682.31,37 CDM,5696,BLOCK C/T SPI SGL,2889.1,2889.1,173.35,2455.74,37 CDM,5698,MYELO W S&I THORACIC,8370.67,8370.67,502.24,7115.07,37 CDM,5699,MYELO W S&I CERVICAL,11863.45,11863.45,711.81,10083.93,37 CDM,5700,INJ BLOOD PATCH,4019.38,4019.38,241.16,3416.47,37 CDM,5703,PLC URTR STNT SEP CTH,10479.67,10479.67,628.78,8907.72,37 CDM,5705,PLCMT URETERAL STNT,9265.75,9265.75,555.95,7875.89,37 CDM,5706,NEPH CATH CONV TO NEPURT,9966.14,9966.14,597.97,8471.22,37 CDM,5707,NEPHURETERAL CATH PLCMT,8812.34,8812.34,528.74,7490.49,37 CDM,5708,INJ NEPH NEW ACCESS,3308.55,3308.55,198.51,2812.27,37 CDM,5709,REPLACE NEPHRO CATH W FL,21968.11,21968.11,1318.09,18672.89,37 CDM,5710,CONT INJ GS/ DU/ JJ/ GJ/,3624.76,3624.76,217.49,3081.05,37 CDM,5712,RPLC GAST OR CECO TUBE,11587.74,11587.74,695.26,9849.58,37 CDM,5713,INS DUO/JEJSTMT TUBE,11587.74,11587.74,695.26,9849.58,37 CDM,5714,EXCHG CATH ABS/CYS,12575.61,12575.61,754.54,10689.27,37 CDM,5717,PLCMT STNT BILE DUCT,6839.23,6839.23,410.35,5813.35,37 CDM,5718,EXCHANGE BILIARY CATH,7663.74,7663.74,459.82,6514.18,37 CDM,5719,REMOVE BILIARY CATH,7224.7,7224.7,433.48,6140.99,37 CDM,5720,PLC BILIARY CATH INT/EXT,20417.07,20417.07,1225.02,17354.51,37 CDM,5721,CHLECYSTOSTMY PERC,2720.53,2720.53,163.23,2312.45,37 CDM,5722,INTRO LONG GI TUBE,2190.01,2190.01,131.4,1861.51,37 CDM,5723,TRANS BAL ANGIO EACH IN,31226.02,31226.02,1873.56,26542.12,37 CDM,5724,TRANS ANGIO SAME ART INT,20640.51,20640.51,1238.43,17544.43,37 CDM,5725,VASC EMBOLIZ ARTERIAL,56971.77,56971.77,3418.31,48426.0,37 CDM,5726,VASC EMBOLIZ VENOUS,56971.77,56971.77,3418.31,48426.0,37 CDM,5728,TRANSCTH STNT PLC IA,12017.65,12017.65,721.06,10215.0,37 CDM,5736,INJ PERC EXTREM PSEAN,3133.45,3133.45,188.01,2663.43,37 CDM,5738,PUNCTURE LUMBAR THER,5004.63,5004.63,300.28,4253.94,37 CDM,5739,DX PERC ASP NP/DISC/TISS,4387.87,4387.87,263.27,3729.69,37 CDM,5740,RMV MRTL GS/DU/JJ/GJ/CC,7644.15,7644.15,458.65,6497.53,37 CDM,5746,LINER REVERSE +6MM,21552.0,21552.0,2801.76,18319.2,28 CDM,5747,COMPNT HUM SHLDR SMR,68177.0,68177.0,8863.01,57950.45,28 CDM,5751,SCREW BN 6.5MM 20MM,2541.0,2541.0,330.33,2159.85,28 CDM,5759,CATH IVC/SVC,2686.55,2686.55,161.19,2283.57,37 CDM,576,CATECHOL FRACTION UR,1020.74,1020.74,61.24,867.63,14 CDM,5762,BX BONE SUPERFICIAL,7167.0,7167.0,430.02,6091.95,37 CDM,5763,LOOP ENDO .012IN 26FR,2905.5,2905.5,174.33,2469.68,49 CDM,5771,INS TUN CVC CENT WO=>5Y,12736.33,12736.33,764.18,10825.88,37 CDM,5774,SCREW BN 2.2MM 12MM IBS,16374.0,16374.0,2128.62,13917.9,28 CDM,5776,SCISSORS LAPSCP CRV 5MM,2282.0,2282.0,136.92,1939.7,49 CDM,5777,BLOCK L-SPINE SGL,18257.1,18257.1,1095.43,15518.53,37 CDM,5778,I131 SOD IOD CAP DX MCI,300.71,300.71,18.04,255.6,41 CDM,5778,"Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie ",300.71,300.71,91.71,250.5,8 CDM,5779,F18 FDG DX 45MCI,1325.37,1325.37,79.52,1126.56,44 CDM,5779,"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries ",1325.37,1325.37,382.2,526.5,5 CDM,5781,IN111 PENTETAT DX 0.5MCI,3122.79,3122.79,187.37,2654.37,36 CDM,5781,"Indium in-111 pentetate, diagnostic, per 0.5 millicurie ",3122.79,3122.79,806.62,2818.02,8 CDM,5783,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,44 CDM,5786,PENCIL SMOKE EVAC 70MM,1511.0,1511.0,90.66,1284.35,49 CDM,5787,TAPR ADPT SHLDR 2MM SMR,4633.0,4633.0,602.29,3938.05,28 CDM,5789,BODY HUM SMR TI LCK SCR,44625.0,44625.0,5801.25,37931.25,28 CDM,5791,STEM HUM SHLDR 80MM 15MM,23552.0,23552.0,3061.76,20019.2,28 CDM,5804,PENCIL SMKEVC 165MM,214.0,214.0,12.84,181.9,49 CDM,5821,SCREW BN 2.7MM 12MM,2135.0,2135.0,277.55,1814.75,28 CDM,5822,SCREW BN THRD 2.7 14MM,5200.0,5200.0,676.0,4420.0,28 CDM,5823,SCREW BN 2.7MM 14MM,2135.0,2135.0,277.55,1814.75,28 CDM,5830,SHELL BIP HIP 50MM 28MM,12898.0,12898.0,1676.74,10963.3,28 CDM,5832,I123 SODIUM IOD DX 1 MCI,772.75,772.75,46.37,656.84,41 CDM,5832,"Iodine i-123 sodium iodide, diagnostic, per millicurie ",772.75,772.75,347.37,4863.43,8 CDM,5835,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,44 CDM,5836,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,44 CDM,584,CHOLESTEROL BLD,707.0,707.0,42.42,600.95,14 CDM,584,"Cholesterol, serum or whole blood, total ",707.0,707.0,3.65,29.96,76 CDM,5843,SLEEVE SUCT/IRR 125MM,241.0,241.0,14.46,204.85,49 CDM,5853,LINER HUM SMR STD UHMWPE,10594.0,10594.0,1377.22,9004.9,28 CDM,5854,STEM FIN SHLDR DIA 16MM,23552.0,23552.0,3061.76,20019.2,28 CDM,5857,SP ANGIO EXT BI,7178.21,7178.21,430.69,6101.48,17 CDM,5860,DEVICE WNDCLS 30CM SZ2,1682.5,1682.5,100.95,1430.13,49 CDM,5864,SHEATH STPLR DISP 45MM,1150.0,1150.0,69.0,977.5,49 CDM,5868,CORD SILCNE RETRCT 10PK,439.0,439.0,26.34,373.15,49 CDM,5869,KIT SURG KN TRK STRL,6798.5,6798.5,407.91,5778.73,49 CDM,5881,DEVICE RET 2.4MM 230CM,4600.5,4600.5,276.03,3910.43,49 CDM,5882,CATH PORTAL VN,4701.48,4701.48,282.09,3996.26,37 CDM,5884,STAPLER INT 12MM,17607.0,17607.0,1056.42,14965.95,49 CDM,5891,SHELL ACTB HIP SZG 58MM,28172.0,28172.0,3662.36,23946.2,28 CDM,5896,STEM FEM HIP 13MM 146MM,50710.0,50710.0,6592.3,43103.5,28 CDM,5898,PLUG CERV 4D 5X12X14MM,27488.0,27488.0,3573.44,23364.8,28 CDM,5907,SCREW BN SPN 4.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 CDM,5908,SCREW SPN 4.5MM 8MM,2633.0,2633.0,342.29,2238.05,28 CDM,5910,OCCLUDER CV 30X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,5914,CATH ANGO 4.0FR 100CM,601.5,601.5,36.09,511.27,49 CDM,5925,DEVICE SLD MOTOR DISP,2278.0,2278.0,136.68,1936.3,49 CDM,5926,GRAFT BN CHIPS 30CC,9050.0,9050.0,1176.5,7692.5,28 CDM,5927,STENT VASC 7MM 60MM,70060.0,70060.0,9107.8,59551.0,28 CDM,5928,STENT VASC 7MM 80MM,79218.0,79218.0,10298.34,67335.3,28 CDM,5929,STENT VASC 6MM 100MM,79218.0,79218.0,10298.34,67335.3,28 CDM,5931,KIT CLOSURE GRASP GUIDE,752.5,752.5,45.15,639.63,49 CDM,5932,RELOAD STPLR BLUE 3.5MM,8938.0,8938.0,1161.94,7597.3,28 CDM,5937,STENT VASC 7MM 120MM,88376.0,88376.0,11488.88,75119.6,28 CDM,5943,STENT VASC 7MM 40MM,60902.0,60902.0,7917.26,51766.7,28 CDM,5949,NEEDLE SCLRTX 25GA 1.8MM,1471.5,1471.5,88.29,1250.78,49 CDM,5950,ELECTRODE ESURG 44CM,1550.0,1550.0,93.0,1317.5,49 CDM,5951,DEVICE SUT 3X1.2MM,19299.0,19299.0,1157.94,16404.15,49 CDM,5952,SUTURE PP CP SZ 0 48IN,2905.5,2905.5,174.33,2469.68,49 CDM,5954,HEAD HUM SHLDR 45MM SMR,22313.0,22313.0,2900.69,18966.05,28 CDM,5957,NEEDLE SCLRTX 23GA 2.3MM,1471.5,1471.5,88.29,1250.78,49 CDM,5959,DEVICE CLSR 6FR .035IN,9817.0,9817.0,1276.21,8344.45,28 CDM,5963,INTRO SHTH 11FR 10CM,639.5,639.5,38.37,543.58,49 CDM,5965,STEM HUM 24X80MM FN,23552.0,23552.0,3061.76,20019.2,28 CDM,5966,SCREW BN 6.5MM 40MM,1779.0,1779.0,231.27,1512.15,28 CDM,5967,KIT CATH MIDLINE 3FR,6273.0,6273.0,376.38,5332.05,49 CDM,5974,CLIP IRR MICS STRL,3868.5,3868.5,232.11,3288.22,49 CDM,5978,CMPNT FEM KN RM/LL SZ5,38596.0,38596.0,5017.48,32806.6,28 CDM,5979,BASEPLATE TIB KN SZ4,28172.0,28172.0,3662.36,23946.2,28 CDM,5982,STAPLER RIENF GREEN 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,5983,STAPLER REINF BLACK 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,5985,SUTURE CT-1 SZ1 8X18IN,535.5,535.5,32.13,455.18,49 CDM,5988,STENT VASC 6MM 80MM,79218.0,79218.0,10298.34,67335.3,28 CDM,5990,STENT VASC 6MM 40MM,60902.0,60902.0,7917.26,51766.7,28 CDM,5992,STEM SHLDR 80MM 14MM,23552.0,23552.0,3061.76,20019.2,28 CDM,5994,LINER REV SHO 6X40MM,21552.0,21552.0,2801.76,18319.2,28 CDM,60000,INTVSC US NONCORN EADD,939.51,939.51,56.37,798.58,37 CDM,600002,XR ARTHROGRAM SHLDR BI,4580.26,4580.26,274.82,3893.22,17 CDM,600004,XR ARTHROGRAM ELBOW BI,3047.54,3047.54,182.85,2590.41,17 CDM,600006,XR ARTHROGRAM WRIST BI,4580.26,4580.26,274.82,3893.22,17 CDM,600008,XR ARTHROGRAM HIP BI,4580.26,4580.26,274.82,3893.22,17 CDM,60001,INTVSC US NONCORN INIT,939.51,939.51,56.37,798.58,37 CDM,600014,CTA UPPER EXTREMITY LT,18467.35,18467.35,1108.04,15697.25,14 CDM,600015,CTA UPPER EXTREMITY RT,18467.35,18467.35,1108.04,15697.25,14 CDM,60002,TRANSCTH STNT PLC EA VN,28681.89,28681.89,1720.91,24379.61,37 CDM,600024,INFLIXIMAB 10 MG INJJW,736.44,736.44,44.19,625.97,19 CDM,600026,RASBURICASE 0.5 MG INJJW,6605.37,6605.37,396.32,5614.56,19 CDM,600027,SARGRAMOSTIM 50 MCGJW,573.45,573.45,34.41,487.43,19 CDM,600028,TENECTEPLASE 1 MG INJJW,986.29,986.29,59.18,838.35,19 CDM,60003,SUTURE CT-2 SZ0 8X18IN,3982.5,3982.5,238.95,3385.13,49 CDM,600036,MESH SURG HERNIA 10X15CM,19633.0,19633.0,2552.29,16688.05,28 CDM,600039,SEAL CANN 10MM,915.5,915.5,54.93,778.17,49 CDM,600044,INSERT KN TIB STD 20MM,21346.0,21346.0,2774.98,18144.1,28 CDM,600048,IRRIGATOR SUC 8MM,9798.5,9798.5,587.91,8328.73,49 CDM,600051,MYELO W S&I LUMBOSAC,11863.45,11863.45,711.81,10083.93,37 CDM,600052,INTRODUCR SHTH 10F 25CM,2696.5,2696.5,161.79,2292.03,49 CDM,600053,MESH SURG HERNIA 10X15CM,19633.0,19633.0,2552.29,16688.05,28 CDM,600054,GRAFT EVAS 14.5MM 7CM,92650.0,92650.0,12044.5,78752.5,28 CDM,600055,BLN 10-37MMX4.0CMX90CM,17255.0,17255.0,1035.3,14666.75,49 CDM,600057,STENT EPRSTH 6MM 7.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,600061,STENT EPRSTH 6MM 5CM,95062.0,95062.0,12358.06,80802.7,28 CDM,600072,INTRO LD 49CM 9FR SFSH,16656.5,16656.5,999.39,14158.02,49 CDM,600077,COIL EMBL 6.7MM 6MM,3061.0,3061.0,397.93,2601.85,28 CDM,600078,COIL EMBL 5.5MM 5MM,2871.0,2871.0,373.23,2440.35,28 CDM,600079,CATH ANGIO CRV 5FR 100CM,2994.0,2994.0,179.64,2544.9,49 CDM,600096,SYSTEM PRESS 20CM 10CM,14641.5,14641.5,878.49,12445.27,49 CDM,6001,SUTURE P-3 5-0 1X18IN,260.5,260.5,15.63,221.43,49 CDM,600101,DEVICE SUT LAP 10MM 15IN,17607.0,17607.0,1056.42,14965.95,49 CDM,600106,KIT SHDR SUSP LF,2819.5,2819.5,169.17,2396.57,49 CDM,600107,SYSTEM CATH ARTHRCM 1.5M,96863.0,96863.0,5811.78,82333.55,49 CDM,600108,CATH GD 4FR 90CM,6273.0,6273.0,376.38,5332.05,49 CDM,600110,CATH GD AR1 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,600111,TRAY CATH BASIC 18G 10CM,2905.5,2905.5,174.33,2469.68,49 CDM,600113,STENT VASC 6MM 60MM,70060.0,70060.0,9107.8,59551.0,28 CDM,600114,STENT VASC 6MM 100MM,79218.0,79218.0,10298.34,67335.3,28 CDM,600115,STENT VASC 6MM 120MM,88376.0,88376.0,11488.88,75119.6,28 CDM,600118,NEEDLE BX 18GA 11CM,2905.5,2905.5,174.33,2469.68,49 CDM,600119,NEEDLE ART 18GA 2.75IN,322.5,322.5,19.35,274.13,49 CDM,60013,SUTURE CT-1 SZ1 1X36IN,85.5,85.5,5.13,72.67,49 CDM,600130,NEEDLE BX 20GA 11CM,2905.5,2905.5,174.33,2469.68,49 CDM,600136,GLOVE CMPR LT SM,521.0,521.0,31.26,442.85,49 CDM,600139,PIN SKULL DISP 1.285IN,2541.0,2541.0,152.46,2159.85,49 CDM,600140,CATH PCNG TEMP 5FR 110CM,5403.0,5403.0,324.18,4592.55,49 CDM,600141,GWIRE VASC 335CM .014IN,5808.5,5808.5,348.51,4937.23,49 CDM,600142,LEAD PCNG 65CM,67522.0,67522.0,8777.86,57393.7,28 CDM,600156,HEAD HUM SHLDR MED SMR,27065.0,27065.0,3518.45,23005.25,28 CDM,600159,LINER HUM SHLDR 36MM,21552.0,21552.0,2801.76,18319.2,28 CDM,600161,SCREW SPN 5.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,600162,SCREW SPN P-AX 05.5X40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,600173,STEM HUM 80X18MM CMNTLS,23552.0,23552.0,3061.76,20019.2,28 CDM,600175,STEM SHLDR CMNTLS 17MM,23552.0,23552.0,3061.76,20019.2,28 CDM,600182,GWIRE VASC 190CM .014IN,2905.5,2905.5,174.33,2469.68,49 CDM,600185,MODEL-5F CONVEY AR2,2150.5,2150.5,129.03,1827.92,49 CDM,600189,GWIRE ORTH 150MM 1.6MM,1498.0,1498.0,89.88,1273.3,49 CDM,600198,IMPLANT BREAST 335CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600199,IMPLANT BREAST 345CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6002,SUTURE BLU MONO 3-0 18IN,226.0,226.0,13.56,192.1,49 CDM,600200,IMPLANT BREAST 365CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600201,IMPLANT BREAST 385CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600202,IMPLANT BREAST 415CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600203,IMPLANT BREAST 450CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600204,IMPLANT BREAST 485CC,25709.0,25709.0,3342.17,21852.65,28 CDM,600206,SHEATH INTRO 10F 25CM,1395.0,1395.0,83.7,1185.75,49 CDM,600210,PIN FX 3.2MM 110MM,4759.0,4759.0,285.54,4045.15,49 CDM,600211,PIN FX STRL 3.2X140MM,4759.0,4759.0,285.54,4045.15,49 CDM,600215,DEVICE CLSR 6FR-7FR,7854.0,7854.0,1021.02,6675.9,28 CDM,600226,MARKER FDCL 1.0MM 3MM,1601.0,1601.0,208.13,1360.85,28 CDM,600232,GWIRE VASC 190CM .014IN,2905.5,2905.5,174.33,2469.68,49 CDM,600265,SCREW BN 6.5MM 50MM,2541.0,2541.0,330.33,2159.85,28 CDM,600267,STEM FEM HIP 6MM 132MM,56344.0,56344.0,7324.72,47892.4,28 CDM,600271,SHELL ACTB HIP SZE 52MM,28172.0,28172.0,3662.36,23946.2,28 CDM,600272,SHEATH INTRO 21G 5F 16CM,2789.5,2789.5,167.37,2371.07,49 CDM,600275,PIN SPED RIM STRL 45MM,1918.0,1918.0,115.08,1630.3,49 CDM,600291,SCREW BN LCK 3.5MN 12MM,3574.0,3574.0,464.62,3037.9,28 CDM,600292,CANNULA ART 15FR 31.8CM,10705.5,10705.5,642.33,9099.67,49 CDM,600293,CANNULA ART 17FR 31.8CM,10705.5,10705.5,642.33,9099.67,49 CDM,600294,CANNULA ART 19FR 3/8IN,10705.5,10705.5,642.33,9099.67,49 CDM,600295,CANNULA ART 21FR 31.8CM,10705.5,10705.5,642.33,9099.67,49 CDM,600296,KIT BIOMD INSRTN ART JUG,3791.0,3791.0,227.46,3222.35,49 CDM,6003,SUTURE UND BRD 7-0 18IN,218.5,218.5,13.11,185.72,49 CDM,600300,CANN PRFSN ADLT L30 OD21,6585.0,6585.0,395.1,5597.25,49 CDM,600309,SENSOR MNTR 12X10X9IN LG,3792.0,3792.0,227.52,3223.2,49 CDM,600314,KIT COMBO DEVICE/FASTNER,22741.0,22741.0,1364.46,19329.85,49 CDM,600315,DEVICE UNIT SUT FASTNER,2185.0,2185.0,284.05,1857.25,28 CDM,600324,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,600325,GWIRE VASC .035IN 260CM,778.5,778.5,46.71,661.73,49 CDM,600326,GWIRE VASC .035IN 150CM,718.5,718.5,43.11,610.73,49 CDM,600327,CATH GD 6F XBRCA 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,600331,RNG ANLPLS TRCSPD 26,59925.0,59925.0,7790.25,50936.25,28 CDM,600345,RNG ANLPLS TRCSPD 32,59925.0,59925.0,7790.25,50936.25,28 CDM,600346,RNG ANLPLS TRCSPD 34,59925.0,59925.0,7790.25,50936.25,28 CDM,600347,RNG ANLPLS TRCSPD 36,67007.0,67007.0,8710.91,56955.95,28 CDM,600348,RING ANLPLS 24MM,60291.0,60291.0,7837.83,51247.35,28 CDM,600349,RNG ANLPLS TRCSPD 28,59925.0,59925.0,7790.25,50936.25,28 CDM,600350,RING ANLPLS 26MM,85476.0,85476.0,11111.88,72654.6,28 CDM,600351,RING ANNULPLSTY 28X5200,63306.0,63306.0,8229.78,53810.1,28 CDM,600352,RING ANLPLS 30MM,63306.0,63306.0,8229.78,53810.1,28 CDM,600353,RING ANLPLS 32MM,63306.0,63306.0,8229.78,53810.1,28 CDM,600354,RING ANLPLS 34MM,63306.0,63306.0,8229.78,53810.1,28 CDM,600355,RING ANLPLS 36MM,63306.0,63306.0,8229.78,53810.1,28 CDM,600356,RING ANLPLS 38MM,60291.0,60291.0,7837.83,51247.35,28 CDM,600357,RING ANLPLS MTRL 40MM,60291.0,60291.0,7837.83,51247.35,28 CDM,600358,HANDPIECE HDRSRG 45D 8MM,80078.0,80078.0,4804.68,68066.3,49 CDM,600360,CATH ANGIO 5FR 125CM,1148.0,1148.0,68.88,975.8,49 CDM,600364,HANDPIECE DISP 45D 14MM,56482.0,56482.0,3388.92,48009.7,49 CDM,600366,CATH CHLGM DLV ACC,75494.5,75494.5,4529.67,64170.32,49 CDM,600375,CATH EP 5FR 115CM,6937.5,6937.5,416.25,5896.88,49 CDM,600377,CATH ABL 7FR 115CM,28688.0,28688.0,1721.28,24384.8,49 CDM,600378,CATH EP 7FR 115CM,61085.0,61085.0,3665.1,51922.25,49 CDM,600379,CATH ABL 8FR 115CM D CRV,100000.0,100000.0,6000.0,85000.0,49 CDM,6004,SUTURE P-3 5-0 1X18IN,165.5,165.5,9.93,140.68,49 CDM,600408,CLAMP SURG 2.75IN TWL PL,212.0,212.0,12.72,180.2,49 CDM,600409,FELT CV PTCH PTFE .5X4IN,3533.0,3533.0,459.29,3003.05,28 CDM,600412,CATH ANGIO PGTL 5F 100CM,3446.5,3446.5,206.79,2929.53,49 CDM,600425,STEM FEM HIP 140MM 10MM,70430.0,70430.0,9155.9,59865.5,28 CDM,600432,INSERT CLAMP 86MM,1743.5,1743.5,104.61,1481.97,49 CDM,600433,LEAD PCNG 53CM,3773.0,3773.0,490.49,3207.05,28 CDM,600437,CLIP LIGATING MICROCLIP,257.0,257.0,33.41,218.45,28 CDM,600438,CAUT BTRY 2 TIP HI TMP,399.5,399.5,23.97,339.57,49 CDM,600439,NEEDLE ASP BLU CAP 16GA,4304.0,4304.0,258.24,3658.4,49 CDM,600444,SCREW BN 2.7MM 14MM,2440.0,2440.0,317.2,2074.0,28 CDM,600445,SCREW BN 2.7MM 12MM,2440.0,2440.0,317.2,2074.0,28 CDM,600446,BLADE STERNUM STD,3973.0,3973.0,238.38,3377.05,49 CDM,600449,SCREW BN 2.7MM 10MM,3786.0,3786.0,492.18,3218.1,28 CDM,600450,SCREW BN 2.7MM 20MM,3786.0,3786.0,492.18,3218.1,28 CDM,600453,SCREW BN 2.7MM 8MM,3786.0,3786.0,492.18,3218.1,28 CDM,600457,SHUNT CV TEMP 1MM,15983.0,15983.0,958.98,13585.55,49 CDM,600464,PUNCH AORTIC 4MM,2905.5,2905.5,174.33,2469.68,49 CDM,600465,PUNCH CV 4.5MM 14.6CM,2905.5,2905.5,174.33,2469.68,49 CDM,600466,RUNCH RND 3.5MMX14.5CM,2499.0,2499.0,149.94,2124.15,49 CDM,600467,PUNCH AORTIC 7.75X4.8,2558.0,2558.0,153.48,2174.3,49 CDM,600468,CATH IAB BLN 7FR 34CC,27069.0,27069.0,1624.14,23008.65,49 CDM,600469,SHUNT CV TEMP 1.5MM,12189.5,12189.5,731.37,10361.08,49 CDM,600470,SHUNT CV TEMP 2MM,12189.5,12189.5,731.37,10361.08,49 CDM,600471,SHNT CV TEMP 2.5MM,13314.0,13314.0,798.84,11316.9,49 CDM,600472,SHUNT CV TEMP 3MM,12189.5,12189.5,731.37,10361.08,49 CDM,600473,SHUNT CV TEMP 3.5MM,12189.5,12189.5,731.37,10361.08,49 CDM,600476,CATH IA BLN 8FR 50CC,28694.0,28694.0,1721.64,24389.9,49 CDM,600477,SHEATH INTR TER 10CM 4F,1743.5,1743.5,104.61,1481.97,49 CDM,600478,GWIRE VASC 260CM 3MM,1162.0,1162.0,69.72,987.7,49 CDM,600479,CATH BLNDIL 20X4.5X110,21308.0,21308.0,1278.48,18111.8,49 CDM,600480,CATH BLNDIL 18X4.5X110,21308.0,21308.0,1278.48,18111.8,49 CDM,600482,CATH EP 5FR 110CM,9684.0,9684.0,581.04,8231.4,49 CDM,600484,CATH ULTSND 8FR 90CM,79951.0,79951.0,4797.06,67958.35,49 CDM,600487,NEEDLE TRNSPTL 18GA 71CM,5440.0,5440.0,326.4,4624.0,49 CDM,600490,SCREW BN 2.7MM 24MM,3435.0,3435.0,446.55,2919.75,28 CDM,600496,SCREW BN LCK 5X40,5341.0,5341.0,694.33,4539.85,28 CDM,600499,INTRO SHTH 12FR 12CM,848.5,848.5,50.91,721.23,49 CDM,600501,DRAIN WND RND 24FR,743.5,743.5,44.61,631.98,49 CDM,600509,SHELL ACTB HIP 3 H 50MM,28172.0,28172.0,3662.36,23946.2,28 CDM,600513,CLIP LIGATING MD,290.0,290.0,37.7,246.5,28 CDM,600516,GWIRE VASC .035IN 260CM,6273.0,6273.0,376.38,5332.05,49 CDM,600517,CATH OCC 10FR 46MM 140CM,17279.0,17279.0,1036.74,14687.15,49 CDM,600518,CATH BLNOCC 9FR 120CM,17607.0,17607.0,1056.42,14965.95,49 CDM,600520,INTRO SHTH 6F 110CM,4244.5,4244.5,254.67,3607.82,49 CDM,600522,CATH THOR RT ANG 28FR,392.0,392.0,23.52,333.2,49 CDM,600523,CATH DRN THOR 32FR 23IN,1753.0,1753.0,105.18,1490.05,49 CDM,600526,GRAFT PTCH CV 8X6CM,19633.0,19633.0,2552.29,16688.05,28 CDM,600528,GRAFT CV 10MM 30CM,12829.0,12829.0,1667.77,10904.65,28 CDM,600529,GRAFT CV 8MM 30CM,12829.0,12829.0,1667.77,10904.65,28 CDM,600530,SYS STBLZR RTRCTR CHST,31570.5,31570.5,1894.23,26834.92,49 CDM,600531,STABILIZER SURG VAC,20839.5,20839.5,1250.37,17713.58,49 CDM,600549,OCCLUDER VSD 7X8X16MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600644,SYSTEM VESSEL HARVESTING,33953.5,33953.5,2037.21,28860.47,49 CDM,600647,VALVE AORTIC 19MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600648,ADHSV SKNCL PRFLSYR 10ML,31692.0,31692.0,4119.96,26938.2,28 CDM,600654,VALVE AORTIC 19MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600656,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600658,VALVE AORTIC 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600659,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600660,VALVE AORTIC 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600661,VALVE AORTIC 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600669,VALVE AORTIC 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600670,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600674,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600677,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600683,KIT CATH 12FR 16CM,4851.0,4851.0,291.06,4123.35,49 CDM,600698,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,6007,SUTURE PS-2 5-0 1X18IN,152.5,152.5,9.15,129.63,49 CDM,600700,SCREW BN 1.5MM 8MM,6440.0,6440.0,837.2,5474.0,28 CDM,600706,PLATE BN FIB 8HL 137MM,19993.0,19993.0,2599.09,16994.05,28 CDM,600708,VALVE MITRAL 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600712,GWIRE VASC .018IN 9.75IN,4659.0,4659.0,279.54,3960.15,49 CDM,600716,TUBING PRSS MNTR 84IN,182.0,182.0,10.92,154.7,49 CDM,600718,CATH ANGIO 4.0FR 100CM,464.0,464.0,27.84,394.4,49 CDM,600734,SUTURE GRN BRD 2-0 30IN,2456.5,2456.5,147.39,2088.03,49 CDM,600736,KIT ANGIO HAND CONTROL,2092.0,2092.0,125.52,1778.2,49 CDM,600737,CATH BLNDIL 1.5MM 8MM,4391.0,4391.0,263.46,3732.35,49 CDM,600740,SUTURE BLU MONO 4-0 36IN,642.5,642.5,38.55,546.13,49 CDM,600741,SCREW BN 5MM 32MM,15432.0,15432.0,2006.16,13117.2,28 CDM,600745,SUTURE BLU MONO 6-0 30IN,1195.5,1195.5,71.73,1016.17,49 CDM,600748,SUTURE GRN BRD 2-0 36IN,391.5,391.5,23.49,332.77,49 CDM,600751,DEVICE CLSR WND +1 60CM,1348.0,1348.0,80.88,1145.8,49 CDM,600752,PLEDGET CV 9.5X4.8X1.5MM,211.5,211.5,12.69,179.78,49 CDM,600754,SUTURE BLU MONO 4-0 36IN,3915.5,3915.5,234.93,3328.18,49 CDM,600755,SUTURE BLU MONO 4-0 36IN,3729.5,3729.5,223.77,3170.07,49 CDM,600757,SUTURE PCK 48IN 2-0 PRLN,3938.0,3938.0,236.28,3347.3,49 CDM,600766,STENT BIL PGTL 7FR 3CM,2541.0,2541.0,330.33,2159.85,28 CDM,600767,SYSTEM NEG PRSS PLS 90CM,11234.0,11234.0,674.04,9548.9,49 CDM,600769,SUTURE GRN BRD 2-0 30IN,2571.5,2571.5,154.29,2185.78,49 CDM,600771,SUTURE PS-2 3-0 1X27IN,248.0,248.0,14.88,210.8,49 CDM,600777,GWIRE VASC .032IN 260CM,1162.0,1162.0,69.72,987.7,49 CDM,600778,NEEDLE TRNSPTL 18GA 98CM,6273.0,6273.0,376.38,5332.05,49 CDM,600781,KIT ART LN 5IN 20GA,2905.5,2905.5,174.33,2469.68,49 CDM,600782,SUMP INTRCRD 20FR 12IN,627.0,627.0,37.62,532.95,49 CDM,600783,SUTURE GRN BRD 2-0 36IN,1996.5,1996.5,119.79,1697.03,49 CDM,600786,GLENOSPHERE SMR ECC 36MM,50790.0,50790.0,6602.7,43171.5,28 CDM,600789,LINER HUM 36MMSMR+3MM,21552.0,21552.0,2801.76,18319.2,28 CDM,600790,SPACER SPN 4D 14X9X12MM,22538.0,22538.0,2929.94,19157.3,28 CDM,600791,KIT TEMP EX-FX ANKLE,100000.0,100000.0,6000.0,85000.0,49 CDM,600795,SCREW BN LCK 2.7MM 12MM,3578.0,3578.0,465.14,3041.3,28 CDM,600799,SCREW BN LCK 2.7MM 8MM,3578.0,3578.0,465.14,3041.3,28 CDM,600803,PLATE BN 4HL 89MM,19633.0,19633.0,2552.29,16688.05,28 CDM,600807,SUTURE BLK MONO 8-0 24IN,1198.5,1198.5,71.91,1018.73,49 CDM,600812,SUTURE BLU MONO 2-0 36IN,3429.5,3429.5,205.77,2915.07,49 CDM,600815,OCCLUDER CV 10X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600817,SCREW BN T8 2.7/L16MM,2135.0,2135.0,277.55,1814.75,28 CDM,600818,OCCLUDER CV 11X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600819,SET VNTRC 17.4X13.8IN,100000.0,100000.0,6000.0,85000.0,49 CDM,600820,OCCULDER CV 15X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600821,OCCULDER CV 17X4MM,109000.0,109000.0,14170.0,92650.0,28 CDM,600822,OCCULDER CV 20X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600823,OCCULDER CV 22X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600825,OCCULDER CV 32X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600826,OCCULDER CV 34X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600827,OCCULDER CV 36X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600828,OCCULDER CV 38X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600832,OCCULDER CV 5X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600836,SUTURE GRN BRD 2-0 30IN,2209.5,2209.5,132.57,1878.08,49 CDM,600844,BASEPLT KN RT SZ4,25355.0,25355.0,3296.15,21551.75,28 CDM,600846,SCREW BN 6.5MM 40MM,2541.0,2541.0,330.33,2159.85,28 CDM,600858,CATH PERI .014IN 130CM,16903.0,16903.0,1014.18,14367.55,49 CDM,600860,INTRODUCER SHTH 8FR 90CM,2905.5,2905.5,174.33,2469.68,49 CDM,600861,INTRODUCER SHTH 8FR 70CM,3512.5,3512.5,210.75,2985.63,49 CDM,600867,FEMORAL PREP KT SIZE 7 T,6303.5,6303.5,378.21,5357.98,49 CDM,600869,SCREW BN 2.7MM 20MM,3435.0,3435.0,446.55,2919.75,28 CDM,600870,KWIRE TROC 2.0MM 150MM,1033.5,1033.5,62.01,878.48,49 CDM,600873,WIRE SUT .5CIRC 54MM,4168.5,4168.5,250.11,3543.22,49 CDM,600876,CATH EP 6FR 110CM,10564.5,10564.5,633.87,8979.83,49 CDM,600878,CMPNT HIP FEM 9MM 137MM,47893.0,47893.0,6226.09,40709.05,28 CDM,600881,FORCEPS GRSP 115CM 2.5FR,7612.5,7612.5,456.75,6470.63,49 CDM,600883,KIT CELLSAVER TBG,892.0,892.0,53.52,758.2,49 CDM,600884,SYSTEM RETR SCROTAL,17607.0,17607.0,1056.42,14965.95,49 CDM,600885,RESERVOIR PENL 100MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600888,SUTURE UND MONO 4-0 27IN,95.0,95.0,5.7,80.75,49 CDM,600890,KIT PROSTH PENL ACC,36381.0,36381.0,4729.53,30923.85,28 CDM,600897,PROSTHESIS PENL TTN PMP,100000.0,100000.0,13000.0,85000.0,28 CDM,600899,PROSTHESIS PENL TTN 26CM,100000.0,100000.0,13000.0,85000.0,28 CDM,6009,WAX BN 2.5GM,235.5,235.5,14.13,200.18,49 CDM,600903,GRAFT STENT 14-25X103MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600904,STENT GRAFT 16X10X124MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600905,STENT GRAFT 16X10X93MM,100000.0,100000.0,13000.0,85000.0,28 CDM,600906,CATH BLN 4MM 100CM,13997.0,13997.0,839.82,11897.45,49 CDM,600912,STEM FEM HIP 11MM 142MM,47893.0,47893.0,6226.09,40709.05,28 CDM,600915,SUTURE GRN BRD 2-0 30IN,2141.0,2141.0,128.46,1819.85,49 CDM,600916,INTRO SHEATH NTNL 6FR,2034.0,2034.0,122.04,1728.9,49 CDM,600927,CATH INFS 90D 130CM,16903.0,16903.0,1014.18,14367.55,49 CDM,600935,GLIDE SHORT ANGLED,2778.0,2778.0,166.68,2361.3,49 CDM,600939,CATH ANGIO 4FR 100CM,601.5,601.5,36.09,511.27,49 CDM,600941,CATH ANGIO BERN 4FR100CM,627.0,627.0,37.62,532.95,49 CDM,600942,CATH .038 65CM 4FR,1453.0,1453.0,87.18,1235.05,49 CDM,600943,IMPLANT BREAST 405CC,33147.0,33147.0,4309.11,28174.95,28 CDM,600947,GRAFT CV 10X30MM 50CM,31789.0,31789.0,4132.57,27020.65,28 CDM,600956,SUTURE ETHBND 00 PXX80,2701.5,2701.5,162.09,2296.28,49 CDM,600959,CATH BLNDIL 2.25MM 8MM,4600.5,4600.5,276.03,3910.43,49 CDM,600962,GWIRE ORTH 1.4MM 150MM,2905.5,2905.5,174.33,2469.68,49 CDM,600963,SCREW BN 4MM 44MM 15MM,5990.0,5990.0,778.7,5091.5,28 CDM,600964,KWIRE FX 150MM 1.6MM,395.0,395.0,23.7,335.75,49 CDM,600967,INTRO SHTH 8.5FR 67CM,6273.0,6273.0,376.38,5332.05,49 CDM,600975,WRE STRQ .035 300,2905.5,2905.5,174.33,2469.68,49 CDM,600976,INTRO OC R 9FR 47CM,13368.5,13368.5,802.11,11363.23,49 CDM,600980,SHEATH SZ 9F TIP 80CM,22648.5,22648.5,1358.91,19251.22,49 CDM,600989,CABLE FXTN 1.8MM 91CM,19633.0,19633.0,2552.29,16688.05,28 CDM,601007,VALVE AORTIC 33MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601008,VALVE AORTIC 31MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601009,VALVE AORTIC 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601010,VALVE AORTIC 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601011,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601033,OSTEOTOME SURG 12X93MM,18581.0,18581.0,1114.86,15793.85,49 CDM,601058,CATH GD 6FR 150CM,13205.5,13205.5,792.33,11224.67,49 CDM,601062,CATH BLN 5FR 6X130X40MM,35107.0,35107.0,2106.42,29840.95,49 CDM,601063,GRAFT CV 10X28MM 50CM,30863.0,30863.0,4012.19,26233.55,28 CDM,601065,CATH THRMB 6FR 140CM,14262.0,14262.0,855.72,12122.7,49 CDM,601068,INTRO SHEATH 26FR 33CM,14700.0,14700.0,882.0,12495.0,49 CDM,601069,COMPNT FEM KN RT SZ5,42258.0,42258.0,5493.54,35919.3,28 CDM,601071,GWIRE VASC 275X2.9X3.2CM,35004.0,35004.0,2100.24,29753.4,49 CDM,601072,GWIRE VASC 275X4.2X4.2CM,25723.0,25723.0,1543.38,21864.55,49 CDM,601075,CATH GUIDE 100CM 5FR,2208.5,2208.5,132.51,1877.22,49 CDM,601076,CATHETER GD 100CM 5FR,2371.0,2371.0,142.26,2015.35,49 CDM,601077,CATHETER GD 100CM 5FR,2208.5,2208.5,132.51,1877.22,49 CDM,601078,CATH GD ADRT 3D 5F 100CM,2208.5,2208.5,132.51,1877.22,49 CDM,601080,CATH GD ADROIT 5F 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,601081,CATH GUIDE 100CM 5FR,2371.0,2371.0,142.26,2015.35,49 CDM,601082,CATHETER GD 100CM 5FR,2371.0,2371.0,142.26,2015.35,49 CDM,601083,CATH GUIDE 100CM 5FR,2371.0,2371.0,142.26,2015.35,49 CDM,601084,PLUG VASC 7MM 8MM,26906.0,26906.0,3497.78,22870.1,28 CDM,601085,PLUG VASC 9MM 12MM,26906.0,26906.0,3497.78,22870.1,28 CDM,601087,TUBING HYSTERSCPE INFL,5562.0,5562.0,333.72,4727.7,49 CDM,601088,SHELL ACTB HIP 5 SCR56MM,28172.0,28172.0,3662.36,23946.2,28 CDM,601091,GRAFT CV 12MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,601092,GRAFT CV 16MM 30CM,12433.0,12433.0,1616.29,10568.05,28 CDM,601093,GRAFT CV 22MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,601094,GRAFT CV 10X22MM 50CM,30863.0,30863.0,4012.19,26233.55,28 CDM,601097,GRAFT CV 24MM 50MM,36087.0,36087.0,4691.31,30673.95,28 CDM,601098,GRAFT CV 26MM 50MM,34368.0,34368.0,4467.84,29212.8,28 CDM,601099,GRAFT CV 30MM 50MM,36087.0,36087.0,4691.31,30673.95,28 CDM,601100,GRAFT CV 15CM 24X32X24MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601101,GRAFT CV 15CM 30X38X30MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601102,GRAFT CV 15CM 32X40X32MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601103,GRAFT CV 15CM 28X36X28MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601104,TROCAR LAPSCP 100MM 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,601105,GWIRE VASC 145CM .014IN,3178.5,3178.5,190.71,2701.72,49 CDM,601106,EXTENSION GW VASC 165CM,2905.5,2905.5,174.33,2469.68,49 CDM,601107,GRAFT CV 10X34MM 50CM,30863.0,30863.0,4012.19,26233.55,28 CDM,601108,GRAFT CV 15CM 26X34X26MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601111,TUBING HYSTERSCPE OFLW,3872.0,3872.0,232.32,3291.2,49 CDM,601113,KIT FASTENER ENDO,100000.0,100000.0,13000.0,85000.0,28 CDM,601123,GRAFT ST TIS 7X4CM,69633.0,69633.0,9052.29,59188.05,28 CDM,601131,KIT CATH CANN PRFSN,100000.0,100000.0,6000.0,85000.0,49 CDM,601133,STENT COR 3.5X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601134,STENT COR 3.0X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601135,STENT COR 2.5X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601139,GWIRE SNSR ENDO .035X150,2076.5,2076.5,124.59,1765.03,49 CDM,601140,GWIRE URO ANGLD .035X150,2119.0,2119.0,127.14,1801.15,49 CDM,601141,GWIRE VASC .035IN 145CM,1253.5,1253.5,75.21,1065.47,49 CDM,601151,SCREW BN 2.7MM 18MM,1017.0,1017.0,132.21,864.45,28 CDM,601153,SCREW BN 3.5MM 16MM,10799.0,10799.0,1403.87,9179.15,28 CDM,601162,ANCHOR SUT 4.75MM,13940.0,13940.0,1812.2,11849.0,28 CDM,601163,ANCHOR SUT 4.75MM,13940.0,13940.0,1812.2,11849.0,28 CDM,601165,PIN FX 15MM 1.1MM,5400.0,5400.0,324.0,4590.0,49 CDM,601166,INSERT XLPE KN SZ5-6 9MM,18312.0,18312.0,2380.56,15565.2,28 CDM,601172,DRILL SURG SM SHRT 2.5MM,5560.0,5560.0,333.6,4726.0,49 CDM,601174,DRILL SURG SM SHRT 2MM,2905.5,2905.5,174.33,2469.68,49 CDM,601179,KIT DISP ORTH QFIX 2.8MM,17607.0,17607.0,1056.42,14965.95,49 CDM,601180,PATCH SLNT 9.5CMX4.8CM,23942.5,23942.5,1436.55,20351.13,49 CDM,601181,CMPNT FEM KN SZ8,42258.0,42258.0,5493.54,35919.3,28 CDM,601186,SHELL ACTB HIP SZF 54MM,28172.0,28172.0,3662.36,23946.2,28 CDM,601188,PROSTHESIS PENL TTN 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601191,BASEPLT KN LT SZ5,25355.0,25355.0,3296.15,21551.75,28 CDM,601192,GRAFT VASC THIN 90CM 8MM,93779.0,93779.0,12191.27,79712.15,28 CDM,601196,GRAFT CV 6MM 30CM,12455.0,12455.0,1619.15,10586.75,28 CDM,6012,SUTURE PS-2 4-0 1X18IN,194.5,194.5,11.67,165.32,49 CDM,601204,DEVICE CLSR CLP INT 35MM,59826.0,59826.0,7777.38,50852.1,28 CDM,601223,SCREW BN 4MM 42MM 14MM,5699.0,5699.0,740.87,4844.15,28 CDM,601228,DEVICE WNDCLS 23CM SZ3,1614.5,1614.5,96.87,1372.33,49 CDM,601235,DEVICE CLSR CLP INT 40MM,59826.0,59826.0,7777.38,50852.1,28 CDM,601236,DEVICE CLSR CLP INT 45MM,59826.0,59826.0,7777.38,50852.1,28 CDM,601237,DEVICE CLSR CLP INT 50MM,59826.0,59826.0,7777.38,50852.1,28 CDM,601239,DEVICE WNDCLS 30CM SZ3,1695.5,1695.5,101.73,1441.17,49 CDM,601242,STENT BIL 10FR 12CM,4608.0,4608.0,599.04,3916.8,28 CDM,601243,OCCLUDER CV 13X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601244,OCCULDER CV 24X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601245,OCCULDER CV 18X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601246,CATH ANGIO 6FR 110CM,6273.0,6273.0,376.38,5332.05,49 CDM,601247,CATH BLNDL 24MM 110CM,21508.5,21508.5,1290.51,18282.22,49 CDM,601250,CATHETER GD BLU YLW 100C,2371.0,2371.0,142.26,2015.35,49 CDM,601252,CATH GUIDE 100CM 5FR,2208.5,2208.5,132.51,1877.22,49 CDM,601253,CATH GUIDE 100CM 5FR,2208.5,2208.5,132.51,1877.22,49 CDM,601255,CATH GUIDE 100CM 5FR,2371.0,2371.0,142.26,2015.35,49 CDM,601257,CATH GD LCB 5FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,601258,CATH GD 6F JL3 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,601259,CATH GD 6F JR4 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,601260,CTHGD VBT 6F 070 RCB 100,2371.0,2371.0,142.26,2015.35,49 CDM,601261,CTHGD VBT 6F 070 LCB 100,2371.0,2371.0,142.26,2015.35,49 CDM,601263,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,601264,OCCLUDER CV VSD 7X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601265,OCCLUDER CV VSD 7X6MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601266,OCLDR AGA VSD 6F 10,100000.0,100000.0,13000.0,85000.0,28 CDM,601273,OCCLUDER CV 25X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601274,OCCLUDER CV 35X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601275,OCLDR AGA VSD 7F 12,100000.0,100000.0,13000.0,85000.0,28 CDM,601276,OCLDR AGA VSD 8F 14,100000.0,100000.0,13000.0,85000.0,28 CDM,601277,OCCLUD CV 7MM 16MM MSC,100000.0,100000.0,13000.0,85000.0,28 CDM,601285,SCREW BN 2.4MM 12MM,3180.0,3180.0,413.4,2703.0,28 CDM,601291,SYSTEM DLV 1 CATH 1 CLIP,100000.0,100000.0,6000.0,85000.0,49 CDM,601292,CATH EP 5FR 110CM,3739.0,3739.0,224.34,3178.15,49 CDM,601293,OCCLUD CV 7MM 18MM MSCL,100000.0,100000.0,13000.0,85000.0,28 CDM,601295,SHEATH GD 5FR 110CM,4244.5,4244.5,254.67,3607.82,49 CDM,601297,SUTURE ETHBND 2-0 10X86,1792.5,1792.5,107.55,1523.63,49 CDM,601298,SCREW BN 2.5MM 14MM,15432.0,15432.0,2006.16,13117.2,28 CDM,601300,SCREW BN 2.5MM 16MM,10406.0,10406.0,1352.78,8845.1,28 CDM,601309,SCREW BN 4MM 50MM 17MM,5990.0,5990.0,778.7,5091.5,28 CDM,601310,SCREW BN 4MM 48MM,5990.0,5990.0,778.7,5091.5,28 CDM,601311,SCREW BN CANN 2.5MM 20MM,10406.0,10406.0,1352.78,8845.1,28 CDM,601312,KIT INTERNAL BRACE W CC,52407.0,52407.0,6812.91,44545.95,28 CDM,601319,PROSTH PENL PS 14CM 24CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601328,SCREW BN P-AX 5MM 30MM,1881.0,1881.0,244.53,1598.85,28 CDM,601337,GRAFT CV 10X26MM 50CM,30863.0,30863.0,4012.19,26233.55,28 CDM,601353,PROS PENILE PUMP INFL,100000.0,100000.0,13000.0,85000.0,28 CDM,601354,RETRACTOR SCROTAL DISP,15177.5,15177.5,910.65,12900.88,49 CDM,601360,CATH BLN 5FR 4X130X150MM,48532.5,48532.5,2911.95,41252.63,49 CDM,601361,CATH BLN 5FR 4X130X40MM,33895.5,33895.5,2033.73,28811.17,49 CDM,601362,CATH BALLOON 12FR 70CM,89361.0,89361.0,5361.66,75956.85,49 CDM,601363,SET CATH BALLN PTMC 28MM,89361.0,89361.0,5361.66,75956.85,49 CDM,601364,CATH BALLOON 70CM 12F,89361.0,89361.0,5361.66,75956.85,49 CDM,601382,STEM FEM HIP 12MM 144MM,47945.0,47945.0,6232.85,40753.25,28 CDM,6014,SUTURE CT-1 SZ0 8X18IN,550.5,550.5,33.03,467.93,49 CDM,601406,PLATE BN STR 7HL 91MM,14720.0,14720.0,1913.6,12512.0,28 CDM,601422,SCREW BN 4MM 70MM 23.5MM,6181.0,6181.0,803.53,5253.85,28 CDM,601424,COMPNT PTLR KN 9MM 29MM,10892.0,10892.0,1415.96,9258.2,28 CDM,601428,INSERT TIB KN SZ3-4 9MM,18453.0,18453.0,2398.89,15685.05,28 CDM,601429,BASEPLATE TIB KN RT SZ3,26085.0,26085.0,3391.05,22172.25,28 CDM,601440,GWIRE ORTH 1.1MM 150MM,1453.0,1453.0,87.18,1235.05,49 CDM,601442,SCREW BN 2.5MM 12MM,10406.0,10406.0,1352.78,8845.1,28 CDM,601443,SUTURE CT-1 2-0 1X27IN,516.0,516.0,30.96,438.6,49 CDM,601455,GRAFT CV 10X20MM 50CM,29394.0,29394.0,3821.22,24984.9,28 CDM,601458,LEAD PCNG 4.1FR 69CM,9393.0,9393.0,1221.09,7984.05,28 CDM,601459,EXPANDER TISS 225CC,65970.0,65970.0,8576.1,56074.5,28 CDM,601460,EXPANDER TISS 350CC,65970.0,65970.0,8576.1,56074.5,28 CDM,601461,EXPNDR TISS BRST 455CC,65970.0,65970.0,8576.1,56074.5,28 CDM,601463,EXPANDER TISS BRST 535CC,65970.0,65970.0,8576.1,56074.5,28 CDM,601464,EXP TIS BRST SMTH 650CC,65970.0,65970.0,8576.1,56074.5,28 CDM,601465,WIRE DB .5CIR S6 3X14X49,4530.5,4530.5,271.83,3850.93,49 CDM,601466,CATH HEMO 14.5F 23CM,9684.0,9684.0,581.04,8231.4,49 CDM,601470,TUBE GASTM 20FR,1213.5,1213.5,72.81,1031.47,49 CDM,601497,SCREW BN 2.4MM 18MM,3435.0,3435.0,446.55,2919.75,28 CDM,601498,SCREW BN 2.4MM 20MM,3435.0,3435.0,446.55,2919.75,28 CDM,6015,SUTURE VIO BRD 2-0 18IN,362.5,362.5,21.75,308.13,49 CDM,601517,SCREW BN NLCKG 2.7X18MM,2135.0,2135.0,277.55,1814.75,28 CDM,601529,SCREW BN 3.5MMX26MM,1881.0,1881.0,244.53,1598.85,28 CDM,601552,CATH BLNDIL 2.25MM 15MM,4600.5,4600.5,276.03,3910.43,49 CDM,601553,NEEDLE BLNT 18GA 20CM,999.5,999.5,59.97,849.58,49 CDM,601559,SCREW BN LAG 85/80MM,20050.0,20050.0,2606.5,17042.5,28 CDM,601614,LEAD PCNG 6FR 65CM,6792.0,6792.0,882.96,5773.2,28 CDM,601615,CMPNT KN FEM STR14.5X150,36289.0,36289.0,4717.57,30845.65,28 CDM,6017,SUTURE UND BRD 2 54IN,147.5,147.5,8.85,125.38,49 CDM,601715,SUTURE SLK 3-0 144IN,62.5,62.5,3.75,53.13,49 CDM,601724,INSERT TIB KN BRNG 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,601734,SUTURE GRN BRD 2-0 36IN,2595.5,2595.5,155.73,2206.18,49 CDM,601740,SHEATH SZ 12F TIP 80CM,26498.0,26498.0,1589.88,22523.3,49 CDM,601745,SEALANT PLR PROGL 4ML,38840.5,38840.5,2330.43,33014.43,49 CDM,601746,GWIRE ORTH 3MM 100CM,6273.0,6273.0,376.38,5332.05,49 CDM,601748,STEM FEM HIP 12MM 250MM,60285.0,60285.0,7837.05,51242.25,28 CDM,601753,SCREW BN 2.4MM 14MM,3180.0,3180.0,413.4,2703.0,28 CDM,601755,RELOAD STPLR 30 2.5MM,6318.5,6318.5,821.4,5370.73,28 CDM,601756,RELOAD STPLR 30 4.3MM,6318.5,6318.5,821.4,5370.73,28 CDM,601757,RELOAD STPLR 30 4.3MM,6318.5,6318.5,821.4,5370.73,28 CDM,601758,STAPLER ROBTC 45MM,17008.5,17008.5,1020.51,14457.23,49 CDM,601759,STAPLER CRVD TIP 45MM,17607.0,17607.0,1056.42,14965.95,49 CDM,601760,RELOAD STPLR 45MM,7772.0,7772.0,1010.36,6606.2,28 CDM,601762,RELOAD STPLR 45MM,7772.0,7772.0,1010.36,6606.2,28 CDM,601763,RELOAD STPLR 45MM,7395.0,7395.0,961.35,6285.75,28 CDM,601764,RELOAD STPLR 45MM,7395.0,7395.0,961.35,6285.75,28 CDM,601767,CATH GD 6F JR3.5 100CM,1611.0,1611.0,96.66,1369.35,49 CDM,601768,CATH GD 6F XB3 100CM,1611.0,1611.0,96.66,1369.35,49 CDM,601769,CATH GD 6F XB3.25 100CM,1501.0,1501.0,90.06,1275.85,49 CDM,601777,SYSTEM VENTRICAL SHUNT,100000.0,100000.0,13000.0,85000.0,28 CDM,601783,CTHGD VBT 7F 078 XB4 100,2274.5,2274.5,136.47,1933.33,49 CDM,601786,GDWIRE VASC W/FLX TP.014,6358.0,6358.0,381.48,5404.3,49 CDM,601847,TUBE SPLNT ACC BLN 132CM,7591.0,7591.0,455.46,6452.35,49 CDM,601853,SCREW BN 2.0MM 12MM,3424.0,3424.0,445.12,2910.4,28 CDM,601855,SCREW BN 2.0MM 14MM,3421.0,3421.0,444.73,2907.85,28 CDM,601889,GRAFT CV 10X32MM 50CM,31789.0,31789.0,4132.57,27020.65,28 CDM,601890,PROSPENL PUMP 6FR 45CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601897,STEM FEM KN PRSFT 100X13,22442.0,22442.0,2917.46,19075.7,28 CDM,601901,SUTURE BLU MONO 4-0 48IN,21253.0,21253.0,1275.18,18065.05,49 CDM,601905,SYSTEM FX 30FSTN,24173.0,24173.0,3142.49,20547.05,28 CDM,601908,CANNULA PRFSN 14FR 18MM,3944.0,3944.0,236.64,3352.4,49 CDM,601909,SUTURE UND MONO 6-0 18IN,286.0,286.0,17.16,243.1,49 CDM,601911,SHEATH CLOTREM 13FR,36633.0,36633.0,2197.98,31138.05,49 CDM,601912,CATH THRMB 16MM 105CM,100000.0,100000.0,6000.0,85000.0,49 CDM,601918,OCCULDER CV 8X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601919,CEMENT BN PMMA 40GM,2541.0,2541.0,330.33,2159.85,28 CDM,601921,MESH SURG 15X10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,601922,PATCH VASC 0.8X8CM,5259.0,5259.0,683.67,4470.15,28 CDM,601927,APPLICATOR HEMOSTAT PWD,1487.0,1487.0,89.22,1263.95,49 CDM,601928,SCREW SD LCK 2.3X12MM,4335.0,4335.0,563.55,3684.75,28 CDM,601960,GWIRE URO .035IN 150CM,6419.5,6419.5,385.17,5456.57,49 CDM,601963,LINER ACTB HIP 36MM SZG,21129.0,21129.0,2746.77,17959.65,28 CDM,601975,SHEATH TPR 13FR 11FR 2,4164.5,4164.5,249.87,3539.82,49 CDM,601980,RETRCTR WND SM 2.5-6CM,2905.5,2905.5,174.33,2469.68,49 CDM,601981,DEVICE WNDCLS 15CM SZ3,1614.0,1614.0,96.84,1371.9,49 CDM,601982,STAPLER INT CRV 29MM,16030.5,16030.5,961.83,13625.92,49 CDM,601983,COMPONENT SHLDR REV 40MM,55492.0,55492.0,7213.96,47168.2,28 CDM,601984,STAPLER CIRC PWR 29MM,12328.0,12328.0,739.68,10478.8,49 CDM,601986,GRAFT CV 15CM 34X42X34MM,56262.0,56262.0,7314.06,47822.7,28 CDM,601988,SUTURE BLU MONO 4-0 48IN,2905.5,2905.5,174.33,2469.68,49 CDM,601989,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,601995,ELECTRODE RESCT BTN HF 1,14612.5,14612.5,876.75,12420.63,49 CDM,602002,VALVE MITRAL 31-33MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602003,GRAFT VASC 90CM 8MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602006,PLATFORM TRANSVAG 4CM,26962.5,26962.5,1617.75,22918.13,49 CDM,602007,PLATFORM TRANSVAG 5.5CM,26962.5,26962.5,1617.75,22918.13,49 CDM,602008,PLATFORM TRANSVAG 9CM,26962.5,26962.5,1617.75,22918.13,49 CDM,602009,PLATFORM ACC 10MM 12MM,23110.5,23110.5,1386.63,19643.92,49 CDM,602015,STAPLER INT 5.2X1.5-2.2,16030.5,16030.5,961.83,13625.92,49 CDM,602017,PROSTH PENL PS 10CM 18CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602018,PROSTH PENL PUMP PS 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602020,HEMOSTAT ABS PWD 3GM,8715.0,8715.0,522.9,7407.75,49 CDM,602022,IMPLANT BREAST 325CC,32338.0,32338.0,4203.94,27487.3,28 CDM,602027,LINER HIP ACTB F 36MM,21129.0,21129.0,2746.77,17959.65,28 CDM,602029,DEVICE RTRVL DAKOTA NTNL,6812.0,6812.0,408.72,5790.2,49 CDM,602031,SCREW BN LCK 3.5X16.0MM,5616.0,5616.0,730.08,4773.6,28 CDM,602033,TUNNELER SURG INST 300MM,3744.5,3744.5,224.67,3182.82,49 CDM,602035,SHEATH SZ 10F TIP 80CM,26747.0,26747.0,1604.82,22734.95,49 CDM,602043,MESH HRN OPEN PSTN 6X8,100000.0,100000.0,13000.0,85000.0,28 CDM,602044,MESH HERNIA 8X10IN,100000.0,100000.0,13000.0,85000.0,28 CDM,602045,MESH HRN 10CM 15CM,98001.0,98001.0,12740.13,83300.85,28 CDM,602046,MESH SURG 20CM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602047,CMPNT PTLR KN 10X35MM,9513.0,9513.0,1236.69,8086.05,28 CDM,602054,TRAY CATH PICC 3FR 1LUM,8098.5,8098.5,485.91,6883.73,49 CDM,602062,SCREW TT LCK SELFDRILL 5,7042.0,7042.0,915.46,5985.7,28 CDM,602063,SCREW BN 5MM 26MM,7042.0,7042.0,915.46,5985.7,28 CDM,602064,SCREW BN 5MM 40MM,7042.0,7042.0,915.46,5985.7,28 CDM,602065,SCREW TT LCK SELFDRILL 5,7158.0,7158.0,930.54,6084.3,28 CDM,602066,SCREW BN 5MM 65MM,7158.0,7158.0,930.54,6084.3,28 CDM,602067,SCREW BN 5.0MM 75MM,7158.0,7158.0,930.54,6084.3,28 CDM,602069,KWIRE FX 2MM 280MM,2050.5,2050.5,123.03,1742.92,49 CDM,602072,GRAFT PTLR 8-13X10-10.5,69132.0,69132.0,8987.16,58762.2,28 CDM,602074,KIT AXLRY INS 23FR 6CM,8803.5,8803.5,528.21,7482.98,49 CDM,602083,PLATE TIB 300MM 13H,47379.0,47379.0,6159.27,40272.15,28 CDM,602084,SHELL ACTB HIP 50MM,83743.0,83743.0,10886.59,71181.55,28 CDM,602088,OCCLUDER CV 4X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602089,OCCULDER CV 6X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602090,OCCLUDER CV 18X3MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602091,OCCLUDER CV 12X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602092,OCCLUDER CV 14X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602093,OCCULDER CV 16X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602094,OCCULDER CV 19X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602095,OCCULDER CV 26X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602096,OCCULDER CV 28X4MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602097,KWIRE FX 150MM 1.6MM,5483.5,5483.5,329.01,4660.98,49 CDM,602099,CMPNT TIB BLCK 10 79/83,21085.0,21085.0,2741.05,17922.25,28 CDM,602100,GRASPER LAPSCP 5CM 35CM,3555.0,3555.0,213.3,3021.75,49 CDM,602106,REAMER SHFT STRL 8X448MM,7817.5,7817.5,469.05,6644.88,49 CDM,602109,SET TBG IRR HYSTEROSCOPY,4432.5,4432.5,265.95,3767.63,49 CDM,602113,DILATOR VASC 20FR 20CM,933.5,933.5,56.01,793.48,49 CDM,602114,DILATOR VASC 16FR 20CM,813.0,813.0,48.78,691.05,49 CDM,602121,SHTH 7FX63 RCFW,2990.0,2990.0,179.4,2541.5,49 CDM,602128,KIT CATH PRTNL CRL 62CM,2945.5,2945.5,176.73,2503.68,49 CDM,602130,KIT INTRO 14FR IMPELLA,21570.0,21570.0,1294.2,18334.5,49 CDM,602134,KIT CATH PRTNL 57CM,2945.5,2945.5,176.73,2503.68,49 CDM,602137,GWIRE VASC .018IN 300CM,11115.5,11115.5,666.93,9448.17,49 CDM,602148,CATH BLNDIL 18MM 6X100CM,20079.0,20079.0,1204.74,17067.15,49 CDM,602151,SUTURE BLU MONO 2-0 36IN,285.0,285.0,17.1,242.25,49 CDM,602153,IMPLANT BREAST 560CC,32662.0,32662.0,4246.06,27762.7,28 CDM,602154,IMPLANT BREAST 630CC,32662.0,32662.0,4246.06,27762.7,28 CDM,602155,IMPLANT BREAST 685CC,32662.0,32662.0,4246.06,27762.7,28 CDM,602162,SHEATH GD MED 71CM,31252.5,31252.5,1875.15,26564.63,49 CDM,602163,SHEATH GD LG 71CM,29581.5,29581.5,1774.89,25144.28,49 CDM,602167,SURGICEL NU-KNIT 6X9,4754.5,4754.5,285.27,4041.32,49 CDM,602168,CATH URET 5FR 70CM,474.0,474.0,28.44,402.9,49 CDM,602169,WIRE PCNG TEMP 26MM 89MM,1029.5,1029.5,61.77,875.08,49 CDM,602170,KIT IMPLANT HEADLS 3MM,19437.0,19437.0,2526.81,16521.45,28 CDM,602179,TIP FEMORAL CANAL W/SUCT,384.5,384.5,23.07,326.82,49 CDM,602180,RETRIEVR RNG NRYL RSN SM,2912.0,2912.0,174.72,2475.2,49 CDM,602181,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,602183,GRAFT CV 24MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,602187,MANIFOLD ANGIO 12ML,1598.0,1598.0,95.88,1358.3,49 CDM,602188,BLADE SAW 9.5MM 41MM,387.5,387.5,23.25,329.38,49 CDM,602189,MOLD SPCR CMNT MED,37946.5,37946.5,2276.79,32254.53,49 CDM,602190,MOLD SPCR TIB CMNT 70X45,20029.5,20029.5,1201.77,17025.08,49 CDM,602191,PLATE BN 69X9X1MM,5850.0,5850.0,760.5,4972.5,28 CDM,602196,PLATE BN 8HL 3.5MM 112MM,17817.0,17817.0,2316.21,15144.45,28 CDM,602202,PLATE BN RT 3.5MM 52MM,11545.0,11545.0,1500.85,9813.25,28 CDM,602210,GRAFT CV 10X24MM 50CM,30863.0,30863.0,4012.19,26233.55,28 CDM,602216,SCREW BN 4.0MM 14MM,698.0,698.0,90.74,593.3,28 CDM,602221,SCREW BN CORT 3.5MM 38MM,897.0,897.0,116.61,762.45,28 CDM,602222,SCREW BN 3.5MM 45MM,897.0,897.0,116.61,762.45,28 CDM,602223,SCREW BN 4MM 12MM,698.0,698.0,90.74,593.3,28 CDM,602231,GRAFT CV 20MM 30CM,13055.0,13055.0,1697.15,11096.75,28 CDM,602232,GRAFT CV 28MM 50MM,36087.0,36087.0,4691.31,30673.95,28 CDM,602233,SET SHTH URT 11-14F 28CM,4274.5,4274.5,256.47,3633.32,49 CDM,602243,GWIRE URO .035IN 150CM,1801.0,1801.0,108.06,1530.85,49 CDM,602244,SET SHTH URT 11-13F 36CM,4274.5,4274.5,256.47,3633.32,49 CDM,602252,LINER HIP 20D 52MM 36MM,15495.0,15495.0,2014.35,13170.75,28 CDM,602253,SHELL ACTB HIP 3H 52MM,25355.0,25355.0,3296.15,21551.75,28 CDM,602255,SCREW BN 10.5MM 100MM,15834.0,15834.0,2058.42,13458.9,28 CDM,602257,STENT BIL 8FR 10X80MM,50370.0,50370.0,6548.1,42814.5,28 CDM,602258,STENT BIL 8FR 10X100MM,50370.0,50370.0,6548.1,42814.5,28 CDM,602260,BIT DRILL 4.2MM 300MM,5520.5,5520.5,331.23,4692.43,49 CDM,602267,EXPANDER BRST 250CC,43657.0,43657.0,5675.41,37108.45,28 CDM,602268,EXPANDER BRST SMTH 350CC,43657.0,43657.0,5675.41,37108.45,28 CDM,602283,INTRO SHTH 10FR 10CM,639.5,639.5,38.37,543.58,49 CDM,602284,GRAFT DBM PTTY 2.5CC,9817.0,9817.0,1276.21,8344.45,28 CDM,602285,GRAFT DBM PTTY 1CC,4160.0,4160.0,540.8,3536.0,28 CDM,602286,SHUNT CV STR 13CM,42986.0,42986.0,2579.16,36538.1,49 CDM,602290,SHEATH INTRO 14F 28CM,7043.0,7043.0,422.58,5986.55,49 CDM,602291,SHEATH INTRO 12F 28CM,6273.0,6273.0,376.38,5332.05,49 CDM,602292,SPACER MOLD SMALL,20029.5,20029.5,1201.77,17025.08,49 CDM,602300,ELECTRODE ESURG 10FT,113.5,113.5,6.81,96.47,49 CDM,602307,SHEARS ESURG 36CM 5MM,13768.0,13768.0,826.08,11702.8,49 CDM,602311,TRAY PRCNTS 5FR 7CM,1758.5,1758.5,105.51,1494.72,49 CDM,602317,GWIRE VASC .035IN 260CM,755.0,755.0,45.3,641.75,49 CDM,602321,TRAY CATH 5FR 40CM,2905.5,2905.5,174.33,2469.68,49 CDM,602323,CATH BLNOCC 6FR 80CM,6273.0,6273.0,376.38,5332.05,49 CDM,602336,TUBING IIR STRL LF,3621.5,3621.5,217.29,3078.28,49 CDM,602341,CTHDX INFN 6F JR6 100,616.0,616.0,36.96,523.6,49 CDM,602342,CATH ANGIO JL6 7FR 100CM,601.5,601.5,36.09,511.27,49 CDM,602345,SUTURE RB-1 5-0 1X27IN,123.0,123.0,7.38,104.55,49 CDM,602346,SUTURE VIO MONO 3-0 27IN,125.5,125.5,7.53,106.67,49 CDM,602350,SUTURE BLK MONO 0 18IN,500.5,500.5,30.03,425.43,49 CDM,602356,SUTURE GRN BRD 2-0 36IN,4605.0,4605.0,276.3,3914.25,49 CDM,602366,LEAD PCNG BIP TEMP,9226.5,9226.5,553.59,7842.52,49 CDM,602370,TRAY HYPERBARIC DRESSING,107.0,107.0,6.42,90.95,49 CDM,602371,SPONE ABS PWD GEL 1GM,3368.5,3368.5,202.11,2863.22,49 CDM,602375,KIT PRS MNTR TRANS 12IN,579.0,579.0,34.74,492.15,49 CDM,602392,OBTURATOR BLDLSS 8MM,1830.5,1830.5,109.83,1555.92,49 CDM,602397,CATHETER EP 5F 120CM 5MM,955.0,955.0,57.3,811.75,49 CDM,602399,LINER SHLDR HUM 36MM,21552.0,21552.0,2801.76,18319.2,28 CDM,602404,STAPLER REINF STRL 45MM,6273.0,6273.0,376.38,5332.05,49 CDM,602417,CATH BLN 22X4.5X110MM,21508.5,21508.5,1290.51,18282.22,49 CDM,602424,SUTURE BLU 5-0 47.2IN,3295.5,3295.5,197.73,2801.18,49 CDM,602436,SPHERE EMBL 250UM 2ML,6240.0,6240.0,811.2,5304.0,28 CDM,602438,SYSTEM WND IRR 0.05% 450,2905.5,2905.5,174.33,2469.68,49 CDM,602462,GWIRE CROSSING 190CM,5018.5,5018.5,301.11,4265.73,49 CDM,602463,GUIDEWIRE VASC 190CM,5018.5,5018.5,301.11,4265.73,49 CDM,602464,GUIDEWIRE VASC 190CM,5018.5,5018.5,301.11,4265.73,49 CDM,602465,MICROCATH VASC2.9F 135CM,17718.5,17718.5,1063.11,15060.73,49 CDM,602466,MICROCATH VASC2.9F 150CM,18488.5,18488.5,1109.31,15715.23,49 CDM,602471,LEAD ICD SC DF4 59CM,59127.0,59127.0,7686.51,50257.95,28 CDM,602472,ICD CRD 5.37X7.68CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602478,BASEPLATE TIB KN LFT SZ3,25355.0,25355.0,3296.15,21551.75,28 CDM,602481,DEVICE CLSR WND 0 30CM,1348.5,1348.5,80.91,1146.22,49 CDM,602482,LEAD PCNG 45CM,5971.0,5971.0,776.23,5075.35,28 CDM,602483,DEVICE CLSR WND 0 45CM,4451.0,4451.0,267.06,3783.35,49 CDM,602484,DEVICE WNDCLS 45CM SZ3,1524.0,1524.0,91.44,1295.4,49 CDM,602489,TUBE ET NIM EMG 7MM,11127.0,11127.0,667.62,9457.95,49 CDM,602496,PROSTH PENL PUMP PS 16CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602518,STEM FEM HIP OFST 170X16,53527.0,53527.0,6958.51,45497.95,28 CDM,602520,CATH GD 6FR 85CM,2150.5,2150.5,129.03,1827.92,49 CDM,602524,SHEATH VASC 18FR 28CM,7043.0,7043.0,422.58,5986.55,49 CDM,602534,SHELL ACTB 58MM HIP MLH,83743.0,83743.0,10886.59,71181.55,28 CDM,602539,MOLD FEM SPR LG 53X75MM,23110.5,23110.5,1386.63,19643.92,49 CDM,602540,MOLD TIB SPACER LG 52MM,20029.5,20029.5,1201.77,17025.08,49 CDM,602541,CABLE FXTN 1.8MM 635CM,18183.0,18183.0,2363.79,15455.55,28 CDM,602542,CONE FEM HIP 50MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602543,STEM FEM HIP 19MM 250MM,60285.0,60285.0,7837.05,51242.25,28 CDM,602587,CLIP EX FIX 4-6M HLF PIN,623.0,623.0,37.38,529.55,49 CDM,602598,CAP PROT EXFX BLK OD 5MM,1350.0,1350.0,81.0,1147.5,49 CDM,6026,RELOAD STPLR 6ROW 4.6MM,9483.0,9483.0,1232.79,8060.55,28 CDM,602613,CRT-P MR 15MM,93749.0,93749.0,12187.37,79686.65,28 CDM,602614,SET CLOSURE 50CM,46221.0,46221.0,2773.26,39287.85,49 CDM,602623,CATH GD 6FR 110CM,2150.5,2150.5,129.03,1827.92,49 CDM,602626,CATH GD 5F 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,602628,CATH GD CLS4 100CM 6FR,2150.5,2150.5,129.03,1827.92,49 CDM,602629,CATH GD CRV 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,602636,BASKET RTRV 3WR 1.9X120,6273.0,6273.0,376.38,5332.05,49 CDM,602637,STENT URET 6FR 28CM,4908.0,4908.0,638.04,4171.8,28 CDM,602638,CATH GD 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,602640,GWIRE VASC 300CM .014IN,5646.0,5646.0,338.76,4799.1,49 CDM,602641,STENT URET 5FR 26CM,4367.0,4367.0,567.71,3711.95,28 CDM,602642,DEVICE BX 20GA 9CM,782.0,782.0,46.92,664.7,49 CDM,602643,GUIDEWIRE VASC .035IN 30,2905.5,2905.5,174.33,2469.68,49 CDM,602644,GWIRE VASC .035X185X15,2905.5,2905.5,174.33,2469.68,49 CDM,602645,GWIRE VASC CTIP 10X260CM,2905.5,2905.5,174.33,2469.68,49 CDM,602646,CTH URET AXXCESS 6F OE,3734.5,3734.5,224.07,3174.32,49 CDM,602647,STEM FEM KN 225X12.5MM,37976.0,37976.0,4936.88,32279.6,28 CDM,602648,CMPNT FEM KN STR12.5X150,36289.0,36289.0,4717.57,30845.65,28 CDM,602649,LINER ACTB HIP SZE 36MM,21129.0,21129.0,2746.77,17959.65,28 CDM,602650,GDWIRE VASC .035IN 300CM,12433.0,12433.0,745.98,10568.05,49 CDM,602652,SYSTEM MECH THRMB,100000.0,100000.0,6000.0,85000.0,49 CDM,602655,SCREW BN 4.5X52MM,6676.0,6676.0,867.88,5674.6,28 CDM,602665,BASEPLATE KN TIB TI SZ5,36624.0,36624.0,4761.12,31130.4,28 CDM,602666,CMPNT PTLR KN 10MM 32MM,12325.0,12325.0,1602.25,10476.25,28 CDM,602667,KIT PREP FEM SZ5,6303.5,6303.5,378.21,5357.98,49 CDM,602668,PREP KIT TIB SZ 5,5353.0,5353.0,321.18,4550.05,49 CDM,602679,DVC SKIN CLSR CMPR 16CM,3136.5,3136.5,188.19,2666.03,49 CDM,602681,SHEATH GD 149CM 6FR,9613.5,9613.5,576.81,8171.48,49 CDM,602685,GWIRE VASC .014IN 475CM,5808.5,5808.5,348.51,4937.23,49 CDM,602686,CATH GD .035IN 200CM,6521.0,6521.0,391.26,5542.85,49 CDM,602690,CATH GD 6F MPA1 125CM,2371.0,2371.0,142.26,2015.35,49 CDM,602693,GWIRE VASC 180CM .014IN,6273.0,6273.0,376.38,5332.05,49 CDM,602694,COMPNT FEM RT KN SZ5,42258.0,42258.0,5493.54,35919.3,28 CDM,6027,BASEPLATE TIB KN UNV SZ2,28172.0,28172.0,3662.36,23946.2,28 CDM,602723,CATH BLNDIL 2MM 15MM,4600.5,4600.5,276.03,3910.43,49 CDM,602732,BASEPLATE KN SZ4,25355.0,25355.0,3296.15,21551.75,28 CDM,602747,STENT VASC 8X39MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,602749,CATH BLNDIL 9X40MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,602760,ANCHOR SUT 4.75MM 22MM,22475.0,22475.0,2921.75,19103.75,28 CDM,602761,SUTURE PS2 PDS 4.0 15CM,11225.0,11225.0,673.5,9541.25,49 CDM,602763,CATH ANGIO ARMOD 100CM,601.5,601.5,36.09,511.27,49 CDM,602772,STENT BIL 6.0MM 18MM,28296.0,28296.0,3678.48,24051.6,28 CDM,602773,INSERT KN BMPR 3DEG,11666.0,11666.0,1516.58,9916.1,28 CDM,602774,BASEPLATE KN SZ SM-2,56359.0,56359.0,7326.67,47905.15,28 CDM,602778,COMPNT FEM KN RT 65MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602780,INSERT TIB KN 20MM,21298.0,21298.0,2768.74,18103.3,28 CDM,602781,INSERT TIB KN SZ3-4 9MM,18312.0,18312.0,2380.56,15565.2,28 CDM,602782,BASEPLATE TIB KN RT SZ3,25355.0,25355.0,3296.15,21551.75,28 CDM,602783,MOLD SPACER FEM SML,40983.0,40983.0,2458.98,34835.55,49 CDM,602784,STEM SHLDR FIN 20MM SMR,23552.0,23552.0,3061.76,20019.2,28 CDM,602785,BASEPLT TIB KN RM/LL SZ3,28172.0,28172.0,3662.36,23946.2,28 CDM,602789,GWIRE VASC 95CM,6273.0,6273.0,376.38,5332.05,49 CDM,602790,KIT MINTRDCR 7CM 21GA ND,6064.0,6064.0,363.84,5154.4,49 CDM,602791,KIT INTVN TRANSCAROTID,100000.0,100000.0,6000.0,85000.0,49 CDM,602792,VALVE MITRAL 27-29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602796,PROSTHESIS PENILE TITAN,100000.0,100000.0,13000.0,85000.0,28 CDM,602797,KIT ACCESSORY CONN,49148.5,49148.5,2948.91,41776.22,49 CDM,602798,IMP URN CTRL 61-70CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602799,PUMP CONTRL URN AB SYS,100000.0,100000.0,13000.0,85000.0,28 CDM,6028,DEVICE CLSR WND +1 45CM,1067.5,1067.5,64.05,907.38,49 CDM,602800,CUFF URTH SPHNCR AB 4CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602802,CEMENT BN PMMA FULL DOSE,8698.0,8698.0,1130.74,7393.3,28 CDM,602803,STENT CAROTID SYS 8X40MM,74792.0,74792.0,9722.96,63573.2,28 CDM,602804,SET STENT URTH 7.2F 75CM,4513.0,4513.0,586.69,3836.05,28 CDM,602809,VALVE AORTIC 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,602810,SYSTEM EMB 6FR 95CM,90901.5,90901.5,5454.09,77266.27,49 CDM,602812,MESH HRN LG 10X16CM,11565.0,11565.0,1503.45,9830.25,28 CDM,602816,INTRO SHEATH 10FR 33CM,14790.0,14790.0,887.4,12571.5,49 CDM,602817,INTRO SHEATH 20FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,602824,CMPNT PTLR KN 9MM 29MM,12325.0,12325.0,1602.25,10476.25,28 CDM,602825,CATH BLNDIL 7X40MM 80CM,3877.0,3877.0,232.62,3295.45,49 CDM,602826,CATH BLNDIL 4X40MM 80CM,3877.0,3877.0,232.62,3295.45,49 CDM,602827,SCREWDRIVER SURG DISP,6273.0,6273.0,376.38,5332.05,49 CDM,602828,KIT TNL REPR NO DSTRCT,31706.0,31706.0,1902.36,26950.1,49 CDM,602846,HEAD FEM HIP 36MM,19721.0,19721.0,2563.73,16762.85,28 CDM,602856,SCREW BN 6.5MM 20MM,2541.0,2541.0,330.33,2159.85,28 CDM,602857,SCREW BN 6.5MM 25MM,2541.0,2541.0,330.33,2159.85,28 CDM,602858,SCREW BN 6.5MM 30MM,2541.0,2541.0,330.33,2159.85,28 CDM,602859,GRAFT EVAS 14.5MM 12CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602862,GLENOID PEG SM STD LONG,37187.0,37187.0,4834.31,31608.95,28 CDM,602863,BASEPLATE GLENOID STD,30990.0,30990.0,4028.7,26341.5,28 CDM,602874,STENT URET 7FR 22CM,4908.0,4908.0,638.04,4171.8,28 CDM,602875,STENT URET 7FR 28CM,4908.0,4908.0,638.04,4171.8,28 CDM,602876,STENT URET 7FR 24CM,5009.0,5009.0,651.17,4257.65,28 CDM,602877,STENT URET 7FR 26CM,5009.0,5009.0,651.17,4257.65,28 CDM,602880,CANNULA SUCT/IRR,8541.5,8541.5,512.49,7260.27,49 CDM,602881,CATH ABL QDPL 5MM REPR,955.0,955.0,57.3,811.75,49 CDM,602882,CATH ABL 7FR 115CM,4112.0,4112.0,246.72,3495.2,49 CDM,602887,CATHETER DRN 32FR,611.5,611.5,36.69,519.77,49 CDM,602888,CATHETER ULTSND 8FR 90CM,18343.0,18343.0,1100.58,15591.55,49 CDM,602894,SET DILATOR SHTH 24-30FR,6273.0,6273.0,376.38,5332.05,49 CDM,602895,DRAIN WND 10FR 3/16IN,4434.0,4434.0,266.04,3768.9,49 CDM,602896,DRAIN WND 19FR 2.5IN,4954.5,4954.5,297.27,4211.32,49 CDM,602897,DRAIN WND SIL 18X.5IN,172.0,172.0,10.32,146.2,49 CDM,602902,GWIRE FILTER 5.5MM 190CM,43621.0,43621.0,2617.26,37077.85,49 CDM,602903,INTRODCR SHTH 8.5F 91X71,17607.0,17607.0,1056.42,14965.95,49 CDM,602905,KIT NDL GD 5.5IN 36IN,1019.5,1019.5,61.17,866.58,49 CDM,602907,SET TUBING PRFSN CRCT,46221.0,46221.0,2773.26,39287.85,49 CDM,602915,SUTURE CT-1 2-0 1X27IN,113.5,113.5,6.81,96.47,49 CDM,602924,INTRO SHTH 6FR 13CM,2020.0,2020.0,121.2,1717.0,49 CDM,602925,INTRO SHTH 7FR 13CM,2020.0,2020.0,121.2,1717.0,49 CDM,602926,SCREW BN 2MM 13MM,10449.0,10449.0,1358.37,8881.65,28 CDM,602930,GUIDE AAA 16FR 28MM,56948.0,56948.0,3416.88,48405.8,49 CDM,602962,BIT DRILL 4.0MM,2905.5,2905.5,174.33,2469.68,49 CDM,602963,NAIL BN TROCH 10MM 36CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602964,SCREW BN 100MM 4.5MM,20050.0,20050.0,2606.5,17042.5,28 CDM,602972,FILLER BN CA PHOS 10ML,81584.0,81584.0,10605.92,69346.4,28 CDM,602980,CATH PRF20MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 CDM,602981,APPLIER INT CLIP 86CM,100000.0,100000.0,13000.0,85000.0,28 CDM,602989,CEMENT BN PMMA 40GM,2541.0,2541.0,330.33,2159.85,28 CDM,602990,CATHETER BLNDIL 12X80X40,3973.0,3973.0,238.38,3377.05,49 CDM,602994,BLADE SAW 9.8X39X.4MM,5320.0,5320.0,319.2,4522.0,49 CDM,603001,GRAFT CV 26MM 30CM,13909.0,13909.0,1808.17,11822.65,28 CDM,603002,GRAFT CV 30MM 30CM,13909.0,13909.0,1808.17,11822.65,28 CDM,603003,PORT IMPL INFSN 8FR,10974.0,10974.0,1426.62,9327.9,28 CDM,603005,STENT URET 6FR 22CM,4908.0,4908.0,638.04,4171.8,28 CDM,603006,STENT URET 6FR 24CM,5166.0,5166.0,671.58,4391.1,28 CDM,603007,STENT URET 6FR 26CM,4908.0,4908.0,638.04,4171.8,28 CDM,603012,CATH BLNDIL 3.5MM 8MM,5247.0,5247.0,314.82,4459.95,49 CDM,603013,CATH BLNDIL 4MM 8MM,4770.0,4770.0,286.2,4054.5,49 CDM,603014,CATH BLNDIL 4MM 12MM,5247.0,5247.0,314.82,4459.95,49 CDM,603016,CATH BLN 2.5X60MM 150CM,7173.5,7173.5,430.41,6097.48,49 CDM,603017,CATH BLNDIL2X120MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603018,CATH BLNDIL2X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603019,CATH BLNDIL2X40M 150CM,7747.5,7747.5,464.85,6585.38,49 CDM,603020,CATH BLNDIL2X60MM 150CM,7173.5,7173.5,430.41,6097.48,49 CDM,603021,CATH BLNDIL2X80MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603022,CATH BLNDL 3X120MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603023,CATH BLNDL 3X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603024,CATH BLNDIL 3X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603025,CATH BLNDIL 3X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603026,CATH BLNDIL 3X80MM 150CM,9684.0,9684.0,581.04,8231.4,49 CDM,603027,CATH BLN 2.5X120MM 150CM,9684.0,9684.0,581.04,8231.4,49 CDM,603029,CATH BLNDL 2.5X8MM 150CM,9684.0,9684.0,581.04,8231.4,49 CDM,603030,CATH BLN 2.5X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 CDM,603031,CATH BLNDIL 2.0X8MM,5719.0,5719.0,343.14,4861.15,49 CDM,603034,CATH GD 9FR 45CM,8698.0,8698.0,521.88,7393.3,49 CDM,603038,KIT CATH VASC 8.5F 40CM,32509.0,32509.0,1950.54,27632.65,49 CDM,603039,SET DILATION SHEATH 6FR,1898.5,1898.5,113.91,1613.72,49 CDM,603043,CATHETER BLNDIL 14X80X40,3973.0,3973.0,238.38,3377.05,49 CDM,603046,BSKT RTRV 1.9FR 12CM,7122.5,7122.5,427.35,6054.13,49 CDM,603047,PLATE BN LT 18MM,49047.0,49047.0,6376.11,41689.95,28 CDM,603049,SCREW BN P-AX 3.5X18MM,5745.0,5745.0,746.85,4883.25,28 CDM,603055,STENT BIL 4MM 15MM,28296.0,28296.0,3678.48,24051.6,28 CDM,603078,STENT BIL 4MM 18MM,28296.0,28296.0,3678.48,24051.6,28 CDM,603083,STENT BIL 5.0MM 15MM,28296.0,28296.0,3678.48,24051.6,28 CDM,603090,INTRO SHTH 17FR 45CM,11445.0,11445.0,686.7,9728.25,49 CDM,603098,DEVICE FX FSTFX RVRS CRV,18459.0,18459.0,2399.67,15690.15,28 CDM,603099,STENT VASC 6X40X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603100,STENT VASC 6X60X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603101,STENT VASC 6X80X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603102,STENT VASC 7X100X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603103,STENT VASC 7X100X80,21895.0,21895.0,2846.35,18610.75,28 CDM,603105,STENT VASC 7X80X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603106,STENT VASC 8X40X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603107,STENT VASC 8X60X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603110,STENT BIL 6.0MM 15MM,39075.0,39075.0,5079.75,33213.75,28 CDM,603111,STENT BIL 5.0MM 18MM,29094.0,29094.0,3782.22,24729.9,28 CDM,603113,STENT VASC 6X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603114,STENT VASC 9X19MM 135CM,24977.0,24977.0,3247.01,21230.45,28 CDM,603115,STENT VASC 8X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603116,STENT VASC 10X29MM 80CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603117,STENT VASC 10X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603118,STENT VASC 6X29MM 135CM,24977.0,24977.0,3247.01,21230.45,28 CDM,603119,STENT VASC 6X29MM 80CM,24977.0,24977.0,3247.01,21230.45,28 CDM,603121,STENT VASC 6X39MM 80CM,24040.0,24040.0,3125.2,20434.0,28 CDM,603122,STENT VASC 6X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603124,STENT VASC 7X29MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603125,STENT VASC 7X39MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603126,STENT VASC 7X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603127,STENT VASC 8X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603129,STENT VASC 8X39MM 80CM,24040.0,24040.0,3125.2,20434.0,28 CDM,603130,STENT VASC 8X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603131,STENT VASC 8X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603132,STENT VASC 9X29MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603134,STENT VASC 9X59MM 135CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603135,STENT VSC 10X29MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603136,STENT VSC 10X39MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603137,STENT VASC 10X19MM 80CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603138,STENT VASC 10X59MM 80CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603139,STENT VASC 6X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 CDM,603140,STENT VASC 6X100X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603142,STENT VASC 6X19MM 80CM,24040.0,24040.0,3125.2,20434.0,28 CDM,603143,STENT VASC 8X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 CDM,603144,CATH BLNDIL 4X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603145,CATH BLNDIL 4X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603148,CATH BLNDL 5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603149,CATH BLNDL 5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603150,CATH BLNDL 5X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603152,CATH BLNDL 6X200MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603153,CATH BLNDIL 6X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603155,CATH BLNDIL 4X100MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603156,CATH BLNDIL 4X100MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603157,CATH BLNDIL 7X100MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603158,CATH BLNDIL 4X120MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603159,CATH BLNDIL 4X120MM 80CM,5808.5,5808.5,348.51,4937.23,49 CDM,603160,CATH BLN 5.5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603162,CATH BLNDIL 7X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603163,CATH BLNDL 5X250MM 135CM,5852.0,5852.0,351.12,4974.2,49 CDM,603164,CATH BLNDIL 6X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603165,CATH BLNDIL 10X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603166,CATH BLNDIL 8X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603167,CATH BLNDL 4X120MM 135CM,5808.5,5808.5,348.51,4937.23,49 CDM,603168,CATH BLNDL 4X250MM 135CM,6642.0,6642.0,398.52,5645.7,49 CDM,603169,CATH BLNDIL 4X40MM 135CM,3973.0,3973.0,238.38,3377.05,49 CDM,603170,CATH BLNDIL 4X80MM 135CM,4739.0,4739.0,284.34,4028.15,49 CDM,603171,CATH BLNDL 5X120MM 135CM,4739.0,4739.0,284.34,4028.15,49 CDM,603172,CATH BLNDIL 5X40MM 135CM,3952.0,3952.0,237.12,3359.2,49 CDM,603173,CATH BLNDIL 5X80MM 135CM,6273.0,6273.0,376.38,5332.05,49 CDM,603174,CATH BLNDL 6X120MM 135CM,3973.0,3973.0,238.38,3377.05,49 CDM,603175,CATH BLNDL 6X250MM 135CM,5852.0,5852.0,351.12,4974.2,49 CDM,603176,CATH BLNDIL 6X40MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603177,CATH BLNDL 7X120MM 135CM,6273.0,6273.0,376.38,5332.05,49 CDM,603178,CATH BLNDL 7X200MM 135CM,7747.5,7747.5,464.85,6585.38,49 CDM,603180,CATH BLNDIL 9X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603182,CATH BLNDIL 8X80MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603183,CATH BLNDIL 10X40MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603184,CATH BLNDIL 10X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603185,CATH BLNDIL 10X80MM 80CM,4739.0,4739.0,284.34,4028.15,49 CDM,603186,CATHETER BLNDIL 12X80X60,3952.0,3952.0,237.12,3359.2,49 CDM,603187,CATHETER BLNDIL 12X80X80,4348.0,4348.0,260.88,3695.8,49 CDM,603188,CATHETER BLNDIL 14X80X60,3952.0,3952.0,237.12,3359.2,49 CDM,603189,CATHETER BLNDIL 14X80X80,4739.0,4739.0,284.34,4028.15,49 CDM,603190,CATH BLNDIL 4X60MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603192,CATH BLNDIL 4X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603193,CATH BLNDIL 4X80MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603194,CATH BLNDIL 6X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603195,CATH BLNDIL 7X120MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603196,CATH BLNDIL 7X60MM 80CM,4739.0,4739.0,284.34,4028.15,49 CDM,603197,CATH BLNDL 7X80MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603198,CATH BLNDIL 8X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603199,CATH BLNDIL 9X60MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,6032,SUTURE GUT 3-0 54IN,160.5,160.5,9.63,136.43,49 CDM,603200,CATH BLNDIL 9X80MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603204,KWIRE 4IN 2MM,6147.5,6147.5,368.85,5225.38,49 CDM,603206,KIT INST REAMER,12695.0,12695.0,761.7,10790.75,49 CDM,603208,SCREW TT LCK SELFDRILL 5,7158.0,7158.0,930.54,6084.3,28 CDM,603210,BODY HUM SHLDR FIN RVRS,68177.0,68177.0,8863.01,57950.45,28 CDM,603213,BIT DRILL 4.2MM 130MM,5587.0,5587.0,335.22,4748.95,49 CDM,603221,CATH BLNDL 4X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603222,CATH BLNDIL 4X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603223,CATH BLNDL 5X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603225,STENT VASC 8X80X135,19080.0,19080.0,2480.4,16218.0,28 CDM,603228,STENT VASC 10X100X80,19080.0,19080.0,2480.4,16218.0,28 CDM,603229,STENT VASC 10X40X80,19080.0,19080.0,2480.4,16218.0,28 CDM,603232,CATH BLNDL 6X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603233,CATH BLNDL 6X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,603235,RETRACTOR 32.5CM 18.3CM,1494.0,1494.0,89.64,1269.9,49 CDM,603238,DEVICE WNDCLS 45CM SZ0,1905.5,1905.5,114.33,1619.67,49 CDM,603239,DEVICE WNDCLS 18IN,1905.5,1905.5,114.33,1619.67,49 CDM,603243,RING ANLPLS PRFL 30MM,66946.0,66946.0,8702.98,56904.1,28 CDM,603248,CMPNT GLND SHLDR SZSM-R,7567.0,7567.0,983.71,6431.95,28 CDM,603249,INTRO SHEATH 22FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,603250,PROSTHESIS PNLE 20CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603254,INTRO SHTH 16FR 42CM,4119.0,4119.0,247.14,3501.15,49 CDM,603263,STENT EPRSTH 6X8X29MM,87308.0,87308.0,11350.04,74211.8,28 CDM,603270,STENT EPRSTH 11X16X29MM,89506.0,89506.0,11635.78,76080.1,28 CDM,603271,STENT EPRSTH 11X16X39MM,89506.0,89506.0,11635.78,76080.1,28 CDM,603272,STENT EPRSTH 11X16X59MM,89506.0,89506.0,11635.78,76080.1,28 CDM,603276,STENT EPRSTH 8X16X39MM,87308.0,87308.0,11350.04,74211.8,28 CDM,603277,STENT EPRSTH 8X16X59MM,87308.0,87308.0,11350.04,74211.8,28 CDM,603280,STENT EPRSTH 7MM 2.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603281,STENT EPRSTH 7MM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603282,STENT EPRSTH 8MM 7.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603288,RETRACTOR SURG 7.5IN,10177.0,10177.0,610.62,8650.45,49 CDM,603290,STENT VASC 9X40X80,19080.0,19080.0,2480.4,16218.0,28 CDM,603295,DEVICE WNDCLS 15CM SZ3,1614.5,1614.5,96.87,1372.33,49 CDM,603297,INSERT TIB KN SZ4 9MM,26764.0,26764.0,3479.32,22749.4,28 CDM,603300,CATH VASC 21F 135CM,13857.5,13857.5,831.45,11778.88,49 CDM,603304,STENT EPRSTH 37X37X20CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603312,STENT CAROTID SYS 9X40MM,74792.0,74792.0,9722.96,63573.2,28 CDM,603313,STENT CARTID SYS 10X40MM,74792.0,74792.0,9722.96,63573.2,28 CDM,603314,CATH THRMB 2F 135CM,14966.0,14966.0,897.96,12721.1,49 CDM,603317,DEVICE WNDCLS 2-0,1669.5,1669.5,100.17,1419.08,49 CDM,603318,STENT EPRSTH 8MM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603321,DEVICE WNDCLS SZ2.0,1335.5,1335.5,80.13,1135.17,49 CDM,603323,INTRO CATH CKFL 20F 25CM,15705.5,15705.5,942.33,13349.67,49 CDM,603324,STENT VASC 36MM 120MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603325,STENT VASC 46MM 180MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603331,CMPNT PTLA KN DOME 38MM,10032.0,10032.0,1304.16,8527.2,28 CDM,603334,CRT-D 5.37X8.18X0.99CM,100000.0,100000.0,13000.0,85000.0,28 CDM,603335,GDWRE VASC .014IN 190CM,3931.0,3931.0,235.86,3341.35,49 CDM,603336,SHEATH GD 5FR 45CM,4349.5,4349.5,260.97,3697.07,49 CDM,603337,INTRODUCER CATH 45CM 5FR,2905.5,2905.5,174.33,2469.68,49 CDM,603338,SHEATH GD 5FR 55CM,2969.0,2969.0,178.14,2523.65,49 CDM,603349,CATH GD 7FR 43CM,10566.5,10566.5,633.99,8981.52,49 CDM,603351,CATH MICRO 2X150CM,13857.5,13857.5,831.45,11778.88,49 CDM,603355,VALVE AORTIC 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603360,INSERT ART KN LT 3-4 9MM,18312.0,18312.0,2380.56,15565.2,28 CDM,603362,FEMORAL PREP KT SIZE 2 T,6303.5,6303.5,378.21,5357.98,49 CDM,603376,STAPLER INT CRV 25MM,12325.0,12325.0,739.5,10476.25,49 CDM,603377,STAPLER INT CIR 23MM,12395.0,12395.0,743.7,10535.75,49 CDM,603379,SHEATH CLOTREM 16FR,36977.0,36977.0,2218.62,31430.45,49 CDM,603384,INTRO SHEATH 10FR 33CM,20984.5,20984.5,1259.07,17836.83,49 CDM,603390,SCREW BN 2.7MM 26MM,3786.0,3786.0,492.18,3218.1,28 CDM,603393,GWIRE VASC .018IN 180CM,10399.5,10399.5,623.97,8839.58,49 CDM,603394,DEV CMPR PRCLUD 24CM30ML,1330.0,1330.0,79.8,1130.5,49 CDM,6034,BASEPLATE TIB UNV SZ6,32398.0,32398.0,4211.74,27538.3,28 CDM,603431,CATH BLNDIL 4MM 40MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603432,CATH BLNDIL 4MM 60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603434,STENT VNS 20X60MM 80CM,45791.0,45791.0,5952.83,38922.35,28 CDM,603445,CATH DIL 16MMX6CM 100CM,21508.5,21508.5,1290.51,18282.22,49 CDM,603447,CATH PRF22MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 CDM,603449,CATH BLNDIL 4MM 100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603450,CATH BLNDIL 4MM 150MM,44680.5,44680.5,2680.83,37978.43,49 CDM,603451,CATH BLNDIL 4MM 220MM,57776.5,57776.5,3466.59,49110.03,49 CDM,603455,COMPNT PTLR KN 10X35MM,12325.0,12325.0,1602.25,10476.25,28 CDM,603456,INSERT TIB KN SZ5 11MM,26764.0,26764.0,3479.32,22749.4,28 CDM,603458,CMPNT KNEE FEM RT SZ5,47048.0,47048.0,6116.24,39990.8,28 CDM,603464,PROS PENL 16CM-25CM 11MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603466,PATCH SLNT 4.8CMX4.8CM,12267.5,12267.5,736.05,10427.38,49 CDM,603467,RETRCTR WND XSM 2-4CM,2905.5,2905.5,174.33,2469.68,49 CDM,603468,CATH BLNDIL 4MM 300MM,76881.0,76881.0,4612.86,65348.85,49 CDM,603469,CATH BLNDIL 5MM 60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603470,CATH BLNDIL 5MM 100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603471,CATH BLNDIL 5MM 150MM,44680.5,44680.5,2680.83,37978.43,49 CDM,603472,CATH BLNDIL 5MM 220MM,57776.5,57776.5,3466.59,49110.03,49 CDM,603473,CATH BLNDIL 5MM 300MM,76881.0,76881.0,4612.86,65348.85,49 CDM,603474,CATH BLNDIL 6MM 40MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603475,CATH BLNDIL 6MM 60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603478,ICD ELECTRODE DEFIB 45CM,62968.0,62968.0,8185.84,53522.8,28 CDM,603479,MESH HRN LG 10X16CM,13364.0,13364.0,1737.32,11359.4,28 CDM,603480,MESH HRN MED LT 8X14CM,9067.0,9067.0,1178.71,7706.95,28 CDM,603481,MESH HRN MED RT 3X5IN,9067.0,9067.0,1178.71,7706.95,28 CDM,603485,STENT VNS 20X80MM 80CM,45791.0,45791.0,5952.83,38922.35,28 CDM,603488,STENT APS 14X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603489,STENT VNS 16X100MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603491,STENT VNS 16X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603492,STENT VNS 16X80MM 80CM,47317.0,47317.0,6151.21,40219.45,28 CDM,603495,STENT VNS 18X60MM 80CM,45791.0,45791.0,5952.83,38922.35,28 CDM,603496,STENT VNS 18X80MM 80CM,45791.0,45791.0,5952.83,38922.35,28 CDM,6035,RELOAD STPLR 60 4.3MM,8938.0,8938.0,1161.94,7597.3,28 CDM,603501,STENT VNS 14X80MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603506,STENT VSC 10X59MM 135CM,24977.0,24977.0,3247.01,21230.45,28 CDM,603512,CATH BLNDIL 6X100MM 80CM,3973.0,3973.0,238.38,3377.05,49 CDM,603513,CATH BLNDIL 6X120MM 80CM,4348.0,4348.0,260.88,3695.8,49 CDM,603517,CATH BLNDIL 7X80MM 135CM,3973.0,3973.0,238.38,3377.05,49 CDM,603519,CATH BLNDL 6X2/80MM 80CM,3877.0,3877.0,232.62,3295.45,49 CDM,603520,CATH BLNDIL 4X40MM 80CM,3952.0,3952.0,237.12,3359.2,49 CDM,603522,CATH DIL 12MMX4CM 100CM,15846.5,15846.5,950.79,13469.52,49 CDM,603523,CATH DIL 14MMX4CM 100CM,21508.5,21508.5,1290.51,18282.22,49 CDM,603527,CATH SLITTER ADJ SHTH,1453.0,1453.0,87.18,1235.05,49 CDM,603529,DILATOR URET 8-20X37,10681.0,10681.0,640.86,9078.85,49 CDM,603532,DRESSING GRMCDL 1IN 7MM,360.0,360.0,21.6,306.0,49 CDM,603545,CATH BLNDIL 6MM 100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603546,CATH BLNDIL 6MM 150MM,45571.5,45571.5,2734.29,38735.78,49 CDM,603547,CATH BLNDIL 6MM 220MM,57776.5,57776.5,3466.59,49110.03,49 CDM,603548,CATH BLNDIL 6MM 300MM,76881.0,76881.0,4612.86,65348.85,49 CDM,603549,CATH BLNDIL 7MM 40MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603550,CATH BLNDIL 7MM 60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603551,CATH BLN 5FR 6X130X60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603552,CATH DCB 7X60MM 130CM,35436.5,35436.5,2126.19,30121.03,49 CDM,603554,CATH BLNDIL 7MM 220MM,57776.5,57776.5,3466.59,49110.03,49 CDM,603555,CATH BLNDIL 7MM 100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,603556,STENT VNS 10X100MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603557,STENT VNS 10X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 CDM,603569,TOOL SIZE ESOPH,23110.5,23110.5,1386.63,19643.92,49 CDM,603573,CATH ULTSND 6FR 120CM,78576.0,78576.0,4714.56,66789.6,49 CDM,603580,HEAD HIP -4MM 32MM,18312.0,18312.0,2380.56,15565.2,28 CDM,603582,GRAFT STNT 22MM 13X40MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603584,LEAD NRSTM 0.170IN 28CM,97960.0,97960.0,12734.8,83266.0,28 CDM,603587,SEALER INSTRMNT 8MM,22325.0,22325.0,1339.5,18976.25,49 CDM,603592,VALVE AORTIC 21MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603597,DRAIN WND RND 28FR,1230.0,1230.0,73.8,1045.5,49 CDM,6036,SUT CHRM SZ 4-0 1X27IN,144.0,144.0,8.64,122.4,49 CDM,603606,COMPNT FEM LT KN SZ4,47048.0,47048.0,6116.24,39990.8,28 CDM,603612,INSERT CLAMP 33MM,778.5,778.5,46.71,661.73,49 CDM,603616,SHELL ACTB HIP 4HL 60MM,28172.0,28172.0,3662.36,23946.2,28 CDM,603691,RETRACTOR ATRL LFT SYS 3,74416.0,74416.0,4464.96,63253.6,49 CDM,603699,CATH BLNOCC 26-42MM,20276.0,20276.0,1216.56,17234.6,49 CDM,6037,SUTURE SH 2-0 1X27IN,3034.5,3034.5,182.07,2579.32,49 CDM,603705,SHEATH INTR 5FR 25CM,1336.5,1336.5,80.19,1136.03,49 CDM,603708,GLOVE BRN SHDR RT LG,627.0,627.0,37.62,532.95,49 CDM,603716,GLOVE BRN HND LT LG,627.0,627.0,37.62,532.95,49 CDM,603717,GLOVE BRN SHDR RT MED,627.0,627.0,37.62,532.95,49 CDM,603718,GUIDEWIRE VASC 180CM,10588.0,10588.0,635.28,8999.8,49 CDM,603730,CATH ANGIO 5FR 65CM,2905.5,2905.5,174.33,2469.68,49 CDM,603734,SHEATH GD 8FR 45CM,4349.5,4349.5,260.97,3697.07,49 CDM,603735,STENT PANC 29MM 146MM,100000.0,100000.0,13000.0,85000.0,28 CDM,603738,CATH BLNDIL 1.5MM 10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603739,CATH BLNDIL 1.75X10M,2905.5,2905.5,174.33,2469.68,49 CDM,603740,CATHETER BLNDIL 2X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603741,CATH BLN 2.25MMX10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603742,CATHETER BLNDIL 2.5X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603743,CATH BLNDL 2.75MM 10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603744,CATHETER BLNDIL 3X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603745,CATHETER BLNDL 3.25X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603746,CATHETER BLNDIL 3.5X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603747,CATHETER BLNDIL 4X10MM,2905.5,2905.5,174.33,2469.68,49 CDM,603751,CATHETER BLNDIL 1.5X12MM,2905.5,2905.5,174.33,2469.68,49 CDM,603752,CATHETER BLNDIL 2X12MM,2905.5,2905.5,174.33,2469.68,49 CDM,603753,CATH BLN 2.5MMX12MM,2905.5,2905.5,174.33,2469.68,49 CDM,603754,CATHETER BLNDIL 3X12MM,2905.5,2905.5,174.33,2469.68,49 CDM,603755,CATH BLNDIL 1.5MM 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603757,CATH BLNDIL 2X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603758,CATH BLN 2.25MM 15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603759,CATHETER BLNDIL 2.5X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603760,CATHETER BLNDL 2.75X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603761,CATHETER BLNDIL 3X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603762,CATHETER BLNDL 3.25X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603764,CATHETER BLNDIL 4X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,603767,CATHETER BLNDIL 2X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603768,CATHETER BLNDL 2.25X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603769,CATHETER BLNDIL 2.5X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603771,CATHETER BLNDIL 3X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603772,CATHETER BLNDL 3.25X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603773,CATHETER BLNDIL 3.5X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603774,CATHETER BLNDIL 4X20MM,2905.5,2905.5,174.33,2469.68,49 CDM,603775,CATHETER BLNDIL 2.5X30MM,2905.5,2905.5,174.33,2469.68,49 CDM,603776,CATHETER BLNDIL 3X30MM,2905.5,2905.5,174.33,2469.68,49 CDM,603779,PLUG VASC 3MM 6MM,26906.0,26906.0,3497.78,22870.1,28 CDM,603780,PLUG VASC 4MM 6MM,36324.0,36324.0,4722.12,30875.4,28 CDM,603781,PLUG VASC 6MM 6MM,26906.0,26906.0,3497.78,22870.1,28 CDM,603791,PLATE BN STRNL 4H,17493.0,17493.0,2274.09,14869.05,28 CDM,603796,KIT ANCH SUT DISP 1.8MM,17607.0,17607.0,1056.42,14965.95,49 CDM,603815,CATH BLN 4.0X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 CDM,603846,CATH BLN 2X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 CDM,603854,CATH BLN 2X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 CDM,603865,GWIRE VASC 300CM .018IN,22825.0,22825.0,1369.5,19401.25,49 CDM,603866,GWIRE VASC 300CM .014IN,6273.0,6273.0,376.38,5332.05,49 CDM,603867,GWIRE VASC 300CM .014IN,6273.0,6273.0,376.38,5332.05,49 CDM,603871,HEAD HUMRL SHLDR IMP42MM,22313.0,22313.0,2900.69,18966.05,28 CDM,603873,CATH GD 2.6FR 150CM,6338.5,6338.5,380.31,5387.73,49 CDM,603874,CATH SUPP ANG 2.6F 90CM,6338.5,6338.5,380.31,5387.73,49 CDM,603876,CATH SUPP STR 2.6F 90CM,6338.5,6338.5,380.31,5387.73,49 CDM,6040,SYSTEM BNCMNT MIXER,2905.5,2905.5,174.33,2469.68,49 CDM,6042,SUTURE RB-1 4-0 1X27IN,3234.0,3234.0,194.04,2748.9,49 CDM,6051,SUTURE CTX 1 1X36IN,159.0,159.0,9.54,135.15,49 CDM,6054,SUT CHRM 2-0 CT1 36IN,152.5,152.5,9.15,129.63,49 CDM,6061,K WIRE 2.5MM,1515.5,1515.5,90.93,1288.17,49 CDM,6064,SUTURE BLK MONO 2-0 18IN,191.0,191.0,11.46,162.35,49 CDM,6067,SUTURE BLK MONO 2-0 30IN,81.5,81.5,4.89,69.28,49 CDM,6068,SCREW BN 6.5MM 25MM,2541.0,2541.0,330.33,2159.85,28 CDM,6070,APPLIER CLP LOAD M/L,2541.0,2541.0,330.33,2159.85,28 CDM,6073,SUTURE PS-1 3-0 1X18IN,172.5,172.5,10.35,146.63,49 CDM,6074,SUTURE NYLON 3-0 18IN,157.5,157.5,9.45,133.88,49 CDM,6087,PIN BN TEMP 3.2MM 80MM,2905.5,2905.5,174.33,2469.68,49 CDM,6088,SUTURE CT-1 0 8X18IN,508.0,508.0,30.48,431.8,49 CDM,6089,SUTURE GRN BRD 0 30IN,78.5,78.5,4.71,66.72,49 CDM,6091,SUTURE CT-1 1 1X30IN,78.5,78.5,4.71,66.72,49 CDM,6092,PIN FX INSTR HP THRD,5402.5,5402.5,324.15,4592.13,49 CDM,6096,SUTURE UND MONO 2-0 27IN,91.0,91.0,5.46,77.35,49 CDM,6097,SUTURE SZ4-0 27IN,248.0,248.0,14.88,210.8,49 CDM,6099,SUTURE MNCRL 4-0 18IN,260.5,260.5,15.63,221.43,49 CDM,61000,KIT PEG SIL 20F,2905.5,2905.5,174.33,2469.68,49 CDM,610000,CATH PA 2LUM 5FR 110CM,2905.5,2905.5,174.33,2469.68,49 CDM,610005,SCREW BN 2.4MM 16MM,4332.0,4332.0,563.16,3682.2,28 CDM,610006,LEAD PCNG 4.7FR 86CM,25144.0,25144.0,3268.72,21372.4,28 CDM,61001,SUTURE BLU MONO 6-0 30IN,1222.5,1222.5,73.35,1039.13,49 CDM,610011,CATH URET 14FR 5CC,379.0,379.0,22.74,322.15,49 CDM,610013,CATH URTH 2WY 20FR,379.0,379.0,22.74,322.15,49 CDM,610015,CLIP LIGATING LG,818.0,818.0,106.34,695.3,28 CDM,610017,KIT WND DRN 400CC 1/4IN,486.0,486.0,29.16,413.1,49 CDM,61002,KIT IMPL 0D 2.5MM 17MM,27067.0,27067.0,3518.71,23006.95,28 CDM,610021,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,610022,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,610023,CATH ANGIO 5FR 100CM,616.0,616.0,36.96,523.6,49 CDM,610024,CATH ANGIO 5F 100CM,615.5,615.5,36.93,523.17,49 CDM,610025,CATH ANGIO 5FR 110CM,615.5,615.5,36.93,523.17,49 CDM,610027,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,610028,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,610033,CATH UMB 3.5FR 15IN,10923.0,10923.0,655.38,9284.55,49 CDM,61009,CATH GD 2.6FR 150CM,6338.5,6338.5,380.31,5387.73,49 CDM,61021,OCCLUD CV 80CM 12FR,22648.5,22648.5,1358.91,19251.22,49 CDM,61022,SHTH DLV 80CM 14FR 5.5IN,22648.5,22648.5,1358.91,19251.22,49 CDM,61023,KIT PREP REAMER 3.0MM,17431.0,17431.0,1045.86,14816.35,49 CDM,61025,STENTCAROTID SYS 7X40MM,74792.0,74792.0,9722.96,63573.2,28 CDM,61031,GWIRE VASC 300CM .018IN,6273.0,6273.0,376.38,5332.05,49 CDM,61037,VALVE AORTIC 23MM,100000.0,100000.0,13000.0,85000.0,28 CDM,61038,VALVE AORTIC 25MM,100000.0,100000.0,13000.0,85000.0,28 CDM,61039,VALVE AORTIC 29MM,100000.0,100000.0,13000.0,85000.0,28 CDM,6104,SUTURE CT-1 3-0 1X36IN,100.5,100.5,6.03,85.42,49 CDM,61041,BIT DRILL 3.2MM,2905.5,2905.5,174.33,2469.68,49 CDM,61056,STENT COR 2.25X8MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61057,STENT COR 2.50X8MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61058,STENT COR 2.75X8MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61059,STENT COR 3.00X8MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61060,STENT COR 3.50X8MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61066,STENT COR 3.50X12MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61068,STENT COR 4.50X12MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61069,STENT COR 5.00X12MM,7863.0,7863.0,1022.19,6683.55,28 CDM,6107,COMPNT PTLR KN 9X32MM,6808.0,6808.0,885.04,5786.8,28 CDM,61073,STENT COR 3.00X16MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61074,STENT COR 3.50X16MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61076,STENT COR 4.50X16MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61077,STENT COR 5.00X16MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61079,STENT COR 2.50X20MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61080,STENT COR 2.75X20MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61083,STENT COR 4.00X20MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61084,STENT COR 4.50X20MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61085,STENT COR 5.00X20MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61087,STENT COR 2.50X24MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61090,STENT COR 3.50X24MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61097,STENT COR 2.75X28MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61099,STENT COR 3.50X28MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61100,STENT COR 4.00X28MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61103,STENT COR 2.25X32MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61105,STENT COR 3.00X32MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61106,STENT COR 3.50X32MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61113,STENT COR 3.00X38MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61114,STENT COR 3.50X38MM,7863.0,7863.0,1022.19,6683.55,28 CDM,61116,STENT COR 2.50X48MM,15223.0,15223.0,1978.99,12939.55,28 CDM,61118,STENT COR 3.00X48MM,15223.0,15223.0,1978.99,12939.55,28 CDM,61119,STENT COR 3.50X48MM,15223.0,15223.0,1978.99,12939.55,28 CDM,61127,LINER ACTB HIP SZD 36MM,21129.0,21129.0,2746.77,17959.65,28 CDM,61129,CURETTE CRVD 12MM,221.5,221.5,13.29,188.28,49 CDM,61141,DEVICE CLSR 27MM,100000.0,100000.0,13000.0,85000.0,28 CDM,61147,CATH GD 8.4FR 45CM,10952.0,10952.0,657.12,9309.2,49 CDM,61150,CATH ANGIO 5FR 110CM,615.5,615.5,36.93,523.17,49 CDM,61152,CMPNT FEM KN LT SZ4,42258.0,42258.0,5493.54,35919.3,28 CDM,6126,SUTURE CT-1 0 1X27IN,2690.5,2690.5,161.43,2286.93,49 CDM,6127,SUTURE VIO MONO 1 36IN,132.0,132.0,7.92,112.2,49 CDM,6128,SUTURE CTX 1 1X36IN,194.0,194.0,11.64,164.9,49 CDM,6131,SUTURE CLR MONO 4-0 18IN,244.0,244.0,14.64,207.4,49 CDM,6132,SUTURE CLR MONO 3-0 18IN,227.0,227.0,13.62,192.95,49 CDM,6134,CHECKPOINT IMP 3.5MM,2905.5,2905.5,174.33,2469.68,49 CDM,6135,KIT SURG HIP TRK STRL,6798.5,6798.5,407.91,5778.73,49 CDM,6137,TUBE IRRIG RIO SYSTEM,4255.5,4255.5,255.33,3617.18,49 CDM,6138,SUTURE GUT 0 54IN,162.0,162.0,9.72,137.7,49 CDM,6139,PIN BN TEMP 4MM 170MM,2541.0,2541.0,152.46,2159.85,49 CDM,6140,PIN BN TEMP 4MM 140MM,4759.0,4759.0,285.54,4045.15,49 CDM,6141,PIN BN TEMP 4MM 100MM,2905.5,2905.5,174.33,2469.68,49 CDM,6146,SUTURE GUT 2-0 27IN,137.5,137.5,8.25,116.88,49 CDM,6150,HUM REV BDYEXT SHLDR SMR,44963.0,44963.0,5845.19,38218.55,28 CDM,6152,SUTURE C-1 5-0 1X36IN,504.5,504.5,30.27,428.82,49 CDM,6153,STEM HUM 80X18MM FN CMNT,23552.0,23552.0,3061.76,20019.2,28 CDM,6154,SUTURE BLU MONO 0 30IN,2720.0,2720.0,163.2,2312.0,49 CDM,6155,SUTURE CT-1 0 1X30IN,123.0,123.0,7.38,104.55,49 CDM,6157,SUTURE SH 4-0 1X36IN,265.5,265.5,15.93,225.68,49 CDM,6158,SUTURE SH 2-0 1X36IN,5682.0,5682.0,340.92,4829.7,49 CDM,6159,SUTURE BLU MONO 3-0 48IN,264.0,264.0,15.84,224.4,49 CDM,6165,SET IRR TBNG CORD DISP,2382.5,2382.5,142.95,2025.13,49 CDM,6166,SUTURE BLU MONO 4-0 18IN,5205.5,5205.5,312.33,4424.68,49 CDM,6174,SUTURE C-1 7-0 1X30IN,486.5,486.5,29.19,413.52,49 CDM,6175,SUTURE TP-1 1 1X60IN,187.0,187.0,11.22,158.95,49 CDM,6178,SUTURE SH 2-0 8X18IN,377.5,377.5,22.65,320.88,49 CDM,6180,MESH SURG 2X12IN,2231.0,2231.0,290.03,1896.35,28 CDM,6182,SUTURE NONDL 2-0 2X60IN,59.0,59.0,3.54,50.15,49 CDM,6186,SUTURE BLK BRD 3-0 30IN,2780.0,2780.0,166.8,2363.0,49 CDM,6187,SUTURE NONDL 2-0 12X30IN,113.5,113.5,6.81,96.47,49 CDM,6188,SUTURE SILK 0 30IN,61.0,61.0,3.66,51.85,49 CDM,6189,SUTURE BLU MONO 1 30IN,61.0,61.0,3.66,51.85,49 CDM,6190,PLUG SURG HRN 1.35X1IN,10233.0,10233.0,1330.29,8698.05,28 CDM,6191,BOLSTER SUT RTNT 2.5,91.0,91.0,5.46,77.35,49 CDM,6194,SUTURE KS 2-0 1X30IN,68.0,68.0,4.08,57.8,49 CDM,6197,SUTURE BLK BRD 3-0 18IN,165.5,165.5,9.93,140.68,49 CDM,619818,SEALANT FIBRN PREFL 10ML,15556.5,15556.5,933.39,13223.02,49 CDM,6199,SUTURE SH 3-0 1X30IN,57.5,57.5,3.45,48.88,49 CDM,6200,SCREW BN 2.7MM 12MM,4913.0,4913.0,638.69,4176.05,28 CDM,6208,CORD MNPLR STR 10FT,999.0,999.0,59.94,849.15,49 CDM,6213,DEVICE WNDCLS 23CM SZ1,1929.0,1929.0,115.74,1639.65,49 CDM,6215,SUTURE UND BRD 0 27IN,2557.0,2557.0,153.42,2173.45,49 CDM,6216,SUTURE UND BRD 1 27IN,86.0,86.0,5.16,73.1,49 CDM,6217,SUTURE UNDYE 2-0 1X27IN,82.5,82.5,4.95,70.13,49 CDM,6220,BASEPLATE TIB KN RT SZ2,28172.0,28172.0,3662.36,23946.2,28 CDM,6224,BURR CUT STRL DISP 6MM,3136.0,3136.0,188.16,2665.6,49 CDM,6225,SUTURE UND BRD 4-0 27IN,82.0,82.0,4.92,69.7,49 CDM,6228,SUTURE SH 2-0 1X27IN,77.5,77.5,4.65,65.88,49 CDM,6239,SUTURE UND BRD 5-0 18IN,216.0,216.0,12.96,183.6,49 CDM,624010,OBS PER HOUR,100.39,100.39,14.05,85.33,15 CDM,6245,SUTURE UND BRD 1 27IN,88.0,88.0,5.28,74.8,49 CDM,6251,SCREW BN CORT 6.5X15MM,2541.0,2541.0,330.33,2159.85,28 CDM,6258,DEVICE CLSR WND 2-0 30CM,1256.5,1256.5,75.39,1068.03,49 CDM,6263,DEVICE CLSR WND 0 23CM,1348.0,1348.0,80.88,1145.8,49 CDM,6264,SUTURE CT-1 3-0 1X36IN,83.0,83.0,4.98,70.55,49 CDM,6265,DEVICE WNDCLS SZ0 6IN,2437.5,2437.5,146.25,2071.88,49 CDM,6266,SUTURE CT-1 SZ0 1X36IN,81.5,81.5,4.89,69.28,49 CDM,6269,SUTURE UND BRD 1 36IN,86.5,86.5,5.19,73.53,49 CDM,6274,BLADE REAMER 46MM,4182.0,4182.0,250.92,3554.7,49 CDM,6276,SUTURE POLY SZ 0 18IN,1452.5,1452.5,87.15,1234.63,49 CDM,6278,BLADE REAMER 51MM,4182.0,4182.0,250.92,3554.7,49 CDM,6282,BARRIER ADH ABS 3X4IN,7857.0,7857.0,471.42,6678.45,49 CDM,6293,GUIDE ROD 3MM 100MM,4330.5,4330.5,259.83,3680.93,49 CDM,6294,BIT DRILL 4.0MM,2905.5,2905.5,174.33,2469.68,49 CDM,6295,GD PIN 3.2MMX343MM,9975.0,9975.0,598.5,8478.75,49 CDM,6296,SCREW BN 5MM 35MM,14609.0,14609.0,1899.17,12417.65,28 CDM,6297,SCREW BN 95MM 90MM,20050.0,20050.0,2606.5,17042.5,28 CDM,6302,SCREW BN LCK THRD 3.5X12,6240.0,6240.0,811.2,5304.0,28 CDM,6303,SCREW BN 3.5MM 14MM,6240.0,6240.0,811.2,5304.0,28 CDM,6317,BLOCKER SPN ROD CLSR,2201.0,2201.0,286.13,1870.85,28 CDM,6320,SCREW BN 6.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 CDM,6321,SCREW SPN 6.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 CDM,6327,SUTURE UND BRD 4-0 27IN,2416.5,2416.5,144.99,2054.03,49 CDM,6335,BASEPLATE TIB KN SZ5,28172.0,28172.0,3662.36,23946.2,28 CDM,6337,SYSTEM PRESS 10CM 30CM,9020.5,9020.5,541.23,7667.43,49 CDM,6345,SUTURE UND MONO 3-0 27IN,115.0,115.0,6.9,97.75,49 CDM,6352,SUTURE TP-1 1 1X96IN,218.5,218.5,13.11,185.72,49 CDM,6354,SUTURE BLK MONO 3-0 30IN,162.0,162.0,9.72,137.7,49 CDM,6360,DEVICE CLSR WND 14X14CM,1337.5,1337.5,80.25,1136.88,49 CDM,6362,DEVICE CLS WND +2-0 23CM,1270.0,1270.0,76.2,1079.5,49 CDM,6366,SUTURE SH 3-0 1X36IN,260.5,260.5,15.63,221.43,49 CDM,637270,STENT COR 2.50X32MM,20121.0,20121.0,2615.73,17102.85,28 CDM,6373,DEVICE CLSR 5FR,7854.0,7854.0,1021.02,6675.9,28 CDM,6387,SUTURE VCL 2-0 CT2,538.0,538.0,32.28,457.3,49 CDM,6409,PUTTY DBM ALLOGRFT 1CC,3973.0,3973.0,516.49,3377.05,28 CDM,6424,IMPLANT BREAST 325CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6427,FINE NDL ASP W US E ADD,3403.93,3403.93,204.24,2893.34,37 CDM,6433,SHELL ACTB HIP MLH 56MM,40166.0,40166.0,5221.58,34141.1,28 CDM,6459,DRESSING NSL 1.5X2X8CM,627.0,627.0,37.62,532.95,49 CDM,6462,SCREW BN 6.5MM 35MM,2541.0,2541.0,330.33,2159.85,28 CDM,6466,KIT INTSTM SMART PROGRMR,44988.5,44988.5,2699.31,38240.22,49 CDM,6471,CMPNT FEM KN LT SZ3,38596.0,38596.0,5017.48,32806.6,28 CDM,6473,TIBIAL PREP KT SIZE 3 TR,5353.0,5353.0,321.18,4550.05,49 CDM,6474,SYSTEM PRESS 10CM 40CM,15813.0,15813.0,948.78,13441.05,49 CDM,6478,SCREW BN ACTB 25MM,2591.0,2591.0,336.83,2202.35,28 CDM,6479,CMPNT FEM HIP SZ15,52170.0,52170.0,6782.1,44344.5,28 CDM,6480,LINER ACTB HIP 36MM 56MM,15495.0,15495.0,2014.35,13170.75,28 CDM,6481,HEAD FEM 12/14 36MM,18312.0,18312.0,2380.56,15565.2,28 CDM,6482,SHELL HIP R3 POR 56MM,25355.0,25355.0,3296.15,21551.75,28 CDM,6483,SHELL ACTB HIP 54MM,83743.0,83743.0,10886.59,71181.55,28 CDM,6488,SHELL ACTB HIP 5H 54MM,28172.0,28172.0,3662.36,23946.2,28 CDM,6490,IMPLANT BREAST 370CC,37189.0,37189.0,4834.57,31610.65,28 CDM,6491,IMPLANT BREAST 275CC,32338.0,32338.0,4203.94,27487.3,28 CDM,6494,SCREW BN 3.5X36MM,5218.0,5218.0,678.34,4435.3,28 CDM,6497,GRAFT PRCN 3.9X2.4IN,55441.0,55441.0,7207.33,47124.85,28 CDM,6498,SYSTEM IMPLNT ACH MID SB,34178.0,34178.0,4443.14,29051.3,28 CDM,6509,CMPNT PATELLAR OVAL 35MM,7166.0,7166.0,931.58,6091.1,28 CDM,6510,CMPNT FEM KN RT SZ6,42258.0,42258.0,5493.54,35919.3,28 CDM,6522,SCREW BN 6.5MM 30MM,2541.0,2541.0,330.33,2159.85,28 CDM,6523,SCREW BN 6.5MM 25MM,2541.0,2541.0,330.33,2159.85,28 CDM,6547,PLATFORM ACC 10MM 12MM,23110.5,23110.5,1386.63,19643.92,49 CDM,654839,INS PICC W/ SQ PORT=>5Y,17448.25,17448.25,1046.89,14831.01,37 CDM,6551,STENT ESPH 18.5FR 23MM,67656.0,67656.0,8795.28,57507.6,28 CDM,6552,SYSTEM DLV 7FR 202.5CM,3254.5,3254.5,195.27,2766.32,49 CDM,6553,SYSTEM DLV 10FR 202.5CM,3254.5,3254.5,195.27,2766.32,49 CDM,6554,STENT BIL PGTL 10FR 5CM,1975.0,1975.0,256.75,1678.75,28 CDM,6559,SCREW BN T10 3.5X20MM,2135.0,2135.0,277.55,1814.75,28 CDM,6562,GRAFT CV 7MM 45CM,81477.0,81477.0,10592.01,69255.45,28 CDM,6563,DEVICE CLSE WND 2-0 23CM,1279.0,1279.0,76.74,1087.15,49 CDM,6603,DEVICE BRST IMPLNT DLVRY,5838.0,5838.0,350.28,4962.3,49 CDM,6607,ANCHOR 2.9MM JUGGERKNOT,11745.0,11745.0,1526.85,9983.25,28 CDM,6611,GRAFT CV 6MM 30CM,50950.0,50950.0,6623.5,43307.5,28 CDM,6615,ROD SPN 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,28 CDM,6616,KIT ASMBL PROS PENILE,17607.0,17607.0,1056.42,14965.95,49 CDM,6617,PROSTH PENL OD PMP 22CM,100000.0,100000.0,13000.0,85000.0,28 CDM,6618,PROSTH RESRVOIR 125ML,76221.0,76221.0,9908.73,64787.85,28 CDM,6621,BASEPLATE TIB KN SZ3,36624.0,36624.0,4761.12,31130.4,28 CDM,6622,CMPNT FEM KN SZ2,47048.0,47048.0,6116.24,39990.8,28 CDM,6627,COMPNT FEM KN LT SZ5,47048.0,47048.0,6116.24,39990.8,28 CDM,6676,KIT BNCMNT BIOPRP INST,3645.0,3645.0,218.7,3098.25,49 CDM,6692,SPACER SPN PLG 4D 7MM,23947.0,23947.0,3113.11,20354.95,28 CDM,6696,NEEDLE INSFL 13GA 120MM,1743.5,1743.5,104.61,1481.97,49 CDM,6699,PATELLA KN POLY SZ4 7MM,7166.0,7166.0,931.58,6091.1,28 CDM,6700,BASEPLATE TIB KN SZ4,36624.0,36624.0,4761.12,31130.4,28 CDM,6701,CMPNT FEM KN RM/LL SZ4,38596.0,38596.0,5017.48,32806.6,28 CDM,6703,IMPLANT BREAST 180CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6709,IMPLANT BREAST 200CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6710,IMPLANT BREAST 220CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6713,IMPLANT BREAST 240CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6715,IMPLANT BREAST 295CC,25709.0,25709.0,3342.17,21852.65,28 CDM,6716,IMPLANT BREAST 265CC,25709.0,25709.0,3342.17,21852.65,28 CDM,672333,ENALAPRILAT 1.25 MG INJ,152.07,152.07,9.12,129.26,49 CDM,672335,DARUNAVIR 800 MG PO,1169.62,1169.62,70.18,994.18,49 CDM,672336,CEFTOLOZ TAZOBACT 1.5 G,1597.81,1597.81,95.87,1358.14,19 CDM,672336,"Injection, ceftolozane 50 mg and tazobactam 25 mg ",1597.81,1597.81,8.84,28.49,10 CDM,672337,HEPARIN 2000 U/NS 1L INJ,245.08,245.08,14.7,208.32,24 CDM,672339,WARFARIN 4 MG PO,51.16,51.16,3.07,43.49,49 CDM,672340,CYCLOSPO 0.05% 0.4ML OPH,149.9,149.9,8.99,127.42,49 CDM,672341,DARUNAVIR 600 MG PO,715.02,715.02,42.9,607.77,49 CDM,672342,DICLOFENAC 1% 100 G TOP,879.21,879.21,52.75,747.33,49 CDM,672343,FLUCONAZOLE 200 MG PO,794.74,794.74,47.68,675.53,49 CDM,672346,LEVALBU NCUD 0.63 MG INH,149.9,149.9,8.99,127.42,24 CDM,672347,LEVALBU NCUD 1.25 MG INH,72.58,72.58,4.35,61.69,24 CDM,672349,METOPROLOL 100 MG PO,32.12,32.12,1.93,27.3,49 CDM,672350,NORTRIPTYLINE 10 MG PO,10.7,10.7,0.64,9.09,49 CDM,672351,POTASSI CHL ER 20 MEQ PO,29.74,29.74,1.78,25.28,49 CDM,672352,RALTEGRAVIR 400 MG PO,694.8,694.8,41.69,590.58,49 CDM,672359,ALBUMIN INF 5% 500 ML,2463.92,2463.92,147.84,2094.33,15 CDM,672360,ARIPIPRAZOLE 15 MG PO,657.91,657.91,39.47,559.22,49 CDM,672365,CARB/LEV ER 25/100 MG PO,46.4,46.4,2.78,39.44,49 CDM,672367,CEFTAZIDIME 2 G INJ,845.9,845.9,50.75,719.01,24 CDM,672368,CLOTRIMAZOLE 1% 45G VAG,67.81,67.81,4.07,57.64,49 CDM,672369,CYCLOBENZAPRINE 5 MG PO,67.81,67.81,4.07,57.64,49 CDM,672370,DOFETILIDE 500 MCG PO,233.18,233.18,13.99,198.2,49 CDM,672371,DOXAZOSIN 4 MG PO,38.07,38.07,2.28,32.36,49 CDM,672372,FENOFIBRATE 54 MG PO,22.6,22.6,1.36,19.21,49 CDM,672373,FENOFIBRATE 160 MG PO,190.36,190.36,11.42,161.81,49 CDM,672375,ITRACONAZOLE 100 MG PO,535.36,535.36,32.12,455.06,49 CDM,672376,MELOXICAM 7.5 MG PO,159.42,159.42,9.57,135.51,49 CDM,672377,MIDAZOLAM 5 MG/1 ML INJ,52.35,52.35,3.14,44.5,24 CDM,672378,OFLOXACIN 0.3% 5ML OTIC,1961.86,1961.86,117.71,1667.58,30 CDM,672381,RISPERIDONE 2 MG PO,337.88,337.88,20.27,287.2,49 CDM,6727,INTRODUCER INTRA 11.5FR,22555.0,22555.0,1353.3,19171.75,49 CDM,6728,INTRO DR 8.5F 22.4MM,27292.0,27292.0,1637.52,23198.2,49 CDM,6729,INTR0 SHTH 8.5FR 71CM,27292.0,27292.0,1637.52,23198.2,49 CDM,6730,INTRO SHTH GD 8.5FR 63CM,4751.0,4751.0,285.06,4038.35,49 CDM,6732,CATH EP J 2-5-2X120 6FR,3119.0,3119.0,187.14,2651.15,49 CDM,6735,CATH MAP 13X13MM 105CM,59528.0,59528.0,3571.68,50598.8,49 CDM,6740,CATH EP 6FR 120CM,3119.0,3119.0,187.14,2651.15,49 CDM,674001,DEVICE CLSR WND +1 45CM,1358.0,1358.0,81.48,1154.3,49 CDM,674021,SCREW BN 2.7MM 12MM,5200.0,5200.0,676.0,4420.0,28 CDM,6762,CATH BLNDIL 1.25MM 5MM,2905.5,2905.5,174.33,2469.68,49 CDM,6763,CATH BLNDIL 1MM 15MM,6273.0,6273.0,376.38,5332.05,49 CDM,6764,CATH BLNDIL 1MM 10MM,6273.0,6273.0,376.38,5332.05,49 CDM,6765,CATH BLNDL 1MM 8MM PERC,5440.0,5440.0,326.4,4624.0,49 CDM,6766,CATH BLNDIL 1MM 5MM,6273.0,6273.0,376.38,5332.05,49 CDM,6767,SUTURE CTX 0 1X30IN,307.0,307.0,18.42,260.95,49 CDM,677002,SCREW BN 6.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,677003,LEAD PCNG 86CM,22228.0,22228.0,2889.64,18893.8,28 CDM,6771,SUTURE CT-1 SZ1 8X18IN,801.5,801.5,48.09,681.27,49 CDM,6773,OSTEO FLEX 8MM 80MM,16988.0,16988.0,1019.28,14439.8,49 CDM,679184,CATH CV 7FR 6IN,602.0,602.0,36.12,511.7,49 CDM,6808,COMPONENT FEM KN LT 3,47048.0,47048.0,6116.24,39990.8,28 CDM,6810,COMPONENT FEM KN LT CR 6,47048.0,47048.0,6116.24,39990.8,28 CDM,6832,DEVICE CLSR WND 1 45CM,7478.5,7478.5,448.71,6356.73,49 CDM,6839,STAPLER INT LNG 60MM,11790.0,11790.0,707.4,10021.5,49 CDM,6842,BLADE SHAVER SOFT PLUS,14688.0,14688.0,881.28,12484.8,49 CDM,6846,DRSG WND AG 4X14IN,1924.0,1924.0,115.44,1635.4,49 CDM,6847,IMG GD FLD COLL SOFT TIS,3689.0,3689.0,221.34,3135.65,37 CDM,6851,SYSTEM SHNT 2 PROSA 20,100000.0,100000.0,13000.0,85000.0,28 CDM,6864,PASSER SURG XL 65CM,4018.0,4018.0,241.08,3415.3,49 CDM,6869,BIT DRILL 4.2MM 180MM,5988.5,5988.5,359.31,5090.23,49 CDM,6871,KWIRE FX 450MM 3.2MM,3722.0,3722.0,223.32,3163.7,49 CDM,6872,GWIRE ORTH S2 3X1000MM,5687.5,5687.5,341.25,4834.38,49 CDM,688502,DIRECT REFERRAL TO OBS,220.38,220.38,30.85,187.32,10 CDM,6895,US ELASTO EACH ORG,697.88,697.88,41.87,593.2,17 CDM,6895,"Ultrasound, elastography; parenchyma (eg, organ) ",697.88,697.88,104.59,853.3,29 CDM,6935,BX LIVER,8938.0,8938.0,536.28,7597.3,37 CDM,6936,BX RENAL,10465.0,10465.0,627.9,8895.25,37 CDM,6941,BX PANCREAS,8937.78,8937.78,536.27,7597.11,37 CDM,6942,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,44 CDM,6943,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,44 CDM,6944,ABL 1/MORE RENL TU PC RF,29256.83,29256.83,1755.41,24868.31,37 CDM,6945,BX ABD/RETROPERITO,12908.81,12908.81,774.53,10972.49,37 CDM,6946,THORACENTESIS W/ IMAG,6504.0,6504.0,390.24,5528.4,37 CDM,6954,CATH 2ND ORDER VEN,1374.63,1374.63,82.48,1168.44,37 CDM,6955,SP VENOGM RENAL BI,15144.49,15144.49,908.67,12872.82,17 CDM,6955,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",15144.49,15144.49,147.01,10724.85,29 CDM,6956,INS PICC WO P W IMG=>5Y,6962.06,6962.06,417.72,5917.75,37 CDM,6957,3D OTH W POST IMG IND,2960.69,2960.69,177.64,2516.59,31 CDM,6960,EMERGENCY HOLDING ICU,11767.9,11767.9,,,0 CDM,6965,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,6966,INTERMEDIATE,9175.38,9175.38,,,0 CDM,6986,CATH 1ST ORDER VEN,1215.23,1215.23,72.91,1032.95,37 CDM,6987,SUTURE TF 4-0 8X18IN,4703.5,4703.5,282.21,3997.97,49 CDM,6990,ACC/CLS FEM ART PERC ADD,24346.29,24346.29,1460.78,20694.35,37 CDM,6992,CATH 2ND ORD UP ART,5864.43,5864.43,351.87,4984.77,34 CDM,6993,CATH 1ST ORD UP ART,5864.43,5864.43,351.87,4984.77,34 CDM,6996,TRNSCTH DEL ENHCD FX DEV,23357.12,23357.12,1401.43,19853.55,37 CDM,700008,SUTURE UND MONO 4-0 18IN,256.5,256.5,15.39,218.03,49 CDM,70007,KIT DRSG 7.5X11.5CM,1753.0,1753.0,105.18,1490.05,49 CDM,70008,KIT DRSG 14.5X11.5CM,4618.0,4618.0,277.08,3925.3,49 CDM,70009,DRESSING WND 26X15CM,2757.5,2757.5,165.45,2343.88,49 CDM,70024,PRESSURIZER FEM CANAL MD,812.5,812.5,48.75,690.63,49 CDM,70025,KWIRE FX 150MM 1.25MM,476.5,476.5,28.59,405.02,49 CDM,70026,KWIRE FX 150MM 1.6MM,476.5,476.5,28.59,405.02,49 CDM,70041,CATH URET 22FR 2W 5CC,522.0,522.0,31.32,443.7,49 CDM,7005,BLOCK L-SPINE ADDL,4762.9,4762.9,285.77,4048.46,37 CDM,70053,CATH THOR 20FR FRM,755.5,755.5,45.33,642.17,49 CDM,7006,COMPNT FEM KN LT SZ5,44288.0,44288.0,5757.44,37644.8,28 CDM,7007,INSERT ARTC 5-6 9MM DSH,18312.0,18312.0,2380.56,15565.2,28 CDM,70071,APPLIER CLP PRLD 13IN,2012.5,2012.5,261.63,1710.63,28 CDM,70072,APPLIER CLP PRLD 11IN,1776.0,1776.0,230.88,1509.6,28 CDM,70086,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,70087,CATH ANGIO 5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,70094,PLUG SURG 1.55X1.3IN,10326.0,10326.0,1342.38,8777.1,28 CDM,70095,MESH SURG PLG 1.9X1.6IN,10422.0,10422.0,1354.86,8858.7,28 CDM,70113,TUBE VNT 1.14MM 5MM,829.0,829.0,107.77,704.65,28 CDM,7024,CMPNT KN TIB SZ2,36624.0,36624.0,4761.12,31130.4,28 CDM,7025,TIBIAL PREP KT SIZE 2 TR,5353.0,5353.0,321.18,4550.05,49 CDM,70251,SCREW BN 4MM 1.35MM 32MM,6558.0,6558.0,852.54,5574.3,28 CDM,70253,SCREW BN 4MM 1.35MM 36MM,6558.0,6558.0,852.54,5574.3,28 CDM,70255,SCREW BN 4MM 1.35MM 40MM,6558.0,6558.0,852.54,5574.3,28 CDM,70256,SCREW BN 4MM 1.35MM 42MM,6558.0,6558.0,852.54,5574.3,28 CDM,7027,BASEPLATE TIB KN SZ6,36624.0,36624.0,4761.12,31130.4,28 CDM,7030,SCREW BN T10 3.5X18MM,3574.0,3574.0,464.62,3037.9,28 CDM,70318,DRESSING PETRO 18X3IN,28.5,28.5,1.71,24.23,49 CDM,70320,TROCAR LAPSCP 12MM 100MM,1374.0,1374.0,82.44,1167.9,49 CDM,70321,GRAFT CV 14X7MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,7034,CATH BLNDIL 5MM 40MM,35107.0,35107.0,2106.42,29840.95,49 CDM,7038,BUSHNG KN FEM SM,5876.0,5876.0,763.88,4994.6,28 CDM,7039,AXLE FEM KN GMRS SM,19129.0,19129.0,2486.77,16259.65,28 CDM,70394,SUTURE BV-1 6-0 1X30IN,604.0,604.0,36.24,513.4,49 CDM,7043,HOOK INST DISP 250X6MM,24898.0,24898.0,1493.88,21163.3,49 CDM,7045,GWIRE ORTH T2 3X800MM,5888.5,5888.5,353.31,5005.23,49 CDM,70459,SYS DRN PLS THRX 1 CHMBR,6273.0,6273.0,376.38,5332.05,49 CDM,70479,LEAD PCNG 6.2FR 52CM,7623.0,7623.0,990.99,6479.55,28 CDM,70485,GWIRE VASC .018IN 300CM,3053.0,3053.0,183.18,2595.05,49 CDM,7050,COMPNT TIB LT KN XS-XL,54696.0,54696.0,7110.48,46491.6,28 CDM,70509,DRAIN WND 7IN 20IN,2439.5,2439.5,146.37,2073.57,49 CDM,7051,SLEEVE KN TIBTRY ROT HNG,9760.0,9760.0,1268.8,8296.0,28 CDM,70587,DRESSING ABD 5X9IN,5.0,5.0,0.3,4.25,49 CDM,70620,LEAD PCNG 45CM,8309.0,8309.0,1080.17,7062.65,28 CDM,70631,SHEATH GD 7FR 45CM,4349.5,4349.5,260.97,3697.07,49 CDM,70640,GUIDE NDL BX DSP,819.5,819.5,49.17,696.58,49 CDM,70644,SCREW BN 3.5MM 16MM,4362.0,4362.0,567.06,3707.7,28 CDM,70645,SCREW BN 3.5MM 18MM,3897.0,3897.0,506.61,3312.45,28 CDM,70646,SCREW BN 3.5MM 20MM,3810.0,3810.0,495.3,3238.5,28 CDM,70647,SCREW BN 3.5MM 24MM,3810.0,3810.0,495.3,3238.5,28 CDM,70660,BURR CARBIDE RD 6.5X48,2905.5,2905.5,174.33,2469.68,49 CDM,70695,PLATE BN T 3HL 3.5X67MM,14934.0,14934.0,1941.42,12693.9,28 CDM,70717,GWIRE ENDO .025IN 450CM,4284.0,4284.0,257.04,3641.4,49 CDM,70795,DEVICE FASCIA CLOSURE,4606.0,4606.0,276.36,3915.1,49 CDM,70840,CEMENT BN PMMA FULL DOSE,80005.0,80005.0,10400.65,68004.25,28 CDM,7087,INTENSIVE CARE,11767.9,11767.9,,,0 CDM,7088,INTERMEDIATE CCU,9175.38,9175.38,,,0 CDM,70884,SUTURE BLK BRD 4-0 144IN,63.5,63.5,3.81,53.98,49 CDM,70885,SUTURE UND BRD 200 18IN,237.0,237.0,14.22,201.45,49 CDM,70887,SUTURE UND MONO 5-0 18IN,244.0,244.0,14.64,207.4,49 CDM,70893,SUTURE SH 3-0 8X18IN,557.5,557.5,33.45,473.88,49 CDM,7090,PLACE NG/OG TUBE FLUORO,2216.15,2216.15,132.97,1883.73,37 CDM,7091,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,7092,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,7093,EMBOLIZE EXTRACRAN,64546.66,64546.66,3872.8,54864.66,37 CDM,7094,EMBLZ INTRACRAN/SP,64546.66,64546.66,3872.8,54864.66,37 CDM,70974,CATH SUC 10FR 24IN,556.0,556.0,33.36,472.6,49 CDM,7099,INS SQ CARD RHYTHM MONTR,47133.68,47133.68,2828.02,40063.63,34 CDM,7100,INTRCRN ENDOV RX ADM INI,5195.4,5195.4,311.72,4416.09,37 CDM,7104,CHG CYSTOSTOMY TB SIMPL,1472.64,1472.64,88.36,1251.74,37 CDM,71105,CATH URTH 2WY 22FR,379.0,379.0,22.74,322.15,49 CDM,71112,CATH DRN BIL 8.5F 40,2927.0,2927.0,175.62,2487.95,49 CDM,71146,SCREW BN 3.5MM 6MM 14MM,897.0,897.0,116.61,762.45,28 CDM,71147,SCREW BN S/T 3.5MM 16MM,897.0,897.0,116.61,762.45,28 CDM,71148,SCREW BN 3.5MM 6MM 18MM,897.0,897.0,116.61,762.45,28 CDM,71149,SCREW BN 3.5MM 20MM,897.0,897.0,116.61,762.45,28 CDM,71150,SCREW BN 3.5MM 6MM 22MM,897.0,897.0,116.61,762.45,28 CDM,71151,SCREW BN 3.5MM 6MM 24MM,897.0,897.0,116.61,762.45,28 CDM,71152,SCREW BN 3.5MM 6MM 26MM,897.0,897.0,116.61,762.45,28 CDM,71154,SCREW BN 3.5MM 6MM 30MM,924.0,924.0,120.12,785.4,28 CDM,71155,SCREW BN 3.5MM 6MM 32MM,924.0,924.0,120.12,785.4,28 CDM,71159,SCREW BN 3.5MM 6MM 40MM,897.0,897.0,116.61,762.45,28 CDM,71161,SCREW BN 3.5MM 50MM,897.0,897.0,116.61,762.45,28 CDM,71163,SCREW BN 3.5MM 6MM 60MM,897.0,897.0,116.61,762.45,28 CDM,71194,SCREW BN 4MM 6MM 45MM,706.0,706.0,91.78,600.1,28 CDM,71202,PLATE BN 111MM 3.5MM,13409.0,13409.0,1743.17,11397.65,28 CDM,71203,PLATE BN CRV 10HL 3.5MM,13939.0,13939.0,1812.07,11848.15,28 CDM,71206,PLATE BN 14HL 3.5X189MM,19633.0,19633.0,2552.29,16688.05,28 CDM,71219,PLATE BN T 3H 3.5MM 63MM,16635.0,16635.0,2162.55,14139.75,28 CDM,7122,BLADE MYRNGTM NAR,717.5,717.5,43.05,609.88,49 CDM,71232,SCREW BN 3.5MM 10MM,4156.0,4156.0,540.28,3532.6,28 CDM,71234,SCREW BN 3.5MM 14MM,4362.0,4362.0,567.06,3707.7,28 CDM,71238,SCREW BN 3.5MM 22MM,4471.0,4471.0,581.23,3800.35,28 CDM,71241,SCREW BN 3.5MM 28MM,3810.0,3810.0,495.3,3238.5,28 CDM,71242,SCREW BN 3.5MM 30MM,3810.0,3810.0,495.3,3238.5,28 CDM,71244,SCREW BN 3.5MM 34MM,3810.0,3810.0,495.3,3238.5,28 CDM,71245,SCREW BN LCK 3.5X36MM,3810.0,3810.0,495.3,3238.5,28 CDM,71246,SCREW BN LCK 3.5X38MM,3897.0,3897.0,506.61,3312.45,28 CDM,71247,SCREW BN 3.5MM 40MM,3810.0,3810.0,495.3,3238.5,28 CDM,71249,SCREW BN 3.5MM 50MM,3810.0,3810.0,495.3,3238.5,28 CDM,71250,SCREW BN 3.5X2.9X55MM,4247.0,4247.0,552.11,3609.95,28 CDM,71341,GW STRQ 035 180 ANG,2758.0,2758.0,165.48,2344.3,49 CDM,71481,FORCEP BX 2.2MM 240CM,901.5,901.5,54.09,766.27,49 CDM,71503,DILATOR ENDO 6-7-8MM,6273.0,6273.0,376.38,5332.05,49 CDM,71504,DILATOR BLN 8-9-10MM,6273.0,6273.0,376.38,5332.05,49 CDM,71505,DILATOR BLN 8X180CM,6273.0,6273.0,376.38,5332.05,49 CDM,71506,DILATOR BLN 8X180CM,6273.0,6273.0,376.38,5332.05,49 CDM,71507,DILATOR BLN 8X180CM,5546.5,5546.5,332.79,4714.52,49 CDM,71509,MESH SURG 3IN 5IN,6699.0,6699.0,870.87,5694.15,28 CDM,71510,MESH SURG 3IN 5IN,9008.0,9008.0,1171.04,7656.8,28 CDM,71516,NEEDLE SCLRTX 25GA 2.3MM,1471.5,1471.5,88.29,1250.78,49 CDM,71605,KIT CEMENT MIX PMMA 30%,4650.0,4650.0,279.0,3952.5,49 CDM,71608,STAPLER INT CRV ADJ 25MM,6940.5,6940.5,416.43,5899.43,49 CDM,71616,GWIRE ORTH 2.8MM 300MM,2324.5,2324.5,139.47,1975.83,49 CDM,71621,DRESSING WND 5X5IN,536.5,536.5,32.19,456.02,49 CDM,71627,CLIP SUTURE LAPRATY,2905.5,2905.5,174.33,2469.68,49 CDM,71645,TRAY PROC 12 - 18 FR,16938.0,16938.0,1016.28,14397.3,49 CDM,71647,DEVICE TORQUE .010-.038,416.0,416.0,24.96,353.6,49 CDM,71656,SUTURE UND BRD 0 27IN,80.5,80.5,4.83,68.42,49 CDM,71730,SCREW BN CORT 4.5X40MM,922.0,922.0,119.86,783.7,28 CDM,71778,BASKET RET 2.0CM 3.2MM,8980.0,8980.0,538.8,7633.0,49 CDM,71791,LIGATOR ENDO 7BAND 2.8MM,4611.0,4611.0,276.66,3919.35,49 CDM,71993,GWIRE VASC .014IN 300CM,2905.5,2905.5,174.33,2469.68,49 CDM,71995,GWIRE STRT 300CM,2905.5,2905.5,174.33,2469.68,49 CDM,72001,SUTURE PS-2 4-0 1X18IN,232.0,232.0,13.92,197.2,49 CDM,72012,SUTURE BLU MONO 0 30IN,116.0,116.0,6.96,98.6,49 CDM,72013,SUTURE BLU MONO 1 30IN,118.0,118.0,7.08,100.3,49 CDM,72014,ELECTRODE ESURG 20X15MM,627.0,627.0,37.62,532.95,49 CDM,7203,ETOMIDATE 40 MG INJ,635.5,635.5,38.13,540.17,49 CDM,72056,CATH URTH INTRMT 10FR,42.0,42.0,2.52,35.7,49 CDM,72057,DRAIN INCS 19FR .25IN,701.0,701.0,42.06,595.85,49 CDM,72085,SCREW BN 4.5MM 8MM 38MM,922.0,922.0,119.86,783.7,28 CDM,72111,SNARE VASC 4-8MM 175CM,18575.0,18575.0,1114.5,15788.75,49 CDM,72112,SNARE VASC 120CM 6-10MM,11103.5,11103.5,666.21,9437.98,49 CDM,72121,DEVICE CLSR VASC 6FR,67910.0,67910.0,8828.3,57723.5,28 CDM,72144,CATH BLNDIL 14MM 40MM,6273.0,6273.0,376.38,5332.05,49 CDM,7216,CROFELEMER ER 125 MG PO,104.7,104.7,6.28,89.0,49 CDM,7218,ETHIODIZED OIL INJ,9602.29,9602.29,576.14,8161.95,33 CDM,7219,PHENYLEPHR 1% 15ML NASAL,29.74,29.74,1.78,25.28,49 CDM,72199,BLADE ARTH 4X130MM,2615.0,2615.0,156.9,2222.75,49 CDM,7220,DOTAREM 15 ML INJ,394.99,394.99,23.7,335.74,24 CDM,72226,SCOSSPRS LAPSCP MNPLR,938.0,938.0,56.28,797.3,49 CDM,72270,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,72278,CATH GD XB3 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,72280,CATH GD XB3.5 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,7231,CISATRACURIUM 200 MG INJ,2556.73,2556.73,153.4,2173.22,30 CDM,72314,SUTURE MAXON 4-0 42 T5,610.0,610.0,36.6,518.5,49 CDM,72325,SCREW BN 6.5MM 35MM,2541.0,2541.0,330.33,2159.85,28 CDM,72351,STAPLER INT 5MM,8225.0,8225.0,493.5,6991.25,49 CDM,72407,CATH GLIDE ANGLED 120CM,2905.5,2905.5,174.33,2469.68,49 CDM,7241,TRUXIMA BS 10 MG INJJW,795.93,795.93,47.76,676.54,19 CDM,7242,TRUXIMA BS 10 MG INJ,795.93,795.93,47.76,676.54,19 CDM,72420,PASSER SUTURE 45D CRV LT,8240.5,8240.5,494.43,7004.43,49 CDM,72433,SHVR BLDE 4.2 GRT WHT,2789.5,2789.5,167.37,2371.07,49 CDM,72435,KIT DRESSING FOAM SM,2323.0,2323.0,139.38,1974.55,49 CDM,72520,SUTURE VIO BRD 0 18IN,660.0,660.0,39.6,561.0,49 CDM,72527,CATH ANGIO JR5 4FR 100CM,601.5,601.5,36.09,511.27,49 CDM,72528,SYSTEM LAPSCP ACCESS,24651.5,24651.5,1479.09,20953.78,49 CDM,72549,BSKT RTRV 3F 16MM 120CM,5833.0,5833.0,349.98,4958.05,49 CDM,7257,RUXIENCE BS 10 MG INJ,674.58,674.58,40.47,573.39,19 CDM,7258,SIROLIMUS 0.5 MG PO,69.0,69.0,4.14,58.65,24 CDM,72582,APPLIER INT CLIP MD/LG,3432.0,3432.0,446.16,2917.2,28 CDM,72593,GRAFT BN SM 2.8CC 1X2IN,92213.0,92213.0,11987.69,78381.05,28 CDM,72594,GRAFT BN MED 5.6CC 1X2IN,100000.0,100000.0,13000.0,85000.0,28 CDM,7261,OXYCODONE 15 MG PO,14.28,14.28,0.86,12.14,49 CDM,72614,SET DRIL 2.4MM,6273.0,6273.0,376.38,5332.05,49 CDM,72638,SCREW BN 6.5MM 30MM,2541.0,2541.0,330.33,2159.85,28 CDM,72657,SUTURE PASSER 90D STR,6273.0,6273.0,376.38,5332.05,49 CDM,7269,PCN V K 125MG PO,9.51,9.51,0.57,8.08,49 CDM,72729,SCREW BN 4.5MM 8MM 30MM,922.0,922.0,119.86,783.7,28 CDM,72730,SCREW BN 4.5MM 8MM 32MM,922.0,922.0,119.86,783.7,28 CDM,72749,PIN PSTN 4.5MM,6124.0,6124.0,796.12,5205.4,28 CDM,72750,CABLE ORTHO 1.7X750MM,16551.0,16551.0,2151.63,14068.35,28 CDM,7277,"Injection, zoledronic acid, 1 mg ",70.19,70.19,12.58,30.88,10 CDM,7277,ZOLEDRONIC ACID 4MG INJ,70.19,70.19,4.21,59.66,24 CDM,72797,SCREW BN 4.5MM 22MM,1244.0,1244.0,161.72,1057.4,28 CDM,728104,ABD XR 1V,1424.14,1424.14,85.45,1210.52,17 CDM,728105,ABD XR 2V,1896.74,1896.74,113.8,1612.23,17 CDM,728106,ABD XR 3+V,1995.08,1995.08,119.7,1695.82,17 CDM,7282,"Injection, pralidoxime chloride, up to 1 gm ",741.2,741.2,169.93,275.9,8 CDM,7282,PRALIDOXIME 1 G INJ,741.2,741.2,44.47,630.02,25 CDM,7285,GENTAMICIN 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 CDM,72859,GWIRE VASC 180CM .009IN,5018.5,5018.5,301.11,4265.73,49 CDM,7286,METOCLOPRM 0.2 MG/ML INJ,14.28,14.28,0.86,12.14,24 CDM,7287,TOBRAMYCIN 2 MG/ML INJ,14.28,14.28,0.86,12.14,24 CDM,7288,FLUCONAZOLE 2 MG/ML INJ,14.28,14.28,0.86,12.14,24 CDM,72885,DEVICE LCK BX CAP,555.5,555.5,33.33,472.18,49 CDM,72946,SCREW BN SPRCL 6.5X30MM,2541.0,2541.0,330.33,2159.85,28 CDM,72951,BIT DRILL 25MM,19505.5,19505.5,1170.33,16579.67,49 CDM,72958,BLN CATH RTRV 9-12MM,5849.5,5849.5,350.97,4972.07,49 CDM,7296,LOKELMA 10 G PO,123.74,123.74,7.42,105.18,49 CDM,73019,SUTURE POLY SZ 0 18IN,1553.0,1553.0,93.18,1320.05,49 CDM,73072,LEAD PCNG 45CM,8309.0,8309.0,1080.17,7062.65,28 CDM,73104,NEEDLE TIP 3CM,81629.0,81629.0,4897.74,69384.65,49 CDM,73105,GWIRE VASC 0.018IN 80CM,2905.5,2905.5,174.33,2469.68,49 CDM,731105,TUBING IRRIGTR ESPC W-TP,2905.5,2905.5,174.33,2469.68,49 CDM,73184,HEAD FEM HIP 12/14 36MM,18312.0,18312.0,2380.56,15565.2,28 CDM,73217,KIT PCKMR WRENCH,1883.5,1883.5,113.01,1600.97,49 CDM,73228,BURR SURG RND 38X4MM,2905.5,2905.5,174.33,2469.68,49 CDM,7325,"Injection, levocarnitine, per 1 gm ",284.34,284.34,23.09,89.42,10 CDM,7325,LEVOCARNITINE 1 G INJ,284.34,284.34,17.06,241.69,24 CDM,73250,SNARE VASC 6F-20X120,11103.5,11103.5,666.21,9437.98,49 CDM,73266,CATH DRN 10.2FR 25CM,5462.0,5462.0,327.72,4642.7,49 CDM,73294,TUBE INNR CANN 6MM,268.5,268.5,16.11,228.22,49 CDM,73295,CANNULA INR 8X13.3X105MM,268.5,268.5,16.11,228.22,49 CDM,73364,PARTICLES EMBL 500-700UM,9817.0,9817.0,1276.21,8344.45,28 CDM,73370,STAPLER INT 35.5X5MM,17498.0,17498.0,1049.88,14873.3,49 CDM,73392,CATH ANGIO 5FR 65CM,1151.0,1151.0,69.06,978.35,49 CDM,7342,INTRALIPID 20% 250ML INJ,365.97,365.97,21.96,311.07,49 CDM,73425,TRAY INTRO OSTEO,70872.5,70872.5,4252.35,60241.63,49 CDM,73427,GWIRE VASC .035IN 180CM,814.0,814.0,48.84,691.9,49 CDM,73429,KIT INST ARTHSCP DISP,12762.0,12762.0,1659.06,10847.7,28 CDM,7344,MICAFUNGIN 1 MG INJ,15.47,15.47,0.93,13.15,24 CDM,73457,BARRIER ADH 5IN 6IN,13528.5,13528.5,811.71,11499.23,49 CDM,73502,STENT URET 8.5F 22CM.038,3765.0,3765.0,489.45,3200.25,28 CDM,73535,SHEATH GD 6FR 45CM,4349.5,4349.5,260.97,3697.07,49 CDM,7356,KETAMINE 100 MG INJ,11.12,11.12,0.67,9.45,46 CDM,7357,AMPHOT B LIPOSOME 10MGJW,124.92,124.92,7.5,106.18,19 CDM,7358,AMPHOT B LIPOSOME 10 MG,124.92,124.92,7.5,106.18,19 CDM,73622,GWIRE VASC .035IN 260CM,1737.0,1737.0,104.22,1476.45,49 CDM,73657,INTRO SHTH 7FR 6CM,1090.0,1090.0,65.4,926.5,49 CDM,73663,DEVICE SHEATH STATLOCK,8264.0,8264.0,495.84,7024.4,49 CDM,73665,CNNCTR WND DRN Y,331.0,331.0,19.86,281.35,49 CDM,73679,INTRO SHTH 11 10FR,577.0,577.0,34.62,490.45,49 CDM,7368,CATH ANGIO 4FR 100CM,601.5,601.5,36.09,511.27,49 CDM,73691,CANNULA INR 7X100X12.3MM,268.5,268.5,16.11,228.22,49 CDM,73738,DRESSING WND 4.34X4.34IN,444.5,444.5,26.67,377.82,49 CDM,73739,DRESSING WND CLGEN 28CM,511.0,511.0,30.66,434.35,49 CDM,73820,FILTER BLOODTRNSF 40UM,1176.0,1176.0,70.56,999.6,49 CDM,73826,GRAFT CV 15.2X15.2CM,10137.0,10137.0,1317.81,8616.45,28 CDM,73828,CATH THMB 2F 0.67MM 60CM,2905.5,2905.5,174.33,2469.68,49 CDM,73843,SUTURE STEEL CCS 7-0,642.5,642.5,38.55,546.13,49 CDM,73844,SUTURE NO NDL 4-0 1X36IN,130.5,130.5,7.83,110.92,49 CDM,73845,SUTURE SILK BRD 0 18IN,387.5,387.5,23.25,329.38,49 CDM,73858,CLIP LIGATING SM,495.0,495.0,64.35,420.75,28 CDM,73872,MISTER/BLOWER ARIES 16.5,3440.0,3440.0,206.4,2924.0,49 CDM,73938,SUTURE CTX 0 1-36IN,159.0,159.0,9.54,135.15,49 CDM,74170,EXTENSION NRSTM 40CM,19633.0,19633.0,2748.62,16688.05,24 CDM,74264,KIT CATH EXP 2.5IN 3.25I,2069.0,2069.0,124.14,1758.65,49 CDM,74265,KIT CATH EXP 5IN 6IN,2696.5,2696.5,161.79,2292.03,49 CDM,74300,TIP MNPLT 6.7MM 10CM,2459.5,2459.5,147.57,2090.57,49 CDM,74302,TIP MNPLT 6.7MM 6.0CM,2459.5,2459.5,147.57,2090.57,49 CDM,74303,TIP MNPLT 6.7MM 8CM,2459.5,2459.5,147.57,2090.57,49 CDM,74321,DEVICE BN BX SZ2 10GA,4530.5,4530.5,271.83,3850.93,49 CDM,74329,PORT IMPL INFSN 8FR,9581.0,9581.0,1245.53,8143.85,28 CDM,74335,KWIRE FX 150MM 1.6MM,1900.5,1900.5,114.03,1615.42,49 CDM,74336,CATH SURG OCLDR 6FR,2905.5,2905.5,174.33,2469.68,49 CDM,74409,TROCAR LAPSCP 12MM 150MM,1278.5,1278.5,76.71,1086.72,49 CDM,74424,STENT URET 6FR 26CM,6714.0,6714.0,872.82,5706.9,28 CDM,74498,SUTURE VIO MONO 2-0 27IN,109.5,109.5,6.57,93.08,49 CDM,74511,STENT BIL PANC GNN 5X5,4992.0,4992.0,648.96,4243.2,28 CDM,74547,IMPLANT BREAST 500CC,32338.0,32338.0,4203.94,27487.3,28 CDM,74591,CANN ARTHSCOP 5.5X75MM,2266.5,2266.5,135.99,1926.53,49 CDM,74592,CANN ARTHSCOP 7.0X75MM,2441.0,2441.0,146.46,2074.85,49 CDM,74715,FILTER EMBL 6MM 320CM,29304.5,29304.5,1758.27,24908.83,49 CDM,74755,DEVICE CLSR 8FR .038IN,9817.0,9817.0,1276.21,8344.45,28 CDM,74820,GWIRE VASC .014IN 300CM,3555.0,3555.0,213.3,3021.75,49 CDM,74830,ELCTRD ESURG 12D 24FR,14612.5,14612.5,876.75,12420.63,49 CDM,74878,BLADE SHVR 4.2MM 13CM,2615.0,2615.0,156.9,2222.75,49 CDM,75058,GRAFT CV 28MM 30CM,13909.0,13909.0,1808.17,11822.65,28 CDM,75136,POUCH SPEC RET 15MM,13233.5,13233.5,794.01,11248.48,49 CDM,75189,DEVICE ENDO SZ2-0 48IN,3390.5,3390.5,203.43,2881.93,49 CDM,75202,DEVICE SUTURE 14GA 15CM,565.0,565.0,33.9,480.25,49 CDM,75219,SUTURE FBRWR 38IN,2977.0,2977.0,387.01,2530.45,28 CDM,75222,SUTURE VIO BRD 3-0 18IN,545.5,545.5,32.73,463.68,49 CDM,75305,SCREW BN 2.7MM 5MM 18MM,1619.0,1619.0,210.47,1376.15,28 CDM,75315,IMPLANT BREAST 600CC,26647.0,26647.0,3464.11,22649.95,28 CDM,75316,IMPLANT BREAST 650CC,26647.0,26647.0,3464.11,22649.95,28 CDM,75317,IMPLANT BREAST 700CC,26647.0,26647.0,3464.11,22649.95,28 CDM,75397,CATH SHUNT PRNTL 120CM,5646.0,5646.0,733.98,4799.1,28 CDM,75444,SUTURE MTPS 4-018IN,2134.5,2134.5,128.07,1814.33,49 CDM,75465,SUTURE V-37 5 4X30IN,691.5,691.5,41.49,587.77,49 CDM,75466,SUTURE V-37 2 4X30IN,5357.5,5357.5,321.45,4553.88,49 CDM,75513,SCREW BN 2.7X5MM 14MM,1619.0,1619.0,210.47,1376.15,28 CDM,75568,SUTURE CT-2 2-0 1X30IN,79.0,79.0,4.74,67.15,49 CDM,75632,KIT PEG FEEDING 20FR,4739.0,4739.0,284.34,4028.15,49 CDM,75727,STEM FEM HIP 155X13MM,53527.0,53527.0,6958.51,45497.95,28 CDM,75731,STEM FEM HIP SZ14,50851.0,50851.0,6610.63,43223.35,28 CDM,75746,LINER ACTB HIP 32MM 50MM,14720.0,14720.0,1913.6,12512.0,28 CDM,75752,SUTURE VCL 2-0 CT1 18IN,537.5,537.5,32.25,456.88,49 CDM,75787,KIT INST ACL TRT BLD SAW,13205.5,13205.5,792.33,11224.67,49 CDM,7581,DIRECT REFERRAL TO OBS,606.02,606.02,84.84,515.12,10 CDM,7583,OBS PER HOUR,110.19,110.19,15.43,93.66,15 CDM,7590,INJECTION IM OR SQ,429.98,429.98,25.8,365.48,39 CDM,7591,IV INITIAL UP TO 1 HOUR,389.74,389.74,23.38,331.28,39 CDM,7592,IVP SINGLE/INITIAL DRUG,356.11,356.11,21.37,302.69,39 CDM,75944,DEVICE CLSR 8.5-10FR,12762.0,12762.0,1659.06,10847.7,28 CDM,75947,CANNULA ARTHSCP 7CM 7MM,2441.0,2441.0,146.46,2074.85,49 CDM,75992,CLIP LIGATING MD LG,2237.0,2237.0,290.81,1901.45,28 CDM,75998,IMPLANT BREAST 400CC,32338.0,32338.0,4203.94,27487.3,28 CDM,76039,SLR/DVDR BIP 18CM 13.5MM,17607.0,17607.0,1056.42,14965.95,49 CDM,7608,ADMIN PNEUMOCOCCAL VAC,279.41,279.41,16.76,237.5,39 CDM,76095,FILTER EMBL 5MM 320CM,29304.5,29304.5,1758.27,24908.83,49 CDM,7616,IV HYDRAT EA ADD HR,307.33,307.33,18.44,261.23,39 CDM,7618,IV EACH ADD HOUR,429.83,429.83,25.79,365.36,39 CDM,76190,SNARE ESCPC 18-30X120 7F,11103.5,11103.5,666.21,9437.98,49 CDM,76310,GRAFT VASC THIN 40CM 6MM,41846.0,41846.0,5439.98,35569.1,28 CDM,76311,GRAFT VASC THIN 80CM 6MM,93005.0,93005.0,12090.65,79054.25,28 CDM,76411,STENT URO 8.5FR 24CM,3765.0,3765.0,489.45,3200.25,28 CDM,76434,STENT NPHURSTM 28CM,3765.0,3765.0,489.45,3200.25,28 CDM,76435,CATH DRN 8.5FR 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,76436,CATH DRN 10.2FR 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,76461,DILATOR BLN 5.5X240CM,6286.5,6286.5,377.19,5343.52,49 CDM,764667,AMINOCAPROIC 5 G INJ,49.79,49.79,2.99,42.32,24 CDM,764667,"Injection, aminocaproic acid, 1 gram ",49.79,49.79,1.57,4.68,10 CDM,764675,SMX/TMP 2400/480MG MDV,49.63,49.63,2.98,42.19,24 CDM,764715,EPI NOS 10 MG MDV,248.02,248.02,14.88,210.82,24 CDM,764716,EPI NOS 30 MG MDV,555.5,555.5,33.33,472.18,24 CDM,764717,NALOX NOS 4 MG MDV,198.34,198.34,11.9,168.59,24 CDM,764718,VANCO 5 G MDV,541.55,541.55,32.49,460.32,24 CDM,764728,OMNIPAQUE 300 500 ML INJ,2537.45,2537.45,152.25,2156.83,24 CDM,764734,LIDO 0.5% 250MG/50ML INJ,46.98,46.98,2.82,39.93,25 CDM,764739,LIDO 1% 500MG/50ML MDV,23.49,23.49,1.41,19.97,25 CDM,764754,LIDO 200MG/EPI 0.2MG MDV,17.63,17.63,1.06,14.99,25 CDM,764755,LIDO 300MG/EPI 0.3MG MDV,25.96,25.96,1.56,22.07,25 CDM,764756,LIDO 500MG/EPI 0.5MG MDV,29.68,29.68,1.78,25.23,25 CDM,764757,LIDO 400MG/EPI 0.2MG MDV,158.25,158.25,9.49,134.51,25 CDM,764758,LIDO 600MG/EPI 0.3MG MDV,30.91,30.91,1.85,26.27,25 CDM,764766,LIDO 1G/EPI 0.5MG MDV,42.2,42.2,2.53,35.87,25 CDM,764819,BALFAXAR 640 U IX INJ,5018.89,5018.89,301.13,4266.06,20 CDM,764820,BALFAXAR 1280 U IX INJ,9447.32,9447.32,566.84,8030.22,20 CDM,764827,METHYLPRED SS 500 MG MDV,521.1,521.1,31.27,442.94,24 CDM,764833,FIBRYGA 1000 MG INJ,4847.04,4847.04,290.82,4119.98,19 CDM,764833,"Injection, human fibrinogen concentrate (fibryga), 1 mg ",4847.04,4847.04,1.24,3.78,10 CDM,764833,"Injection, human fibrinogen concentrate (fibryga), 1 mg Chemotherapy Drugs",4847.04,4847.04,,,0 CDM,764840,ASCORBIC ACID 25 G MDV,1364.96,1364.96,81.9,1160.22,49 CDM,764866,ISOVUE 370 200 ML INJ,655.78,655.78,39.35,557.41,24 CDM,764871,BUMETANIDE 2.5 MG MDV,17.63,17.63,1.06,14.99,24 CDM,764896,PHENYLEPHRINE 50 MG MDV,98.27,98.27,5.9,83.53,24 CDM,764904,"Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu ",4847.04,4847.04,1.41,4.74,10 CDM,764904,NOVOEIGHT 1000 U INJ,4847.04,4847.04,290.82,4119.98,19 CDM,764906,PHENYLEPHRINE 100 MG MDV,47.14,47.14,2.83,40.07,24 CDM,764918,"Factor viii (antihemophilic factor, human) per i.u. ",4075.92,4075.92,1.39,3.53,10 CDM,764918,KOATE 1000 U INJ,4075.92,4075.92,244.56,3464.53,19 CDM,764940,TRIAMCINOLN ACE NOS 10MG,62.19,62.19,3.73,52.86,24 CDM,764952,HUMATE-P 1200 U VWF:RCO,7138.37,7138.37,428.3,6067.61,19 CDM,764952,"Injection, von willebrand factor complex (humate-p), per iu vwf:rco ",7138.37,7138.37,1.49,4.65,10 CDM,764975,PROFILNINE 500 U INJ,4675.0,4675.0,280.5,3973.75,19 CDM,764976,PROFILNINE 1000 U INJ,9350.0,9350.0,561.0,7947.5,19 CDM,764982,BENEFIX 3000 U INJ,16524.0,16524.0,991.44,14045.4,19 CDM,764985,BENEFIX 1000 U INJ,5508.0,5508.0,330.48,4681.8,19 CDM,765155,BENEFIX 2000 U INJ,11016.0,11016.0,660.96,9363.6,19 CDM,765157,THROMBATE III 500 U INJ,9446.22,9446.22,566.77,8029.29,19 CDM,76554,CATH GD 6FR,3872.5,3872.5,232.35,3291.63,49 CDM,76631,BLADE SAW 5.5MM,1220.0,1220.0,73.2,1037.0,49 CDM,76769,GWIRE VASC .035IN 180CM,2905.5,2905.5,174.33,2469.68,49 CDM,76779,SCREW SPNL 6.5MM 45MM,19298.0,19298.0,2508.74,16403.3,28 CDM,76928,BLADE SAW SGTL 31X9X.38,1238.5,1238.5,74.31,1052.72,49 CDM,76957,CATH GD .035IN 150CM,5227.5,5227.5,313.65,4443.38,49 CDM,77026,GD WIRE 22GA 7FR 18CM,2905.5,2905.5,174.33,2469.68,49 CDM,77083,CATH DRN 14FR 25CM MCLC,2905.5,2905.5,174.33,2469.68,49 CDM,77124,STAPLER SKN ABS STRL,2619.0,2619.0,157.14,2226.15,49 CDM,77127,SUTURE SH 2-0 8X18IN,3840.0,3840.0,230.4,3264.0,49 CDM,77181,DEVICE FX NDL CRV AB,9436.5,9436.5,566.19,8021.02,49 CDM,77216,SCREW BN 2.7MM 5MM 16MM,1619.0,1619.0,210.47,1376.15,28 CDM,772253,"Injection, succinylcholine chloride, up to 20 mg ",17.28,17.28,2.03,3.59,8 CDM,772253,SUCCINYLCHOL 200 MG MDV,17.28,17.28,1.04,14.69,25 CDM,772258,FLUMAZENIL 0.1 MG INJ,48.06,48.06,2.88,40.85,30 CDM,772283,CISPLATIN 100MG MDV,186.61,186.61,11.2,158.62,24 CDM,772286,CISPLATIN 50MG MDV,106.41,106.41,6.38,90.45,24 CDM,772343,GENTAMICIN 800 MG MDV,123.77,123.77,7.43,105.2,24 CDM,772346,HEPAR 30000U/30ML MDV,26.99,26.99,1.62,22.94,24 CDM,772399,KETAMINE 200 MG MDV,97.79,97.79,5.87,83.12,30 CDM,772499,LABETALOL 100 MG MDV,17.63,17.63,1.06,14.99,24 CDM,77444,CATHETER GD 6FR 150CM,13205.5,13205.5,792.33,11224.67,49 CDM,77483,SCREW BN 4.5MM 50MM,7367.0,7367.0,957.71,6261.95,28 CDM,77486,GWIRE ORTH 150MM 1.6MM,1543.0,1543.0,92.58,1311.55,49 CDM,7752,RELOAD STPLR 55MM,2105.5,2105.5,273.71,1789.67,28 CDM,7754,RELOAD STPLR 75MM,4792.0,4792.0,622.96,4073.2,28 CDM,777460,LORAZEPAM 20 MG MDV,55.03,55.03,3.3,46.78,24 CDM,77760,SCREW BN 2.4MM 18MM,4709.0,4709.0,612.17,4002.65,28 CDM,778047,BORDETELL PARAPERTUS AMP,224.19,224.19,13.45,190.56,14 CDM,778473,"Injection, mesna, 200 mg ",129.28,129.28,1.33,19.12,10 CDM,778473,"Injection, mesna, 200 mg Chemotherapy Drugs",129.28,129.28,,,0 CDM,778473,MESNA 1000 MG MDV,129.28,129.28,7.76,109.89,24 CDM,77885,SHEATH INTRO M00115727B1,916.0,916.0,54.96,778.6,49 CDM,77886,INTRO SHEATH 12FR 11CM,916.0,916.0,54.96,778.6,49 CDM,77910,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,77913,GWIRE VASC .014IN 190CM,3555.0,3555.0,213.3,3021.75,49 CDM,77948,DRESSING FOM 10X4IN,1341.0,1341.0,80.46,1139.85,49 CDM,78053,NEEDLE BX 22GA 15CM,755.0,755.0,45.3,641.75,49 CDM,78060,CATH DRN BIL 10.2FR 40CM,2927.0,2927.0,175.62,2487.95,49 CDM,781295,MIDAZOLAM 50 MG MDV,55.2,55.2,3.31,46.92,24 CDM,7814,SUTURE NONDL 2-0 12X18IN,2071.0,2071.0,124.26,1760.35,49 CDM,78143,DRSG WND NADH 6X4IN,150.0,150.0,9.0,127.5,49 CDM,78151,MESH PRFX XL 1.6IN 2IN,12017.0,12017.0,1562.21,10214.45,28 CDM,78152,MESH HRN RT 6.2X4.1IN,8902.0,8902.0,1157.26,7566.7,28 CDM,78213,CATH DRN 12FR 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,78215,CATH DRN 8.5FR 25CM,5907.0,5907.0,354.42,5020.95,49 CDM,782162,NEOSTIGMINE 10 MG MDV,123.93,123.93,7.44,105.34,25 CDM,78242,INSTR BX 18GA 20CM,2012.0,2012.0,120.72,1710.2,49 CDM,78253,GWIRE VASC .014 335CM,6273.0,6273.0,376.38,5332.05,49 CDM,78264,DEVICE END ISFL TUBING,3555.0,3555.0,213.3,3021.75,49 CDM,782861,"Injection, paclitaxel, 1 mg ",40.6,40.6,0.15,0.49,10 CDM,782861,"Injection, paclitaxel, 1 mg Chemotherapy Drugs",40.6,40.6,,,0 CDM,782861,PACLITAXEL 30 MG MDV,40.6,40.6,2.44,34.51,24 CDM,78294,LEAD PACING 6FR 58CM,6180.0,6180.0,803.4,5253.0,28 CDM,78324,TRAY ARTHROGRAM,631.0,631.0,37.86,536.35,49 CDM,78336,MESH HRN LT 6.2X4.1IN,7936.0,7936.0,1031.68,6745.6,28 CDM,78359,CATH BLNDIL 2.50X12MM,4600.5,4600.5,276.03,3910.43,49 CDM,78397,LEAD PCNG 46CM,6278.0,6278.0,816.14,5336.3,28 CDM,78417,SCREW BN 2.7MM 5MM 12MM,1619.0,1619.0,210.47,1376.15,28 CDM,78510,BIT DRILL 2.3MM 30MM,2905.5,2905.5,174.33,2469.68,49 CDM,78533,LEAD PCNG 52CM,6278.0,6278.0,816.14,5336.3,28 CDM,786362,ROCURONIUM 100 MG MDV,35.26,35.26,2.12,29.97,30 CDM,786365,ROCURONIUM 50 MG MDV,17.63,17.63,1.06,14.99,30 CDM,786884,XACDURO 1 G/1 G INJ,2694.6,2694.6,161.68,2290.41,30 CDM,78723,TUBE TRACH 6.0MM,2905.5,2905.5,174.33,2469.68,49 CDM,78726,TUBE TRACH 8MM 105MM,2905.5,2905.5,174.33,2469.68,49 CDM,78730,COIL EMBL 3.7MM 41MM,3061.0,3061.0,397.93,2601.85,28 CDM,78788,CTHGD INFS CRMC 5X50X135,5395.0,5395.0,323.7,4585.75,49 CDM,78803,HEAD FEM HIP STD 36MM,10032.0,10032.0,1304.16,8527.2,28 CDM,78884,LEAD CRT PCNG 88CM,22720.0,22720.0,2953.6,19312.0,28 CDM,78891,SCREW BN 6.5MM 25MM,5782.0,5782.0,751.66,4914.7,28 CDM,78996,KIT SPNL XLIF NRVSN DIL,19274.5,19274.5,1156.47,16383.33,49 CDM,79052,CMPNT PTLA 3PEG STD31X8,7166.0,7166.0,931.58,6091.1,28 CDM,79056,SUTURE LR 2 1X30IN,149.5,149.5,8.97,127.08,49 CDM,79096,HEAD FEM HIP -3MM 36MM,10032.0,10032.0,1304.16,8527.2,28 CDM,7916,BSKT RTR 2.4F 12MM 90CM,6273.0,6273.0,376.38,5332.05,49 CDM,79199,SEALER BIP 20CM 13MM,20606.0,20606.0,1236.36,17515.1,49 CDM,79295,GRAFT ST TIS 3IN 3IN,24819.0,24819.0,3226.47,21096.15,28 CDM,79385,CLIP LIGATING LG,2237.0,2237.0,290.81,1901.45,28 CDM,79393,HEAD FEM HIP +3MM 36MM,10032.0,10032.0,1304.16,8527.2,28 CDM,79418,DEVICE CLSR PATCH 3X4CM,4600.5,4600.5,276.03,3910.43,49 CDM,79496,SUTURE BLK BRD 2-0 30IN,58.5,58.5,3.51,49.73,49 CDM,79518,SCREW BN 4MM 44MM,6532.0,6532.0,849.16,5552.2,28 CDM,79526,KIT WND DRN RND12X3/15IN,486.5,486.5,29.19,413.52,49 CDM,79619,CATH ANGIO 5FR 110CM,2421.5,2421.5,145.29,2058.28,49 CDM,79635,GWIRE ORTH NSE 3MM 80CM,6273.0,6273.0,376.38,5332.05,49 CDM,79679,BNDG CMPR 2L 4INX5.1YD,970.0,970.0,58.2,824.5,49 CDM,79807,HEAD HIP TPR STD NK 28MM,10032.0,10032.0,1304.16,8527.2,28 CDM,79809,DRESSING FOAM SM,524.5,524.5,31.47,445.82,49 CDM,79878,CATH BLNDIL 3.5MM0MM,3765.0,3765.0,225.9,3200.25,49 CDM,79879,CATH BLNDIL 4MM0MM,4391.0,4391.0,263.46,3732.35,49 CDM,79935,CATH BLNDIL 1.5MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,79936,CATH BLNDIL 2MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 CDM,79937,CATH BLNDIL 2.5MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,79938,CATH BLNDIL 3MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 CDM,79939,CATH BLNDIL 3.5MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,79940,CATH BLNDIL 4MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 CDM,79941,CATH BLNDIL 1.5MM 12MM,3765.0,3765.0,225.9,3200.25,49 CDM,79942,CATH BLNDIL 2MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,79944,CATH BLNDIL 3MM 12MM,4066.0,4066.0,243.96,3456.1,49 CDM,79945,CATH BLNDIL 3.5MM 12MM,3765.0,3765.0,225.9,3200.25,49 CDM,79946,CATH BLNDIL 4MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,79947,CATH BLNDIL 15MM 1.50MM,4391.0,4391.0,263.46,3732.35,49 CDM,79948,CATH BLNDIL 2MM 15MM,3765.0,3765.0,225.9,3200.25,49 CDM,79950,CATH BLNDIL 3MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,79951,CATH BLNDIL 3.5MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,79952,CATH BLNDIL 15MM 4.00MM,3317.0,3317.0,199.02,2819.45,49 CDM,79953,CATH BLNDIL 20MM 1.5MM,4066.0,4066.0,243.96,3456.1,49 CDM,79954,CATH BLNDIL 2MM0MM,3317.0,3317.0,199.02,2819.45,49 CDM,79955,CATH BLNDIL 2.5MM0MM,4066.0,4066.0,243.96,3456.1,49 CDM,79956,CATH BLNDIL 3MM0MM,4066.0,4066.0,243.96,3456.1,49 CDM,79964,KIT DRESSING FOAM AG MED,2905.5,2905.5,174.33,2469.68,49 CDM,79997,NEEDLE BX CHBA 22GA 20CM,755.0,755.0,45.3,641.75,49 CDM,79998,NEEDLE BX 20G 15CM,755.0,755.0,45.3,641.75,49 CDM,79999,NEEDLE BX 22GA 10CM,755.0,755.0,45.3,641.75,49 CDM,80000,NEEDLE BX 20GA 20CM,755.0,755.0,45.3,641.75,49 CDM,800002,ACETYLCYSTEIN 6000MG INJ,4089.1,4089.1,245.35,3475.74,24 CDM,800002,"Injection, acetylcysteine, 100 mg ",4089.1,4089.1,0.51,5.86,10 CDM,800009,ABACAVIR 300 MG PO,86.85,86.85,5.21,73.82,49 CDM,800011,ALBUMIN INF 25% 100 ML,2686.4,2686.4,161.18,2283.44,20 CDM,800012,ALBUMIN INF 25% 50ML INJ,1637.06,1637.06,98.22,1391.5,20 CDM,800013,ALBUMIN INF 5% 250ML INJ,1637.06,1637.06,98.22,1391.5,15 CDM,800014,ALTEPLASE RECOMB 2 MG,2462.73,2462.73,147.76,2093.32,19 CDM,800015,ALTEPLASE RECOMB 100 MG,101105.46,101105.46,6066.33,85939.64,19 CDM,800016,AMIODARONE 150 MG INJ,142.77,142.77,8.57,121.35,24 CDM,800017,AMPHOT B LIPOSOME 50 MG,625.8,625.8,37.55,531.93,19 CDM,800018,AMPICILLIN 1 G INJ,393.8,393.8,23.63,334.73,24 CDM,800019,AMPICILLIN 2 G INJ,765.0,765.0,45.9,650.25,24 CDM,800020,BUTAL/ACETA/CAFF PO,19.79,19.79,1.19,16.82,49 CDM,800023,ANTIVENIN CROFAB 1 G INJ,33776.37,33776.37,2026.58,28709.91,19 CDM,800023,"Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram ",33776.37,33776.37,1841.02,8634.6,10 CDM,800026,APIXABAN 5 MG PO,190.4,190.4,11.42,161.84,49 CDM,800039,KIT DRESSING FOAM LG,2685.5,2685.5,161.13,2282.68,49 CDM,800041,ARIPIPRAZOLE 10 MG PO,683.72,683.72,41.02,581.16,49 CDM,800044,ARIPIPRAZOLE 2 MG PO,683.72,683.72,41.02,581.16,49 CDM,800073,DRESSING FOAM LG 15X10CM,627.0,627.0,37.62,532.95,49 CDM,800099,DRESSING WND 7.1X4.9IN,4905.5,4905.5,294.33,4169.68,49 CDM,800102,SUTURE BLK BRD 2 30IN,88.5,88.5,5.31,75.22,49 CDM,800120,ASPIRIN 81 MG PO,2.47,2.47,0.15,2.1,49 CDM,800127,CATH INTVN .014IN 135CM,26500.5,26500.5,1590.03,22525.42,49 CDM,800131,CATH GD VASC 135CM,19875.5,19875.5,1192.53,16894.17,49 CDM,800133,GWIRE VASC 300CM .014IN,5646.0,5646.0,338.76,4799.1,49 CDM,800170,ATENOLOL 50 MG PO,33.38,33.38,2.0,28.37,49 CDM,800171,ATENOLOL 25 MG PO,38.33,38.33,2.3,32.58,49 CDM,800176,ATOVAQU 750MG/5ML LIQ PO,874.12,874.12,52.45,743.0,49 CDM,800200,ATROPINE 0.5MG / 5ML INJ,310.33,310.33,18.62,263.78,24 CDM,800210,ATROPINE 1 MG/10 ML INJ,253.41,253.41,15.2,215.4,24 CDM,80022,ERAVACYCLINE 50 MG INJ,378.33,378.33,22.7,321.58,24 CDM,800221,ATROPINE 1% 2 ML OPHTH,202.77,202.77,12.17,172.35,49 CDM,800263,GWIRE VASC .018IN 260CM,2943.0,2943.0,176.58,2501.55,49 CDM,800265,ATORVASTATIN 10 MG PO,136.0,136.0,8.16,115.6,49 CDM,800268,ATORVASTATIN 40 MG PO,119.93,119.93,7.2,101.94,49 CDM,800269,ATORVASTATIN 20 MG PO,246.05,246.05,14.76,209.14,49 CDM,800281,AZATHIOPRINE 50 MG PO,57.11,57.11,3.43,48.54,24 CDM,800281,"Azathioprine, oral, 50 mg ",57.11,57.11,0.18,6.68,10 CDM,800295,AZELASTINE 0.1% 30ML NAS,52.35,52.35,3.14,44.5,49 CDM,800305,CEFTAZ/AVIBACT 2.5 G INJ,4523.34,4523.34,271.4,3844.84,19 CDM,800307,AZITHROMYCIN 600MG PO,754.2,754.2,45.25,641.07,25 CDM,800310,AZITHROMYCIN 250 MG PO,452.52,452.52,27.15,384.64,25 CDM,800314,AZITHROMYCIN 500 MG INJ,214.15,214.15,12.85,182.03,24 CDM,800340,BACITRACIN 0.9 G TOPICAL,2.38,2.38,0.14,2.02,49 CDM,800362,ELCTRDE ESURG 90D 3.75MM,16080.0,16080.0,964.8,13668.0,49 CDM,800372,GRAFT EVAS 12MM 14CM,100000.0,100000.0,13000.0,85000.0,28 CDM,800387,STENT BIL 8.5FR 10X80MM,77612.0,77612.0,10089.56,65970.2,28 CDM,800390,BACITR/POLYMXB 3.5G OPH,812.3,812.3,48.74,690.46,49 CDM,800400,BACLOFEN 10 MG PO,28.44,28.44,1.71,24.17,49 CDM,800409,CATH ANGIO MPA 125CM,601.5,601.5,36.09,511.27,49 CDM,800446,CATH BLNDIL 4MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,800447,CATH BLNDIL 6MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,800458,CATH BLNDIL 5MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,800484,CATH BLNDIL 7MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,800528,CAGE SPN 4D 14X12X6MM,53527.0,53527.0,6958.51,45497.95,28 CDM,80053,BIT DRILL 2.3MM 20MM,2905.5,2905.5,174.33,2469.68,49 CDM,800530,BENZONATATE 100 MG PO,42.03,42.03,2.52,35.73,49 CDM,800560,BENZTROPINE 1 MG PO,11.12,11.12,0.67,9.45,49 CDM,800571,BENZTROPINE 2 MG INJ,2397.3,2397.3,143.84,2037.71,24 CDM,800571,"Injection, benztropine mesylate, per 1 mg ",2397.3,2397.3,13.52,53.88,10 CDM,800685,SYSTEM EMBL PRTC 75CM .0,100000.0,100000.0,6000.0,85000.0,49 CDM,800730,BETHANECHOL 10 MG PO,52.35,52.35,3.14,44.5,49 CDM,800740,BETHANECHOL 25 MG PO,71.39,71.39,4.28,60.68,49 CDM,800755,BICALUTAMIDE 50 MG PO,832.09,832.09,49.93,707.28,49 CDM,80079,TUBE TRCH 95MM 6MM,2905.5,2905.5,174.33,2469.68,49 CDM,8008,CATH ANGIO 5FR 100CM,2905.5,2905.5,174.33,2469.68,49 CDM,800852,BIVALIRUDIN 250 MG INJ,11551.06,11551.06,693.06,9818.4,24 CDM,800852,"Injection, bivalirudin, 1 mg ",11551.06,11551.06,0.12,3.73,10 CDM,800857,"Injection, onabotulinumtoxina, 1 unit ",11096.59,11096.59,6.51,19.53,10 CDM,800857,ONABOTULINUMTOXA 100 U,11096.59,11096.59,665.8,9432.1,19 CDM,800880,PROSTH PENL PS 12CM 21CM,100000.0,100000.0,13000.0,85000.0,28 CDM,800898,SEALER/DVDR LAP 5MM 37CM,11268.5,11268.5,676.11,9578.23,49 CDM,800916,BROMOCRIPTINE 2.5 MG PO,90.26,90.26,5.42,76.72,49 CDM,800924,BUDESONIDE 3 MG EC PO,398.12,398.12,23.89,338.4,49 CDM,800940,BUMETANIDE 1 MG PO,10.7,10.7,0.64,9.09,49 CDM,800942,"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection) ",2475.69,2475.69,255.13,352.17,5 CDM,800942,HOLTER RECORD VISUAL,2475.69,2475.69,148.54,2104.34,39 CDM,800943,External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report ,2475.69,2475.69,255.13,352.17,5 CDM,800943,HOLTER SCAN VISUAL,2475.69,2475.69,148.54,2104.34,39 CDM,800950,BUPIVACAINE 75 MG INJ,19.04,19.04,1.14,16.18,24 CDM,800960,BUPIVACAINE 150 MG INJ,23.03,23.03,1.38,19.58,24 CDM,800965,RELOAD STPLR 45MM,5323.5,5323.5,692.05,4524.98,28 CDM,800966,STAPLER INT CTR 45MM,10283.0,10283.0,616.98,8740.55,49 CDM,800967,RELOAD STPLR 45MM,5323.5,5323.5,692.05,4524.98,28 CDM,800968,RELOAD STPLR 45MM,5323.5,5323.5,692.05,4524.98,28 CDM,800971,RELOAD STPLR 60MM,5175.5,5175.5,672.82,4399.18,28 CDM,800972,RELOAD STPLR 60MM,6050.0,6050.0,786.5,5142.5,28 CDM,800973,RELOAD STPLR 60MM,5900.0,5900.0,767.0,5015.0,28 CDM,800974,RELOAD STPLR 60MM,5771.0,5771.0,750.23,4905.35,28 CDM,800981,BUPIV2.5/EPI0.005MG 10ML,46.98,46.98,2.82,39.93,46 CDM,800991,STAPLER INT CTR 60MM,12182.0,12182.0,730.92,10354.7,49 CDM,801010,BUPROPION IR 100 MG PO,144.66,144.66,8.68,122.96,30 CDM,801020,BUPROPION IR 75 MG PO,106.33,106.33,6.38,90.38,30 CDM,801030,BUSPIRONE 5 MG PO,30.93,30.93,1.86,26.29,49 CDM,801039,SUTURE VIOL BRD+2-0 27IN,85.5,85.5,5.13,72.67,49 CDM,80104,CATH ULTSND 5FR 150CM,22032.0,22032.0,1321.92,18727.2,49 CDM,801042,SUTURE UND BRD +2-0 27IN,83.5,83.5,5.01,70.97,49 CDM,801048,SUTURE SH 3-0 1X27IN,84.0,84.0,5.04,71.4,49 CDM,801051,SUTURE UR-6 1 1X36IN,103.0,103.0,6.18,87.55,49 CDM,801060,BUTORPHANOL 2 MG INJ,61.86,61.86,3.71,52.58,24 CDM,801060,"Injection, butorphanol tartrate, 1 mg ",61.86,61.86,1.78,15.76,10 CDM,801076,CATH ART LN 7FR 110CM,2905.5,2905.5,174.33,2469.68,49 CDM,801100,CALAM/ZINC 8% 177 ML TOP,11.12,11.12,0.67,9.45,49 CDM,801130,CALCITONIN 3.7 ML NASAL,349.76,349.76,20.99,297.3,49 CDM,801150,CALCITRIOL 0.25 MCG PO,74.19,74.19,4.45,63.06,25 CDM,801150,"Calcitrol, 0.25 microgram ",74.19,74.19,0.68,1.51,8 CDM,801173,SUCT/IRR SURG DISP,3639.0,3639.0,218.34,3093.15,49 CDM,801191,CALCI CARB 1250MG/5ML PO,3.7,3.7,0.22,3.15,49 CDM,801200,CALCIUM CARB 500 MG PO,2.47,2.47,0.15,2.1,49 CDM,80123,SHEATH INTRO 7FR 25CM,1918.0,1918.0,115.08,1630.3,49 CDM,80124,SHEATH INTRO 6FR 25CM,1918.0,1918.0,115.08,1630.3,49 CDM,801299,STYLET LD WIRE CRD 140CM,20953.5,20953.5,1257.21,17810.47,49 CDM,801302,SET SHTH DIL 9FR 13.6CM,56062.5,56062.5,3363.75,47653.13,49 CDM,801312,CARBAMAZE ER 200 MG PO,42.03,42.03,2.52,35.73,49 CDM,801330,CARBAMAZE 200 MG PO,19.79,19.79,1.19,16.82,49 CDM,801335,CARBAMAZE ER 100 MG PO,23.49,23.49,1.41,19.97,49 CDM,801350,CARBAMIDE 6.5% 15ML OTIC,122.41,122.41,7.34,104.05,49 CDM,801370,CARB/LEVO 10/100 MG PO,30.91,30.91,1.85,26.27,49 CDM,801380,CARB/LEVO 25/100 MG PO,32.14,32.14,1.93,27.32,49 CDM,801401,STENT COR 3MM 18MM,16695.0,16695.0,2170.35,14190.75,28 CDM,801465,CARVEDILOL 3.125 MG PO,103.85,103.85,6.23,88.27,49 CDM,801466,CARVEDILOL 6.25 MG PO,103.85,103.85,6.23,88.27,49 CDM,801467,CARVEDILOL 12.5 MG PO,103.85,103.85,6.23,88.27,49 CDM,801512,CEFAZOLIN 20 MG/ML INJ,38.07,38.07,2.28,32.36,24 CDM,801522,LEAD PCNG 4.7FR 86CM,24749.0,24749.0,3217.37,21036.65,28 CDM,801588,CEFAZOLIN 1 G INJ,293.87,293.87,17.63,249.79,24 CDM,801589,CEFAZOLIN 2 G INJ,186.79,186.79,11.21,158.77,24 CDM,801599,CEFDINIR 125MG/5ML LIQPO,182.98,182.98,10.98,155.53,49 CDM,801606,CEFEPIME HCL 1 G INJ,315.27,315.27,18.92,267.98,24 CDM,801616,TUBE JJNSTM 20FR 51CM,4592.0,4592.0,275.52,3903.2,49 CDM,801700,CEFOXITIN 2 G INJ,924.42,924.42,55.47,785.76,24 CDM,801701,CEFOXITIN 1 G INJ,535.38,535.38,32.12,455.07,24 CDM,801721,CEFTAROLINE 400 MG INJ,1469.32,1469.32,88.16,1248.92,19 CDM,801722,CEFTAROLINE 600 MG INJ,1469.32,1469.32,88.16,1248.92,19 CDM,801730,CEFTAZIDIME 1 G INJ,326.41,326.41,19.58,277.45,24 CDM,801754,CEFTAZIDME 280 MG/ML INJ,55.92,55.92,3.36,47.53,24 CDM,801771,CEFTRIAXONE 1 G INJ,553.22,553.22,33.19,470.24,24 CDM,801772,CEFTRIAXONE 500MG INJ,530.61,530.61,31.84,451.02,24 CDM,801773,CEFTRIAXONE 2 G INJ,360.48,360.48,21.63,306.41,24 CDM,801785,OCCLUDER CV 18X18MM,100000.0,100000.0,13000.0,85000.0,28 CDM,801810,CEFUROXIME 250 MG PO,464.88,464.88,27.89,395.15,49 CDM,801845,CELECOXIB 100 MG PO,106.33,106.33,6.38,90.38,49 CDM,801846,CELECOXIB 200 MG PO,176.81,176.81,10.61,150.29,49 CDM,801851,PROBE LTHTRP 1.9FR 375CM,15107.0,15107.0,906.42,12840.95,49 CDM,801857,CATH BLNDIL 2MM 6MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801858,CATH BLNDIL 2.25MM 6MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801859,CATH BLNDIL 2.5MM 6MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801863,CATH BLNDIL 2MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801864,CATH BLNDIL 10MM 2.5MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801865,CATH BLNDIL 3MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801866,CATH BLNDIL 3.5MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801867,CATH BLNDIL 4MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,801880,CEPHALEXIN 250 MG PO,33.38,33.38,2.0,28.37,49 CDM,801881,SENSOR HEMODYNAMIC SMALL,8275.5,8275.5,496.53,7034.18,49 CDM,801882,SENSOR HEMODYNAMIC MED,8275.5,8275.5,496.53,7034.18,49 CDM,801883,SENSOR HEMODYNAMIC LARGE,8275.5,8275.5,496.53,7034.18,49 CDM,801886,SLR/DVDR LAPSCP 37CM 5MM,21685.0,21685.0,1301.1,18432.25,49 CDM,801902,MARKER ENDO SPOT SYR PRE,2005.0,2005.0,120.3,1704.25,49 CDM,80199,DEVICE WNDCLS 23CM SZ0,1614.5,1614.5,96.87,1372.33,49 CDM,802010,CHLORDIAZEPOXID 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,802020,CHLORDIAZEPOXIDE 5 MG PO,11.12,11.12,0.67,9.45,49 CDM,802025,STENT EPRSTH 7X11X29MM,87308.0,87308.0,11350.04,74211.8,28 CDM,802067,PCMKR SNGL 7.4 50.8X42.6,76500.0,76500.0,9945.0,65025.0,28 CDM,802075,CHLOROTHIAZIDE 500MG INJ,9836.67,9836.67,590.2,8361.17,24 CDM,802075,"Injection, chlorothiazide sodium, per 500 mg ",9836.67,9836.67,46.92,388.02,10 CDM,802100,CHLORPROMAZINE 10 MG PO,10.7,10.7,0.64,9.09,49 CDM,802117,LEAD CRT PCNG 62CM,66165.0,66165.0,8601.45,56240.25,28 CDM,802130,CHLORPROMAZINE 25 MG PO,14.28,14.28,0.86,12.14,49 CDM,80214,BLN CATH RTRV 12-15MM,5849.5,5849.5,350.97,4972.07,49 CDM,802160,CHLORPROMAZINE 50 MG INJ,358.11,358.11,21.49,304.39,24 CDM,802160,"Injection, chlorpromazine hcl, up to 50 mg ",358.11,358.11,20.96,84.46,10 CDM,802211,CHLORTHALIDONE 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,802228,CRT-P CRD 11X46.5X59MM,100000.0,100000.0,13000.0,85000.0,28 CDM,802247,SCREW SPN XIA 4823-16535,19298.0,19298.0,2508.74,16403.3,28 CDM,802275,CILOSTAZOL 50 MG PO,90.26,90.26,5.42,76.72,49 CDM,802279,GWIRE VASC .035IN 260CM,2905.5,2905.5,174.33,2469.68,49 CDM,802291,CINACALCET 30MG NESRD PO,574.92,574.92,34.5,488.68,49 CDM,80232,CAGE SPN 4D 14X12X6MM,22538.0,22538.0,2929.94,19157.3,28 CDM,802330,CIPROFLOXCN 0.3%2.5MLOPH,844.71,844.71,50.68,718.0,49 CDM,802331,CIPROFLOX 0.3% 3.5 G OPH,1834.56,1834.56,110.07,1559.38,30 CDM,802340,CIPROFLOXACIN 250 MG PO,222.54,222.54,13.35,189.16,49 CDM,802350,CIPROFLOXACIN 500 MG PO,263.35,263.35,15.8,223.85,49 CDM,802356,CIP/DEX0.3/0.1%7.5MLOTIC,1278.96,1278.96,76.74,1087.12,30 CDM,802370,CIPRO/D5W 200MG/100ML IV,630.56,630.56,37.83,535.98,24 CDM,802380,CIPRO/D5W 400MG/200ML IV,950.59,950.59,57.04,808.0,24 CDM,80241,CANNULA ERCP XL 195CM,2905.5,2905.5,174.33,2469.68,49 CDM,802424,CITALOPRAM 10 MG PO,76.66,76.66,4.6,65.16,49 CDM,802425,CITALOPRAM 20 MG PO,136.0,136.0,8.16,115.6,49 CDM,802510,CLINDAMYCIN 150 MG PO,48.22,48.22,2.89,40.99,49 CDM,802511,CLINDAMYCIN 300 MG PO,5.51,5.51,0.33,4.68,49 CDM,802580,CLONAZEPAM 0.5 MG PO,32.14,32.14,1.93,27.32,49 CDM,802581,CLONAZEPAM 1 MG PO,38.33,38.33,2.3,32.58,49 CDM,802610,CLONIDINE 0.1 MG PO,11.12,11.12,0.67,9.45,49 CDM,802630,CLONIDINE 0.2 MG PO,11.12,11.12,0.67,9.45,49 CDM,802645,CLONIDINE 0.3 MG PO,19.79,19.79,1.19,16.82,49 CDM,802655,CLOPIDOGREL 75 MG PO,233.68,233.68,14.02,198.63,49 CDM,80266,BIT DRILL 2.0X125,519.5,519.5,31.17,441.57,49 CDM,802680,CLOTRIMAZOLE 10 MG PO,86.55,86.55,5.19,73.57,49 CDM,802790,ACETAM/COD 300/30 MG PO,11.12,11.12,0.67,9.45,49 CDM,802860,COLCHICINE 0.6 MG PO,11.12,11.12,0.67,9.45,49 CDM,802891,COLISTIMETHATE 150MG INJ,2416.34,2416.34,144.98,2053.89,24 CDM,802891,"Injection, colistimethate sodium, up to 150 mg ",2416.34,2416.34,14.27,43.55,10 CDM,802975,IVABRADINE 5 MG PO,52.35,52.35,3.14,44.5,49 CDM,802981,COSYNTROPIN 0.25 MG INJ,2048.72,2048.72,122.92,1741.41,24 CDM,802981,"Injection, cosyntropin, 0.25 mg ",2048.72,2048.72,16.26,164.57,10 CDM,803012,DAPTOMYCIN 500 MG INJ,6955.15,6955.15,417.31,5911.88,24 CDM,80303,TIP MNPLT 5.1MM 6CM,2459.5,2459.5,147.57,2090.57,49 CDM,803040,CYCLOBENZAPRINE 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,80305,CUP OCCLDR 3.0CM,3663.5,3663.5,219.81,3113.97,49 CDM,803050,CYCLOPENTOLAT 1% 2ML OPH,720.81,720.81,43.25,612.69,49 CDM,80306,CUP OCCLDR 3.5CM,3663.5,3663.5,219.81,3113.97,49 CDM,80307,CUP OCCLDR 4.0CM,3663.5,3663.5,219.81,3113.97,49 CDM,803093,CYCLOSPORINE 25 MG PO,60.67,60.67,3.64,51.57,24 CDM,803108,CYCLOSPORINE 100 MG PO,311.71,311.71,18.7,264.95,24 CDM,80311,GWIRE VASC .035IN 260CM,1843.0,1843.0,110.58,1566.55,49 CDM,803115,CYCLOSPORINE 25 MG PO,90.42,90.42,5.43,76.86,24 CDM,803125,CYSTEINE 500 MG INJ,493.41,493.41,29.6,419.4,49 CDM,803129,GANCICLOVIR 500 MG INJ,1885.72,1885.72,113.14,1602.86,24 CDM,80318,DEV CMPR PRCLUD 29CM30ML,1446.0,1446.0,86.76,1229.1,49 CDM,803210,DANTROLENE 25 MG PO,54.4,54.4,3.26,46.24,49 CDM,803211,DANTROLENE 20 MG INJ,667.44,667.44,40.05,567.32,30 CDM,803220,DAPSONE 100 MG PO,11.12,11.12,0.67,9.45,49 CDM,803230,DEFEROX MESY 500 MG INJ,110.65,110.65,6.64,94.05,24 CDM,803230,"Injection, deferoxamine mesylate, 500 mg ",110.65,110.65,8.58,28.14,10 CDM,803260,DESIPRAMINE 25 MG PO,14.28,14.28,0.86,12.14,49 CDM,803270,DESMOPRESSIN 4 MCG INJ,560.36,560.36,33.62,476.31,24 CDM,803271,DESMOPRESSIN 0.2 MG PO,254.7,254.7,15.28,216.5,49 CDM,803280,DESMOPRES 0.01% 5MLNASAL,2487.61,2487.61,149.26,2114.47,30 CDM,803335,DESVENLAFAX ER 50 MG PO,178.04,178.04,10.68,151.33,49 CDM,803370,DEXAMETHASONE 1 MG PO,10.7,10.7,0.64,9.09,24 CDM,803390,DEXAMETHASONE 4 MG PO,27.37,27.37,1.64,23.26,24 CDM,803400,DEXAMETH 0.5MG/5ML LIQPO,52.35,52.35,3.14,44.5,24 CDM,803420,DEXAMTH NAP 4MG/ML INJ,53.54,53.54,3.21,45.51,24 CDM,803461,DEXMEDETOMID 200 MCG INJ,2061.05,2061.05,123.66,1751.89,46 CDM,803565,DEXTROSE 50% 50 ML INJ,221.04,221.04,13.26,187.88,49 CDM,803570,BUPIVACAINE 15 MG INJ,197.82,197.82,11.87,168.15,24 CDM,803584,K30/D5NS0.45 1000 ML INJ,64.29,64.29,3.86,54.65,24 CDM,803590,DIAZEPAM 10 MG INJ,172.51,172.51,10.35,146.63,24 CDM,803590,"Injection, diazepam, up to 5 mg ",172.51,172.51,8.51,19.25,10 CDM,803591,DIAZEPAM 10 MG RECTAL,1427.67,1427.67,85.66,1213.52,30 CDM,803600,DIAZEPAM 2 MG PO,11.12,11.12,0.67,9.45,49 CDM,803610,DIAZEPAM 5 MG PO,11.12,11.12,0.67,9.45,49 CDM,803611,DIAZEPAM 10 MG PO,8.65,8.65,0.52,7.35,49 CDM,803654,CLOPIDOGREL 300 MG PO,895.15,895.15,53.71,760.88,49 CDM,803659,DACARBAZINE 200 MG INJ,154.67,154.67,9.28,131.47,24 CDM,803659,"Dacarbazine, 100 mg ",154.67,154.67,3.85,15.31,10 CDM,803659,"Dacarbazine, 100 mg Chemotherapy Drugs",154.67,154.67,,,0 CDM,803700,DICYCLOMINE 10 MG PO,19.79,19.79,1.19,16.82,49 CDM,803711,DICYCLOMINE 20 MG PO,11.12,11.12,0.67,9.45,49 CDM,803720,DICYCLOMINE 20 MG INJ,694.8,694.8,41.69,590.58,24 CDM,803720,"Injection, dicyclomine hcl, up to 20 mg ",694.8,694.8,9.37,75.82,10 CDM,80375,CTHGD VBT 6X070 3DRC,2371.0,2371.0,142.26,2015.35,49 CDM,803770,DIGOXIN 125 MCG PO,19.79,19.79,1.19,16.82,49 CDM,803780,DIGOXIN 250 MCG PO,19.79,19.79,1.19,16.82,49 CDM,803790,DIGOXIN 0.5 MG INJ,92.79,92.79,5.57,78.87,24 CDM,803790,"Injection, digoxin, up to 0.5 mg ",92.79,92.79,7.45,12.48,10 CDM,803810,DIG IMMUNE FAB 40 MG INJ,14493.27,14493.27,869.6,12319.28,19 CDM,803810,"Injection, digoxin immune fab (ovine), per vial ",14493.27,14493.27,5166.99,15501.97,10 CDM,803820,DIHYDROERGOT 1 MG INJ,3138.5,3138.5,188.31,2667.72,24 CDM,803820,"Injection, dihydroergotamine mesylate, per 1 mg ",3138.5,3138.5,54.89,524.12,10 CDM,803830,DILTIAZEM ER 120 MG PO,102.62,102.62,6.16,87.23,49 CDM,803840,DILTIAZEM ER 180 MG PO,163.2,163.2,9.79,138.72,49 CDM,80385,SPACER 4D 14X12X7MM,22538.0,22538.0,2929.94,19157.3,28 CDM,803851,DILTIAZEM ER 240 MG PO,121.35,121.35,7.28,103.15,49 CDM,803870,DILTIAZEM 30 MG PO,19.79,19.79,1.19,16.82,49 CDM,803880,DILTIAZEM ER 60 MG PO,33.38,33.38,2.0,28.37,49 CDM,803890,DILTIAZEM 60 MG PO,30.91,30.91,1.85,26.27,49 CDM,803900,DILTIAZEM ER 90 MG PO,38.33,38.33,2.3,32.58,49 CDM,803913,DILTIAZEM ER 300 MG PO,5.95,5.95,0.36,5.06,49 CDM,803982,DIPHENHYDRAMINE 25 MG PO,2.38,2.38,0.14,2.02,49 CDM,804010,DIPHENHYDRAMNE 50 MG INJ,51.16,51.16,3.07,43.49,24 CDM,804010,"Injection, diphenhydramine hcl, up to 50 mg ",51.16,51.16,0.69,2.81,10 CDM,804020,DIPHENOX/ATROPINE PO,19.79,19.79,1.19,16.82,49 CDM,804060,DIPYRIDAMOLE 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,804080,DIPYRIDAMOLE 75 MG PO,38.33,38.33,2.3,32.58,49 CDM,804085,DIPYRI/ ASA 200/25 MG PO,126.11,126.11,7.57,107.19,49 CDM,804144,DIVALPROEX DR 125 MG PO,45.75,45.75,2.75,38.89,49 CDM,80415,TROCAR LAPSCP 12MM 100MM,2491.0,2491.0,149.46,2117.35,49 CDM,804150,DIVALPROEX DR 250 MG PO,90.26,90.26,5.42,76.72,49 CDM,804151,DIVALPROEX DR 500 MG PO,152.07,152.07,9.12,129.26,49 CDM,804160,DOBUTAM 250 MG 20 ML INJ,140.39,140.39,8.42,119.33,24 CDM,804195,DONEPEZIL 5 MG PO,314.04,314.04,18.84,266.93,49 CDM,804196,DONEPEZIL 10 MG PO,314.04,314.04,18.84,266.93,49 CDM,804200,DOPAMINE 400 MG INJ,158.23,158.23,9.49,134.5,20 CDM,804206,DORZOLAMIDE 2% 10 ML OPH,1985.63,1985.63,119.14,1687.79,49 CDM,804211,DOFETILIDE 125 MCG PO,255.93,255.93,15.36,217.54,49 CDM,804212,DOFETILIDE 250 MCG PO,255.93,255.93,15.36,217.54,49 CDM,804240,DOXEPIN 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,804260,DOXEPIN 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,804271,DOXORUBICIN 50 MG INJ,1038.64,1038.64,62.32,882.84,24 CDM,804271,"Injection, doxorubicin hydrochloride, 10 mg ",1038.64,1038.64,2.73,9.42,10 CDM,804271,"Injection, doxorubicin hydrochloride, 10 mg Chemotherapy Drugs",1038.64,1038.64,,,0 CDM,804294,DRONABINOL 2.5 MG PO,322.41,322.41,19.34,274.05,49 CDM,804295,DRONEDARONE 400 MG PO,178.04,178.04,10.68,151.33,49 CDM,804297,RELOAD STPLR 60MM,5900.0,5900.0,767.0,5015.0,28 CDM,804308,DROXIDOPA 100 MG PO,7.14,7.14,0.43,6.07,49 CDM,804309,DROPERIDOL 5 MG INJ,42.83,42.83,2.57,36.41,24 CDM,804315,DULOXETINE 30 MG PO,200.3,200.3,12.02,170.25,49 CDM,804316,DULOXETINE 20 MG PO,178.04,178.04,10.68,151.33,49 CDM,804317,SHEARS ESURG 9CM,7300.0,7300.0,438.0,6205.0,49 CDM,804332,NET RETRIEVAL 3CM 5.5CM,3501.5,3501.5,210.09,2976.28,49 CDM,804380,ENALAPRILAT 2.5 MG INJ,155.78,155.78,9.35,132.41,49 CDM,804401,ENOXAPARIN 80 MG INJ,2750.65,2750.65,165.04,2338.05,24 CDM,804405,ENOXAPARIN 60 MG INJ,2594.8,2594.8,155.69,2205.58,24 CDM,804406,ENOXAPARIN 30 MG INJ,1039.82,1039.82,62.39,883.85,24 CDM,804409,ENTACAPONE 200 MG PO,134.76,134.76,8.09,114.55,49 CDM,804412,ENOXAPARIN 100 MG INJ,2750.65,2750.65,165.04,2338.05,24 CDM,804413,ENOXAPARIN 40 MG INJ,1391.98,1391.98,83.52,1183.18,24 CDM,804416,ENOXAPARIN 120 MG INJ,2430.62,2430.62,145.84,2066.03,24 CDM,804421,SACUB/VALS 49/51MG PO,202.77,202.77,12.17,172.35,49 CDM,804423,SACUB/VALS 97/103MG PO,77.33,77.33,4.64,65.73,49 CDM,804424,SACUB/VALS 24/26MG PO,202.77,202.77,12.17,172.35,49 CDM,804435,DEXAMETH NA PHOS 10 MG,117.78,117.78,7.07,100.11,24 CDM,804460,RACEPINEPHRINE 2.25% INH,45.75,45.75,2.75,38.89,49 CDM,80448,DEVICE FSTFX MNSCL,18459.0,18459.0,2399.67,15690.15,28 CDM,80450,PUSHER CANN KNT FSTFX 36,5306.0,5306.0,318.36,4510.1,49 CDM,804505,EPLERENONE 25 MG PO,5.95,5.95,0.36,5.06,49 CDM,804523,EPTIFIBATIDE 20 MG INJ,3214.64,3214.64,192.88,2732.44,25 CDM,804524,EPTIFIBATIDE 75 MG INJ,10099.6,10099.6,605.98,8584.66,25 CDM,804558,ERTAPENEM SOD 1 G INJ,2170.07,2170.07,130.2,1844.56,24 CDM,804558,"Injection, ertapenem sodium, 500 mg ",2170.07,2170.07,7.22,91.04,10 CDM,804580,ERYTHROMYCIN 0.5% 1G OPH,58.11,58.11,3.49,49.39,49 CDM,804660,ERYTHRO LACTO 500 MG INJ,418.78,418.78,25.13,355.96,24 CDM,804660,"Injection, erythromycin lactobionate, per 500 mg ",418.78,418.78,91.23,234.16,10 CDM,80470,DEVICE CLSR VASC 6/7FR,8050.0,8050.0,1046.5,6842.5,28 CDM,804720,ESTRADIOL 1 MG PO,58.11,58.11,3.49,49.39,49 CDM,804801,ESTROGEN CONJ 25 MG INJ,2525.8,2525.8,151.55,2146.93,19 CDM,804801,"Injection, estrogen conjugated, per 25 mg ",2525.8,2525.8,391.72,1219.11,10 CDM,804802,GLUCAGON 1 MG INJ,2519.85,2519.85,151.19,2141.87,19 CDM,804802,"Injection, glucagon hydrochloride, per 1 mg ",2519.85,2519.85,146.33,610.86,10 CDM,804881,ETHAMBUTOL 400 MG PO,74.19,74.19,4.45,63.06,49 CDM,804995,ETOMIDATE 20 MG INJ,634.26,634.26,38.06,539.12,49 CDM,804998,ETOPOSIDE 100 MG MDV,80.9,80.9,4.85,68.77,24 CDM,804998,"Injection, etoposide, 10 mg ",80.9,80.9,0.9,4.06,10 CDM,804998,"Injection, etoposide, 10 mg Chemotherapy Drugs",80.9,80.9,,,0 CDM,805003,RIVASTIG 9.5 MG PATCH,1461.4,1461.4,87.68,1242.19,49 CDM,805005,EZETIMIBE 10 MG PO,163.2,163.2,9.79,138.72,49 CDM,805009,RIVASTIG 4.6 MG PATCH,314.04,314.04,18.84,266.93,49 CDM,805020,FAMOTIDINE 20 MG PO,67.81,67.81,4.07,57.64,49 CDM,805059,FEBUXOSTAT 40 MG PO,227.49,227.49,13.65,193.37,49 CDM,80508,BIT DRILL 2.3MM 20MM,3044.5,3044.5,182.67,2587.82,49 CDM,805120,FENTANYL 100 MCG/HR PAT,1236.38,1236.38,74.18,1050.92,49 CDM,805139,FENTANYL 12 MCG/HR PAT,598.41,598.41,35.9,508.65,49 CDM,805140,FENTANYL 25 MCG/HR PAT,628.08,628.08,37.68,533.87,49 CDM,805150,FENTANYL 50 MCG/HR PAT,895.15,895.15,53.71,760.88,49 CDM,805155,FENTANYL 75 MCG/HR PAT,1079.36,1079.36,64.76,917.46,49 CDM,805160,FENTANYL CIT 0.1 MG INJ,51.16,51.16,3.07,43.49,24 CDM,805180,FENTANYL CIT 0.25 MG INJ,51.16,51.16,3.07,43.49,24 CDM,805203,"Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg ",1201.63,1201.63,2.39,6.8,10 CDM,805203,NA FERRIC GLUCON 62.5 MG,1201.63,1201.63,72.1,1021.39,24 CDM,805338,FIDAXOMICIN 200 MG PO,1825.04,1825.04,109.5,1551.28,30 CDM,805352,TBO-FILGRASTM 480MCG INJ,3111.13,3111.13,186.67,2644.46,19 CDM,805360,FINASTERIDE 5 MG PO,5.95,5.95,0.36,5.06,25 CDM,805360,"Finasteride, 5 mg ",5.95,5.95,0.27,0.47,8 CDM,805381,FLECAINIDE 50 MG PO,108.8,108.8,6.53,92.48,49 CDM,805400,FLUCONAZOLE 100 MG PO,505.68,505.68,30.34,429.83,49 CDM,805401,FLUCONAZOLE 150 MG PO,799.95,799.95,48.0,679.96,49 CDM,805408,FLUCON 100MG/NACL50MLINJ,46.4,46.4,2.78,39.44,24 CDM,805409,FLUCO 400MG/NACL200MLINJ,5125.35,5125.35,307.52,4356.55,24 CDM,805411,FLUCO 200MG/NACL100MLINJ,3504.93,3504.93,210.3,2979.19,24 CDM,805417,FLUCYTOSINE 500 MG PO,1244.45,1244.45,74.67,1057.78,30 CDM,805430,FLUDROCORTISO 0.1 MG PO,42.03,42.03,2.52,35.73,49 CDM,805610,FLUOXETINE 20 MG PO,106.33,106.33,6.38,90.38,49 CDM,805611,FLUOXETINE 10 MG PO,103.85,103.85,6.23,88.27,49 CDM,80562,SYSTEM RETRIEVAL 5MM,7043.0,7043.0,422.58,5986.55,49 CDM,805620,FLUOXETI 20MG/5ML LIQ PO,238.63,238.63,14.32,202.84,49 CDM,805720,FLUTICAS 50MCG 16G NASAL,2277.14,2277.14,136.63,1935.57,30 CDM,805750,FOLIC ACID 1 MG PO,11.12,11.12,0.67,9.45,49 CDM,80576,FORCEPS BIP 5MM 33CM,1436.5,1436.5,86.19,1221.03,49 CDM,805762,FOMEPIZOLE 1500 MG INJ,10552.89,10552.89,633.17,8969.96,20 CDM,805777,FONDAPARINUX 5 MG INJ,3711.95,3711.95,222.72,3155.16,24 CDM,805778,FONDAPARINUX 7.5 MG INJ,3711.95,3711.95,222.72,3155.16,24 CDM,805779,FONDAPARINUX 2.5 MG INJ,1913.08,1913.08,114.78,1626.12,24 CDM,805793,FOSPHEN PE 100 MG INJ,660.3,660.3,39.62,561.25,25 CDM,805794,FOSPHEN PE 500 MG INJ,324.8,324.8,19.49,276.08,25 CDM,805796,FOSFOMYCIN 3 G PO,1322.94,1322.94,79.38,1124.5,49 CDM,805800,FUROSEMIDE 20 MG PO,11.12,11.12,0.67,9.45,49 CDM,805820,FUROSEMIDE 40 MG PO,10.7,10.7,0.64,9.09,49 CDM,805850,GABAPENTIN 100 MG PO,38.33,38.33,2.3,32.58,49 CDM,805851,GALANTAMINE 4 MG PO,149.6,149.6,8.98,127.16,49 CDM,805852,GABAPENTIN 400 MG PO,102.62,102.62,6.16,87.23,49 CDM,805853,GABAPENTIN 300 MG PO,78.53,78.53,4.71,66.75,49 CDM,805890,GEMFIBROZIL 600 MG PO,42.03,42.03,2.52,35.73,49 CDM,805920,GENTAMICIN 20 MG INJ,192.74,192.74,11.56,163.83,24 CDM,805940,GENTAMICIN 0.3% 5ML OPH,20.23,20.23,1.21,17.2,49 CDM,805945,GENTAMICIN 0.1% 15 G TOP,132.03,132.03,7.92,112.23,49 CDM,805950,GENTAMICIN 80 MG INJ,99.93,99.93,6.0,84.94,24 CDM,805955,GENTAMI 80MG/NS 100MLINJ,185.6,185.6,11.14,157.76,24 CDM,805995,GLIMEPIRIDE 1 MG PO,28.44,28.44,1.71,24.17,49 CDM,806000,GLIPIZIDE 10 MG PO,30.91,30.91,1.85,26.27,49 CDM,806010,GLIPIZIDE 5 MG PO,11.12,11.12,0.67,9.45,49 CDM,806131,GLYCOPYRROLATE 1 MG PO,155.78,155.78,9.35,132.41,49 CDM,806251,GUAIFENESIN ER 600 MG PO,19.79,19.79,1.19,16.82,49 CDM,806280,GUAIF/DEXTR 600/30MG PO,11.12,11.12,0.67,9.45,49 CDM,806450,HALOPERIDOL 1 MG PO,19.79,19.79,1.19,16.82,49 CDM,806459,HALOPERIDOL 0.5 MG PO,11.12,11.12,0.67,9.45,49 CDM,806460,HALOPERIDOL 5 MG PO,38.33,38.33,2.3,32.58,49 CDM,806480,HALOPERIDOL LACT 5MG INJ,296.24,296.24,17.77,251.8,24 CDM,806480,"Injection, haloperidol, up to 5 mg ",296.24,296.24,0.79,10.72,10 CDM,806505,WITCH HAZEL 50% RECT,15.47,15.47,0.93,13.15,49 CDM,806560,TRIAMTER/HCTZ 37.5/25 PO,19.79,19.79,1.19,16.82,49 CDM,806570,TRIAMTER/HCTZ 75/50 PO,38.33,38.33,2.3,32.58,49 CDM,806640,HEPARIN 10000U / 1ML INJ,51.16,51.16,3.07,43.49,24 CDM,806663,HEPARIN 5000U / 1ML INJ,113.02,113.02,6.78,96.07,24 CDM,806682,HBIG HUMAN 0.5 ML IM,1901.19,1901.19,114.07,1616.01,19 CDM,806757,HYALURONIDASE RECB 150 U,282.44,282.44,16.95,240.07,24 CDM,806757,"Injection, hyaluronidase, recombinant, 1 usp unit ",282.44,282.44,0.36,1.12,10 CDM,806760,HYDRALAZINE 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,806770,HYDRALAZINE 20 MG INJ,726.93,726.93,43.62,617.89,24 CDM,806770,"Injection, hydralazine hcl, up to 20 mg ",726.93,726.93,4.29,17.5,10 CDM,806780,HYDRALAZINE 25 MG PO,19.79,19.79,1.19,16.82,49 CDM,806800,HCTZ 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,806805,HCTZ 12.5 MG PO,30.93,30.93,1.86,26.29,49 CDM,806815,HYDROCOD/APAP 10/325 PO,30.91,30.91,1.85,26.27,49 CDM,806816,HYDROCOD/APAP 7.5/325 PO,54.4,54.4,3.26,46.24,49 CDM,806817,HYDROCOD/APAP 5/325 PO,48.22,48.22,2.89,40.99,49 CDM,80691,DEVICE CLSR VASC 5FR,8050.0,8050.0,1046.5,6842.5,28 CDM,806930,HYDROCORTIS 1% 28G TOP,19.79,19.79,1.19,16.82,49 CDM,80695,DRESSING WND 4X4IN,458.0,458.0,27.48,389.3,49 CDM,806951,HYDROCORTISONE 10 MG PO,28.44,28.44,1.71,24.17,49 CDM,806980,HYDROCORTI 2.5% 30G RECT,2336.76,2336.76,140.21,1986.25,30 CDM,806991,HYDROCORTISN 1 MG/ML INJ,15.47,15.47,0.93,13.15,24 CDM,807000,HYDROCORT SUCC 100MG INJ,184.41,184.41,11.06,156.75,24 CDM,807100,CYANOCOBAL 1000 MCG INJ,51.16,51.16,3.07,43.49,24 CDM,807100,"Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg ",51.16,51.16,0.67,9.32,10 CDM,807150,HYDROXYUREA 500 MG PO,55.92,55.92,3.36,47.53,25 CDM,807150,"Hydroxyurea, oral, 500 mg ",55.92,55.92,0.99,2.0,8 CDM,807150,"Hydroxyurea, oral, 500 mg Chemotherapy Drugs",55.92,55.92,,,0 CDM,807160,HYDROXYZINE HCL 10 MG PO,28.44,28.44,1.71,24.17,49 CDM,807180,HYDROXYZ 10MG/5ML LIQ PO,11.12,11.12,0.67,9.45,49 CDM,807190,HYDROXYZIN HCL 50 MG INJ,159.42,159.42,9.57,135.51,24 CDM,807190,"Injection, hydroxyzine hcl, up to 25 mg ",159.42,159.42,1.33,52.82,10 CDM,807230,IBUPROFEN 200 MG PO,2.47,2.47,0.15,2.1,49 CDM,807240,IBUPROFEN 400 MG PO,11.12,11.12,0.67,9.45,49 CDM,807260,IBUPROFEN 600 MG PO,11.12,11.12,0.67,9.45,49 CDM,807270,IBUPROFEN 800 MG PO,11.12,11.12,0.67,9.45,49 CDM,807276,IBUTILIDE FUM 1 MG INJ,9220.39,9220.39,553.22,7837.33,20 CDM,807276,"Injection, ibutilide fumarate, 1 mg ",9220.39,9220.39,751.68,1159.81,8 CDM,807284,IMATINIB 100 MG PO,1321.69,1321.69,79.3,1123.44,25 CDM,807284,"Imatinib, 100 mg ",1321.69,1321.69,7.33,35.42,8 CDM,807284,"Imatinib, 100 mg Chemotherapy Drugs",1321.69,1321.69,,,0 CDM,807310,IMIPRAMINE 25 MG PO,8.33,8.33,0.5,7.08,49 CDM,807380,INDOMETHACIN 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,80739,GRAFT SFT TIS AT 10MM,65910.0,65910.0,8568.3,56023.5,28 CDM,807415,INFLIXIMAB 100 MG INJ,12448.12,12448.12,746.89,10580.9,19 CDM,807422,ALBUT/IPRA 2.5/0.5MG INH,69.24,69.24,4.15,58.85,24 CDM,807422,"Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme ",69.24,69.24,0.21,0.65,10 CDM,807610,IPRATROPIUM NC 0.5MG INH,55.92,55.92,3.36,47.53,24 CDM,807610,"Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram ",55.92,55.92,0.44,1.38,10 CDM,807617,IRINOTECAN 100 MG INJ,2221.23,2221.23,133.27,1888.05,24 CDM,807617,"Injection, irinotecan, 20 mg ",2221.23,2221.23,1.53,7.72,10 CDM,807617,"Injection, irinotecan, 20 mg Chemotherapy Drugs",2221.23,2221.23,,,0 CDM,807680,ISONIAZID 300 MG PO,11.12,11.12,0.67,9.45,49 CDM,807700,ISOPROTERENOL 0.2MG INJ,14198.63,14198.63,851.92,12068.84,30 CDM,807710,ISOSORB DINIT 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,807730,ISOSORB DINIT 20 MG PO,11.12,11.12,0.67,9.45,49 CDM,807760,ISOSORBIDE MONO 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,807763,ISOSOR MONO ER 30 MG PO,113.75,113.75,6.83,96.69,49 CDM,807770,ISOSOR MONO ER 60 MG PO,54.4,54.4,3.26,46.24,49 CDM,807811,LOPIN/RITON 200/50 MG PO,293.03,293.03,17.58,249.08,49 CDM,807833,LEVETIRAC 500MG/5ML INJ,1771.5,1771.5,106.29,1505.78,24 CDM,807870,KETOCONAZOL 2% 120ML TOP,1324.17,1324.17,79.45,1125.54,49 CDM,807920,KETOROLAC 0.5% 5 ML OPH,2540.76,2540.76,152.45,2159.65,49 CDM,807921,KETOROLAC 30 MG INJ,65.44,65.44,3.93,55.62,19 CDM,807930,KETOROLAC 10 MG PO,38.33,38.33,2.3,32.58,49 CDM,807950,KETOROLAC 60 MG INJ,255.93,255.93,15.36,217.54,19 CDM,807951,KETOTIFEN 0.025% 5ML OPH,489.61,489.61,29.38,416.17,49 CDM,807960,LABETALOL 100 MG PO,32.14,32.14,1.93,27.32,49 CDM,807980,LABETALOL 200 MG PO,30.91,30.91,1.85,26.27,49 CDM,80799,GWIRE URO .035IN 150CM,1801.0,1801.0,108.06,1530.85,49 CDM,80803,SCREW BN 2.7MM 14MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,80804,SCREW BN 2.7MM 20MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,80805,SCREW BN 2.7MM 26MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,808140,LACOSAMIDE 50 MG PO,59.49,59.49,3.57,50.57,49 CDM,808150,LACTULOSE 20 G PO,119.93,119.93,7.2,101.94,49 CDM,808153,LAMIVUDINE 150 MG PO,309.1,309.1,18.55,262.74,49 CDM,808155,LAMOTRIGINE 25 MG PO,212.66,212.66,12.76,180.76,49 CDM,808156,LAMOTRIGINE 150 MG PO,5.95,5.95,0.36,5.06,49 CDM,808157,LAMOTRIGINE 100 MG PO,242.33,242.33,14.54,205.98,49 CDM,808159,"Injection, lacosamide, 1 mg ",1064.8,1064.8,0.48,0.62,3 CDM,808159,LACOSAMIDE 200 MG INJ,1064.8,1064.8,63.89,905.08,30 CDM,808185,LATANOP 0.005% 2.5ML OPH,1088.01,1088.01,65.28,924.81,49 CDM,808186,LETROZOLE 2.5 MG PO,583.58,583.58,35.01,496.04,49 CDM,808188,LEUCOVORIN 5 MG PO,149.6,149.6,8.98,127.16,49 CDM,808227,LEVETIRACETAM 500 MG PO,166.91,166.91,10.01,141.87,49 CDM,808228,LEVETIRACETAM 250 MG PO,140.95,140.95,8.46,119.81,49 CDM,808232,LEVETIR 500MG/5ML LIQ PO,19.79,19.79,1.19,16.82,49 CDM,808246,LEVOF 250MG/D5W 50ML INJ,883.97,883.97,53.04,751.37,24 CDM,808247,LEVOFLOXACIN 250 MG PO,536.59,536.59,32.2,456.1,49 CDM,808248,LEVOF 500MG/D5W100ML INJ,1384.84,1384.84,83.09,1177.11,24 CDM,808249,LEVOFLOXACIN 500 MG PO,624.37,624.37,37.46,530.71,49 CDM,808250,LEVOTHYROXINE 75 MCG PO,28.44,28.44,1.71,24.17,49 CDM,808251,LEVOFLOXACIN 750 MG PO,907.5,907.5,54.45,771.38,49 CDM,808252,LEVOF 750MG/D5W150ML INJ,1513.34,1513.34,90.8,1286.34,24 CDM,808260,LEVOTHYROXINE 88 MCG PO,11.12,11.12,0.67,9.45,49 CDM,808270,LEVOTHYROXINE 112 MCG PO,23.49,23.49,1.41,19.97,49 CDM,808290,LEVOTHYROXINE 100 MCG PO,28.44,28.44,1.71,24.17,49 CDM,808320,LEVOTHYROXINE 50 MCG PO,23.49,23.49,1.41,19.97,49 CDM,808325,LEVOTHYROXINE 25 MCG PO,19.79,19.79,1.19,16.82,49 CDM,808440,LIDOCAINE 2% 10 ML TOP,322.69,322.69,19.36,274.29,49 CDM,80850,SEALER BIP .137IN .226IN,12149.0,12149.0,728.94,10326.65,49 CDM,808500,LIDO 2% 100MG/5ML INJ,511.87,511.87,30.71,435.09,25 CDM,808540,LIDOCAINE 5% 35.44G TOP,31.05,31.05,1.86,26.39,49 CDM,808600,LIDO/PRILO 2.5% 5G TOP,410.48,410.48,24.63,348.91,49 CDM,808634,LINEZ/D5W 600MG/300MLINJ,3120.66,3120.66,187.24,2652.56,24 CDM,808636,LINEZOLID 600 MG PO,2277.42,2277.42,136.65,1935.81,30 CDM,808640,LIOTHYRONINE 5 MCG PO,33.38,33.38,2.0,28.37,49 CDM,808641,LIOTHYRONINE 25 MCG PO,48.22,48.22,2.89,40.99,49 CDM,808660,LISINOPRIL 10 MG PO,36.88,36.88,2.21,31.35,49 CDM,808661,LISINOPRIL 20 MG PO,45.75,45.75,2.75,38.89,49 CDM,808663,LISINOPRIL 2.5 MG PO,27.37,27.37,1.64,23.26,49 CDM,808670,LISINOPRIL 5 MG PO,38.33,38.33,2.3,32.58,49 CDM,808680,LITHIUM CARB 300 MG PO,11.12,11.12,0.67,9.45,49 CDM,808710,LOPERAMIDE 2 MG PO,28.44,28.44,1.71,24.17,49 CDM,808750,LORATADINE 10 MG PO,33.38,33.38,2.0,28.37,49 CDM,808760,LORAZEPAM 0.5 MG PO,29.74,29.74,1.78,25.28,49 CDM,808761,LORAZEPAM 1 MG PO,33.38,33.38,2.0,28.37,49 CDM,808782,LORAZEPAM 2 MG INJ,115.41,115.41,6.92,98.1,24 CDM,808799,LOSARTAN 25 MG PO,81.6,81.6,4.9,69.36,49 CDM,808800,LOSARTAN 50 MG PO,102.62,102.62,6.16,87.23,49 CDM,808811,LUBIPROSTONE 24 MCG PO,145.9,145.9,8.75,124.02,49 CDM,808813,LUBIPROSTONE 8 MCG PO,165.67,165.67,9.94,140.82,49 CDM,808852,MAG-AL PLUS 30 ML LIQ,2.38,2.38,0.14,2.02,49 CDM,808910,MAG OH 2400MG/30ML LIQPO,11.12,11.12,0.67,9.45,49 CDM,808921,MAG SULF 2G/WFI 50ML INJ,479.46,479.46,28.77,407.54,24 CDM,808952,MAG SUL 4G/WFI 100ML INJ,883.97,883.97,53.04,751.37,24 CDM,808958,MAG SUL 20G/WFI 500MLINJ,245.08,245.08,14.7,208.32,24 CDM,808962,MAG SUL 1G/D5W 100ML INJ,222.48,222.48,13.35,189.11,24 CDM,808970,MAG SULFATE 1G INJ,53.17,53.17,3.19,45.19,24 CDM,808980,"Injection, mannitol, 25% in 50 ml ",185.6,185.6,5.42,6.99,3 CDM,808980,MANNITOL 25% 50 ML INJ,185.6,185.6,11.14,157.76,30 CDM,808982,CEFEPIME HCL 2 G INJ,1806.01,1806.01,108.36,1535.11,24 CDM,809040,MMR VAC LIVE SQ,703.13,703.13,42.19,597.66,24 CDM,809040,"Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use ",703.13,703.13,102.53,332.65,10 CDM,809060,MECLIZINE 12.5 MG PO,30.91,30.91,1.85,26.27,49 CDM,809070,MECLIZINE 25 MG PO,33.38,33.38,2.0,28.37,49 CDM,809101,MEDROXYPROGEST 5 MG PO,19.04,19.04,1.14,16.18,49 CDM,809113,"Injection, medroxyprogesterone acetate, 1 mg ",1186.16,1186.16,0.41,1.78,8 CDM,809113,MEDRXYPRGTRN 150MG INJ,1186.16,1186.16,71.17,1008.24,25 CDM,809121,MEMANTINE 5 MG PO,134.76,134.76,8.09,114.55,49 CDM,809130,MEGESTROL ACET 40 MG PO,45.75,45.75,2.75,38.89,25 CDM,809141,MEGESTROL ACET 400MG PO,166.91,166.91,10.01,141.87,25 CDM,809155,MEPERIDINE 25 MG INJ,51.16,51.16,3.07,43.49,24 CDM,809200,MEPERIDINE 50 MG INJ,51.16,51.16,3.07,43.49,24 CDM,809266,MEROPENEM 1 G INJ,2516.27,2516.27,150.98,2138.83,24 CDM,809267,MEROPENEM 500 MG INJ,1516.9,1516.9,91.01,1289.37,24 CDM,809280,MESALAMINE 4 G RECTAL,854.34,854.34,51.26,726.19,49 CDM,809289,MESALAMINE DR 400 MG PO,96.43,96.43,5.79,81.97,49 CDM,809400,METFORMIN 500 MG PO,48.22,48.22,2.89,40.99,49 CDM,809410,METFORMIN 850 MG PO,81.6,81.6,4.9,69.36,49 CDM,809440,METHADONE 5 MG PO,10.7,10.7,0.64,9.09,25 CDM,809442,METHADONE 10 MG PO,19.04,19.04,1.14,16.18,25 CDM,809470,METHIMAZOLE 5 MG PO,32.14,32.14,1.93,27.32,49 CDM,809490,METHOCARBAMOL 500 MG PO,11.12,11.12,0.67,9.45,49 CDM,809500,METHOCARBAMOL 750 MG PO,19.79,19.79,1.19,16.82,49 CDM,809510,METHOTREXATE 2.5 MG PO,185.6,185.6,11.14,157.76,24 CDM,809510,"Methotrexate; oral, 2.5 mg ",185.6,185.6,0.14,5.54,10 CDM,809510,"Methotrexate; oral, 2.5 mg Chemotherapy Drugs",185.6,185.6,,,0 CDM,809620,METHYLERGONOV 0.2 MG PO,173.09,173.09,10.39,147.13,49 CDM,809630,"Injection, methylergonovine maleate, up to 0.2 mg ",296.73,296.73,21.61,68.83,10 CDM,809630,METHYLERGONOV 0.2 MG INJ,296.73,296.73,17.8,252.22,24 CDM,809631,"Injection, methylnaltrexone, 0.1 mg ",1151.66,1151.66,1.88,4.52,8 CDM,809631,METHYLNLTRXONE 12 MG INJ,1151.66,1151.66,69.1,978.91,41 CDM,809660,METHYLPRED 4 MG PO,53.54,53.54,3.21,45.51,24 CDM,809660,"Methylprednisolone oral, per 4 mg ",53.54,53.54,0.14,1.0,10 CDM,809760,METOCLOPRAMIDE 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,809770,METOCLOPRAMIDE 10 MG INJ,90.42,90.42,5.43,76.86,24 CDM,809780,METOCLOPRAMIDE 5 MG PO,11.12,11.12,0.67,9.45,49 CDM,809791,METOCLO 10MG/10ML LIQ PO,28.44,28.44,1.71,24.17,49 CDM,809800,METOLAZONE 5 MG PO,86.55,86.55,5.19,73.57,49 CDM,809801,METOLAZONE 2.5 MG PO,74.19,74.19,4.45,63.06,49 CDM,809809,METOPROLOL ER 25 MG PO,53.17,53.17,3.19,45.19,49 CDM,809810,METOPROLOL ER 50 MG PO,53.17,53.17,3.19,45.19,49 CDM,809830,METOPROLOL 50 MG PO,23.49,23.49,1.41,19.97,49 CDM,809832,METOPROLOL 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,809840,METRONIDAZOLE 250 MG PO,23.49,23.49,1.41,19.97,49 CDM,809841,METRONIDAZOLE 500 MG PO,33.38,33.38,2.0,28.37,49 CDM,809860,METRONIDAZ 0.75% 70G VAG,1184.46,1184.46,71.07,1006.79,49 CDM,809870,METRON500MG/NACL100MLINJ,57.11,57.11,3.43,48.54,24 CDM,809880,MEXILETINE 150 MG PO,33.38,33.38,2.0,28.37,49 CDM,809890,MEXILETINE 200 MG PO,45.75,45.75,2.75,38.89,49 CDM,809913,MICAFUNGIN 100 MG INJ,1600.18,1600.18,96.01,1360.15,24 CDM,809914,MICAFUNGIN 50 MG INJ,800.69,800.69,48.04,680.59,24 CDM,809996,CMPD MIDZLM 100MG 100B,780.46,780.46,46.83,663.39,30 CDM,810001,MIDAZOLAM 5 MG/5 ML INJ,65.44,65.44,3.93,55.62,24 CDM,810015,MIDODRINE 2.5 MG PO,63.05,63.05,3.78,53.59,49 CDM,81006,GRAFT EVAS 20MM 11.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,810080,MINOXIDIL 2.5 MG PO,28.44,28.44,1.71,24.17,25 CDM,810081,MINOXIDIL 10 MG PO,53.17,53.17,3.19,45.19,25 CDM,810085,MIRTAZAPINE 15 MG PO,166.91,166.91,10.01,141.87,49 CDM,81009,SCREW BN 2.7MM 24MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,810090,MISOPROSTOL 100 MCG PO,36.88,36.88,2.21,31.35,25 CDM,810091,MISOPROSTOL 200 MCG PO,46.4,46.4,2.78,39.44,25 CDM,810101,"Injection, mitomycin, 5 mg ",11373.8,11373.8,28.46,229.34,10 CDM,810101,"Injection, mitomycin, 5 mg Chemotherapy Drugs",11373.8,11373.8,,,0 CDM,810101,MITOMYCIN 20 MG INJ,11373.8,11373.8,682.43,9667.73,19 CDM,81012,SCREW BN 2.7MM 18MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,810123,MODAFINIL 100 MG PO,354.84,354.84,21.29,301.61,49 CDM,810177,MONTELUKAST 10 MG PO,180.51,180.51,10.83,153.43,49 CDM,810194,MORPHINE SULF 2MG INJ,51.16,51.16,3.07,43.49,24 CDM,810195,MORPHINE SULF 4MG INJ,51.16,51.16,3.07,43.49,24 CDM,810210,MORPHINE 10MG PO,85.31,85.31,5.12,72.51,49 CDM,810220,MORPHINE SULF 10MG INJ,51.16,51.16,3.07,43.49,24 CDM,810222,MILRINONE LAC 20 MG INJ,22.78,22.78,1.37,19.36,24 CDM,810230,MORPHINE ER 15 MG PO,45.75,45.75,2.75,38.89,49 CDM,810235,MORPHINE 15 MG PO,11.12,11.12,0.67,9.45,49 CDM,810250,MORPHINE ER 30 MG PO,106.33,106.33,6.38,90.38,49 CDM,81029,SUTURE VIO BRD 4-0 27IN,81.5,81.5,4.89,69.28,49 CDM,810306,MOXIFLOXAC 0.5% 3 ML OPH,2481.78,2481.78,148.91,2109.51,49 CDM,810309,"Injection, moxifloxacin, 100 mg ",1328.93,1328.93,8.74,29.75,10 CDM,810309,MOXIFLOXACIN 400 MG INJ,1328.93,1328.93,79.74,1129.59,24 CDM,81035,DEVICE WNDCLS 30CM SZ0,2559.5,2559.5,153.57,2175.57,49 CDM,810406,MYCOPHENOLATE 500 MG PO,187.97,187.97,11.28,159.77,24 CDM,810460,NALBUPHINE 10 MG INJ,60.67,60.67,3.64,51.57,24 CDM,810555,NAPROXEN 250 MG PO,29.68,29.68,1.78,25.23,49 CDM,810595,NEBIVOLOL 2.5 MG PO,78.53,78.53,4.71,66.75,49 CDM,810650,NEOMYCIN 500 MG PO,81.6,81.6,4.9,69.36,49 CDM,810750,NEO/POLY/BAC 0.9 G TOP,2.47,2.47,0.15,2.1,49 CDM,810760,NEO/POLY/BAC 14.2G TOP,23.49,23.49,1.41,19.97,49 CDM,810770,NEO/POLY/BAC 3.5G OPHTH,92.79,92.79,5.57,78.87,49 CDM,810811,NIACIN ER 500 MG PO,93.96,93.96,5.64,79.87,49 CDM,810896,NICOTINE 2 MG PO,23.49,23.49,1.41,19.97,49 CDM,810910,NIFEDIPINE 10 MG PO,38.33,38.33,2.3,32.58,49 CDM,810920,NIFEDIPINE ER 30 MG PO,70.47,70.47,4.23,59.9,49 CDM,810931,NIFEDIPINE ER 90 MG PO,5.95,5.95,0.36,5.06,49 CDM,810940,NIMODIPINE 30 MG PO,414.19,414.19,24.85,352.06,49 CDM,810965,NITROF MONO/MAC 100MG PO,122.41,122.41,7.34,104.05,49 CDM,810981,NITROGLY 0.4 MG PO,11.12,11.12,0.67,9.45,49 CDM,810990,NITROGLY 0.1 MG/HR PATCH,63.05,63.05,3.78,53.59,49 CDM,811000,NITROGLY 0.2 MG/HR PATCH,64.29,64.29,3.86,54.65,49 CDM,811005,NITROGLY 0.3 MG/HR PATCH,122.41,122.41,7.34,104.05,49 CDM,811010,NITROGLY 0.4 MG/HR PATCH,81.6,81.6,4.9,69.36,49 CDM,811040,NITROGLY 4.9G SPRAY PO,3369.15,3369.15,202.15,2863.78,30 CDM,811111,NITROPRUSSIDE 50 MG INJ,85.67,85.67,5.14,72.82,30 CDM,811115,Contraceptive pills for birth control ,48.22,48.22,0.27,0.38,5 CDM,811115,NORG/EE 0.25/0.035MG PO,48.22,48.22,2.89,40.99,28 CDM,811130,NOREPINEPHRINE 4 MG INJ,265.82,265.82,15.95,225.95,49 CDM,811170,NORTRIPTYLINE 25 MG PO,32.14,32.14,1.93,27.32,49 CDM,811260,NYSTATIN 15 G TOP,58.11,58.11,3.49,49.39,49 CDM,811281,NYSTATIN 5 ML LIQ PO,64.29,64.29,3.86,54.65,49 CDM,811299,OCTREOT 50MCG ND SQIV,171.32,171.32,10.28,145.62,40 CDM,811304,OCTREOTID ND 1000MCG MDV,1029.11,1029.11,61.75,874.74,40 CDM,811316,AZITHROMYCIN 2 MG/ML INJ,69.0,69.0,4.14,58.65,24 CDM,811375,OLANZAPINE 5 MG PO,432.73,432.73,25.96,367.82,49 CDM,811402,"Injection, ondansetron hydrochloride, per 1 mg ",71.39,71.39,0.09,2.59,10 CDM,811402,ONDANSETRON 4 MG INJ,71.39,71.39,4.28,60.68,24 CDM,811405,ONDANSETRON 4 MG PO,794.74,794.74,47.68,675.53,24 CDM,811405,"Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage ",794.74,794.74,0.02,0.62,10 CDM,811448,OSELTAMIVIR 75 MG PO,394.99,394.99,23.7,335.74,49 CDM,811449,OSELTAMIVIR 30 MG PO,375.96,375.96,22.56,319.57,49 CDM,811470,"Injection, orphenadrine citrate, up to 60 mg ",795.93,795.93,8.22,29.48,10 CDM,811470,ORPHENADRINE 60 MG INJ,795.93,795.93,47.76,676.54,24 CDM,811532,OXCARBAZEPINE 300 MG PO,152.07,152.07,9.12,129.26,49 CDM,811534,OXCARBAZEPINE 150 MG PO,86.55,86.55,5.19,73.57,49 CDM,811535,OXYCODONE ER 10 MG PO,87.78,87.78,5.27,74.61,49 CDM,811540,OXYBUTYNIN 5 MG PO,19.79,19.79,1.19,16.82,49 CDM,811543,OXYBUTYNIN ER 5 MG PO,174.33,174.33,10.46,148.18,49 CDM,811545,OXYCODONE 5 MG PO,28.44,28.44,1.71,24.17,49 CDM,811546,OXYCODONE ER 20 MG PO,136.0,136.0,8.16,115.6,49 CDM,811550,OXYCOD/APAP 5/325 MG PO,11.12,11.12,0.67,9.45,49 CDM,811551,OXYCOD/APAP 10/325 MG PO,5.95,5.95,0.36,5.06,49 CDM,811580,"Injection, oxytocin, up to 10 units ",185.6,185.6,1.06,4.46,8 CDM,811580,OXYTOCIN 10 U INJ,185.6,185.6,11.14,157.76,25 CDM,811630,PAMIDRONATE 30 MG INJ,3927.29,3927.29,235.64,3338.2,24 CDM,811656,PANTOPRAZOLE 40 MG PO,200.3,200.3,12.02,170.25,49 CDM,811694,PARICALCITOL 1 MCG PO,364.74,364.74,21.88,310.03,49 CDM,811699,PAROXETINE 10 MG PO,102.62,102.62,6.16,87.23,49 CDM,811700,PAROXETINE 20 MG PO,158.25,158.25,9.49,134.51,49 CDM,811765,"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use ",2087.01,2087.01,117.88,362.08,10 CDM,811765,PEDIARIX VAC IM,2087.01,2087.01,125.22,1773.96,24 CDM,811820,PEN G BEN 1200000 U INJ,1621.6,1621.6,97.3,1378.36,19 CDM,811830,PEN G BEN 2400000 U INJ,2265.25,2265.25,135.91,1925.46,19 CDM,811840,PEN G BEN 600000 U INJ,983.9,983.9,59.03,836.32,19 CDM,811910,PCN V K 250 MG PO,11.12,11.12,0.67,9.45,49 CDM,811980,PENTOXIFYLL ER 400 MG PO,30.91,30.91,1.85,26.27,49 CDM,812,BLADE SHAVER DENSE MINI,26087.5,26087.5,1565.25,22174.38,49 CDM,812000,PERMETHRIN 5% 60G TOP,1808.83,1808.83,108.53,1537.51,49 CDM,812001,PERMETHRIN 1% 59ML TOP,337.53,337.53,20.25,286.9,49 CDM,812030,MINERAL OIL/PETR 3.5GOPH,4.95,4.95,0.3,4.21,49 CDM,812190,"Injection, phentolamine mesylate, up to 5 mg ",1621.6,1621.6,257.45,1361.91,10 CDM,812190,PHENTOLAMINE MES 5MG INJ,1621.6,1621.6,97.3,1378.36,35 CDM,812252,CMPD PHENYLEPN 1MG 10S,178.46,178.46,10.71,151.69,30 CDM,812411,PHENYTO 100MG/4ML LIQ PO,81.6,81.6,4.9,69.36,49 CDM,812440,PHENYTOIN 100 MG INJ,67.81,67.81,4.07,57.64,24 CDM,812450,PHENYTOIN 250 MG INJ,139.2,139.2,8.35,118.32,24 CDM,812460,PHENYTOIN ER 100 MG PO,23.49,23.49,1.41,19.97,49 CDM,812490,VIT K PHYTONAD 1 MG INJ,271.25,271.25,16.27,230.56,24 CDM,812500,VIT K PHYTONAD 10 MG INJ,557.98,557.98,33.48,474.28,24 CDM,812505,CMPD VIT K 5MG/5ML PO,425.31,425.31,25.52,361.51,46 CDM,812529,PILOCARPINE 5 MG PO,51.16,51.16,3.07,43.49,49 CDM,812530,PILOCARPINE 1% 15ML OPH,992.81,992.81,59.57,843.89,49 CDM,812598,ARIPIPRAZOLE 5 MG PO,683.72,683.72,41.02,581.16,49 CDM,812613,PIP SOD/TAZ 2.25 G INJ,615.09,615.09,36.91,522.83,24 CDM,812614,PIP SOD/TAZ 3.375 G INJ,725.74,725.74,43.54,616.88,24 CDM,812615,PIP SOD/TAZ 4.5 G INJ,916.09,916.09,54.97,778.68,24 CDM,812684,POLYETHYLEN (PEG) 17G PO,87.78,87.78,5.27,74.61,49 CDM,812690,POLYMXB/TRIMETH 10ML OPH,379.57,379.57,22.77,322.63,49 CDM,812720,POTASSI ACET 40 MEQ INJ,53.17,53.17,3.19,45.19,49 CDM,812790,POTASS CL 40 MEQ INJ,53.17,53.17,3.19,45.19,24 CDM,812795,K20 / WFI 100 ML INJ,185.6,185.6,11.14,157.76,24 CDM,812797,K10/WFI 100 ML INJ,185.6,185.6,11.14,157.76,24 CDM,812882,PRAMIPEXOLE 0.25 MG PO,136.0,136.0,8.16,115.6,49 CDM,812885,PRAMIPEXOLE 0.125 MG PO,75.42,75.42,4.53,64.11,49 CDM,812887,PRAMIPEXOLE 1 MG PO,136.0,136.0,8.16,115.6,49 CDM,812916,PRASUGREL 10 MG PO,274.48,274.48,16.47,233.31,49 CDM,812922,PRAVASTATIN 20 MG PO,117.78,117.78,7.07,100.11,49 CDM,812923,PRAVASTATIN 10 MG PO,102.32,102.32,6.14,86.97,49 CDM,812925,PRAXBIND 2.5 G INJ,13873.42,13873.42,832.41,11792.41,30 CDM,812950,PREDNISOLONE 15MG PO,117.78,117.78,7.07,100.11,24 CDM,812950,"Prednisolone oral, per 5 mg ",117.78,117.78,0.37,0.84,10 CDM,812960,PREDNISOLONE 1% 5 ML OPH,973.04,973.04,58.38,827.08,49 CDM,812980,PREDNISONE IR/DR 1 MG PO,10.7,10.7,0.64,9.09,24 CDM,812990,PREDNISONE 10 MG PO,11.12,11.12,0.67,9.45,24 CDM,813000,PREDNISONE 20 MG PO,11.12,11.12,0.67,9.45,24 CDM,813010,PREDNISONE 5 MG PO,11.9,11.9,0.71,10.12,24 CDM,813032,PREGABALIN 25 MG PO,106.33,106.33,6.38,90.38,49 CDM,813033,PREGABALIN 50 MG PO,122.41,122.41,7.34,104.05,49 CDM,813035,PREGABALIN 75 MG PO,122.41,122.41,7.34,104.05,49 CDM,813060,PRIMIDONE 250 MG PO,123.64,123.64,7.42,105.09,49 CDM,813070,PRIMIDONE 50 MG PO,58.11,58.11,3.49,49.39,49 CDM,813080,PROBENECID 500 MG PO,11.12,11.12,0.67,9.45,49 CDM,813123,PROCAINAMIDE 4 MG/ML INJ,1054.1,1054.1,63.25,895.98,19 CDM,813140,"Injection, prochlorperazine, up to 10 mg ",372.38,372.38,3.33,33.59,10 CDM,813140,PROCHLORPERAZ 10 MG INJ,372.38,372.38,22.34,316.52,24 CDM,813171,PROCHLORPERAZINE 5 MG PO,17.84,17.84,1.07,15.16,25 CDM,813179,PROGESTERONE 100 MG PO,75.42,75.42,4.53,64.11,49 CDM,813180,PROMETHAZIN 12.5 MG SUPP,163.2,163.2,9.79,138.72,49 CDM,813181,PROMETHAZINE 12.5 MG PO,8.33,8.33,0.5,7.08,25 CDM,813181,"Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to excee",8.33,8.33,0.12,0.28,8 CDM,813190,PROMETHAZINE 25 MG SUPP,191.64,191.64,11.5,162.89,49 CDM,813200,PROMETHAZINE 25 MG PO,19.04,19.04,1.14,16.18,49 CDM,813210,"Injection, promethazine hcl, up to 50 mg ",51.16,51.16,0.59,8.95,10 CDM,813210,PROMETHAZINE 25 MG INJ,51.16,51.16,3.07,43.49,24 CDM,813220,PROMETHAZINE 12.5 MG PO,10.7,10.7,0.64,9.09,49 CDM,813250,PROPAFENONE 150 MG PO,64.29,64.29,3.86,54.65,49 CDM,813270,PROPARACA 0.5% 15ML OPH,359.79,359.79,21.59,305.82,49 CDM,813281,PROPOFOL 1000 MG INJ,375.96,375.96,22.56,319.57,24 CDM,813283,PROPOFOL 200 MG INJ,297.43,297.43,17.85,252.82,24 CDM,813310,PROPRANOLOL 1 MG INJ,297.43,297.43,17.85,252.82,25 CDM,813320,PROPRANOLOL 10 MG PO,11.12,11.12,0.67,9.45,49 CDM,813335,PROPRANOLOL 40 MG PO,11.12,11.12,0.67,9.45,49 CDM,813370,PROPYLTHIOURAC 50 MG PO,11.12,11.12,0.67,9.45,49 CDM,813380,PROTAMINE 50 MG INJ,350.97,350.97,21.06,298.32,24 CDM,813385,PROTAMINE 250 MG INJ,315.27,315.27,18.92,267.98,24 CDM,813400,PSEUDOEPHEDRINE 30 MG PO,2.47,2.47,0.15,2.1,49 CDM,813470,PYRAZINAMIDE 500 MG PO,48.22,48.22,2.89,40.99,49 CDM,813471,PYRIDOSTIGMINE 60 MG PO,28.44,28.44,1.71,24.17,49 CDM,813515,QUETIAPINE 25 MG PO,123.64,123.64,7.42,105.09,49 CDM,813516,QUETIAPINE 100 MG PO,211.42,211.42,12.69,179.71,49 CDM,813603,IMOVAX 1 ML VAC IM,1752.82,1752.82,105.17,1489.9,19 CDM,813603,"Rabies vaccine, for intramuscular use ",1752.82,1752.82,315.22,1518.69,10 CDM,813608,RALOXIFENE 60 MG PO,152.07,152.07,9.12,129.26,49 CDM,813677,RANOLAZINE ER 500 MG PO,158.25,158.25,9.49,134.51,49 CDM,813678,ROPINIROLE 4 MG PO,129.68,129.68,7.78,110.23,49 CDM,813683,SIROLIMUS 1 MG PO,121.35,121.35,7.28,103.15,24 CDM,813721,"Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) ",2336.62,2336.62,78.9,257.15,10 CDM,813721,RHIG HMN FULLDOSE 300MCG,2336.62,2336.62,140.2,1986.13,24 CDM,813740,RIFAMPIN 300 MG PO,144.66,144.66,8.68,122.96,49 CDM,813741,RIFAMPIN 150 MG PO,92.73,92.73,5.56,78.82,49 CDM,813759,RIFAXIMIN 550 MG PO,900.08,900.08,54.0,765.07,49 CDM,813762,RIFAXIMIN 200 MG PO,231.21,231.21,13.87,196.53,49 CDM,813768,RISPERIDONE 0.25 MG PO,9.51,9.51,0.57,8.08,49 CDM,813770,RISPERIDONE 1 MG PO,226.26,226.26,13.58,192.32,49 CDM,813778,RIVASTIGMINE 1.5 MG PO,166.91,166.91,10.01,141.87,49 CDM,813788,ROPINIROLE 1 MG PO,129.82,129.82,7.79,110.35,49 CDM,813789,ROPINIROLE 0.25 MG PO,129.82,129.82,7.79,110.35,49 CDM,813798,RIVAROXABAN 10 MG PO,283.13,283.13,16.99,240.66,49 CDM,813799,ROFLUMILAST 500 MCG PO,230.81,230.81,13.85,196.19,49 CDM,813801,RIVAROXABAN 20 MG PO,309.1,309.1,18.55,262.74,49 CDM,813802,RIVAROXABAN 15 MG PO,309.1,309.1,18.55,262.74,49 CDM,813803,RIVAROXABAN 2.5 MG PO,70.19,70.19,4.21,59.66,49 CDM,813813,ROSUVASTATIN 20 MG PO,63.05,63.05,3.78,53.59,49 CDM,813835,SCOPOLAM 1MG/3 DAY PATCH,440.15,440.15,26.41,374.13,49 CDM,813960,SERTRALINE 50 MG PO,163.2,163.2,9.79,138.72,49 CDM,813968,SERTRALINE 100 MG PO,163.2,163.2,9.79,138.72,49 CDM,813971,SILDENAFIL CIT 20 MG PO,129.68,129.68,7.78,110.23,25 CDM,813971,"Sildenafil citrate, 25 mg ",129.68,129.68,0.65,6.45,8 CDM,813980,SILVER SULFA 1% 400G TOP,1106.57,1106.57,66.39,940.58,49 CDM,813985,SILVER SULFAD 1% 20G TOP,74.47,74.47,4.47,63.3,49 CDM,814010,SIMETH 40MG/0.6ML LIQ PO,32.14,32.14,1.93,27.32,49 CDM,814020,SIMETHICONE 80 MG PO,2.38,2.38,0.14,2.02,49 CDM,814050,SIMVASTATIN 10 MG PO,126.11,126.11,7.57,107.19,49 CDM,814051,SIMVASTATIN 5 MG PO,5.51,5.51,0.33,4.68,49 CDM,814052,SIMVASTATIN 20 MG PO,233.68,233.68,14.02,198.63,49 CDM,814060,"Injection, sincalide, 5 micrograms ",952.97,952.97,108.2,424.23,10 CDM,814060,SINCALIDE 5 MCG INJ,952.97,952.97,57.18,810.02,24 CDM,814100,POVIDONE IOD 10%28.4GTOP,126.11,126.11,7.57,107.19,49 CDM,814130,PEG + ELEC 4000ML LIQ PO,1266.06,1266.06,75.96,1076.15,49 CDM,814160,SOD ACETATE 40 MEQ INJ,70.47,70.47,4.23,59.9,49 CDM,814170,SODIUM BICARB 650 MG PO,11.12,11.12,0.67,9.45,49 CDM,814190,NA BICARB 5 MEQ INJ,192.88,192.88,11.57,163.95,49 CDM,814200,NA BICARB 50 MEQ INJ,126.11,126.11,7.57,107.19,49 CDM,814210,NA BICARB 50 MEQ INJ,53.17,53.17,3.19,45.19,49 CDM,814230,SOD PHOS 45 MMOL INJ,92.73,92.73,5.56,78.82,49 CDM,814383,TENIVAC VAC >= 7 YRS IM,1161.17,1161.17,69.67,986.99,24 CDM,814383,"Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use ",1161.17,1161.17,36.34,147.64,10 CDM,814400,SOD POLY 15G/60ML LIQ PO,211.42,211.42,12.69,179.71,49 CDM,814500,SOTALOL 80 MG PO,140.95,140.95,8.46,119.81,49 CDM,814510,SPIRONOLACTONE 25 MG PO,11.12,11.12,0.67,9.45,49 CDM,814520,SPIRONOLACTONE 50 MG PO,63.05,63.05,3.78,53.59,49 CDM,814580,SUCRALFATE 1 G PO,30.91,30.91,1.85,26.27,49 CDM,814690,SULFAMET/TMP 800/160MGPO,28.44,28.44,1.71,24.17,49 CDM,814720,SULFAMET/TMP 800/160MGPO,140.95,140.95,8.46,119.81,49 CDM,814721,SULFAMET/TMP 400/80MG PO,28.44,28.44,1.71,24.17,49 CDM,814740,SULFASALAZINE 500 MG PO,11.12,11.12,0.67,9.45,49 CDM,814780,"Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",2172.32,2172.32,47.41,117.75,8 CDM,814780,SUMATRIPTAN SUCC 6MG INJ,2172.32,2172.32,130.34,1846.47,41 CDM,814792,TACROLIMUS IMM 0.5 MG PO,98.74,98.74,5.92,83.93,24 CDM,814794,TACROLIMUS IMM 1 MG PO,261.74,261.74,15.7,222.48,24 CDM,814800,TAMOXIFEN 10 MG PO,86.85,86.85,5.21,73.82,25 CDM,814800,"Tamoxifen citrate, oral, 10 mg ",86.85,86.85,0.48,1.49,8 CDM,814800,"Tamoxifen citrate, oral, 10 mg Chemotherapy Drugs",86.85,86.85,,,0 CDM,814805,TAMSULOSIN 0.4 MG PO,164.44,164.44,9.87,139.77,49 CDM,814810,TEMAZEPAM 15 MG PO,30.91,30.91,1.85,26.27,49 CDM,814822,TENECTEPLASE 50 MG INJ,59160.41,59160.41,3549.62,50286.35,19 CDM,814825,TENOFOVIR 300 MG PO,1001.47,1001.47,60.09,851.25,49 CDM,814834,ADACEL VAC >= 7 YRS IM,1138.57,1138.57,68.31,967.78,24 CDM,814834,"Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use ",1138.57,1138.57,39.48,170.35,10 CDM,814855,TERBINAFINE 250 MG PO,705.97,705.97,42.36,600.07,49 CDM,814870,TERBUTALINE 1 MG INJ,192.74,192.74,11.56,163.83,24 CDM,814871,TERBUTALINE 1 MG/ML INJ,1024.36,1024.36,61.46,870.71,24 CDM,814890,TERBUTALINE 5 MG PO,49.45,49.45,2.97,42.03,30 CDM,814960,"Injection, tetanus immune globulin, human, up to 250 units ",8031.85,8031.85,558.12,1800.4,10 CDM,814960,TETANUS IG HUM 250 U INJ,8031.85,8031.85,481.91,6827.07,19 CDM,815323,TICAGRELOR 90 MG PO,160.62,160.62,9.64,136.53,49 CDM,815351,"Injection, tigecycline, 1 mg ",1399.12,1399.12,0.57,5.05,10 CDM,815351,TIGECYCLINE 50 MG INJ,1399.12,1399.12,83.95,1189.25,24 CDM,815360,TIMOLOL 0.25% 5 ML OPH,603.35,603.35,36.2,512.85,30 CDM,815380,TIMOLOL 0.5% 5 ML OPH,686.19,686.19,41.17,583.26,30 CDM,815410,TOBRAMYCIN 0.3% 5 ML OPH,603.35,603.35,36.2,512.85,30 CDM,815430,TOBRAMYCIN 80 MG INJ,97.56,97.56,5.85,82.93,24 CDM,815440,TOBR0.3%/DEX0.1%2.5MLOPH,29.74,29.74,1.78,25.28,30 CDM,815511,TOLVAPTAN 15 MG PO,5885.19,5885.19,353.11,5002.41,30 CDM,815516,TOPIRAMATE 100 MG PO,314.04,314.04,18.84,266.93,49 CDM,815517,TOPIRAMATE 25 MG PO,113.75,113.75,6.83,96.69,49 CDM,815550,TRAMADOL 50 MG PO,32.14,32.14,1.93,27.32,49 CDM,815551,TRAZODONE 100 MG PO,29.74,29.74,1.78,25.28,49 CDM,815553,TRANEXAMIC ACID 1 G INJ,208.95,208.95,12.54,177.61,49 CDM,815570,TRAZODONE 50 MG PO,11.12,11.12,0.67,9.45,49 CDM,815591,TRIAMCINOLO 0.1% 15G TOP,13.93,13.93,0.84,11.84,49 CDM,815620,TRIAMCINOLO 0.1% 15G TOP,53.17,53.17,3.19,45.19,49 CDM,815651,TRIAMCINOLN ACE 40MG INJ,359.29,359.29,21.56,305.4,24 CDM,815720,TRIFLURIDINE 1%7.5ML OPH,3078.59,3078.59,184.72,2616.8,30 CDM,815730,TRIHEXYPHENIDYL 2 MG PO,11.12,11.12,0.67,9.45,49 CDM,815810,TROPICAMIDE 1% 3ML OPH,667.65,667.65,40.06,567.5,49 CDM,815890,URSODIOL 300 MG PO,212.66,212.66,12.76,180.76,49 CDM,815892,URSODIOL 250 MG PO,149.6,149.6,8.98,127.16,49 CDM,815896,VALACYCLOVIR 500 MG PO,344.95,344.95,20.7,293.21,49 CDM,815898,VALGANCICLOVIR 450 MG PO,1468.82,1468.82,88.13,1248.5,49 CDM,815901,VALPRO ACID 250MG/5ML PO,10.7,10.7,0.64,9.09,49 CDM,815914,VALSARTAN 40 MG PO,92.73,92.73,5.56,78.82,49 CDM,815916,VALSARTAN 160 MG PO,104.7,104.7,6.28,89.0,49 CDM,815980,VECURONIUM 10 MG INJ,200.3,200.3,12.02,170.25,49 CDM,816000,VENLAFAXINE 37.5 MG PO,81.6,81.6,4.9,69.36,49 CDM,816005,VENLAFAXIN ER 37.5 MG PO,126.11,126.11,7.57,107.19,49 CDM,816006,VENLAFAXINE ER 75 MG PO,190.36,190.36,11.42,161.81,49 CDM,816010,VERAPAMIL ER AM 120MG PO,45.75,45.75,2.75,38.89,49 CDM,816015,VERAPAMIL 40 MG PO,10.7,10.7,0.64,9.09,49 CDM,816030,VERAPAMIL ER AM 180MG PO,93.96,93.96,5.64,79.87,49 CDM,816050,VERAPAMIL 5 MG INJ,730.71,730.71,43.84,621.1,49 CDM,816140,PETROLAT 93.5% 56.6G TOP,4.95,4.95,0.3,4.21,49 CDM,816141,VORICONAZOLE 200 MG PO,1525.69,1525.69,91.54,1296.84,49 CDM,816147,"Injection, voriconazole, 10 mg ",3722.66,3722.66,0.65,11.85,10 CDM,816147,VORICONAZOLE 200 MG INJ,3722.66,3722.66,223.36,3164.26,24 CDM,816150,WARFARIN 1 MG PO,48.22,48.22,2.89,40.99,49 CDM,816170,WARFARIN 2 MG PO,48.22,48.22,2.89,40.99,49 CDM,816171,WARFARIN 3 MG PO,53.17,53.17,3.19,45.19,49 CDM,816180,WARFARIN 2.5 MG PO,53.17,53.17,3.19,45.19,49 CDM,816190,WARFARIN 5 MG PO,53.17,53.17,3.19,45.19,49 CDM,816200,WARFARIN 7.5 MG PO,5.95,5.95,0.36,5.06,49 CDM,816331,ZIPRASIDONE 20 MG PO,314.04,314.04,18.84,266.93,49 CDM,816337,"Injection, ziprasidone mesylate, 10 mg ",816.16,816.16,5.87,67.07,10 CDM,816337,ZIPRASIDONE 20 MG INJ,816.16,816.16,48.97,693.74,24 CDM,816340,ZOLPIDEM 5 MG PO,246.05,246.05,14.76,209.14,49 CDM,816341,ZOLPIDEM 10 MG PO,246.05,246.05,14.76,209.14,49 CDM,816342,ZONISAMIDE 100 MG PO,134.76,134.76,8.09,114.55,49 CDM,816355,OLANZAPINE 2.5 MG PO,355.73,355.73,21.34,302.37,49 CDM,816380,GASTROGRAFIN 37% 120 ML,832.81,832.81,49.97,707.89,24 CDM,817009,ROD SPN 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,28 CDM,817032,STENT BIL 10MM 60MM,77450.0,77450.0,10068.5,65832.5,28 CDM,817033,STENT BIL 10MM 80MM,77450.0,77450.0,10068.5,65832.5,28 CDM,82006,ROD SPN 5.5MM 40MM,5265.0,5265.0,684.45,4475.25,28 CDM,82035,ROD SPN 5.5X45MM,5265.0,5265.0,684.45,4475.25,28 CDM,82052,STAPLER INT LONG 60MM,10099.0,10099.0,605.94,8584.15,49 CDM,82101,TUBE GASTM 18FR,1103.0,1103.0,66.18,937.55,49 CDM,82181,GRAFT EVAS 27MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,82182,TROCAR LAPSCP 5MM 100MM,2905.5,2905.5,174.33,2469.68,49 CDM,82245,GWIRE ORTH 1.35X150MM,1947.0,1947.0,116.82,1654.95,49 CDM,82298,TUBE CONN 14FR 30CM,532.5,532.5,31.95,452.63,49 CDM,82300,CATH GD JR4 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,82303,CATH ULTSND 8.5FR 90CM,29273.5,29273.5,1756.41,24882.47,49 CDM,82332,MESH SURG HRN 4IN 6IN,34909.0,34909.0,4538.17,29672.65,28 CDM,82333,MESH SURG 6IN,46940.0,46940.0,6102.2,39899.0,28 CDM,82334,MESH SURG 8X6IN,59480.0,59480.0,7732.4,50558.0,28 CDM,82337,MESH SURG GYN 10IN 8IN,57679.0,57679.0,7498.27,49027.15,28 CDM,82350,GWIRE VASC .014IN 300CM,4056.5,4056.5,243.39,3448.03,49 CDM,82475,MESH SURG 4.5IN,42026.0,42026.0,5463.38,35722.1,28 CDM,82619,SUTURE BV-1 7-0 1X30IN,610.0,610.0,36.6,518.5,49 CDM,82654,SHEATH INTRO 6FR 65CM,5102.0,5102.0,306.12,4336.7,49 CDM,82655,SHEATH INTRO 7FR 65CM,5102.0,5102.0,306.12,4336.7,49 CDM,82666,CATH GD ALI 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,82667,MODEL-5F CONVEY AL.75,2150.5,2150.5,129.03,1827.92,49 CDM,82669,GCATH 5F CONVEY LTBU3.75,2441.0,2441.0,146.46,2074.85,49 CDM,82670,CATH ANGIO 6FR 100CM,615.5,615.5,36.93,523.17,49 CDM,82677,KIT ENDO HYSTO PROC,8855.0,8855.0,531.3,7526.75,49 CDM,82737,CATH DLYS 15FR 62CM,2905.5,2905.5,174.33,2469.68,49 CDM,82859,MESH HRN LT 5.3X3.1IN,7064.0,7064.0,918.32,6004.4,28 CDM,82923,GWIRE VASC 300CM .014IN,6273.0,6273.0,376.38,5332.05,49 CDM,82928,CATH ANGIO 5FR 65CM,2905.5,2905.5,174.33,2469.68,49 CDM,82929,LEAD PCNG 58CM,6278.0,6278.0,816.14,5336.3,28 CDM,82932,GWIRE VASC .035IN 180CM,2905.5,2905.5,174.33,2469.68,49 CDM,82933,NEEDLE PERC 21GA 2.5CM,203.5,203.5,12.21,172.97,49 CDM,82935,CATH ANGIO 5FR 110CM,2421.5,2421.5,145.29,2058.28,49 CDM,83000,GRAFT EVAS 31X14.5M 13CM,100000.0,100000.0,13000.0,85000.0,28 CDM,83019,KIT BNGF FAST CURE 5CC,16845.0,16845.0,2189.85,14318.25,28 CDM,83035,ICD VVED 36.5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,83039,MESH SURG 4X6IN,14631.0,14631.0,1902.03,12436.35,28 CDM,83060,PROBE ESURG 220 APC,9085.5,9085.5,545.13,7722.68,49 CDM,83110,CRT-D VOLUME 36MM,100000.0,100000.0,13000.0,85000.0,28 CDM,83146,STAY ELASTIC RETR 12MM,506.0,506.0,30.36,430.1,49 CDM,83258,DILATOR VASC 12FR 20CM,563.5,563.5,33.81,478.98,49 CDM,83259,DILATOR VSC 8F 20CM,563.5,563.5,33.81,478.98,49 CDM,83280,CATH XTRN DRN 35CM 2.8MM,5436.5,5436.5,326.19,4621.02,49 CDM,83473,GWIRE VASC 185CM .014IN,19875.5,19875.5,1192.53,16894.17,49 CDM,83475,SYSTEM CATH ARTHRCM 135C,100000.0,100000.0,6000.0,85000.0,49 CDM,83476,GWIRE VASC ORBT 360,6358.0,6358.0,381.48,5404.3,49 CDM,83477,TACK ORTH PLT ANK DISP,5227.5,5227.5,313.65,4443.38,49 CDM,83504,SCREW GD 2.5MM 5MM,4705.0,4705.0,282.3,3999.25,49 CDM,83529,INTERLEUKIN 6 IA QN,718.75,718.75,43.13,610.94,27 CDM,83529,Interleukin-6 (IL-6) ,718.75,718.75,14.51,55.09,63 CDM,83610,FORCEPS BIP 33CM 5MM,6628.0,6628.0,397.68,5633.8,49 CDM,83680,KIT STENT PANC 5FR 3CM,6460.0,6460.0,839.8,5491.0,28 CDM,83682,SNARE RND 2.8MM 240MM,722.5,722.5,43.35,614.13,49 CDM,83685,STENT BIL 7FR 9CM,5286.0,5286.0,687.18,4493.1,28 CDM,83686,STENT BIL 10FR 5CM,5286.0,5286.0,687.18,4493.1,28 CDM,83687,STENT BIL 10FR 7CM,5286.0,5286.0,687.18,4493.1,28 CDM,83688,STENT BIL 10FR 9CM,5286.0,5286.0,687.18,4493.1,28 CDM,83699,SCREW BN 2.7MM 22MM,4642.0,4642.0,603.46,3945.7,28 CDM,83700,SCREW BN 2.7MM 24MM,4642.0,4642.0,603.46,3945.7,28 CDM,83702,DRILL BIT SURG 2.2MM,3471.0,3471.0,208.26,2950.35,49 CDM,83719,PIN HDLSS 3.2MM 75MM,7315.0,7315.0,438.9,6217.75,49 CDM,83739,LEAD CRT PCNG 55CM,66165.0,66165.0,8601.45,56240.25,28 CDM,83741,ENVELOPE MESH 2.5X2.7IN,14090.0,14090.0,1831.7,11976.5,28 CDM,83742,ENVELOPE MESH 2.9X3.3IN,14090.0,14090.0,1831.7,11976.5,28 CDM,83744,LEAD CRT PCNG 5.3FR 78CM,20827.0,20827.0,2707.51,17702.95,28 CDM,83747,KIT DLV FILTER EMBL FEM,57400.0,57400.0,7462.0,48790.0,28 CDM,83820,GWIRE ORTH 1.25MM 150MM,1281.5,1281.5,76.89,1089.28,49 CDM,84006,NRSTM IMP 44MM 51MM,100000.0,100000.0,13000.0,85000.0,28 CDM,84009,CATH BLNDIL 4MM 40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84011,CATH BLNDIL 4MM 80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84012,CATH BLNDIL 4MM 120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84013,CATH BLNDIL 5MM 40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84015,CATH BLNDIL 5MM 80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84016,CATH BLNDIL 5MM 120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84017,CATH BLNDIL 6MM 40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84018,CATH BLNDIL 6MM 60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84020,CATH BLNDIL 6MM 120MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84021,CATH BLNDIL 7MM 40MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84022,CATH BLNDIL 7MM 60MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84023,CATH BLNDIL 7MM 80MM,38517.5,38517.5,2311.05,32739.88,49 CDM,84056,DILATOR VASC 10FR 20CM,563.5,563.5,33.81,478.98,49 CDM,84095,GWIRE VASC 300CM .014IN,6273.0,6273.0,376.38,5332.05,49 CDM,84134,CMPNT FEM KN TWN PEG LG,36624.0,36624.0,4761.12,31130.4,28 CDM,84284,CATH BLNDIL 2MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84285,CATH BLNDIL 2.25MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84286,CATH BLNDIL 2.5MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84287,CATH BLNDIL 2.75MM 8MM,4391.0,4391.0,263.46,3732.35,49 CDM,84289,CATH BLNDIL 3.25MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84290,CATH BLNDIL 3.5MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84291,CATH BLNDIL 3.75MM 8MM,3317.0,3317.0,199.02,2819.45,49 CDM,84292,CATH BLNDIL 4MM 8MM,3765.0,3765.0,225.9,3200.25,49 CDM,84295,CATH BLNDIL 2MM 1MM,3317.0,3317.0,199.02,2819.45,49 CDM,84296,CATH BLNDIL 2.25MM 6MM,3317.0,3317.0,199.02,2819.45,49 CDM,84297,CATH BLNDIL 2.5MM 6MM,3317.0,3317.0,199.02,2819.45,49 CDM,84298,CATH BLNDIL 2.75MM 6MM,4391.0,4391.0,263.46,3732.35,49 CDM,84300,CATH BLNDIL 3.25MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,84301,CATH BLNDIL 3.5MM 12MM,4066.0,4066.0,243.96,3456.1,49 CDM,84302,CATH BLNDIL 3.75MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,84303,CATH BLNDIL 4MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,84304,CATH BLNDIL 4.5MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,84305,CATH BLNDIL 5MM 12MM,3765.0,3765.0,225.9,3200.25,49 CDM,84306,CATH BLNDIL 2MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,84307,CATH BLNDIL 2.25MM 15MM,3765.0,3765.0,225.9,3200.25,49 CDM,84308,CATH BLNDIL 2.5MM 15MM,3765.0,3765.0,225.9,3200.25,49 CDM,84309,CATH BLNDIL 2.75MM 15MM,3765.0,3765.0,225.9,3200.25,49 CDM,84311,CATH BLNDIL 3.25MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,84312,CATH BLNDIL 3.5MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,84314,CATH BLNDIL 4MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,84315,CATH BLNDIL 4.5MM 15MM,3317.0,3317.0,199.02,2819.45,49 CDM,84317,CATH BLNDIL 2MM 20MM,3765.0,3765.0,225.9,3200.25,49 CDM,84319,CATH BLNDIL 2.50X20MM,3317.0,3317.0,199.02,2819.45,49 CDM,84320,CATH BLNDIL 2.75MM 20MM,4391.0,4391.0,263.46,3732.35,49 CDM,84321,CATH BLNDIL 3MM 20MM,3765.0,3765.0,225.9,3200.25,49 CDM,84322,CATH BLNDIL 3.25MM 20MM,3317.0,3317.0,199.02,2819.45,49 CDM,84323,CATH BLNDIL 3.5MM 20MM,4066.0,4066.0,243.96,3456.1,49 CDM,84324,CATH BLNDIL 3.75MM 20MM,4391.0,4391.0,263.46,3732.35,49 CDM,84325,CATH BLNDIL 4MM 20MM,3765.0,3765.0,225.9,3200.25,49 CDM,84326,CATH BLNDIL 4.5MM 20MM,4066.0,4066.0,243.96,3456.1,49 CDM,84327,CATH BLNDIL 5MM 20MM,4066.0,4066.0,243.96,3456.1,49 CDM,84466,STENT EPRSTH 5MM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84469,STENT EPRSTH 6MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84470,STENT EPRSTH 6MM 15CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84472,STENT EPRSTH 7MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 CDM,84473,STENT EPRSTH 7MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84476,STENT EPRSTH 5MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84549,LEAD CRT PCNG 88CM,23440.0,23440.0,3047.2,19924.0,28 CDM,84550,STENT EPRSTH 5MM 25CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84551,STENT EPRSTH 6MM 5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84553,STENT EPRSTH 8MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 CDM,84554,STENT EPRSTH 8MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,84571,TROCAR LAPSCP 12MM 100MM,2491.0,2491.0,149.46,2117.35,49 CDM,84573,TROCAR LAPSCP 5MM 100MM,4098.5,4098.5,245.91,3483.72,49 CDM,84574,SLEEVE LAPSCP 5MM 100MM,1495.0,1495.0,89.7,1270.75,49 CDM,84575,TROCAR LAPSCP 8MM 100MM,2491.0,2491.0,149.46,2117.35,49 CDM,84577,TROCAR LAPSCP 5MM 100MM,4098.5,4098.5,245.91,3483.72,49 CDM,84578,SLEEVE LAPSCP 5MM 100MM,2789.5,2789.5,167.37,2371.07,49 CDM,84608,SNARE RND 2.8MM 240MM,722.5,722.5,43.35,614.13,49 CDM,84783,CATH INFS 5FR 100CM,3471.0,3471.0,208.26,2950.35,49 CDM,84784,CATH INFS 5FR 135CM,3596.5,3596.5,215.79,3057.03,49 CDM,84882,SCREW BN 2.7MM 14MM,3802.0,3802.0,494.26,3231.7,28 CDM,84922,INTRO CATH 14FR 30CM,4119.0,4119.0,247.14,3501.15,49 CDM,84936,SCREW BN 4.5MM 32MM,7257.0,7257.0,943.41,6168.45,28 CDM,84937,SCREW BN 4.5MM 34MM,6676.0,6676.0,867.88,5674.6,28 CDM,84957,CAGE SPN 4D 5X12X14MM,22538.0,22538.0,2929.94,19157.3,28 CDM,84966,HEAD FEM HIP -6MM 36MM,10032.0,10032.0,1304.16,8527.2,28 CDM,84981,CATH ANGIO 5FR 65CM,2905.5,2905.5,174.33,2469.68,49 CDM,850002,INS GASTRO TUBE PERC,9710.03,9710.03,582.6,8253.53,37 CDM,85106,CATH BLNDIL 5.5MM 12MM,4391.0,4391.0,263.46,3732.35,49 CDM,85107,CATH ANGIO DIL 5.50X15MM,3317.0,3317.0,199.02,2819.45,49 CDM,85108,CATH BLNDIL 5.5MM 20MM,4391.0,4391.0,263.46,3732.35,49 CDM,85110,CATH BLNDIL 6MM 12MM,3317.0,3317.0,199.02,2819.45,49 CDM,85111,CATH ANGIO DIL 6X15MM,4391.0,4391.0,263.46,3732.35,49 CDM,85112,CATH BLNDIL 6MM 20MM,4391.0,4391.0,263.46,3732.35,49 CDM,85120,RELOAD STPLR 60MM,12600.0,12600.0,1638.0,10710.0,28 CDM,85121,RELOAD STPLR 60MM,12600.0,12600.0,1638.0,10710.0,28 CDM,85150,SCREW BN 3.5MM 65MM,5218.0,5218.0,678.34,4435.3,28 CDM,85151,SCREW BN 3.5MM 85MM,5218.0,5218.0,678.34,4435.3,28 CDM,85152,SCREW BN 3.5X50MM,5218.0,5218.0,678.34,4435.3,28 CDM,85153,SCREW BN 3.5MM 70MM,5218.0,5218.0,678.34,4435.3,28 CDM,85154,SCREW BN LCK 3.5MM 75MM,5218.0,5218.0,678.34,4435.3,28 CDM,85156,SCREW BN 3.5MM 80MM,5218.0,5218.0,678.34,4435.3,28 CDM,85248,COIL EMBL 14CM 10MM,3505.0,3505.0,455.65,2979.25,28 CDM,85249,COIL EMBL 14CM 12MM,3505.0,3505.0,455.65,2979.25,28 CDM,85256,COIL EMBL 4.5LP 7CM 5MM,3249.0,3249.0,422.37,2761.65,28 CDM,85258,COIL EMBL 7CM 3MM PLTN,3225.0,3225.0,419.25,2741.25,28 CDM,85275,PASSER SUT SELF CAPTURE,33414.5,33414.5,2004.87,28402.33,49 CDM,85293,SCREW BN 2.7MM 16MM,3802.0,3802.0,494.26,3231.7,28 CDM,85297,DEVICE CATH GD 18X106CM,83044.0,83044.0,4982.64,70587.4,49 CDM,85310,GRAFT EVAS 16MM 9.5CM,100000.0,100000.0,13000.0,85000.0,28 CDM,85384,SET GSTRM ANCH FASTENER,4308.0,4308.0,258.48,3661.8,49 CDM,85471,CRT-D VOLUME 36MM,100000.0,100000.0,13000.0,85000.0,28 CDM,85489,CRT-P 59X59X6MM,93749.0,93749.0,12187.37,79686.65,28 CDM,85490,LEAD PCNG 58CM,68600.0,68600.0,8918.0,58310.0,28 CDM,85491,DILATOR VSC 14F 038X20,563.5,563.5,33.81,478.98,49 CDM,85493,DRAIN WND RND 7FR 3/32IN,459.0,459.0,27.54,390.15,49 CDM,85522,STENT NPHURSTM 24CM,3765.0,3765.0,489.45,3200.25,28 CDM,85523,SNARE VASC 9-15MM 120CM,11103.5,11103.5,666.21,9437.98,49 CDM,85524,LEAD ICD 62CM,51382.0,51382.0,6679.66,43674.7,28 CDM,85525,KIT BONE TAMP,80116.5,80116.5,4806.99,68099.02,49 CDM,85541,LEAD CRT PCNG 78CM,25754.0,25754.0,3348.02,21890.9,28 CDM,85557,STENT ESPH 18.5FR 23MM,71670.0,71670.0,9317.1,60919.5,28 CDM,85596,SUTURE BLU MONO 0 30IN,125.0,125.0,7.5,106.25,49 CDM,85646,POWDER COLGN TYPE1 1GM,12853.5,12853.5,771.21,10925.48,49 CDM,85667,STENT NPHURSTM 22CM,3765.0,3765.0,489.45,3200.25,28 CDM,856704,LEAD DEFIB 58CM,67522.0,67522.0,8777.86,57393.7,28 CDM,85723,CATH ANGIO 4FR 65CM,2905.5,2905.5,174.33,2469.68,49 CDM,85740,SYSTEM PRO LEAD DELIVERY,31276.5,31276.5,1876.59,26585.03,49 CDM,85789,TRAY CATH PICC 6FR 50CM,8130.5,8130.5,487.83,6910.93,49 CDM,85831,GWIRE VASC .018IN 300CM,7206.5,7206.5,432.39,6125.52,49 CDM,85884,SYSTEM FX ANCHOR 37CM,33236.0,33236.0,4320.68,28250.6,28 CDM,85886,SYSTM FX 30 TISS ANCHORS,27446.0,27446.0,3567.98,23329.1,28 CDM,85957,SCREW BN 3.5X18MM,5200.0,5200.0,676.0,4420.0,28 CDM,85958,SCREW BN T10 3.5X20MM,5200.0,5200.0,676.0,4420.0,28 CDM,86003,SYSTEM INTRO 9FR 19.5CM,6974.0,6974.0,418.44,5927.9,49 CDM,86023,SCREW BN LCK 3.5MM 14MM,3574.0,3574.0,464.62,3037.9,28 CDM,86060,CATH ATHRCM 145CM 1.25MM,96863.0,96863.0,5811.78,82333.55,49 CDM,86078,FORCEP ENDO 1MM 270CM,17431.0,17431.0,1045.86,14816.35,49 CDM,86079,CATH CHLGM DLV ACC,75494.5,75494.5,4529.67,64170.32,49 CDM,86099,GWIRE VASC .035IN 260CM,2542.5,2542.5,152.55,2161.13,49 CDM,86100,INTRO SHTH PNCL R/O,1918.0,1918.0,115.08,1630.3,49 CDM,86101,SHEATH INTRO 8FR 25CM,1918.0,1918.0,115.08,1630.3,49 CDM,86113,GUIDEWIRE ORTH 1.4X150MM,4558.5,4558.5,273.51,3874.72,49 CDM,8614,LEAD PCNG 6FR 58CM,6040.0,6040.0,785.2,5134.0,28 CDM,86167,LEAD PCNG 3.9-5.2FR 86CM,22228.0,22228.0,2889.64,18893.8,28 CDM,86171,LEAD PCNG 86CM,25979.0,25979.0,3377.27,22082.15,28 CDM,86325,GRAFT PRCN 5.9X3.9IN,100000.0,100000.0,13000.0,85000.0,28 CDM,86326,GRAFT PRCN 7.9X5.9IN,100000.0,100000.0,13000.0,85000.0,28 CDM,86362,GWIRE VASC 300CM .018IN,6273.0,6273.0,376.38,5332.05,49 CDM,86397,DRESSING WND CLEANSE MED,4282.0,4282.0,256.92,3639.7,49 CDM,86421,CATH BLNDIL 4MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,86429,ADAPTER CATH CKFL 9FR,872.0,872.0,52.32,741.2,49 CDM,86435,SCREW BN 3.5MM 16MM,5200.0,5200.0,676.0,4420.0,28 CDM,86504,ICD 12MM 36J ANG 51X68MM,100000.0,100000.0,13000.0,85000.0,28 CDM,86588,SYSTEM BN CEMENT DEL,25078.0,25078.0,3260.14,21316.3,28 CDM,86592,PCMKR DR 4.45X5.02X.75CM,42819.0,42819.0,5566.47,36396.15,28 CDM,86625,KIT SNARE RTRVL 20MM,22016.0,22016.0,1320.96,18713.6,49 CDM,86700,CATH BLNDIL 4MM 150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,86701,CATH BLNDIL 5MM 150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,86702,CATH BLNDIL 6MM 150MM,47762.0,47762.0,2865.72,40597.7,49 CDM,867534,INJ DISKOGRAM C/T SPI,28713.25,28713.25,1722.8,24406.26,37 CDM,867536,DIALYSIS CIRCUIT EMBOLJ,43510.23,43510.23,2610.61,36983.7,37 CDM,867537,DIAL SEG CTRL BLN ANGIOP,6716.4,6716.4,402.98,5708.94,37 CDM,867560,IMG GD FLD COL PER TV/TR,22046.5,22046.5,1322.79,18739.53,37 CDM,86784,CLIP LGT 2.8MM 235CM,7398.0,7398.0,961.74,6288.3,28 CDM,8683,PACKING NSL 10X1.5X2.5CM,965.5,965.5,57.93,820.67,49 CDM,86963,SUTURE CT-1 0 1X36IN,82.5,82.5,4.95,70.13,49 CDM,86969,MCTH INFS 3-2.4FR 130CM,10423.5,10423.5,625.41,8859.98,49 CDM,86976,SYS CATH DLV 9FR 80CM,22648.5,22648.5,1358.91,19251.22,49 CDM,86984,COIL EMBL 5MM 15CM,12935.0,12935.0,1681.55,10994.75,28 CDM,87009,STENT DUODENAL 22MM 90MM,79474.0,79474.0,10331.62,67552.9,28 CDM,87028,HEAD HIP TPR NK-6X28MM,10032.0,10032.0,1304.16,8527.2,28 CDM,87064,STEM HIP FEM STD 10X130,49208.0,49208.0,6397.04,41826.8,28 CDM,87097,INTRO SHEATH 18FR 33CM,17607.0,17607.0,1056.42,14965.95,49 CDM,87101,GRAFT EVAS 10CM 10MM,100000.0,100000.0,13000.0,85000.0,28 CDM,87150,SHELL ACTB HIP 54MM,22538.0,22538.0,2929.94,19157.3,28 CDM,87180,ELCTRD ESURG 50D 3.75MM,16080.0,16080.0,964.8,13668.0,49 CDM,8719,SUTURE P-3 6-0 1X18IN,2535.5,2535.5,152.13,2155.18,49 CDM,87229,CTHGD VBT 6F 070 IM 100,2371.0,2371.0,142.26,2015.35,49 CDM,87232,CATHGD VBT 6X070HSTK 100,2371.0,2371.0,142.26,2015.35,49 CDM,87233,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,87236,CATH GD AL1 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,87240,CATH ATHRCM 145CM 1.25MM,96863.0,96863.0,5811.78,82333.55,49 CDM,87244,SYSTEM CATH ARTHRCM 2MM,100000.0,100000.0,6000.0,85000.0,49 CDM,87297,ICD-S 12.7MM 83.1X69.1MM,100000.0,100000.0,13000.0,85000.0,28 CDM,87298,GWIRE VASC 300CM .014IN,5018.5,5018.5,301.11,4265.73,49 CDM,87328,CATH INTVN 2.9FR 135CM,18642.5,18642.5,1118.55,15846.13,49 CDM,87346,INTRO SHEATH 10FR 33CM,14790.0,14790.0,887.4,12571.5,49 CDM,87352,CATH ANGIO 4.0FR 100CM,601.5,601.5,36.09,511.27,49 CDM,87354,VALVE HMSTS 8FR,1582.0,1582.0,94.92,1344.7,49 CDM,87403,SHEATH NVGRT 12/14F 36CM,4081.0,4081.0,244.86,3468.85,49 CDM,87512,PASSER SURG 38CM ONQ PNB,3096.0,3096.0,185.76,2631.6,49 CDM,87598,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,87645,SHEATH GD RDC 6FR 45CM,4349.5,4349.5,260.97,3697.07,49 CDM,87646,SHTH DSTN 7F 45 C-C RDC,4349.5,4349.5,260.97,3697.07,49 CDM,87648,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,87735,PCMKR CRD 47X50X6MM,46215.0,46215.0,6007.95,39282.75,28 CDM,87755,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,87786,PCMKR CRD 47X50X6MM,45489.0,45489.0,5913.57,38665.65,28 CDM,87798,BURR SURG RND 38X4MM,2905.5,2905.5,174.33,2469.68,49 CDM,87819,STENT ESPH 18.5FR 23MM,71144.0,71144.0,9248.72,60472.4,28 CDM,88013,GWIRE ENDO .035IN 260CM,6273.0,6273.0,376.38,5332.05,49 CDM,8873,CATH ANGIO 4.0FR 100CM,601.5,601.5,36.09,511.27,49 CDM,8875,CATH ANGIO 4FR 110CM,601.5,601.5,36.09,511.27,49 CDM,8876,CATHDX ANGI JR4 F4 100CM,601.5,601.5,36.09,511.27,49 CDM,8878,SUTURE UND BRD 2-0 27IN,194.5,194.5,11.67,165.32,49 CDM,88979,RPLC DUO OR JEJSTMY TUBE,15122.34,15122.34,907.34,12853.99,37 CDM,8916,BLADE OPTH 180D MINI,704.0,704.0,42.24,598.4,49 CDM,8971,KIT WND DRN 400CC 1/8IN,809.0,809.0,48.54,687.65,49 CDM,900004,INTENSIVE CARE UNIT,11767.9,11767.9,,,0 CDM,900005,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900006,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900007,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900008,INTENSIVE CARE UNIT,11767.9,11767.9,,,0 CDM,900009,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900010,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900011,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900012,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,900013,ISOLATION STERILE ENVIR,4461.53,4461.53,,,0 CDM,900014,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900016,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900017,INTENSIVE CARE UNIT,11767.9,11767.9,,,0 CDM,900019,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900020,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900021,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900022,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,900023,ISOLATION STERILE ENVIR,4461.53,4461.53,,,0 CDM,900024,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900025,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900026,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900027,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900029,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900030,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900031,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,900032,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,900033,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,900034,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,900543,FFP,468.0,468.0,28.08,397.8,32 CDM,900543,"Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit ",468.0,468.0,435.17,587.8,12 CDM,900545,RBC DEGLYCEROLIZED EA UN,2416.52,2416.52,144.99,2054.04,28 CDM,900545,"Red blood cells, deglycerolized, each unit ",2416.52,2416.52,244.66,1800.68,18 CDM,900546,CRYOPRECIPITATE,449.0,449.0,26.94,381.65,32 CDM,900550,PLTS PH LR IRR EA UNIT,7021.65,7021.65,421.3,5968.4,28 CDM,900550,"Platelets, pheresis, leukocytes reduced, irradiated, each unit ",7021.65,7021.65,483.98,7315.48,18 CDM,900551,RBC LEUKOREDUC IRR EA UN,1823.4,1823.4,109.4,1549.89,28 CDM,900551,"Red blood cells, leukocytes reduced, irradiated, each unit ",1823.4,1823.4,215.83,2446.22,18 CDM,900567,CARDIOVERSION EXTERNAL,3332.23,3332.23,199.93,2832.4,43 CDM,900745,INJ EPI C/T W IMAGING,10443.08,10443.08,626.58,8876.62,37 CDM,900750,REPO PREV PLCD CVC FLURO,5166.66,5166.66,310.0,4391.66,37 CDM,900780,CATH 1ST OD RENAL BIL,37568.7,37568.7,2254.12,31933.39,37 CDM,900783,INS CVC NON-TUN CENT=>5Y,9779.28,9779.28,586.76,8312.39,37 CDM,900786,INS PICC WO PORT/IMG=>5Y,9779.28,9779.28,586.76,8312.39,37 CDM,900787,INS CVAD W/ SQ PUMP,14633.64,14633.64,878.02,12438.59,37 CDM,900790,REPL TUN CVAD W/ PUMP,9779.28,9779.28,586.76,8312.39,37 CDM,900792,REM TUN CV CATH WO/P-P,17329.35,17329.35,1039.76,14729.95,37 CDM,900794,DECLOT THROM IMP VAD CTH,9201.73,9201.73,552.1,7821.47,37 CDM,900795,CONT INJ EX CVAD W FLURO,3589.49,3589.49,215.37,3051.07,37 CDM,900798,INSRT IVC FILTER W IMAG,61204.15,61204.15,3672.25,52023.53,37 CDM,900799,REMOVAL IVCF ENDO APRCH,41998.39,41998.39,2519.9,35698.63,37 CDM,900804,TRANSCTH STNT PLC IN VN,152072.81,152072.81,9124.37,129261.89,37 CDM,900806,VASC EMBOL TUM/ORG/INF,67708.86,67708.86,4062.53,57552.53,37 CDM,900819,CATH AORTA,8860.68,8860.68,531.64,7531.58,34 CDM,900826,CATH 3RD ORD UP ART,9587.2,9587.2,575.23,8149.12,34 CDM,900844,PLACE NG/OG TUBE FLUORO,7003.86,7003.86,420.23,5953.28,37 CDM,901112,DUP LE ART BIL,3835.39,3835.39,230.12,3260.08,33 CDM,901113,DUP VEIN BIL,6121.63,6121.63,367.3,5203.39,33 CDM,901116,DUP AO/IVC/IV/BPG COMP,3376.62,3376.62,202.6,2870.13,33 CDM,901116,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",3376.62,3376.62,180.76,491.25,18 CDM,901119,DUP EXTRACRANIAL BIL,5074.46,5074.46,304.47,4313.29,33 CDM,901142,DUP AO/IVC/IV/BPG LTD,2846.68,2846.68,170.8,2419.68,33 CDM,901142,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",2846.68,2846.68,106.88,362.02,18 CDM,901143,DUP A/V STUDY,1874.49,1874.49,112.47,1593.32,33 CDM,901143,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",1874.49,1874.49,106.88,362.02,18 CDM,901144,DOP ART 1-2 LEVELS BIL,1010.32,1010.32,60.62,858.77,39 CDM,901144,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",1010.32,1010.32,255.13,352.17,5 CDM,901145,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",1621.6,1621.6,128.31,366.67,18 CDM,901145,DOP ART >3 LEVELS BIL,1621.6,1621.6,97.3,1378.36,33 CDM,901146,DUP LE ART UNI/LTD,2253.2,2253.2,135.19,1915.22,33 CDM,901188,I123 IOFLUPANE DX 5MCI,21984.36,21984.36,1319.06,18686.71,36 CDM,901188,"Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries ",21984.36,21984.36,4817.93,8248.78,8 CDM,9019,CATH URTH INTRMT 14FR,57.0,57.0,3.42,48.45,49 CDM,902049,CYCLOSP 100 MG/ML LIQ PO,8.28,8.28,0.5,7.04,24 CDM,902058,FLUCONAZOL 200MG/5ML LIQ,1791.73,1791.73,107.5,1522.97,49 CDM,902204,DESMOPRESSIN 1 MCG INJ,113.02,113.02,6.78,96.07,24 CDM,902254,FILGRASTIM 1 MCG INJ,10.7,10.7,0.64,9.09,19 CDM,902254,"Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram ",10.7,10.7,1.02,3.09,10 CDM,902900,REM DEVITLIZD TISS NS PT,724.68,724.68,43.48,615.98,33 CDM,902900,"Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound as",724.68,724.68,408.87,564.38,5 CDM,902936,CAT 1 ED PROCEDURE,658.66,658.66,85.63,559.86,44 CDM,902937,CAT 2 ED PROCEDURE,1322.24,1322.24,171.89,1123.9,44 CDM,902938,CAT 3 ED PROCEDURE,2202.49,2202.49,286.32,1872.12,44 CDM,902939,LVL 1 EMER DEPT,430.64,430.64,72.35,366.04,9 CDM,902941,LVL 2 EMER DEPT,799.45,799.45,134.31,679.53,9 CDM,902942,LVL 3 EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CDM,902943,LVL 4 EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CDM,902944,LVL 5 EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CDM,902947,IV HYDRAT INIT UP TO 1HR,909.75,909.75,118.27,773.29,34 CDM,902948,IV HYDRAT EA ADD HR,394.19,394.19,51.24,335.06,34 CDM,902949,IV INITIAL UP TO 1 HOUR,909.75,909.75,118.27,773.29,34 CDM,902950,IV EACH ADD HOUR,394.19,394.19,51.24,335.06,34 CDM,902951,IV ADDL SEQ INF UP TO 1H,394.19,394.19,51.24,335.06,34 CDM,902952,IV CONCURRENT INFUSION,394.19,394.19,51.24,335.06,39 CDM,902953,IVP SINGLE/INITIAL DRUG,1138.03,1138.03,147.94,967.33,34 CDM,902954,IVP EA ADD SEQ NEW DRUG,1138.03,1138.03,147.94,967.33,34 CDM,902955,IVP EA ADD SEQ SAME DRUG,1138.03,1138.03,147.94,967.33,39 CDM,902956,INJECTION IM OR SQ,825.12,825.12,107.27,701.35,34 CDM,902957,CRIT CARE EACH ADD 30MIN,1265.6,1265.6,164.53,1075.76,23 CDM,902962,OBS PER HOUR,484.82,484.82,67.87,412.1,15 CDM,902966,OBS PER HOUR,242.41,242.41,33.94,206.05,15 CDM,902968,OBS PER HOUR,242.41,242.41,33.94,206.05,15 CDM,902970,OBS PER HOUR,242.41,242.41,33.94,206.05,15 CDM,902972,OBS PER HOUR,282.81,282.81,39.59,240.39,15 CDM,902988,EVAL PT LOW COMPLEX,1052.7,1052.7,63.16,894.79,20 CDM,902989,EVAL PT MOD COMPLEX,1052.7,1052.7,63.16,894.79,20 CDM,902990,EVAL PT HIGH COMPLEX,1052.7,1052.7,63.16,894.79,20 CDM,902991,RE-EVALUATION PT,1067.96,1067.96,64.08,907.77,20 CDM,904080,SUTURE MO7 22MM 1/2C,2905.5,2905.5,174.33,2469.68,49 CDM,904193,PRIVATE DELUXE,5349.77,5349.77,,,0 CDM,904194,PRIVATE ROOM,5074.02,5074.02,,,0 CDM,904195,SEMI-PRIVATE ROOM,4882.14,4882.14,,,0 CDM,904196,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,904197,PRIVATE DELUXE,5349.77,5349.77,,,0 CDM,904198,PRIVATE SUITE,5074.02,5074.02,,,0 CDM,904199,INTENSIVE CARE INTERMED,9175.38,9175.38,,,0 CDM,904200,SEMI-PRIVATE OBSTETRICS,2432.0,2432.0,,,0 CDM,904201,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,904202,PSYCHIATRIC ISOLATION,6395.57,6395.57,,,0 CDM,904203,SEMI-PRIVATE PSYCHIATRIC,6882.26,6882.26,,,0 CDM,904204,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,904206,HIGH RISK OB SEMI-PRIV,3459.0,3459.0,,,0 CDM,904207,PRIV ISOLATION,5074.02,5074.02,,,0 CDM,904327,INTRCRN ART THROMBECTOMY,30622.33,30622.33,1837.34,26028.98,37 CDM,904560,ADMIN PNEUMOCOCCAL VAC,279.41,279.41,16.76,237.5,39 CDM,9046,TIP VACURETE CRV RND 8MM,221.5,221.5,13.29,188.28,49 CDM,904694,DIRECT REFERRAL TO OBS,727.23,727.23,101.81,618.15,10 CDM,904695,DIRECT REFERRAL TO OBS,1212.05,1212.05,169.69,1030.24,10 CDM,904723,IV HYDRAT EA ADD HR,307.33,307.33,18.44,261.23,39 CDM,904834,ABL 1/MORE RENL TU PC RF,54724.26,54724.26,3283.46,46515.62,37 CDM,911696,"Injection, paricalcitol, 1 mcg ",274.83,274.83,1.02,3.92,10 CDM,911696,PARICALCITOL 2 MCG INJ,274.83,274.83,16.49,233.61,24 CDM,911979,BIKTARVY 50/200/25 MG PO,712.65,712.65,42.76,605.75,30 CDM,916,AMPICILLIN 250 MG/ML INJ,98.74,98.74,5.92,83.93,24 CDM,921921,DIALYSIS CIRC DX ANGIO,9192.58,9192.58,551.55,7813.69,37 CDM,9250,KIT CRTD SHNT 6IN,21561.0,21561.0,1293.66,18326.85,49 CDM,93697,SCREW BN 2.7MM 18MM,3802.0,3802.0,494.26,3231.7,28 CDM,937217,INJ DISKOGRAM L-SPIN,28713.25,28713.25,1722.8,24406.26,37 CDM,948,STAPLER INT 60MM,5653.0,5653.0,339.18,4805.05,49 CDM,950087,SET GRVTY IRR INFL 11FT,483.5,483.5,29.01,410.98,49 CDM,950090,ROD SPN 5.5MM 90MM,5265.0,5265.0,684.45,4475.25,28 CDM,950100,CTHDX IMG2 5F035CNTRA 65,627.0,627.0,37.62,532.95,49 CDM,950102,SUTURE VIOL MON+2-0 27IN,123.0,123.0,7.38,104.55,49 CDM,950103,SUTURE VIOL MON+4-0 27IN,124.5,124.5,7.47,105.83,49 CDM,950104,SUTURE VIOL MON +0 27IN,124.5,124.5,7.47,105.83,49 CDM,950105,SUTURE VIOL MON +1 36IN,137.5,137.5,8.25,116.88,49 CDM,950106,SUTURE VIOL MON +1 36IN,142.5,142.5,8.55,121.13,49 CDM,950107,SUTURE VIOL MON+3-0 27IN,125.5,125.5,7.53,106.67,49 CDM,950109,SUTURE VIO MON +4-0 18IN,262.5,262.5,15.75,223.13,49 CDM,950110,SUTURE VIOL MON+3-0 18IN,249.0,249.0,14.94,211.65,49 CDM,950111,SUT VIO MON +1 27IN,141.5,141.5,8.49,120.28,49 CDM,950113,SUTURE VIOL MON +1 96IN,236.0,236.0,14.16,200.6,49 CDM,950114,SUTURE VIO MON +0 60IN,272.5,272.5,16.35,231.63,49 CDM,950120,CATH BLNDIL 5MM 150MM,6319.5,6319.5,379.17,5371.57,49 CDM,950121,CATH BLNDIL 5MM 200MM,6303.5,6303.5,378.21,5357.98,49 CDM,950122,CATH BLNDIL 5MM 220MM,6303.5,6303.5,378.21,5357.98,49 CDM,950123,CATH BLNDIL 6MM 150MM,6273.0,6273.0,376.38,5332.05,49 CDM,950124,CATH BLNDIL 6MM 200MM,6303.5,6303.5,378.21,5357.98,49 CDM,950125,CATH BLNDIL 6MM 220MM,6303.5,6303.5,378.21,5357.98,49 CDM,950126,CATH BLNDIL 7MM 150MM,9836.5,9836.5,590.19,8361.02,49 CDM,950127,CATH BLNDIL 7MM 200MM,6303.5,6303.5,378.21,5357.98,49 CDM,950128,CATH BLNDIL 7MM 220MM,6303.5,6303.5,378.21,5357.98,49 CDM,950143,CATH BLN 40MM 80CM,10164.5,10164.5,609.87,8639.83,49 CDM,950151,CATH DRN 16FR 25CM,2905.5,2905.5,174.33,2469.68,49 CDM,950157,CATH GD 130D 7.1FR 5.7FR,7677.0,7677.0,460.62,6525.45,49 CDM,950163,SCREW BN 1.5MM 5MM,4228.0,4228.0,549.64,3593.8,28 CDM,950176,SCREW SPN DSTRCT 14MM,2201.0,2201.0,286.13,1870.85,28 CDM,950182,LEAD DEFIB 65CM,74775.0,74775.0,9720.75,63558.75,28 CDM,950189,BAG DRAIN 600ML 61CM,551.5,551.5,33.09,468.77,49 CDM,950193,GWIRE CATH .027IN 130CM,19320.5,19320.5,1159.23,16422.42,49 CDM,950212,BUR DMD RND 6 ELITE X-,4423.5,4423.5,265.41,3759.97,49 CDM,950213,INTRO SHTH 5FR 25CM,1424.0,1424.0,85.44,1210.4,49 CDM,950220,BANDAGE ADH DRY 4X3.6IN,484.0,484.0,29.04,411.4,49 CDM,950227,BLADE BONE MILL MED 5MM,8909.5,8909.5,534.57,7573.07,49 CDM,950229,WAND BIP SLR 5MM 12.75IN,17607.0,17607.0,1056.42,14965.95,49 CDM,950230,BURR EAR 50MM,4423.5,4423.5,265.41,3759.97,49 CDM,950231,TUBING ANGIO 1200 P148IN,181.5,181.5,10.89,154.28,49 CDM,950242,NEEDLE BX 17GA 6.8CM,602.0,602.0,36.12,511.7,49 CDM,950249,INTRODUCER SHTH 8FR 45CM,2905.5,2905.5,174.33,2469.68,49 CDM,950251,COLLECTOR BN DUST DISP,2324.5,2324.5,139.47,1975.83,49 CDM,950276,PACKING WND 36X4IN,366.5,366.5,21.99,311.52,49 CDM,950324,TUBING PRSS MNTR 72IN,174.5,174.5,10.47,148.32,49 CDM,950339,CTHGD 8F 100CM M1 JL3.5,2150.5,2150.5,129.03,1827.92,49 CDM,950344,CTHGD 8F 100CM M1 JL4,2150.5,2150.5,129.03,1827.92,49 CDM,950355,KIT CATH EXP 1IN 3.25IN,2905.5,2905.5,174.33,2469.68,49 CDM,950360,SCREW BN 6.5MM 45MM,3498.0,3498.0,454.74,2973.3,28 CDM,950362,KIT PRSS MNTR 3W 60IN,627.0,627.0,37.62,532.95,49 CDM,950364,TRAY NDL 10/12GA 10/14CM,13034.0,13034.0,782.04,11078.9,49 CDM,950383,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,950386,FORCEPS RTRVL 3FR 120CM,14966.0,14966.0,897.96,12721.1,49 CDM,950387,NEEDLE BN BIOP 11GA 15CM,2905.5,2905.5,174.33,2469.68,49 CDM,950393,SHEARS ESURG 23CM 5MM,12091.5,12091.5,725.49,10277.77,49 CDM,950398,TUBE NJJ 240CM 8FR,7395.0,7395.0,443.7,6285.75,49 CDM,950401,CTH CREBRL SIM 1 5F BXT,1151.0,1151.0,69.06,978.35,49 CDM,950408,CATH BLN 20MM 80CM,10164.5,10164.5,609.87,8639.83,49 CDM,950410,GWIRE VASC 190CM .014IN,5034.0,5034.0,302.04,4278.9,49 CDM,950413,INSTR BX 18GA 25CM,2663.0,2663.0,159.78,2263.55,49 CDM,950420,DEVICE TISS SLR 3MM,13425.5,13425.5,805.53,11411.67,49 CDM,950427,INTRO CATH UNIV MIC 6FR,1739.5,1739.5,104.37,1478.58,49 CDM,950446,INTRODUCER CATH 6FR 45CM,2905.5,2905.5,174.33,2469.68,49 CDM,950453,SNARE VASC 2-4MM 175CM,18575.0,18575.0,1114.5,15788.75,49 CDM,950455,BLADE CUT 1.5MM 98CM,100000.0,100000.0,6000.0,85000.0,49 CDM,950460,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,950468,KIT PRSS MNTR 3W 84IN,1867.5,1867.5,112.05,1587.38,49 CDM,950469,KIT PRSS TRNDCR 1 3ML/HR,1494.0,1494.0,89.64,1269.9,49 CDM,950470,TUBING PRSS MNTR 24IN,204.0,204.0,12.24,173.4,49 CDM,950475,SET TRANSDUCER BP 12IN,549.0,549.0,32.94,466.65,49 CDM,950479,MESH SURG 5IN 7IN,7854.0,7854.0,1021.02,6675.9,28 CDM,950480,MESH SURG 5IN 7IN,9742.0,9742.0,1266.46,8280.7,28 CDM,950486,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,950487,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,950491,TRAY LBRCTH FOL 16FR,465.5,465.5,27.93,395.68,49 CDM,950496,SUTURE CT-1 3-0 1X36IN,87.5,87.5,5.25,74.38,49 CDM,950501,ROD SPNL L80MM OD5.5MM Q,5265.0,5265.0,684.45,4475.25,28 CDM,950524,ROD SPN 5.5MM 500MM,5265.0,5265.0,684.45,4475.25,28 CDM,950537,JOINT FNGR COMPONENT 30D,50287.0,50287.0,6537.31,42743.95,28 CDM,950551,STIMULATOR NS MICROSTIM,14374.0,14374.0,862.44,12217.9,49 CDM,950563,STENT BIL 6FR 10MM 37MM,22025.0,22025.0,2863.25,18721.25,28 CDM,950564,STENT BIL 6FR 7MM 37MM,21020.0,21020.0,2732.6,17867.0,28 CDM,950565,STENT BIL 6FR 8MM 37MM,24007.0,24007.0,3120.91,20405.95,28 CDM,950566,STENT BIL 7FR 10MM 37MM,27488.0,27488.0,3573.44,23364.8,28 CDM,950570,CATH BLNDIL 6X20MM 135CM,3952.0,3952.0,237.12,3359.2,49 CDM,950571,CATH BLNDIL 6X20MM 135CM,3973.0,3973.0,238.38,3377.05,49 CDM,950572,CATH BLNDIL 8X80MM 135CM,6273.0,6273.0,376.38,5332.05,49 CDM,950578,SCREW BN 6.5X2.9MM 85MM,9511.0,9511.0,1236.43,8084.35,28 CDM,950579,SCREW BN 6.5X100X32MM,11675.0,11675.0,1517.75,9923.75,28 CDM,950583,GRAFT CV 6MM 40CM,78730.0,78730.0,10234.9,66920.5,28 CDM,950591,SUTURE CT-1 1 1X36IN,92.0,92.0,5.52,78.2,49 CDM,950596,HANDPIECE ESURG PNCL SGL,2905.5,2905.5,174.33,2469.68,49 CDM,950601,SUTURE CTX 1 8X18IN,592.5,592.5,35.55,503.63,49 CDM,950620,IMPLANT BREAST 150CC,32338.0,32338.0,4203.94,27487.3,28 CDM,950640,DRESSING NADH 4X4IN,414.5,414.5,24.87,352.32,49 CDM,950647,GWIRE ORTH 0.8MM 70MM,627.0,627.0,37.62,532.95,49 CDM,950653,BLADE SHAVER 13CM 4.2MM,2615.0,2615.0,156.9,2222.75,49 CDM,950656,PCMKR CRD 4.45X5.88X0.75,42819.0,42819.0,5566.47,36396.15,28 CDM,950657,DRSG WND AG 4X12IN,2014.0,2014.0,120.84,1711.9,49 CDM,950670,NEEDLE BX 22GA 15CM,282.5,282.5,16.95,240.13,49 CDM,950671,INTRODUCER SHTH 6FR 90CM,5269.5,5269.5,316.17,4479.07,49 CDM,950672,STENT PANC 7FR 5CM,4992.0,4992.0,648.96,4243.2,28 CDM,950673,STENT PANC 7FR 7CM,4992.0,4992.0,648.96,4243.2,28 CDM,950682,BAG DRN URO SURG,7108.0,7108.0,426.48,6041.8,49 CDM,950685,ELECTRODE ESURG 10FT,148.0,148.0,8.88,125.8,49 CDM,950687,STEM FEM HIP 8MM 136MM,47893.0,47893.0,6226.09,40709.05,28 CDM,950693,CUP KOH OCCLDR SS 3.5CM,3663.5,3663.5,219.81,3113.97,49 CDM,950694,CUP KOH OCCLDR SS 4.0CM,3663.5,3663.5,219.81,3113.97,49 CDM,950695,CUP KOH OCCLDR SS 3.0CM,3663.5,3663.5,219.81,3113.97,49 CDM,950702,GWIRE KNIFE 5.5FR 200CM,6417.5,6417.5,385.05,5454.88,49 CDM,950704,SNARE RND 2.8MM 240MM,962.5,962.5,57.75,818.13,49 CDM,950705,SNARE MED OVAL 240CM,1027.0,1027.0,61.62,872.95,49 CDM,950718,SNARE POLY 7FR 3CM 6CM,564.5,564.5,33.87,479.82,49 CDM,950729,INTRODUCER SHTH 7FR 90CM,5269.5,5269.5,316.17,4479.07,49 CDM,950738,PCMKR DR 50.3X47.9X7.5MM,100000.0,100000.0,13000.0,85000.0,28 CDM,950741,GWIRE VASC .035IN 260CM,814.0,814.0,48.84,691.9,49 CDM,950746,CATH ANGIO 5FR 65CM,671.5,671.5,40.29,570.77,49 CDM,950752,PUNCH SURG 5MM,203.5,203.5,12.21,172.97,49 CDM,950756,DRESSING HDRPH GEL 4X4IN,235.5,235.5,14.13,200.18,49 CDM,950757,BANDAGE ADH 12X3.6IN,243.0,243.0,14.58,206.55,49 CDM,950766,GWIRE VASC 260CM,987.5,987.5,59.25,839.38,49 CDM,950770,SPLINT NSL SM/MD 65X35MM,2256.0,2256.0,135.36,1917.6,49 CDM,950778,IMPLANT BREAST 475CC,26647.0,26647.0,3464.11,22649.95,28 CDM,950781,CMPNT KN PLTR 38MM,7166.0,7166.0,931.58,6091.1,28 CDM,950796,GW NWTN TFE 035 145 10,784.0,784.0,47.04,666.4,49 CDM,950804,SHEATH INTRO 11GA 8IN,2644.0,2644.0,158.64,2247.4,49 CDM,950805,SPLINT ORTH POST RT LG,1905.0,1905.0,114.3,1619.25,49 CDM,950810,NEEDLE BX 20CM 18GA,2905.5,2905.5,174.33,2469.68,49 CDM,950811,NEEDLE PERC 9CM 18GA,281.5,281.5,16.89,239.28,49 CDM,950815,GRAFT VASC THIN 80CM 6MM,79455.0,79455.0,10329.15,67536.75,28 CDM,950816,GRAFT VASC THIN 40CM 8MM,41846.0,41846.0,5439.98,35569.1,28 CDM,950819,BURR SURG RND 38X6MM,2905.5,2905.5,174.33,2469.68,49 CDM,950820,IMPLANT BREAST 275CC,32338.0,32338.0,4203.94,27487.3,28 CDM,950822,IMPLANT BREAST 375CC,32338.0,32338.0,4203.94,27487.3,28 CDM,950833,SHUNT CSF DRAIN EXT VENT,4061.5,4061.5,243.69,3452.28,49 CDM,950835,GLOVE CMPR RT MED,288.5,288.5,17.31,245.22,49 CDM,950836,GLOVE CMPR RT LG,288.5,288.5,17.31,245.22,49 CDM,950852,SIGMDSCP DISP 25CM 20MM,3906.0,3906.0,234.36,3320.1,49 CDM,950870,CATH ANGIO 5FR .035IN,1151.0,1151.0,69.06,978.35,49 CDM,950874,STENT PANC 7FR 9CM,4992.0,4992.0,648.96,4243.2,28 CDM,950883,TUBING ANGIO 1200 72IN,534.5,534.5,32.07,454.32,49 CDM,950885,BAG SPEC RETRVL 224ML,2237.0,2237.0,134.22,1901.45,49 CDM,950891,SHEATH GD 6FR 90CM,5269.5,5269.5,316.17,4479.07,49 CDM,950892,PATCH CV PRCRD .08X8CM,6283.0,6283.0,816.79,5340.55,28 CDM,950894,ELCTRD ESURG RND LP 8X25,872.0,872.0,52.32,741.2,49 CDM,950897,DIALTOR VASC 6FR 20CM,608.5,608.5,36.51,517.23,49 CDM,950898,DILATOR SURG 7FR 20CM,608.5,608.5,36.51,517.23,49 CDM,950908,GWIRE VASC 300CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,950913,TUBE CATH Y CONN 30CM,799.0,799.0,47.94,679.15,49 CDM,950937,NDL SUT CIRC TPR 2.5,266.0,266.0,15.96,226.1,49 CDM,950949,TRAY INCS & DRAIN,139.5,139.5,8.37,118.58,49 CDM,950951,CATH BLNDIL 144CM 40MM,6452.0,6452.0,387.12,5484.2,49 CDM,950952,CATH BLNDIL 145CM 40MM,6968.5,6968.5,418.11,5923.23,49 CDM,950956,NEEDLE BX CHBA 18GX10,813.0,813.0,48.78,691.05,49 CDM,950959,CTHDX TORC NBXB,1151.0,1151.0,69.06,978.35,49 CDM,950973,KIT BIT DRILL 2MM 3.2MM,11445.0,11445.0,686.7,9728.25,49 CDM,950977,SCREW BN 6.5X2.9MM 90MM,9355.0,9355.0,1216.15,7951.75,28 CDM,950991,IMPLANT BREAST 400CC,26647.0,26647.0,3464.11,22649.95,28 CDM,950992,IMPLANT BREAST 425CC,32338.0,32338.0,4203.94,27487.3,28 CDM,950993,IMPLANT BREAST 450CC,32338.0,32338.0,4203.94,27487.3,28 CDM,950994,IMPLANT BREAST 500CC,26647.0,26647.0,3464.11,22649.95,28 CDM,950998,PATCH VASC 9X2CM,10565.0,10565.0,1373.45,8980.25,28 CDM,951002,INTRO CATH 12FR 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,951003,CATH DRN 18FR 25CM,3721.5,3721.5,223.29,3163.28,49 CDM,951004,TROCAR ESCP L100X11 11LT,4412.0,4412.0,264.72,3750.2,49 CDM,951007,TROCAR LAPSCP 12MM 100MM,1223.0,1223.0,73.38,1039.55,49 CDM,951008,TROCAR LAPSCP 5MM 100MM,1652.0,1652.0,99.12,1404.2,49 CDM,951009,ELECTRD CLEAN NDL 6IN,296.0,296.0,17.76,251.6,49 CDM,951012,SHEATH GD 90CM 6FR.087IN,4244.5,4244.5,254.67,3607.82,49 CDM,951015,TROCAR LAPSCP 12MM 100MM,2491.0,2491.0,149.46,2117.35,49 CDM,951018,STENT URET 10.2FR 28CM,3765.0,3765.0,489.45,3200.25,28 CDM,951021,TRAY BX NDL 6X10CM,13034.0,13034.0,782.04,11078.9,49 CDM,951033,NEEDLE BX 15CM 18GA,2905.5,2905.5,174.33,2469.68,49 CDM,951044,TROCAR APPLE EXT LENGTH,2905.5,2905.5,174.33,2469.68,49 CDM,951047,CATH ANGIO 100CM,520.5,520.5,31.23,442.43,49 CDM,951067,GRAFT VASC STD 80CM 6MM,93108.0,93108.0,12104.04,79141.8,28 CDM,951068,BLADE ASSEMBLY STD DISP,8921.0,8921.0,535.26,7582.85,49 CDM,951070,BANDAGE ADH DRY 6X3.6IN,38.5,38.5,2.31,32.73,49 CDM,951076,GFT VSC SWL STRCH 4-7X45,21699.0,21699.0,2820.87,18444.15,28 CDM,951084,CATH BLNDIL 6X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,951088,GWIRE VASC 180CM .014IN,3764.0,3764.0,225.84,3199.4,49 CDM,951089,GWIRE VASC 300CM .014IN,3678.5,3678.5,220.71,3126.72,49 CDM,951091,CATH BLNDIL 4X40MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,951101,KIT UT ABL DEV CTRL ENDO,31327.5,31327.5,1879.65,26628.38,49 CDM,951103,GWIRE VASC .014IN 182CM,3241.0,3241.0,194.46,2754.85,49 CDM,951108,GWIRE VASC .014IN 182CM,2905.5,2905.5,174.33,2469.68,49 CDM,951110,BLADE SHVR 3.5MM 130MM,2615.0,2615.0,156.9,2222.75,49 CDM,951117,KIT DEVICE CATH CUFF,755.5,755.5,45.33,642.17,49 CDM,951119,CLIP XTRN SCALP TEMP,65.5,65.5,3.93,55.67,49 CDM,951125,GWIRE .46MM 3CM 150CM,2905.5,2905.5,174.33,2469.68,49 CDM,951128,GWIRE VASC .035IN 260CM,2905.5,2905.5,174.33,2469.68,49 CDM,951129,GUIDEWIRE VASC 260CM,1921.0,1921.0,115.26,1632.85,49 CDM,951132,GWIRE VASC .018IN 180CM,2905.5,2905.5,174.33,2469.68,49 CDM,951137,TUBE EAR 1.32MM 4.8MM,2378.0,2378.0,309.14,2021.3,28 CDM,951138,BUTTON FX 15MM,9270.0,9270.0,1205.1,7879.5,28 CDM,951139,PLATE BN 12HL .5MM,14534.0,14534.0,1889.42,12353.9,28 CDM,951142,CATH GD 2.3FR 90CM,6273.0,6273.0,376.38,5332.05,49 CDM,951143,CATH GD 2.3FR 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,951144,CATH SUPP 2.3FR 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,951145,CATH SUP ANG 2.3FR 135CM,6273.0,6273.0,376.38,5332.05,49 CDM,951160,DRSG WND CAALG 4IN 5IN,564.5,564.5,33.87,479.82,49 CDM,951162,CATHETER DRN 32FR 5 EYLT,363.0,363.0,21.78,308.55,49 CDM,951174,KIT GSTRM INTRO RNG 16FR,6699.5,6699.5,401.97,5694.57,49 CDM,951190,TUNNLER SHTH 11GA 8IN,1604.0,1604.0,96.24,1363.4,49 CDM,951213,STOPCOCK 3WAY MALE LS,31.0,31.0,1.86,26.35,49 CDM,951232,DRSNG TRNS 6X6IN,210.0,210.0,12.6,178.5,49 CDM,951233,BLADE SHAVER 4.2MM 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,951236,SET INFS 20GA 1.5IN,348.0,348.0,20.88,295.8,49 CDM,951245,CATHETER EMB 5.5FR 40CM,3230.5,3230.5,193.83,2745.93,49 CDM,951271,KIT VAC CMNT MX BWL,2905.5,2905.5,174.33,2469.68,49 CDM,951297,DRESSING TRNS 10X18CM,468.0,468.0,28.08,397.8,49 CDM,951309,DRSG TRNS 4X3IN,486.0,486.0,29.16,413.1,49 CDM,951336,GWIRE ENDO .035IN 260CM,6273.0,6273.0,376.38,5332.05,49 CDM,951362,KIT ARTHSCP FX 1.2MM RPC,9339.0,9339.0,560.34,7938.15,49 CDM,951367,ELECTRODE ESURG 165MM,2288.5,2288.5,137.31,1945.22,49 CDM,951370,STENT ESPH 18.5FR 23MM,70077.0,70077.0,9110.01,59565.45,28 CDM,951375,KWIRE FX PRCPT BVL BLNT,1453.0,1453.0,87.18,1235.05,49 CDM,951377,SCREW BN NLCK 3.5MM 28MM,3827.0,3827.0,497.51,3252.95,28 CDM,951378,SCREW BN NLCK 3.5MM 30MM,3827.0,3827.0,497.51,3252.95,28 CDM,951386,KIT SURGILAN PLUS,1268.0,1268.0,76.08,1077.8,49 CDM,951387,TUBING IRR SYS PK,1676.0,1676.0,100.56,1424.6,49 CDM,951391,Tracheostomy speaking valve ,5001.5,5001.5,144.92,317.94,45 CDM,951391,VALVE SPEAKING 15MM,5001.5,5001.5,300.09,4251.27,27 CDM,951402,BALLN LUTNX OTW4X100X130,44680.5,44680.5,2680.83,37978.43,49 CDM,951412,BALLN LTNX 6X60MM 130CM,44680.5,44680.5,2680.83,37978.43,49 CDM,951413,LUTONIC 6X80MMX130CM,44680.5,44680.5,2680.83,37978.43,49 CDM,951419,BLADE SAW 14X25.5X0.4MM,580.0,580.0,34.8,493.0,49 CDM,951420,BLADE SAW 4X9.5X25.5MM,432.0,432.0,25.92,367.2,49 CDM,951421,BLADE SAW 9.5MM 25.5MM,464.0,464.0,27.84,394.4,49 CDM,951422,BLADE SAW 5.5MM 12.0MM,619.0,619.0,37.14,526.15,49 CDM,951424,BLADE SAW 5.5MM 18.5MM,548.0,548.0,32.88,465.8,49 CDM,951425,BLADE SAW 10.0MM 18.5MM,328.0,328.0,19.68,278.8,49 CDM,951432,DSCTNG HOOK ESURG 5MM HR,5398.0,5398.0,323.88,4588.3,49 CDM,951446,GRAFT PRCN 3.9X3.9IN,100000.0,100000.0,13000.0,85000.0,28 CDM,951448,GRAFT PRCN 7.9X7.9IN,100000.0,100000.0,13000.0,85000.0,28 CDM,951458,DRESSING FOM 8X6IN,352.0,352.0,21.12,299.2,49 CDM,951485,SET TUBE DISP 3000MM,6273.0,6273.0,376.38,5332.05,49 CDM,951497,PUSHER DEL SYS PANC 4FR,2789.5,2789.5,167.37,2371.07,49 CDM,951523,SYSTEM NEG PRSS TUBING,2905.5,2905.5,174.33,2469.68,49 CDM,951524,DRESSING WND OPEN ABD,15679.5,15679.5,940.77,13327.58,49 CDM,951526,FORCEP BX 2.4MM 240CM,938.5,938.5,56.31,797.73,49 CDM,951529,DRESSING WND NADH 39X3IN,1887.5,1887.5,113.25,1604.38,49 CDM,951538,BURR SURG 6MM,4405.5,4405.5,264.33,3744.68,49 CDM,951542,DRSSING CLGN ALG 2X2IN,371.5,371.5,22.29,315.77,49 CDM,951543,DRSSING WND ALG 4X43/8IN,840.0,840.0,50.4,714.0,49 CDM,951549,SET TBG FLUID GAS,1513.5,1513.5,90.81,1286.47,49 CDM,951562,CATH BLNDIL 2MM 20MM,6452.0,6452.0,387.12,5484.2,49 CDM,951563,CATH BLNDIL 2.5MM 20MM,6968.5,6968.5,418.11,5923.23,49 CDM,951566,CATH BLNDIL 3MM 20MM,6968.5,6968.5,418.11,5923.23,49 CDM,951570,PATCH SURG MFL 6.4CM,23799.0,23799.0,3093.87,20229.15,28 CDM,951571,CATH BLNDIL 145CM 40MM,6303.5,6303.5,378.21,5357.98,49 CDM,951572,LEAD PCNG 52CM,6040.0,6040.0,785.2,5134.0,28 CDM,951574,CATH BLNDIL 145CM 40MM,6303.5,6303.5,378.21,5357.98,49 CDM,951576,CATH BLNDIL 145CM 40MM,6303.5,6303.5,378.21,5357.98,49 CDM,951577,CATH INFS 5FR 65CM,3471.0,3471.0,208.26,2950.35,49 CDM,951590,KIT REPAIR DEV AND MESH,24513.0,24513.0,3186.69,20836.05,28 CDM,951604,STAPLER INT CRV 21MM,21097.5,21097.5,1265.85,17932.88,49 CDM,951606,STAPLER INT ENDO HT 29MM,20429.0,20429.0,1225.74,17364.65,49 CDM,951607,STAPLER INT CIR 33MM,20857.5,20857.5,1251.45,17728.88,49 CDM,951634,SCREW SET SPN 5.5MM,2201.0,2201.0,286.13,1870.85,28 CDM,951636,SCREW SPN 6.5MM 40MM,19298.0,19298.0,2508.74,16403.3,28 CDM,951644,SUTURE BRD 2 36IN,1355.5,1355.5,81.33,1152.17,49 CDM,951657,BIT DRILL 3.2MM 50MM,2905.5,2905.5,174.33,2469.68,49 CDM,951677,GWIRE VASC .035IN 180CM,697.5,697.5,41.85,592.88,49 CDM,951696,SCREW BN 2.7MM 30MM SS,5225.0,5225.0,679.25,4441.25,28 CDM,951705,DEVICE FX 25 STRAP 5MM,18670.0,18670.0,2427.1,15869.5,28 CDM,951717,STENT PANC 5FR 3CM,3120.0,3120.0,405.6,2652.0,28 CDM,951718,STENT PANC 5FR 5CM,3120.0,3120.0,405.6,2652.0,28 CDM,951719,STENT BIL PGTL 10FR 3CM,2541.0,2541.0,330.33,2159.85,28 CDM,951721,OBTURATOR SLING 12CM,35718.0,35718.0,4643.34,30360.3,28 CDM,951729,BIT DRILL 9MM STRL,4705.0,4705.0,282.3,3999.25,49 CDM,951730,DRAIN EVCTR KIT 400CC,2981.5,2981.5,178.89,2534.28,49 CDM,951733,KIT WND DRN 20CM 7MM,689.5,689.5,41.37,586.08,49 CDM,951734,KIT WND DRN 20CM 10MM,689.5,689.5,41.37,586.08,49 CDM,951735,DRAIN INC SIL 5/8IN 15IN,1263.0,1263.0,75.78,1073.55,49 CDM,951741,DRAIN PENROSE 18IN,141.0,141.0,8.46,119.85,49 CDM,951742,DRAIN INCS 1IN 18IN,108.0,108.0,6.48,91.8,49 CDM,951748,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,951749,KIT STENT PANC 5FR 5CM,6460.0,6460.0,839.8,5491.0,28 CDM,951750,GWIRE VASC 300CM .035IN,2905.5,2905.5,174.33,2469.68,49 CDM,951753,GWIRE VASC 300CM .014IN,2905.5,2905.5,174.33,2469.68,49 CDM,951776,GWIRE VASC .014IN 300CM,2905.5,2905.5,174.33,2469.68,49 CDM,951778,GWIRE VASC .014IN 182CM,2905.5,2905.5,174.33,2469.68,49 CDM,951785,SHEATH INTRO 10FR 11CM,1017.0,1017.0,61.02,864.45,49 CDM,951789,WRE STRQ .035 180 MJ,2758.0,2758.0,165.48,2344.3,49 CDM,951792,INTRO SHTH 5FR 11CM,492.5,492.5,29.55,418.63,49 CDM,951793,SHEATH INTRO GW 6F 11CM,492.5,492.5,29.55,418.63,49 CDM,951794,SHEATH INTRO GW 7F 11CM,492.5,492.5,29.55,418.63,49 CDM,951795,SHEATH INTRO GW 8F 11CM,492.5,492.5,29.55,418.63,49 CDM,951797,SHEATH INTRO GW 9F 11CM,492.5,492.5,29.55,418.63,49 CDM,951798,DRSG WND NADH 5X5IN,143.0,143.0,8.58,121.55,49 CDM,951804,CATH ANGIO 3.5FR 100CM,615.5,615.5,36.93,523.17,49 CDM,951805,CATH ANGIO 6FR 100CM,616.0,616.0,36.96,523.6,49 CDM,951806,CTHDX ANGIO 6F JR4 100,615.5,615.5,36.93,523.17,49 CDM,951807,CATH ANGIO 6F JL5,615.5,615.5,36.93,523.17,49 CDM,951808,CATH ANGIO 6FR 100CM,616.0,616.0,36.96,523.6,49 CDM,951809,CATH ANGIO 6FR 110CM,615.5,615.5,36.93,523.17,49 CDM,951810,CATH ANGIO .057IN 110CM,615.5,615.5,36.93,523.17,49 CDM,951811,CATH ANGIO AL1 100CM,601.5,601.5,36.09,511.27,49 CDM,951812,CATH ANGIO AL2 100CM,601.5,601.5,36.09,511.27,49 CDM,951813,CATH ANGIO PIG 4FR 110CM,601.5,601.5,36.09,511.27,49 CDM,951844,BIT DRILL 3.2X15MM,2905.5,2905.5,174.33,2469.68,49 CDM,951845,GWIRE VASC .014IN 185CM,8803.5,8803.5,528.21,7482.98,49 CDM,951847,CATH ART 4LUM 7FR 110CM,2905.5,2905.5,174.33,2469.68,49 CDM,951857,SUTURE MNDRM 2-0,997.5,997.5,59.85,847.88,49 CDM,951859,SCREW BN 6.5MM 70MM,3180.0,3180.0,413.4,2703.0,28 CDM,951866,DRSG WND FM AG 12X4IN,1608.5,1608.5,96.51,1367.22,49 CDM,951867,MESH FULL INGUINAL 6X4IN,5988.0,5988.0,778.44,5089.8,28 CDM,951868,MESH FULL INGUINAL 15 X,5988.0,5988.0,778.44,5089.8,28 CDM,951869,PATCH HERN 4.3CM,16437.0,16437.0,2136.81,13971.45,28 CDM,951873,CATH BLN 2.5X40MM 150CM,9508.0,9508.0,570.48,8081.8,49 CDM,951877,CATH GD JR3.5 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,951878,CATH GD AL2 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,951879,CATH GD 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 CDM,951884,SUTURE GUT 5-0 18IN,280.0,280.0,16.8,238.0,49 CDM,951893,SUTURE SS 2-0 24IN,508.5,508.5,30.51,432.23,49 CDM,951895,SUTURE CT-1 1 8X18IN,497.5,497.5,29.85,422.88,49 CDM,951900,SUTURE NO NDL 0 10X30IN,102.0,102.0,6.12,86.7,49 CDM,951907,SUTURE UND BRD 3-0 18IN,406.5,406.5,24.39,345.52,49 CDM,951919,SUTURE UND BRD 3-0 27IN,76.5,76.5,4.59,65.03,49 CDM,951920,SUTURE ABS 2-0 CT-1 L27,78.0,78.0,4.68,66.3,49 CDM,951926,SUTURE VIO BRD 4-0 27IN,78.5,78.5,4.71,66.72,49 CDM,951927,SUTURE VIO MONO 4-0 27IN,126.0,126.0,7.56,107.1,49 CDM,951928,SUTURE VIO BRD 3-0 27IN,77.5,77.5,4.65,65.88,49 CDM,951929,SUTURE VIO MONO 3-0 27IN,2690.5,2690.5,161.43,2286.93,49 CDM,951930,SUTURE VIO BRD 2-0 27IN,95.0,95.0,5.7,80.75,49 CDM,951934,SUTURE VIO BRD 3-0 27IN,86.5,86.5,5.19,73.53,49 CDM,951935,SUTURE VIO BRD 2-0 27IN,79.0,79.0,4.74,67.15,49 CDM,951936,SUTURE VIO BRD 2-0 27IN,2391.0,2391.0,143.46,2032.35,49 CDM,951937,SUTURE CT-2 2-0 1X27IN,2690.5,2690.5,161.43,2286.93,49 CDM,951939,SUTURE VIO MONO 0 27IN,115.5,115.5,6.93,98.17,49 CDM,951941,SUTURE CT-1 2-0 1X36IN,82.5,82.5,4.95,70.13,49 CDM,951942,SUTURE VIO BRD 136IN,85.5,85.5,5.13,72.67,49 CDM,951945,SUTURE VIO BRD 1 36IN,86.5,86.5,5.19,73.53,49 CDM,951948,SUTURE VIO BRD 0 27IN,85.0,85.0,5.1,72.25,49 CDM,951950,SUTURE CTX 1 1X36IN,256.0,256.0,15.36,217.6,49 CDM,951955,SUTURE RB-1 4-0 1X27IN,113.5,113.5,6.81,96.47,49 CDM,951956,SUTURE UND BRD 3-0 27IN,110.0,110.0,6.6,93.5,49 CDM,951963,SUTURE PDS 4-0 18IN,227.0,227.0,13.62,192.95,49 CDM,951969,SUTURE GRN BRD 3-0 36IN,197.5,197.5,11.85,167.88,49 CDM,951970,SUTURE VIO BRD 3-0 36IN,159.0,159.0,9.54,135.15,49 CDM,951976,SUTURE GRN BRD 3-0 36IN,201.5,201.5,12.09,171.28,49 CDM,951988,SUTURE VIO BRD 0 54IN,93.5,93.5,5.61,79.47,49 CDM,951989,SUTURE VIO BRD 3-0 54IN,90.5,90.5,5.43,76.92,49 CDM,951990,SUTURE VIO BRD 0 54IN,92.5,92.5,5.55,78.63,49 CDM,951991,SUTURE VIO BRD 1 54IN,93.5,93.5,5.61,79.47,49 CDM,951994,SUTURE VIO BRD 2-0 18IN,624.0,624.0,37.44,530.4,49 CDM,951995,SUTURE VIO BRD 1 18IN,574.5,574.5,34.47,488.32,49 CDM,951998,SUTURE VIO BRD 2-0 18IN,102.0,102.0,6.12,86.7,49 CDM,951999,SUTURE GUT 3-0 27IN,132.5,132.5,7.95,112.63,49 CDM,952000,SUTURE SLK 5-0 P-3 18IN,141.5,141.5,8.49,120.28,49 CDM,952004,SUTURE SS 5 18IN,627.0,627.0,37.62,532.95,49 CDM,952009,SUTURE FS-1 3-0 1X30IN,76.0,76.0,4.56,64.6,49 CDM,952017,SUTURE BLK BRD 4-0 18IN,76.0,76.0,4.56,64.6,49 CDM,952018,SUTURE VIO BRD 3-0 18IN,4579.5,4579.5,274.77,3892.57,49 CDM,952019,SUTURE BLK BRD 3-0 18IN,76.0,76.0,4.56,64.6,49 CDM,952021,SUTURE BLK MONO 4-0 18IN,169.5,169.5,10.17,144.07,49 CDM,952030,SUTURE VIO BRD 3-0 18IN,534.0,534.0,32.04,453.9,49 CDM,952032,SUTURE VCL CR 1 CTX 18IN,536.5,536.5,32.19,456.02,49 CDM,952036,SUTURE VIO BRD 2-0 27IN,539.5,539.5,32.37,458.57,49 CDM,952040,SUTURE GUT 3-0 27IN,139.0,139.0,8.34,118.15,49 CDM,952045,SUTURE GUT 2-0 27IN,146.5,146.5,8.79,124.53,49 CDM,952047,SUTURE BLU MONO 2-0 18IN,672.5,672.5,40.35,571.63,49 CDM,952048,SUTURE BLU MONO 0 18IN,680.5,680.5,40.83,578.42,49 CDM,952051,SUTURE GRN BRD 2-0 30IN,98.0,98.0,5.88,83.3,49 CDM,952059,SUTURE GUT 2-0 27IN,139.5,139.5,8.37,118.58,49 CDM,952067,SUTURE TP-1 1 1X54IN,1987.0,1987.0,119.22,1688.95,49 CDM,952071,SUTURE NDNDL 3-0 12X18IN,371.5,371.5,22.29,315.77,49 CDM,952072,SUTURE NDNDL SZ0 12X18IN,2783.5,2783.5,167.01,2365.97,49 CDM,952074,SUTURE BLK MONO 4-0 18IN,81.0,81.0,4.86,68.85,49 CDM,952077,SUTURE GUT 4-0 18IN,276.5,276.5,16.59,235.03,49 CDM,952079,SUTURE PS-1 3-0 1X27IN,260.5,260.5,15.63,221.43,49 CDM,952082,SUTURE BLK MONO 4-0 18IN,158.0,158.0,9.48,134.3,49 CDM,952083,SUTURE FSL 3-0 1X30IN,81.0,81.0,4.86,68.85,49 CDM,952090,SUTURE PLN ABS 6-0 18IN,928.0,928.0,55.68,788.8,49 CDM,952097,SUTURE BLU MONO 6-0 24IN,627.0,627.0,37.62,532.95,49 CDM,952100,SUTURE GUT 4-0 18IN,142.0,142.0,8.52,120.7,49 CDM,952104,SUTURE PC-3 5-0 1-18IN,174.0,174.0,10.44,147.9,49 CDM,952105,SUTURE PS-2 4-0 1X18IN,241.0,241.0,14.46,204.85,49 CDM,952113,SUTURE BLU MONO 6-0 24IN,611.0,611.0,36.66,519.35,49 CDM,952116,SUTURE PRLN 2-0 8433H,125.5,125.5,7.53,106.67,49 CDM,952117,SUTURE BLU MONO 1 30IN,126.0,126.0,7.56,107.1,49 CDM,952119,SUTURE BLU MONO 2-0 48IN,274.0,274.0,16.44,232.9,49 CDM,952122,SUTURE BLU MONO 6-0 18IN,2658.0,2658.0,159.48,2259.3,49 CDM,952123,SUTURE BLU MONO 4-0 18IN,262.5,262.5,15.75,223.13,49 CDM,952127,SUTURE PC-5 3-0 1X18IN,260.0,260.0,15.6,221.0,49 CDM,952129,SUTURE BLU MONO 5-0 18IN,2661.5,2661.5,159.69,2262.28,49 CDM,952130,SUTURE BLU MONO 6-0 18IN,264.0,264.0,15.84,224.4,49 CDM,952134,SUTURE BLU MONO 4-0 18IN,1364.0,1364.0,81.84,1159.4,49 CDM,952141,SUTURE BLK MONO 7-0 30IN,14961.0,14961.0,897.66,12716.85,49 CDM,952142,SUTURE BLK MONO 6-0 30IN,1747.0,1747.0,104.82,1484.95,49 CDM,952144,SUTURE BLU MONO 5-0 30IN,263.5,263.5,15.81,223.97,49 CDM,952149,SUTURE BLU MONO 5-0 18IN,265.5,265.5,15.93,225.68,49 CDM,952151,SUTURE BLK MONO 6-0 30IN,16418.5,16418.5,985.11,13955.73,49 CDM,952152,SUTURE BLU MONO 6-0 30IN,587.5,587.5,35.25,499.38,49 CDM,952153,SUTURE BLU MONO 7-0 18IN,468.5,468.5,28.11,398.23,49 CDM,952154,SUTURE BV-1 6-0 1X24IN,598.5,598.5,35.91,508.73,49 CDM,952155,SUTURE BLU MONO 2-0 30IN,135.5,135.5,8.13,115.17,49 CDM,952156,SUTURE BLU MONO 0 30IN,146.5,146.5,8.79,124.53,49 CDM,952168,SUTURE VIO BRD 2-0 18IN,529.5,529.5,31.77,450.07,49 CDM,952170,SUTURE GRN BRD 3-0 30IN,674.5,674.5,40.47,573.33,49 CDM,952178,SUTURE UND MONO 2-0 27IN,97.0,97.0,5.82,82.45,49 CDM,952179,SUTURE UND MONO 4-0 27IN,5655.0,5655.0,339.3,4806.75,49 CDM,952180,SUTURE BLK BRD 6-0 18IN,174.0,174.0,10.44,147.9,49 CDM,952184,SUTURE CLR MONO 2-0 27IN,114.5,114.5,6.87,97.33,49 CDM,952185,SUTURE CT-1 1 1X27IN,2690.5,2690.5,161.43,2286.93,49 CDM,952188,SUTURE PS-2 3-0 1X18IN,241.0,241.0,14.46,204.85,49 CDM,952192,APPLIER CLP PRLD 11IN,2036.0,2036.0,264.68,1730.6,28 CDM,952198,FORCEPS BIPOLAR 5MM,2135.0,2135.0,128.1,1814.75,49 CDM,952212,SCREW BN 2.7X52MM,5533.0,5533.0,719.29,4703.05,28 CDM,952214,CAP REDUCER 1SEAL 5-12MM,195.0,195.0,11.7,165.75,49 CDM,952221,NEEDLE ART 18GA 2-3/4IN,83.0,83.0,4.98,70.55,49 CDM,952223,NEEDLE BX 22GA 6IN,248.5,248.5,14.91,211.22,49 CDM,952232,ELECTRODE ESURG 3.75MM,16080.0,16080.0,964.8,13668.0,49 CDM,952275,DRSNG TRNS 2.75X2IN,16.5,16.5,0.99,14.03,49 CDM,952302,CATH NPHSTM 16FR,539.5,539.5,32.37,458.57,49 CDM,952311,CATH URET 2W 20FR 30CC,241.0,241.0,14.46,204.85,49 CDM,952318,CATH URET 18FR 2W 30CC,503.0,503.0,30.18,427.55,49 CDM,952386,SET URN BG 4000ML,543.0,543.0,32.58,461.55,49 CDM,952388,TRAY CATH LBRCTH 16FR,292.5,292.5,17.55,248.63,49 CDM,952411,CATH THOR STR 24FR 22IN,336.5,336.5,20.19,286.02,49 CDM,952413,CATH DRN THOR 32FR 23IN,313.0,313.0,18.78,266.05,49 CDM,952414,CATH DRN THOR 36FR 23IN,313.0,313.0,18.78,266.05,49 CDM,952415,CATH THOR STR 40FR,337.0,337.0,20.22,286.45,49 CDM,952416,CATH DRN THOR 36FR 23IN,392.0,392.0,23.52,333.2,49 CDM,952459,SOLUTION IRR LR 3000ML,498.0,498.0,29.88,423.3,49 CDM,952488,DRESSING WND ADH 4X3.6IN,23.0,23.0,1.38,19.55,49 CDM,952494,KIT CATH 9.6FR 56CM,4738.5,4738.5,284.31,4027.72,49 CDM,952497,INTRODUCR SHTH 7CM 4FR,2905.5,2905.5,174.33,2469.68,49 CDM,952543,STENT COR 2.5MM 23MM,24816.0,24816.0,3226.08,21093.6,28 CDM,952580,MESH HRN GRN 2X4IN,1992.0,1992.0,258.96,1693.2,28 CDM,952589,SHEATH INTRO 5F 10CM,1743.5,1743.5,104.61,1481.97,49 CDM,952608,HEMOSAT ABS 2X4IN,3404.0,3404.0,204.24,2893.4,49 CDM,952613,SCREW BN NLCK 3.5MM 34MM,3827.0,3827.0,497.51,3252.95,28 CDM,952623,FORCEP BX 240CM,697.5,697.5,41.85,592.88,49 CDM,952629,CATH THRMB 7F 80CM,1975.5,1975.5,118.53,1679.17,49 CDM,952645,INTRO SHTH 9FR 10CM,1743.5,1743.5,104.61,1481.97,49 CDM,952649,KIT STENT 5FR 7CM,6460.0,6460.0,839.8,5491.0,28 CDM,952655,GRAFT CV 12X6MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,952656,GRAFT CV 20X11MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,952657,GRAFT CV 24X12MM 40CM,17229.0,17229.0,2239.77,14644.65,28 CDM,952670,RETRCTR WND LG 9-14CM,15142.0,15142.0,908.52,12870.7,49 CDM,952681,TROCAR OPTVW DLTIP 5X100,2122.0,2122.0,127.32,1803.7,49 CDM,952682,SLEEVE LAPSCP 5MM 100MM,2845.5,2845.5,170.73,2418.68,49 CDM,952699,ELECTRODE ESURG 33XM 5MM,2150.5,2150.5,129.03,1827.92,49 CDM,952721,CATH GD 2.9FR 135CM,18951.0,18951.0,1137.06,16108.35,49 CDM,952738,SUTURE CTX 0 1X30IN,108.0,108.0,6.48,91.8,49 CDM,952739,SUTURE VIO MONO 1 36IN,108.0,108.0,6.48,91.8,49 CDM,952740,SUTURE VIO MONO 3-0 27IN,89.5,89.5,5.37,76.08,49 CDM,952741,SUTURE VIO MONO 2-0 27IN,89.5,89.5,5.37,76.08,49 CDM,952742,SUTURE VIO MONO 2-0 36IN,109.5,109.5,6.57,93.08,49 CDM,952824,SCREW BN 4.5MM 56MM,6676.0,6676.0,867.88,5674.6,28 CDM,952825,SCREW BN 4.5MM 60MM,6676.0,6676.0,867.88,5674.6,28 CDM,952826,SCREW BN 4.5MM 68MM,7898.0,7898.0,1026.74,6713.3,28 CDM,952827,SCREW BN 4.5MM 72MM,9043.0,9043.0,1175.59,7686.55,28 CDM,952835,SCREW BN CANN 4.5X30MM,7367.0,7367.0,957.71,6261.95,28 CDM,952838,SCREW BN 4.5X38MM,6668.0,6668.0,866.84,5667.8,28 CDM,952844,SCREW CORT 2.0X10,1361.0,1361.0,176.93,1156.85,28 CDM,952862,BURR SURG 25.4MM .8MM,4373.0,4373.0,262.38,3717.05,49 CDM,952863,RASP SURG 3.2MM 18.3MM,4746.5,4746.5,284.79,4034.53,49 CDM,952878,NEEDLE BX 17GA 11.8CM,602.0,602.0,36.12,511.7,49 CDM,952882,SUTURE SH 3-0 8X30IN,415.5,415.5,24.93,353.18,49 CDM,952886,DEVICE INFL 40ATM 30CC,2034.0,2034.0,122.04,1728.9,49 CDM,952890,SCREW BN HIP 6.5MM 60MM,2541.0,2541.0,330.33,2159.85,28 CDM,952917,ANCHOR SUT 5MM,7382.0,7382.0,959.66,6274.7,28 CDM,952922,ELCTRODE ESURG 10X10MM,872.0,872.0,52.32,741.2,49 CDM,952939,CLIP HMST 2.8X11MM 235CM,5803.0,5803.0,754.39,4932.55,28 CDM,952941,NEEDLE PERC 7CM 18G,219.0,219.0,13.14,186.15,49 CDM,952959,COIL EMBL 2.2LP 7CM 10MM,3225.0,3225.0,419.25,2741.25,28 CDM,952962,DRSG WND 6X4IN,2105.0,2105.0,126.3,1789.25,49 CDM,952977,KIT CATH CV 6.0FR 20CM,7946.5,7946.5,476.79,6754.52,49 CDM,953012,CURETTE CRVD 8MM,122.5,122.5,7.35,104.13,49 CDM,953032,CATH BLNDIL 2MM 12MM,4600.5,4600.5,276.03,3910.43,49 CDM,953035,CATH BLNDIL 2.25MM 12MM,4600.5,4600.5,276.03,3910.43,49 CDM,953036,CATH BLN ANGIO 2.50X08MM,4600.5,4600.5,276.03,3910.43,49 CDM,953037,CATH BLNDIL 2.5MM 12MM,4600.5,4600.5,276.03,3910.43,49 CDM,953038,CATH BLN ANGIO 2.50X15MM,4600.5,4600.5,276.03,3910.43,49 CDM,953040,CATH BLNDIL 2.75MM 20MM,4600.5,4600.5,276.03,3910.43,49 CDM,953041,CATH BLNDIL 3MM 8MM,4600.5,4600.5,276.03,3910.43,49 CDM,953042,CATH BLNDIL 3MM 12MM,4600.5,4600.5,276.03,3910.43,49 CDM,953043,CATH BLNDIL 3MM 15MM,4600.5,4600.5,276.03,3910.43,49 CDM,953044,CATH BLN ANGIO 3.0X20MM,4600.5,4600.5,276.03,3910.43,49 CDM,953045,SCREW BN 2.7MM 40MM SS,4913.0,4913.0,638.69,4176.05,28 CDM,953046,ROD SPN 5.5MM 60MM,5265.0,5265.0,684.45,4475.25,28 CDM,953057,CATH GD 5.5FR 150CM,13205.5,13205.5,792.33,11224.67,49 CDM,953059,SUTURE FIBERWIRE 38IN,2033.0,2033.0,264.29,1728.05,28 CDM,953062,CATH BLNDIL 3.5MM 12MM,4600.5,4600.5,276.03,3910.43,49 CDM,953063,CATH BLNDIL 3.5MM 15MM,4600.5,4600.5,276.03,3910.43,49 CDM,953065,STENT ILAC 6X120MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,953066,STENT ILAC 6X40MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,953070,STENT ILAC 6X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 CDM,953078,STENT ILAC 10X40MM 120CM,20439.0,20439.0,2657.07,17373.15,28 CDM,953080,STENT ILAC 10X60MM 120CM,20814.0,20814.0,2705.82,17691.9,28 CDM,953082,STENT ILAC 10X 80MM 75CM,19843.0,19843.0,2579.59,16866.55,28 CDM,953083,STENT ILAC 12X40MM 120CM,20439.0,20439.0,2657.07,17373.15,28 CDM,953084,STENT ILAC 12X60MM 120CM,21377.0,21377.0,2779.01,18170.45,28 CDM,953085,SHELL ACTB HIP 56MM,28172.0,28172.0,3662.36,23946.2,28 CDM,953087,SYSTEM GS IMPL ANRFLX,100000.0,100000.0,13000.0,85000.0,28 CDM,953088,SYS REFLUX MGMT BEAD 14,100000.0,100000.0,13000.0,85000.0,28 CDM,953089,SYS REFLUX MGMT BEAD 15,100000.0,100000.0,13000.0,85000.0,28 CDM,953090,SYS REFLUX MGMT BEAD 16,100000.0,100000.0,13000.0,85000.0,28 CDM,953091,SYS REFLUX MGMT BEAD 17,100000.0,100000.0,13000.0,85000.0,28 CDM,953109,GFT SFT TISS SYN 10X7CM,13712.0,13712.0,1782.56,11655.2,28 CDM,953125,SCREW SPN 6.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,953131,SCREW SPN 7.5MM 50MM,12898.0,12898.0,1676.74,10963.3,28 CDM,953132,TRAY CATH 5FR 3LUM,7430.5,7430.5,445.83,6315.93,49 CDM,953145,HANDPIECE WTRJET 14X.1MM,22186.5,22186.5,1331.19,18858.53,49 CDM,953151,ROD SPN 5.5MM 60MM,5265.0,5265.0,684.45,4475.25,28 CDM,953152,ROD SPN 5.5MM 65MM,5265.0,5265.0,684.45,4475.25,28 CDM,953153,ROD SPN 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,28 CDM,953168,SCREW SPN 5.5MM,2201.0,2201.0,286.13,1870.85,28 CDM,953176,TRAY CATH PICC 4FR 55CM,6273.0,6273.0,376.38,5332.05,49 CDM,953177,TRAY CATH PICC 5FR 55CM,6409.0,6409.0,384.54,5447.65,49 CDM,953178,SYRINGE INFL STRL DISP,1569.0,1569.0,94.14,1333.65,49 CDM,953180,CATH BLNDIL 5.5CM 240CM,7022.0,7022.0,421.32,5968.7,49 CDM,953181,CATH BLNDIL 5.5CM 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,953182,SNARE POLY OVAL LG,797.0,797.0,47.82,677.45,49 CDM,953183,SNARE POLY OVAL STD,797.0,797.0,47.82,677.45,49 CDM,953186,CATH DLTN 9.6FR 5CM,2905.5,2905.5,174.33,2469.68,49 CDM,953188,TRAY GSTRC LAV 34FR 36IN,449.0,449.0,26.94,381.65,49 CDM,953190,DILATOR BLN 30MM 90CM,18757.5,18757.5,1125.45,15943.88,49 CDM,953193,NEEDLE BX 20GA 20CM,3031.5,3031.5,181.89,2576.78,49 CDM,953194,NEEDLE BX 22GA 11CM,2906.5,2906.5,174.39,2470.53,49 CDM,953195,NEEDLE BX 22GA 15CM,2906.5,2906.5,174.39,2470.53,49 CDM,953204,BLADE SHAVER 4.8MM 130MM,2615.0,2615.0,156.9,2222.75,49 CDM,953212,CATH ANGIO 4FR 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,953213,CATH ANGIO 4FR 150CM,6273.0,6273.0,376.38,5332.05,49 CDM,953214,CATH GD 4FR 90CM,6273.0,6273.0,376.38,5332.05,49 CDM,953219,CATH BLNDIL 4MM 15MM,4600.5,4600.5,276.03,3910.43,49 CDM,953221,CATH BLNDIL 2.50X8MM,4600.5,4600.5,276.03,3910.43,49 CDM,953223,JOINT FNGR 30P,55187.0,55187.0,7174.31,46908.95,28 CDM,953233,GWIRE VASC 180X4.5CM,726.5,726.5,43.59,617.52,49 CDM,953234,GWIRE VASC.035 145X10CM,814.0,814.0,48.84,691.9,49 CDM,953238,SET ENDO CHLGM 4FR 43CM,3429.5,3429.5,205.77,2915.07,49 CDM,953253,CATH DRN XTRN 80CM,6409.0,6409.0,384.54,5447.65,49 CDM,953259,GUIDE PIN SUT EYE 2.4MM,2905.5,2905.5,174.33,2469.68,49 CDM,953297,DILTR HCOIL RGSRB 5.5MM,6867.0,6867.0,412.02,5836.95,49 CDM,953304,ROD SPN 5.5MM 50MM,5265.0,5265.0,684.45,4475.25,28 CDM,953308,TRAY BX BM 11GA 4IN,2580.0,2580.0,154.8,2193.0,49 CDM,953323,DEVICE BIOPSY 18GA 10CM,2266.5,2266.5,135.99,1926.53,49 CDM,953324,DEVICE BIOPSY 18GA 20CM,2266.5,2266.5,135.99,1926.53,49 CDM,953337,CURETTE DERMAL DISP 4MM,107.5,107.5,6.45,91.38,49 CDM,953359,NDL SUT CIRC TPR 4.5,119.5,119.5,7.17,101.58,49 CDM,953365,ELECTRODE ESURG 45CM,2511.0,2511.0,150.66,2134.35,49 CDM,953367,TROCAR LAPSCP 8MM 100MM,1053.5,1053.5,63.21,895.48,49 CDM,953370,SPONGE ABS 8X6.25CMX10MM,806.0,806.0,48.36,685.1,49 CDM,953371,SCREW SPN 3.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 CDM,953384,SCREW SPN 5.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 CDM,953398,RETRCTR WND LG 9-14CM,3764.0,3764.0,225.84,3199.4,49 CDM,953399,RETRCTR WND MED 5-9CM,2905.5,2905.5,174.33,2469.68,49 CDM,953402,TUBE GASTM 22FR,1213.5,1213.5,72.81,1031.47,49 CDM,953410,ELECTRODE ESURG 3MM 11CM,906.5,906.5,54.39,770.52,49 CDM,953411,ELCTRD LOOP 12X15,936.0,936.0,56.16,795.6,49 CDM,953419,HNDPC STRL DISP 10FTCRD,2905.5,2905.5,174.33,2469.68,49 CDM,953422,MANIPULATOR UTRN BLN TIP,1382.0,1382.0,82.92,1174.7,49 CDM,953423,CATH ANGIO 5FR .038IN,2994.0,2994.0,179.64,2544.9,49 CDM,953424,CATH ANGIO SIM2 5F,1151.0,1151.0,69.06,978.35,49 CDM,953425,PARTICLS EMB 300-500UM,5034.0,5034.0,654.42,4278.9,28 CDM,953428,DILATOR VASC 9FR 20CM,608.5,608.5,36.51,517.23,49 CDM,953430,NEEDLE BX 18GA 15CM,813.0,813.0,48.78,691.05,49 CDM,953431,NEEDLE BX 18G 20CM,627.0,627.0,37.62,532.95,49 CDM,953433,STAPLE REINF STRL 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,953437,CATH PERI 16GA 1.75IN,1076.0,1076.0,64.56,914.6,49 CDM,953439,DRESSING CLGN 2X2IN,627.0,627.0,37.62,532.95,49 CDM,953444,SCREW BN 6.5MM 20MM,1926.0,1926.0,250.38,1637.1,28 CDM,953445,SCREW BN 6.5X25MM,1926.0,1926.0,250.38,1637.1,28 CDM,953446,DRESSING FOM 4X4IN,2542.5,2542.5,152.55,2161.13,49 CDM,953458,IMPLANT BREAST 330CC,25709.0,25709.0,3342.17,21852.65,28 CDM,953459,IMPLANT BREAST 345CC,25709.0,25709.0,3342.17,21852.65,28 CDM,953460,IMPLANT BREAST 360CC,25709.0,25709.0,3342.17,21852.65,28 CDM,953470,NEEDLE BX 18GA 15CM,282.5,282.5,16.95,240.13,49 CDM,953476,PLUG BNCMNT 15.0MM,3335.0,3335.0,433.55,2834.75,28 CDM,953482,DEVICE BIOPSY 18GA 15CM,2266.5,2266.5,135.99,1926.53,49 CDM,953483,VALVE HMSTS BORE SM,2502.0,2502.0,150.12,2126.7,49 CDM,953484,KIT PRSS MNTR 3W 12IN,674.5,674.5,40.47,573.33,49 CDM,953485,ELECTROD ESRG 2.75IN 4MM,181.0,181.0,10.86,153.85,49 CDM,953509,DEVICE SCR HMST SM,2069.0,2069.0,124.14,1758.65,49 CDM,953511,GLV CMPR FF OW 7-8 SM RT,291.0,291.0,17.46,247.35,49 CDM,953512,GLOVE CMPR LT LG,288.5,288.5,17.31,245.22,49 CDM,953518,GUARD PIN .054-.062IN,418.5,418.5,25.11,355.73,49 CDM,953519,CATH ANGIO 5FR 40CM,1151.0,1151.0,69.06,978.35,49 CDM,953523,NEEDLE BX 20GA 10CM,755.0,755.0,45.3,641.75,49 CDM,953542,KIT MCTH INFS 20CM 135CM,14790.0,14790.0,887.4,12571.5,49 CDM,953564,SUTURE VIOL BRD+3-0 27IN,84.0,84.0,5.04,71.4,49 CDM,953565,SUTURE SH 2-0 1X27IN,83.5,83.5,5.01,70.97,49 CDM,953566,SUTURE VIOL BRD +0 36IN,90.0,90.0,5.4,76.5,49 CDM,953568,SUTURE ANBCTRL 3-0 27IN,212.0,212.0,12.72,180.2,49 CDM,953569,SUTURE PS-2 4-0 1X18IN,203.5,203.5,12.21,172.97,49 CDM,953570,SUTURE VCL+ 2-0 CT2 18IN,577.5,577.5,34.65,490.88,49 CDM,953571,SUTURE CT-2 1 8X18IN,594.0,594.0,35.64,504.9,49 CDM,953572,SUTURE PS-1 3-0 1X36IN,231.5,231.5,13.89,196.78,49 CDM,953579,PUNCH SURG 3MM,79.0,79.0,4.74,67.15,49 CDM,953590,BURR EGG 4MM,4195.5,4195.5,251.73,3566.18,49 CDM,953593,NEEDLE BX TROC 18GA 10CM,886.5,886.5,53.19,753.52,49 CDM,953604,ELECTRODE ESURG BLDE PNC,1335.0,1335.0,80.1,1134.75,49 CDM,953618,CATH VESSEL 5FR,3446.5,3446.5,206.79,2929.53,49 CDM,953630,GWIRE VASC .035IN 80CM,929.5,929.5,55.77,790.08,49 CDM,953634,CATH THRMB 6FR 65CM,15846.5,15846.5,950.79,13469.52,49 CDM,953643,CATH GD 6FR 55CM,2905.5,2905.5,174.33,2469.68,49 CDM,953652,VALVE HMSTS W/TRQ 9FR,870.0,870.0,52.2,739.5,49 CDM,953660,SPHNTM GWIRE 4.4FR 20MM,13527.5,13527.5,811.65,11498.38,49 CDM,953664,SUTURE NYL SPRMD E2 4-0,2905.5,2905.5,174.33,2469.68,49 CDM,953667,BURR SURG 4MM 47.8MM,1723.5,1723.5,103.41,1464.97,49 CDM,953669,SNARE MINI OVL 7FR 3CM,564.5,564.5,33.87,479.82,49 CDM,953671,INTRO PLWY 12F 30,2905.5,2905.5,174.33,2469.68,49 CDM,953675,NEEDLE BLNT 18GA 15CM,999.5,999.5,59.97,849.58,49 CDM,953701,CURETTE SUC 8MM,226.0,226.0,13.56,192.1,49 CDM,953703,PIN GUIDE ORTH 2.4MM 30C,1859.5,1859.5,111.57,1580.58,49 CDM,953705,DEVICE SUT CINCH DISP,4203.0,4203.0,252.18,3572.55,49 CDM,953706,DEVICE SUT 1 SYSTEM,39288.0,39288.0,2357.28,33394.8,49 CDM,953707,SUTURE POLY 2-1,2905.5,2905.5,174.33,2469.68,49 CDM,953708,DEVICE SUT 2.8MM 165CM,7600.5,7600.5,456.03,6460.43,49 CDM,953728,STENT VASC 5.5MM 40MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953729,STENT VASC 5.5MM 80MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953735,STENT BIL 6FR 7MM 27MM,21020.0,21020.0,2732.6,17867.0,28 CDM,953736,STENT BIL 6FR 8MM 27MM,30893.0,30893.0,4016.09,26259.05,28 CDM,953739,STENT VASC 5.5X100M,42738.0,42738.0,5555.94,36327.3,28 CDM,953740,STENT VASC 5.5X120MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953741,STENT VASC 5.5MM 150MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953745,SCREW BN S/T 3.5X14MM,1327.0,1327.0,172.51,1127.95,28 CDM,953746,SCREW BN 3.5MM 18MM,1292.0,1292.0,167.96,1098.2,28 CDM,953747,SCREW BN 3.5MM 24MM SS,1292.0,1292.0,167.96,1098.2,28 CDM,953748,SCREW BN 3.5X32MM,1492.0,1492.0,193.96,1268.2,28 CDM,953752,SCREW BN 3.5MM 20MM,1292.0,1292.0,167.96,1098.2,28 CDM,953761,ANCHOR SUT 5MM 15.5MM,7657.0,7657.0,995.41,6508.45,28 CDM,953763,BURR SURG 5MM,4699.0,4699.0,281.94,3994.15,49 CDM,953765,CAPSULE ENDO 11.4X26.2MM,17607.0,17607.0,1056.42,14965.95,49 CDM,953787,SHEATH DLV TUN 16GA 12IN,1575.0,1575.0,94.5,1338.75,49 CDM,953802,CATH BLNDL 4X200MM 150CM,7182.0,7182.0,430.92,6104.7,49 CDM,953804,CATH BLNDL 5X200MM 150MM,7182.0,7182.0,430.92,6104.7,49 CDM,953812,STENT VASC 5X40MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953813,STENT VASC 5X60MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953814,STENT VASC 5X100MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953815,STENT VASC 5X120MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953817,STENT VASC 6X100MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953818,STENT VASC 6.0X120MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953819,STENT VASC 6MM 150MM,42738.0,42738.0,5555.94,36327.3,28 CDM,953820,STENT VASC 6FR 120X5MM,22729.0,22729.0,2954.77,19319.65,28 CDM,953821,STENT VASC 6FR 150X5MM,25002.0,25002.0,3250.26,21251.7,28 CDM,953826,STENT VASC 6FR 120X6MM,22729.0,22729.0,2954.77,19319.65,28 CDM,953841,STENT VASC 6FR 60X7MM,21058.0,21058.0,2737.54,17899.3,28 CDM,953845,STENT VASC 6FR 100X8MM,24007.0,24007.0,3120.91,20405.95,28 CDM,953860,DEVICE CLSR WND 30X30CM,1077.5,1077.5,64.65,915.88,49 CDM,953865,INSERT KN TIB STD 12MM,21346.0,21346.0,2774.98,18144.1,28 CDM,953867,CMPNT KN FEM BSHNG STD,4899.0,4899.0,636.87,4164.15,28 CDM,953868,CMPNT KN TIB AXLE,8673.0,8673.0,1127.49,7372.05,28 CDM,953869,KIT CATH EXP 5IN 6IN,2696.5,2696.5,161.79,2292.03,49 CDM,953872,PIN BN KN CMPNTRESS,6139.0,6139.0,798.07,5218.15,28 CDM,953880,ELECTRODE ESURG 33CM 5MM,2435.0,2435.0,146.1,2069.75,49 CDM,953882,SUTURE VIOL BRD+2-0 36IN,154.0,154.0,9.24,130.9,49 CDM,953883,SUTURE VIOL BRD +0 36IN,93.0,93.0,5.58,79.05,49 CDM,953884,SUTURE UND BRD +4-0 27IN,86.0,86.0,5.16,73.1,49 CDM,953886,SPHNTM CAN 4.4FR 5X20MM,7104.5,7104.5,426.27,6038.82,49 CDM,953896,STENT DUODENAL 22X120MM,79474.0,79474.0,10331.62,67552.9,28 CDM,953904,PROBE ABL 17GA 15CM,57006.0,57006.0,3420.36,48455.1,49 CDM,953917,SUTURE FIBERWIRE 26IN,2541.0,2541.0,330.33,2159.85,28 CDM,953926,CATH GDLINER 6F 2.24X135,13205.5,13205.5,792.33,11224.67,49 CDM,953931,GWIRE VASC 190CM .014IN,3555.0,3555.0,213.3,3021.75,49 CDM,953934,COMP PTLR KN 8.5MM 29MM,7166.0,7166.0,931.58,6091.1,28 CDM,953937,BLADE SAW 18.5X10X.4MM,635.5,635.5,38.13,540.17,49 CDM,953975,SUTURE UND BRD 2-0 18IN,3263.5,3263.5,195.81,2773.97,49 CDM,953976,SUTURE VIO BRAD 3-0 36UB,174.0,174.0,10.44,147.9,49 CDM,953977,SUTURE ANBCTRL +2-0 27IN,255.5,255.5,15.33,217.18,49 CDM,953978,JOINT FNGR 20 DIST PROX,50287.0,50287.0,6537.31,42743.95,28 CDM,953992,INTRO LD 50CM 9FR 18GA,10564.5,10564.5,633.87,8979.83,49 CDM,953996,SCISSORS CURVED W/MONOPO,1436.5,1436.5,86.19,1221.03,49 CDM,953997,DRAIN WND 10FR 1/18IN,671.0,671.0,40.26,570.35,49 CDM,954002,CEMENT BN PMMA 40GM,124.0,124.0,16.12,105.4,28 CDM,954005,DEVICE BX 14GA 10CM,988.0,988.0,59.28,839.8,49 CDM,954007,CTHGD 8F 90CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 CDM,954010,BEARING HUM STD 44X41MM,20425.0,20425.0,2655.25,17361.25,28 CDM,954031,DEVICE CLSR WND 5MM,1311.0,1311.0,78.66,1114.35,49 CDM,954035,DRESSING WND 10X7.5CM,1643.0,1643.0,98.58,1396.55,49 CDM,954036,DRESSING WND 18X12.5CM,2286.0,2286.0,137.16,1943.1,49 CDM,954037,SET TUB PAD WND NEG PRSS,881.0,881.0,52.86,748.85,49 CDM,954038,CANISTER WND DRN 1L,2170.0,2170.0,130.2,1844.5,49 CDM,954042,LEAD NRSTM 5MM 60CM,70966.0,70966.0,9225.58,60321.1,28 CDM,954068,WIRE FX 2MM .079IN,2905.5,2905.5,174.33,2469.68,49 CDM,954070,CEMENT BN PMMA 40GM,2541.0,2541.0,330.33,2159.85,28 CDM,954073,STENT BIL 6FR 5MM 15MM,34174.0,34174.0,4442.62,29047.9,28 CDM,954086,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954087,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954088,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954089,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954090,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954091,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,49 CDM,954103,LEAD NRSTM 60CM,27035.0,27035.0,3784.9,22979.75,24 CDM,954106,SCREW BN 6.5MM 35MM,1926.0,1926.0,250.38,1637.1,28 CDM,954117,DEVICE INFL 10ML,2577.0,2577.0,154.62,2190.45,49 CDM,954121,GRASPER W RATCHET ENDPTH,649.0,649.0,38.94,551.65,49 CDM,954136,ROUTER SURG LF 1.1MM,4138.0,4138.0,248.28,3517.3,49 CDM,954137,KIT INSTRUMENT DISP,60087.5,60087.5,3605.25,51074.38,49 CDM,954140,SUTURE UND BRD +3.0 27IN,81.5,81.5,4.89,69.28,49 CDM,954141,SUTURE ANBCTRL +0 36IN,92.0,92.0,5.52,78.2,49 CDM,954152,CATH ANG .038IN BRN CRV,627.0,627.0,37.62,532.95,49 CDM,954153,BASKET RET 3.0CM 3.2MM,8845.5,8845.5,530.73,7518.68,49 CDM,954169,STENT BIL 6FR 5MM 19MM,36231.0,36231.0,4710.03,30796.35,28 CDM,954170,STENT BIL 6FR 6MM 18MM,34174.0,34174.0,4442.62,29047.9,28 CDM,954172,SUTURE CT-1 2-0 1X27IN,83.5,83.5,5.01,70.97,49 CDM,954174,HANDPIECE ESG 9IN 10FT,3734.5,3734.5,224.07,3174.32,49 CDM,954179,NEEDLE BX 17GA 16.8CM,602.0,602.0,36.12,511.7,49 CDM,954190,SOLUTION IRR H2O 1000CC,204.5,204.5,12.27,173.82,49 CDM,954191,SOLUTION IRR NACL 1000ML,204.5,204.5,12.27,173.82,49 CDM,954198,PASSER SUT GR UP 45D,6273.0,6273.0,376.38,5332.05,49 CDM,954203,KIT ACC INTRO 6FR 15CM,2905.5,2905.5,174.33,2469.68,49 CDM,954207,GWIRE ENDO .035IN 450CM,6273.0,6273.0,376.38,5332.05,49 CDM,954215,TIP MNPLT CONTOR LARGE,3965.5,3965.5,237.93,3370.68,49 CDM,954235,COIL EMBL 3CM 3MM,2956.0,2956.0,384.28,2512.6,28 CDM,954236,COIL EMBL 7CM 4MM,3225.0,3225.0,419.25,2741.25,28 CDM,954237,COIL EMBL 3.7LP 7CM 6MM,3225.0,3225.0,419.25,2741.25,28 CDM,954246,TUBE VNT POPE EAR GRMT,898.0,898.0,116.74,763.3,28 CDM,954256,IMPLANT BREAST 200CC,32338.0,32338.0,4203.94,27487.3,28 CDM,954275,CATH GD .035IN 135CM,5227.5,5227.5,313.65,4443.38,49 CDM,954281,DRESSING PETRO .5X72IN,46.0,46.0,2.76,39.1,49 CDM,954282,PRPMP BLD ST8M A209YV803,410.5,410.5,24.63,348.93,49 CDM,954295,IMPLANT BREAST 450CC,32338.0,32338.0,4203.94,27487.3,28 CDM,954296,IMPLANT BREAST 150CC,32338.0,32338.0,4203.94,27487.3,28 CDM,954297,IMPLANT BREAST 175CC,26647.0,26647.0,3464.11,22649.95,28 CDM,954298,IMPLANT BREAST 300CC,32338.0,32338.0,4203.94,27487.3,28 CDM,954299,IMPLANT BREAST 350CC,32338.0,32338.0,4203.94,27487.3,28 CDM,954310,SCREW BN 3.5X26MM,5218.0,5218.0,678.34,4435.3,28 CDM,954311,SCREW BN 3.5MM 30MM,5218.0,5218.0,678.34,4435.3,28 CDM,954312,SCREW BN 3.5MM 32MM,5853.0,5853.0,760.89,4975.05,28 CDM,954314,SCREW BN 3.5X40MM,5924.0,5924.0,770.12,5035.4,28 CDM,954315,SCREW BN 3.5MM 44MM,5218.0,5218.0,678.34,4435.3,28 CDM,954317,SCREW BN 3.5MM 48MM,5420.0,5420.0,704.6,4607.0,28 CDM,954318,SCREW BN 3.5MM 54MM,5218.0,5218.0,678.34,4435.3,28 CDM,954320,SCREW BN 3.5MM 60MM,5218.0,5218.0,678.34,4435.3,28 CDM,954322,PLATE BN 6HL 117X3.5MM,46768.0,46768.0,6079.84,39752.8,28 CDM,954325,DILATOR BLN 35MM 90CM,18757.5,18757.5,1125.45,15943.88,49 CDM,954337,TUBE SET ARTHSCP 10FT,1819.0,1819.0,109.14,1546.15,49 CDM,954338,TIP MNPLT CONTOR SMALL,3965.5,3965.5,237.93,3370.68,49 CDM,954339,TIP MNPLT CONTOR LARGE,3965.5,3965.5,237.93,3370.68,49 CDM,954340,TIP MNPLT CONTOR SMALL,3965.5,3965.5,237.93,3370.68,49 CDM,954343,TROCAR LAPSCP 12MM 150MM,2045.0,2045.0,122.7,1738.25,49 CDM,954348,STIMULATOR NRV LOCATOR,2905.5,2905.5,174.33,2469.68,49 CDM,954349,SPLINT NSL 1.2X1.2X3.5CM,569.0,569.0,34.14,483.65,49 CDM,954351,SPLNT NSL IMP TEMP,1448.0,1448.0,86.88,1230.8,49 CDM,954352,NAS SPL STD THK 5,848.0,848.0,50.88,720.8,49 CDM,954359,DRSG KIT 20X10CM PICO,7840.5,7840.5,470.43,6664.43,49 CDM,954365,DRSG WND ADH 12X3.6IN,59.0,59.0,3.54,50.15,49 CDM,954378,KWIRE FX 4IN .062IN,3596.5,3596.5,215.79,3057.03,49 CDM,954379,KWIRE FX 4IN .028IN,3596.5,3596.5,215.79,3057.03,49 CDM,954380,KWIRE FX 4IN .035IN,3596.5,3596.5,215.79,3057.03,49 CDM,954381,WIRE FX 1.1MM 4IN KRSH S,3136.5,3136.5,188.19,2666.03,49 CDM,954383,PORT IMPL INFSN 6FR,9581.0,9581.0,1245.53,8143.85,28 CDM,954391,GWIRE VASC .035IN 175CM,2905.5,2905.5,174.33,2469.68,49 CDM,954392,GEL DRSG THERAHONEY .5OZ,536.5,536.5,32.19,456.02,49 CDM,954399,TUBE TRACH XLT PROX CUFD,2905.5,2905.5,174.33,2469.68,49 CDM,954401,GUIDEWIRE VASC 180CM,7008.5,7008.5,420.51,5957.23,49 CDM,954403,CATH ANGIO C2 5FR 65CM,2905.5,2905.5,174.33,2469.68,49 CDM,954426,DEVICE CMPR RADIAL 24CM,1918.0,1918.0,115.08,1630.3,49 CDM,954439,CATH PICC PWR 5FR DL,3647.5,3647.5,218.85,3100.38,49 CDM,954442,CATH BLNDL 10X40MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,954443,CATH BLNDIL 6MM 75X4CM,6273.0,6273.0,376.38,5332.05,49 CDM,954444,CATH BLNDL 6FR 7MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,954446,CATH BLNDL 8MM 75X4CM,6273.0,6273.0,376.38,5332.05,49 CDM,954447,CATH BLNDIL 8X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,954448,STENT VASC 6X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 CDM,954450,STENT VASC 6X80MM 125CM,54796.0,54796.0,7123.48,46576.6,28 CDM,954451,STENT VASC 6X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 CDM,954455,SCREW BN S/T LCK2.7X16MM,4913.0,4913.0,638.69,4176.05,28 CDM,954457,TUBE ET NIM EMG 7MM,11346.0,11346.0,680.76,9644.1,49 CDM,954460,STENT VASC 6X100MM 123CM,54796.0,54796.0,7123.48,46576.6,28 CDM,954462,ANCHOR SUT 4.5MM,10613.0,10613.0,1379.69,9021.05,28 CDM,954471,CATH GD 5F 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,954472,CATH CLS4 GD 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,954473,CATH GD 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,954474,CATH GD JL4 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 CDM,954475,MODEL-5F CONVEY JR3.5,2150.5,2150.5,129.03,1827.92,49 CDM,954477,BLADE SHAVER DENSE PLUS,21819.5,21819.5,1309.17,18546.58,49 CDM,954482,TUBE TRACH XL 8MM 130MM,5744.5,5744.5,344.67,4882.82,49 CDM,954485,CATH BLNDIL 4MM 40MM,6273.0,6273.0,376.38,5332.05,49 CDM,954486,CATH BLNDIL 4MM 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,954487,CATH BLNDIL 5MM 100MM,6273.0,6273.0,376.38,5332.05,49 CDM,954488,CATH BLNDIL 5MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,954489,CATH BLNDIL 5MM 40MM,6273.0,6273.0,376.38,5332.05,49 CDM,954490,CATH BLNDIL 5MM 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,954491,CATH BLNDIL 6MM 100MM,6273.0,6273.0,376.38,5332.05,49 CDM,954492,CATH BLNDIL 6MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,954493,CATH BLNDIL 6MM 40MM,6273.0,6273.0,376.38,5332.05,49 CDM,954494,CATH BLNDIL 6MM 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,954495,CATH BLNDIL 7MM 100MM,6273.0,6273.0,376.38,5332.05,49 CDM,954496,CATH BLNDIL 7MM 20MM,6273.0,6273.0,376.38,5332.05,49 CDM,954497,CATH BLNDIL 7MM 40MM,6273.0,6273.0,376.38,5332.05,49 CDM,954498,CATH BLNDIL 7MM 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,954500,CATH BLNDIL 1.2MM 8MM,4391.0,4391.0,263.46,3732.35,49 CDM,954501,CATH BLNDIL 1.2MM 12MM,4066.0,4066.0,243.96,3456.1,49 CDM,954502,CATH BLNDIL 1.2MM 15MM,4391.0,4391.0,263.46,3732.35,49 CDM,954503,CATH BLNDIL 1.2MM0MM,3317.0,3317.0,199.02,2819.45,49 CDM,954533,SUTURE OTHCRD VIO/BLU,2905.5,2905.5,174.33,2469.68,49 CDM,954536,CATH BLNDIL 4MM 100MM,6273.0,6273.0,376.38,5332.05,49 CDM,954569,SCREW BN 6.5X30MM,1926.0,1926.0,250.38,1637.1,28 CDM,954576,LEAD NRSTM 2.8MM 65CM,100000.0,100000.0,13000.0,85000.0,28 CDM,954580,ANCHOR SUT 5.5MM 16.3MM,9790.0,9790.0,1272.7,8321.5,28 CDM,954584,GWIRE VASC .018IN 180CM,6273.0,6273.0,376.38,5332.05,49 CDM,954585,FORCEP RADIAL JAW 240CM,407.5,407.5,24.45,346.38,49 CDM,954605,CMPNT JNT FNGR SZ 40P,39441.0,39441.0,5127.33,33524.85,28 CDM,954624,KIT ANGIO CNTRST ST FLD,2018.0,2018.0,121.08,1715.3,49 CDM,954627,PROS TSTCLR SAL FIL LG,82074.0,82074.0,10669.62,69762.9,28 CDM,954628,SUTURE UND MON +4-0 27IN,102.0,102.0,6.12,86.7,49 CDM,954629,SUTURE UND MON +2-0 27IN,106.0,106.0,6.36,90.1,49 CDM,954631,SUTURE UND MON +3-0 27IN,98.5,98.5,5.91,83.72,49 CDM,954632,SUTURE UND MON +2-0 27IN,98.5,98.5,5.91,83.72,49 CDM,954633,SUTURE PS-2 4-0 1X27IN,270.0,270.0,16.2,229.5,49 CDM,954634,SUTURE UND MON +3-0 27IN,268.0,268.0,16.08,227.8,49 CDM,954636,SUTURE UND MONO +4-0 18N,281.0,281.0,16.86,238.85,49 CDM,954637,SUTURE PS-2 4-0 1X18IN,265.5,265.5,15.93,225.68,49 CDM,954638,SUTURE PS-2 3-0 1X27IN,261.0,261.0,15.66,221.85,49 CDM,954640,SUTURE UND MON +2-0 27IN,117.5,117.5,7.05,99.88,49 CDM,954641,SUTURE UND MON +4-0 18IN,281.0,281.0,16.86,238.85,49 CDM,954643,SUTURE UND MON +3-0 27IN,281.0,281.0,16.86,238.85,49 CDM,954644,SUTURE UND MON +2-0 36IN,109.5,109.5,6.57,93.08,49 CDM,954645,SUTURE VIO BRD +0 18IN,723.5,723.5,43.41,614.98,49 CDM,954646,DRESSING WND 19.1 SQ IN,1261.0,1261.0,75.66,1071.85,49 CDM,954647,PRTCL EMBL 100-300 SPHR,54975.0,54975.0,7146.75,46728.75,28 CDM,954649,DEVICE WNDCLS 45CM SZ3,1768.0,1768.0,106.08,1502.8,49 CDM,954654,STAPLE BN 16MM 18MM,78840.0,78840.0,10249.2,67014.0,28 CDM,954657,BURR SURG 6MM PRCSN ACRN,7720.0,7720.0,463.2,6562.0,49 CDM,954658,TROCAR LAPSCP 100MM 5MM,3890.5,3890.5,233.43,3306.93,49 CDM,954660,TROCAR LAPSCP 11MM 100MM,5169.5,5169.5,310.17,4394.07,49 CDM,954672,TROCAR LAP 5MM 100MM,479.0,479.0,28.74,407.15,49 CDM,954675,INTRO 10CM 6FR GLDESHTH,3199.5,3199.5,191.97,2719.57,49 CDM,954688,TUBING IRRIGATION,3478.0,3478.0,208.68,2956.3,49 CDM,954710,ELECTRODE EMG NRVSN M5,20799.5,20799.5,1247.97,17679.58,49 CDM,954722,GRAFT MESH 20X15CM,47796.0,47796.0,6213.48,40626.6,28 CDM,954728,SYSTEM OVERTUBE ACC,8158.5,8158.5,489.51,6934.73,49 CDM,954746,CATH CV 5FR 55CM,8962.5,8962.5,537.75,7618.13,49 CDM,954750,TROC REPROC 100X11MM,415.0,415.0,24.9,352.75,49 CDM,954751,TROCAR LAPSCP 100MM 12MM,919.0,919.0,55.14,781.15,49 CDM,954776,MESH GRAFT KNIT 12CM,19633.0,19633.0,2552.29,16688.05,28 CDM,954792,CATH BLN 5F 5X40MM 130CM,33895.5,33895.5,2033.73,28811.17,49 CDM,954793,CATH BLN 5FR 5X130X60MM,35436.5,35436.5,2126.19,30121.03,49 CDM,954794,CATH BLN 5FR 5X130X100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,954795,CATH BLN 6FR 4X130X100MM,35436.5,35436.5,2126.19,30121.03,49 CDM,954797,CATH BLNDIL 5X150MM,44680.5,44680.5,2680.83,37978.43,49 CDM,954805,KIT THRMB MED DELIVERY,3296.0,3296.0,197.76,2801.6,49 CDM,954809,SUTURE CTX SZ1 1X14IN,1047.5,1047.5,62.85,890.38,49 CDM,954814,CATH BLNDIL 7F 12X80X4,9226.5,9226.5,553.59,7842.52,49 CDM,954815,CATH BLNDL 14X40MM 80CM,9508.0,9508.0,570.48,8081.8,49 CDM,954816,CATH ANGIO 16MM 4CM 80CM,9226.5,9226.5,553.59,7842.52,49 CDM,954894,PACK CYSTO AURORA,2905.5,2905.5,174.33,2469.68,49 CDM,954901,SCREW SHLDR RVRS,14136.0,14136.0,1837.68,12015.6,28 CDM,954902,STAPLER REINF STRL 60MM,6273.0,6273.0,376.38,5332.05,49 CDM,954903,STAPLER REINF STRL 60MM,6594.0,6594.0,857.22,5604.9,28 CDM,954905,GRAFT DBM PTTY 5ML,13711.0,13711.0,1782.43,11654.35,28 CDM,954907,CATH GD RT IR1.0 100CM,3178.5,3178.5,190.71,2701.72,49 CDM,954920,TROCAR LAP 15MM 100MM,4469.5,4469.5,268.17,3799.07,49 CDM,954923,DRSG WND CA ALG 4X4IN,494.0,494.0,29.64,419.9,49 CDM,954925,BRACHYTX NS YTTRIUM 90,100000.0,100000.0,13000.0,85000.0,18 CDM,954925,"Brachytherapy source, non-stranded, yttrium-90, per source ",100000.0,100000.0,31277.57,51274.71,5 CDM,954932,SLING GYNECARE TVT EXACT,39747.0,39747.0,5167.11,33784.95,28 CDM,954936,NEEDLE SHLD 18GA 2.25IN,112.0,112.0,6.72,95.2,49 CDM,954939,SET TRANSFER SAL 120IN,175.0,175.0,10.5,148.75,49 CDM,954946,CATH BLNDIL 3X30X80CM,8559.5,8559.5,513.57,7275.57,49 CDM,954968,DRSG WND AG 8X4IN,1461.5,1461.5,87.69,1242.28,49 CDM,954977,BSKT RTRV 1.3FR 12CM,6529.0,6529.0,391.74,5549.65,49 CDM,954995,SYSTM PMP 2ML/HR ONQ SKR,3820.0,3820.0,229.2,3247.0,49 CDM,954996,SUTURE FBSWR 7IN,708.0,708.0,92.04,601.8,28 CDM,955006,INTRO SHTH 8FR 10CM MRKR,10564.5,10564.5,633.87,8979.83,49 CDM,955035,BSKT RTRV 1.3FR 90CM,6529.0,6529.0,391.74,5549.65,49 CDM,955041,WAND BIP SLR 4MM 12.75IN,17607.0,17607.0,1056.42,14965.95,49 CDM,955044,SNARE POLY SM OVL 240CM,3463.0,3463.0,207.78,2943.55,49 CDM,955048,SCREW BN 2.7MM 42MM,4913.0,4913.0,638.69,4176.05,28 CDM,955050,TRAY RVRS HUM +0,47893.0,47893.0,6226.09,40709.05,28 CDM,955052,SCREW BN 4.5MM 30MM,4160.0,4160.0,540.8,3536.0,28 CDM,955053,SCREW BN 4.5MM 38MM,4160.0,4160.0,540.8,3536.0,28 CDM,955057,COIL EMBL 7CM 2MM,3225.0,3225.0,419.25,2741.25,28 CDM,955063,SNARE 47X.79IN 1SNR1LOOP,8383.5,8383.5,503.01,7125.98,49 CDM,955064,SCREW BN GLND PLATE LT,4160.0,4160.0,540.8,3536.0,28 CDM,955065,GRAFT ST TIS 35.4CM,36293.0,36293.0,4718.09,30849.05,28 CDM,955078,SUTURE 2-0 CV-305 30IN,8620.5,8620.5,517.23,7327.43,49 CDM,955087,CATH GD 5FR 100CM,3178.5,3178.5,190.71,2701.72,49 CDM,955089,SNARE RND 2.8MM 240MM,834.0,834.0,50.04,708.9,49 CDM,955091,KIT FLWMT CMPT FX INJ,2833.0,2833.0,169.98,2408.05,49 CDM,955097,SNARE CATH XTRC 4F 100CM,8383.5,8383.5,503.01,7125.98,49 CDM,955098,SUT BDR MNDRM QUL 3 30CM,975.5,975.5,58.53,829.17,49 CDM,955100,DRESSING NADH 3INX4.25IN,120.0,120.0,7.2,102.0,49 CDM,955115,CATH ANG 5FR .038IN,627.0,627.0,37.62,532.95,49 CDM,955121,BLD SHVR MRLN TGR 3.7 PR,2905.5,2905.5,174.33,2469.68,49 CDM,955124,SHEATH GD 5FR 70CM,3512.5,3512.5,210.75,2985.63,49 CDM,955128,CEMENT BN PMMA MIXER,6593.5,6593.5,395.61,5604.48,49 CDM,955129,CATH BLNDIL 1.5MM 40MM,6303.5,6303.5,378.21,5357.98,49 CDM,955130,CATH BLNDIL 2MM 60MM,6303.5,6303.5,378.21,5357.98,49 CDM,955131,CATH BLNDIL 2MM 80MM,6319.5,6319.5,379.17,5371.57,49 CDM,955132,CATH BLNDIL 2MM 100MM,6303.5,6303.5,378.21,5357.98,49 CDM,955133,CATH BLNDIL 2MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,955134,CATH BLNDIL 2.5MM 60MM,6319.5,6319.5,379.17,5371.57,49 CDM,955135,CATH BLNDIL 2.5MM 80MM,6303.5,6303.5,378.21,5357.98,49 CDM,955136,CATH BLNDIL 2.5MM 100MM,6303.5,6303.5,378.21,5357.98,49 CDM,955137,CATH BLNDIL 2.5MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,955139,CATH BLNDIL 3MM 80MM,6303.5,6303.5,378.21,5357.98,49 CDM,955140,CATH BLNDIL 3MM 100MM,6303.5,6303.5,378.21,5357.98,49 CDM,955141,CATH BLNDIL 3MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,955142,CATH BLNDIL 3.5MM 60MM,6319.5,6319.5,379.17,5371.57,49 CDM,955143,CATH BLNDIL 3.5MM 80MM,6303.5,6303.5,378.21,5357.98,49 CDM,955144,CATH BLNDIL 3.5MM 100MM,6319.5,6319.5,379.17,5371.57,49 CDM,955145,CATH BLNDIL 3.5MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,955147,CATH BLNDIL 4MM 80MM,6303.5,6303.5,378.21,5357.98,49 CDM,955148,CATH BLNDIL 4MM 100MM,6303.5,6303.5,378.21,5357.98,49 CDM,955149,CATH BLNDIL 4MM 220MM,6972.5,6972.5,418.35,5926.63,49 CDM,955155,SYSTEM LUB ARTHRCM 100ML,3253.0,3253.0,195.18,2765.05,49 CDM,955167,CATH BLNDIL 3MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955169,CATH BLNDIL 3MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955171,CATH BLNDIL 3MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955172,CATH BLNDIL 3MM 150MM,6273.0,6273.0,376.38,5332.05,49 CDM,955173,CATH BLNDIL 3MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955175,CATH BLNDIL 4MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955176,CATH BLNDIL 4X40MM 135CM,5478.5,5478.5,328.71,4656.73,49 CDM,955178,CATH BLNDIL 4MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955180,CATH BLNDIL 4MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955181,CATH BLNDIL 4MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955182,CATH BLNDIL 4MM 150MM,5478.5,5478.5,328.71,4656.73,49 CDM,955183,CATH BLNDIL 4MM 150MM,5478.5,5478.5,328.71,4656.73,49 CDM,955184,CATH BLNDIL 5MM 20MM,5855.0,5855.0,351.3,4976.75,49 CDM,955185,CATH BLNDIL 5MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955186,CATH MUST 5MM 40MM 135CM,5478.5,5478.5,328.71,4656.73,49 CDM,955187,CATH BLNDIL 5MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955189,CATH BLNDIL 5MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955190,CATH BLNDIL 5MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955191,CATH BLNDIL 5MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955192,CATH BLNDIL 5MM 150MM,5808.5,5808.5,348.51,4937.23,49 CDM,955193,CATH BLNDIL 5MM 150MM,6273.0,6273.0,376.38,5332.05,49 CDM,955194,CATH BLNDIL 5MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955195,CATH BLNDIL 5MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955196,CATH BLNDIL 6MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955197,CATH BLNDIL 6MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955198,CATH BLNDIL 6MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955200,CATH BLNDIL 6MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955204,CATH BLNDIL 6MM 150MM,6273.0,6273.0,376.38,5332.05,49 CDM,955206,CATH BLNDIL 6MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955207,CATH BLNDIL 6MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955208,CATH BLNDIL 7MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955209,CATH BLNDIL 7MM 40MM,5476.5,5476.5,328.59,4655.02,49 CDM,955210,CATH BLNDIL 7MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955211,CATH BLNDIL 7MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955212,CATH BLNDIL 7MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955213,CATH BLNDIL 7MM 100MM,5478.5,5478.5,328.71,4656.73,49 CDM,955214,CATH BLNDIL 7MM 100MM,5476.5,5476.5,328.59,4655.02,49 CDM,955215,CATH BLNDIL 7MM 150MM,6273.0,6273.0,376.38,5332.05,49 CDM,955216,CATH BLNDIL 7MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955217,CATH BLNDIL 7MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955219,CATH BLNDIL 8MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955220,CATH MUST 8MM 40MM 75CM,5478.5,5478.5,328.71,4656.73,49 CDM,955223,CATH BLNDIL 8MM 100MM,5476.5,5476.5,328.59,4655.02,49 CDM,955226,CATH BLNDIL 8MM 150MM,5478.5,5478.5,328.71,4656.73,49 CDM,955227,CATH BLNDIL 8MM 200MM,6273.0,6273.0,376.38,5332.05,49 CDM,955229,CATH BLNDIL 9MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955231,CATH BLNDIL 9X40MM 75CM,5478.5,5478.5,328.71,4656.73,49 CDM,955232,CATH BLNDIL 9MM 60MM,5719.0,5719.0,343.14,4861.15,49 CDM,955233,CATH BLNDIL 9MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955235,CATH BLNDIL 9MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,955236,CATH BLNDIL 10MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955237,CATH BLNDIL 10MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955238,CATH BLNDIL 10X40MM 75CM,5478.5,5478.5,328.71,4656.73,49 CDM,955239,CATH BLNDIL 10MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955241,CATH BLNDIL 10MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,955243,CATH BLNDIL 12MM 20MM,5478.5,5478.5,328.71,4656.73,49 CDM,955244,CATH BLNDIL 12MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955245,CATH BLNDIL 12MM 40MM,5478.5,5478.5,328.71,4656.73,49 CDM,955246,CATH BLNDIL 12MM 60MM,5476.5,5476.5,328.59,4655.02,49 CDM,955247,CATH BLNDIL 12MM 60MM,5478.5,5478.5,328.71,4656.73,49 CDM,955249,CATH BLNDIL 12MM 80MM,5478.5,5478.5,328.71,4656.73,49 CDM,955251,BLN CATH RTRV 15-18MM,5849.5,5849.5,350.97,4972.07,49 CDM,955255,SLEEVE LAPSCP 5MM 100MM,483.0,483.0,28.98,410.55,49 CDM,955257,CATH HMDIAL 14.5FR 47CM,12339.0,12339.0,740.34,10488.15,49 CDM,955258,TROCAR LAPSCP 100X5MM,919.0,919.0,55.14,781.15,49 CDM,955260,SNARE 1 LOOP 47IN .98IN,8383.5,8383.5,503.01,7125.98,49 CDM,955261,SNARE 1 LP 6FR 100CM,8383.5,8383.5,503.01,7125.98,49 CDM,955262,SNARE 47IN 1.4IN 1 SNR 1,8383.5,8383.5,503.01,7125.98,49 CDM,955276,PLATE BN 4HL LT 2.7MM,21028.0,21028.0,2733.64,17873.8,28 CDM,955283,FILLER BN VOID 10CC,38483.0,38483.0,5002.79,32710.55,28 CDM,955284,FORCEP BX 1.8MM 100CM,1685.5,1685.5,101.13,1432.67,49 CDM,955285,SCREW SPN SET GRY,2201.0,2201.0,286.13,1870.85,28 CDM,955300,BURR SURG 7.5MM,7823.5,7823.5,469.41,6649.98,49 CDM,955313,CATH BLN 7FR 14MM 80CM,9508.0,9508.0,570.48,8081.8,49 CDM,955315,CANNULA ENDO 7MM 95MM,1535.0,1535.0,92.1,1304.75,49 CDM,955331,CATH GD .018IN 150CM,5227.5,5227.5,313.65,4443.38,49 CDM,955332,SHEATH GD 6FR 70CM,3512.5,3512.5,210.75,2985.63,49 CDM,955333,INTRODUCER SHTH 7FR 70CM,3512.5,3512.5,210.75,2985.63,49 CDM,955335,INTRODUCER SHTH 7FR 55CM,2905.5,2905.5,174.33,2469.68,49 CDM,955340,LAPBAND GSTRC LG 50CM,100000.0,100000.0,13000.0,85000.0,28 CDM,955341,CAP ENDO GRN LG,1395.0,1395.0,83.7,1185.75,49 CDM,955342,ENDO OVERTUBE 10.4MM,1395.0,1395.0,83.7,1185.75,49 CDM,955349,GWIRE EXTN STRETCH 150CM,3165.5,3165.5,189.93,2690.68,49 CDM,955355,KIT LPBND ACC PORT 10CC,25422.0,25422.0,1525.32,21608.7,49 CDM,955365,TRAP EYE TRNS LID 1CHMBR,149.5,149.5,8.97,127.08,49 CDM,955368,KIT VALVE HMSTS BORE LG,1178.0,1178.0,70.68,1001.3,49 CDM,955370,GWIRE ORTH 0.9X150MM,2195.0,2195.0,131.7,1865.75,49 CDM,955375,PROBE RF COOL 17GA 75MM,40983.0,40983.0,2458.98,34835.55,49 CDM,955382,CATH BLNDIL 2.25MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,955383,CATH BLNDIL 2.75MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,955384,CATH BLNDIL 3.25MM 10MM,22340.5,22340.5,1340.43,18989.42,49 CDM,955395,CATH ATHRCM 150CM 2MM,100000.0,100000.0,6000.0,85000.0,49 CDM,955397,CRT DEFIB CARD 51X73MM,100000.0,100000.0,13000.0,85000.0,28 CDM,955401,BURR RND CARBIDE 4MM,8822.0,8822.0,529.32,7498.7,49 CDM,955402,BUR SURG 5MM,8822.0,8822.0,529.32,7498.7,49 CDM,955403,BUR SURG 3MM,8421.0,8421.0,505.26,7157.85,49 CDM,955404,STENT EPRSTH 8X16X79MM,100000.0,100000.0,13000.0,85000.0,28 CDM,955406,SHEARS ESURG 23CM 5MM,5563.0,5563.0,333.78,4728.55,49 CDM,955412,BUR SURG 6MM,8822.0,8822.0,529.32,7498.7,49 CDM,955416,ALLOGRAFT STR 2.5X16MM,35442.0,35442.0,4607.46,30125.7,28 CDM,955418,KIT CATH 18GA 10CM PWGLD,4631.5,4631.5,277.89,3936.78,49 CDM,955423,GWIRE VASC .016IN 180CM,10353.0,10353.0,621.18,8800.05,49 CDM,955433,RETR FREEHLD TRIO HEX,6867.0,6867.0,412.02,5836.95,49 CDM,955437,TUBING INSFL HFLO DISP,2458.0,2458.0,147.48,2089.3,49 CDM,955442,CATH DBC 7X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 CDM,955446,SYSTEM PROGRAMR CHARGING,27579.0,27579.0,1654.74,23442.15,49 CDM,955447,SYSTEM PROGRAMR CHARGING,46221.0,46221.0,2773.26,39287.85,49 CDM,955452,SEALER LAP 5MM 44MM,24338.0,24338.0,1460.28,20687.3,49 CDM,955456,SCREW BN 3.5X18MM,4285.0,4285.0,557.05,3642.25,28 CDM,955460,BURR SURG 5MM,4423.5,4423.5,265.41,3759.97,49 CDM,955556,BLADE SAW 28.5X10MM M100,517.5,517.5,31.05,439.88,49 CDM,955562,BLADE SAW 90X25MM W SGTL,1668.0,1668.0,100.08,1417.8,49 CDM,955565,BLADE SAW 90X25X1X9MM IN,1693.0,1693.0,101.58,1439.05,49 CDM,955568,BLADE SHVR 5.5MM GWHT ST,6273.0,6273.0,376.38,5332.05,49 CDM,955578,BURR SURG RND 2MM,8822.0,8822.0,529.32,7498.7,49 CDM,955579,BURR SURG RND 38X2MM,4044.0,4044.0,242.64,3437.4,49 CDM,955580,BURR SURG 2MM 38MM,4486.0,4486.0,269.16,3813.1,49 CDM,955581,BURR SURG 3MM,2905.5,2905.5,174.33,2469.68,49 CDM,955582,BURR DIAMOND 3MM,4195.5,4195.5,251.73,3566.18,49 CDM,955585,BURR SURG RND DMD 6MM,4195.5,4195.5,251.73,3566.18,49 CDM,955614,CATH ANGIO PGTL 4F90 .04,627.0,627.0,37.62,532.95,49 CDM,955616,CATH ANGIO STR 5F 100CM,7958.5,7958.5,477.51,6764.73,49 CDM,955617,CATH ANGIO BERN 5F 100CM,627.0,627.0,37.62,532.95,49 CDM,955623,CATH ANGIO 5FR 65CM,2173.5,2173.5,130.41,1847.47,49 CDM,955626,CATH BLNDIL 5X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 CDM,955650,CLIP SURG STERILE DISP,285.0,285.0,17.1,242.25,49 CDM,955677,DEVICE ESURG LAP 45CM,13323.5,13323.5,799.41,11324.98,49 CDM,955692,DISSECTOR LGSR 21CM,24784.0,24784.0,1487.04,21066.4,49 CDM,955701,DRESSING FOAM 6X4IN,23.0,23.0,1.38,19.55,49 CDM,955719,DRESSING WND 8X6IN COVAD,167.0,167.0,10.02,141.95,49 CDM,955720,DRESSING WND NADH 8X8IN,980.0,980.0,58.8,833.0,49 CDM,955758,GWIRE ORTH 150X1.4MM,1756.0,1756.0,105.36,1492.6,49 CDM,955761,GW VASC 3MMJSTR .035X150,433.0,433.0,25.98,368.05,49 CDM,955764,GW VASC HDRPHSPC.035X180,1865.0,1865.0,111.9,1585.25,49 CDM,955790,IMPLANT VOC CRD PROLARYN,19633.0,19633.0,2552.29,16688.05,22 CDM,955808,INTRO SHTH 14FR 11CM,832.0,832.0,49.92,707.2,49 CDM,955819,KIT CATH IV 22GA 1.25IN,1253.0,1253.0,75.18,1065.05,49 CDM,955826,KIT HMDIAL 12FR 24CM,7043.0,7043.0,422.58,5986.55,49 CDM,955830,KIT HMDIAL 15.5FR 36CM,7043.0,7043.0,422.58,5986.55,49 CDM,955835,DEV INFL CSTM PRK PLZ,3243.5,3243.5,194.61,2756.97,49 CDM,955839,KIT INSERT FLXBLE DEV,19043.5,19043.5,1142.61,16186.98,49 CDM,955844,KIT BN STAPLE 9X9MM,30848.0,30848.0,4010.24,26220.8,28 CDM,955849,KIT MINTRDCR 5FR 35CM UN,1703.0,1703.0,102.18,1447.55,49 CDM,955851,KIT MNTR TRDCR 1 3ML/HR,4707.5,4707.5,282.45,4001.38,49 CDM,955856,SCREW BN 3.5X22MM,4138.0,4138.0,537.94,3517.3,28 CDM,955858,KIT STAPLE BN 9MM,30722.0,30722.0,1843.32,26113.7,49 CDM,955912,PASSER SUT UP 90D,6273.0,6273.0,376.38,5332.05,49 CDM,955940,POST FX DSP 5.0 X 30 MM,12369.0,12369.0,1607.97,10513.65,28 CDM,955944,PUNCH BIOPSY 6MM,71.5,71.5,4.29,60.77,49 CDM,955951,RETRACTOR RING LG,3764.0,3764.0,225.84,3199.4,49 CDM,955976,SCREW BN 2MM 14MM,16335.0,16335.0,2123.55,13884.75,28 CDM,955978,SCREW BN 2MM 18MM IBS 1.,16374.0,16374.0,2128.62,13917.9,28 CDM,955979,SCREW BN 3.5MM 16MM,1422.0,1422.0,184.86,1208.7,28 CDM,956104,STAPLE BN 18X18X18MM,38891.0,38891.0,5055.83,33057.35,28 CDM,956121,STENT EPRSTH 9MM 10CM,100000.0,100000.0,13000.0,85000.0,28 CDM,956122,STENT EPRSTH 9MM 5CM,90635.0,90635.0,11782.55,77039.75,28 CDM,956123,STENT ESPH 22X150X70MM,45791.0,45791.0,5952.83,38922.35,28 CDM,956124,STENT PANC 5FR 7CM,2720.0,2720.0,353.6,2312.0,28 CDM,956153,SUTURE BLK MONO 4-0 18IN,2905.5,2905.5,174.33,2469.68,49 CDM,956155,SUTURE 3-0 PS1 BLU 18IN,220.5,220.5,13.23,187.43,49 CDM,956157,SUTURE PRLN MFL 18IN,226.0,226.0,13.56,192.1,49 CDM,956163,SUTURE SS 1 30IN,356.5,356.5,21.39,303.02,49 CDM,956186,TRAY CATH 4FR P PICC PRO,8343.0,8343.0,500.58,7091.55,49 CDM,956193,TROCAR ENDO SOFT 12MM,3435.0,3435.0,206.1,2919.75,49 CDM,9566,SHUNT CRTD 8-14FR 13CM,2905.5,2905.5,174.33,2469.68,49 CDM,957,KIT HEMOS MATRX THROMB,25955.5,25955.5,1557.33,22062.17,49 CDM,962,STAPLER CUTTER 75MM,4219.5,4219.5,253.17,3586.57,49 CDM,963,STAPLER INT CTR 55MM,2905.5,2905.5,174.33,2469.68,49 CDM,980005,CATH EA ADDL LOW ART,462.56,462.56,27.75,393.18,37 CDM,980007,CATH 2ND OD LOW ART,2499.7,2499.7,149.98,2124.74,37 CDM,980008,CATH 1ST OD LOW ART,2346.82,2346.82,140.81,1994.8,37 CDM,987,RETRACTOR 32CM 10MM,14990.0,14990.0,899.4,12741.5,49 CDM,987792,INJ EPI L/S W IMAGING,11291.13,11291.13,677.47,9597.46,37 CPT,0001M,Infectious DX chronic hcv 6 assays ,,,175.42,175.42,1 CPT,0001U,"Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported ",,,705.6,3817.28,132 CPT,0002M,"Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo",,,493.33,3462.35,143 CPT,0002U,"Oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine) by liquid chromatography with tandem mass spectrometry (LCMS/MS) using multiple r",,,24.5,132.92,130 CPT,0003M,"Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo",,,493.33,3462.35,143 CPT,0003U,"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1, CA 125 II, follicle stimulating hormone, human epididymis protein 4, transferrin), utilizing serum, algorithm reported as a ",,,931.0,5035.22,131 CPT,0004M,"Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score ",,,77.42,543.36,142 CPT,0005U,"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score ",,,744.8,5227.28,143 CPT,0006M,"Oncology (hepatic), mRNA expression levels of 161 genes, utilizing fresh hepatocellular carcinoma tumor tissue, with alpha-fetoprotein level, algorithm reported as a risk classifier ",,,147.0,1031.7,142 CPT,0006U,"Prescription drug monitoring, 120 or more drugs and substances, definitive tandem mass spectrometry with chromatography, urine, qualitative report of presence (including quantitative levels, when dete",,,600.01,600.01,1 CPT,0007M,"Oncology (gastrointestinal neuroendocrine tumors), real-time PCR expression analysis of 51 genes, utilizing whole peripheral blood, algorithm reported as a nomogram of tumor disease index ",,,367.5,2579.25,142 CPT,0007U,"Drug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine, includes specimen verification including DNA authentication in comparison to buccal DNA,",,,112.14,787.08,143 CPT,0008U,"Helicobacter pylori detection and antibiotic resistance, DNA, 16S and 23S rRNA, gyrA, pbp1, rdxA and rpoB, next generation sequencing, formalin-fixed paraffin embedded or fresh tissue, predictive, rep",,,585.95,4112.41,143 CPT,0009U,"Oncology (breast cancer), ERBB2 (HER2) copy number by FISH, tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting, reported as ERBB2 gene ",,,104.86,735.95,142 CPT,0010U,"Infectious disease (bacterial), strain typing by whole genome sequencing, phylogenetic-based report of strain relatedness, per submitted isolate ",,,418.71,2938.72,142 CPT,0011M,"Oncology, prostate cancer, mRNA expression assay of 12 genes (10 content and 2 housekeeping), RT-PCR test utilizing blood plasma and urine, algorithms to predict high-grade prostate cancer risk ",,,744.8,4029.26,130 CPT,0011U,"Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds a",,,112.14,787.08,145 CPT,0012M,"Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 ºCDK1», IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo",,,744.8,4029.26,130 CPT,0013M,"Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 ºCDK1», IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo",,,744.8,4029.26,130 CPT,0014M,"LIVER DISEASE, ANALYSIS OF 3 BIOMARKERS (HYALURONIC ACID ºHA», PROCOLLAGEN III AMINO TERMINAL PEPTIDE ºPIIINP», TISSUE INHIBITOR OF METALLOPROTEINASE 1 ºTIMP-1»), USING IMMUNOASSAYS, UTILIZING SERUM, ",,,724.84,934.09,81 CPT,0015M,"Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical ster",,,1216.24,6919.59,130 CPT,0016M,"Oncology (bladder), mRNA, microarray gene expression profiling of 219 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as molecular subtype (luminal, luminal infiltrated, b",,,1535.2,18498.93,130 CPT,0016U,"Oncology (hematolymphoid neoplasia), RNA, BCR/ABL1 major and minor breakpoint fusion transcripts, quantitative PCR amplification, blood or bone marrow, report of fusion not detected or detected with q",,,160.68,1127.72,143 CPT,0017M,"Oncology (diffuse large B-cell lymphoma ºDLBCL»), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of",,,2460.01,13307.46,132 CPT,0017U,"Oncology (hematolymphoid neoplasia), JAK2 mutation, DNA, PCR amplification of exons 12-14 and sequence analysis, blood or bone marrow, report of JAK2 mutation not detected or detected ",,,89.83,630.42,143 CPT,0018M,"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection ",,,627.92,10335.6,130 CPT,0018U,"Oncology (thyroid), microRNA profiling by RT-PCR of 10 miRNA sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy ",,,2942.05,15913.94,130 CPT,0019M,"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations ",,,51.81,2058.84,49 CPT,0019T,EXTRACORP SHOCK WV TX MS NOS ,,,2358.0,6077.0,24 CPT,0019U,"Oncology, RNA, gene expression by whole transcriptome sequencing, formalin-fixed paraffin embedded tissue or fresh frozen tissue, predictive algorithm reported as potential targets for therapeutic age",,,3601.5,19481.51,130 CPT,0020M,"Oncology (central nervous system), analysis of 30,000 DNA methylation loci by methylation array, utilizing DNA extracted from tumor tissue, diagnostic algorithm reported as probability of matching a r",,,303.0,7225.0,49 CPT,0021U,"Oncology (prostate), detection of 8 autoantibodies (ARF 6, NKX3-1, 5'-UTR-BMI1, CEP 164, 3'-UTR-Ropporin, Desmocollin, AURKAIP-1, CSNK2A2), multiplexed immunoassay and flow cytometry serum, algorithm ",,,744.8,4029.26,130 CPT,0022U,"Targeted genomic sequence analysis panel, cholangiocarcinoma and non-small cell lung neoplasia, DNA and RNA analysis, 1-23 genes, interrogation for sequence variants and rearrangements, reported as pr",,,166.01,6220.5,132 CPT,0023U,"Oncology (acute myelogenous leukemia), DNA, genotyping of internal tandem duplication, p.D835, p.I836, using mononuclear cells, reported as detection or nondetection of FLT3 mutation and indication fo",,,243.54,1316.71,132 CPT,0024U,"Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative ",,,33.51,235.12,142 CPT,0025U,"Tenofovir, by liquid chromatography with tandem mass spectrometry (LC-MS/MS), urine, quantitative ",,,112.14,589.97,142 CPT,0026U,"Oncology (thyroid), DNA and mRNA of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule, algorithmic analysis reported as a categorical result (""Positive, high probability of",,,3528.0,24760.8,142 CPT,0027U,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 ",,,119.47,838.48,142 CPT,0029U,"Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823) ",,,742.27,5105.38,100 CPT,0030U,"Drug metabolism (warfarin drug response), targeted sequence analysis (ie, CYP2C9, CYP4F2, VKORC1, rs12777823) ",,,131.45,922.56,142 CPT,0031U,"CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F, *1K, *6, *7) ",,,174.81,1202.38,100 CPT,0032U,"COMT (catechol-O-methyltransferase) (eg, drug metabolism) gene analysis, c.472G>A (rs4680) variant ",,,171.31,1202.38,142 CPT,0033U,"HTR2A (5-hydroxytryptamine receptor 2A), HTR2C (5-hydroxytryptamine receptor 2C) (eg, citalopram metabolism) gene analysis, common variants (ie, HTR2A rs7997012 [c.614-2211T>C], HTR2C rs3813929 [c.-75",,,1438.56,1853.84,81 CPT,0034U,"TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15) (eg, thiopurine metabolism), gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5) ",,,456.85,3206.32,142 CPT,0035U,"Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative ",,,530.17,3720.91,142 CPT,0036U,"Exome (ie, somatic mutations), paired formalin-fixed paraffin-embedded tumor tissue and normal specimen, sequence analyses ",,,4684.4,32876.84,142 CPT,0037U,"Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instabiit",,,3430.0,24073.0,144 CPT,0038U,"Vitamin D, 25 hydroxy D2 and D3, by LC-MS/MS, serum microsample, quantitative ",,,29.01,203.63,144 CPT,0039U,"Deoxyribonucleic acid (DNA) antibody, double stranded, high avidity ",,,13.47,94.48,142 CPT,0040U,"BCR/ABL1 (eg, chronic myelogenous leukemia) translocation analysis, major breakpoint, quantitative ",,,401.7,2819.26,144 CPT,0041U,"Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM ",,,16.87,118.37,142 CPT,0042T,"Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and m",,,1007.0,1361.0,12 CPT,0042U,"Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG ",,,16.87,118.37,142 CPT,0043U,"Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM ",,,14.56,102.17,142 CPT,0044U,"Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG ",,,14.56,102.17,142 CPT,0045U,"Oncology (breast ductal carcinoma in situ), mRNA, gene expression progiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm",,,3795.54,26638.49,142 CPT,0046U,"FLT3 (fms-related tyrosine kinase 3) (eg, acute lyeloid leukemia) internal tandem duplication (ITD) variants, quantitative ",,,334.33,2802.33,142 CPT,0047U,"Oncology (prostate), mRNA, gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm report as a risk scor",,,3795.54,26638.49,142 CPT,0048U,"Oncology (solid organ neoplasia), DNA, targeted sequencing of protein-coding exons of 468 cancer-associated genes, including interrogation for somatic mutations and microsatellite instability, matched",,,2861.21,20081.05,144 CPT,0049U,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative ",,,192.18,2802.33,142 CPT,0050U,"Targeted genomic sequence analysis panel, acute myelogenous leukemia, DNA analysis, 194 genes, interrogation for sequence variants, copy number variants or rearrangements ",,,2858.27,20060.41,142 CPT,0051T,HImplantation of a total replacement heart system (artificial heart) with recipient cardiectomy ,,,5841.0,16207.0,16 CPT,0051U,"Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, urine, 31 drug panel, reported as quantitative results, detected or not-detected, per date of service ",,,241.98,1332.34,142 CPT,0052T,HReplacement or repair of thoracic unit of a total replacement heart system (artificial heart) ,,,5841.0,16207.0,16 CPT,0052U,"Lipoprotein, blood, high resolution fractionation and quantitation of lipoproteins, including all five major lipoprotein classes and subclasses of HDL, LDL, and VLDL by vertical auto profile ultracent",,,33.18,232.86,142 CPT,0053T,"HReplacement or repair of implantable component or components of total replacement heart system (artificial heart), excluding thoracic unit ",,,5841.0,16207.0,16 CPT,0053U,"Oncology (prostate cancer), FISH analysis of 4 genes, needle biopsy specimen, algorithm reported as probability of higher tumor grade ",,,8349.76,10760.19,81 CPT,0054T,"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure) ",,,1672.0,3083.0,112 CPT,0054U,"Prescription drug monitoring, 14 or more classes of drugs and substances, definitive tandem mass spectrometry with chromatography, capillary blood, quantitative report with therapeutic and toxic range",,,194.77,1024.55,142 CPT,0055T,"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure) ",,,1672.0,3083.0,112 CPT,0055U,"Cardiology (heart transplant), cell-free DNA, PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets), plasma ",,,3175.2,22284.72,142 CPT,0058U,"Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative ",,,316.5,2221.32,142 CPT,0059U,"Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative ",,,316.5,2221.32,142 CPT,0060U,"Twin zygosity, genomic targeted sequence analysis of cromosome 2, using circulating cell-free fetal DNA in maternal blood ",,,743.87,5220.76,142 CPT,0061U,"Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis ",,,24.6,172.67,142 CPT,0062U,"Autoimmune (systemic lupus erythematosus), IgG and IgM analysis of 80 biomarkers, utilizing serum, algorithm reported with a risk score ",,,18.79,2017.34,130 CPT,0063U,"Neurology (autism), 32 amines by LC-MS/MS, using plasma, algorithm reported as metabolic signature associated with autism spectrum disorder ",,,220.24,3975.36,130 CPT,0064U,"Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative ",,,30.7,165.28,132 CPT,0065U,"Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR) ",,,17.73,95.19,132 CPT,0066U,"Placental alpha-micro globulin-1 (PAMG-1), immunoassay with direct optical observation, cervico-vaginal fluid, each specimen ",,,62.74,80.85,81 CPT,0067U,"Oncology (breast), immunohistochemistry, protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1], carcinoembryonic antigen-related cell adhesion molecule 6 [CEACAM6], hyaluron",,,144.15,10056.05,130 CPT,0068U,"Candida species panel (C. albicans, C. glabrata, C. parapsilosis, C. kruseii, C. tropicalis, and C. auris), amplified probe technique with qualitative report of the presence or absence of each species",,,139.78,756.26,132 CPT,0069U,"Oncology (colorectal), microRNA, RT-PCR expression profiling of miR-31-3p, formalin-fixed paraffin-embedded tissue, algorithm reported as an expression score ",,,372.4,2013.71,130 CPT,0070U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, common and select rare variants (ie, *2, *3, *4, *4N, *5, *6, *7, *8, *9, *10, *11, *12, *13, *14A, ",,,662.84,3585.54,130 CPT,0071T,"Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume less than 200 cc of tissue ",,,3041.0,15059.0,58 CPT,0071U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, full gene sequence (List separately in addition to code for primary procedure) ",,,588.0,3181.38,130 CPT,0072T,"Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to 200 cc of tissue ",,,3041.0,15059.0,58 CPT,0072U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D6-2D7 hybrid gene) (List separately in addition to code for pri",,,441.89,2390.97,130 CPT,0073U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D7-2D6 hybrid gene) (List separately in addition to code for pri",,,441.89,2390.97,130 CPT,0074U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, nonduplicated gene when duplication/multiplication is trans) (List s",,,441.89,2390.97,130 CPT,0075T,"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel ",,,5841.0,16207.0,81 CPT,0075U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 5? gene duplication/multiplication) (List separately in addition to ",,,441.89,2390.97,130 CPT,0076T,"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (List separately in addition to cod",,,5841.0,16207.0,81 CPT,0076U,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 3? gene duplication/multiplication) (List separately in addition to ",,,441.89,2390.97,130 CPT,0077U,"Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype ",,,42.56,229.95,132 CPT,0078U,"Pain management (opioid-use disorder) genotyping panel, 16 common variants (ie, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2, DRD4, GABA, GAL, HTR2A, HTTLPR, MTHFR, MUOR, OPRK1, OPRM1), buccal swab or othe",,,1855.36,2390.97,81 CPT,0079U,"Comparative Deoxyribonucleic Acid (DNA) analysis using multiple selected Single-Nucleotide Polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification ",,,51.81,81.82,5 CPT,0080U,"Oncology (lung), mass spectrometric analysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein M130, with five clinical risk factors (age, smoking status, nodule diamet",,,3449.6,18658.79,130 CPT,0082U,"Drug test(s), definitive, 90 or more drugs or substances, definitive chromatography with mass spectrometry, and presumptive, any number of drug classes, by instrument chemistry analyzer (utilizing imm",,,241.98,1309.57,130 CPT,0083U,"Oncology, response to chemotherapy drugs using motility contrast tomography, fresh or frozen tissue, reported as likelihood of sensitivity or resistance to drugs or drug combinations ",,,44.44,887.39,130 CPT,0084U,"Red blood cell antigen typing, DNA, genotyping of 10 blood groups with phenotype pdediction of 37 red blood cell antigens ",,,705.6,3817.28,132 CPT,0085T,BREATH TEST FOR HEART TRANSPLANT REJECTION ,,,,,0 CPT,0086U,"Infectious disease (bacterial and fungal), organism identification, blood culture, using rRNA FISH, 6 or more organism targets, reported as positive or negative with phenotypic minimum inhibitory conc",,,41.33,1059.87,132 CPT,0087U,"Cardiology (heart transplant), mRNA gene expression progiling by microarray of 1283 genes, transplant biopsy tissue, allograft rejection and injury algorithm reported as a probability score ",,,3096.23,16747.48,130 CPT,0088U,"Transplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing transplant biopsy tissue, algorithm reported as a probability score for rejection ",,,3096.23,16747.48,130 CPT,0089U,"Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es) ",,,744.8,4029.26,130 CPT,0090U,"Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a categori",,,1911.0,9303.37,130 CPT,0091U,"Oncology (colorectal) screening, cell enumeration of circulating tumor cells, utilizing whole blood, algorithm, for the presence of adenoma or cancer, reported as a positive or negative result ",,,506.58,799.99,5 CPT,0092U,"Oncology (lung), three protein biomarkers, immunoassay using Q4 magnetic nanosensor technology, plasma, algorithm reported as risk score for likelihood of malignancy ",,,2438.24,13188.89,130 CPT,0093U,"Prescription drug monitoring, evaluation of 65 common drug by LCMS/MS, urine, each drug reported detected or not detected ",,,60.9,328.72,130 CPT,0094U,"Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis ",,,7430.56,40193.58,130 CPT,0095T,"Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) ",,,1986.0,13835.0,153 CPT,0095U,"Inflammation (eosinophilic esophagitis), ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2, pro eosinophil major basic protein]), specim",,,186.37,4092.09,130 CPT,0096U,"Human papillomavirus (HPV), high-risk types (ie, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), male urine ",,,34.39,186.82,130 CPT,0098T,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) ",,,1986.0,13835.0,153 CPT,0100T,"Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intraocular retinal electrode array, with vitrectomy ",,,3673.0,416326.36,177 CPT,0101T,"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified ",,,4988.0,15059.0,89 CPT,0101U,"Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel utilizing a combination A of NGS, San",,,1709.07,9244.05,130 CPT,0102T,"Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle ",,,4988.0,15059.0,89 CPT,0102U,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, San",,,1277.87,6912.39,130 CPT,0103U,"Hereditary ovarian cancer (eg, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, Sanger, MLPA, and array CGH, with MRNA analyti",,,1709.07,9244.05,130 CPT,0105U,"Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KI",,,931.0,5035.22,130 CPT,0106T,"Quantitative sensory testing (QST), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation ",,,78.23,107.98,5 CPT,0106U,"Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rat",,,48.7,4636.42,132 CPT,0107T,"Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli to assess large diameter fiber sensation ",,,78.23,107.98,5 CPT,0107U,"Clostridium difficile toxin(s) antigen detection by immunoassay technique, stool, qualitative, multiple-step method ",,,15.68,84.43,130 CPT,0108T,"Quantitative sensory testing (QST), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia ",,,128.72,177.68,5 CPT,0108U,"Gastroenterology (Barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-",,,289.87,26239.45,130 CPT,0109T,"Quantitative sensory testing (QST), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia ",,,78.23,107.98,5 CPT,0109U,"Infectious disease (Aspergillus species), real-time PCR for detection of DNA from 4 species (A. fumigatus, A. terreus, A. niger, and A. flavus), blood, lavage fluid, or tissue, qualitative reporting o",,,139.78,756.26,130 CPT,0110T,"Quantitative sensory testing (QST), testing and interpretation per extremity; using other stimuli to assess sensation ",,,255.13,352.17,5 CPT,0110U,"Prescription drug monitoring, one or more oral oncology drug(s) and substances, definitive tandem mass spectrometry with chromatography, serum or plasma from capillary blood or venous blood, quantita",,,26.57,143.69,130 CPT,0111U,"Oncology (colon cancer), targeted KRAS (codons 12, 13, and 61) and NRAS (codons 12, 13, and 61) gene analysis, utilizing formalin-fixed paraffin-embedded tissue ",,,668.64,3616.06,132 CPT,0112U,"Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene ",,,70.88,1887.99,130 CPT,0113U,"Oncology (prostate), measurement of PCA3 and TMPRSS2-ERG in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence-based detection, algorithm reported as risk score ",,,744.8,4029.26,130 CPT,0114U,"Gastroenterology (Barrett's esophagus), VIM and CCNA1 methylation analysis, esophageal cells, algorithm reported as likelihood for Barrett's esophagus ",,,289.87,10273.39,130 CPT,0115U,"Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral types and subtypes and 2 bacterial targets, amplified probe technique, including multiplex reverse transcription for RNA ",,,70.88,1460.45,130 CPT,0116U,"Prescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with LC-MS/MS, oral fluid, algorithm results reported as a patient-compliance measurement with risk of drug to drug inter",,,241.98,1309.57,130 CPT,0117U,"Pain management, analysis of 11 endogenous analytes (methymalonic acid, xanthurenic acid, homocysteine, proglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acidm, hydroxymethyglutarate, ethylmalon",,,23.29,4456.75,130 CPT,0118U,"Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donoe-derived cell-free DNA in the total cell-f",,,2698.18,14595.44,130 CPT,0119U,"Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events ",,,48.66,443.72,130 CPT,0120U,"Oncology (B-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissu",,,2460.01,13307.46,130 CPT,0121U,"Sickle cell disease, microfluidic flow adhesion (VCAM-1), whole blood ",,,11.13,2699.94,130 CPT,0122U,"Sickle cell disease, microfluidic flow adhesion (P-Selectin), whole blood ",,,11.13,2789.72,130 CPT,0123U,"Mechanical fragility, RBC, shear stress and spectral analysis profiling ",,,17.37,1895.14,130 CPT,0129U,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and eletion/duplication analysis panel (A",,,1277.87,6912.39,130 CPT,0130U,"Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), targeted mRNA sequence analysis panel (APC, CDH1, CHEK2, MLH1, MSH2, ",,,573.2,3100.53,130 CPT,0131U,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (13 genes) (List separately i",,,2920.33,3763.38,81 CPT,0132U,"Hereditary ovarian cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (17 genes) (List separately ",,,3051.35,3932.23,81 CPT,0133U,"Hereditary prostate cancer-related disorders, targeted mRNA sequence analysis panel (11 genes) (List separately in addition to code for primary procedure) ",,,676.48,12354.87,130 CPT,0134U,"Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (18 genes) (List separately in addi",,,733.42,12354.87,130 CPT,0135U,"Hereditary gynecological cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (12 genes) (List separate",,,2881.31,3713.1,81 CPT,0136U,"ATM (ataxia telangiectasia mutated) (eg, ataxia telangiectasia) mRNA sequence analysis (List separately in addition to code for primary procedure) ",,,399.28,6380.0,130 CPT,0137U,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) mRNA sequence analysis (List separately in additional to code for primary procedure) ",,,277.22,1499.96,130 CPT,0138U,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) mRNA sequence analysis (List separately in addition to code for primary procedure)",,,458.96,5821.37,130 CPT,0140U,"Infectious disease (fungi), fungal pathogen identification, DNA (15 fungal targets), blood culture, amplified probe technique, each target reported as detected or not detected ",,,70.88,831.7,132 CPT,0141U,"Infectious disease (bacteria and fungi), gram-positive organism identification and drug resistance element detection, DNA (20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative b",,,70.88,831.7,132 CPT,0142U,"Infectious disease (bacteria and fungi), gram-negative bacterial identification and drug resistance element detection, DNA (21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive ",,,70.88,831.7,132 CPT,0143U,"Drug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,471.15,607.16,81 CPT,0144U,"Drug assay, definitive, 160 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,471.15,607.16,81 CPT,0145U,"Drug assay, definitive, 65 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,471.15,607.16,81 CPT,0146U,"Drug assay, definitive, 80 or more drugs or metabolites, urine, by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or me",,,471.15,607.16,81 CPT,0147U,"Drug assay, definitive, 85 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,471.15,607.16,81 CPT,0148U,"Drug assay, definitive, 100 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,471.15,607.16,81 CPT,0149U,"Drug assay, definitive, 60 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metab",,,471.15,607.16,81 CPT,0150U,"Drug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or meta",,,471.15,607.16,81 CPT,0152U,"Infectious disease (bacteria, fungi, parasites, and DNA viruses), DNA, PCR and next-generation sequencing, plasma, detection of >1,000 potential microbial organisms for significant positive pathogens ",,,41.33,11270.37,130 CPT,0153U,"Oncology (breast), mRNA, gene expression profiling by next-generation sequencing of 101 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a triple negative breast cancer ",,,3096.23,16747.48,130 CPT,0154U,FGFR3 (fibroblast growth factor receptor 3) gene analysis ,,,276.74,2556.2,132 CPT,0155U,"PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha) (eg, breast cancer) gene analysis ",,,269.33,1456.83,132 CPT,0156U,"Copy number (eg, intellectual disability, dysmorphology), sequence analysis ",,,1705.2,9224.3,130 CPT,0157U,"APC (APC regulator of WNT signaling pathway) (eg, familial adenomatosis polyposis [FAP]) mRNA sequence analysis ",,,277.22,2488.2,130 CPT,0158U,"MLH1 (mutL homolog 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure) ",,,277.22,2154.53,130 CPT,0159U,"MSH2 (mutS homolog 2) (eg, hereditary colon cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure) ",,,277.22,1499.96,130 CPT,0160U,"MSH6 (mutS homolog 6) (eg, hereditary colon cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure) ",,,277.22,2047.5,130 CPT,0161U,"PMS2 (PMS1 homolog 2, mismatch repair system component) (eg, hereditary nonpolyposis colorectal cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedur",,,277.22,2158.03,130 CPT,0162U,"Hereditary colon cancer (Lynch syndrome), targeted mRNA sequence analysis panel (MLH1, MSH2, MSH6, PMS2) (List separately in addition to code for primary procedure) ",,,476.81,2579.58,130 CPT,0163T,"TOTAL DISC ARTHROPLASTY (ARTIFICIAL DISC), ANTERIOR APPROACH, INCLUDING DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), EACH ADDITIONAL INTERSPACE, LUMBAR (LIST SEPARATELY IN ADDITION",,,5841.0,16207.0,16 CPT,0163U,"Oncology (colorectal) screening, biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins(teratocarcinoma derived growth factor-1 [TDGF-1, Cropto-1], carcinoembryonic antige",,,382.94,2071.18,130 CPT,0164T,"Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (List separately in addition to code for primary procedure) ",,,1672.0,16207.0,177 CPT,0164U,"Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results ",,,34.89,594.6,130 CPT,0165T,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (List separately in addition to code for primary procedure) ",,,1672.0,16207.0,177 CPT,0165U,"Peanut allergen-specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA), blood, individual epitope results and interpretation ",,,36.22,2459.22,130 CPT,0166U,"Liver disease, 10 biochemical assays (a2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT, ALT, AST, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utili",,,493.33,2669.42,130 CPT,0167U,"Gonadotropin, chorionic (hCG), immunoassay with direct optical observation, blood ",,,30.66,39.51,81 CPT,0169T,PLACE STEREO CATH BRAIN ,,,5841.0,16207.0,16 CPT,0169U,"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) (eg, drug metabolism) gene analysis, common variants ",,,456.85,2471.77,130 CPT,0170U,"Neurology (autism spectrum disorder [ASD]), RNA, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of ASD diagnosis ",,,220.24,9303.37,130 CPT,0171T,LUMBAR SPINE PROCES DISTRACT ,,,9124.0,9493.0,16 CPT,0171U,"Targeted genomic sequence analysis panel, acute myeloid leukemia, myelodysplastic syndrome, and myeloproliferative neoplasms, DNA analysis, 23 genes, interrogation for sequence variants, rearrangement",,,1488.68,8053.11,130 CPT,0172U,"Oncology (solid tumor as indicated by the label), somatic mutation analyis of BRCA1, BRCA2 and analysis of homologous recombination deficiency pathways, DNA, formalin-fixed paraffin-embedded tissue, a",,,51.81,16061.25,132 CPT,0173U,"Psychiatry (ie, depression, anxiety), genomic analysis panel, includes variant analysis of 14 genes ",,,51.81,2471.77,130 CPT,0174T,"Computer-aided detection (CAD) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of fil",,,32.98,72.52,5 CPT,0174U,"Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 che",,,1216.24,6919.59,130 CPT,0175T,"Computer-aided detection (CAD) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of fil",,,32.98,72.52,5 CPT,0175U,"Psychiatry (eg, depression, anxiety), genomic analysis panel, variant analysis of 15 genes ",,,51.81,7083.03,130 CPT,0176U,"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie, ELISA) ",,,28.76,339.49,130 CPT,0177U,"Oncology (breast cancer), DNA, PIK3CA gene analysis of 11 gene variants utilizing plasma, reported as PIK3CA gene mutation status ",,,269.33,1456.83,132 CPT,0178U,"Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (ELISA), blood, report of minimum eliciting exposure for a clinical reaction ",,,44.72,2437.68,130 CPT,0179U,"Oncology (non-small cell lung cancer), cell-free DNA, targeted sesquence analysis of 23 gene (single nucleotide variations, insertions and deletions, fusions without prior knowledge of partner/breakpo",,,655.65,10300.35,130 CPT,0180U,"Red cell antigen (ABO blood group) genotyping (ABO), gene analysis Sanger/chain termination/conventional sequencing, ABO gene, including subtyping, 7 exons ",,,38.08,1456.83,130 CPT,0181T,CORNEAL HYSTERESIS ,,,9653.0,9653.0,8 CPT,0181U,"Red cell antigen (colton blood group) genotyping (CO), gene analysis, AQP1 (aquaporin 1) exon 1 ",,,38.08,982.58,130 CPT,0182T,HDR ELECT BRACHYTHERAPY ,,,2358.0,2358.0,8 CPT,0182U,"Red cell antigen (cromlton blood group) genotyping (CROM), gene analysis, CD55 (CD55 molecule) exons 1-10 ",,,38.08,1596.94,130 CPT,0183U,"Red cell antigen (Diego blood group) genotyping (DI), gene analysis, SLC4A1 (solute carrier family 4 member 1) exon 19 ",,,38.08,982.58,130 CPT,0184T,"Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness) ",,,2699.0,13835.0,185 CPT,0184U,"Red cell antigen (Dombrock blood group) genotyping (DO), gene analysis ART4 (ADP-ribosyltransferase 4) exon 2 ",,,38.08,982.58,130 CPT,0185U,"Red cell antigen (H blood group) genotyping (FUT1), gene analysis, FUT1 (fucosyltransferase) exon 4 ",,,38.08,982.58,130 CPT,0186U,"Red cell antigen (H blood group) genotyping (FUT2), gene analysis, FUT2 (fycosyltransferase 2) exon 2 ",,,38.08,982.58,130 CPT,0187U,"Red cell antigen (Duffy blood group) genotyping (FY), gene analysis, ACKR1 (atypical chemokine receptor 1) exons 1-2 ",,,38.08,1456.83,130 CPT,0188U,"Red cell antigen (Gerbich blood group) genotyping (GE), gene analysis, GYPC (glycophorin C) exons 1-4 ",,,38.08,1456.83,130 CPT,0189U,"Red cell antigen (MNS blood group) genotyping (GYPA), gene analysis, GYPA (flycophorin A) introns 1, 5, exon 2 ",,,38.08,1456.83,130 CPT,0190T,PLACEMENT OF INTRAOCULAR RADIATION SOURCE APPLICATOR (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE) ,,,2358.0,2358.0,8 CPT,0190U,"Red cell antigen (MNS blood group) genotyping (GYPB), gene analysis, GYPB (glycophorin B) introns 1, 5, pseudoexon 3 ",,,38.08,1456.83,130 CPT,0191T,"INSERTION OF ANTERIOR SEGMENT AQUEOUS DRAINAGE DEVICE, WITHOUT EXTRAOCULAR RESERVOIR, INTERNAL APPROACH, INTO THE TRABECULAR MESHWORK; INITIAL INSERTION ",,,6326.0,9653.0,24 CPT,0191U,"Red cell antigen (Indian blood group) genotyping (IN), gene analysis CD44 (CD44 molecule) exons 2, 3, 6 ",,,38.08,1456.83,130 CPT,0192U,"Red cell antigen (Kidd blood group) genotyping (JK), gene analysis, SLC14A1 (solute carrier family 14 member 1) gene promoter, exon 9 ",,,38.08,1456.83,130 CPT,0193U,"Red cell antigen (JR blood group) genotyping (JR), gene analysis, ABCG2 (ATP binding cassette subfamily G member 2) exons 2-26 ",,,38.08,1499.96,130 CPT,0194U,"Red cell antigen (Kell blood group) genotyping (KEL), gene analysis, KEL (Kell metallo-endopeptidase) exon 8 ",,,38.08,982.58,130 CPT,0195T,"ARTHRODESIS, PRE-SACRAL INTERBODY TECHNIQUE, DISC SPACE PREPARATION, DISCECTOMY, WITHOUT INSTRUMENTATION, WITH IMAGE GUIDANCE, INCLUDES BONE GRAFT WHEN PERFORMED; L5-S1 INTERSPACE ",,,5841.0,16207.0,16 CPT,0195U,"KLF1 (Kruppel-like factor 1), targeted sequencing (ie, exon 13) ",,,38.08,1988.54,130 CPT,0196T,"ARTHRODESIS, PRE-SACRAL INTERBODY TECHNIQUE, DISC SPACE PREPARATION, DISCECTOMY, WITHOUT INSTRUMENTATION, WITH IMAGE GUIDANCE, INCLUDES BONE GRAFT WHEN PERFORMED; L4-L5 INTERSPACE (LIST SEPARATELY IN ",,,5841.0,16207.0,16 CPT,0196U,"Red cell antigen (Lutheran blood group) genotyping (LU), gene analysis, BCAM (basal cell adhesion molecule) exon 3 ",,,38.08,982.58,130 CPT,0197U,"Red cell antigen (Landsteiner-Wiener blood group) genotyping (LW), gene analysis, ICAM4 (intercellular adhesion molecule 4) exon 1 ",,,38.08,982.58,130 CPT,0198T,"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report ",,,223.51,297.65,36 CPT,0198U,"Red cell antigen (RH blood group) genotyping (RHD and RHCE), gene analysis Sanger/chain termination/conventional sequencing, RHD (Rh blood group D antigen) exons 1-10 and RHCE (Rhblood group CcEe anti",,,38.08,1499.96,130 CPT,0199U,"Red cell antigen (Scianna blood group) genotyping (SC), gene analysis, ERMAP (erythroblast membrane associated protein) exons 4, 12 ",,,38.08,1456.83,130 CPT,0200T,"Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, w",,,4988.0,16330.72,89 CPT,0200U,"Red cell antigen (Kx blood group) genotyping (XK), gene analysis, XK (X-linked Kx blood group) exons 1-3 ",,,38.08,1456.83,130 CPT,0201T,"Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when",,,4988.0,16330.72,89 CPT,0201U,"Red cell antigen (Yt blood group) genotyping (YT), gene analysis, ACHE (acetylcholinesterase (Cartwright blood group)) exon 2 ",,,38.08,982.58,130 CPT,0202T,"Posterior vertebral joint(s) arthroplasty (eg, facet jointºs» replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, i",,,3375.0,16207.0,177 CPT,0202U,"Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua",3066.19,3066.19,408.44,1329.53,51 CPT,0202U,NFCT DS 22 TRGT SARSCOV2,3066.19,3066.19,183.97,2606.26,37 CPT,0203U,Azutoimmun IBD mRNA gen Xprsn PRFL 17 Gen Whl Bld ,,,744.8,4029.26,130 CPT,0204U,Onc Thyr mRNA Gene Xprsn Alys 593 Genes FNA ,,,12010.29,15477.47,81 CPT,0205T,"INTRAVASCULAR CATHETER-BASED CORONARY VESSEL OR GRAFT SPECTROSCOPY (EG, INFRARED) DURING DIAGNOSTIC EVALUATION AND/OR THERAPEUTIC INTERVENTION INCLUDING IMAGING SUPERVISION, INTERPRETATION, AND REPORT",,,2358.0,2358.0,8 CPT,0205U,Oph Age-related Mac Degeneration Alys 3 Gen Vrnt ,,,46.06,437.03,130 CPT,0206U,Neurology Alzheimer Disease Cell Aggregation ,,,276.74,11744.62,130 CPT,0207T,"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral ",,,112.77,3083.0,148 CPT,0207U,Neurology Alzheimer Disease Quantitative Imaging ,,,276.74,2710.71,130 CPT,0208T,"Pure tone audiometry (threshold), automated; air only ",,,78.23,107.98,5 CPT,0209T,"Pure tone audiometry (threshold), automated; air and bone ",,,78.23,107.98,5 CPT,0209U,Cytog Const Alys Interrog Gen Reg F/Copy Number ,,,771.41,4172.95,130 CPT,0210T,"Speech audiometry threshold, automated; ",,,78.23,107.98,5 CPT,0210U,Syphilis Tst Non-Treponemal Antibody IA Quan Rpr ,,,18.26,98.82,132 CPT,0211T,"Speech audiometry threshold, automated; with speech recognition ",,,78.23,107.98,5 CPT,0211U,Onc Pan-Tumor DNA & RNA Next-Generation Sequencing ,,,276.74,44819.17,132 CPT,0212T,"Comprehensive audiometry threshold evaluation and speech recognition (0209T, 0211T combined), automated ",,,323.74,446.87,5 CPT,0212U,Rare DS Whl Gen & Mitochdrl DNA Seq Alys Proband ,,,863.07,29023.81,130 CPT,0213T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level ",,,2012.0,5875.78,89 CPT,0213U,Rare DS Whl Gen & Mitochdrl DNA Seq Alys Ea Cmprtr ,,,863.07,14365.49,130 CPT,0214T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (List separatel",,,1672.0,2358.0,16 CPT,0214U,Rare DS Whl Xom & Mitochdrl DNA Seq Alys Proband ,,,863.07,27696.27,130 CPT,0215T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third and any additional lev",,,1672.0,2358.0,16 CPT,0215U,Rare DS Whl Xom & Mitochdrl DNA Seq Alys Ea Cmprtr ,,,863.07,13648.74,130 CPT,0216T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level ",,,1986.0,5875.78,185 CPT,0216U,Neuro Inh Ataxia Genomic DNA Seq Alys 12 Bld/Slv ,,,608.73,8148.31,130 CPT,0217T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (List separately in",,,1672.0,3083.0,104 CPT,0217U,Neuro Inh Ataxia Genomic DNA Seq Alys 51 Bld/Slv ,,,608.73,11652.99,130 CPT,0218T,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s",,,1672.0,3083.0,112 CPT,0218U,Neuro Muscular Dystrophy Dmd Seq Alys Bld/Saliva ,,,608.73,12080.53,130 CPT,0219T,"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical ",,,3293.0,16207.0,177 CPT,0219U,Nfct Agent HIV Trgt Viral Next-Gnrj Seq Alys Alg ,,,608.73,3842.39,132 CPT,0220T,"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic ",,,3293.0,16207.0,177 CPT,0220U,Onc Brst CA Image Alys w/ AI Assmt 12 Features ,,,144.15,3743.62,130 CPT,0221T,"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar ",,,3293.0,16330.72,185 CPT,0221U,Abo Gnotyp Gene Alys Next-Generation Seq Abo Gen ,,,269.33,1456.83,130 CPT,0222T,"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (List ",,,1672.0,3083.0,112 CPT,0222U,RHD & RHCE Gnotyp Next-Genrj Seq RH Prox Promoter ,,,277.22,1499.96,130 CPT,0223U,"Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua",,,408.44,1329.53,51 CPT,0224U,"Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease (COVID-19)), includes titer(s), when performed ",,,50.4,148.63,51 CPT,0225U,"Infectious disease (bacterial or viral RTI) pathogen-specific DNA & RN A,21 targets,incl severe acute respiratory syndrome coronavirus 2(SARS- CoV-2), amplified probe technique,including multiple ",,,408.44,1329.53,51 CPT,0226U,"Surrogate viral neutralization test (sVNT), severe acute respiratory s yndrome coronavirus 2 (SARS-CoV-2) (Corornavirus disease (COVID-19)), ( ELISA, plasma, serum ",,,41.43,134.87,51 CPT,0227U,"Drug Assay, presumptive, 30 or more drugs or metabolites, urine, liquid chromatography with tandem mass spectrometry using multiple reaction monitoring w drug or metabolite description, incl simple va",,,60.9,328.72,130 CPT,0228T,"INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, WITH ULTRASOUND GUIDANCE, CERVICAL OR THORACIC; SINGLE LEVEL ",,,2128.0,2315.0,24 CPT,0228U,"Oncology (prostate), multianalyte molecular progile by photometric detection of macromolecules absorbed on nanosponge array slides w machine learning, utilizing first morning voided urine, algorithm r",,,51.81,917.97,130 CPT,0229T,"INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, WITH ULTRASOUND GUIDANCE, CERVICAL OR THORACIC; EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE",,,2358.0,2358.0,8 CPT,0229U,"BCAT1 or IKZF1 (eg, colorectal cancer) promoter methylation analysis ",,,251.77,2035.25,130 CPT,0230T,"INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, WITH ULTRASOUND GUIDANCE, LUMBAR OR SACRAL; SINGLE LEVEL ",,,2128.0,2315.0,24 CPT,0230U,"AR (androgen receptor), full sequence analyis, including small sequence changes in exonic and intronic regions, deletions, duplications, short tandem repeat (STR) expansions, mobile element insertions",,,276.74,1596.94,130 CPT,0231T,"INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, WITH ULTRASOUND GUIDANCE, LUMBAR OR SACRAL; EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,2358.0,2358.0,8 CPT,0231U,"CACNA1A, full gene analysis, including small sequence changes in exonic and intronic regions, deletions duplications, Short Tandem Requests (STR) gene expansions, mobile element insertions, and varian",,,276.74,4485.54,130 CPT,0232T,"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed ",,,745.36,3244.0,169 CPT,0232U,"CSTB (cystatin B), full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, Short Tandem Requests (STR) expansions, mobile element insertions, and ",,,269.33,1456.83,130 CPT,0233U,"FXN (frataxin), gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, short tandem requests (STR) expansions, mobile element insertions, and variants",,,269.33,1456.83,130 CPT,0234T,"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; renal artery ",,,2699.0,27050.15,185 CPT,0234U,"MECP2 (methyl CpG binding protein 2) full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, mobile element insertions, and variants in non-unique",,,517.31,2798.7,130 CPT,0235T,"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; visceral artery (except renal), each vessel ",,,5841.0,16207.0,81 CPT,0235U,"PTEN (Phosphatase and tensin monolog) full gene analysis, including small sequence changes in exonic and intronic regions, deletions, duplications, mobile element insertions and variants in non-unique",,,588.0,3181.38,130 CPT,0236T,"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta ",,,2699.0,27050.15,185 CPT,0236U,"SMN1 (survival of motor neuton 1, telomeric) and SMN2 (survival of motor neuron 2, centromeric) full gene analysis, including small sequence changes in exonic and intronic regions, duplications and de",,,276.74,3195.72,130 CPT,0237T,"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel ",,,2699.0,27050.15,185 CPT,0237U,"Cardiac ion channelopathies, genomic sequence analysis panel including ANK2, CASQ2, CAV3, KCNE1, KCNE2, KCNH2, KCNJ2, KCNQ1, RYR2, and SCN5A, including small sequence changes in exonic and intronic re",,,555.16,3100.53,130 CPT,0238T,"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel ",,,3673.0,43516.12,185 CPT,0238U,"Oncology (Lynch syndrome), genomic DNA sequence analysis of MLH1, MSH2, MSH6, PMS2, and EPCAM, including small sequence changes in exonic and intronic regions, deletions, duplications, mobile element ",,,573.2,3100.53,130 CPT,0239U,"Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free DNA, analysis of 311 or more genes, interrogation for sequence variants, including substitutions, insertions, deletions, selec",,,3430.0,18552.83,132 CPT,0242U,"Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearra",,,1207.78,26505.28,132 CPT,0243U,"Obstetrics (preeclampsia), biochemical assay of placental-growth factor, time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia ",,,63.12,341.33,130 CPT,0244U,"Oncology (solid organ), DNA, comprehensive genomic profiling, 257 genes, interrogation for single-nucleotide variants, insertions/deletions, copy number alterations, gene rearrangements, tumor-mutatio",,,3430.0,18552.83,130 CPT,0245U,"Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of maligna",,,1240.75,9576.67,130 CPT,0246U,"Red blood cell antigen typing, DNA, genotyping of at least 16 blood groups with phenotype prediction of at least 51 red blood cell antigens ",,,705.6,3817.28,130 CPT,0247U,"Obstetrics (preterm birth), insulin-like growth factor-binding protein 4 (IBP4), sex hormone-binding globulin (SHBG), quantitative measurement by LC-MS/MS, utilizing maternal serum, combined with clin",,,64.24,3975.36,130 CPT,0248U,"Oncology, spheroid cell culture in 3D microenvironment, 12 drug panel, response prediction for each drug ",,,1170.51,16082.79,130 CPT,0249T,"LIGATION, HEMORRHOIDAL VASCULAR BUNDLE(S), INCLUDING ULTRASOUND GUIDANCE ",,,4988.0,7014.0,24 CPT,0249U,"Oncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, incl laser capture microdissection, w algorithmic analysis and interpretative report ",,,572.49,11764.37,130 CPT,0250U,"Oncology (Solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for somatic alterations, microsatellite instability and tumor-mutation burden ",,,2861.21,15477.47,132 CPT,0251U,"Hepcidin-25, enzyme-linked immunosorbent assay (ELISA), serum or plasma ",,,16.92,91.62,130 CPT,0252U,"Fetal aneuploidy short tandem-repeat comparative analysis, fetal DNA from products of conception, reported as normal, monosomy, trisomy, or partial deletion/duplications, mosaicism, and segmental ane ",,,743.87,4023.85,130 CPT,0253T,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the suprachoroidal space ",,,6326.0,15059.0,89 CPT,0253U,"Reproductive medicine, RNA gene expression profile 238 genes by next-generation sequencing, endometrial tissue, predictive algorithm reported as endometrial window of implantation ",,,99.93,16747.48,130 CPT,0254T,"ENDOVASCULAR REPAIR OF ILIAC ARTERY BIFURCATION (EG, ANEURYSM, PSEUDOANEURYSM, ARTERIOVENOUS MALFORMATION, TRAUMA, DISSECTION) USING BIFURCATED ENDOGRAFT FROM THE COMMON ILIAC ARTERY INTO BOTH THE EXT",,,5841.0,16207.0,16 CPT,0254U,"Reproductive medicine, analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, results reported as normal, monosomy, ",,,99.93,4023.85,130 CPT,0255T,"HEndovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external ",,,5841.0,16207.0,16 CPT,0255U,"Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and prob",,,24.87,167.07,130 CPT,0256U,"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile, tandem mass spectrometry (MS/MS), urine, with algorithmic analysis and interpretive report ",,,48.7,847.88,130 CPT,0257U,"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD), leukocyte enzyme activity, whole blood ",,,44.78,3775.93,130 CPT,0258U,"Autoimmune (psoriasis), mRNA, next-generation sequencing, gene expression profiling of 50- 100 genes, skin-surface collection using adhesive patch, algorithm reported as likelihood of response to psor",,,3601.5,19481.51,130 CPT,0259U,"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin C and demographic data to deter",,,51.66,280.23,130 CPT,0260U,"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping ",,,51.81,6698.62,130 CPT,0261U,"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border and tumor core), tissue, r",,,144.15,26239.45,130 CPT,0262U,"Oncology (solid tumor), gene expression profiling by real-time RT-PCR of 7 gene pathways (ER, AR, PI3K, MAPK, HH, TGFB, Notch), formalin-fixed paraffin-embedded (FFPE), algorithm reported as gene path",,,3136.0,16963.03,130 CPT,0263T,"Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure including unilater",,,6326.0,13835.0,89 CPT,0263U,"Neurology (autism spectrum disorder [ASD]), quantitative measurements of 16 central carbon metabolites , liquid chromatography tandem mass spectrometry (LC-MS/MS), plasma, algorithmic analysis with re",,,220.24,3975.36,130 CPT,0264T,"Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone mar",,,6326.0,13835.0,89 CPT,0264U,"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping ",,,51.81,6698.62,130 CPT,0265T,"Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; unilateral or bilateral bone marrow h",,,6326.0,13835.0,89 CPT,0265U,"Rare constitutional and other heritable disorders, whole genome and mitochondrial DNA sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (FFPE) tissue, saliva, buccal swabs or cell ",,,863.07,29027.38,130 CPT,0266T,"Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programmin",,,5841.0,16207.0,37 CPT,0266U,"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (FF",,,51.81,16963.03,130 CPT,0267T,"Implantation or replacement of carotid sinus baroreflex activation device; lead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) ",,,4988.0,13835.0,53 CPT,0267U,"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole g",,,6604.54,35726.01,130 CPT,0268T,"Implantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) ",,,8579.0,13835.0,45 CPT,0268U,"Hematology (atypical hemolytic uremic syndrome [aHUS]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid ",,,571.42,3224.46,130 CPT,0269T,"Revision or removal of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and r",,,6326.0,13835.0,53 CPT,0269U,"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid ",,,555.16,3224.46,130 CPT,0270T,"Revision or removal of carotid sinus baroreflex activation device; lead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) ",,,4988.0,13835.0,53 CPT,0270U,"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid ",,,596.01,3224.46,130 CPT,0271T,"Revision or removal of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) ",,,4988.0,13835.0,53 CPT,0271U,"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid ",,,571.42,3224.46,130 CPT,0272U,"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive ",,,596.01,3224.46,130 CPT,0273U,"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (F13A1, F13B, FGA, FGB, FGG, SERPINA1, SERPINE1, SERPINF2, PLAU), blood, buccal swab, or amniotic fluid ",,,51.81,3224.46,130 CPT,0274T,"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde",,,8778.0,16330.72,71 CPT,0274U,"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid ",,,555.16,3224.46,130 CPT,0275T,"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde",,,8778.0,14908.0,35 CPT,0275U,"Hematology (heparin-induced thrombocytopenia), platelet antibody reactivity by flow cytometry, serum ",,,18.0,96.98,130 CPT,0276U,"Hematology (inherited thrombocytopenia), geonomic sequence analysis of 42 genes, blood, buccal swab, or amniotic fluid ",,,51.81,12980.48,130 CPT,0277U,"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid ",,,555.16,3224.46,130 CPT,0278T,"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes) ",,,283.62,2358.0,52 CPT,0278U,"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid ",,,51.81,3224.46,130 CPT,0279U,"Hematology (von Willebrand disease [VWD]), von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA), plasma, report of collagen III binding ",,,11.3,61.1,130 CPT,0280U,"Hematology (von Willebrand disease [VWD]), von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA), plasma, report of collagen IV binding ",,,16.92,91.62,130 CPT,0281T,LAA CLOSURE W/IMPLANT ,,,5841.0,16207.0,16 CPT,0281U,"Hematology (von Willebrand disease [VWD]), von Willebrand propeptide, enzyme-linked immunosorbent assays (ELISA), plasma, diagnostic report of von Willebrand factor (VWF) propeptide antigen level ",,,16.92,91.62,130 CPT,0282T,PERIPH FIELD STIMUL TRIAL ,,,9124.0,9653.0,24 CPT,0282U,"Red blood cell antigen typing, DNA, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes ",,,705.6,3817.28,130 CPT,0283T,PERIPH FIELD STIMUL PERM ,,,11178.0,15976.0,24 CPT,0283U,"von Willebrand factor (VWF), type 2B, platelet-binding evaluation, radioimmunoassay, plasma ",,,18.03,96.98,130 CPT,0284T,PERIPH FIELD STIMUL REVISE ,,,4988.0,6077.0,24 CPT,0284U,"von Willebrand factor (VWF), type 2N, factor VIII and VWF binding evaluation, enzyme-linked immunosorbent assays (ELISA), plasma ",,,16.92,91.62,130 CPT,0285U,"Oncology, disease progression and response monitoring to radiation, chemotherapy, or other systemic cancer treatments, cell-free DNA, quantitative branced chain DNA amplification, plasma, reporting ",,,51.81,1281.17,49 CPT,0286U,"CEP72 (centrosomal protein, 72-Kda) NUDT15 (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) gene analysis, conmmon variants ",,,131.45,1487.08,130 CPT,0287U,"Oncology (thyroid), DNA and mRNA, next generation sequencing analysis of 112 genes, fine needle aspirate or formalin-fixed paraffin-embedded (FFPE) tissue, algorithmic prediction of cancer recurrence,",,,3528.0,19082.76,130 CPT,0288T,ANOSCOPY W/RF DELIVERY ,,,4988.0,7014.0,24 CPT,0288U,"Oncology (lung), mRNA, quantitative PCR analysis of 11 genes (BAG1,BRCA1,CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR, WNT3A) and 3 reference genes (ESD, TBP, YAP1), formalin-fixed paraffin emb",,,51.81,20530.61,130 CPT,0289T,LASER INC FOR PKP/LKP DONOR ,,,2358.0,2358.0,8 CPT,0289U,"Neurology (Alzheimer Disease), mRNA, gene expression profiling by RNA sequencing of 24 genes, whole blood, algorithm reported as predictive risk score ",,,276.74,4029.26,130 CPT,0290T,"CORNEAL INCISIONS IN THE RECIPIENT CORNEA CREATED USING A LASER, IN PREPARATION FOR PENETRATING OR LAMELLAR KERATOPLASTY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,2358.0,2358.0,8 CPT,0290U,"Pain management, mRNA, gene expression profiling by RNA sequencing of 36 genes, whole blood, algorithm reported as predictive risk score ",,,23.29,4029.26,130 CPT,0291T,IV OCT FOR PROC INIT VESSEL ,,,2358.0,2358.0,8 CPT,0291U,"Psychiatry (mood disorders), mRNA, gene expression profiling by RNA sequencing of 144 genes, whole blood, algorithm reported as predictive risk score ",,,51.81,5071.95,49 CPT,0292T,IV OCT FOR PROC ADDL VESSEL ,,,2358.0,2358.0,8 CPT,0292U,"Psychiatry (stress disorders), mRNA, gene expression profiling by RNA sequencing of 72 genes, whole blood, algorithm reported as predictive risk score ",,,51.81,5071.95,49 CPT,0293T,"HInsertion of left atrial hemodynamic monitor; complete system, includes implanted communication module and pressure sensor lead in left atrium including transseptal access, radiological supervision ",,,5841.0,17009.0,28 CPT,0293U,"Psychiatry (suicidial ideation), mRNA, gene expression profiling by RNA sequencing of 54 genes, whole blood, algorithm reported as predictive risk score ",,,51.81,4029.26,130 CPT,0294T,HInsertion of left atrial hemodynamic monitor; pressure sensor lead at time of insertion of pacing cardioverter-defibrillator pulse generator including radiological supervision and interpretation and ,,,5841.0,17009.0,28 CPT,0294U,"Longevity and mortality risk, mRNA, gene expression profiling by RNA sequencing of 18 genes, whole blood, algorithm reported as predictive risk score ",,,303.0,4029.26,130 CPT,0295U,"Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicpathologic factors, utilizing fo",,,216.14,15707.15,130 CPT,0296U,"Oncology (oral and/or oropharyngeal cancer), gene expression profiling by RNA sequencing at least 20 molecular features, saliva, algorithm reported as positive or negative for signature associated wit",,,303.0,9303.37,130 CPT,0297U,"Oncology (pan tumor) whole genome sequencing of paired malignant and normal DNA specimens, fresh or formalin-fixed paraffin-embedded (FFPE) tissue, blood or bone marrow, comparative sequence analyses ",,,276.74,8437.64,49 CPT,0298U,"Oncology (pan tumor) whole genome sequencing of paired malignant and normal DNA specimens, fresh or formalin-fixed paraffin-embedded (FFPE) tissue, blood or bone marrow, comparative sequence analyses ",,,276.74,15477.47,130 CPT,0299T,"HExtracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; initial wound ",,,2358.0,2358.0,8 CPT,0299U,"Oncology (pan tumor), whole genome optical genome mapping of paired malignant and normal DNA specimens, fresh frozen tissue, blood, or bone marrow, comparative structural variant identification ",,,276.74,5384.71,49 CPT,0300T,"HExtracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; each additional wound (List separately in addition to code for primary proced ",,,2358.0,2358.0,8 CPT,0300U,"Oncology (pan tumor), whole genome sequencing and optical genome mapping of paired malignant and normal DNA specimens, comparative sequecne analyses and variant identification ",,,276.74,12089.25,49 CPT,0301T,"HDestruction/reduction of malignant breast tumor with externally applied focused microwave, including interstitial placement of disposable catheter with combined temperature monitoring probe and micr ",,,4988.0,6077.0,24 CPT,0301U,"Infectious agent detection by nucleic acid (DNA or RNA), Bartonella henselae and Bartonella quintana, droplet digital PCR (ddPCR); ",,,70.88,759.26,49 CPT,0302T,HInsertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when ,,,10586.0,11113.0,24 CPT,0302U,"Infectious agent detection by nucleic acid (DNA or RNA), Bartonella henselae and Bartonella quintana, droplet digital PCR (ddPCR); following liquid enrichment ",,,70.88,1044.36,49 CPT,0303T,HInsertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when ,,,9124.0,9653.0,24 CPT,0303U,"Hematology, red blood cell (RBC) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood with algorithmic analysis and result reported as an RBC adhesion index; h",,,15.7,6362.68,49 CPT,0304T,HInsertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when ,,,10586.0,11113.0,24 CPT,0304U,"Hematology, red blood cell (RBC) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood with algorithmic analysis and result reported as an RBC adhesion index; n",,,15.7,5999.06,49 CPT,0305U,"Hematology, red blood cell (RBC) functionality and deformity as a function of shear stress, whole blood, reported as a maximum elongation index ",,,26.99,1914.86,49 CPT,0306U,"Oncology (minimal residual disease [MRD]), next-generation targeted sequencing analysis, cell-free DNA, initial (baseline) assessment to determine a patient specific panel for future comparisons to ev",,,51.81,11208.72,49 CPT,0307T,HRemoval of intracardiac ischemia monitoring device ,,,4988.0,7014.0,24 CPT,0307U,"Oncology (minimal residual disease [MRD]), next-generation targeted sequencing analysis of a patient-specific panel, cell-free DNA, subsequent assessment with comparison to previously analyzed patient",,,51.81,2296.08,49 CPT,0308T,Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis ,,,2195.0,56444.44,177 CPT,0308U,"Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD ",,,51.81,2071.18,130 CPT,0309T,"HArthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4-L5 int ",,,5841.0,16207.0,16 CPT,0309U,"Cardiology (cardiovascular disease), analysis of 4 proteins (NT-proBNP, osteopontin, tissue inhibitor of metalloproteinase-1 [TIMP-1], and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported",,,51.81,2071.18,130 CPT,0310U,"Pediatrics (vasculitis, Kawasaki disease [KD]), analysis of 3 biomarkers (NTproBNP, C-reactive protein, and T-uptake), plasma, algorithm reported as a risk score for KD ",,,382.94,2071.18,130 CPT,0311U,"Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi",,,7.92,43.13,132 CPT,0312T,"VAGUS NERVE BLOCKING THERAPY (MORBID OBESITY); LAPAROSCOPIC IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY, ANTERIOR AND POSTERIOR VAGAL TRUNKS ADJACENT TO ESOPHAGOGASTRIC JUNCTION (EGJ), WITH IMPLAN",,,5202.0,13313.0,28 CPT,0312U,"Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), fl",,,823.84,4456.75,130 CPT,0313T,"VAGUS NERVE BLOCKING THERAPY (MORBID OBESITY); LAPAROSCOPIC REVISION OR REPLACEMENT OF VAGAL TRUNK NEUROSTIMULATOR ELECTRODE ARRAY, INCLUDING CONNECTION TO EXISTING PULSE GENERATOR ",,,4988.0,7026.0,36 CPT,0313U,"Oncology (pancreas), DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression, pancreatic cyst fluid, algorithm reported as a categorical result (ie, ",,,3528.0,19082.76,130 CPT,0314T,VAGUS NERVE BLOCKING THERAPY (MORBID OBESITY); LAPAROSCOPIC REMOVAL OF VAGAL TRUNK NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR ,,,4988.0,7026.0,36 CPT,0314U,"Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as a c",,,1911.0,6220.5,49 CPT,0315T,VAGUS NERVE BLOCKING THERAPY (MORBID OBESITY); REMOVAL OF PULSE GENERATOR ,,,4988.0,6077.0,24 CPT,0315U,"Oncology (cutaneous squamous cell carcinoma), mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm ",,,3939.0,24565.0,49 CPT,0316T,VAGUS NERVE BLOCKING THERAPY (MORBID OBESITY); REPLACEMENT OF PULSE GENERATOR ,,,8579.0,13313.0,24 CPT,0316U,"Borrelia burgdorferi (Lyme disease), OspA protein evaluation, urine ",,,18.29,98.82,130 CPT,0317U,"Oncology (lung cancer), four-probe FISH (3q29, 3p22.1, 10q22.3, 10cen) assay, whole blood, predictive algorithmgenerated evaluation reported as decreased or increased risk for lung cancer ",,,1989.4,10760.19,130 CPT,0318T,REPLACE AORTIC VALVE TTHORAC ,,,2358.0,2358.0,8 CPT,0318U,"Pediatrics (congenital epigenetic disorders), whole genome methylation analysis by microarray for 50 or more genes, blood ",,,95.45,5116.69,49 CPT,0319U,"""Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using pretransplant peripheral blood, algorithm reported as a risk scorefor early acute rejection"" ",,,2597.0,10335.6,49 CPT,0320U,"Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection ",,,2597.0,10335.6,49 CPT,0321U,"Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms and identification of 16 associated antibiotic-resistance genes, m",,,70.88,3364.57,130 CPT,0322U,"Neurology (autism spectrum disorder [ASD]), quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites, liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma, ",,,220.24,3975.36,130 CPT,0323U,"Infectious agent detection by nucleic acid (DNA/RNA), central nervous system pathogen, metagenomic next-generation sequencing , cerebrospinal fluid (CSF), identification of pathogenic bacteria, viruse",,,841.9,11270.37,130 CPT,0326U,"Target genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 83 or more genes, iterrogation for sequence variants, gene copy number amplifications, gene rearrang",,,4900.0,14450.0,51 CPT,0327U,"Fetal aneuploidy (trisomy 13, 18, and 21), DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy, includes sex reporting, if performed ",,,779.1,4214.24,130 CPT,0328U,"Drug assay, definitive, 120 or more drugs and metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS), includes specimen validity and algorithmic analysis descr",,,112.14,787.67,130 CPT,0329U,"Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutation",,,51.81,9935.76,49 CPT,0330T,"Tear film imaging, unilateral or bilateral, with interpretation and report ",,,58.84,129.37,5 CPT,0330U,"Infectious agent detection by nucleic acid (DNA/RNA), vaginal pathogen panel, identification of 27 organisms, amplified probe technique, vaginal swab ",,,70.88,2209.51,130 CPT,0331T,"Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment; ",,,2239.05,4923.38,5 CPT,0331U,"Oncology (hematolymphoid neoplasia), optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow, report of clinically significant alterations ",,,51.81,5384.71,49 CPT,0332T,"Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment; with tomographic SPECT ",,,2239.05,4923.38,5 CPT,0332U,"Oncology (pan-tumor), genetic profiling of 8 DNA-regulatory markers by qPCR, whole blood, reported as a high or low probability of responding to immune checkpoint-inhibitor therapy ",,,1119.22,11962.5,49 CPT,0333U,"Oncology (liver), surveillance for HCC in high-rish patients, analysis of methylation patterns on circulating cfDNA plus measurement of serum of APF/APF-L3 and oncoprotein DCP, algorithm reported as n",,,649.07,1914.1,49 CPT,0334U,"Oncology (solid organ), target geonomic sequence analysis, FFPE tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements,",,,3430.0,15477.47,130 CPT,0335T,Insertion of sinus tarsi implant ,,,2699.0,15059.0,149 CPT,0335U,"Rare diseases, whole genome sequence analysis, incl small sequence changes, copy number variants, deletions, duplications, mobile element insertions, UPD, inversions, aneuploidy, mitochondrial genome ",,,863.07,27696.27,130 CPT,0336T,LAP ABLAT UTERINE FIBROIDS ,,,10586.0,11113.0,24 CPT,0336U,"Rare diseases, whole genome sequence analysis, incl small sequence changes, copy number variants, deletions, duplications, mobile element insertions, UPD, inversions, aneuploidy, mitochondrial genome ",,,863.07,13648.74,130 CPT,0337U,"Oncology (Plasma cell disorders and myeloma), circulating plasma cell immunologic selection, id, morphological characterization, and enumeration of plasma cells based on differential CD138, CD38, CD19",,,2386.3,9158.49,49 CPT,0338T,"Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r",,,3673.0,15059.0,185 CPT,0338U,"Oncology (Solid Tumor), circulating tumor cell selection, id, morphological characterization, detection and enumeration based on differential EpCAM, cytokeratins 8, 18 and 19, and CD45 protein biomark",,,51.81,7037.15,51 CPT,0339T,RENAL SYMP DENERV BI,26682.0,26682.0,1600.92,22679.7,20 CPT,0339T,"Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r",26682.0,26682.0,3673.0,15059.0,185 CPT,0339U,"Oncology (prostate), mRNA expression profiling of HOXC6 and DLX1, reverse transcription polymerase chain reaction (RT-PCR), first void urine following digital rectal examination, algorithn reporteed a",,,744.8,12354.87,130 CPT,0340T,"HAblation, pulmonary tumor(s), including pleura or chest wall when involved by tumor extension, percutaneous, cryoablation, unilateral, includes imaging guidance ",,,9124.0,9653.0,24 CPT,0340U,"Oncology (pan-cancer), analysis of MRD from plasma, with assays personalized to each patient based on prior next generation sequencing of the patient's tumor and germline DNA, reported as absence or p",,,3518.2,20780.31,130 CPT,0341U,"Fetal aneuploidy DNA sequencing comparative analysis, fetal DNA from products of conception, reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism and segmental ",,,1605.9,5491.58,49 CPT,0342T,Therapeutic apheresis with selective HDL delipidation and plasma reinfusion ,,,6326.0,13835.0,89 CPT,0342U,"Oncology (pancreatic cancer), multiplex immonoassay of C5, C4, Cystatin C, factor B, osteoprotegerin, gelsolin, IGFBP3, CA125 and multiplex electrochemiluminescent immunoassay for CA19-9, serum, diagn",,,42.04,4754.94,130 CPT,0343U,"Oncology (prostate), exosome-based analysis of 442 small noncoding RNAs by quantitative reverse transcription polymerase chain reaction, urine, reported as molecular evidence of no-, low-, intermediat",,,744.8,12354.87,132 CPT,0344U,"Hepatology (nonalcoholic fatty liver disease), semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectometry, serum, reported as at-risk for nonalcoholic steato",,,51.81,2289.37,49 CPT,0345T,TMVR PERC APRCH COR SIN,79097.99,79097.99,4745.88,67233.29,26 CPT,0345T,Transcatheter mitral valve repair percutaneous approach via the coronary sinus ,79097.99,79097.99,5841.0,17927.53,81 CPT,0345U,"Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6 ",,,51.81,7083.03,130 CPT,0347T,Placement of interstitial device(s) in bone for radiostereometric analysis (RSA) ,,,112.77,3249.0,148 CPT,0347U,"Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes ",,,910.84,7083.03,130 CPT,0348T,"Radiologic examination, radiostereometric analysis (RSA); spine, (includes cervical, thoracic and lumbosacral, when performed) ",,,197.26,591.63,98 CPT,0348U,"Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes ",,,727.42,3934.01,130 CPT,0349T,"Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow, and wrist, when performed) ",,,197.26,2541.94,98 CPT,0349U,"Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interactions ",,,727.42,3934.01,130 CPT,0350T,"Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed) ",,,140.47,2210.52,98 CPT,0350U,"Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis and reported phenotypes ",,,910.84,7083.03,130 CPT,0351T,"Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; real-time intraoperative ",,,7877.12,10654.92,12 CPT,0351U,"Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor related apoptosis-inducing ligand interferon gamma induced protein-10, and C-reactive protein, serum, algorithm repor",,,202.0,1381.38,132 CPT,0352T,"Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred ",,,7877.12,10654.92,12 CPT,0352U,"Infectious disease (bact vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-assoc bacteria, algorithm reported as detected or not detected and separate",,,586.84,756.26,81 CPT,0353T,"Optical coherence tomography of breast, surgical cavity; real-time intraoperative ",,,2806.56,3796.28,12 CPT,0353U,"Infectious agent detection by nucleic acid, Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technque, urine, vaginal, pharyngeal or rectal, each pathogen reported as detecte",,,288.55,371.85,81 CPT,0354T,"Optical coherence tomography of breast, surgical cavity; interpretation and report, real-time or referred ",,,7877.12,10654.92,12 CPT,0354U,"Human papilloma virus, high-risk types (ie, 16, 18, 31, 33, 45, 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction ",,,144.97,186.82,81 CPT,0355T,"GASTROINTESTINAL TRACT IMAGING, INTRALUMINAL (EG, CAPSULE ENDOSCOPY), COLON, WITH INTERPRETATION AND REPORT ",,,2431.0,2979.0,24 CPT,0355U,"Apol1 (apolipoprotein l1) (eg, chronic kidney disease), risk variants ",,,134.26,3030.5,49 CPT,0356T,"INSERTION OF DRUG-ELUTING IMPLANT (INCLUDING PUNCTAL DILATION AND IMPLANT REMOVAL WHEN PERFORMED) INTO LACRIMAL CANALICULUS, EACH ",,,2358.0,2358.0,8 CPT,0356U,"Oncology evaluation of 17 DNA biomarkers using droplet digital PCR, cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence ",,,303.0,5202.0,49 CPT,0358T,"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report ",,,53.8,74.26,5 CPT,0358U,"Neurology (mild cognitive impairment), analysis of b-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative ",,,255.29,1725.76,49 CPT,0359U,"Oncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer ",,,744.8,2424.4,49 CPT,0360U,"Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy ",,,823.84,9158.49,49 CPT,0362U,"Oncology (papillary thyroid cancer), gene-expression profiling via targeted hybrid capture-enrichment rna sequencing of 82 content genes and 10 housekeeping genes, formalin-fixed paraffin embedded (ff",,,3528.0,11723.25,49 CPT,0363U,"Oncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of 5 genes (mdk, hoxa13, cdc2 ºcdk1», igfbp5, and cxcr2), utilizing urine, algorithm incorporates age, sex, smoking",,,744.8,2424.4,49 CPT,0364U,"Oncology (hematolymphoid neoplasm), genomic seq anal using multiplex (PCR) & next gen seq w altorithm, quantification of dominatnt clonal sequ, reported as presence or absence of minimal residual dise",,,1967.11,11962.5,51 CPT,0365U,"Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer ",,,879.06,2592.33,49 CPT,0366U,"Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer ",,,879.06,2592.33,49 CPT,0367U,"Oncology (Bladder), analysis of 10 protein biomarkers by immunoassays, urine, diagnostic algorithm reported as a risk score for probability of rapid recurrence of recurrent or persistent cancer follow",,,884.14,2607.3,49 CPT,0368U,"Oncology (colorectal cancer), eval for mutations of APC, BRAF, CTNNB1, KRAS, NRAS, IPK3CA, SMAD4, and TP53, and methylation markers, multiplex quantitative polymerase chain reaction (qPCR), circulatin",,,144.15,1204.49,49 CPT,0371U,"Infectious agent detection by nucleic a3cid, genitourinary pathogen, semiquantitative identification, DNA from 16 bacterial organisms and 1 fungal organism, multiplex amplified probe technique via qua",,,70.88,1204.49,49 CPT,0372U,"Infectious disease (genitourinary pathogens), antibiotic-resistance gene detection, multiplex amplified probe technique, urine, reported as an antimicrobial stewardship risk score ",,,288.11,1204.49,49 CPT,0375T,"TOTAL DISC ARTHROPLASTY (ARTIFICIAL DISC), ANTERIOR APPROACH, INCLUDING DISCECTOMY WITH END PLATE PREPARATION (INCLUDES OSTEOPHYTECTOMY FOR NERVE ROOT OR SPINAL CORD DECOMPRESSION AND MICRODISSECTION)",,,5841.0,16207.0,16 CPT,0375U,"Oncology (ovarian), biochemical assays of 7 proteins (follicle stimulating hormone, human epididymis protein 4, apolipoprotein A-1, transferrin, beta-2 macroglobulin, prea0lbumin, and cancer antigen 1",,,724.78,2592.33,51 CPT,0376T,"INSERTION OF ANTERIOR SEGMENT AQUEOUS DRAINAGE DEVICE, WITHOUT EXTRAOCULAR RESERVOIR, INTERNAL APPROACH, INTO THE TRABECULAR MESHWORK; EACH ADDITIONAL DEVICE INSERTION (LIST SEPARATELY IN ADDITION TO ",,,2358.0,2358.0,8 CPT,0376U,"Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prostate cancer-specific morta",,,692.13,12354.87,49 CPT,0377T,ANOSCOPY WITH DIRECTED SUBMUCOSAL INJECTION OF BULKING AGENT FOR FECAL INCONTINENCE ,,,4988.0,7014.0,24 CPT,0377U,"Cardiovascular disease, quantification of advanced serum or plasma lipoprotein profile, by nuclear magnetic resonance spectrometry with report of a lipoprotein profile (incl 23 variables) ",,,46.63,137.51,51 CPT,0378U,"RFC1 repeat expansion variant analysis by traditional and repeat-primed PCR, blood, saliva, or buccal swab ",,,51.81,395.93,49 CPT,0379T,"Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; technical suppor",,,78.23,107.98,5 CPT,0379U,"Targeted genomic sequence analysis panel, solid organ neoplasm, DNA (523 genes) and RNA (55 genes) by next-gen seq, interrogation for sequence variants, gene copy number amplifications, gene rearrange",,,3222.74,9503.79,49 CPT,0381U,"Maple syrup urine disease monitoring by patient-collected blood card sample, quantitative measurement of allo-isoleucine, leucine, isoleucine, and valine, liquid chromatography with tandem mass spectr",,,43.24,303.02,49 CPT,0382U,"Hyperphenylalaninemia monitoring by patient-collected blood card sample, quantitative measurement of phenylalanine and tyrosine, liquid chromatography with tandem mass spectrometry ",,,50.61,347.81,49 CPT,0383U,"Tyrosinemia typr I monitoring by patient-collected blood card sample, quantitative measurement of tyrosine, phenylalanine, methionine, succinylacetone, nitisinone, liquid chromatography with tandem ma",,,51.01,347.81,49 CPT,0384U,"Nephrology (chronic kidney disease), carboxymethyllysine, methylglyoxal hydroimidazolone, and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry and HbA1c and estimated glomeru",,,735.0,3030.5,49 CPT,0385U,"Nephrology (chronic kidney disease), apolipoprotein A4, CD5 antigen-like, and insulin-like growth factor binding protein 3 by enzyme-linked immunoassay, plasma, algorithm, combining results with HDL, ",,,382.94,3030.5,49 CPT,0387T,"TRANSCATHETER INSERTION OR REPLACEMENT OF PERMANENT LEADLESS PACEMAKER, VENTRICULAR ",,,8579.0,13313.0,24 CPT,0387U,"Oncology, autophagy and beclin 1 revulator 1 and loricrin by immunohistochemistry, formalinfixed paraffin-embedded tissue, report for risk of progression ",,,929.53,6220.5,49 CPT,0388T,"TRANSCATHETER REMOVAL OF PERMANENT LEADLESS PACEMAKER, VENTRICULAR ",,,4988.0,7014.0,24 CPT,0388U,"Oncology, next-generation sequencing with ident of single nucleotide variants, copy number variants, insertions and deletions, and scructural variants in 37 cancer related genes, plasma, with report f",,,655.65,10115.0,49 CPT,0389U,"Pediatric febrile illness (Kawasaki disease) interferon alphainducible protein 27 and mast cell-expressed membraine protein 1, RNA, using reverse transcription polymerase chain reaction, blood, report",,,68.8,1605.85,49 CPT,0390U,"Obstetrics (preeclampsia), kinase insert domain receptor, Endoglin, and retinol-binding protein 4, by immunoassay, serum, algorithm reported as a risk score ",,,63.12,186.14,49 CPT,0391U,"Oncology, DNA and RNA by nex-gen sequencing, utilizing FFPE tissue, 437 genes, interpretive report for single nucleotide variants, splicesite variants, inserts/deletions, copy number alterations, gene",,,3528.0,11962.5,49 CPT,0392T,Lap es sph augment dev place ,,,10586.0,11113.0,24 CPT,0392U,"Drug metabolism (ADHD), gene-drug interactions, variant analysis of 16 genes, including deletion/duplication analysis of CYP2D6, reported as impact of gene-drug interaction for each drug ",,,910.84,3861.3,49 CPT,0393T,Es sph augmnt device removal ,,,9124.0,9653.0,24 CPT,0393U,"Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative ",,,530.17,1725.76,51 CPT,0394U,"Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative ",,,48.66,574.36,49 CPT,0395T,"High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed ",,,1303.32,2865.81,5 CPT,0395U,"Oncology (lung), multi-omics, plasma, algorithm reported as malignancy risk for lung nodules in early-stage disease ",,,781.5,6475.7,49 CPT,0396T,INTRA-OPERATIVE USE OF KINETIC BALANCE SENSOR FOR IMPLANT STABILITY DURING KNEE REPLACEMENT ARTHROPLASTY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ,,,2358.0,2358.0,8 CPT,0397T,"Endoscopic retrograde cholangiopancreatography (ERCP), with optical endomicroscopy (List separately in addition to code for primary procedure) ",,,1672.0,3755.0,133 CPT,0398T,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation lesion, intracranial for movement disorder including stereotactic navigation and frame placement when ",,,5841.0,16207.0,45 CPT,0398U,"Gastroenterology (Barret esophagus), P16, RUNX3,HPP1, & FBN1 DNA methylation analysis using PCR, FFPE tissue, algorithm reported as risk score for progression to high-grade dysplasia or cancer ",,,289.87,5071.95,51 CPT,0399U,"Neurology (cerebral folate deficiency), serum, detection of anti-human folate receptor IgGbinding antibody and blocking antibodies by enzyme-linked immunoassay, qualitative and blocking autoantibodies",,,29.69,867.0,49 CPT,0400U,"Obstetrics (exp carrier screen), 145 genes by nextgeneration sequencing, fragment analysis and multiplex ligationdependent probe amplification, DNA, reported as carrier positive or negative ",,,1427.74,7810.91,49 CPT,0401U,"Cardiology (CAD), 9 genes (12 variants), targeted variant genotyping, blood, saliva, or buccal swab, algorithm reported as a genetic risk score for a coronary event ",,,51.81,1415.18,49 CPT,0402T,"Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed ",,,1986.0,12562.0,185 CPT,0402U,"Infectious agent, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, multiples amplified probe technique, vaginal, endocervical, or male urine, each pathogen r",,,70.88,412.2,51 CPT,0403T,"Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per",,,37.95,52.39,5 CPT,0403U,"Oncology (Prostate), mRNA, gene expression peofiling of 18 genes, first-catch, algorithm reported as percentage of likelihood of detecting clinical significant prostate cancer ",,,51.81,2196.4,49 CPT,0404T,"TRANSCERVICAL UTERINE FIBROID(S) ABLATION WITH ULTRASOUND GUIDANCE, RADIOFREQUENCY ",,,6326.0,9653.0,32 CPT,0404U,"Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression ",,,316.5,933.35,51 CPT,0405U,"Oncology (pancreatic), 59 methylation haplotype block markers, next-generation sequencing, plasma, reported as cancer signal detected or not detected ",,,42.04,5116.69,49 CPT,0406T,"NASAL ENDOSCOPY, SURGICAL, ETHMOID SINUS, PLACEMENT OF DRUG ELUTING IMPLANT; ",,,2358.0,2358.0,8 CPT,0406U,"Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer ",,,744.8,9158.49,49 CPT,0407T,"NASAL ENDOSCOPY, SURGICAL, ETHMOID SINUS, PLACEMENT OF DRUG ELUTING IMPLANT; WITH BIOPSY, POLYPECTOMY OR DEBRIDEMENT ",,,2358.0,2358.0,8 CPT,0407U,"Nephrology (diabetic chronic kidney disease), multiplex electrochiluminescent immunoassay of soluble tumor necrosis factor receptor 1, 2, and kidney injury molecule 1 combined with clinical data, plas",,,931.0,3030.5,51 CPT,0408T,INS/REPL CCM SYSTEM,209569.42,209569.42,12574.17,178134.01,20 CPT,0408T,"Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator",209569.42,209569.42,10740.0,62006.19,93 CPT,0408U,"Infectious agent antigen detection by bulk acoustic wave biosensor immumoassay, severe acute reporatory syndrome conronavirus 2 (COVID-19) ",,,13.85,144.28,49 CPT,0409T,"Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator",,,3673.0,62006.19,177 CPT,0409U,"Oncology (solid tumor), DNA (80 genes) & RNA (36 genes), by next-generation sequencing from plasma, including single nucleotide variants, insertions, deletions, copy number alterations, microsatellite",,,2861.21,11962.5,49 CPT,0410T,"Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; atrial electrod",,,8579.0,20862.25,101 CPT,0410U,"Oncology (pancreatic), DNA, whole genome sequencing with 5-hydrosymethylcytosine enrichment, whole blood or plasma, algorithm reported as cancer detected or not detected ",,,42.04,3352.4,49 CPT,0411T,"Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; ventricular ele",,,8579.0,20862.25,101 CPT,0411U,"Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6 ",,,51.81,3861.3,49 CPT,0412T,Removal of permanent cardiac contractility modulation system; pulse generator only ,,,2699.0,15059.0,185 CPT,0412U,"Beta amyloid, AB42/40 ratio, immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry and ApoE isoform-specific peotyotyping, plasma combined with age ",,,48.66,2167.5,51 CPT,0413T,Removal of permanent cardiac contractility modulation system; transvenous electrode (atrial or ventricular) ,,,4988.0,17009.0,101 CPT,0413U,"Oncology (hematolymphoid neoplasm), optical genome mapping for ocpy number alterations, aneuploidy, and balanced/complex structural rearrangements, DNA from blood or bone marrow, report of clinically ",,,51.81,3651.6,49 CPT,0414T,Removal and replacement of permanent cardiac contractility modulation system pulse generator only ,,,3673.0,62006.19,177 CPT,0414U,"Oncology (lung), augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK, BRAF, EGFR, ERBB2, MET, NTRK1-3, RET, ROSI), and KRAS G12C and PL-L1, if performed, formalin-fixed",,,51.81,2041.06,49 CPT,0415T,Repositioning of previously implanted cardiac contractility modulation transvenous electrode (atrial or ventricular lead) ,,,1292.55,17009.0,101 CPT,0415U,"Cardiovascular disease , IL-16, FAS, FASLigand, HGF, CTACK, EOTAXIN, and MCP-3 by immunoassay combined with age, sex, family history, and personal history of diabetes, blood, algorithm reported as a 5",,,51.81,1129.27,49 CPT,0416T,Relocation of skin pocket for implanted cardiac contractility modulation pulse generator ,,,2195.0,12909.0,185 CPT,0417T,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including",,,84.82,117.09,5 CPT,0417U,"Rare diseases (constitutional/heritable disorders), whole mitochordrial genome sequence with heteroplasmy detection and deletion analysis, nuclear-encoded mitochrondrial gene analysis of 335 nuclear g",,,863.07,8214.91,49 CPT,0418T,"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, implantable cardiac contractility modulation syste",,,84.82,117.09,5 CPT,0418U,"Oncology (breast), augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features, reported as a recurrence score ",,,144.15,2041.06,49 CPT,0419T,"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater than 50 neurofibromas ",,,1672.0,3596.32,169 CPT,0419U,"Neuropsychiatry (eg, depression, anxiety), genomic sequence analysis panel, variant analysis of 13 genes, saliva or buccal swab, report of each gene phenotype ",,,51.81,3861.3,49 CPT,0420T,"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas ",,,1672.0,3596.32,169 CPT,0420U,"Oncology (urothelial), mRNA expression profiling by real-time quantitative PCR of MDK HOXA13, CDC2, IGFBP5, and CXCR2 in combination with droplet digital PCR analysis of 6 single-nucleotide polymorphi",,,1301.75,3838.84,49 CPT,0421T,"Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,5841.0,16207.0,45 CPT,0421U,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 8 RNA markers and fecal hemoglobin, algorithm reported as a positive or negative for colorectal cancer risk ",,,498.69,1623.3,49 CPT,0422T,"Tactile breast imaging by computer-aided tactile sensors, unilateral or bilateral ",,,140.47,308.86,5 CPT,0422U,"Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-treatment cell-free circulating D",,,276.74,5615.88,49 CPT,0423U,"Psychiatry (eg, depression, anxiety), geonomic analysis panel, including variant analysis of 26 genes, buccal swab, report including metabolizer status and risk of drug toxicity by condition ",,,51.81,1204.49,7 CPT,0424T,"INSERTION OR REPLACEMENT OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; COMPLETE SYSTEM (TRANSVENOUS PLACEMENT OF RIGHT OR LEFT STIMULATION LEAD, SENSING LEAD, IMPLANTABLE PULSE GENER",,,11178.0,15976.0,24 CPT,0424U,"Oncology (prostate), exosome-based analysis of 53 small noncoding RNAs by quantitative reverse transcription polymerase chain reaction, urine, reported as no molecular evidence, low-, moderate- or ele",,,744.8,12354.87,49 CPT,0425T,INSERTION OR REPLACEMENT OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; SENSING LEAD ONLY ,,,8778.0,10586.0,32 CPT,0425U,"Genome, rapid sequence analysis, each comparator genome ",,,4012.5,16049.53,49 CPT,0426T,INSERTION OR REPLACEMENT OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; STIMULATION LEAD ONLY ,,,9875.0,13313.0,32 CPT,0426U,"Genome, ultra-rapid sequence analysis ",,,7430.56,21912.56,49 CPT,0427T,INSERTION OR REPLACEMENT OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; PULSE GENERATOR ONLY ,,,11178.0,13313.0,24 CPT,0427U,"Monocyte distribution width, whole blood ",,,4.39,22.71,51 CPT,0428T,REMOVAL OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; PULSE GENERATOR ONLY ,,,4988.0,7014.0,32 CPT,0429T,REMOVAL OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; SENSING LEAD ONLY ,,,4988.0,7014.0,32 CPT,0429U,"Human papillomavirus (HPV), oropharyngeal swab, 14 high-risk types ",,,34.39,111.94,49 CPT,0430T,REMOVAL OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; STIMULATION LEAD ONLY ,,,4988.0,7014.0,32 CPT,0430U,"Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative ",,,46.4,177.85,49 CPT,0431T,"REMOVAL AND REPLACEMENT OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA, PULSE GENERATOR ONLY ",,,11178.0,13313.0,24 CPT,0431U,"Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative ",,,24.34,105.69,49 CPT,0432T,REPOSITIONING OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; STIMULATION LEAD ONLY ,,,4988.0,7014.0,32 CPT,0432U,"Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative ",,,24.34,105.69,49 CPT,0433T,REPOSITIONING OF NEUROSTIMULATOR SYSTEM FOR TREATMENT OF CENTRAL SLEEP APNEA; SENSING LEAD ONLY ,,,4988.0,7014.0,32 CPT,0433U,"Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer ",,,744.8,2424.4,49 CPT,0434U,"Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes ",,,408.44,2367.84,49 CPT,0435U,"Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells, from culturedCSCs and primary tumor cells, categorical drug response reported based on cytotoxicity percentage observed, minimu",,,99.93,8767.86,49 CPT,0436U,"Oncology (lung), plasma analysis of 388 proteins, using aptamer-based proteomics technology, predictive algorithm reported as clinical benefit from immune checkpoint inhibitor therapy ",,,1474.16,11962.5,49 CPT,0437T,"Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure) ",,,1672.0,3083.0,112 CPT,0437U,"Psychiatry (anxiety disorders), mRNA, gene expression profiling by RNA sequencing of 15 biomarkers, whole blood, algorithm reported as predictive risk score ",,,51.81,2196.4,49 CPT,0438T,"HTransperineal placement of biodegradable material, peri-prostatic (via needle), single or multiple, includes image guidance ",,,7014.0,7014.0,8 CPT,0438U,"Drug metabolism (adverse drug reactions and drug response), buccal specimen, gene-drug interactions, variant analysis of 33 genes, including deletion/duplication analysis of CYP2D6, including reported",,,408.44,1438.4,49 CPT,0439T,"Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (List separately in addition to code for primary procedure) ",,,226.86,313.15,5 CPT,0439U,"Cardiology (Coronary Heart Disease), DNA, analysis of 5 single-nucleotide polymorphisms and 3 DNA methylation markers, qPCR and digital PCR, whole blood, algorighm reported as a 4-tiered risk score fo",,,51.81,2468.06,49 CPT,0440T,"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve ",,,1986.0,13835.0,169 CPT,0440U,"Cardiology (Coronary Heart Disease), DNA, analysis of 10 single-necleotide polymorphisms (SNPs) and 6 DNA methylation markers, qPCD and digital PCR, whole blood, algorithm reported as detected for CHD",,,51.81,2468.06,49 CPT,0441T,"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve ",,,1986.0,13835.0,169 CPT,0441U,"Infectious disease (bacterial, fungal or viral infection), semiquantitative biomechanical assessment, whole blood with algorighmic analysis and result reported as an Index ",,,36.54,1283.39,51 CPT,0442T,"Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve) ",,,2195.0,15039.6,169 CPT,0442U,"Infectious disease (respiratory infection), Myxovirus resistance protein A and C-reactive protein, fingerstick whole blood specimen, each biomarker reported as present or absent ",,,40.55,119.59,51 CPT,0443T,"Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (List separately in addition to code for primary procedure) ",,,278.32,2358.0,28 CPT,0443U,"Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid ",,,34.89,335.9,51 CPT,0444T,"Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral ",,,1672.0,4220.0,112 CPT,0444U,"Oncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using DNA from formalin-fixed paraffin",,,2861.21,9313.52,49 CPT,0445T,"Subsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of existing insert, unilateral or bilateral ",,,1672.0,4220.0,112 CPT,0445U,"B-amyloid and phosphotau, electrochemiluminescent immunoassay, cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology ",,,255.29,1725.76,51 CPT,0446T,"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training ",,,1018.89,3249.0,169 CPT,0446U,"Autoimmune diseases (systemic lupus erythematosus), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic risk score for curren",,,18.79,2429.48,49 CPT,0447T,Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision ,,,358.2,3244.0,169 CPT,0447U,"Autoimmune diseases, analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic prognostic risk score for developing a clinical flar",,,18.79,2429.48,49 CPT,0448T,"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation ",,,1018.89,3249.0,169 CPT,0449T,"Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device ",,,2699.0,13835.0,169 CPT,0449U,"Carrier screening for severe inherited conditions (CF, spinal musc atrophy, beta hemoglobinopathies), regardless of race or self-identified ancestry, genomic sequence analysis panel, must include anal",,,1788.38,7810.91,51 CPT,0450T,"Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedur",,,1672.0,3083.0,112 CPT,0452U,"Oncology (bladder),methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTR-qMSP),urine reported as likelihood of bladder cancer ",,,188.16,2424.4,49 CPT,0453U,"Oncology (colorectal cancer),cellfree DNA (cfDNA),methylationbased quantitative PCR assay (SEPTIN9,IKZF1,BCATI,Septin9-2,VAV3,BCAN),plasma,reported as presence or absence of circulating tumor DNA ",,,144.15,554.88,49 CPT,0454U,"Rare diseases (constitutional/heritable disorders),identification of copy number variations,inversions,insertions,translocations,and other structural variants by optical genome mapping ",,,51.81,3651.6,49 CPT,0455U,"Infectious agents (Sexually transmitted infection),Chlamydia tracomatic, Neisseria gonorrhoeae,and Trichomonas vaginalis,multiples amplified probe technique,vaginal,endocervical,gynecological specimen",,,70.88,412.2,51 CPT,0457U,"Perfluoroalkyl substances (PFAS) (eg perfluorooctanoic acid, perflurooctaine sulfonic acid),9 PFAS compounds by LC-MS/MS,plasma or serum, quantitative ",,,48.66,574.36,49 CPT,0458U,"Oncology (breast cancer),S100A8 and S100A9,by enzymelinked immunosorbent assay (ELISA),terafluid with age, algorithm reported as a risk score ",,,255.29,9158.49,49 CPT,0459U,"B-amyloid (Abeta42) and total tau (tTau), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology ",,,255.29,1725.76,51 CPT,0460U,"Oncology, whole blood or buccal,DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes, with variant analysis and reported phenotypes ",,,51.81,2650.36,49 CPT,0461U,"Oncology,parmacogenomic analysis of single-necleotide polymorphism (SNP)genotyping by real time PCR of 24 genes,whole blood or buccal swab,with variant analysis, incl impacted gene-drug interactions ",,,898.74,2650.36,49 CPT,0462U,"Melatonin levels test,sleep study,7 or 9 sample melatonin profile (cortisol optional),enzyme-linked immunosorbent assay (ELISA),saliva screening/preliminary ",,,16.92,49.91,44 CPT,0463U,"Oncology (cervix),mRNA gene expression profiling of 14 biomarkers (E6&E7 of the highest-risk human papillomavirus (HPV) types 16,18,31,33,42,52,58),by real time nucleic acid sequence-based amplifica ",,,744.8,3030.5,49 CPT,0464T,"Visual evoked potential, testing for glaucoma, with interpretation and report ",,,279.47,441.34,5 CPT,0464U,"Oncology (colorectal) screening,quantitative real-time target and signal amplification,methylated DNA markers,incl LASS4,LRRC4 and PPP24RC,a reference marker ZDHHC1,and a protein marker (fecal hemoglo",,,580.08,1710.65,51 CPT,0465T,SUPRACHOROIDAL INJECTION OF A PHARMACOLOGIC AGENT (DOES NOT INCLUDE SUPPLY OF MEDICATION) ,,,1672.0,1672.0,8 CPT,0465U,"Oncology (urothelial carcinoma),DNA,quantitative methylationspecific PCR of 2 genes (ONECUT2,VIM),algorithmic analysis reported as positive or negative ",,,1535.2,5600.85,51 CPT,0466U,"Cardiology (Coronary artery disease (CAD)),DNA,genomewide association studies (564856 single-nucleotide polymorphisms (SNPs),targeted variant genotyping),patient lifestyle & clinical data,buccal swab,",,,51.81,998.29,49 CPT,0467U,"Oncology (bladder),DNA,nextgeneration sequencing (NGS) of 60 genes and whole genome aneuploidy,urine,altorighms reported as minimal residual disease (MRD) status positive or negative and quantitative ",,,51.81,4390.08,49 CPT,0468U,"Hepatology (nonalcoholic steatohepatitis(NASH)),miR-34a5p,alpha 2-macroglobulin, YKL40, HbA1c, serum and whole blood, algorithm reported as a single score for NASH activity & fibrosis ",,,51.81,727.41,49 CPT,0469T,"Retinal polarization scan, ocular screening with on-site automated results, bilateral ",,,13.5,18.64,5 CPT,0469U,"Rare diseases (constitutional/heritble disorders),whole genome seq analysis for chromosonal abnormalities, copy number variants,duplications,deletions,inversions,unbalanced translocations,regions of ",,,863.07,3462.05,49 CPT,0470U,"Oncology (oropharyngeal),detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets,cell-free HPV 15 and 18 DNA from plasma ",,,303.0,1727.96,49 CPT,0471U,"Oncology (colorectal cancer),qualitative real-time PCR of 35 variants of KRAS & NRAS genes (exons 2,3,4),formalinfixed paraffine-embedded (FFPE),predictive,identification of detected mutations ",,,144.15,2196.4,51 CPT,0472T,"Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functi",,,547.24,864.2,5 CPT,0472U,"Carbonic anhydrase VI (CA VI),paraotid specific/secretory protein (PSP) and salivary protein (SP1 IgG,IgM,IgA antibodies, enzyme-linked immunosorbent assay (ELISA), semiqualitative,blood,reported as ",,,27.34,80.63,49 CPT,0473T,"Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a",,,229.13,361.84,5 CPT,0473U,"Oncology (solid tumor),nextgeneration sequencing (NGS) of DNA from formalin-fixed paraffinembedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen (blood or saliva), 68",,,4410.0,13005.0,51 CPT,0474T,"Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space ",,,2699.0,13835.0,161 CPT,0474U,"Hereditary pan-cancer (eg, Hereditary sarcomas, hereditary endocrine tumors, hereditary cutaneous melanoma),genomic sequence analysis panel of 88 genes with 20 duplications/deletions using nextgen ",,,1277.87,12354.87,49 CPT,0475U,"Hereditary prostate cancer-related disorders,genomic sequence analysis panel using next-generation sequencing (NGS),Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA),and array",,,1277.87,3768.42,49 CPT,0476U,"Drug metabolism, psychiatry (eg major depressive disorder, general anxiety disorder, ADHD, schizophrenia), whole blood, buccal swab, and pharmacogenomic genotyping of 14 genes and CYP2D6 copy number v",,,408.44,1438.4,49 CPT,0477U,"Drug metabolism, psychiatry (ev major depressive disorder, general anxiety disorder, ADHD, schizophrenia), whole blood buccal swab, and pharmacogenomic genotyping of 14 genes and CYP2D6 copy number va",,,408.44,1438.4,49 CPT,0478U,"Oncology (non-small cell lung cancer), DNA and RNA, digital PCR analysis of 9 genes (EGFR, KRAS, BRAF, ALK, ROS1, RET, NTRK 1/2/3, ERBB2, and Met) in formalin-fixed paraffin-embedded (FFPE) tissue, in",,,541.93,2176.51,49 CPT,0479T,"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children ",,,655.0,3128.0,161 CPT,0479U,"Tau, phosphorylated, pTau217 ",,,16.92,55.09,49 CPT,0480T,"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part ther",,,1672.0,3083.0,104 CPT,0480U,"Infectious disease (bacteria, viruses, fungi, and parasites), cerebrospinal fluid, metagenomic next-generation sequencing (DNA and RNA), bioinformatic analysis, with positive pathogen identification ",,,841.9,6144.72,49 CPT,0481T,"Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed ",,,745.36,3128.0,161 CPT,0481U,"IDH1, IDH2, and TERT promoter (eg, central nervous system tumors), next-generatin sequencing (single-nucleotide variants (SNV), deletions, and insertions) ",,,390.37,1948.55,49 CPT,0482U,"Obstetrics (preeclampsia), biochemical assay of suoluble fms-like tyrosine kinasi 1 and placental growth factor, serum, ratio reported for sFIt-1/PIGF, with risk of progression for preeclampsia with s",,,64.24,372.29,49 CPT,0483T,TMVI PERC APRCH,79097.99,79097.99,4745.88,67233.29,28 CPT,0483T,"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed ",79097.99,79097.99,10120.0,22203.94,47 CPT,0483U,"Infectios disease (Neisseria gonorrhoeae), sensitivity, ciprofloxacin resistance (gyrA S91F point mutation), oral, rectal, or vaginal swab, algorithm reported as probability of fluoroquinolone resista",,,34.39,111.94,49 CPT,0484T,"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) ",,,10120.0,22203.94,47 CPT,0484U,"Infectious disease (Mycoplasma genitalium), macrolide sensitivity (23S rRNA point mutation), oral, rectal or vaginal sway, algorithm reported as probability of macrolide resistance ",,,34.39,111.94,49 CPT,0485T,"Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral ",,,58.84,129.37,5 CPT,0485U,"Oncology (solid tumor), cell-free DNA and RNA by next-generation sequencing, interpretative report for germline mutations, clonal hematopoiesis of indeterminate potential, and tumor-derived single-nuc",,,276.74,10547.0,49 CPT,0486T,"Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral ",,,58.84,129.37,5 CPT,0486U,"Oncology (pan-solid tumor), next-generation sequencing analysis of tumor methylation markers present in cell-free circulating tumor DNA, algorithm reported as quantitative measurement of methylation a",,,276.74,4751.88,49 CPT,0487U,"Oncology (solid tumor), cell-free circulating DNA, targeted, genomic sequence analysis panel of 84 genes, interrogation for sequence variants, aneuploidy-corrected gene copy number amplifications and ",,,1207.78,8437.64,49 CPT,0488T,"Preventive behavior change, online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum, provided to an individual, per 30 day",,,37.95,52.39,5 CPT,0488U,"Obstetrics (fetal antigen noninvasive prenatal test), cell-free DNA sequence analysis for detection of fetal presence or absence of 1 or more of the Rh, C, c, D, E, Duffy, or Kell antigen in alloimmun",,,743.87,7810.91,49 CPT,0489T,"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting, isolation and preparation of harvested cells including incubation with cell dissociation e",,,1354.96,13835.0,161 CPT,0489U,"Obstetrics (single gene noninvasive prenatal test), cell-free DNA sequence analysis of 1 or more targets to identify paternally inherited pathogenic variants, and relative mutation-dosage analysis bas",,,1130.55,7810.91,49 CPT,0490T,Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands ,,,1612.73,13835.0,161 CPT,0490U,"Oncology (cutaneous or uveal melanoma), circulating tumor cell selection, morphological characterization and enumeration based on differential CD146, high molecular-weight melanoma- associated antigen",,,51.81,7037.15,49 CPT,0491U,"Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule, cytokeratins 8, 18 & 19, CD45 protein ",,,51.81,7037.15,51 CPT,0492U,"Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule (EpCAM), cytokeratins 8, 18 & 19, CD45 ",,,51.81,7037.15,51 CPT,0493U,"Transplantation medicine, quantification of donor-derived cell-free DNA (cfDNA) using next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA ",,,2698.18,10335.6,49 CPT,0494T,"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservatio",,,9913.14,13835.0,65 CPT,0494U,"Red blood cell antigen (fetal RhD gene analysis), next-generation sequencing of circulating cell-free DNA (cfDNA) of blood in pregnant individuals known to be RhD negative, reported as positive or neg",,,743.87,2193.65,49 CPT,0495T,"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pu",,,9913.14,12713.03,44 CPT,0495U,"Oncology (prostate), analysis of circulating plasma proteins (tPSA, fPSA, KLK2, PSP94 and GDF15), germline polygenic risk score (60 variants), clinical information (age, family history of prostate can",,,51.81,2196.4,49 CPT,0496T,"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pu",,,9913.14,12713.03,44 CPT,0496U,"Oncology (colorectal), cell-free DNA, 8 genes for mutations, 7 genes for methylation by real-time RT-PCR, and 4 proteins by enzyme-linked immunosorbent assay, blood, reported positive or negative for ",,,144.15,1404.14,49 CPT,0497U,"Oncology (prostate), mRNA gene-expression profiling by real-time RT-PCR of 6 genes (FOXM1, MCM3, MTUS1, TTC21B, ALAS1, PPP2CA), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm repo",,,3795.54,12354.87,49 CPT,0498U,"Oncology (colorectal), next-generation seequencing for mutation detection in 43 genes and methylation pattern in 45 genes, blood and formalin-fixed paraffin-embedded (FFPE) tissue, report of variants ",,,1318.4,3887.95,49 CPT,0499T,"CYSTOURETHROSCOPY, WITH MECHANICAL DILATION AND URETHRAL THERAPEUTIC DRUG DELIVERY FOR URETHRAL STRICTURE OR STENOSIS, INCLUDING FLUOROSCOPY, WHEN PERFORMED ",,,4807.0,4807.0,8 CPT,0499U,"Oncology (colorectal and lung), DNA from formalin-fixed paraffin-embedded (FFPE) tissue, next-generation sequencing of 8 genes (NRAS, EGFR, CTNNB1, PIK3CA, APC, BRAF, KRAS and TP53), mutation detectio",,,585.95,2176.51,49 CPT,0500U,"Autoinflammatory disease (VEXAS syndrome), DNA, UBA1 gene mutations, targeted variant analysis (M41T, M41V, M41L, c. 118-2A>C, c.118-1G>C, c.118-9_118-2del, S56F, S621C) ",,,51.81,506.91,49 CPT,0501U,"Oncology (colorectal), blood, quantitative measurement of cell-free DNA (cfDNA) ",,,144.15,554.88,49 CPT,0502U,"Human papillomavirus (HPC), E6/E7 markers for high-risk types (16,18,31,33,35,39,45,51,52,56,58,59,66 and 68), cervical cells, branched-chain capture hybridization, reported as negative or positive fo",,,34.39,111.94,49 CPT,0503U,"Neurology (Lazheimer disease), beta amyloid (AB40,AB42,AB42/40 ratio) and tau-protein (ptau217, np-tau217, ptau217/np-tau217 ratio), blood, immunoprecipitation with quantitation by liquid chomatograph",,,276.74,2167.5,49 CPT,0504U,"Infectious disease (urinary tract infection), identification of 17 pathologic organisms, urine, real-time PCR, reported as positive or negative for each organism ",,,16.34,1204.49,51 CPT,0505T,"Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultraso",,,2996.0,27050.15,161 CPT,0505U,"Infectious disease (vaginal infection), identification of 32 pathogenic organisms, swab, real-time PCR, reported as positive or negative for each organism ",,,288.11,1964.54,49 CPT,0506T,"Macular pigment optical density measurement by heterochromatic flicker photometry, unilateral or bilateral, with interpretation and report ",,,111.12,175.48,5 CPT,0506U,"Gastroenterology (Barrett's esophagus), esophageal cells, DNA methylation analysis by next-generation sequencing of at least 89 differentially methylated genomic regions, algorithm reported as likelih",,,289.87,5600.85,49 CPT,0507T,"Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report ",,,96.82,212.89,5 CPT,0507U,"Oncology (ovarian), DNA, whole-genome sequencing with 5-hydroxymethylcytosine (5hmC) enrichment, using whole blood or plasma, algorithm reported as cancer detected or not detected ",,,724.78,3352.4,49 CPT,0508T,"PULSE-ECHO ULTRASOUND BONE DENSITY MEASUREMENT RESULTING IN INDICATOR OF AXIAL BONE MINERAL DENSITY, TIBIA ",,,35.51,45.69,81 CPT,0509T,"Electroretinography (ERG) with interpretation and report, pattern (PERG) ",,,117.93,186.23,5 CPT,0510T,Removal of sinus tarsi implant ,,,2699.0,13835.0,161 CPT,0510U,"Oncology (pancreatic cancer), augumentative algorithmic analysis of 16 genes from previously sequenced RNA whole-transcriptome data, reported as probability of predicted molecular subtype ",,,464.43,11962.5,49 CPT,0511T,Removal and reinsertion of sinus tarsi implant ,,,2699.0,16330.72,161 CPT,0511U,"Oncology (solid tumor), tumor cell culture in 3D microenvironment, 36 or more drug panel, reported as tumor-response prediction for each drug ",,,1170.51,8767.86,49 CPT,0512T,"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound ",,,747.65,3128.0,34 CPT,0512U,"Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) status, formalin-fixed paraffin-embedded (FFPE) tiss",,,51.81,2041.06,49 CPT,0513T,"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure) ",,,1672.0,8841.96,13 CPT,0513U,"Oncology (prostate), augmentative algorighmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) and homologous recombination deficience (HRD) status",,,51.81,2041.06,49 CPT,0514U,"Gastroenterology (irritable bowel disease (IBD), immunoassay for quantitative determination of adalimumab (ADL) levels in venous serum in patients undergoing adalimumab therapy, results reported as a ",,,34.89,111.47,49 CPT,0515T,"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (inclu",,,2996.0,62006.19,153 CPT,0515U,"Gastoenterology (irritable bowel disease (IBD)), immunoassay for quantitative determination of infliximab (IFX) levels in venous serum in patients undergoing infliximab therapy, results reported as a ",,,34.89,111.47,49 CPT,0516T,"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only ",,,2996.0,20862.25,161 CPT,0516U,"Drug metabolism, whole blood, pharmacogenomic genotyping of 40 genes and CYP2D6 copy number variant analysis, reported as metabolizer status ",,,408.44,2367.84,49 CPT,0517T,"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pul",,,2996.0,20862.25,161 CPT,0517U,"Therapeutic drug monitoring, 80 or more psychoactive drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally and maximally effective dose of prescribed and non-prescr",,,241.98,713.6,49 CPT,0518T,Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only ,,,2996.0,13835.0,161 CPT,0518U,"Therapeutic drug monitoring, 90 or more pain and mental health drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therpeutic minimally effective range of prescribed and non-prescribed",,,241.98,713.6,49 CPT,0519T,"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter) ",,,2996.0,13835.0,161 CPT,0519U,"Therapeutic drug monitoring, medications specific to pain, depression, and anxiety, LC-MS/MS, plasma, 110 or more drugs or substances, qualitative and quantitative therpeutic minimally effective range",,,241.98,713.6,49 CPT,0520T,"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only ",,,2996.0,62006.19,153 CPT,0520U,"Therapeutic drug monitoring, 200 or more drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therpeutic minimally effective range of prescribed and non-prescribed medications ",,,241.98,713.6,49 CPT,0521T,"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular ",,,46.44,73.34,5 CPT,0522T,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including",,,73.22,115.64,5 CPT,0523T,"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interp",,,1672.0,1672.0,8 CPT,0524T,"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or percutaneous, including all vascular access, catheter manipulation, diagnostic imaging, ima",,,2699.0,13835.0,161 CPT,0525T,"Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; complete system ",,,3982.0,27987.8,161 CPT,0526T,"Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; electrode only ",,,2996.0,20862.25,161 CPT,0527T,"Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; implantable moni",,,2996.0,20862.25,161 CPT,0528T,"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values, with analysis, review, and report ",,,73.22,115.64,5 CPT,0529T,"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis, review, and report ",,,73.22,115.64,5 CPT,0530T,"Removal of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; complete system (electrode and implantable monitor) ",,,2699.0,13835.0,161 CPT,0531T,"Removal of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; electrode only ",,,2699.0,13835.0,161 CPT,0531U,"Infectious disease (acid-fast bacteria and invasive fungi), DNA (673 organisms), next-generation sequencing, plasma ",,,41.33,65.27,5 CPT,0532T,"Removal of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; implantable monitor only ",,,2699.0,13835.0,161 CPT,0532U,"Rare diseases (constitutional disease/hereditary disorders), rapid whole genome and mitochondrial DNA sequencing for single-nucleotide variants, insertions/deletions, copy number variations ",,,863.07,14540.17,49 CPT,0533U,"Drug metabolism (adverse drug reactions and drug response), genotyping of 16 genes (ie, ABCG2, CYP2B6, CYP2C9, CYP2C19, CYP2C, CYP2D6, CYP3A5, CYP4F2, DPYD, G6PD, GGCX, NUDT15, SLCO1B1, TPMT, ",,,408.44,2367.84,49 CPT,0534U,"Oncology (prostate), microRNA, singlenucleotide polymorphisms (SNPs) analysis by RT-PCR of 32 variants, using buccal swab, algorithm reported as a risk score ",,,1535.2,2424.4,5 CPT,0535U,"Perfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), by liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma or serum, quantitative ",,,48.66,179.58,49 CPT,0536U,"Red blood cell antigen (fetal RhD), PCR analysis of exon 4 of RHD gene and housekeeping control gene GAPDH from whole blood in pregnant individuals at 10+ weeks gestation ",,,188.16,1362.96,49 CPT,0537U,"Oncology (colorectal cancer), analysis of cell-free DNA for epigenomic patterns, nextgeneration sequencing, >2500 differentially methylated regions (DMRs), plasma, algorithm reported as pos or neg ",,,144.15,4320.55,49 CPT,0538U,"Oncology (solid tumor), nextgeneration targeted sequencing analysis, formalin-fixed paraffinembedded (FFPE) tumor tissue, DNA analysis of 600 genes, interrogation for singlenucleotide variants, inse ",,,2929.76,9313.52,49 CPT,0539U,"Oncology (solid tumor), cell-free circulating tumor DNA (ctDNA), 152 genes, next-generation sequencing, interrogation for single-nucleotide variants, insertions/deletions, gene rearrangements ",,,1207.78,9503.79,49 CPT,0540U,"Transplantation medicine, quantification of donorderived cell-free DNA using next-generation sequencing analysis of plasma, reported as percentage of donor-derived cell-free DNA to determine ",,,2698.18,10335.6,49 CPT,0541T,"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia, by signal acquisition using minimum 36 channel grid, generation of magnetic-field time-series images, quantitative an",,,1136.33,1568.52,5 CPT,0541U,"Cardiovascular disease (HDL reverse cholesterol transport), cholesterol efflux capacity, LCMS/MS, quantitative measurement of 5 distinct HDL-bound apolipoproteins (apolipoproteins A1, C1, C2, C3, ",,,51.81,81.82,5 CPT,0542T,"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia, by signal acquisition using minimum 36 channel grid, generation of magnetic-field time-series images, quantitative an",,,8674.85,11974.26,5 CPT,0542U,"Nephrology (renal transplant), urine, nuclear magnetic resonance (NMR) spectroscopy measurement of 84 urinary metabolites, combined with patient data, quantification of BK virus (human polyo ",,,6544.8,10335.6,5 CPT,0543T,"Transapical mitral valve repair, including transthoracic echocardiography, when performed, with placement of artificial chordae tendineae ",,,9913.14,13835.0,65 CPT,0543U,"Oncology (solid tumor), next-generation sequencing of DNA from formalin-fixed paraffinembedded (FFPE) tissue of 517 genes, interrogation for single-nucleotide variants, multinucleotide variants ",,,2929.76,9313.52,51 CPT,0544T,"Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture ",,,9913.14,36462.0,47 CPT,0545T,"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device, percutaneous approach ",,,9913.14,36462.0,47 CPT,0545U,"Acetylcholine receptor (AChR), antibody identification by immunofluorescence, using live cells, reported as positive or negative ",,,36.98,109.04,51 CPT,0546T,"Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report ",,,73.57,161.77,5 CPT,0546U,"Low-density lipoprotein receptor-related protein 4 (LRP4), antibody identification by immunofluorescence, using live cells, reported as positive or negative ",,,24.34,109.04,49 CPT,0547T,"Bone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score ",,,226.4,3083.0,101 CPT,0547U,"Neurofilament light chain (NfL), chemiluminescent enzyme immunoassay, plasma, quantitative ",,,34.89,335.9,49 CPT,0548U,"Glial fibrillary acidic protein (GFAP), chemiluminescent enzyme immunoassay, using plasma ",,,113.91,457.76,49 CPT,0549U,"Oncology (urothelial), DNA, quantitative methylated real-time PCR of TRNA-Cys, SIM2, and NKX1-1, using urine, diagnostic algorithm reported as a probability index for bladder cancer ",,,744.8,2424.4,49 CPT,0552T,"Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional ",,,52.14,3128.0,26 CPT,0552U,"Reproductive medicine (preimplantation genetic assessment), analysis for known genetic disorders from trophectoderm biopsy, linkage analysis of diseasecausing locus, and when possible, targeted muta ",,,99.93,157.81,5 CPT,0553T,"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessa",,,12018.0,36462.0,11 CPT,0553U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural rearrangements, aneuploidy, and ",,,99.93,2193.65,49 CPT,0554T,"Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing data from a computed tomography scan; retrieval and transmission of the scan data, a",,,105.48,231.93,5 CPT,0554U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from trophectoderm biopsy for aneuploidy, ploidy, a mitochondrial DNA score ",,,99.93,2193.65,49 CPT,0555T,Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing data from a computed tomography scan; retrieval and transmission of the scan data ,,,40.46,111.02,86 CPT,0555U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural arrangements ",,,99.93,2193.65,49 CPT,0556T,Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing data from a computed tomography scan; assessment of bone strength and fracture risk ,,,410.15,1034.17,86 CPT,0556U,"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific DNA and RNA by real-time PCR, 12 targets, nasopharyngeal or oropharyngeal swab, including multiplex reverse ",,,139.78,1329.53,49 CPT,0557T,Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing data from a computed tomography scan; interpretation and report ,,,197.26,433.75,5 CPT,0557U,"Infectious disease (bacterial vaginosis and vaginitis), realtime amplification of DNA markers for Atopobium vaginae, Gardnerella vaginalis, Megasphaera types 1 and 2, bacterial vaginosis associated ",,,257.73,838.94,49 CPT,0558T,Computed tomography scan taken for the purpose of biomechanical computed tomography analysis ,,,140.47,2106.0,29 CPT,0558U,"Oncology (colorectal), quantitative enzyme-linked immunosorbent assay (ELISA) for secreted colorectal cancer protein marker (BF7 antigen), using serum, result reported as indicative of response ",,,20.39,1623.3,49 CPT,0559T,Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure ,,,128.72,177.68,5 CPT,0559U,"Oncology (breast), quantitative enzyme-linked immunosorbent assay (ELISA) for secreted breast cancer protein marker (BF9 antigen), serum, result reported as indicative of response ",,,20.39,904.08,49 CPT,0560T,Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code for primary procedure) ,,,55.43,76.52,5 CPT,0560U,"Oncology (minimal residual disease ºMRD»), genomic sequence analysis, cell-free DNA, whole blood and tumor tissue, baseline assessment for design and construction of a personalized variant panel to ",,,51.81,11208.72,49 CPT,0561T,Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide ,,,128.72,177.68,5 CPT,0561U,"Oncology (minimal residual disease ºMRD»), genomic sequence analysis, cell-free DNA, whole blood, subsequent assessment with comparison to initial assessment to evaluate for MRD ",,,51.81,2296.08,49 CPT,0562T,Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure) ,,,55.43,76.52,5 CPT,0562U,"Oncology (solid tumor), targeted genomic sequence analysis, 33 genes, detection of single-nucleotide variants (SNVs), insertions and deletions, copy-number amplifications, and translocations in human ",,,585.95,11165.0,51 CPT,0563T,"Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral ",,,112.77,3244.0,161 CPT,0563U,"Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 11 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respi ",,,408.44,1329.53,51 CPT,0564T,"Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on percent of cytotoxicity observed",,,2.6,3.35,81 CPT,0564U,"Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 10 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respiratory sp",,,408.44,1329.53,51 CPT,0565T,Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation ,,,112.77,4220.0,161 CPT,0565U,"Oncology (hepatocellular carcinoma), next-generation sequencing methylation pattern assay to detect 6626 epigenetic alterations, cellfree DNA, plasma, algorithm reported as ",,,1027.92,3352.4,49 CPT,0566T,"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral ",,,954.99,3128.0,161 CPT,0566U,"Oncology (lung), qPCRbased analysis of 13 differentially methylated regions (CCDC181, HOXA7, LRRC8A, MARCHF11, MIR129-2, NCOR2, PANTR1, PRKCB, SLC9A3, TBR1_2, TRAP1, VWC2, ZNF781), pleural fluid, ",,,51.81,1204.49,49 CPT,0567T,"Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound ",,,10740.0,13835.0,29 CPT,0567U,"Rare diseases (constitutional/heritable disorders), whole-genome sequence analysis combination of short and long reads, for single-nucleotide variants, insertions/deletions and characterized intronic ",,,863.07,14540.17,49 CPT,0568T,"Introduction of mixture of saline and air for sonosalpingography to confirm occlusion of fallopian tubes, transcervical approach, including transvaginal ultrasound and pelvic ultrasound ",,,2428.0,12018.0,29 CPT,0568U,"Neurology (dementia), beta amyloid (A?40, A?42, A?42/40 ratio), tau-protein phosphorylated at residue (eg, pTau217), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP), ",,,276.74,2592.33,51 CPT,0569T,"Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis ",,,9913.14,36462.0,47 CPT,0569U,"Oncology (solid tumor), nextgeneration sequencing analysis of tumor methylation markers (>20000 differentially methylated regions) present in cell-free circulating tumor DNA (ctDNA), whole blood, ",,,3019.9,4769.05,5 CPT,0570T,"Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure) ",,,9913.14,36462.0,47 CPT,0570U,"Neurology (traumatic brain injury), analysis of glial fibrillary acidic protein (GFAP) and ubiquitin carboxylterminal hydrolase L1 (UCHL1), immunoassay, whole blood or plasma, individual components ",,,230.68,752.85,51 CPT,0571T,INSRT REPLAC IMPLNT ICD,38584.71,38584.71,2315.08,32797.0,27 CPT,0571T,"Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation thre",38584.71,38584.71,3673.0,88131.61,153 CPT,0571U,"Oncology (solid tumor), DNA (80 genes) and RNA (10 genes), by next-generation sequencing, plasma, including single-nucleotide variants, insertions/deletions, copy-number alterations, microsatellite in",,,2861.21,11962.5,49 CPT,0572T,Insertion of substernal implantable defibrillator electrode ,,,2699.0,20862.25,161 CPT,0572U,"Oncology (prostate), highthroughput telomere length quantification by FISH, whole blood, diagnostic algorithm reported as risk of prostate cancer ",,,4100.6,6475.7,5 CPT,0573T,Removal of substernal implantable defibrillator electrode ,,,2699.0,13835.0,161 CPT,0573U,"Oncology (pancreas), 3 biomarkers (glucose, carcinoembryonic antigen, and gastricsin), pancreatic cyst lesion fluid, algorithm reported as categorical mucinous or non-mucinous ",,,7272.0,11484.0,5 CPT,0574T,Repositioning of previously implanted substernal implantable defibrillator-pacing electrode ,,,2699.0,13835.0,161 CPT,0574U,"Mycobacterium tuberculosis, culture filtrate protein?10-kDa (CFP-10), serum or plasma, liquid chromatography mass spectrometry (LC-MS) ",,,86.54,136.66,5 CPT,0575T,"Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with iterative adjustment of the implantable device to test the function of the de",,,73.22,115.64,5 CPT,0575U,"Transplantation medicine (liver allograft rejection), miRNA gene expression profiling by RT-PCR of 4 genes (miR-122, miR-885, miR-23a housekeeping, spike-in control), ",,,372.4,2043.93,51 CPT,0576T,"Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care p",,,73.22,115.64,5 CPT,0576U,"Transplantation medicine (liver allograft rejection), quantitative donor-derived cell-free DNA (cfDNA) by whole genome nextgeneration sequencing, ",,,1294.27,9363.6,49 CPT,0577T,"Electrophysiologic evaluation of implantable cardioverter-defibrillator system with substernal electrode (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing f",,,2310.89,3189.82,5 CPT,0577U,"Oncology (ovarian), serum, analysis of 39 glycoproteins by liquid chromatography with tandem mass spectrometry (LC-MS/MS) in multiple reaction ",,,246.92,2861.43,7 CPT,0578T,"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualifi",,,73.36,101.26,5 CPT,0578U,"Oncology (cutaneous melanoma), RNA, gene expression profiling by realtime qPCR of 10 genes (8 content and 2 housekeeping), utilizing formalin-fixed ",,,3795.54,22945.67,49 CPT,0579T,"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, t",,,73.22,115.64,5 CPT,0579U,"Nephrology (diabetic chronic kidney disease), enzymelinked immunosorbent assay (ELISA) of apolipoprotein A4 (APOA4), CD5 antigen-like (CD5L) combined ",,,382.94,3030.5,49 CPT,0580T,Removal of substernal implantable defibrillator pulse generator only ,,,2699.0,13835.0,161 CPT,0580U,"Borrelia burgdorferi, antibody detection of 24 recombinant protein groups, by immunoassay, IgG ",,,16.87,54.9,51 CPT,0581T,"Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral ",,,2996.0,13835.0,161 CPT,0581U,"Transplantation medicine, antibody to non-human leukocyte antigens (nonHLA), blood specimen, flow cytometry, single-antigen bead technology, 39 targets ",,,319.28,8782.87,49 CPT,0582T,"Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative imaging and needle guidance ",,,2195.0,13835.0,161 CPT,0582U,"Rare diseases (constitutional disease/hereditary disorders), rapid whole genome DNA sequencing for singlenucleotide variants, insertions/deletions, copy number variations, blood, ",,,7430.56,21912.56,49 CPT,0583T,"Tympanostomy (requiring insertion of ventilating tube), using an automated tube delivery system, iontophoresis local anesthesia ",,,2428.0,12713.03,161 CPT,0583U,"Rare diseases (constitutional disease/hereditary disorders), rapid whole genome comparator DNA sequencing for single-nucleotide variants, insertions/deletions, copy number variations ",,,3715.28,17465.89,49 CPT,0584T,"Islet cell transplant, includes portal vein catheterization and infusion, including all imaging, including guidance, and radiological supervision and interpretation, when performed; percutaneous ",,,9913.14,13835.0,65 CPT,0584U,"Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quakinginduced conformational conversion, qualitative ",,,530.17,1725.76,49 CPT,0585T,"Islet cell transplant, includes portal vein catheterization and infusion, including all imaging, including guidance, and radiological supervision and interpretation, when performed; laparoscopic ",,,9913.14,13835.0,65 CPT,0585U,"Targeted genomic sequence analysis panel, solid organ neoplasm, circulating cell-free DNA (cfDNA) analysis from plasma of 521 genes, interrogation for sequence variants, ",,,2861.21,10490.35,49 CPT,0586T,"Islet cell transplant, includes portal vein catheterization and infusion, including all imaging, including guidance, and radiological supervision and interpretation, when performed; open ",,,9913.14,13835.0,65 CPT,0586U,"Oncology, mRNA, gene expression profiling of 216 genes (204 targeted and 12 housekeeping genes), RNA expression analysis, formalinfixed paraffin-embedded ",,,2861.21,11723.25,49 CPT,0587T,"Percutaneous implantation or replacement of integrated single device neurostimulation system for bladder dysfunction including electrode array and receiver or pulse generator, including analysis, prog",,,1281.35,3128.0,161 CPT,0587U,"Therapeutic drug monitoring, 60-150 drugs and metabolites, urine, saliva, quantitative liquid chromatography with tandem mass spectrometry (LCMS/MS), ",,,112.14,787.67,49 CPT,0588T,"Revision or removal of percutaneously placed integrated single device neurostimulation system for bladder dysfunction including electrode array and receiver or pulse generator, including analysis, pro",,,954.99,5849.0,161 CPT,0588U,"Infectious disease (bacterial or viral), 32 genes (29 informative and 3 housekeeping), immune response mRNA, gene expression profiling by splitwell multiplex infection ",,,526.21,2196.4,51 CPT,0589T,"Electronic analysis with simple programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse wid",,,229.13,361.84,5 CPT,0589U,"Perfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), 24 PFAS compounds by high-performance liquid chromatography ",,,194.77,633.98,49 CPT,0590T,"Electronic analysis with complex programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse wi",,,229.13,361.84,5 CPT,0590U,"Infectious disease (bacterial and fungal), DNA of 44 organisms (34 bacteria, 10 fungi), urine, next-generation sequencing, reported as positive or negative ",,,404.0,638.0,5 CPT,0591T,"Health and well-being coaching face-to-face; individual, initial assessment ",,,59.04,81.49,5 CPT,0591U,"Oncology (prostate cancer), biochemical analysis of 3 proteins (total PSA, free PSA, and HE4), plasma, serum, prognostic algorithm incorporating 3 proteins and digital ",,,744.8,2424.4,49 CPT,0592T,"Health and well-being coaching face-to-face; individual, follow-up session, at least 30 minutes ",,,119.76,165.31,5 CPT,0592U,"Oncology (hematolymphoid neoplasms), DNA, targeted genomic sequence of 417 genes, interrogation for gene fusions, translocations, rearrangements ",,,185.15,8437.64,49 CPT,0593T,"Health and well-being coaching face-to-face; group (2 or more individuals), at least 30 minutes ",,,18.56,25.61,5 CPT,0593U,"Infectious disease (genitourinary pathogens), DNA, 46 targets (28 pathogens, 18 resistance genes), RT-PCR amplified probe technique, urine, each ",,,622.14,1834.69,49 CPT,0594T,"Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device, including intraoperative imaging, initial and subsequent alignment assessments, computations of adjust",,,2996.0,16330.72,161 CPT,0594U,"Infectious disease (sepsis), semiquantitative measurement of pancreatic stone protein concentration, whole blood, reported as risk of sepsis ",,,13.49,21.31,5 CPT,0595U,"Infectious disease (tropical fever pathogens), vectorborne and zoonotic pathogens, including 2 viruses (Chikungunya virus and Dengue virus serotypes 1, 2, 3, and 4), ",,,257.73,1329.53,51 CPT,0596T,"Temporary female intraurethral valve-pump (ie, voiding prosthesis); initial insertion, including urethral measurement ",,,1986.0,4026.93,161 CPT,0596U,"Neurology (Alzheimer disease), plasma, 3 distinct isoform-specific peptides (APOE2, APOE3, and APOE4) by liquid chromatography with tandem mass spectrometry ",,,1032.62,1630.73,5 CPT,0597T,"Temporary female intraurethral valve-pump (ie, voiding prosthesis); replacement ",,,1986.0,4026.93,161 CPT,0597U,"Oncology (breast), RNA expression profiling of 329 genes by targeted nextgeneration sequencing and 20 proteins by multiplex immunofluorescence, formalin-fixed ",,,1426.63,2252.94,5 CPT,0598T,"Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and measure wound size, per session; first anatomic site (eg, lower extremity, right leg)",,,445.46,979.5,5 CPT,0598U,"Gastroenterology (irritable bowel syndrome), IgG antibodies to 18 food items by microarray-based immunoassay, whole blood or serum, report as elevated ",,,226.28,867.0,49 CPT,0599U,"Oncology (pancreatic cancer), multiplex immunoassay of ICAM1, TIMP1, CTSD, THBS1, and CA 19-9, serum, diagnostic algorithm reported as positive or negative ",,,879.06,2861.43,49 CPT,0600T,"Ablation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous ",,,2996.0,13835.0,161 CPT,0601T,"Ablation, irreversible electroporation; 1 or more tumors per organ, including fluoroscopic and ultrasound guidance, when performed, open ",,,3293.0,13835.0,161 CPT,0604T,"Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; initial device provision, set-up and pa",,,204.04,448.65,5 CPT,0605T,"Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; remote surveillance center technical su",,,63.8,140.29,5 CPT,0606T,"Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; review, interpretation and report by th",,,98.49,216.57,5 CPT,0607T,"Remote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency-derived pulmonary fluid levels, heart rate, respiration rate, activity, posture, ",,,271.28,374.45,5 CPT,0608T,"Remote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency-derived pulmonary fluid levels, heart rate, respiration rate, activity, posture, ",,,84.82,117.09,5 CPT,0609T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); acquisition of single voxel data, per disc, on biomarkers (ie, lactic acid, carbohyd",,,677.76,1490.3,5 CPT,0610T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); transmission of biomarker data for software analysis ",,,677.76,1490.3,5 CPT,0611T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); postprocessing for algorithmic analysis of biomarker data for determination of relat",,,677.76,1490.3,5 CPT,0612T,"Magnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); interpretation and report ",,,677.76,1490.3,5 CPT,0613T,"Percutaneous transcatheter implantation of interatrial septal shunt device, including right and left heart catheterization, intracardiac echocardiography, and imaging guidance by the proceduralist, wh",,,2389.1,36462.0,51 CPT,0614T,Removal and replacement of substernal implantable defibrillator pulse generator ,,,3375.0,62006.19,153 CPT,0615T,"Automated analysis of binocular eye movements without spatial calibration, including disconjugacy, saccades, and pupillary dynamics for the assessment of concussion, with interpretation and report ",,,220.24,347.81,5 CPT,0616T,"Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or intraocular lens, without insertion of intraocular lens ",,,4188.0,5394.0,29 CPT,0617T,"Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of intraocular lens ",,,4188.0,7799.0,29 CPT,0618T,"Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or intraocular lens exchange ",,,4188.0,7799.0,29 CPT,0619T,"Cystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, including transrectal ultrasound and fluoroscopy, when performed ",,,4807.0,15059.0,29 CPT,0620T,"Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ul",,,2996.0,43854.72,161 CPT,0621T,Trabeculostomy ab interno by laser; ,,,2996.0,36571.01,161 CPT,0622T,Trabeculostomy ab interno by laser; with use of ophthalmic endoscope ,,,2996.0,36571.01,161 CPT,0627T,"Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level ",,,1986.0,33619.29,161 CPT,0628T,"Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separ",,,1672.0,3083.0,104 CPT,0629T,"Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level ",,,1986.0,33619.29,161 CPT,0630T,"Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in a",,,1672.0,3083.0,104 CPT,0632T,"Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance ",,,3673.0,36462.0,147 CPT,0633T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material ",,,191.79,1361.0,17 CPT,0634T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s) ",,,314.25,1361.0,17 CPT,0635T,"Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast material(s) ",,,314.25,1361.0,17 CPT,0636T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s) ",,,405.03,1361.0,17 CPT,0637T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s) ",,,647.89,1424.62,17 CPT,0638T,"Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s) ",,,647.89,1424.62,17 CPT,0639T,"Wireless skin sensor thermal anisotropy measurement(s) and assessment of flow in cerebrospinal fluid shunt, including ultrasound guidance, when performed ",,,214.02,3083.0,101 CPT,0640T,"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisit",,,17.65,38.82,5 CPT,0641T,"NONCONTACT NEAR-INFRARED SPECTROSCOPY STUDIES OF FLAP OR WOUND (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION ºSTO2»); IMAGE ACQUISITION ONLY, EACH FLAP OR WOU",,,116.15,149.43,81 CPT,0643T,"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach ",,,2389.1,13036.0,51 CPT,0644T,REM DBLK/IC MASS DEV,50930.06,50930.06,3055.8,43290.55,23 CPT,0644T,"Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated bloo",50930.06,50930.06,3673.0,18984.7,147 CPT,0645T,"Transcatheter implantation of coronary sinus reduction device including vascular access and closure, right heart catheterization, venous angiography, coronary sinus angiography, imaging guidance, and ",,,2389.1,13036.0,147 CPT,0646T,TTVI PERC APRCH,41709.85,41709.85,2502.59,35453.37,28 CPT,0646T,"Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ve",41709.85,41709.85,2389.1,13036.0,51 CPT,0647T,"Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report ",,,2613.0,12909.0,161 CPT,0648T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",,,405.03,890.6,5 CPT,0649T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",,,405.03,890.6,5 CPT,0650T,PROG DEV RMT SUBCU CARD,389.5,389.5,23.37,331.07,39 CPT,0650T,"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system, with iterative adjustment of the implantable device to test the function of the device and select optimal permanen",389.5,389.5,75.04,118.51,5 CPT,0651T,"Magnetically controlled capsule endoscopy, esophagus through stomach, including intraprocedural positioning of capsule, with interpretation and report ",,,1424.9,13394.0,34 CPT,0652T,"Esophagogastroduodenoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,1659.68,13394.0,161 CPT,0653T,"Esophagogastroduodenoscopy, flexible, transnasal; with biopsy, single or multiple ",,,1659.68,13394.0,161 CPT,0654T,"Esophagogastroduodenoscopy, flexible, transnasal; with insertion of intraluminal tube or catheter ",,,2195.0,12909.0,161 CPT,0655T,"Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging ",,,2195.0,15059.0,161 CPT,0656T,Anterior lumbar or thoracolumbar vertebral body tethering; up to 7 vertebral segments ,,,3375.0,13835.0,161 CPT,0657T,Anterior lumbar or thoracolumbar vertebral body tethering; 8 or more vertebral segments ,,,3375.0,13835.0,161 CPT,0658T,Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score ,,,112.43,177.56,5 CPT,0659T,"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction with percutaneous coronary revascularization during acute myocardial infarction, including catheter placement, imaging guid",,,2389.1,36462.0,51 CPT,0660T,"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system, internal approach ",,,2699.0,12713.03,161 CPT,0661T,Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant ,,,2699.0,12713.03,161 CPT,0664T,"Donor hysterectomy (including cold preservation); open, from cadaver donor ",,,3673.0,13835.0,161 CPT,0665T,"Donor hysterectomy (including cold preservation); open, from living donor ",,,3673.0,13835.0,161 CPT,0666T,"Donor hysterectomy (including cold preservation); laparoscopic or robotic, from living donor ",,,3293.0,13835.0,161 CPT,0667T,Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor ,,,9913.14,13835.0,65 CPT,0668T,"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation, including dissection and removal of surrounding soft tissues and preparation of uterine vein(s) an",,,9913.14,13835.0,65 CPT,0669T,"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis, each ",,,9913.14,13835.0,65 CPT,0670T,"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis, each ",,,9913.14,13835.0,65 CPT,0671T,"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more ",,,2699.0,15059.0,161 CPT,0672T,"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence ",,,2699.0,13835.0,161 CPT,0673T,"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance ",,,1986.0,12909.0,161 CPT,0674T,"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and d",,,2699.0,13835.0,161 CPT,0675T,"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to",,,2699.0,13835.0,161 CPT,0676T,"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to",,,1986.0,13835.0,161 CPT,0677T,"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse",,,2195.0,13835.0,161 CPT,0678T,"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse",,,1986.0,13835.0,161 CPT,0679T,"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function ",,,2195.0,13835.0,161 CPT,0680T,"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s) ",,,2699.0,13835.0,161 CPT,0681T,"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads ",,,2195.0,13835.0,161 CPT,0682T,"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function ",,,2195.0,13835.0,161 CPT,0683T,"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,0684T,"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualif",,,47.22,65.18,5 CPT,0685T,"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient e",,,84.82,117.09,5 CPT,0686T,"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance ",,,2996.0,34126.36,153 CPT,0687T,"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session ",,,128.72,177.68,5 CPT,0688T,"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month ",,,128.72,177.68,5 CPT,0689T,"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tiss",,,145.39,382.33,86 CPT,0690T,"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue,",,,243.5,535.41,5 CPT,0691T,"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report ",,,29.18,64.16,5 CPT,0692T,Therapeutic ultrafiltration ,,,948.57,1309.35,5 CPT,0693T,Comprehensive full body computer-based markerless 3D kinematic and kinetic motion analysis and report ,,,616.88,1356.43,5 CPT,0694T,"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time",,,55.81,122.72,5 CPT,0695T,"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, d",,,1994.87,3150.32,5 CPT,0696T,"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, d",,,76.82,121.32,5 CPT,0697T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",,,413.6,909.45,5 CPT,0698T,"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep",,,405.03,890.6,5 CPT,0699T,"Injection, posterior chamber of eye, medication ",,,4347.76,15059.0,65 CPT,0700T,Molecular fluorescent imaging of suspicious nevus; first lesion ,,,445.46,979.5,5 CPT,0704T,Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment ,,,128.72,177.68,5 CPT,0705T,"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days ",,,128.72,177.68,5 CPT,0706T,"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month ",,,128.72,177.68,5 CPT,0707T,"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance a",,,2195.0,15059.0,161 CPT,0708T,Intradermal cancer immunotherapy; preparation and initial injection ,,,141.5,12018.0,13 CPT,0709T,Intradermal cancer immunotherapy; each additional injection (List separately in addition to code for primary procedure) ,,,141.5,12018.0,13 CPT,0710T,"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structu",,,243.5,535.41,5 CPT,0711T,Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission ,,,243.5,535.41,5 CPT,0712T,Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and ass,,,145.39,319.7,5 CPT,0713T,"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report ",,,243.5,535.41,5 CPT,0714T,"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 mL ",,,2195.0,13835.0,161 CPT,0715T,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ,,,1672.0,36462.0,11 CPT,0716T,Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score ,,,114.84,1672.0,13 CPT,0717T,"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with ",,,2699.0,13835.0,161 CPT,0718T,"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral ",,,1986.0,13835.0,161 CPT,0719T,"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment ",,,3375.0,13835.0,161 CPT,0720T,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,2613.0,2613.0,8 CPT,0721T,"Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnos",,,1144.88,2517.43,5 CPT,0722T,"Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained with concurrent CT examination of any structure contained in the concurrently acquired diag",,,243.5,535.41,5 CPT,0723T,"Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (MRI) e",,,1672.88,3678.43,5 CPT,0724T,"Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) exam",,,243.5,535.41,5 CPT,0725T,"Vestibular device implantation, unilateral ",,,3673.0,13835.0,161 CPT,0726T,"Removal of implanted vestibular device, unilateral ",,,2699.0,13835.0,161 CPT,0727T,"Removal and replacement of implanted vestibular device, unilateral ",,,3673.0,13835.0,161 CPT,0730T,"Trabeculotomy by laser, including optical coherence tomography (OCT) guidance ",,,2996.0,13835.0,161 CPT,0731T,Augmentative AI-based facial phenotype analysis with report ,,,133.03,183.63,5 CPT,0732T,"Immunotherapy administration with electroporation, intramuscular ",,,141.5,12018.0,13 CPT,0733T,"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days ",,,88.99,122.84,5 CPT,0734T,"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified h",,,820.17,1132.12,5 CPT,0735T,"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately in addition to code for pr",,,1672.0,3083.0,104 CPT,0736T,"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter ",,,116.54,3083.0,140 CPT,0737T,Xenograft implantation into the articular surface ,,,2195.0,13835.0,161 CPT,0738T,"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (MRI) examination ",,,133.88,219.48,5 CPT,0739T,"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature ",,,2195.0,13835.0,161 CPT,0740T,Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education ,,,116.11,183.36,5 CPT,0741T,"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days ",,,70.7,111.65,5 CPT,0742T,"Absolute quantitation of myocardial blood flow (AQMBF), single-photon emission computed tomography (SPECT), with exercise or pharmacologic stress, and at rest, when performed (List separately in addit",,,55.81,122.72,5 CPT,0743T,"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD), with concurrent vertebral fracture assessment, utilizing data from a computed tomograph",,,105.48,231.93,5 CPT,0744T,"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, ePTFE, bovine peri",,,3375.0,14031.54,161 CPT,0745T,"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, CT, MRI, or myoca",,,2389.1,13835.0,69 CPT,0746T,Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan ,,,2389.1,13835.0,69 CPT,0747T,"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia ",,,2389.1,13835.0,69 CPT,0748T,"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings) ",,,1986.0,13835.0,161 CPT,0749T,"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and t",,,105.48,231.93,5 CPT,0750T,"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digital X ray, retrieval and t",,,105.48,231.93,5 CPT,0751T,"Digitization of glass microscope slides for level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ",,,46.44,73.34,5 CPT,0752T,"Digitization of glass microscope slides for level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0753T,"Digitization of glass microscope slides for level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0754T,"Digitization of glass microscope slides for level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ",,,572.49,904.08,5 CPT,0755T,"Digitization of glass microscope slides for level VI, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure) ",,,1268.96,2003.96,5 CPT,0756T,"Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (eg, acid fast, methenamine silver) (List separately in addition to code for",,,99.93,157.81,5 CPT,0757T,"Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituen",,,67.53,106.64,5 CPT,0758T,"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ",,,141.97,224.19,5 CPT,0759T,"Digitization of glass microscope slides for special stain, including interpretation and report, group III, for enzyme constituents (List separately in addition to code for primary procedure) ",,,1268.96,2003.96,5 CPT,0760T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (List separately in addition to code for primary procedur",,,289.87,457.76,5 CPT,0761T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to code for primary ",,,130.31,205.79,5 CPT,0762T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to code for primary procedur",,,572.49,904.08,5 CPT,0763T,"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, ",,,289.87,457.76,5 CPT,0764T,"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performe",,,17.47,27.59,5 CPT,0765T,"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed ",,,17.47,27.59,5 CPT,0766T,"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurograph",,,340.31,469.74,5 CPT,0767T,"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurograph",,,430.09,593.67,5 CPT,0771T,Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural,,,183.78,253.68,5 CPT,0772T,Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the VR procedural,,,49.75,68.67,5 CPT,0773T,Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performin,,,183.78,253.68,5 CPT,0774T,Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performin,,,49.75,68.67,5 CPT,0775T,"ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS, WITH IMAGE GUIDANCE, INCLUDES PLACEMENT OF INTRA-ARTICULAR IMPLANT(S) (EG, BONE ALLOGRAFTºS», SYNTHETIC DEVICEºS») ",,,9875.0,9875.0,8 CPT,0776T,"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs an",,,35.43,48.9,5 CPT,0777T,Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure) ,,,131.3,3083.0,101 CPT,0778T,"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function ",,,293.77,463.92,5 CPT,0779T,"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report ",,,850.84,1870.87,5 CPT,0780T,Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract ,,,1986.0,13835.0,161 CPT,0781T,"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; ",,,2699.0,15059.0,161 CPT,0782T,"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; ",,,2699.0,15059.0,161 CPT,0783T,"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment ",,,298.13,397.02,36 CPT,0784T,"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed ",,,2699.0,35432.53,153 CPT,0785T,"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator ",,,1986.0,15059.0,153 CPT,0786T,"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed ",,,2699.0,35432.53,153 CPT,0787T,"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator ",,,1986.0,15059.0,153 CPT,0788T,"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/o",,,186.3,294.21,5 CPT,0789T,"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (Hz), on/",,,186.3,294.21,5 CPT,0790T,"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed ",,,10740.0,42785.11,57 CPT,0791T,"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (List separately in addition to code for primary procedure) ",,,72.52,100.1,5 CPT,0792T,"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional ",,,24.45,33.75,5 CPT,0793T,"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance ",,,3673.0,65790.21,165 CPT,0794T,"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient's tumor-specific cancer marker information obtained from prior molecular pathol",,,134.5,1672.0,13 CPT,0795T,INS LEADLESS PPM DUAL,61265.66,61265.66,3675.94,52075.81,27 CPT,0795T,"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venograp",61265.66,61265.66,3375.0,13835.0,161 CPT,0796T,"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venograp",,,2996.0,13835.0,161 CPT,0797T,"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venograp",,,2996.0,46894.85,161 CPT,0798T,"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography",,,3293.0,15059.0,161 CPT,0799T,"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography",,,2996.0,15059.0,161 CPT,0800T,"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography",,,2996.0,15059.0,161 CPT,0801T,"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, fe",,,3673.0,13835.0,161 CPT,0802T,"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, fe",,,3293.0,13835.0,161 CPT,0803T,"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, fe",,,3293.0,46894.85,161 CPT,0804T,"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and r",,,70.7,111.65,5 CPT,0805T,"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation ºCAVI»); percutaneous femoral vein approach ",,,3375.0,13835.0,161 CPT,0806T,"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation ºCAVI»); open femoral vein approach ",,,3375.0,13835.0,161 CPT,0807T,"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (CT) images, ",,,255.96,562.81,5 CPT,0808T,Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) images taken for the purpose,,,492.91,1083.83,5 CPT,0809T,"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, placement of transfixing device and intra-articular implant, including allograft or synthetic device ",,,9875.0,9875.0,8 CPT,0810T,"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies ",,,3293.0,15059.0,161 CPT,0811T,"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment ",,,294.72,406.82,5 CPT,0812T,"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days ",,,84.08,116.05,5 CPT,0813T,"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon ",,,1770.56,13394.0,153 CPT,0814T,"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral ",,,1986.0,42785.11,153 CPT,0815T,"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine ",,,8.25,18.15,5 CPT,0816T,"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, program",,,2195.0,56900.95,153 CPT,0817T,"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, program",,,2195.0,56900.95,153 CPT,0818T,"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous ",,,1986.0,15059.0,153 CPT,0819T,"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial ",,,1986.0,15059.0,153 CPT,0820T,"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional",,,371.05,512.18,5 CPT,0821T,"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professiona",,,183.85,253.78,5 CPT,0822T,"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other ",,,183.85,253.78,5 CPT,0823T,INS LEADLESS PPM ATRIAL,67392.23,67392.23,4043.53,57283.4,24 CPT,0823T,"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculogr",67392.23,67392.23,3375.0,71105.29,157 CPT,0824T,"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculograp",,,2996.0,15059.0,157 CPT,0825T,"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or righ",,,3375.0,71105.29,157 CPT,0826T,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,72.58,114.62,5 CPT,0827T,"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (List separately in addition to code for primary proce",,,99.93,157.81,5 CPT,0828T,"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (List separately in addition to code for",,,99.93,157.81,5 CPT,0829T,"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, Saccomanno technique) (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0830T,"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (List se",,,99.93,157.81,5 CPT,0831T,"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (List separately in addition to code for primary procedure)",,,99.93,157.81,5 CPT,0832T,"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0833T,"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0834T,"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition to code for primary proc",,,99.93,157.81,5 CPT,0835T,"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (",,,99.93,157.81,5 CPT,0836T,"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation e",,,99.93,157.81,5 CPT,0837T,"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary procedure) ",,,99.93,157.81,5 CPT,0838T,Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure) ,,,67.53,106.64,5 CPT,0839T,Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary procedure) ,,,99.93,157.81,5 CPT,0840T,"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (List separately in addition to code for primary procedu",,,99.93,157.81,5 CPT,0841T,"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (List separately in addition to code for primary procedur",,,46.44,73.34,5 CPT,0842T,Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,46.44,73.34,5 CPT,0843T,"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (List separately in addition to code ",,,46.44,73.34,5 CPT,0844T,"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (List separately in addition ",,,46.44,73.34,5 CPT,0845T,"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedure) ",,,289.87,457.76,5 CPT,0846T,"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,289.87,457.76,5 CPT,0847T,"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) (List separately ",,,46.44,73.34,5 CPT,0848T,"Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; initial single probe stain procedure (List separately in addition to code for primary procedure) ",,,289.87,457.76,5 CPT,0849T,"Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,289.87,457.76,5 CPT,0850T,"Digitization of glass microscope slides for in situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure (List separately in addition to code for primary procedure) ",,,289.87,457.76,5 CPT,0851T,"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (List separately",,,289.87,457.76,5 CPT,0852T,"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (List se",,,289.87,457.76,5 CPT,0853T,"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (List separately",,,289.87,457.76,5 CPT,0854T,"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (List separately in addition to code for primary procedure) ",,,50.96,80.48,5 CPT,0855T,"Digitization of glass microscope slides for bone marrow, smear interpretation (List separately in addition to code for primary procedure) ",,,1268.96,2003.96,5 CPT,0856T,"Digitization of glass microscope slides for electron microscopy, diagnostic (List separately in addition to code for primary procedure) ",,,1268.96,2003.96,5 CPT,0857T,"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (List separately in addition to code for primary proced",,,184.36,405.38,5 CPT,0858T,Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report ,,,430.09,593.67,5 CPT,0859T,"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisit",,,17.65,38.82,5 CPT,0860T,"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative man",,,17.65,38.82,5 CPT,0861T,Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter) ,,,2996.0,15059.0,157 CPT,0862T,"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only ",,,2195.0,15059.0,157 CPT,0863T,"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only ",,,2195.0,15059.0,157 CPT,0864T,"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy ",,,925.6,3244.0,153 CPT,0865T,"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion identification, characterization, and quantification, wi",,,501.96,994.58,5 CPT,0866T,"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion detection, characterization, and quantification, with br",,,501.96,994.58,5 CPT,0867T,"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 mL ",,,2195.0,13459.12,132 CPT,0868T,"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report ",,,898.8,1976.33,5 CPT,0869T,"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed ",,,2195.0,8419.4,132 CPT,0870T,"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, incl",,,2195.0,42785.11,132 CPT,0871T,"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed ",,,2195.0,42785.11,132 CPT,0872T,"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when",,,2195.0,42785.11,132 CPT,0873T,"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, whe",,,2195.0,42785.11,132 CPT,0874T,"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters ",,,1986.0,42785.11,132 CPT,0875T,Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional ,,,84.82,117.09,5 CPT,0876T,"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula) ",,,197.26,433.75,5 CPT,0881T,"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device ",,,888.33,1226.2,5 CPT,0882T,"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (List s",,,1986.0,3083.0,96 CPT,0883T,"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve",,,1986.0,3083.0,96 CPT,0884T,"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal s",,,2699.0,9961.66,132 CPT,0885T,"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, includ",,,2699.0,7303.41,132 CPT,0886T,"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, incl",,,2195.0,7303.41,132 CPT,0888T,"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance ",,,2996.0,47776.36,132 CPT,0889T,"Personalized target development for accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state functional MRI, including d",,,2224.17,3070.11,5 CPT,0890T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and manageme",,,5266.17,7269.11,5 CPT,0891T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day ",,,5266.17,7269.11,5 CPT,0892T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delive",,,5266.17,7269.11,5 CPT,0893T,"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report ",,,136.38,188.24,5 CPT,0894T,Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion ,,,33362.2,42785.11,36 CPT,0895T,"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate",,,33362.2,42785.11,36 CPT,0896T,"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusa",,,33362.2,42785.11,36 CPT,0897T,"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded",,,1753.28,3855.22,5 CPT,0898T,"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determina",,,1753.28,3855.22,5 CPT,0899T,"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR",,,1555.45,3420.23,5 CPT,0900T,"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR), pharm",,,1555.45,3420.23,5 CPT,0901T,"Placement of bone marrow sampling port, including imaging guidance when performed ",,,1986.0,42785.11,132 CPT,0902T,"QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device ",,,260.38,411.19,5 CPT,0903T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; with interpretation and report ",,,34.95,55.19,5 CPT,0904T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only ",,,119.99,189.49,5 CPT,0905T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; interpretation and report only ",,,17.47,27.59,5 CPT,0906T,"Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm ",,,464.96,641.8,5 CPT,0907T,"Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (List separately",,,747.65,1032.02,5 CPT,0908T,"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed ",,,2195.0,42785.11,132 CPT,0909T,"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed ",,,2195.0,42785.11,132 CPT,0910T,"Removal of integrated neurostimulation system, vagus nerve ",,,1986.0,42785.11,132 CPT,0911T,"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional ",,,220.24,347.81,5 CPT,0912T,"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional ",,,85.18,134.52,5 CPT,0913T,PERC DRUG DEL BLN SGL LC,28874.99,28874.99,1732.5,24543.74,24 CPT,0913T,PERC DRUG DEL BLN SGL LD,28874.99,28874.99,1732.5,24543.74,24 CPT,0913T,PERC DRUG DEL BLN SGL LM,28874.99,28874.99,1732.5,24543.74,24 CPT,0913T,PERC DRUG DEL BLN SGL RC,28874.99,28874.99,1732.5,24543.74,24 CPT,0913T,PERC DRUG DEL BLN SGL RI,28874.99,28874.99,1732.5,24543.74,24 CPT,0913T,"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endo",,,3673.0,21836.82,136 CPT,0914T,PERC DRUG DEL BLN SEP LC,28874.99,28874.99,1732.5,24543.74,34 CPT,0914T,PERC DRUG DEL BLN SEP LD,28874.99,28874.99,1732.5,24543.74,34 CPT,0914T,PERC DRUG DEL BLN SEP LM,28874.99,28874.99,1732.5,24543.74,34 CPT,0914T,PERC DRUG DEL BLN SEP RC,28874.99,28874.99,1732.5,24543.74,34 CPT,0914T,PERC DRUG DEL BLN SEP RI,28874.99,28874.99,1732.5,24543.74,34 CPT,0914T,"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with ba",,,1986.0,3083.0,96 CPT,0915T,INSERT CCMD SYSTEM,138506.03,138506.03,8310.36,117730.13,27 CPT,0915T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse",138506.03,138506.03,3673.0,87528.11,132 CPT,0916T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse",,,2699.0,61278.1,132 CPT,0917T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; singl",,,2996.0,22593.43,132 CPT,0918T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual ",,,2996.0,22593.43,132 CPT,0919T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only ,,,2996.0,9935.29,132 CPT,0920T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only ,,,2996.0,9935.29,132 CPT,0921T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only ,,,2996.0,9935.29,132 CPT,0922T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only ,,,2996.0,9935.29,132 CPT,0923T,Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only ,,,2699.0,61278.1,132 CPT,0924T,"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic param",,,1267.43,3249.0,132 CPT,0925T,Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator ,,,2195.0,4993.8,132 CPT,0926T,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including",,,75.33,118.96,5 CPT,0927T,"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-d",,,75.33,118.96,5 CPT,0928T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care profes",,,63.33,100.01,5 CPT,0929T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical supp",,,75.33,118.96,5 CPT,0930T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arr",,,1986.0,3872.63,101 CPT,0931T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arr",,,2195.0,3872.63,101 CPT,0932T,"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qua",,,527.84,1160.65,5 CPT,0933T,"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal ",,,3673.0,12318.85,136 CPT,0934T,"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustme",,,86.02,118.73,5 CPT,0935T,"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and mul",,,2699.0,42785.11,132 CPT,0936T,"Photobiomodulation therapy of retina, single session ",,,33362.2,42785.11,36 CPT,0937T,"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation",,,218.28,344.71,5 CPT,0938T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording) ,,,112.43,177.56,5 CPT,0939T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report ,,,226.14,357.12,5 CPT,0940T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care profe,,,57.51,90.82,5 CPT,0941T,"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization ",,,2699.0,42785.11,132 CPT,0942T,"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold ",,,2699.0,42785.11,132 CPT,0943T,"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold ",,,2195.0,42785.11,132 CPT,0944T,3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation ,,,495.53,659.9,36 CPT,0945T,"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (List separately in addition to code for primary",,,73.57,3083.0,101 CPT,0946T,"Orthopedic implant movement analysis using paired computed tomography (CT) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report",,,187.16,411.54,5 CPT,0947T,"Magnetic resonance image guided low intensity focused ultrasound (MRgFUS), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomark",,,2699.0,48376.94,101 CPT,0948T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional",,,63.33,100.01,5 CPT,0949T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distri",,,75.33,118.96,5 CPT,0950T,"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,2195.0,25244.72,132 CPT,0951T,"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor ",,,2699.0,42785.11,132 CPT,0952T,"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor ",,,2699.0,42785.11,132 CPT,0953T,"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor ",,,2699.0,42785.11,132 CPT,0954T,"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers ",,,2699.0,42785.11,132 CPT,0955T,"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components ",,,2195.0,42785.11,132 CPT,0956T,"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitor",,,2699.0,61426.36,132 CPT,0957T,"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance ",,,2195.0,4369.12,132 CPT,0958T,"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance ",,,2195.0,8857.79,132 CPT,0959T,"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance ",,,2195.0,4423.26,132 CPT,0960T,"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidan",,,2195.0,61426.36,132 CPT,0961T,"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (List separately in addition to code for",,,98.27,155.19,5 CPT,0962T,"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and i",,,260.38,411.19,5 CPT,0963T,Anoscopy with directed submucosal injection of bulking agent into anal canal ,,,1986.0,3218.89,132 CPT,0964T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism ",,,6648.29,8853.58,36 CPT,0965T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechani",,,6648.29,8853.58,36 CPT,0966T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism ",,,6648.29,8853.58,36 CPT,0967T,"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring syste",,,2195.0,3249.0,132 CPT,0968T,"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array ",,,2195.0,42785.11,132 CPT,0969T,Removal of epicranial neurostimulator system ,,,1986.0,42785.11,132 CPT,0970T,"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor ",,,2195.0,10453.93,132 CPT,0971T,"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral ",,,2195.0,10453.93,132 CPT,0972T,"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, w",,,17.47,27.59,5 CPT,0973T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs;",,,819.04,3083.0,132 CPT,0974T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs;",,,1986.0,3083.0,96 CPT,0975T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands",,,819.04,3083.0,132 CPT,0976T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands",,,1986.0,3083.0,96 CPT,0977T,"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report ",,,1650.11,3628.36,5 CPT,0978T,"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil ",,,888.33,3249.0,101 CPT,0979T,Submucosal cryolysis therapy; soft palate only ,,,888.33,3249.0,101 CPT,0980T,Submucosal cryolysis therapy; base of tongue and lingual tonsil only ,,,888.33,3249.0,101 CPT,0981T,"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart cath",,,3375.0,49021.85,132 CPT,0982T,"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of",,,301.56,416.25,5 CPT,0983T,"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(",,,87.26,120.45,5 CPT,0984T,"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,176.97,3083.0,101 CPT,0985T,"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,140.82,3083.0,101 CPT,0986T,"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,176.97,3083.0,101 CPT,0987T,"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,140.82,3083.0,101 CPT,0988T,"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, program",,,2195.0,42785.11,132 CPT,0989T,"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial ",,,1986.0,9751.1,132 CPT,0990T,"Transcervical instillation of biodegradable hydrogel materials, intrauterine ",,,1986.0,42785.11,132 CPT,0991T,"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging ",,,2996.0,26403.19,132 CPT,0992T,"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (CT) scan of the heart, including patient-specific clinica",,,429.04,943.39,5 CPT,0993T,"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factor",,,429.04,943.39,5 CPT,0994T,"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radio",,,2996.0,42785.11,132 CPT,0995T,"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radio",,,2996.0,42785.11,132 CPT,0996T,"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis,",,,3293.0,6436.82,132 CPT,0997T,"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived ",,,2224.17,3070.11,5 CPT,0998T,"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing",,,8776.17,12114.11,5 CPT,0999T,"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed ",,,2195.0,42785.11,132 CPT,10004,"Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,120 CPT,10005,"Fine needle aspiration biopsy, including ultrasound guidance; first lesion ",,,270.48,5841.0,205 CPT,10006,"Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,120 CPT,10007,"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion ",,,203.77,5841.0,205 CPT,10008,"Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,120 CPT,10009,"Fine needle aspiration biopsy, including CT guidance; first lesion ",,,270.48,5841.0,205 CPT,1000T,"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed ",,,2195.0,42785.11,132 CPT,10010,"Fine needle aspiration biopsy, including CT guidance; each additional lesion (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,10011,"Fine needle aspiration biopsy, including MR guidance; first lesion ",,,270.48,5841.0,225 CPT,10012,"Fine needle aspiration biopsy, including MR guidance; each additional lesion (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,1001T,"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed ",,,2195.0,42785.11,132 CPT,10021,"Fine needle aspiration biopsy, without imaging guidance; first lesion ",,,54.36,5841.0,225 CPT,10022,FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE ,,,2128.0,2315.0,24 CPT,1002T,"Air displacement plethysmography, whole-body composition assessment, with interpretation and report ",,,69.15,95.45,5 CPT,10030,IMG GD FLD COLL SOFT TIS,4010.23,4010.23,561.43,3408.7,10 CPT,10030,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous ",4010.23,4010.23,270.48,3249.0,233 CPT,10035,"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion ",,,714.92,3755.0,206 CPT,10036,"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in additi",,,948.0,5841.0,140 CPT,1003T,"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint) ",,,3293.0,35808.75,132 CPT,10040,"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) ",,,202.56,5841.0,102 CPT,1004T,"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact groupºs», gain, bandpass filters) by physician or other qualified health care prof",,,274.58,433.62,5 CPT,1005T,"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact groupºs», gain, bandpass filters) by physician or other qualified health care prof",,,196.2,309.84,5 CPT,10060,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single ",,,68.31,5841.0,225 CPT,10061,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple ",,,103.19,5841.0,225 CPT,1006T,"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact groupºs», gain, bandpass filters) by physician or other qualified health care prof",,,87.63,138.38,5 CPT,10080,Incision and drainage of pilonidal cyst; simple ,,,182.85,5841.0,225 CPT,10081,Incision and drainage of pilonidal cyst; complicated ,,,219.77,3244.0,233 CPT,1008T,"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment ",,,318.29,439.34,5 CPT,1009T,"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of s",,,87.26,120.45,5 CPT,1010T,"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when perfor",,,274.58,433.62,5 CPT,1011T,"Photobiomodulation (PBM) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device ",,,933.75,1288.9,5 CPT,10120,"Incision and removal of foreign body, subcutaneous tissues; simple ",,,90.7,5841.0,225 CPT,10121,"Incision and removal of foreign body, subcutaneous tissues; complicated ",,,510.77,3755.0,233 CPT,1012T,"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed ",,,2996.0,11528.65,132 CPT,1013T,"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connecti",,,3293.0,54109.45,132 CPT,10140,"Incision and drainage of hematoma, seroma or fluid collection ",,,95.35,3244.0,233 CPT,1014T,"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes ",,,2996.0,31078.43,132 CPT,1015T,"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver ",,,2996.0,9751.1,132 CPT,10160,"Puncture aspiration of abscess, hematoma, bulla, or cyst ",,,71.22,5841.0,225 CPT,1016T,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, ",,,91.73,144.86,5 CPT,1017T,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, ",,,121.75,192.26,5 CPT,10180,"Incision and drainage, complex, postoperative wound infection ",,,855.96,6330.57,233 CPT,1018T,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, ",,,77.02,121.63,5 CPT,1019T,"Lymphovenous bypass, including robotic assistance, when performed, per extremity ",,,2699.0,18520.29,132 CPT,1020T,"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion ",,,121.75,192.26,5 CPT,1021T,Active thoracic irrigation (separate procedure) ,,,1313.82,3249.0,132 CPT,1022T,"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,96 CPT,1023T,"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,96 CPT,1024T,"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,96 CPT,1025T,"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification ",,,277.39,438.05,5 CPT,1026T,"Transvaginal laser photobiomodulation therapy of pelvis, provided by a physician or other qualified health care professional ",,,2699.0,4220.0,96 CPT,1037T,"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant pancreatic tissue, including imaging guidance ",,,2996.0,4390.0,96 CPT,1038T,"Autologous muscle cell therapy, injection(s) of muscle progenitor cells into the tongue, including esophagoscopy, when performed ",,,1986.0,3083.0,96 CPT,1040T,"Bronchoscopy, flexible, with bronchial cryotherapy, 1 lung, including trachea, when performed ",,,2195.0,3249.0,96 CPT,1042T,Implantation of absorbable urologic scaffold for prostatic urethra restoration of reconstructed bladder neck and urethral anastomosis (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,96 CPT,1044T,"Harvest of full-thickness skin for autologous heterogeneous skin construct graft, including direct closure of donor site; first 5 sq cm or less ",,,2195.0,3249.0,96 CPT,1045T,"Harvest of full-thickness skin for autologous heterogeneous skin construct graft, including direct closure of donor site; each additional 5 sq cm, or part thereof (List separately in addition ",,,1986.0,3083.0,96 CPT,1046T,"Autologous heterogeneous skin construct graft application, trunk, arms, legs; first 50 sq cm or less, or 0.5% of body area of infants and children ",,,2195.0,3249.0,96 CPT,1047T,"Autologous heterogeneous skin construct graft application, trunk, arms, legs; each additional 50 sq cm, or each additional 0.5% of body area of infants and children, or part thereof (List separately ",,,1986.0,3083.0,96 CPT,1048T,"Autologous heterogeneous skin construct graft application, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 50 sq cm or less, or 0.5% of ",,,2195.0,3249.0,96 CPT,1049T,"Autologous heterogeneous skin construct graft application, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 50 sq cm, or each additional",,,1986.0,3083.0,96 CPT,1050T,"Insertion, subcutaneous heart failure decompensation monitor, containing sensors that measure, at a minimum, heart rate, impedance, respiration rate, physical activity, heart sounds ",,,1986.0,3083.0,96 CPT,11000,Debridement of extensive eczematous or infected skin; up to 10% of body surface ,,,30.43,5841.0,225 CPT,11001,"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11004,"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum ",,,948.0,16207.0,109 CPT,11005,"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure ",,,948.0,16207.0,109 CPT,11006,"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure ",,,948.0,16207.0,109 CPT,11008,"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (List separately in addition to code for primary",,,948.0,13835.0,109 CPT,11010,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues ",,,270.48,3755.0,233 CPT,11011,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle ",,,270.48,5841.0,225 CPT,11012,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone ",,,855.96,6330.57,233 CPT,11040,"DEBRIDE SKIN, PARTIAL ",,,3390.0,5841.0,16 CPT,11041,"DEBRIDE SKIN, FULL ",,,3390.0,5841.0,16 CPT,11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less ",,,153.53,5841.0,225 CPT,11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less ",,,232.63,5841.0,225 CPT,11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less ",,,521.99,3755.0,233 CPT,11045,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11046,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary proced",,,948.0,5841.0,140 CPT,11047,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary proc",,,948.0,5841.0,140 CPT,11055,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion ",,,202.56,5841.0,198 CPT,11056,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions ",,,202.56,5841.0,198 CPT,11057,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions ",,,58.43,5841.0,225 CPT,11100,"BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED; SINGLE LESION ",,,2358.0,5841.0,16 CPT,11101,"BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED; EACH SEPARATE/ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED ",,,2358.0,5841.0,16 CPT,11102,"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion ",,,67.44,5841.0,225 CPT,11103,"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11104,"Punch biopsy of skin (including simple closure, when performed); single lesion ",,,83.43,5841.0,225 CPT,11105,"Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11106,"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion ",,,103.77,5841.0,225 CPT,11107,"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11200,"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions ",,,202.56,5841.0,198 CPT,11201,"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,44 CPT,11300,"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less ",,,358.2,5841.0,102 CPT,11301,"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm ",,,202.56,5841.0,102 CPT,11302,"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm ",,,202.56,5841.0,102 CPT,11303,"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm ",,,410.41,5841.0,102 CPT,11305,"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less ",,,202.56,5841.0,102 CPT,11306,"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm ",,,202.56,5841.0,102 CPT,11307,"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm ",,,78.06,5841.0,129 CPT,11308,"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm ",,,410.41,5841.0,102 CPT,11310,"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less ",,,75.58,5841.0,129 CPT,11311,"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm ",,,78.06,5841.0,129 CPT,11312,"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm ",,,93.89,5841.0,129 CPT,11313,"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm ",,,103.49,5841.0,129 CPT,11400,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less ",,,81.68,3128.0,233 CPT,11401,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm ",,,93.6,3128.0,233 CPT,11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm ",,,101.45,3128.0,233 CPT,11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm ",,,110.46,3128.0,233 CPT,11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm ",,,510.77,3747.2,233 CPT,11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm ",,,510.77,3755.0,233 CPT,11420,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less ",,,77.9,3249.0,233 CPT,11421,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm ",,,90.99,3249.0,233 CPT,11422,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm ",,,100.58,3128.0,233 CPT,11423,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm ",,,109.6,3128.0,233 CPT,11424,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm ",,,510.77,3755.0,233 CPT,11426,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm ",,,855.96,6330.57,233 CPT,11440,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less ",,,90.7,3249.0,233 CPT,11441,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm ",,,100.86,3249.0,233 CPT,11442,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm ",,,109.01,3128.0,233 CPT,11443,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm ",,,120.06,3128.0,233 CPT,11444,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm ",,,510.77,3747.2,233 CPT,11446,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm ",,,855.96,6330.57,233 CPT,11450,"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair ",,,855.96,6330.57,233 CPT,11451,"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair ",,,855.96,6330.57,233 CPT,11462,"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair ",,,855.96,6330.57,233 CPT,11463,"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair ",,,855.96,6330.57,233 CPT,11470,"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair ",,,855.96,6330.57,233 CPT,11471,"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair ",,,855.96,6330.57,233 CPT,11600,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less ",,,118.31,3128.0,233 CPT,11601,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm ",,,130.52,3128.0,233 CPT,11602,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm ",,,137.78,3128.0,233 CPT,11603,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm ",,,148.54,3128.0,233 CPT,11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm ",,,270.48,3755.0,233 CPT,11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm ",,,510.77,3755.0,233 CPT,11620,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less ",,,118.6,3128.0,233 CPT,11621,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm ",,,130.81,3128.0,233 CPT,11622,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm ",,,140.11,3128.0,233 CPT,11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm ",,,153.78,3244.0,233 CPT,11624,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm ",,,510.77,3755.0,233 CPT,11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm ",,,855.96,6330.57,233 CPT,11640,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less ",,,121.8,3249.0,233 CPT,11641,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm ",,,134.3,3249.0,233 CPT,11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm ",,,145.93,3249.0,233 CPT,11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm ",,,159.87,3249.0,233 CPT,11644,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm ",,,510.77,3755.0,233 CPT,11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm ",,,855.96,6330.57,233 CPT,11719,"Trimming of nondystrophic nails, any number ",,,59.56,5841.0,102 CPT,11720,Debridement of nail(s) by any method(s); 1 to 5 ,,,59.56,5841.0,198 CPT,11721,Debridement of nail(s) by any method(s); 6 or more ,,,59.56,5841.0,198 CPT,11730,"Avulsion of nail plate, partial or complete, simple; single ",,,202.56,5841.0,198 CPT,11732,"Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,11740,Evacuation of subungual hematoma ,,,134.32,5841.0,198 CPT,11750,"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal ",,,88.95,5841.0,225 CPT,11752,REMOVE NAIL BED/TIP ,,,3041.0,4052.0,24 CPT,11755,"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure) ",,,67.44,3390.0,233 CPT,11760,Repair of nail bed ,,,110.46,5841.0,225 CPT,11762,Reconstruction of nail bed with graft ,,,156.39,3390.0,233 CPT,11765,"Wedge excision of skin of nail fold (eg, for ingrown toenail) ",,,410.41,5841.0,198 CPT,11770,Excision of pilonidal cyst or sinus; simple ,,,855.96,12562.0,233 CPT,11771,Excision of pilonidal cyst or sinus; extensive ,,,855.96,12562.0,233 CPT,11772,Excision of pilonidal cyst or sinus; complicated ,,,855.96,12562.0,233 CPT,11900,"Injection, intralesional; up to and including 7 lesions ",,,202.56,5841.0,198 CPT,11901,"Injection, intralesional; more than 7 lesions ",,,202.56,5841.0,198 CPT,11920,"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less ",,,113.96,5841.0,225 CPT,11921,"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm ",,,125.86,5841.0,225 CPT,11922,"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (List separately in addition",,,948.0,5841.0,140 CPT,11950,"Subcutaneous injection of filling material (eg, collagen); 1 cc or less ",,,40.4,5841.0,129 CPT,11951,"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc ",,,51.45,5841.0,129 CPT,11952,"Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc ",,,65.4,5841.0,129 CPT,11954,"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc ",,,72.39,5841.0,129 CPT,11960,"Insertion of tissue expander(s) for other than breast, including subsequent expansion ",,,948.0,8128.0,233 CPT,11970,Replacement of tissue expander with permanent implant ,,,948.0,16330.72,233 CPT,11971,Removal of tissue expander without insertion of implant ,,,855.96,6330.57,233 CPT,11975,INSERT CONTRACEPTIVE CAP ,,,3390.0,5841.0,16 CPT,11976,"Removal, implantable contraceptive capsules ",,,64.83,5841.0,225 CPT,11977,REMOVAL/REINSERT CONTRA CAP ,,,3390.0,5841.0,16 CPT,11980,Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin) ,,,451.0,5841.0,198 CPT,11981,"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable) ",,,48.7,5841.0,225 CPT,11982,"Removal, non-biodegradable drug delivery implant ",,,57.14,5841.0,225 CPT,11983,"Removal with reinsertion, non-biodegradable drug delivery implant ",,,79.8,5841.0,225 CPT,12001,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less ",,,202.56,5841.0,198 CPT,12002,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm ",,,202.56,5841.0,102 CPT,12004,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm ",,,202.56,5841.0,198 CPT,12005,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm ",,,150.23,5841.0,225 CPT,12006,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm ",,,150.23,5841.0,225 CPT,12007,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm ",,,78.06,5841.0,225 CPT,12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less ",,,202.56,5841.0,102 CPT,12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm ",,,202.56,5841.0,102 CPT,12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm ",,,202.56,5841.0,198 CPT,12015,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm ",,,78.06,5841.0,225 CPT,12016,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm ",,,150.23,5841.0,225 CPT,12017,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm ",,,150.23,5841.0,225 CPT,12018,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm ",,,78.06,5841.0,225 CPT,12020,Treatment of superficial wound dehiscence; simple closure ,,,227.64,5841.0,225 CPT,12021,Treatment of superficial wound dehiscence; with packing ,,,150.23,5841.0,225 CPT,12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less ",,,150.23,5841.0,225 CPT,12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm ",,,150.23,5841.0,225 CPT,12034,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm ",,,150.23,5841.0,225 CPT,12035,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm ",,,150.23,5841.0,225 CPT,12036,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm ",,,227.64,5841.0,225 CPT,12037,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm ",,,744.46,4430.08,233 CPT,12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less ",,,150.23,5841.0,225 CPT,12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm ",,,150.23,5841.0,225 CPT,12044,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm ",,,227.64,5841.0,225 CPT,12045,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm ",,,227.64,5841.0,225 CPT,12046,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm ",,,227.64,5841.0,225 CPT,12047,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm ",,,744.46,5841.0,225 CPT,12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less ",,,150.23,5841.0,225 CPT,12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm ",,,150.23,5841.0,225 CPT,12053,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm ",,,150.23,5841.0,225 CPT,12054,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm ",,,150.23,5841.0,225 CPT,12055,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm ",,,150.23,5841.0,225 CPT,12056,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm ",,,150.23,5841.0,225 CPT,12057,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm ",,,150.23,5841.0,225 CPT,13100,"Repair, complex, trunk; 1.1 cm to 2.5 cm ",,,227.64,3755.0,233 CPT,13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm ",,,227.64,12562.0,225 CPT,13102,"Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,13120,"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm ",,,227.64,5841.0,225 CPT,13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm ",,,227.64,12562.0,225 CPT,13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,13131,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm ",,,150.23,5841.0,225 CPT,13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm ",,,227.64,12562.0,225 CPT,13133,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,13150,CMPLX RPR E/N/E/L 1.0 CM/< ,,,3390.0,5841.0,16 CPT,13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm ",,,227.64,12562.0,225 CPT,13152,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm ",,,227.64,12562.0,225 CPT,13153,"Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,13160,"Secondary closure of surgical wound or dehiscence, extensive or complicated ",,,744.46,4430.08,233 CPT,13300,Comp unusual REP >7.5 cm ,,,3390.0,5841.0,16 CPT,14000,"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less ",,,744.46,4430.08,233 CPT,14001,"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm ",,,744.46,12562.0,233 CPT,14020,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less ",,,744.46,12562.0,233 CPT,14021,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm ",,,744.46,12562.0,233 CPT,14040,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less ",,,744.46,4430.08,233 CPT,14041,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm ",,,744.46,12562.0,233 CPT,14060,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less ",,,744.46,12562.0,233 CPT,14061,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm ",,,744.46,12562.0,233 CPT,14300,SKIN TISSUE REARRANGEMENT ,,,3390.0,5841.0,16 CPT,14301,"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm ",,,948.0,15059.0,233 CPT,14302,"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,14350,"Filleted finger or toe flap, including preparation of recipient site ",,,744.46,12562.0,233 CPT,15000,"WOUND PREP, 1ST 100 SQ CM ",,,3390.0,5841.0,16 CPT,15001,"WOUND PREP, ADDL 100 SQ CM ",,,3390.0,5841.0,16 CPT,15002,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; firs",,,760.8,4430.08,233 CPT,15003,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each",,,948.0,5841.0,140 CPT,15004,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, m",,,232.63,5841.0,225 CPT,15005,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, m",,,948.0,5841.0,140 CPT,15011,Harvest of skin for skin cell suspension autograft; first 25 sq cm or less ,,,948.0,4993.8,161 CPT,15012,Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (List separately in addition to code for primary procedure) ,,,948.0,3390.0,124 CPT,15013,"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin ",,,948.0,48050.04,65 CPT,15014,"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereo",,,948.0,3390.0,28 CPT,15015,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less ",,,948.0,4993.8,161 CPT,15016,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (List separately in addi",,,948.0,3390.0,124 CPT,15017,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multi",,,948.0,4993.8,161 CPT,15018,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multi",,,948.0,3390.0,124 CPT,15040,"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less ",,,760.8,5841.0,225 CPT,15050,"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter ",,,232.63,5841.0,225 CPT,15100,"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) ",,,744.46,7014.0,233 CPT,15101,"Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary pr",,,948.0,5841.0,140 CPT,15110,"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children ",,,744.46,4430.08,233 CPT,15111,"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedur",,,948.0,5841.0,140 CPT,15115,"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children ",,,744.46,4430.08,233 CPT,15116,"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and child",,,948.0,5841.0,140 CPT,15120,"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except ",,,948.0,8128.0,233 CPT,15121,"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and",,,948.0,5841.0,140 CPT,15130,"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children ",,,744.46,7014.0,233 CPT,15131,"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,15135,"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children ",,,948.0,8128.0,233 CPT,15136,"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children",,,948.0,5841.0,140 CPT,15150,"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less ",,,744.46,4430.08,233 CPT,15151,"Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,15152,"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for prima",,,948.0,5841.0,140 CPT,15155,"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less ",,,948.0,8128.0,233 CPT,15156,"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (List separately in addition to code for",,,948.0,5841.0,140 CPT,15157,"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infant",,,948.0,5841.0,140 CPT,15170,ACELL GRAFT TRUNK/ARMS/LEGS ,,,3390.0,5841.0,16 CPT,15171,ACELL GRAFT T/ARM/LEG ADD-ON ,,,3390.0,5841.0,16 CPT,15175,ACELLULAR GRAFT F/N/HF/G ,,,3390.0,5841.0,16 CPT,15176,ACELL GRAFT F/N/HF/G ADD-ON ,,,3390.0,5841.0,16 CPT,15200,"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less ",,,744.46,12562.0,233 CPT,15201,"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,15220,"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less ",,,744.46,4430.08,233 CPT,15221,"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,15240,"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less ",,,744.46,12562.0,233 CPT,15241,"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separat",,,948.0,5841.0,140 CPT,15260,"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less ",,,744.46,4430.08,233 CPT,15261,"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedu",,,948.0,5841.0,140 CPT,15271,"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,760.8,4430.08,233 CPT,15272,"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code f",,,948.0,5841.0,140 CPT,15273,"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children ",,,948.0,8128.0,233 CPT,15274,"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additiona",,,948.0,5841.0,140 CPT,15275,"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or les",,,74.72,4430.08,233 CPT,15276,"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq",,,948.0,5841.0,140 CPT,15277,"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; fi",,,760.8,4430.08,233 CPT,15278,"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; ea",,,948.0,5841.0,140 CPT,15300,APPLY SKINALLOGRFT T/ARM/LG ,,,3390.0,5841.0,16 CPT,15301,APPLY SKNALLOGRFT T/A/L ADDL ,,,3390.0,5841.0,16 CPT,15320,APPLY SKIN ALLOGRFT F/N/HF/G ,,,3390.0,5841.0,16 CPT,15321,APLY SKNALLOGRFT F/N/HFG ADD ,,,3390.0,5841.0,16 CPT,15330,APLY ACELL ALOGRFT T/ARM/LEG ,,,3390.0,5841.0,16 CPT,15331,APLY ACELL GRFT T/A/L ADD-ON ,,,3390.0,5841.0,16 CPT,15335,APPLY ACELL GRAFT F/N/HF/G ,,,3390.0,5841.0,16 CPT,15336,APLY ACELL GRFT F/N/HF/G ADD ,,,3390.0,5841.0,16 CPT,15340,APPLY CULT SKIN SUBSTITUTE ,,,3390.0,5841.0,16 CPT,15341,APPLY CULT SKIN SUB ADD-ON ,,,3390.0,5841.0,16 CPT,15342,"CULTURED SKIN GRAFT, 25 CM ",,,3390.0,5841.0,16 CPT,15343,CULTURE SKN GRAFT ADDL 25 CM ,,,3390.0,5841.0,16 CPT,15350,SKIN HOMOGRAFT ,,,3390.0,5841.0,16 CPT,15351,SKIN HOMOGRAFT ADD-ON ,,,3390.0,5841.0,16 CPT,15360,APPLY CULT DERM SUB T/A/L ,,,3390.0,5841.0,16 CPT,15361,APLY CULT DERM SUB T/A/L ADD ,,,3390.0,5841.0,16 CPT,15365,APPLY CULT DERM SUB F/N/HF/G ,,,3390.0,5841.0,16 CPT,15366,APPLY CULT DERM F/HF/G ADD ,,,3390.0,5841.0,16 CPT,15400,APPLY SKIN XENOGRAFT T/A/L ,,,3390.0,5841.0,16 CPT,15401,APPLY SKN XENOGRFT T/A/L ADD ,,,3390.0,5841.0,16 CPT,15420,APPLY SKIN XGRAFT F/N/HF/G ,,,3390.0,5841.0,16 CPT,15421,APPLY SKN XGRFT F/N/HF/G ADD ,,,3390.0,5841.0,16 CPT,15430,APPLY ACELLULAR XENOGRAFT ,,,3390.0,5841.0,16 CPT,15431,APPLY ACELLULAR XGRAFT ADD ,,,3390.0,5841.0,16 CPT,15570,"Formation of direct or tubed pedicle, with or without transfer; trunk ",,,744.46,12562.0,233 CPT,15572,"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs ",,,948.0,12562.0,233 CPT,15574,"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet ",,,744.46,12562.0,233 CPT,15576,"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral ",,,744.46,12562.0,233 CPT,15580,Cross finger flap ,,,3390.0,5841.0,16 CPT,15600,Delay of flap or sectioning of flap (division and inset); at trunk ,,,948.0,12562.0,233 CPT,15610,"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs ",,,744.46,12562.0,233 CPT,15620,"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet ",,,744.46,8234.0,233 CPT,15625,Section cross fing flap ,,,3390.0,5841.0,16 CPT,15630,"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips ",,,744.46,12562.0,233 CPT,15650,"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location ",,,744.46,13394.0,233 CPT,15730,"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s) ",,,948.0,15059.0,225 CPT,15731,"Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap) ",,,948.0,12562.0,233 CPT,15732,"HMuscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator scapulae) ",,,2431.0,2979.0,24 CPT,15733,"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae) ",,,948.0,15059.0,225 CPT,15734,"Muscle, myocutaneous, or fasciocutaneous flap; trunk ",,,948.0,12562.0,233 CPT,15736,"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity ",,,744.46,12562.0,233 CPT,15738,"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity ",,,948.0,12562.0,233 CPT,15740,Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel ,,,744.46,4430.08,233 CPT,15750,Flap; neurovascular pedicle ,,,948.0,8128.0,233 CPT,15756,Free muscle or myocutaneous flap with microvascular anastomosis ,,,948.0,28061.12,205 CPT,15757,Free skin flap with microvascular anastomosis ,,,948.0,27764.42,205 CPT,15758,Free fascial flap with microvascular anastomosis ,,,948.0,28010.2,205 CPT,15760,"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area ",,,744.46,4430.08,233 CPT,15769,"Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia) ",,,948.0,15059.0,225 CPT,15770,Graft; derma-fat-fascia ,,,948.0,12562.0,233 CPT,15771,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate ",,,948.0,15059.0,225 CPT,15772,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for pri",,,948.0,5841.0,140 CPT,15773,"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate ",,,744.46,15059.0,225 CPT,15774,"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separat",,,948.0,5841.0,140 CPT,15775,Punch graft for hair transplant; 1 to 15 punch grafts ,,,410.41,12562.0,198 CPT,15776,Punch graft for hair transplant; more than 15 punch grafts ,,,410.41,12562.0,198 CPT,15777,"Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,15778,"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma ",,,948.0,13835.0,197 CPT,15780,"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis) ",,,948.0,13835.0,110 CPT,15781,"Dermabrasion; segmental, face ",,,714.92,4413.85,110 CPT,15782,"Dermabrasion; regional, other than face ",,,948.0,5421.27,110 CPT,15783,"Dermabrasion; superficial, any site (eg, tattoo removal) ",,,410.41,5841.0,102 CPT,15786,"Abrasion; single lesion (eg, keratosis, scar) ",,,202.56,5841.0,102 CPT,15787,Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure) ,,,948.0,5841.0,44 CPT,15788,"Chemical peel, facial; epidermal ",,,358.2,5841.0,102 CPT,15789,"Chemical peel, facial; dermal ",,,746.15,5841.0,102 CPT,15792,"Chemical peel, nonfacial; epidermal ",,,655.0,5841.0,102 CPT,15793,"Chemical peel, nonfacial; dermal ",,,410.41,5841.0,102 CPT,15810,SALABRASION ,,,3390.0,5841.0,16 CPT,15811,SALABRASION ,,,3390.0,5841.0,16 CPT,15819,Cervicoplasty ,,,760.8,3128.0,60 CPT,15820,"Blepharoplasty, lower eyelid; ",,,744.46,12562.0,233 CPT,15821,"Blepharoplasty, lower eyelid; with extensive herniated fat pad ",,,744.46,12562.0,233 CPT,15822,"Blepharoplasty, upper eyelid; ",,,744.46,12562.0,233 CPT,15823,"Blepharoplasty, upper eyelid; with excessive skin weighting down lid ",,,744.46,13394.0,233 CPT,15824,Rhytidectomy; forehead ,,,744.46,12562.0,233 CPT,15825,"Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap) ",,,948.0,12562.0,233 CPT,15826,Rhytidectomy; glabellar frown lines ,,,948.0,12562.0,233 CPT,15828,"Rhytidectomy; cheek, chin, and neck ",,,948.0,12562.0,233 CPT,15829,Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap ,,,948.0,13394.0,233 CPT,15830,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy ",,,948.0,14297.8,233 CPT,15831,EXCISE EXCESSIVE SKIN TISSUE ,,,3390.0,5841.0,16 CPT,15832,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh ",,,948.0,12562.0,206 CPT,15833,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg ",,,948.0,12562.0,206 CPT,15834,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip ",,,948.0,12562.0,206 CPT,15835,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock ",,,948.0,12562.0,206 CPT,15836,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm ",,,948.0,12562.0,206 CPT,15837,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand ",,,948.0,13835.0,206 CPT,15838,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad ",,,948.0,13835.0,206 CPT,15839,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area ",,,948.0,12562.0,206 CPT,15840,Graft for facial nerve paralysis; free fascia graft (including obtaining fascia) ,,,948.0,8234.0,233 CPT,15841,Graft for facial nerve paralysis; free muscle graft (including obtaining graft) ,,,948.0,8234.0,233 CPT,15842,Graft for facial nerve paralysis; free muscle flap by microsurgical technique ,,,744.46,8234.0,233 CPT,15845,Graft for facial nerve paralysis; regional muscle transfer ,,,948.0,8234.0,233 CPT,15847,"Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for pr",,,948.0,5841.0,140 CPT,15850,"REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON ",,,2431.0,2979.0,24 CPT,15851,"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation) ",,,65.4,5841.0,225 CPT,15852,Dressing change (for other than burns) under anesthesia (other than local) ,,,746.15,5841.0,198 CPT,15853,Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code) ,,,948.0,5841.0,140 CPT,15854,Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code) ,,,948.0,5841.0,140 CPT,15860,"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft ",,,451.0,5841.0,198 CPT,15876,Suction assisted lipectomy; head and neck ,,,948.0,12562.0,206 CPT,15877,Suction assisted lipectomy; trunk ,,,948.0,12562.0,206 CPT,15878,Suction assisted lipectomy; upper extremity ,,,948.0,12562.0,206 CPT,15879,Suction assisted lipectomy; lower extremity ,,,948.0,12562.0,206 CPT,15920,"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture ",,,855.96,12562.0,233 CPT,15922,"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure ",,,948.0,8234.0,233 CPT,15931,"Excision, sacral pressure ulcer, with primary suture; ",,,855.96,12562.0,233 CPT,15933,"Excision, sacral pressure ulcer, with primary suture; with ostectomy ",,,855.96,12562.0,233 CPT,15934,"Excision, sacral pressure ulcer, with skin flap closure; ",,,948.0,12562.0,233 CPT,15935,"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy ",,,948.0,8234.0,233 CPT,15936,"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; ",,,744.46,8234.0,233 CPT,15937,"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy ",,,744.46,8234.0,233 CPT,15940,"Excision, ischial pressure ulcer, with primary suture; ",,,855.96,12562.0,233 CPT,15941,"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy) ",,,855.96,12562.0,233 CPT,15944,"Excision, ischial pressure ulcer, with skin flap closure; ",,,948.0,12562.0,233 CPT,15945,"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy ",,,744.46,8234.0,233 CPT,15946,"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure ",,,744.46,8234.0,233 CPT,15950,"Excision, trochanteric pressure ulcer, with primary suture; ",,,510.77,12562.0,233 CPT,15951,"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy ",,,855.96,8234.0,233 CPT,15952,"Excision, trochanteric pressure ulcer, with skin flap closure; ",,,744.46,12562.0,233 CPT,15953,"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy ",,,948.0,8234.0,233 CPT,15956,"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; ",,,744.46,12562.0,233 CPT,15958,"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy ",,,948.0,8234.0,233 CPT,15999,"Unlisted procedure, excision pressure ulcer ",,,714.92,13835.0,102 CPT,16000,"Initial treatment, first degree burn, when no more than local treatment is required ",,,202.56,5841.0,102 CPT,16010,TREATMENT OF BURN(S) ,,,3390.0,5841.0,16 CPT,16015,TREATMENT OF BURN(S) ,,,3390.0,5841.0,16 CPT,16020,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area) ",,,46.53,5841.0,225 CPT,16025,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area) ",,,79.77,5841.0,225 CPT,16030,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area) ",,,153.53,5841.0,225 CPT,16035,Escharotomy; initial incision ,,,150.23,13835.0,225 CPT,16036,Escharotomy; each additional incision (List separately in addition to code for primary procedure) ,,,779.91,13835.0,109 CPT,17000,"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion ",,,202.56,5841.0,198 CPT,17003,"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addi",,,948.0,5841.0,140 CPT,17004,"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions ",,,102.04,5841.0,225 CPT,17106,"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm ",,,150.23,5841.0,225 CPT,17107,"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm ",,,226.74,5841.0,225 CPT,17108,"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm ",,,294.47,5841.0,225 CPT,17110,"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions ",,,202.56,5841.0,198 CPT,17111,"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions",,,202.56,5841.0,198 CPT,17250,"Chemical cauterization of granulation tissue (ie, proud flesh) ",,,202.56,5841.0,198 CPT,17260,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less ",,,202.56,5841.0,198 CPT,17261,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm ",,,202.56,5841.0,198 CPT,17262,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm ",,,202.56,5841.0,198 CPT,17263,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm ",,,202.56,5841.0,198 CPT,17264,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm ",,,114.53,5841.0,225 CPT,17266,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm ",,,126.16,5841.0,225 CPT,17270,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less ",,,78.06,5841.0,225 CPT,17271,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm ",,,78.06,5841.0,225 CPT,17272,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm ",,,202.56,5841.0,198 CPT,17273,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm ",,,112.79,5841.0,225 CPT,17274,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm ",,,126.16,5841.0,225 CPT,17276,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm ",,,140.41,5841.0,225 CPT,17280,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less ",,,202.56,5841.0,198 CPT,17281,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm ",,,98.26,5841.0,225 CPT,17282,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm ",,,110.18,5841.0,225 CPT,17283,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm ",,,122.95,5841.0,225 CPT,17284,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm ",,,135.18,5841.0,225 CPT,17286,"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm ",,,161.05,5841.0,225 CPT,17304,"1 STAGE MOHS, UP TO 5 SPEC ",,,3390.0,5841.0,16 CPT,17305,"2 STAGE MOHS, UP TO 5 SPEC ",,,3390.0,5841.0,16 CPT,17306,"3 STAGE MOHS, UP TO 5 SPEC ",,,3390.0,5841.0,16 CPT,17307,MOHS ADDL STAGE UP TO 5 SPEC ,,,3390.0,5841.0,16 CPT,17310,MOHS ANY STAGE > 5 SPEC EACH ,,,3390.0,5841.0,16 CPT,17311,"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and h",,,227.64,5841.0,225 CPT,17312,"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and h",,,948.0,5841.0,140 CPT,17313,"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and h",,,227.64,5841.0,225 CPT,17314,"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and h",,,948.0,5841.0,140 CPT,17315,"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and h",,,948.0,5841.0,140 CPT,17340,"Cryotherapy (CO2 slush, liquid N2) for acne ",,,59.56,5841.0,102 CPT,17360,"Chemical exfoliation for acne (eg, acne paste, acid) ",,,202.56,5841.0,102 CPT,17380,"Electrolysis epilation, each 30 minutes ",,,746.15,5841.0,102 CPT,17999,"Unlisted procedure, skin, mucous membrane and subcutaneous tissue ",,,202.56,13835.0,198 CPT,19000,Puncture aspiration of cyst of breast; ,,,62.21,3128.0,233 CPT,19001,Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,19020,"Mastotomy with exploration or drainage of abscess, deep ",,,510.77,5571.0,233 CPT,19030,Injection procedure only for mammary ductogram or galactogram ,,,948.0,5841.0,140 CPT,19081,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including s",,,510.77,12562.0,233 CPT,19082,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, i",,,948.0,5841.0,140 CPT,19083,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including u",,,510.77,12562.0,233 CPT,19084,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, i",,,948.0,5841.0,140 CPT,19085,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including m",,,510.77,12562.0,233 CPT,19086,"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, i",,,948.0,5841.0,140 CPT,19100,"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure) ",,,510.77,3747.2,233 CPT,19101,"Biopsy of breast; open, incisional ",,,948.0,8270.67,233 CPT,19102,BX BREAST PERCUT W/IMAGE ,,,3390.0,5841.0,16 CPT,19103,BX BREAST PERCUT W/DEVICE ,,,3390.0,5841.0,16 CPT,19105,"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma ",,,948.0,15059.0,206 CPT,19110,"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct ",,,948.0,8270.67,233 CPT,19112,Excision of lactiferous duct fistula ,,,948.0,12562.0,233 CPT,19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions ",,,1011.84,12562.0,213 CPT,19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions High Cost Surg",,,2369.0,2369.0,20 CPT,19125,"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion ",,,1011.84,12562.0,213 CPT,19125,"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion High Cost Surgery",,,2369.0,2369.0,20 CPT,19126,"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (List separately in addi",,,1672.0,5841.0,140 CPT,19140,REMOVAL OF BREAST TISSUE ,,,3390.0,5841.0,16 CPT,19160,PARTIAL MASTECTOMY ,,,3390.0,5841.0,16 CPT,19162,P-MASTECTOMY W/LN REMOVAL ,,,3390.0,5841.0,16 CPT,19180,REMOVAL OF BREAST ,,,3390.0,5841.0,16 CPT,19182,REMOVAL OF BREAST ,,,3390.0,5841.0,16 CPT,19200,REMOVAL OF BREAST ,,,3390.0,5841.0,16 CPT,19220,REMOVAL OF BREAST ,,,3390.0,5841.0,16 CPT,19240,REMOVAL OF BREAST ,,,3390.0,5841.0,16 CPT,19260,EXCISION OF CHEST WALL TUMOR INCLUDING RIBS ,,,2431.0,2979.0,24 CPT,19271,"EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC RECONSTRUCTION; WITHOUT MEDIASTINAL LYMPHADENECTOMY ",,,3390.0,16207.0,24 CPT,19272,"EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC RECONSTRUCTION; WITH MEDIASTINAL LYMPHADENECTOMY ",,,3390.0,16207.0,24 CPT,19281,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance ",,,948.0,5841.0,198 CPT,19282,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (List separately in additi",,,948.0,5841.0,140 CPT,19283,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance ",,,714.92,5841.0,198 CPT,19284,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (List separately in additi",,,948.0,5841.0,140 CPT,19285,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance ",,,714.92,5841.0,198 CPT,19286,"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (List separately in addition",,,948.0,5841.0,140 CPT,19287,"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance ",,,714.92,5841.0,198 CPT,19288,"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (List separately in a",,,948.0,5841.0,140 CPT,19290,PLACE NEEDLE WIRE BREAST ,,,3390.0,5841.0,16 CPT,19291,PLACE NEEDLE WIRE BREAST ,,,3390.0,5841.0,16 CPT,19294,"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately in addition to code for pr",,,948.0,5841.0,140 CPT,19295,PLACE BREAST CLIP PERCUT ,,,3390.0,5841.0,16 CPT,19296,"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; o",,,948.0,25988.0,249 CPT,19297,"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; c",,,948.0,25988.0,164 CPT,19298,Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) pa,,,948.0,25988.0,249 CPT,19300,Mastectomy for gynecomastia ,,,1011.84,8270.67,213 CPT,19300,Mastectomy for gynecomastia High Cost Surgery,,,2369.0,2369.0,20 CPT,19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); ",,,1011.84,12562.0,213 CPT,19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); High Cost Surgery",,,2369.0,2369.0,20 CPT,19302,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy ",,,1937.47,14297.8,213 CPT,19302,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,19303,"Mastectomy, simple, complete ",,,1937.47,14297.8,213 CPT,19303,"Mastectomy, simple, complete High Cost Surgery",,,2369.0,2369.0,20 CPT,19304,"MASTECTOMY, SUBCUTANEOUS ",,,4988.0,7014.0,24 CPT,19305,"Mastectomy, radical, including pectoral muscles, axillary lymph nodes ",,,3390.0,16207.0,89 CPT,19305,"Mastectomy, radical, including pectoral muscles, axillary lymph nodes High Cost Surgery",,,2369.0,2369.0,20 CPT,19306,"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation) ",,,3390.0,16207.0,89 CPT,19306,"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation) High Cost Surgery",,,2369.0,2369.0,20 CPT,19307,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle ",,,3293.0,15059.0,186 CPT,19307,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle High Cost Surgery",,,2369.0,2369.0,20 CPT,19316,Mastopexy ,,,1937.47,14297.8,213 CPT,19316,Mastopexy High Cost Surgery,,,2369.0,2369.0,20 CPT,19318,Breast reduction ,,,1937.47,14297.8,213 CPT,19318,Breast reduction High Cost Surgery,,,2369.0,2369.0,20 CPT,19324,"MAMMAPLASTY, AUGMENTATION; WITHOUT PROSTHETIC IMPLANT ",,,6326.0,9653.0,24 CPT,19325,Breast augmentation with implant ,,,2395.82,35343.0,229 CPT,19325,Breast augmentation with implant High Cost Surgery,,,2369.0,2369.0,20 CPT,19328,Removal of intact breast implant ,,,1011.84,8270.67,213 CPT,19328,Removal of intact breast implant High Cost Surgery,,,2369.0,2369.0,20 CPT,19330,"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel) ",,,1011.84,8270.67,213 CPT,19330,"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel) High Cost Surgery",,,2369.0,2369.0,20 CPT,19340,"Insertion of breast implant on same day of mastectomy (ie, immediate) ",,,1937.47,35343.0,229 CPT,19340,"Insertion of breast implant on same day of mastectomy (ie, immediate) High Cost Surgery",,,2369.0,2369.0,20 CPT,19342,Insertion or replacement of breast implant on separate day from mastectomy ,,,2395.82,35343.0,229 CPT,19342,Insertion or replacement of breast implant on separate day from mastectomy High Cost Surgery,,,2369.0,2369.0,20 CPT,19350,Nipple/areola reconstruction ,,,1011.84,8270.67,213 CPT,19350,Nipple/areola reconstruction High Cost Surgery,,,2369.0,2369.0,20 CPT,19355,Correction of inverted nipples ,,,1011.84,8270.67,213 CPT,19355,Correction of inverted nipples High Cost Surgery,,,2369.0,2369.0,20 CPT,19357,"Tissue expander placement in breast reconstruction, including subsequent expansion(s) ",,,3293.0,37819.59,229 CPT,19357,"Tissue expander placement in breast reconstruction, including subsequent expansion(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,19361,Breast reconstruction; with latissimus dorsi flap ,,,3390.0,35343.0,105 CPT,19361,Breast reconstruction; with latissimus dorsi flap High Cost Surgery,,,2369.0,2369.0,20 CPT,19364,"Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap) ",,,3293.0,33570.8,185 CPT,19364,"Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap) High Cost Surgery",,,2369.0,2369.0,20 CPT,19366,BREAST RECONSTRUCTION WITH OTHER TECHNIQUE ,,,4988.0,7014.0,24 CPT,19367,Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap ,,,6326.0,21758.94,89 CPT,19367,Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap High Cost Surgery,,,2369.0,2369.0,20 CPT,19368,"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap, requiring separate microvascular anastomosis (supercharging) ",,,6326.0,26793.87,89 CPT,19368,"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap, requiring separate microvascular anastomosis (supercharging) High Cost Surgery",,,2369.0,2369.0,20 CPT,19369,Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap ,,,6326.0,24869.7,89 CPT,19369,Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap High Cost Surgery,,,2369.0,2369.0,20 CPT,19370,"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy ",,,1011.84,8270.67,213 CPT,19370,"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,19371,"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents ",,,1011.84,8270.67,213 CPT,19371,"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents High Cost Surgery",,,2369.0,2369.0,20 CPT,19380,"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue exc",,,1937.47,14297.8,233 CPT,19396,Preparation of moulage for custom breast implant ,,,1011.84,13835.0,213 CPT,19396,Preparation of moulage for custom breast implant High Cost Surgery,,,2369.0,2369.0,20 CPT,19499,"Unlisted procedure, breast ",,,1986.0,13835.0,186 CPT,19499,"Unlisted procedure, breast High Cost Surgery",,,2369.0,2369.0,20 CPT,20000,INCISION OF ABSCESS ,,,3390.0,5841.0,16 CPT,20005,"INCISION AND DRAINAGE OF SOFT TISSUE ABSCESS, SUBFASCIAL (IE, INVOLVES THE SOFT TISSUE BELOW THE DEEP FASCIA) ",,,2128.0,2315.0,24 CPT,20100,Exploration of penetrating wound (separate procedure); neck ,,,544.5,3128.0,110 CPT,20101,Exploration of penetrating wound (separate procedure); chest ,,,948.0,13835.0,110 CPT,20102,Exploration of penetrating wound (separate procedure); abdomen/flank/back ,,,948.0,13835.0,110 CPT,20103,Exploration of penetrating wound (separate procedure); extremity ,,,270.48,3128.0,233 CPT,20150,"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision ",,,948.0,13835.0,137 CPT,20200,"Biopsy, muscle; superficial ",,,510.77,3755.0,233 CPT,20205,"Biopsy, muscle; deep ",,,855.96,12562.0,233 CPT,20206,"Biopsy, muscle, percutaneous needle ",,,510.77,3747.2,233 CPT,20220,"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) ",,,510.77,3747.2,233 CPT,20225,BX BONE DEEP,22731.21,22731.21,3182.37,19321.53,10 CPT,20225,"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur) ",22731.21,22731.21,510.77,3755.0,233 CPT,20240,"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx) ",,,855.96,6330.57,233 CPT,20245,"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft) ",,,855.96,12562.0,233 CPT,20250,"Biopsy, vertebral body, open; thoracic ",,,948.0,12562.0,233 CPT,20251,"Biopsy, vertebral body, open; lumbar or cervical ",,,948.0,16330.72,233 CPT,20500,Injection of sinus tract; therapeutic (separate procedure) ,,,63.66,3244.0,233 CPT,20501,INJ SINUS TRACT DX,875.48,875.48,113.81,744.16,29 CPT,20501,Injection of sinus tract; diagnostic (sinogram) ,875.48,875.48,948.0,5841.0,140 CPT,20520,Removal of foreign body in muscle or tendon sheath; simple ,,,125.86,3249.0,233 CPT,20525,Removal of foreign body in muscle or tendon sheath; deep or complicated ,,,855.96,12562.0,233 CPT,20526,"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel ",,,38.37,5841.0,225 CPT,20527,"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, Dupuytren's contracture) ",,,40.4,5841.0,225 CPT,20550,"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) ",,,24.72,5841.0,225 CPT,20551,Injection(s); single tendon origin/insertion ,,,25.58,5841.0,225 CPT,20552,"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) ",,,24.42,5841.0,225 CPT,20553,"Injection(s); single or multiple trigger point(s), 3 or more muscles ",,,28.49,5841.0,225 CPT,20555,Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time of or subsequent to the procedure) ,,,948.0,18419.24,206 CPT,20560,Needle insertion(s) without injection(s); 1 or 2 muscle(s) ,,,29.2,5841.0,167 CPT,20561,Needle insertion(s) without injection(s); 3 or more muscles ,,,29.2,5841.0,167 CPT,20600,"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance ",,,23.84,5841.0,225 CPT,20604,"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting ",,,41.85,5841.0,225 CPT,20605,"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance ",,,24.72,5841.0,225 CPT,20606,"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent re",,,44.48,5841.0,225 CPT,20610,"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance ",,,29.36,5841.0,225 CPT,20611,"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting ",,,49.71,5841.0,225 CPT,20612,Aspiration and/or injection of ganglion cyst(s) any location ,,,31.98,5841.0,225 CPT,20615,Aspiration and injection for treatment of bone cyst ,,,142.44,3244.0,233 CPT,20650,"Insertion of wire or pin with application of skeletal traction, including removal (separate procedure) ",,,948.0,12562.0,233 CPT,20660,"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) ",,,948.0,13835.0,206 CPT,20661,"Application of halo, including removal; cranial ",,,948.0,13835.0,205 CPT,20662,"Application of halo, including removal; pelvic ",,,622.69,12562.0,233 CPT,20663,"Application of halo, including removal; femoral ",,,948.0,18419.24,233 CPT,20664,"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta) ",,,948.0,13835.0,205 CPT,20665,Removal of tongs or halo applied by another individual ,,,117.96,5841.0,225 CPT,20670,"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure) ",,,510.77,3747.2,233 CPT,20680,"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate) ",,,855.96,12562.0,233 CPT,20690,"Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system ",,,948.0,16330.72,233 CPT,20692,"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type) ",,,948.0,32488.94,233 CPT,20693,"Adjustment or revision of external fixation system requiring anesthesia (eg, new pinºs» or wireºs» and/or new ringºs» or barºs») ",,,948.0,16330.72,233 CPT,20694,"Removal, under anesthesia, of external fixation system ",,,622.69,5571.0,233 CPT,20696,"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequ",,,948.0,43532.8,233 CPT,20697,"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, remov",,,622.69,12909.0,233 CPT,20700,"Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20701,"Removal of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20702,"Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20703,"Removal of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20704,"Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20705,"Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20802,"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation ",,,948.0,33774.25,109 CPT,20805,"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation ",,,948.0,40216.26,109 CPT,20808,"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation ",,,948.0,48650.3,109 CPT,20816,"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation ",,,948.0,25293.53,109 CPT,20822,"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation ",,,622.69,12562.0,137 CPT,20824,"Replantation, thumb (includes carpometacarpal joint to MP joint), complete amputation ",,,948.0,25335.98,109 CPT,20827,"Replantation, thumb (includes distal tip to MP joint), complete amputation ",,,948.0,22195.47,109 CPT,20838,"Replantation, foot, complete amputation ",,,948.0,34197.96,109 CPT,20900,"Bone graft, any donor area; minor or small (eg, dowel or button) ",,,948.0,16330.72,233 CPT,20902,"Bone graft, any donor area; major or large ",,,948.0,16330.72,233 CPT,20910,Cartilage graft; costochondral ,,,227.64,12562.0,225 CPT,20912,Cartilage graft; nasal septum ,,,948.0,12562.0,233 CPT,20920,Fascia lata graft; by stripper ,,,744.46,8234.0,233 CPT,20922,"Fascia lata graft; by incision and area exposure, complex or sheet ",,,744.46,12562.0,233 CPT,20924,"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris) ",,,948.0,16330.72,233 CPT,20926,"TISSUE GRAFTS, OTHER (EG, PARATENON, FAT, DERMIS) ",,,4988.0,7014.0,24 CPT,20930,"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20931,"Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20932,"Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (List separately in addition to code for prima",,,948.0,5841.0,140 CPT,20933,"Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary proce",,,948.0,5841.0,140 CPT,20934,"Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20936,"Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary p",,,948.0,7014.0,148 CPT,20937,Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure) ,,,948.0,7014.0,148 CPT,20938,"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary pro",,,948.0,7014.0,148 CPT,20939,"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20950,"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome ",,,270.48,5841.0,225 CPT,20955,Bone graft with microvascular anastomosis; fibula ,,,948.0,30383.61,205 CPT,20956,Bone graft with microvascular anastomosis; iliac crest ,,,948.0,32261.21,205 CPT,20957,Bone graft with microvascular anastomosis; metatarsal ,,,948.0,33791.18,205 CPT,20962,"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal ",,,948.0,32651.05,205 CPT,20969,"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe ",,,948.0,33541.05,205 CPT,20970,Free osteocutaneous flap with microvascular anastomosis; iliac crest ,,,948.0,34914.26,205 CPT,20972,Free osteocutaneous flap with microvascular anastomosis; metatarsal ,,,948.0,16330.72,233 CPT,20973,Free osteocutaneous flap with microvascular anastomosis; great toe with web space ,,,948.0,40144.12,233 CPT,20974,Electrical stimulation to aid bone healing; noninvasive (nonoperative) ,,,94.93,5841.0,145 CPT,20975,Electrical stimulation to aid bone healing; invasive (operative) ,,,948.0,5841.0,140 CPT,20979,"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative) ",,,29.2,5841.0,102 CPT,20982,ABLATION BONE TUMOR RF,13818.27,13818.27,1934.56,11745.53,10 CPT,20982,"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when p",13818.27,13818.27,948.0,16330.72,233 CPT,20983,"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when p",,,948.0,16330.72,206 CPT,20985,"Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,20986,CPTR-ASST DIR MS PX IO IMG ,,,3390.0,5841.0,16 CPT,20987,CPTR-ASST DIR MS PX PRE IMG ,,,3390.0,5841.0,16 CPT,20999,"Unlisted procedure, musculoskeletal system, general ",,,249.03,13835.0,206 CPT,21010,"Arthrotomy, temporomandibular joint ",,,930.95,7150.66,233 CPT,21011,"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm ",,,222.38,3540.05,233 CPT,21012,"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater ",,,510.77,8253.9,233 CPT,21013,"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm ",,,280.22,4578.82,233 CPT,21014,"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater ",,,855.96,14238.95,233 CPT,21015,"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm ",,,855.96,12562.0,233 CPT,21016,"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater ",,,855.96,15059.0,233 CPT,21025,"Excision of bone (eg, for osteomyelitis or bone abscess); mandible ",,,948.0,13241.95,233 CPT,21026,"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s) ",,,948.0,13241.95,233 CPT,21029,"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia) ",,,930.95,7150.66,233 CPT,21030,Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage ,,,243.31,13835.0,233 CPT,21031,Excision of torus mandibularis ,,,227.9,13835.0,233 CPT,21032,Excision of maxillary torus palatinus ,,,215.11,13835.0,233 CPT,21034,Excision of malignant tumor of maxilla or zygoma ,,,948.0,13241.95,233 CPT,21040,"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage ",,,930.95,7150.66,233 CPT,21041,Removal of jaw bone lesion ,,,3390.0,5841.0,16 CPT,21044,Excision of malignant tumor of mandible; ,,,948.0,13241.95,233 CPT,21045,Excision of malignant tumor of mandible; radical resection ,,,948.0,16207.0,205 CPT,21046,"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesionºs») ",,,948.0,13241.95,233 CPT,21047,"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesionºs») ",,,948.0,13241.95,233 CPT,21048,"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesionºs») ",,,948.0,32170.6,233 CPT,21049,"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesionºs») ",,,948.0,13241.95,206 CPT,21050,"Condylectomy, temporomandibular joint (separate procedure) ",,,948.0,13241.95,233 CPT,21060,"Meniscectomy, partial or complete, temporomandibular joint (separate procedure) ",,,948.0,13241.95,233 CPT,21070,Coronoidectomy (separate procedure) ,,,948.0,13241.95,233 CPT,21073,"Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care) ",,,214.24,5571.0,233 CPT,21076,Impression and custom preparation; surgical obturator prosthesis ,,,309.0,13835.0,137 CPT,21077,Impression and custom preparation; orbital prosthesis ,,,948.0,14186.25,110 CPT,21079,Impression and custom preparation; interim obturator prosthesis ,,,530.23,13835.0,137 CPT,21080,Impression and custom preparation; definitive obturator prosthesis ,,,636.91,13835.0,137 CPT,21081,Impression and custom preparation; mandibular resection prosthesis ,,,588.95,13835.0,137 CPT,21082,Impression and custom preparation; palatal augmentation prosthesis ,,,545.92,13835.0,137 CPT,21083,Impression and custom preparation; palatal lift prosthesis ,,,948.0,13835.0,110 CPT,21084,Impression and custom preparation; speech aid prosthesis ,,,948.0,13835.0,110 CPT,21085,Impression and custom preparation; oral surgical splint ,,,91.96,13835.0,137 CPT,21086,Impression and custom preparation; auricular prosthesis ,,,555.81,13835.0,137 CPT,21087,Impression and custom preparation; nasal prosthesis ,,,555.81,13835.0,137 CPT,21088,Impression and custom preparation; facial prosthesis ,,,948.0,15108.46,110 CPT,21089,Unlisted maxillofacial prosthetic procedure ,,,239.12,13835.0,102 CPT,21100,"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure) ",,,948.0,13241.95,233 CPT,21110,"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal ",,,441.67,7684.11,233 CPT,21116,Injection procedure for temporomandibular joint arthrography ,,,948.0,5841.0,140 CPT,21120,"Genioplasty; augmentation (autograft, allograft, prosthetic material) ",,,948.0,13241.95,206 CPT,21121,"Genioplasty; sliding osteotomy, single piece ",,,930.95,12909.0,233 CPT,21122,"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin) ",,,948.0,13241.95,233 CPT,21123,"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts) ",,,930.95,12909.0,233 CPT,21125,"Augmentation, mandibular body or angle; prosthetic material ",,,948.0,13241.95,233 CPT,21127,"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft) ",,,948.0,15059.0,233 CPT,21137,Reduction forehead; contouring only ,,,930.95,13835.0,233 CPT,21138,Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft) ,,,948.0,13835.0,233 CPT,21139,Reduction forehead; contouring and setback of anterior frontal sinus wall ,,,948.0,13835.0,137 CPT,21141,"Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft ",,,948.0,16723.9,206 CPT,21142,"Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft ",,,948.0,17190.18,206 CPT,21143,"Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft ",,,948.0,17936.0,206 CPT,21145,"Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts) ",,,948.0,19597.45,205 CPT,21146,"Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft) ",,,948.0,20377.26,205 CPT,21147,"Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteoto",,,948.0,21547.02,205 CPT,21150,"Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome) ",,,948.0,13835.0,206 CPT,21151,"Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts) ",,,948.0,22242.04,205 CPT,21154,"Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I ",,,948.0,23928.9,205 CPT,21155,"Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I ",,,948.0,26548.08,205 CPT,21159,"Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I ",,,948.0,31824.68,205 CPT,21160,"Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I ",,,948.0,34520.07,205 CPT,21172,"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts) ",,,948.0,13835.0,206 CPT,21175,"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining au",,,948.0,13835.0,206 CPT,21179,"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material) ",,,948.0,18478.49,205 CPT,21180,"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts) ",,,948.0,20792.62,205 CPT,21181,"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial ",,,948.0,13241.95,233 CPT,21182,"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (inclu",,,948.0,25857.3,205 CPT,21183,"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (inclu",,,948.0,28289.97,205 CPT,21184,"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (inclu",,,948.0,30455.7,205 CPT,21188,"Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts) ",,,948.0,20368.79,205 CPT,21193,"Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft ",,,948.0,13835.0,206 CPT,21194,"Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft) ",,,948.0,17965.75,206 CPT,21195,"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation ",,,948.0,13835.0,206 CPT,21196,"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation ",,,948.0,17876.73,206 CPT,21198,"Osteotomy, mandible, segmental; ",,,948.0,13835.0,233 CPT,21199,"Osteotomy, mandible, segmental; with genioglossus advancement ",,,948.0,13835.0,233 CPT,21206,"Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard) ",,,948.0,13394.0,233 CPT,21208,"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant) ",,,948.0,13241.95,233 CPT,21209,"Osteoplasty, facial bones; reduction ",,,948.0,13394.0,233 CPT,21210,"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft) ",,,948.0,13241.95,233 CPT,21215,"Graft, bone; mandible (includes obtaining graft) ",,,948.0,13241.95,233 CPT,21230,"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft) ",,,948.0,13241.95,233 CPT,21235,"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft) ",,,948.0,13241.95,233 CPT,21240,"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft) ",,,948.0,13241.95,233 CPT,21242,"Arthroplasty, temporomandibular joint, with allograft ",,,948.0,13394.0,233 CPT,21243,"Arthroplasty, temporomandibular joint, with prosthetic joint replacement ",,,948.0,43532.8,233 CPT,21244,"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate) ",,,948.0,13241.95,233 CPT,21245,"Reconstruction of mandible or maxilla, subperiosteal implant; partial ",,,948.0,13241.95,233 CPT,21246,"Reconstruction of mandible or maxilla, subperiosteal implant; complete ",,,948.0,13241.95,233 CPT,21247,"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia) ",,,948.0,19936.49,205 CPT,21248,"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial ",,,948.0,13241.95,206 CPT,21249,"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete ",,,948.0,13241.95,206 CPT,21255,Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts) ,,,948.0,17240.98,206 CPT,21256,"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia) ",,,948.0,13835.0,110 CPT,21260,"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach ",,,948.0,13835.0,110 CPT,21261,"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach ",,,948.0,13835.0,110 CPT,21263,"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement ",,,948.0,13835.0,110 CPT,21267,"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach ",,,948.0,13241.95,233 CPT,21268,"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach ",,,948.0,24967.19,205 CPT,21270,"Malar augmentation, prosthetic material ",,,948.0,13394.0,233 CPT,21275,Secondary revision of orbitocraniofacial reconstruction ,,,948.0,13241.95,233 CPT,21280,Medial canthopexy (separate procedure) ,,,930.95,13394.0,233 CPT,21282,Lateral canthopexy ,,,930.95,13394.0,233 CPT,21295,"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach ",,,441.67,3683.7,233 CPT,21296,"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach ",,,930.95,7150.66,233 CPT,21299,Unlisted craniofacial and maxillofacial procedure ,,,239.12,13835.0,102 CPT,21300,TREATMENT OF SKULL FRACTURE ,,,3390.0,5841.0,16 CPT,21310,CLOSED TREATMENT OF NASAL BONE FRACTURE WITHOUT MANIPULATION ,,,2358.0,5841.0,16 CPT,21315,Closed treatment of nasal bone fracture with manipulation; without stabilization ,,,441.67,3755.0,233 CPT,21320,Closed treatment of nasal bone fracture with manipulation; with stabilization ,,,930.95,7150.66,233 CPT,21325,Open treatment of nasal fracture; uncomplicated ,,,930.95,8234.0,233 CPT,21330,"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation ",,,948.0,13394.0,233 CPT,21335,Open treatment of nasal fracture; with concomitant open treatment of fractured septum ,,,930.95,12909.0,233 CPT,21336,"Open treatment of nasal septal fracture, with or without stabilization ",,,948.0,8234.0,233 CPT,21337,"Closed treatment of nasal septal fracture, with or without stabilization ",,,930.95,7150.66,233 CPT,21338,Open treatment of nasoethmoid fracture; without external fixation ,,,948.0,13241.95,233 CPT,21339,Open treatment of nasoethmoid fracture; with external fixation ,,,948.0,13394.0,233 CPT,21340,"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus ",,,930.95,9653.0,233 CPT,21343,Open treatment of depressed frontal sinus fracture ,,,948.0,13835.0,205 CPT,21344,"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches ",,,948.0,16808.69,205 CPT,21345,"Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint ",,,441.67,12909.0,233 CPT,21346,Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and/or local fixation ,,,948.0,13835.0,206 CPT,21347,Open treatment of nasomaxillary complex fracture (LeFort II type); requiring multiple open approaches ,,,948.0,16207.0,206 CPT,21348,Open treatment of nasomaxillary complex fracture (LeFort II type); with bone grafting (includes obtaining graft) ,,,948.0,16207.0,205 CPT,21355,"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation ",,,930.95,12562.0,233 CPT,21356,"Open treatment of depressed zygomatic arch fracture (eg, Gillies approach) ",,,948.0,13241.95,233 CPT,21360,"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod ",,,948.0,13241.95,233 CPT,21365,"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical ap",,,948.0,13241.95,206 CPT,21366,"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft) ",,,948.0,15507.56,206 CPT,21385,Open treatment of orbital floor blowout fracture; transantral approach (Caldwell-Luc type operation) ,,,948.0,15059.0,206 CPT,21386,Open treatment of orbital floor blowout fracture; periorbital approach ,,,948.0,13835.0,206 CPT,21387,Open treatment of orbital floor blowout fracture; combined approach ,,,948.0,13835.0,206 CPT,21390,"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant ",,,948.0,13241.95,233 CPT,21395,Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft) ,,,948.0,13835.0,206 CPT,21400,"Closed treatment of fracture of orbit, except blowout; without manipulation ",,,196.58,3755.0,233 CPT,21401,"Closed treatment of fracture of orbit, except blowout; with manipulation ",,,576.06,12562.0,233 CPT,21406,"Open treatment of fracture of orbit, except blowout; without implant ",,,948.0,13241.95,233 CPT,21407,"Open treatment of fracture of orbit, except blowout; with implant ",,,948.0,13394.0,233 CPT,21408,"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft) ",,,948.0,13394.0,110 CPT,21421,"Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint ",,,930.95,8234.0,233 CPT,21422,Open treatment of palatal or maxillary fracture (LeFort I type); ,,,948.0,13835.0,206 CPT,21423,"Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches ",,,948.0,13835.0,205 CPT,21431,Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint ,,,948.0,16207.0,205 CPT,21432,Open treatment of craniofacial separation (LeFort III type); with wiring and/or internal fixation ,,,948.0,16207.0,205 CPT,21433,"Open treatment of craniofacial separation (LeFort III type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches ",,,948.0,21263.02,205 CPT,21435,"Open treatment of craniofacial separation (LeFort III type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation) ",,,948.0,17092.69,205 CPT,21436,"Open treatment of craniofacial separation (LeFort III type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft) ",,,948.0,24937.55,205 CPT,21440,Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure) ,,,492.43,12562.0,233 CPT,21445,Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure) ,,,948.0,13241.95,233 CPT,21450,Closed treatment of mandibular fracture; without manipulation ,,,263.38,12562.0,225 CPT,21451,Closed treatment of mandibular fracture; with manipulation ,,,441.67,8234.0,233 CPT,21452,"Percutaneous treatment of mandibular fracture, with external fixation ",,,948.0,13241.95,233 CPT,21453,Closed treatment of mandibular fracture with interdental fixation ,,,948.0,13241.95,233 CPT,21454,Open treatment of mandibular fracture with external fixation ,,,948.0,13394.0,233 CPT,21461,Open treatment of mandibular fracture; without interdental fixation ,,,948.0,13241.95,233 CPT,21462,Open treatment of mandibular fracture; with interdental fixation ,,,948.0,13394.0,233 CPT,21465,Open treatment of mandibular condylar fracture ,,,948.0,13241.95,233 CPT,21470,"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints ",,,948.0,13394.0,206 CPT,21480,Closed treatment of temporomandibular dislocation; initial or subsequent ,,,89.59,5841.0,225 CPT,21485,"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent ",,,441.67,5571.0,233 CPT,21490,Open treatment of temporomandibular dislocation ,,,930.95,12562.0,233 CPT,21493,TREAT HYOID BONE FRACTURE ,,,3390.0,5841.0,16 CPT,21494,TREAT HYOID BONE FRACTURE ,,,3390.0,5841.0,16 CPT,21495,TREAT HYOID BONE FRACTURE ,,,2431.0,2979.0,24 CPT,21497,"Interdental wiring, for condition other than fracture ",,,441.67,3755.0,233 CPT,21499,"Unlisted musculoskeletal procedure, head ",,,239.12,13835.0,102 CPT,21501,"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; ",,,855.96,6330.57,233 CPT,21502,"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy ",,,948.0,7473.24,233 CPT,21510,"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax ",,,948.0,13835.0,205 CPT,21550,"Biopsy, soft tissue of neck or thorax ",,,510.77,3747.2,233 CPT,21552,"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,21554,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,21555,"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,21556,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,6330.57,233 CPT,21557,"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm ",,,855.96,13835.0,233 CPT,21558,"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater ",,,855.96,15059.0,233 CPT,21600,"Excision of rib, partial ",,,948.0,16330.72,233 CPT,21601,Excision of chest wall tumor including rib(s) ,,,948.0,13835.0,198 CPT,21602,"Excision of chest wall tumor involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy ",,,948.0,19423.64,197 CPT,21603,"Excision of chest wall tumor involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy ",,,948.0,21496.1,197 CPT,21610,Costotransversectomy (separate procedure) ,,,948.0,7473.24,233 CPT,21615,Excision first and/or cervical rib; ,,,948.0,16207.0,205 CPT,21616,Excision first and/or cervical rib; with sympathectomy ,,,948.0,16207.0,205 CPT,21620,"Ostectomy of sternum, partial ",,,948.0,13835.0,205 CPT,21627,Sternal debridement ,,,948.0,16207.0,205 CPT,21630,Radical resection of sternum ,,,948.0,16207.0,205 CPT,21632,Radical resection of sternum; with mediastinal lymphadenectomy ,,,3390.0,16207.0,24 CPT,21685,Hyoid myotomy and suspension ,,,948.0,13241.95,233 CPT,21700,Division of scalenus anticus; without resection of cervical rib ,,,948.0,16330.72,233 CPT,21705,Division of scalenus anticus; with resection of cervical rib ,,,948.0,16207.0,205 CPT,21720,"Division of sternocleidomastoid for torticollis, open operation; without cast application ",,,948.0,12562.0,233 CPT,21725,"Division of sternocleidomastoid for torticollis, open operation; with cast application ",,,270.48,12562.0,225 CPT,21740,Reconstructive repair of pectus excavatum or carinatum; open ,,,948.0,16207.0,205 CPT,21742,"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), without thoracoscopy ",,,948.0,12562.0,206 CPT,21743,"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy ",,,948.0,12562.0,206 CPT,21750,Closure of median sternotomy separation with or without debridement (separate procedure) ,,,948.0,16207.0,205 CPT,21800,TREATMENT OF RIB FRACTURE ,,,5571.0,5841.0,16 CPT,21805,TREATMENT OF RIB FRACTURE ,,,3390.0,5841.0,16 CPT,21810,TREATMENT OF RIB FRACTURE(S) ,,,3390.0,5841.0,16 CPT,21811,"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs ",,,948.0,16330.72,206 CPT,21812,"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs ",,,948.0,16330.72,206 CPT,21813,"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs ",,,948.0,15059.0,206 CPT,21820,Closed treatment of sternum fracture ,,,89.59,5841.0,225 CPT,21825,Open treatment of sternum fracture with or without skeletal fixation ,,,948.0,16207.0,205 CPT,21899,"Unlisted procedure, neck or thorax ",,,239.12,13835.0,102 CPT,21920,"Biopsy, soft tissue of back or flank; superficial ",,,155.81,3128.0,233 CPT,21925,"Biopsy, soft tissue of back or flank; deep ",,,510.77,5571.0,233 CPT,21930,"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater ",,,510.77,15059.0,233 CPT,21932,"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,12909.0,233 CPT,21933,"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,21935,"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm ",,,855.96,12562.0,233 CPT,21936,"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater ",,,855.96,15059.0,233 CPT,22010,"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic ",,,948.0,16207.0,205 CPT,22015,"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral ",,,948.0,16207.0,205 CPT,22100,"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical ",,,948.0,16330.72,188 CPT,22101,"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic ",,,948.0,16330.72,188 CPT,22102,"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar ",,,948.0,16330.72,215 CPT,22103,"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to co",,,948.0,14908.0,143 CPT,22110,"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical ",,,948.0,16207.0,205 CPT,22112,"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic ",,,948.0,16207.0,205 CPT,22114,"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar ",,,948.0,16207.0,205 CPT,22116,"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (List separately in ad",,,948.0,16207.0,205 CPT,22206,"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic ",,,948.0,30231.08,205 CPT,22207,"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar ",,,948.0,29620.74,205 CPT,22208,"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (List separately in addition to cod",,,948.0,16207.0,205 CPT,22210,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical ",,,948.0,22064.11,205 CPT,22212,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic ",,,948.0,18317.49,205 CPT,22214,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar ",,,948.0,18393.82,205 CPT,22216,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure) ",,,948.0,16207.0,205 CPT,22220,"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical ",,,948.0,19936.49,205 CPT,22222,"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic ",,,948.0,21203.75,205 CPT,22224,"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar ",,,948.0,19453.27,205 CPT,22226,"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List separately in addition to code for primary procedure) ",,,948.0,16207.0,205 CPT,22305,CLOSED TX SPINE PROCESS FX ,,,2358.0,5841.0,16 CPT,22310,"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing ",,,89.59,5841.0,225 CPT,22315,"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction ",,,948.0,7473.24,233 CPT,22318,"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting ",,,948.0,20194.98,205 CPT,22319,"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting ",,,948.0,22364.93,205 CPT,22325,"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar ",,,948.0,17787.71,205 CPT,22326,"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical ",,,948.0,18423.45,205 CPT,22327,"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic ",,,3041.0,18597.26,185 CPT,22327,"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic High Cost Surgery",,,2369.0,2369.0,20 CPT,22328,"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment",,,1672.0,13835.0,205 CPT,22505,"Manipulation of spine requiring anesthesia, any region ",,,622.69,3755.0,213 CPT,22505,"Manipulation of spine requiring anesthesia, any region High Cost Surgery",,,2369.0,2369.0,20 CPT,22510,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic ",18152.42,18152.42,1142.68,19751.0,229 CPT,22510,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic High Cost Surgery",18152.42,18152.42,2369.0,2369.0,20 CPT,22510,VERETEBRO CERVICOTHOR,18152.42,18152.42,2541.34,15429.56,10 CPT,22511,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral ",11634.79,11634.79,1142.68,19751.0,229 CPT,22511,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral High Cost Surgery",11634.79,11634.79,2369.0,2369.0,20 CPT,22511,VERTEBRO LUMBOSACRAL,11634.79,11634.79,1628.87,9889.57,10 CPT,22512,"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacra",,,1672.0,15059.0,161 CPT,22513,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",28272.9,28272.9,2369.0,19751.0,249 CPT,22513,VERT W FRAC RED & BB TH,28272.9,28272.9,3958.21,24031.97,10 CPT,22514,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",28272.9,28272.9,2369.0,19751.0,249 CPT,22514,VERT W FRAC RED & BB LU,28272.9,28272.9,3958.21,24031.97,10 CPT,22515,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or b",3454.9,3454.9,1672.0,19751.0,177 CPT,22515,VERT W FRAC RED & BB EAD,3454.9,3454.9,449.14,2936.66,26 CPT,22520,PERCUT VERTEBROPLASTY THOR ,,,3390.0,5841.0,16 CPT,22521,PERCUT VERTEBROPLASTY LUMB ,,,3390.0,5841.0,16 CPT,22522,PERCUT VERTEBROPLASTY ADDL ,,,3390.0,5841.0,16 CPT,22523,PERCUT KYPHOPLASTY THOR ,,,3390.0,5841.0,16 CPT,22524,PERCUT KYPHOPLASTY LUMBAR ,,,3390.0,5841.0,16 CPT,22525,PERCUT KYPHOPLASTY ADD-ON ,,,3390.0,5841.0,16 CPT,22526,"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level ",,,2699.0,15059.0,185 CPT,22526,"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level High Cost Surgery",,,2369.0,2369.0,20 CPT,22527,"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (List separately in addition to code for primary procedure) ",,,1523.5,15059.0,185 CPT,22527,"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (List separately in addition to code for primary procedure) H",,,2369.0,2369.0,20 CPT,22532,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic ",,,3375.0,68725.0,144 CPT,22532,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22532,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic High Cost Surgery",,,2369.0,2369.0,20 CPT,22532,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22533,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar ",,,3375.0,68725.0,144 CPT,22533,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22533,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,22533,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22534,"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (List separately ",,,1986.0,40517.0,193 CPT,22548,"Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process ",,,3375.0,32267.0,160 CPT,22548,"Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22548,"Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22548,"Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process High Cost Surgery",,,2369.0,2369.0,20 CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 ",,,3375.0,45698.73,172 CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 High Cost Surgery",,,2369.0,2369.0,20 CPT,22552,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List ",,,1986.0,32267.0,132 CPT,22554,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 ",,,3375.0,32488.94,188 CPT,22554,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22554,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22554,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 High Cost Surgery",,,2369.0,2369.0,20 CPT,22556,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic ",,,3375.0,92505.0,160 CPT,22556,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22556,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic High Cost Surgery",,,2369.0,2369.0,20 CPT,22556,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar ",,,3375.0,68725.0,160 CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22585,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primar",,,2369.0,40517.0,42 CPT,22586,"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace ",,,3375.0,68725.0,144 CPT,22586,"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace (wi",,,19500.0,19500.0,2 CPT,22586,"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace Hig",,,2369.0,2369.0,20 CPT,22586,"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace Spi",,,35974.0,40517.0,2 CPT,22590,"Arthrodesis, posterior technique, craniocervical (occiput-C2) ",,,3375.0,32267.0,160 CPT,22590,"Arthrodesis, posterior technique, craniocervical (occiput-C2) (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22590,"Arthrodesis, posterior technique, craniocervical (occiput-C2) Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22590,"Arthrodesis, posterior technique, craniocervical (occiput-C2) High Cost Surgery",,,2369.0,2369.0,20 CPT,22595,"Arthrodesis, posterior technique, atlas-axis (C1-C2) ",,,3375.0,32267.0,160 CPT,22595,"Arthrodesis, posterior technique, atlas-axis (C1-C2) (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22595,"Arthrodesis, posterior technique, atlas-axis (C1-C2) Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22595,"Arthrodesis, posterior technique, atlas-axis (C1-C2) High Cost Surgery",,,2369.0,2369.0,20 CPT,22600,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment ",,,3375.0,32267.0,160 CPT,22600,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22600,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment Cervical Spinal Fusion",,,25468.0,30723.0,2 CPT,22600,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment High Cost Surgery",,,2369.0,2369.0,20 CPT,22610,"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed) ",,,3375.0,68725.0,160 CPT,22610,"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed) (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22610,"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed) High Cost Surgery",,,2369.0,2369.0,20 CPT,22610,"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed) Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) ",,,3375.0,68725.0,172 CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) High Cost Surgery",,,2369.0,2369.0,20 CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22614,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) ",,,1986.0,5841.0,112 CPT,22614,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22614,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,22614,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; ",,,3375.0,68725.0,145 CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; (with cervical/without cervical)",,,19500.0,19500.0,2 CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; High Cost Surgery",,,2369.0,2369.0,20 CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; Spinal Fusion except Cervical",,,35974.0,40517.0,2 CPT,22632,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List se",,,1986.0,68725.0,175 CPT,22633,"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), ",,,2369.0,92505.0,169 CPT,22634,"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), ",,,1986.0,92505.0,135 CPT,22800,"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments ",,,3375.0,92505.0,144 CPT,22800,"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22800,"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22800,"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22800,"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments ",,,3375.0,92505.0,144 CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22804,"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments ",,,3375.0,92505.0,144 CPT,22804,"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22804,"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22804,"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22804,"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22808,"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments ",,,3375.0,92505.0,144 CPT,22808,"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22808,"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22808,"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22808,"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22810,"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments ",,,3375.0,92505.0,144 CPT,22810,"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22810,"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22810,"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22810,"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22812,"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments ",,,3375.0,92505.0,144 CPT,22812,"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments (anterior & posterior combined/extensive)",,,33750.0,33750.0,2 CPT,22812,"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22812,"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments Spinal Fusion w/complications",,,45980.0,45980.0,1 CPT,22812,"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments Spinal Fusion with Complications",,,46305.0,46305.0,1 CPT,22818,"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments ",,,3375.0,26484.46,185 CPT,22818,"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22819,"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments ",,,3375.0,30303.17,185 CPT,22819,"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22830,Exploration of spinal fusion ,,,2996.0,68725.0,167 CPT,22830,Exploration of spinal fusion High Cost Surgery,,,2369.0,2369.0,20 CPT,22836,"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments ",,,3375.0,20467.69,169 CPT,22836,"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22837,"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments ",,,3375.0,22543.92,169 CPT,22837,"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments High Cost Surgery",,,2369.0,2369.0,20 CPT,22838,"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed ",,,3375.0,22842.74,169 CPT,22838,"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,22840,"Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) ",,,1672.0,16207.0,148 CPT,22841,Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure) ,,,1672.0,27027.0,201 CPT,22841,Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,22842,"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) ",,,1672.0,27027.0,144 CPT,22842,"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) Hi",,,2369.0,2369.0,20 CPT,22843,"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure) ",,,1672.0,27027.0,201 CPT,22843,"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure) H",,,2369.0,2369.0,20 CPT,22844,"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure",,,1672.0,27027.0,221 CPT,22845,Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure) ,,,1986.0,27027.0,144 CPT,22845,Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,22846,Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) ,,,1986.0,27027.0,201 CPT,22846,Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,22847,Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) ,,,1986.0,27027.0,201 CPT,22847,Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,22848,Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) ,,,1672.0,27027.0,201 CPT,22848,Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,22849,Reinsertion of spinal fixation device ,,,3375.0,27027.0,201 CPT,22849,Reinsertion of spinal fixation device High Cost Surgery,,,2369.0,2369.0,20 CPT,22850,"Removal of posterior nonsegmental instrumentation (eg, Harrington rod) ",,,3375.0,16207.0,185 CPT,22850,"Removal of posterior nonsegmental instrumentation (eg, Harrington rod) High Cost Surgery",,,2369.0,2369.0,20 CPT,22851,APPLY SPINE PROSTH DEVICE ,,,2358.0,5841.0,16 CPT,22852,Removal of posterior segmental instrumentation ,,,3375.0,16207.0,185 CPT,22852,Removal of posterior segmental instrumentation High Cost Surgery,,,2369.0,2369.0,20 CPT,22853,"Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc spac",,,1672.0,5841.0,140 CPT,22854,"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectom",,,1672.0,5841.0,140 CPT,22855,Removal of anterior instrumentation ,,,3375.0,16207.0,185 CPT,22855,Removal of anterior instrumentation High Cost Surgery,,,2369.0,2369.0,20 CPT,22856,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection)",,,2369.0,61232.95,233 CPT,22857,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar ",,,3375.0,69204.57,201 CPT,22857,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,22858,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection)",,,1672.0,16207.0,148 CPT,22859,"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous ",,,1672.0,5841.0,140 CPT,22860,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (List separately in addition to code ",,,1986.0,13835.0,197 CPT,22861,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical ",,,3375.0,27518.64,185 CPT,22861,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical High Cost Surgery",,,2369.0,2369.0,20 CPT,22862,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar ",,,3375.0,23284.68,185 CPT,22862,"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,22864,"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical ",,,3375.0,25407.95,185 CPT,22864,"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical High Cost Surgery",,,2369.0,2369.0,20 CPT,22865,"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar ",,,3375.0,23894.91,185 CPT,22865,"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,22867,"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level ",,,3293.0,43532.8,178 CPT,22867,"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level High Cost Surger",,,2369.0,2369.0,20 CPT,22868,"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately",,,1672.0,5841.0,140 CPT,22869,"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level ",,,2195.0,32488.94,178 CPT,22869,"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level High Cost Surgery",,,2369.0,2369.0,20 CPT,22870,"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in",,,1672.0,5841.0,140 CPT,22899,"Unlisted procedure, spine ",,,249.03,13835.0,186 CPT,22899,"Unlisted procedure, spine High Cost Surgery",,,2369.0,2369.0,20 CPT,22900,"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,8234.0,233 CPT,22901,"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,22902,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm ",,,510.77,12909.0,233 CPT,22903,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,22904,"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm ",,,855.96,12909.0,233 CPT,22905,"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater ",,,855.96,15059.0,233 CPT,22999,"Unlisted procedure, abdomen, musculoskeletal system ",,,249.03,13835.0,206 CPT,23000,"Removal of subdeltoid calcareous deposits, open ",,,855.96,6330.57,233 CPT,23020,"Capsular contracture release (eg, Sever type procedure) ",,,948.0,7473.24,233 CPT,23030,"Incision and drainage, shoulder area; deep abscess or hematoma ",,,855.96,6330.57,233 CPT,23031,"Incision and drainage, shoulder area; infected bursa ",,,855.96,12562.0,233 CPT,23035,"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area ",,,622.69,12562.0,233 CPT,23040,"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body ",,,948.0,12562.0,233 CPT,23044,"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body ",,,948.0,8234.0,233 CPT,23065,"Biopsy, soft tissue of shoulder area; superficial ",,,120.35,3128.0,233 CPT,23066,"Biopsy, soft tissue of shoulder area; deep ",,,855.96,6330.57,233 CPT,23071,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater ",,,510.77,15059.0,233 CPT,23073,"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,23076,"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,6330.57,233 CPT,23077,"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm ",,,855.96,12562.0,233 CPT,23078,"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; 5 cm or greater ",,,855.96,15059.0,233 CPT,23100,"Arthrotomy, glenohumeral joint, including biopsy ",,,948.0,7473.24,233 CPT,23101,"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage ",,,948.0,12909.0,233 CPT,23105,"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy ",,,948.0,16330.72,233 CPT,23106,"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy ",,,948.0,8234.0,233 CPT,23107,"Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body ",,,948.0,16330.72,233 CPT,23120,Claviculectomy; partial ,,,948.0,13394.0,233 CPT,23125,Claviculectomy; total ,,,948.0,13394.0,233 CPT,23130,"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release ",,,948.0,13394.0,233 CPT,23140,Excision or curettage of bone cyst or benign tumor of clavicle or scapula; ,,,948.0,8234.0,233 CPT,23145,Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft) ,,,948.0,13394.0,233 CPT,23146,Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft ,,,948.0,16330.72,233 CPT,23150,Excision or curettage of bone cyst or benign tumor of proximal humerus; ,,,948.0,8234.0,233 CPT,23155,Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft) ,,,948.0,16330.72,233 CPT,23156,Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft ,,,948.0,16330.72,233 CPT,23170,"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle ",,,948.0,7473.24,233 CPT,23172,"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula ",,,948.0,7473.24,233 CPT,23174,"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck ",,,948.0,16330.72,233 CPT,23180,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle ",,,948.0,16330.72,233 CPT,23182,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula ",,,948.0,16330.72,233 CPT,23184,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus ",,,948.0,16330.72,233 CPT,23190,"Ostectomy of scapula, partial (eg, superior medial angle) ",,,948.0,8234.0,233 CPT,23195,"Resection, humeral head ",,,948.0,16330.72,233 CPT,23200,Radical resection of tumor; clavicle ,,,948.0,18495.54,205 CPT,23210,Radical resection of tumor; scapula ,,,948.0,21724.95,205 CPT,23220,"Radical resection of tumor, proximal humerus ",,,948.0,23873.74,205 CPT,23221,PARTIAL REMOVAL OF HUMERUS ,,,3390.0,5841.0,16 CPT,23222,PARTIAL REMOVAL OF HUMERUS ,,,3390.0,5841.0,16 CPT,23330,"Removal of foreign body, shoulder; subcutaneous ",,,270.48,3128.0,233 CPT,23331,REMOVE SHOULDER FOREIGN BODY ,,,3390.0,5841.0,16 CPT,23332,REMOVE SHOULDER FOREIGN BODY ,,,3390.0,5841.0,16 CPT,23333,"Removal of foreign body, shoulder; deep (subfascial or intramuscular) ",,,855.96,12562.0,233 CPT,23334,"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component ",,,855.96,15059.0,233 CPT,23335,"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder) ",,,948.0,16207.0,205 CPT,23350,Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography ,,,948.0,5841.0,140 CPT,23395,"Muscle transfer, any type, shoulder or upper arm; single ",,,948.0,16330.72,233 CPT,23397,"Muscle transfer, any type, shoulder or upper arm; multiple ",,,948.0,16330.72,233 CPT,23400,"Scapulopexy (eg, Sprengels deformity or for paralysis) ",,,948.0,16330.72,233 CPT,23405,"Tenotomy, shoulder area; single tendon ",,,948.0,16330.72,233 CPT,23406,"Tenotomy, shoulder area; multiple tendons through same incision ",,,948.0,16330.72,233 CPT,23410,"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute ",,,2518.45,16330.72,213 CPT,23410,"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute High Cost Surgery",,,2369.0,2369.0,20 CPT,23412,"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic ",,,2518.45,16330.72,213 CPT,23412,"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic High Cost Surgery",,,2369.0,2369.0,20 CPT,23415,"Coracoacromial ligament release, with or without acromioplasty ",,,2518.45,16330.72,213 CPT,23415,"Coracoacromial ligament release, with or without acromioplasty High Cost Surgery",,,2369.0,2369.0,20 CPT,23420,"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) ",,,2518.45,16330.72,213 CPT,23420,"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) High Cost Surgery",,,2369.0,2369.0,20 CPT,23430,Tenodesis of long tendon of biceps ,,,2518.45,16330.72,213 CPT,23430,Tenodesis of long tendon of biceps High Cost Surgery,,,2369.0,2369.0,20 CPT,23440,Resection or transplantation of long tendon of biceps ,,,2996.0,16330.72,213 CPT,23440,Resection or transplantation of long tendon of biceps High Cost Surgery,,,2369.0,2369.0,20 CPT,23450,"Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation ",,,3293.0,16330.72,213 CPT,23450,"Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation High Cost Surgery",,,2369.0,2369.0,20 CPT,23455,"Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure) ",,,3390.01,16330.72,213 CPT,23455,"Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,23460,"Capsulorrhaphy, anterior, any type; with bone block ",,,3293.0,16330.72,213 CPT,23460,"Capsulorrhaphy, anterior, any type; with bone block High Cost Surgery",,,2369.0,2369.0,20 CPT,23462,"Capsulorrhaphy, anterior, any type; with coracoid process transfer ",,,2518.45,16330.72,213 CPT,23462,"Capsulorrhaphy, anterior, any type; with coracoid process transfer High Cost Surgery",,,2369.0,2369.0,20 CPT,23465,"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block ",,,2518.45,16330.72,213 CPT,23465,"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block High Cost Surgery",,,2369.0,2369.0,20 CPT,23466,"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability ",,,2518.45,16330.72,213 CPT,23466,"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability High Cost Surgery",,,2369.0,2369.0,20 CPT,23470,"Arthroplasty, glenohumeral joint; hemiarthroplasty ",,,948.0,65905.0,187 CPT,23472,"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder)) ",,,948.0,65905.0,187 CPT,23473,"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component ",,,948.0,65905.0,187 CPT,23474,"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component ",,,948.0,68769.07,168 CPT,23480,"Osteotomy, clavicle, with or without internal fixation; ",,,948.0,16330.72,233 CPT,23485,"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation) ",,,948.0,32488.94,233 CPT,23490,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle ",,,948.0,16330.72,233 CPT,23491,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus ",,,948.0,32488.94,233 CPT,23500,Closed treatment of clavicular fracture; without manipulation ,,,89.59,5841.0,225 CPT,23505,Closed treatment of clavicular fracture; with manipulation ,,,622.69,3700.21,233 CPT,23515,"Open treatment of clavicular fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,23520,Closed treatment of sternoclavicular dislocation; without manipulation ,,,622.69,3700.21,233 CPT,23525,Closed treatment of sternoclavicular dislocation; with manipulation ,,,89.59,5841.0,225 CPT,23530,"Open treatment of sternoclavicular dislocation, acute or chronic; ",,,948.0,16330.72,233 CPT,23532,"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,23540,Closed treatment of acromioclavicular dislocation; without manipulation ,,,89.59,5841.0,225 CPT,23545,Closed treatment of acromioclavicular dislocation; with manipulation ,,,89.59,5841.0,225 CPT,23550,"Open treatment of acromioclavicular dislocation, acute or chronic; ",,,948.0,16330.72,233 CPT,23552,"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,23570,Closed treatment of scapular fracture; without manipulation ,,,89.59,5841.0,225 CPT,23575,"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement) ",,,622.69,5841.0,225 CPT,23585,"Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,23600,Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation ,,,89.59,5841.0,225 CPT,23605,"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction ",,,622.69,5571.0,233 CPT,23615,"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; ",,,948.0,32488.94,233 CPT,23616,"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prostheti",,,948.0,43532.8,233 CPT,23620,Closed treatment of greater humeral tuberosity fracture; without manipulation ,,,89.59,5841.0,225 CPT,23625,Closed treatment of greater humeral tuberosity fracture; with manipulation ,,,622.69,3755.0,233 CPT,23630,"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,23650,"Closed treatment of shoulder dislocation, with manipulation; without anesthesia ",,,89.59,5841.0,225 CPT,23655,"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia ",,,622.69,3700.21,233 CPT,23660,Open treatment of acute shoulder dislocation ,,,948.0,16330.72,233 CPT,23665,"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation ",,,622.69,3755.0,233 CPT,23670,"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,23675,"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation ",,,622.69,5841.0,225 CPT,23680,"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed ",,,948.0,32488.94,233 CPT,23700,"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) ",,,622.69,3700.21,233 CPT,23800,"Arthrodesis, glenohumeral joint; ",,,948.0,16330.72,233 CPT,23802,"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft) ",,,948.0,32488.94,233 CPT,23900,Interthoracoscapular amputation (forequarter) ,,,948.0,16940.04,109 CPT,23920,Disarticulation of shoulder; ,,,948.0,16207.0,109 CPT,23921,Disarticulation of shoulder; secondary closure or scar revision ,,,744.46,12562.0,233 CPT,23929,"Unlisted procedure, shoulder ",,,249.03,13835.0,198 CPT,23930,"Incision and drainage, upper arm or elbow area; deep abscess or hematoma ",,,855.96,6330.57,233 CPT,23931,"Incision and drainage, upper arm or elbow area; bursa ",,,510.77,3755.0,233 CPT,23935,"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow ",,,948.0,7473.24,233 CPT,24000,"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body ",,,948.0,8234.0,233 CPT,24006,"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure) ",,,948.0,8234.0,233 CPT,24065,"Biopsy, soft tissue of upper arm or elbow area; superficial ",,,156.97,3128.0,233 CPT,24066,"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular) ",,,855.96,6330.57,233 CPT,24071,"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,24073,"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,24075,"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,24076,"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,6330.57,233 CPT,24077,"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm ",,,855.96,12562.0,233 CPT,24079,"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater ",,,855.96,15059.0,233 CPT,24100,"Arthrotomy, elbow; with synovial biopsy only ",,,948.0,7473.24,233 CPT,24101,"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body ",,,948.0,8234.0,233 CPT,24102,"Arthrotomy, elbow; with synovectomy ",,,948.0,8234.0,233 CPT,24105,"Excision, olecranon bursa ",,,948.0,12562.0,233 CPT,24110,"Excision or curettage of bone cyst or benign tumor, humerus; ",,,948.0,7473.24,233 CPT,24115,"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,24116,"Excision or curettage of bone cyst or benign tumor, humerus; with allograft ",,,948.0,16330.72,233 CPT,24120,Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; ,,,948.0,12562.0,233 CPT,24125,Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft) ,,,948.0,12562.0,233 CPT,24126,Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft ,,,948.0,16330.72,233 CPT,24130,"Excision, radial head ",,,948.0,12562.0,233 CPT,24134,"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus ",,,948.0,16330.72,233 CPT,24136,"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck ",,,948.0,7473.24,233 CPT,24138,"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process ",,,948.0,16330.72,233 CPT,24140,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus ",,,948.0,12562.0,233 CPT,24145,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck ",,,948.0,16330.72,233 CPT,24147,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process ",,,948.0,7473.24,233 CPT,24149,"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure) ",,,948.0,16330.72,233 CPT,24150,"Radical resection of tumor, shaft or distal humerus ",,,948.0,16330.72,206 CPT,24151,EXTENSIVE HUMERUS SURGERY ,,,3390.0,5841.0,16 CPT,24152,"Radical resection of tumor, radial head or neck ",,,948.0,16330.72,233 CPT,24153,EXTENSIVE RADIUS SURGERY ,,,3390.0,5841.0,16 CPT,24155,Resection of elbow joint (arthrectomy) ,,,948.0,12562.0,233 CPT,24160,"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components ",,,948.0,7473.24,233 CPT,24164,"Removal of prosthesis, includes debridement and synovectomy when performed; radial head ",,,948.0,12562.0,233 CPT,24200,"Removal of foreign body, upper arm or elbow area; subcutaneous ",,,129.64,3128.0,137 CPT,24201,"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular) ",,,855.96,6330.57,233 CPT,24220,Injection procedure for elbow arthrography ,,,948.0,5841.0,140 CPT,24300,"Manipulation, elbow, under anesthesia ",,,622.69,8234.0,233 CPT,24301,"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331) ",,,948.0,16330.72,233 CPT,24305,"Tendon lengthening, upper arm or elbow, each tendon ",,,948.0,8234.0,233 CPT,24310,"Tenotomy, open, elbow to shoulder, each tendon ",,,948.0,12562.0,233 CPT,24320,"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (Seddon-Brookes type procedure) ",,,948.0,16330.72,233 CPT,24330,"Flexor-plasty, elbow (eg, Steindler type advancement); ",,,948.0,16330.72,233 CPT,24331,"Flexor-plasty, elbow (eg, Steindler type advancement); with extensor advancement ",,,948.0,16330.72,233 CPT,24332,"Tenolysis, triceps ",,,948.0,12562.0,233 CPT,24340,Tenodesis of biceps tendon at elbow (separate procedure) ,,,948.0,16330.72,233 CPT,24341,"Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) ",,,948.0,16330.72,233 CPT,24342,"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft ",,,948.0,16330.72,233 CPT,24343,"Repair lateral collateral ligament, elbow, with local tissue ",,,948.0,12562.0,233 CPT,24344,"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft) ",,,948.0,16330.72,233 CPT,24345,"Repair medial collateral ligament, elbow, with local tissue ",,,948.0,16330.72,233 CPT,24346,"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft) ",,,948.0,32488.94,226 CPT,24350,REPAIR OF TENNIS ELBOW ,,,3390.0,5841.0,16 CPT,24351,REPAIR OF TENNIS ELBOW ,,,3390.0,5841.0,16 CPT,24352,REPAIR OF TENNIS ELBOW ,,,3390.0,5841.0,16 CPT,24354,REPAIR OF TENNIS ELBOW ,,,3390.0,5841.0,16 CPT,24356,REVISION OF TENNIS ELBOW ,,,3390.0,5841.0,16 CPT,24357,"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); percutaneous ",,,948.0,15059.0,233 CPT,24358,"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open ",,,948.0,15059.0,233 CPT,24359,"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment ",,,948.0,15059.0,233 CPT,24360,"Arthroplasty, elbow; with membrane (eg, fascial) ",,,948.0,26654.0,212 CPT,24361,"Arthroplasty, elbow; with distal humeral prosthetic replacement ",,,948.0,65905.0,212 CPT,24362,"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction ",,,948.0,65905.0,185 CPT,24363,"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow) ",,,948.0,65905.0,212 CPT,24365,"Arthroplasty, radial head; ",,,948.0,32488.94,226 CPT,24366,"Arthroplasty, radial head; with implant ",,,948.0,32488.94,226 CPT,24370,"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component ",,,948.0,65905.0,212 CPT,24371,"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component ",,,948.0,65905.0,212 CPT,24400,"Osteotomy, humerus, with or without internal fixation ",,,948.0,16330.72,233 CPT,24410,"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (Sofield type procedure) ",,,948.0,32488.94,233 CPT,24420,"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876) ",,,948.0,16330.72,233 CPT,24430,"Repair of nonunion or malunion, humerus; without graft (eg, compression technique) ",,,948.0,32488.94,233 CPT,24435,"Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft) ",,,948.0,32488.94,233 CPT,24470,"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus) ",,,948.0,12562.0,233 CPT,24495,"Decompression fasciotomy, forearm, with brachial artery exploration ",,,948.0,16330.72,233 CPT,24498,"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft ",,,948.0,32488.94,233 CPT,24500,Closed treatment of humeral shaft fracture; without manipulation ,,,89.59,5841.0,225 CPT,24505,"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction ",,,622.69,5841.0,225 CPT,24515,"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage ",,,948.0,32488.94,233 CPT,24516,"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws ",,,948.0,32488.94,233 CPT,24530,"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation ",,,89.59,5841.0,225 CPT,24535,"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction ",,,622.69,5841.0,225 CPT,24538,"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension ",,,948.0,16330.72,233 CPT,24545,"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension ",,,948.0,32488.94,233 CPT,24546,"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension ",,,948.0,43532.8,233 CPT,24560,"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation ",,,89.59,5841.0,225 CPT,24565,"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation ",,,622.69,5841.0,225 CPT,24566,"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation ",,,622.69,5571.0,233 CPT,24575,"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed ",,,948.0,32488.94,233 CPT,24576,"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation ",,,89.59,5841.0,225 CPT,24577,"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation ",,,622.69,5841.0,225 CPT,24579,"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed ",,,948.0,32488.94,233 CPT,24582,"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation ",,,948.0,16330.72,233 CPT,24586,Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); ,,,948.0,32488.94,233 CPT,24587,Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty ,,,948.0,32488.94,233 CPT,24600,Treatment of closed elbow dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,24605,Treatment of closed elbow dislocation; requiring anesthesia ,,,622.69,3755.0,233 CPT,24615,Open treatment of acute or chronic elbow dislocation ,,,948.0,16330.72,233 CPT,24620,"Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation ",,,622.69,3755.0,233 CPT,24635,"Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,24640,"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation ",,,51.45,5841.0,129 CPT,24650,Closed treatment of radial head or neck fracture; without manipulation ,,,89.59,5841.0,225 CPT,24655,Closed treatment of radial head or neck fracture; with manipulation ,,,622.69,5841.0,225 CPT,24665,"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; ",,,948.0,16330.72,233 CPT,24666,"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement ",,,948.0,32488.94,233 CPT,24670,"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»); without manipulation ",,,89.59,5841.0,225 CPT,24675,"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»); with manipulation ",,,622.69,5841.0,225 CPT,24685,"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»), includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,24800,"Arthrodesis, elbow joint; local ",,,948.0,16330.72,233 CPT,24802,"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft) ",,,948.0,32488.94,233 CPT,24900,"Amputation, arm through humerus; with primary closure ",,,948.0,16207.0,109 CPT,24920,"Amputation, arm through humerus; open, circular (guillotine) ",,,948.0,16207.0,109 CPT,24925,"Amputation, arm through humerus; secondary closure or scar revision ",,,948.0,12562.0,233 CPT,24930,"Amputation, arm through humerus; re-amputation ",,,948.0,16207.0,109 CPT,24931,"Amputation, arm through humerus; with implant ",,,948.0,16207.0,109 CPT,24935,"Stump elongation, upper extremity ",,,948.0,16330.72,110 CPT,24940,"Cineplasty, upper extremity, complete procedure ",,,948.0,16207.0,205 CPT,24999,"Unlisted procedure, humerus or elbow ",,,249.03,13835.0,198 CPT,25000,"Incision, extensor tendon sheath, wrist (eg, de Quervains disease) ",,,622.69,12562.0,233 CPT,25001,"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis) ",,,948.0,12562.0,233 CPT,25020,"Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; without debridement of nonviable muscle and/or nerve ",,,622.69,12562.0,233 CPT,25023,"Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; with debridement of nonviable muscle and/or nerve ",,,948.0,12562.0,233 CPT,25024,"Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle and/or nerve ",,,948.0,12562.0,233 CPT,25025,"Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; with debridement of nonviable muscle and/or nerve ",,,622.69,12562.0,233 CPT,25028,"Incision and drainage, forearm and/or wrist; deep abscess or hematoma ",,,948.0,7473.24,233 CPT,25031,"Incision and drainage, forearm and/or wrist; bursa ",,,622.69,5571.0,233 CPT,25035,"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess) ",,,948.0,16330.72,233 CPT,25040,"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body ",,,948.0,13394.0,233 CPT,25065,"Biopsy, soft tissue of forearm and/or wrist; superficial ",,,156.97,3128.0,233 CPT,25066,"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular) ",,,855.96,6330.57,233 CPT,25071,"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater ",,,510.77,15059.0,233 CPT,25073,"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater ",,,855.96,15059.0,233 CPT,25075,"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,25076,"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm ",,,510.77,12562.0,233 CPT,25077,"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm ",,,855.96,12562.0,233 CPT,25078,"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater ",,,855.96,15059.0,233 CPT,25085,"Capsulotomy, wrist (eg, contracture) ",,,948.0,12562.0,233 CPT,25100,"Arthrotomy, wrist joint; with biopsy ",,,948.0,7473.24,233 CPT,25101,"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body ",,,948.0,12562.0,233 CPT,25105,"Arthrotomy, wrist joint; with synovectomy ",,,948.0,8234.0,233 CPT,25107,"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex ",,,948.0,12562.0,233 CPT,25109,"Excision of tendon, forearm and/or wrist, flexor or extensor, each ",,,948.0,12562.0,233 CPT,25110,"Excision, lesion of tendon sheath, forearm and/or wrist ",,,622.69,12562.0,233 CPT,25111,"Excision of ganglion, wrist (dorsal or volar); primary ",,,622.69,12562.0,233 CPT,25112,"Excision of ganglion, wrist (dorsal or volar); recurrent ",,,622.69,8234.0,233 CPT,25115,"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors ",,,622.69,8234.0,233 CPT,25116,"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal r",,,948.0,8234.0,233 CPT,25118,"Synovectomy, extensor tendon sheath, wrist, single compartment; ",,,622.69,7014.0,233 CPT,25119,"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna ",,,948.0,12562.0,233 CPT,25120,Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); ,,,948.0,12562.0,233 CPT,25125,Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft) ,,,622.69,12562.0,233 CPT,25126,Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft ,,,948.0,12562.0,233 CPT,25130,Excision or curettage of bone cyst or benign tumor of carpal bones; ,,,948.0,12562.0,233 CPT,25135,Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft) ,,,948.0,16330.72,233 CPT,25136,Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft ,,,948.0,16330.72,233 CPT,25145,"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist ",,,948.0,7473.24,233 CPT,25150,"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna ",,,948.0,7473.24,233 CPT,25151,"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius ",,,948.0,7473.24,233 CPT,25170,"Radical resection of tumor, radius or ulna ",,,948.0,16330.72,206 CPT,25210,Carpectomy; 1 bone ,,,948.0,12562.0,233 CPT,25215,Carpectomy; all bones of proximal row ,,,948.0,8234.0,233 CPT,25230,Radial styloidectomy (separate procedure) ,,,948.0,8234.0,233 CPT,25240,"Excision distal ulna partial or complete (eg, Darrach type or matched resection) ",,,948.0,8234.0,233 CPT,25246,Injection procedure for wrist arthrography ,,,948.0,5841.0,140 CPT,25248,"Exploration with removal of deep foreign body, forearm or wrist ",,,622.69,5571.0,233 CPT,25250,Removal of wrist prosthesis; (separate procedure) ,,,622.69,7014.0,233 CPT,25251,"Removal of wrist prosthesis; complicated, including total wrist ",,,948.0,7473.24,233 CPT,25259,"Manipulation, wrist, under anesthesia ",,,622.69,12562.0,233 CPT,25260,"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle ",,,948.0,8234.0,233 CPT,25263,"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle ",,,948.0,16330.72,233 CPT,25265,"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle ",,,948.0,12562.0,233 CPT,25270,"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle ",,,948.0,8234.0,233 CPT,25272,"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle ",,,948.0,12562.0,233 CPT,25274,"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle ",,,948.0,8234.0,233 CPT,25275,"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation) ",,,948.0,8234.0,233 CPT,25280,"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon ",,,948.0,8234.0,233 CPT,25290,"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon ",,,948.0,12562.0,233 CPT,25295,"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon ",,,948.0,12562.0,233 CPT,25300,Tenodesis at wrist; flexors of fingers ,,,948.0,12562.0,233 CPT,25301,Tenodesis at wrist; extensors of fingers ,,,948.0,12562.0,233 CPT,25310,"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon ",,,948.0,12562.0,233 CPT,25312,"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon ",,,948.0,9653.0,233 CPT,25315,"Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist; ",,,948.0,16330.72,233 CPT,25316,"Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist; with tendon(s) transfer ",,,948.0,16330.72,233 CPT,25320,"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability ",,,948.0,16330.72,233 CPT,25332,"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation ",,,948.0,13394.0,233 CPT,25335,"Centralization of wrist on ulna (eg, radial club hand) ",,,948.0,12562.0,233 CPT,25337,"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without o",,,948.0,16330.72,233 CPT,25350,"Osteotomy, radius; distal third ",,,948.0,16330.72,233 CPT,25355,"Osteotomy, radius; middle or proximal third ",,,948.0,12562.0,233 CPT,25360,Osteotomy; ulna ,,,948.0,16330.72,233 CPT,25365,Osteotomy; radius AND ulna ,,,948.0,32488.94,233 CPT,25370,"Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius OR ulna ",,,948.0,12562.0,233 CPT,25375,"Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius AND ulna ",,,948.0,9653.0,233 CPT,25390,"Osteoplasty, radius OR ulna; shortening ",,,948.0,16330.72,233 CPT,25391,"Osteoplasty, radius OR ulna; lengthening with autograft ",,,948.0,32488.94,233 CPT,25392,"Osteoplasty, radius AND ulna; shortening (excluding 64876) ",,,948.0,16330.72,233 CPT,25393,"Osteoplasty, radius AND ulna; lengthening with autograft ",,,948.0,16330.72,233 CPT,25394,"Osteoplasty, carpal bone, shortening ",,,948.0,9653.0,233 CPT,25400,"Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) ",,,948.0,16330.72,233 CPT,25405,"Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,25415,"Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique) ",,,948.0,16330.72,233 CPT,25420,"Repair of nonunion or malunion, radius AND ulna; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,25425,Repair of defect with autograft; radius OR ulna ,,,948.0,16330.72,233 CPT,25426,Repair of defect with autograft; radius AND ulna ,,,948.0,9653.0,233 CPT,25430,"Insertion of vascular pedicle into carpal bone (eg, Hori procedure) ",,,948.0,12562.0,233 CPT,25431,"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone ",,,948.0,16330.72,233 CPT,25440,"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation) ",,,948.0,16330.72,233 CPT,25441,Arthroplasty with prosthetic replacement; distal radius ,,,948.0,32488.94,233 CPT,25442,Arthroplasty with prosthetic replacement; distal ulna ,,,948.0,43532.8,233 CPT,25443,Arthroplasty with prosthetic replacement; scaphoid carpal (navicular) ,,,948.0,16330.72,233 CPT,25444,Arthroplasty with prosthetic replacement; lunate ,,,948.0,32488.94,233 CPT,25445,Arthroplasty with prosthetic replacement; trapezium ,,,948.0,16330.72,233 CPT,25446,Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist) ,,,948.0,43532.8,233 CPT,25447,"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon) ",,,948.0,13394.0,233 CPT,25448,"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed ",,,948.0,8857.79,161 CPT,25449,"Revision of arthroplasty, including removal of implant, wrist joint ",,,948.0,16330.72,233 CPT,25450,Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna ,,,948.0,12562.0,233 CPT,25455,Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna ,,,948.0,12562.0,233 CPT,25490,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius ",,,948.0,16330.72,233 CPT,25491,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna ",,,948.0,32488.94,233 CPT,25492,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius AND ulna ",,,948.0,12562.0,233 CPT,25500,Closed treatment of radial shaft fracture; without manipulation ,,,89.59,5841.0,225 CPT,25505,Closed treatment of radial shaft fracture; with manipulation ,,,622.69,3700.21,233 CPT,25515,"Open treatment of radial shaft fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,25520,Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation) ,,,622.69,5841.0,225 CPT,25525,"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes percutaneous",,,948.0,16330.72,233 CPT,25526,"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes internal fixat",,,948.0,16330.72,233 CPT,25530,Closed treatment of ulnar shaft fracture; without manipulation ,,,89.59,5841.0,225 CPT,25535,Closed treatment of ulnar shaft fracture; with manipulation ,,,89.59,5841.0,225 CPT,25545,"Open treatment of ulnar shaft fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,25560,Closed treatment of radial and ulnar shaft fractures; without manipulation ,,,89.59,5841.0,225 CPT,25565,Closed treatment of radial and ulnar shaft fractures; with manipulation ,,,622.69,5841.0,225 CPT,25574,"Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius OR ulna ",,,948.0,16330.72,233 CPT,25575,"Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND ulna ",,,948.0,16330.72,233 CPT,25600,"Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation ",,,89.59,5841.0,225 CPT,25605,"Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation ",,,622.69,12562.0,233 CPT,25606,Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation ,,,948.0,12562.0,233 CPT,25607,"Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation ",,,948.0,16330.72,233 CPT,25608,Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments ,,,948.0,16330.72,233 CPT,25609,Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments ,,,948.0,16330.72,233 CPT,25611,TREAT FRACTURE RADIUS/ULNA ,,,3390.0,5841.0,16 CPT,25620,TREAT FRACTURE RADIUS/ULNA ,,,3390.0,5841.0,16 CPT,25622,Closed treatment of carpal scaphoid (navicular) fracture; without manipulation ,,,89.59,5841.0,129 CPT,25624,Closed treatment of carpal scaphoid (navicular) fracture; with manipulation ,,,622.69,3755.0,233 CPT,25628,"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,25630,"Closed treatment of carpal bone fracture (excluding carpal scaphoid ºnavicular»); without manipulation, each bone ",,,89.59,5841.0,225 CPT,25635,"Closed treatment of carpal bone fracture (excluding carpal scaphoid ºnavicular»); with manipulation, each bone ",,,622.69,5841.0,225 CPT,25645,"Open treatment of carpal bone fracture (other than carpal scaphoid ºnavicular»), each bone ",,,948.0,12562.0,233 CPT,25650,Closed treatment of ulnar styloid fracture ,,,89.59,5841.0,129 CPT,25651,Percutaneous skeletal fixation of ulnar styloid fracture ,,,948.0,12562.0,233 CPT,25652,Open treatment of ulnar styloid fracture ,,,948.0,16330.72,233 CPT,25660,"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation ",,,89.59,5841.0,225 CPT,25670,"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones ",,,948.0,16330.72,233 CPT,25671,Percutaneous skeletal fixation of distal radioulnar dislocation ,,,948.0,7473.24,233 CPT,25675,Closed treatment of distal radioulnar dislocation with manipulation ,,,89.59,5841.0,225 CPT,25676,"Open treatment of distal radioulnar dislocation, acute or chronic ",,,948.0,16330.72,233 CPT,25680,"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation ",,,89.59,5841.0,225 CPT,25685,Open treatment of trans-scaphoperilunar type of fracture dislocation ,,,948.0,16330.72,233 CPT,25690,"Closed treatment of lunate dislocation, with manipulation ",,,622.69,3700.21,233 CPT,25695,Open treatment of lunate dislocation ,,,948.0,16330.72,233 CPT,25800,"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints) ",,,948.0,16330.72,233 CPT,25805,"Arthrodesis, wrist; with sliding graft ",,,948.0,16330.72,233 CPT,25810,"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) ",,,948.0,32488.94,233 CPT,25820,"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal) ",,,948.0,16330.72,233 CPT,25825,"Arthrodesis, wrist; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,25830,"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, Sauve-Kapandji procedure) ",,,948.0,16330.72,233 CPT,25900,"Amputation, forearm, through radius and ulna; ",,,948.0,16207.0,109 CPT,25905,"Amputation, forearm, through radius and ulna; open, circular (guillotine) ",,,948.0,16207.0,109 CPT,25907,"Amputation, forearm, through radius and ulna; secondary closure or scar revision ",,,948.0,12562.0,233 CPT,25909,"Amputation, forearm, through radius and ulna; re-amputation ",,,948.0,16330.72,206 CPT,25915,Krukenberg procedure ,,,948.0,16207.0,109 CPT,25920,Disarticulation through wrist; ,,,948.0,16207.0,109 CPT,25922,Disarticulation through wrist; secondary closure or scar revision ,,,622.69,12562.0,233 CPT,25924,Disarticulation through wrist; re-amputation ,,,948.0,16207.0,109 CPT,25927,Transmetacarpal amputation; ,,,948.0,16207.0,205 CPT,25929,Transmetacarpal amputation; secondary closure or scar revision ,,,744.46,12562.0,233 CPT,25931,Transmetacarpal amputation; re-amputation ,,,948.0,13835.0,110 CPT,25999,"Unlisted procedure, forearm or wrist ",,,249.03,13835.0,198 CPT,26010,Drainage of finger abscess; simple ,,,78.06,5841.0,129 CPT,26011,"Drainage of finger abscess; complicated (eg, felon) ",,,510.77,3747.2,233 CPT,26020,"Drainage of tendon sheath, digit and/or palm, each ",,,948.0,7473.24,233 CPT,26025,"Drainage of palmar bursa; single, bursa ",,,948.0,7473.24,233 CPT,26030,Drainage of palmar bursa; multiple bursa ,,,948.0,7473.24,233 CPT,26034,"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess) ",,,622.69,3755.0,233 CPT,26035,"Decompression fingers and/or hand, injection injury (eg, grease gun) ",,,948.0,8234.0,233 CPT,26037,"Decompressive fasciotomy, hand (excludes 26035) ",,,948.0,8234.0,233 CPT,26040,"Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous ",,,622.69,8234.0,233 CPT,26045,"Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial ",,,948.0,12562.0,233 CPT,26055,"Tendon sheath incision (eg, for trigger finger) ",,,622.69,3755.0,233 CPT,26060,"Tenotomy, percutaneous, single, each digit ",,,622.69,3755.0,233 CPT,26070,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint ",,,622.69,3755.0,233 CPT,26075,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each ",,,948.0,8234.0,233 CPT,26080,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each ",,,622.69,8234.0,233 CPT,26100,"Arthrotomy with biopsy; carpometacarpal joint, each ",,,948.0,7473.24,233 CPT,26105,"Arthrotomy with biopsy; metacarpophalangeal joint, each ",,,948.0,7473.24,233 CPT,26110,"Arthrotomy with biopsy; interphalangeal joint, each ",,,622.69,3700.21,233 CPT,26111,"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater ",,,510.77,15059.0,233 CPT,26113,"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater ",,,510.77,15059.0,233 CPT,26115,"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm ",,,510.77,3755.0,233 CPT,26116,"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm ",,,510.77,3755.0,233 CPT,26117,"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm ",,,855.96,12562.0,233 CPT,26118,"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater ",,,855.96,15059.0,233 CPT,26121,"Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) ",,,948.0,8234.0,233 CPT,26123,"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graf",,,948.0,8234.0,233 CPT,26125,"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graf",,,948.0,5841.0,140 CPT,26130,"Synovectomy, carpometacarpal joint ",,,948.0,12562.0,233 CPT,26135,"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit ",,,948.0,8234.0,233 CPT,26140,"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint ",,,622.69,3755.0,233 CPT,26145,"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon ",,,622.69,12562.0,233 CPT,26160,"Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger ",,,622.69,12562.0,233 CPT,26170,"Excision of tendon, palm, flexor or extensor, single, each tendon ",,,622.69,12562.0,233 CPT,26180,"Excision of tendon, finger, flexor or extensor, each tendon ",,,622.69,12562.0,233 CPT,26185,"Sesamoidectomy, thumb or finger (separate procedure) ",,,622.69,8234.0,233 CPT,26200,Excision or curettage of bone cyst or benign tumor of metacarpal; ,,,622.69,3755.0,233 CPT,26205,Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft) ,,,948.0,16330.72,233 CPT,26210,"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; ",,,622.69,3755.0,233 CPT,26215,"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft) ",,,948.0,12562.0,233 CPT,26230,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal ",,,948.0,12909.0,233 CPT,26235,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger ",,,622.69,12562.0,233 CPT,26236,"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger ",,,622.69,12562.0,233 CPT,26250,"Radical resection of tumor, metacarpal ",,,948.0,12562.0,233 CPT,26255,EXTENSIVE HAND SURGERY ,,,3390.0,5841.0,16 CPT,26260,"Radical resection of tumor, proximal or middle phalanx of finger ",,,948.0,12562.0,233 CPT,26261,EXTENSIVE FINGER SURGERY ,,,3390.0,5841.0,16 CPT,26262,"Radical resection of tumor, distal phalanx of finger ",,,622.69,3755.0,233 CPT,26320,Removal of implant from finger or hand ,,,510.77,3755.0,233 CPT,26340,"Manipulation, finger joint, under anesthesia, each joint ",,,622.69,5841.0,225 CPT,26341,"Manipulation, palmar fascial cord (ie, Dupuytren's cord), post enzyme injection (eg, collagenase), single cord ",,,70.06,5841.0,225 CPT,26350,"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary without free graft, each tendon ",,,948.0,7473.24,233 CPT,26352,"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); secondary with free graft (includes obtaining graft), each tendon ",,,948.0,16330.72,233 CPT,26356,"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each tendon ",,,948.0,8234.0,233 CPT,26357,"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, without free graft, each tendon ",,,948.0,8234.0,233 CPT,26358,"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, with free graft (includes obtaining graft), each tendon ",,,948.0,16330.72,233 CPT,26370,"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon ",,,948.0,8234.0,233 CPT,26372,"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon ",,,948.0,16330.72,233 CPT,26373,"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon ",,,948.0,12562.0,233 CPT,26390,"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod ",,,948.0,16330.72,233 CPT,26392,"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod ",,,948.0,16330.72,233 CPT,26410,"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon ",,,622.69,12562.0,233 CPT,26412,"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon ",,,948.0,12562.0,233 CPT,26415,"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod ",,,948.0,8234.0,233 CPT,26416,"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod ",,,948.0,12562.0,206 CPT,26418,"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon ",,,622.69,8234.0,233 CPT,26420,"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon ",,,948.0,8234.0,233 CPT,26426,"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger ",,,948.0,12562.0,233 CPT,26428,"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger ",,,948.0,12562.0,233 CPT,26432,"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger) ",,,622.69,12562.0,233 CPT,26433,"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger) ",,,948.0,12562.0,233 CPT,26434,"Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft) ",,,948.0,12562.0,233 CPT,26437,"Realignment of extensor tendon, hand, each tendon ",,,948.0,12562.0,233 CPT,26440,"Tenolysis, flexor tendon; palm OR finger, each tendon ",,,622.69,12562.0,233 CPT,26442,"Tenolysis, flexor tendon; palm AND finger, each tendon ",,,948.0,12562.0,233 CPT,26445,"Tenolysis, extensor tendon, hand OR finger, each tendon ",,,948.0,12562.0,233 CPT,26449,"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon ",,,948.0,12562.0,233 CPT,26450,"Tenotomy, flexor, palm, open, each tendon ",,,948.0,12562.0,233 CPT,26455,"Tenotomy, flexor, finger, open, each tendon ",,,622.69,12562.0,233 CPT,26460,"Tenotomy, extensor, hand or finger, open, each tendon ",,,622.69,12562.0,233 CPT,26471,"Tenodesis; of proximal interphalangeal joint, each joint ",,,948.0,7473.24,233 CPT,26474,"Tenodesis; of distal joint, each joint ",,,622.69,3755.0,233 CPT,26476,"Lengthening of tendon, extensor, hand or finger, each tendon ",,,948.0,7473.24,233 CPT,26477,"Shortening of tendon, extensor, hand or finger, each tendon ",,,948.0,7473.24,233 CPT,26478,"Lengthening of tendon, flexor, hand or finger, each tendon ",,,948.0,7473.24,233 CPT,26479,"Shortening of tendon, flexor, hand or finger, each tendon ",,,948.0,7473.24,233 CPT,26480,"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon ",,,948.0,12562.0,233 CPT,26483,"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon ",,,948.0,12562.0,233 CPT,26485,"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon ",,,948.0,7473.24,233 CPT,26489,"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon ",,,948.0,12562.0,233 CPT,26490,"Opponensplasty; superficialis tendon transfer type, each tendon ",,,948.0,12562.0,233 CPT,26492,"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon ",,,948.0,12562.0,233 CPT,26494,Opponensplasty; hypothenar muscle transfer ,,,948.0,12562.0,233 CPT,26496,Opponensplasty; other methods ,,,948.0,12562.0,233 CPT,26497,Transfer of tendon to restore intrinsic function; ring and small finger ,,,948.0,12562.0,233 CPT,26498,Transfer of tendon to restore intrinsic function; all 4 fingers ,,,948.0,8234.0,233 CPT,26499,"Correction claw finger, other methods ",,,948.0,12562.0,233 CPT,26500,"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure) ",,,948.0,16330.72,233 CPT,26502,"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure) ",,,948.0,8234.0,233 CPT,26504,HAND TENDON RECONSTRUCTION ,,,3390.0,5841.0,16 CPT,26508,"Release of thenar muscle(s) (eg, thumb contracture) ",,,948.0,12562.0,233 CPT,26510,"Cross intrinsic transfer, each tendon ",,,948.0,12562.0,233 CPT,26516,"Capsulodesis, metacarpophalangeal joint; single digit ",,,948.0,7473.24,233 CPT,26517,"Capsulodesis, metacarpophalangeal joint; 2 digits ",,,948.0,12562.0,233 CPT,26518,"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits ",,,948.0,16330.72,233 CPT,26520,"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint ",,,948.0,12562.0,233 CPT,26525,"Capsulectomy or capsulotomy; interphalangeal joint, each joint ",,,622.69,12562.0,233 CPT,26530,"Arthroplasty, metacarpophalangeal joint; each joint ",,,948.0,16330.72,233 CPT,26531,"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint ",,,948.0,16330.72,233 CPT,26535,"Arthroplasty, interphalangeal joint; each joint ",,,948.0,13394.0,233 CPT,26536,"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint ",,,948.0,16330.72,233 CPT,26540,"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint ",,,948.0,8234.0,233 CPT,26541,"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft) ",,,948.0,12909.0,233 CPT,26542,"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement) ",,,948.0,8234.0,233 CPT,26545,"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint ",,,948.0,8234.0,233 CPT,26546,"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation) ",,,948.0,16330.72,233 CPT,26548,"Repair and reconstruction, finger, volar plate, interphalangeal joint ",,,948.0,8234.0,233 CPT,26550,Pollicization of a digit ,,,948.0,7473.24,233 CPT,26551,"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft ",,,948.0,40106.07,205 CPT,26553,"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single ",,,948.0,39839.12,205 CPT,26554,"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double ",,,948.0,46501.51,205 CPT,26555,"Transfer, finger to another position without microvascular anastomosis ",,,948.0,16330.72,233 CPT,26556,"Transfer, free toe joint, with microvascular anastomosis ",,,948.0,41402.96,205 CPT,26560,Repair of syndactyly (web finger) each web space; with skin flaps ,,,622.69,3755.0,233 CPT,26561,Repair of syndactyly (web finger) each web space; with skin flaps and grafts ,,,948.0,12562.0,233 CPT,26562,"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails) ",,,948.0,8234.0,233 CPT,26565,"Osteotomy; metacarpal, each ",,,948.0,13394.0,233 CPT,26567,"Osteotomy; phalanx of finger, each ",,,948.0,13394.0,233 CPT,26568,"Osteoplasty, lengthening, metacarpal or phalanx ",,,948.0,16330.72,233 CPT,26580,Repair cleft hand ,,,948.0,13394.0,233 CPT,26585,REPAIR FINGER DEFORMITY ,,,3390.0,5841.0,16 CPT,26587,"Reconstruction of polydactylous digit, soft tissue and bone ",,,948.0,13394.0,233 CPT,26590,"Repair macrodactylia, each digit ",,,622.69,13394.0,233 CPT,26591,"Repair, intrinsic muscles of hand, each muscle ",,,948.0,12562.0,233 CPT,26593,"Release, intrinsic muscles of hand, each muscle ",,,948.0,12562.0,233 CPT,26596,"Excision of constricting ring of finger, with multiple Z-plasties ",,,948.0,7473.24,233 CPT,26597,RELEASE OF SCAR CONTRACTURE ,,,3390.0,5841.0,16 CPT,26600,"Closed treatment of metacarpal fracture, single; without manipulation, each bone ",,,89.59,5841.0,129 CPT,26605,"Closed treatment of metacarpal fracture, single; with manipulation, each bone ",,,89.59,5841.0,225 CPT,26607,"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone ",,,948.0,7473.24,233 CPT,26608,"Percutaneous skeletal fixation of metacarpal fracture, each bone ",,,948.0,8234.0,233 CPT,26615,"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone ",,,948.0,9653.0,233 CPT,26641,"Closed treatment of carpometacarpal dislocation, thumb, with manipulation ",,,89.59,5841.0,129 CPT,26645,"Closed treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation ",,,622.69,5841.0,225 CPT,26650,"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation ",,,948.0,7473.24,233 CPT,26665,"Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed ",,,948.0,9653.0,233 CPT,26670,"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia ",,,89.59,5841.0,129 CPT,26675,"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia ",,,622.69,5841.0,225 CPT,26676,"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint ",,,948.0,7473.24,233 CPT,26685,"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint ",,,948.0,12562.0,233 CPT,26686,"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction ",,,948.0,12562.0,233 CPT,26700,"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia ",,,89.59,5841.0,129 CPT,26705,"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia ",,,622.69,5841.0,225 CPT,26706,"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation ",,,948.0,7473.24,233 CPT,26715,"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed ",,,948.0,8234.0,233 CPT,26720,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each ",,,89.59,5841.0,225 CPT,26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each ",,,89.59,5841.0,225 CPT,26727,"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each ",,,948.0,12909.0,233 CPT,26735,"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each ",,,948.0,8234.0,233 CPT,26740,"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each ",,,89.59,5841.0,225 CPT,26742,"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each ",,,622.69,5841.0,225 CPT,26746,"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each ",,,948.0,13394.0,233 CPT,26750,"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each ",,,89.59,5841.0,129 CPT,26755,"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each ",,,89.59,5841.0,129 CPT,26756,"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each ",,,948.0,7473.24,233 CPT,26765,"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each ",,,948.0,8234.0,233 CPT,26770,"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia ",,,89.59,5841.0,129 CPT,26775,"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia ",,,104.85,13835.0,129 CPT,26776,"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation ",,,948.0,7473.24,233 CPT,26785,"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single ",,,948.0,7473.24,233 CPT,26820,"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,26841,"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; ",,,948.0,16330.72,233 CPT,26842,"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,26843,"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; ",,,948.0,16330.72,233 CPT,26844,"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,26850,"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; ",,,948.0,16330.72,233 CPT,26852,"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,26860,"Arthrodesis, interphalangeal joint, with or without internal fixation; ",,,948.0,12562.0,233 CPT,26861,"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,26862,"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft) ",,,948.0,8234.0,233 CPT,26863,"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,26910,"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer ",,,948.0,12562.0,233 CPT,26951,"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure ",,,948.0,7473.24,233 CPT,26952,"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (V-Y, hood) ",,,948.0,8234.0,233 CPT,26989,"Unlisted procedure, hands or fingers ",,,249.03,13835.0,198 CPT,26990,"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma ",,,948.0,7473.24,233 CPT,26991,"Incision and drainage, pelvis or hip joint area; infected bursa ",,,622.69,5571.0,233 CPT,26992,"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess) ",,,948.0,13835.0,205 CPT,27000,"Tenotomy, adductor of hip, percutaneous (separate procedure) ",,,622.69,5571.0,233 CPT,27001,"Tenotomy, adductor of hip, open ",,,948.0,12562.0,233 CPT,27003,"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy ",,,948.0,16330.72,233 CPT,27005,"Tenotomy, hip flexor(s), open (separate procedure) ",,,948.0,16207.0,205 CPT,27006,"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure) ",,,948.0,13835.0,206 CPT,27025,"Fasciotomy, hip or thigh, any type ",,,948.0,16207.0,205 CPT,27027,"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral ",,,948.0,16330.72,206 CPT,27030,"Arthrotomy, hip, with drainage (eg, infection) ",,,948.0,13835.0,205 CPT,27033,"Arthrotomy, hip, including exploration or removal of loose or foreign body ",,,948.0,16330.72,233 CPT,27035,"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves ",,,948.0,8234.0,233 CPT,27036,"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius,",,,948.0,13835.0,205 CPT,27040,"Biopsy, soft tissue of pelvis and hip area; superficial ",,,510.77,3747.2,233 CPT,27041,"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular ",,,510.77,3755.0,233 CPT,27043,"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,27045,"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,27047,"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm ",,,855.96,6330.57,233 CPT,27048,"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,12562.0,233 CPT,27049,"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm ",,,855.96,12562.0,233 CPT,27050,"Arthrotomy, with biopsy; sacroiliac joint ",,,622.69,12562.0,233 CPT,27052,"Arthrotomy, with biopsy; hip joint ",,,622.69,12562.0,233 CPT,27054,"Arthrotomy with synovectomy, hip joint ",,,948.0,16207.0,205 CPT,27057,"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilater",,,948.0,15059.0,206 CPT,27059,"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater ",,,855.96,15059.0,233 CPT,27060,Excision; ischial bursa ,,,948.0,16330.72,233 CPT,27062,Excision; trochanteric bursa or calcification ,,,948.0,13394.0,233 CPT,27065,"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed ",,,948.0,16330.72,233 CPT,27066,"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed ",,,948.0,13394.0,233 CPT,27067,"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision ",,,948.0,16330.72,233 CPT,27070,"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial ",,,948.0,16207.0,205 CPT,27071,"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular) ",,,948.0,13835.0,205 CPT,27075,"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis ",,,948.0,25666.55,205 CPT,27076,"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum ",,,948.0,31066.04,205 CPT,27077,"Radical resection of tumor; innominate bone, total ",,,948.0,34782.9,205 CPT,27078,Radical resection of tumor; ischial tuberosity and greater trochanter of femur ,,,948.0,25306.23,205 CPT,27079,EXTENSIVE HIP SURGERY ,,,3390.0,5841.0,16 CPT,27080,"Coccygectomy, primary ",,,948.0,7473.24,233 CPT,27086,"Removal of foreign body, pelvis or hip; subcutaneous tissue ",,,855.96,6330.57,233 CPT,27087,"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) ",,,948.0,12562.0,233 CPT,27090,Removal of hip prosthesis; (separate procedure) ,,,948.0,16207.0,205 CPT,27091,"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer ",,,948.0,19525.36,205 CPT,27093,Injection procedure for hip arthrography; without anesthesia ,,,948.0,5841.0,140 CPT,27095,Injection procedure for hip arthrography; with anesthesia ,,,948.0,5841.0,140 CPT,27096,"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed ",,,786.51,5841.0,197 CPT,27097,"Release or recession, hamstring, proximal ",,,948.0,12562.0,233 CPT,27098,"Transfer, adductor to ischium ",,,948.0,12562.0,233 CPT,27100,Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft) ,,,948.0,16330.72,233 CPT,27105,Transfer paraspinal muscle to hip (includes fascial or tendon extension graft) ,,,948.0,9653.0,233 CPT,27110,Transfer iliopsoas; to greater trochanter of femur ,,,948.0,16330.72,233 CPT,27111,Transfer iliopsoas; to femoral neck ,,,948.0,9653.0,233 CPT,27120,"Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) ",,,948.0,50804.46,198 CPT,27122,"Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure) ",,,948.0,60464.0,187 CPT,27125,"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty) ",,,948.0,60464.0,184 CPT,27130,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft ",,,948.0,60464.0,189 CPT,27132,"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft ",,,948.0,65774.97,186 CPT,27134,"Revision of total hip arthroplasty; both components, with or without autograft or allograft ",,,948.0,75233.6,186 CPT,27137,"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft ",,,948.0,60464.0,186 CPT,27138,"Revision of total hip arthroplasty; femoral component only, with or without allograft ",,,948.0,60464.0,186 CPT,27140,Osteotomy and transfer of greater trochanter of femur (separate procedure) ,,,948.0,16207.0,205 CPT,27146,"Osteotomy, iliac, acetabular or innominate bone; ",,,948.0,16207.0,205 CPT,27147,"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip ",,,948.0,17791.94,205 CPT,27151,"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy ",,,948.0,19483.03,205 CPT,27156,"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip ",,,948.0,20741.7,205 CPT,27158,"Osteotomy, pelvis, bilateral (eg, congenital malformation) ",,,948.0,16863.84,205 CPT,27161,"Osteotomy, femoral neck (separate procedure) ",,,948.0,16207.0,205 CPT,27165,"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast ",,,948.0,16719.66,205 CPT,27170,"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft) ",,,948.0,16207.0,205 CPT,27175,"Treatment of slipped femoral epiphysis; by traction, without reduction ",,,948.0,16207.0,205 CPT,27176,"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ ",,,948.0,13835.0,205 CPT,27177,Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft) ,,,948.0,16207.0,205 CPT,27178,Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning ,,,948.0,13835.0,205 CPT,27179,Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (Heyman type procedure) ,,,948.0,16330.72,110 CPT,27181,Open treatment of slipped femoral epiphysis; osteotomy and internal fixation ,,,948.0,16207.0,205 CPT,27185,"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur ",,,948.0,16207.0,205 CPT,27187,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur ",,,948.0,16207.0,205 CPT,27193,TREAT PELVIC RING FRACTURE ,,,2358.0,5841.0,16 CPT,27194,TREAT PELVIC RING FRACTURE ,,,2128.0,5841.0,16 CPT,27197,"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or d",,,89.59,5841.0,225 CPT,27198,"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or d",,,89.59,5841.0,225 CPT,27200,Closed treatment of coccygeal fracture ,,,89.59,5841.0,225 CPT,27202,Open treatment of coccygeal fracture ,,,948.0,9653.0,233 CPT,27215,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when pe",,,948.0,13835.0,109 CPT,27216,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or",,,948.0,13835.0,109 CPT,27217,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis ",,,948.0,13835.0,109 CPT,27218,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral il",,,948.0,14676.83,109 CPT,27220,Closed treatment of acetabulum (hip socket) fracture(s); without manipulation ,,,89.59,5841.0,129 CPT,27222,"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction ",,,948.0,16207.0,205 CPT,27226,"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation ",,,948.0,13835.0,205 CPT,27227,"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation ",,,948.0,20322.1,205 CPT,27228,"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse",,,948.0,23038.9,205 CPT,27230,"Closed treatment of femoral fracture, proximal end, neck; without manipulation ",,,89.59,5841.0,225 CPT,27232,"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction ",,,948.0,16207.0,205 CPT,27235,"Percutaneous skeletal fixation of femoral fracture, proximal end, neck ",,,948.0,16330.72,206 CPT,27236,"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement ",,,948.0,16207.0,205 CPT,27238,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation ",,,622.69,5841.0,225 CPT,27240,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction ",,,948.0,16207.0,205 CPT,27244,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage ",,,948.0,16207.0,205 CPT,27245,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage ",,,948.0,15041.39,205 CPT,27246,"Closed treatment of greater trochanteric fracture, without manipulation ",,,89.59,5841.0,225 CPT,27248,"Open treatment of greater trochanteric fracture, includes internal fixation, when performed ",,,948.0,16207.0,205 CPT,27250,"Closed treatment of hip dislocation, traumatic; without anesthesia ",,,89.59,5841.0,225 CPT,27252,"Closed treatment of hip dislocation, traumatic; requiring anesthesia ",,,622.69,3755.0,233 CPT,27253,"Open treatment of hip dislocation, traumatic, without internal fixation ",,,948.0,16207.0,205 CPT,27254,"Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation ",,,948.0,16207.0,205 CPT,27256,"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation ",,,89.59,5841.0,225 CPT,27257,"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia ",,,622.69,12562.0,233 CPT,27258,"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); ",,,948.0,16207.0,205 CPT,27259,"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening ",,,948.0,18995.58,205 CPT,27265,Closed treatment of post hip arthroplasty dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,27266,Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia ,,,622.69,3755.0,233 CPT,27267,"Closed treatment of femoral fracture, proximal end, head; without manipulation ",,,948.0,7473.24,233 CPT,27268,"Closed treatment of femoral fracture, proximal end, head; with manipulation ",,,948.0,16207.0,205 CPT,27269,"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed ",,,948.0,16207.0,205 CPT,27275,"Manipulation, hip joint, requiring general anesthesia ",,,622.69,3755.0,233 CPT,27278,"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortic",,,948.0,48474.64,213 CPT,27279,"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-art",,,948.0,43532.8,206 CPT,27280,"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed ",,,948.0,16622.17,205 CPT,27282,"Arthrodesis, symphysis pubis (including obtaining graft) ",,,948.0,16207.0,205 CPT,27284,"Arthrodesis, hip joint (including obtaining graft); ",,,948.0,19461.86,205 CPT,27286,"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy ",,,948.0,20237.43,205 CPT,27290,Interpelviabdominal amputation (hindquarter amputation) ,,,948.0,19881.34,109 CPT,27295,Disarticulation of hip ,,,948.0,16207.0,109 CPT,27299,"Unlisted procedure, pelvis or hip joint ",,,249.03,13835.0,198 CPT,27301,"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region ",,,855.96,12562.0,233 CPT,27303,"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess) ",,,948.0,13835.0,205 CPT,27305,"Fasciotomy, iliotibial (tenotomy), open ",,,948.0,7473.24,233 CPT,27306,"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure) ",,,948.0,12562.0,233 CPT,27307,"Tenotomy, percutaneous, adductor or hamstring; multiple tendons ",,,948.0,12562.0,233 CPT,27310,"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection) ",,,948.0,8234.0,233 CPT,27315,"PARTIAL REMOVAL, THIGH NERVE ",,,3390.0,5841.0,16 CPT,27320,"PARTIAL REMOVAL, THIGH NERVE ",,,3390.0,5841.0,16 CPT,27323,"Biopsy, soft tissue of thigh or knee area; superficial ",,,510.77,3747.2,233 CPT,27324,"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular) ",,,855.96,6330.57,233 CPT,27325,"Neurectomy, hamstring muscle ",,,692.94,4693.83,233 CPT,27326,"Neurectomy, popliteal (gastrocnemius) ",,,692.94,4693.83,233 CPT,27327,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm ",,,510.77,5571.0,233 CPT,27328,"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,12562.0,233 CPT,27329,"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm ",,,855.96,8234.0,233 CPT,27330,"Arthrotomy, knee; with synovial biopsy only ",,,948.0,8234.0,233 CPT,27331,"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies ",,,948.0,8234.0,233 CPT,27332,"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral ",,,1142.68,8234.0,213 CPT,27332,"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral High Cost Surgery",,,2369.0,2369.0,20 CPT,27333,"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial AND lateral ",,,1142.68,8234.0,213 CPT,27333,"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial AND lateral High Cost Surgery",,,2369.0,2369.0,20 CPT,27334,"Arthrotomy, with synovectomy, knee; anterior OR posterior ",,,948.0,8234.0,233 CPT,27335,"Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area ",,,948.0,16330.72,233 CPT,27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,27339,"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,27340,"Excision, prepatellar bursa ",,,948.0,12562.0,233 CPT,27345,"Excision of synovial cyst of popliteal space (eg, Baker's cyst) ",,,948.0,8234.0,233 CPT,27347,"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee ",,,948.0,8234.0,233 CPT,27350,Patellectomy or hemipatellectomy ,,,948.0,16330.72,233 CPT,27355,Excision or curettage of bone cyst or benign tumor of femur; ,,,948.0,12562.0,233 CPT,27356,Excision or curettage of bone cyst or benign tumor of femur; with allograft ,,,948.0,32488.94,233 CPT,27357,Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft) ,,,948.0,16330.72,233 CPT,27358,Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (List in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,27360,"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess) ",,,948.0,13394.0,233 CPT,27364,"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater ",,,855.96,15059.0,233 CPT,27365,"Radical resection of tumor, femur or knee ",,,948.0,25272.36,205 CPT,27369,Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography ,,,948.0,5841.0,140 CPT,27370,INJECTION OF CONTRAST FOR KNEE ARTHROGRAPHY ,,,2358.0,5841.0,16 CPT,27372,"Removal of foreign body, deep, thigh region or knee area ",,,855.96,12909.0,233 CPT,27380,Suture of infrapatellar tendon; primary ,,,948.0,16330.72,233 CPT,27381,"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft ",,,948.0,16330.72,233 CPT,27385,Suture of quadriceps or hamstring muscle rupture; primary ,,,948.0,16330.72,233 CPT,27386,"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft ",,,948.0,16330.72,233 CPT,27390,"Tenotomy, open, hamstring, knee to hip; single tendon ",,,948.0,7473.24,233 CPT,27391,"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg ",,,948.0,7473.24,233 CPT,27392,"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral ",,,948.0,12562.0,233 CPT,27393,Lengthening of hamstring tendon; single tendon ,,,948.0,16330.72,233 CPT,27394,"Lengthening of hamstring tendon; multiple tendons, 1 leg ",,,948.0,16330.72,233 CPT,27395,"Lengthening of hamstring tendon; multiple tendons, bilateral ",,,948.0,12562.0,233 CPT,27396,"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon ",,,948.0,16330.72,233 CPT,27397,"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons ",,,948.0,16330.72,233 CPT,27400,"Transfer, tendon or muscle, hamstrings to femur (eg, Egger's type procedure) ",,,948.0,16330.72,233 CPT,27403,"Arthrotomy with meniscus repair, knee ",,,948.0,16330.72,233 CPT,27405,"Repair, primary, torn ligament and/or capsule, knee; collateral ",,,948.0,16330.72,233 CPT,27407,"Repair, primary, torn ligament and/or capsule, knee; cruciate ",,,2996.0,16330.72,213 CPT,27407,"Repair, primary, torn ligament and/or capsule, knee; cruciate High Cost Surgery",,,2369.0,2369.0,20 CPT,27409,"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments ",,,2518.45,16330.72,213 CPT,27409,"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments High Cost Surgery",,,2369.0,2369.0,20 CPT,27412,"Autologous chondrocyte implantation, knee ",,,2699.0,16330.72,186 CPT,27412,"Autologous chondrocyte implantation, knee High Cost Surgery",,,2369.0,2369.0,20 CPT,27415,"Osteochondral allograft, knee, open ",,,5202.0,32488.94,129 CPT,27415,"Osteochondral allograft, knee, open High Cost Surgery",,,2369.0,2369.0,20 CPT,27416,"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograftºs») ",,,2518.45,16330.72,213 CPT,27416,"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograftºs») High Cost Surgery",,,2369.0,2369.0,20 CPT,27418,"Anterior tibial tubercleplasty (eg, Maquet type procedure) ",,,2518.45,16330.72,213 CPT,27418,"Anterior tibial tubercleplasty (eg, Maquet type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,27420,"Reconstruction of dislocating patella; (eg, Hauser type procedure) ",,,2518.45,16330.72,213 CPT,27420,"Reconstruction of dislocating patella; (eg, Hauser type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,27422,"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite type procedure) ",,,2518.45,16330.72,213 CPT,27422,"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,27424,Reconstruction of dislocating patella; with patellectomy ,,,2518.45,16330.72,213 CPT,27424,Reconstruction of dislocating patella; with patellectomy High Cost Surgery,,,2369.0,2369.0,20 CPT,27425,"Lateral retinacular release, open ",,,1142.68,12909.0,213 CPT,27425,"Lateral retinacular release, open High Cost Surgery",,,2369.0,2369.0,20 CPT,27427,"Ligamentous reconstruction (augmentation), knee; extra-articular ",,,2699.0,16330.72,213 CPT,27427,"Ligamentous reconstruction (augmentation), knee; extra-articular High Cost Surgery",,,2369.0,2369.0,20 CPT,27428,"Ligamentous reconstruction (augmentation), knee; intra-articular (open) ",,,2996.0,32488.94,206 CPT,27428,"Ligamentous reconstruction (augmentation), knee; intra-articular (open) High Cost Surgery",,,2369.0,2369.0,20 CPT,27429,"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular ",,,2996.0,32488.94,206 CPT,27429,"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular High Cost Surgery",,,2369.0,2369.0,20 CPT,27430,"Quadricepsplasty (eg, Bennett or Thompson type) ",,,948.0,16330.72,233 CPT,27435,"Capsulotomy, posterior capsular release, knee ",,,948.0,8234.0,233 CPT,27437,"Arthroplasty, patella; without prosthesis ",,,948.0,60464.0,231 CPT,27438,"Arthroplasty, patella; with prosthesis ",,,948.0,60464.0,226 CPT,27440,"Arthroplasty, knee, tibial plateau; ",,,948.0,60464.0,226 CPT,27441,"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy ",,,948.0,45698.73,228 CPT,27442,"Arthroplasty, femoral condyles or tibial plateau(s), knee; ",,,948.0,45698.73,228 CPT,27443,"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy ",,,948.0,45698.73,228 CPT,27445,"Arthroplasty, knee, hinge prosthesis (eg, Walldius type) ",,,9653.0,60464.0,16 CPT,27446,"Arthroplasty, knee, condyle and plateau; medial OR lateral compartment ",,,948.0,60464.0,216 CPT,27447,"Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) ",,,948.0,60464.0,189 CPT,27448,"Osteotomy, femur, shaft or supracondylar; without fixation ",,,948.0,16207.0,205 CPT,27450,"Osteotomy, femur, shaft or supracondylar; with fixation ",,,948.0,60464.0,187 CPT,27454,"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, Sofield type procedure) ",,,948.0,16207.0,205 CPT,27455,"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus ºbowleg» or genu valgus ºknock-knee»); before epiphyseal closure ",,,948.0,16207.0,205 CPT,27457,"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus ºbowleg» or genu valgus ºknock-knee»); after epiphyseal closure ",,,948.0,13835.0,205 CPT,27458,"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, compu",,,948.0,20238.53,152 CPT,27465,"Osteoplasty, femur; shortening (excluding 64876) ",,,948.0,16207.0,205 CPT,27466,"Osteoplasty, femur; lengthening ",,,948.0,16207.0,205 CPT,27468,"Osteoplasty, femur; combined, lengthening and shortening with femoral segment transfer ",,,3390.0,16207.0,24 CPT,27470,"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique) ",,,948.0,16207.0,205 CPT,27472,"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft) ",,,948.0,16207.0,205 CPT,27475,"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur ",,,948.0,16330.72,233 CPT,27477,"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal ",,,948.0,16330.72,206 CPT,27479,"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula ",,,948.0,16330.72,233 CPT,27485,"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus) ",,,948.0,16330.72,206 CPT,27486,"Revision of total knee arthroplasty, with or without allograft; 1 component ",,,948.0,60464.0,186 CPT,27487,"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component ",,,948.0,69041.26,186 CPT,27488,"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee ",,,948.0,16207.0,205 CPT,27495,"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur ",,,948.0,16207.0,205 CPT,27496,"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); ",,,948.0,13394.0,233 CPT,27497,"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve ",,,948.0,12562.0,233 CPT,27498,"Decompression fasciotomy, thigh and/or knee, multiple compartments; ",,,622.69,12562.0,233 CPT,27499,"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve ",,,948.0,16330.72,233 CPT,27500,"Closed treatment of femoral shaft fracture, without manipulation ",,,89.59,5841.0,225 CPT,27501,"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation ",,,89.59,5841.0,225 CPT,27502,"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction ",,,622.69,3755.0,233 CPT,27503,"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction ",,,622.69,12562.0,225 CPT,27506,"Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws ",,,948.0,16359.45,205 CPT,27507,"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage ",,,948.0,13835.0,205 CPT,27508,"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation ",,,89.59,5841.0,225 CPT,27509,"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal sepa",,,948.0,16330.72,233 CPT,27510,"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation ",,,622.69,5841.0,225 CPT,27511,"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed ",,,948.0,13835.0,205 CPT,27513,"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed ",,,948.0,15176.99,205 CPT,27514,"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed ",,,948.0,16207.0,205 CPT,27516,Closed treatment of distal femoral epiphyseal separation; without manipulation ,,,89.59,5841.0,225 CPT,27517,"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction ",,,622.69,5841.0,225 CPT,27519,"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed ",,,948.0,16207.0,205 CPT,27520,"Closed treatment of patellar fracture, without manipulation ",,,89.59,5841.0,225 CPT,27524,"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair ",,,948.0,16330.72,233 CPT,27530,"Closed treatment of tibial fracture, proximal (plateau); without manipulation ",,,89.59,5841.0,225 CPT,27532,"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction ",,,948.0,7473.24,233 CPT,27535,"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed ",,,948.0,13835.0,205 CPT,27536,"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation ",,,948.0,14532.77,205 CPT,27538,"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation ",,,89.59,5841.0,225 CPT,27540,"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed ",,,948.0,13835.0,205 CPT,27550,Closed treatment of knee dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,27552,Closed treatment of knee dislocation; requiring anesthesia ,,,622.69,3700.21,233 CPT,27556,"Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction ",,,948.0,13835.0,205 CPT,27557,"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair ",,,948.0,13835.0,205 CPT,27558,"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction ",,,948.0,14528.54,205 CPT,27560,Closed treatment of patellar dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,27562,Closed treatment of patellar dislocation; requiring anesthesia ,,,89.59,5841.0,225 CPT,27566,"Open treatment of patellar dislocation, with or without partial or total patellectomy ",,,948.0,16330.72,233 CPT,27570,Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) ,,,622.69,3700.21,233 CPT,27580,"Arthrodesis, knee, any technique ",,,948.0,17622.48,205 CPT,27590,"Amputation, thigh, through femur, any level; ",,,948.0,16207.0,109 CPT,27591,"Amputation, thigh, through femur, any level; immediate fitting technique including first cast ",,,948.0,16207.0,109 CPT,27592,"Amputation, thigh, through femur, any level; open, circular (guillotine) ",,,948.0,16207.0,109 CPT,27594,"Amputation, thigh, through femur, any level; secondary closure or scar revision ",,,948.0,12562.0,233 CPT,27596,"Amputation, thigh, through femur, any level; re-amputation ",,,948.0,16207.0,109 CPT,27598,Disarticulation at knee ,,,948.0,16207.0,109 CPT,27599,"Unlisted procedure, femur or knee ",,,249.03,13835.0,198 CPT,27600,"Decompression fasciotomy, leg; anterior and/or lateral compartments only ",,,948.0,12562.0,233 CPT,27601,"Decompression fasciotomy, leg; posterior compartment(s) only ",,,948.0,12562.0,233 CPT,27602,"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s) ",,,948.0,12562.0,233 CPT,27603,"Incision and drainage, leg or ankle; deep abscess or hematoma ",,,855.96,6330.57,233 CPT,27604,"Incision and drainage, leg or ankle; infected bursa ",,,948.0,7473.24,233 CPT,27605,"Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia ",,,622.69,5571.0,233 CPT,27606,"Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia ",,,948.0,7473.24,233 CPT,27607,"Incision (eg, osteomyelitis or bone abscess), leg or ankle ",,,948.0,7473.24,233 CPT,27610,"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body ",,,948.0,7473.24,233 CPT,27612,"Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening ",,,948.0,12562.0,233 CPT,27613,"Biopsy, soft tissue of leg or ankle area; superficial ",,,146.52,3128.0,233 CPT,27614,"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) ",,,855.96,6330.57,233 CPT,27615,"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm ",,,855.96,12562.0,233 CPT,27616,"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; 5 cm or greater ",,,855.96,15059.0,233 CPT,27618,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm ",,,510.77,3755.0,233 CPT,27619,"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm ",,,855.96,12562.0,233 CPT,27620,"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body ",,,948.0,8234.0,233 CPT,27625,"Arthrotomy, with synovectomy, ankle; ",,,948.0,8234.0,233 CPT,27626,"Arthrotomy, with synovectomy, ankle; including tenosynovectomy ",,,948.0,8234.0,233 CPT,27630,"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle ",,,948.0,12562.0,233 CPT,27632,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater ",,,855.96,15059.0,233 CPT,27634,"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater ",,,855.96,15059.0,233 CPT,27635,"Excision or curettage of bone cyst or benign tumor, tibia or fibula; ",,,948.0,12562.0,233 CPT,27637,"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,27638,"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft ",,,948.0,16330.72,233 CPT,27640,"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia ",,,948.0,7473.24,233 CPT,27641,"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula ",,,948.0,7473.24,233 CPT,27645,Radical resection of tumor; tibia ,,,948.0,21758.94,205 CPT,27646,Radical resection of tumor; fibula ,,,948.0,18800.59,205 CPT,27647,Radical resection of tumor; talus or calcaneus ,,,948.0,12562.0,233 CPT,27648,Injection procedure for ankle arthrography ,,,948.0,5841.0,140 CPT,27650,"Repair, primary, open or percutaneous, ruptured Achilles tendon; ",,,948.0,16330.72,233 CPT,27652,"Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,27654,"Repair, secondary, Achilles tendon, with or without graft ",,,948.0,16330.72,233 CPT,27656,"Repair, fascial defect of leg ",,,948.0,7473.24,233 CPT,27658,"Repair, flexor tendon, leg; primary, without graft, each tendon ",,,948.0,7473.24,233 CPT,27659,"Repair, flexor tendon, leg; secondary, with or without graft, each tendon ",,,948.0,16330.72,233 CPT,27664,"Repair, extensor tendon, leg; primary, without graft, each tendon ",,,948.0,16330.72,233 CPT,27665,"Repair, extensor tendon, leg; secondary, with or without graft, each tendon ",,,948.0,16330.72,233 CPT,27675,"Repair, dislocating peroneal tendons; without fibular osteotomy ",,,948.0,7473.24,233 CPT,27676,"Repair, dislocating peroneal tendons; with fibular osteotomy ",,,948.0,16330.72,233 CPT,27680,"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon ",,,948.0,12562.0,233 CPT,27681,"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incisionºs») ",,,948.0,7473.24,233 CPT,27685,"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) ",,,948.0,12562.0,233 CPT,27686,"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each ",,,948.0,12562.0,233 CPT,27687,"Gastrocnemius recession (eg, Strayer procedure) ",,,948.0,12562.0,233 CPT,27690,"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot) ",,,948.0,16330.72,233 CPT,27691,"Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longu",,,948.0,16330.72,233 CPT,27692,Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,27695,"Repair, primary, disrupted ligament, ankle; collateral ",,,948.0,16330.72,233 CPT,27696,"Repair, primary, disrupted ligament, ankle; both collateral ligaments ",,,948.0,16330.72,233 CPT,27698,"Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) ",,,948.0,16330.72,233 CPT,27700,"Arthroplasty, ankle; ",,,948.0,22970.69,233 CPT,27702,"Arthroplasty, ankle; with implant (total ankle) ",,,948.0,65905.0,185 CPT,27703,"Arthroplasty, ankle; revision, total ankle ",,,948.0,65905.0,182 CPT,27704,Removal of ankle implant ,,,948.0,7473.24,233 CPT,27705,Osteotomy; tibia ,,,948.0,16330.72,233 CPT,27707,Osteotomy; fibula ,,,948.0,7473.24,233 CPT,27709,Osteotomy; tibia and fibula ,,,948.0,32488.94,233 CPT,27712,"Osteotomy; multiple, with realignment on intramedullary rod (eg, Sofield type procedure) ",,,948.0,16207.0,205 CPT,27713,"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations",,,948.0,20238.53,152 CPT,27715,"Osteoplasty, tibia and fibula, lengthening or shortening ",,,948.0,13835.0,205 CPT,27720,"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique) ",,,948.0,16330.72,233 CPT,27722,"Repair of nonunion or malunion, tibia; with sliding graft ",,,948.0,16330.72,206 CPT,27724,"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft) ",,,948.0,16207.0,205 CPT,27725,"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method ",,,948.0,16207.0,205 CPT,27726,Repair of fibula nonunion and/or malunion with internal fixation ,,,948.0,16330.72,233 CPT,27727,"Repair of congenital pseudarthrosis, tibia ",,,948.0,16207.0,205 CPT,27730,"Arrest, epiphyseal (epiphysiodesis), open; distal tibia ",,,948.0,7473.24,233 CPT,27732,"Arrest, epiphyseal (epiphysiodesis), open; distal fibula ",,,948.0,7473.24,233 CPT,27734,"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula ",,,948.0,7473.24,233 CPT,27740,"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; ",,,948.0,7473.24,233 CPT,27742,"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur ",,,948.0,9653.0,233 CPT,27745,"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia ",,,948.0,16330.72,233 CPT,27750,Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation ,,,89.59,5841.0,225 CPT,27752,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction ",,,622.69,3700.21,233 CPT,27756,"Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws) ",,,948.0,16330.72,233 CPT,27758,"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage ",,,948.0,32488.94,233 CPT,27759,"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage ",,,948.0,32488.94,233 CPT,27760,Closed treatment of medial malleolus fracture; without manipulation ,,,89.59,5841.0,225 CPT,27762,"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction ",,,622.69,3700.21,233 CPT,27766,"Open treatment of medial malleolus fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27767,Closed treatment of posterior malleolus fracture; without manipulation ,,,89.59,5841.0,225 CPT,27768,Closed treatment of posterior malleolus fracture; with manipulation ,,,892.52,5841.0,225 CPT,27769,"Open treatment of posterior malleolus fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27780,Closed treatment of proximal fibula or shaft fracture; without manipulation ,,,89.59,5841.0,225 CPT,27781,Closed treatment of proximal fibula or shaft fracture; with manipulation ,,,622.69,3700.21,233 CPT,27784,"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27786,Closed treatment of distal fibular fracture (lateral malleolus); without manipulation ,,,89.59,5841.0,225 CPT,27788,Closed treatment of distal fibular fracture (lateral malleolus); with manipulation ,,,89.59,5841.0,225 CPT,27792,"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27808,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation ",,,89.59,5841.0,225 CPT,27810,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation ",,,622.69,3700.21,233 CPT,27814,"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27816,Closed treatment of trimalleolar ankle fracture; without manipulation ,,,89.59,5841.0,225 CPT,27818,Closed treatment of trimalleolar ankle fracture; with manipulation ,,,622.69,3700.21,233 CPT,27822,"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip ",,,948.0,16330.72,233 CPT,27823,"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; with fixation of posterior lip ",,,948.0,16330.72,233 CPT,27824,"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation ",,,89.59,5841.0,225 CPT,27825,"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation ",,,622.69,3755.0,233 CPT,27826,"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only ",,,948.0,16330.72,233 CPT,27827,"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only ",,,948.0,32488.94,233 CPT,27828,"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula ",,,948.0,32488.94,233 CPT,27829,"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,27830,Closed treatment of proximal tibiofibular joint dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,27831,Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia ,,,948.0,7473.24,233 CPT,27832,"Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when performed, or with excision of proximal fibula ",,,948.0,16330.72,233 CPT,27840,Closed treatment of ankle dislocation; without anesthesia ,,,89.59,5841.0,225 CPT,27842,"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation ",,,825.28,3700.21,233 CPT,27846,"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation ",,,948.0,16330.72,233 CPT,27848,"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation ",,,948.0,16330.72,233 CPT,27860,Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus) ,,,948.0,7473.24,233 CPT,27870,"Arthrodesis, ankle, open ",,,948.0,32488.94,233 CPT,27871,"Arthrodesis, tibiofibular joint, proximal or distal ",,,948.0,32488.94,233 CPT,27880,"Amputation, leg, through tibia and fibula; ",,,948.0,16207.0,109 CPT,27881,"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast ",,,948.0,16207.0,109 CPT,27882,"Amputation, leg, through tibia and fibula; open, circular (guillotine) ",,,948.0,16207.0,109 CPT,27884,"Amputation, leg, through tibia and fibula; secondary closure or scar revision ",,,948.0,12562.0,233 CPT,27886,"Amputation, leg, through tibia and fibula; re-amputation ",,,948.0,16207.0,109 CPT,27888,"Amputation, ankle, through malleoli of tibia and fibula (eg, Syme, Pirogoff type procedures), with plastic closure and resection of nerves ",,,948.0,16207.0,109 CPT,27889,Ankle disarticulation ,,,948.0,16330.72,233 CPT,27892,"Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve ",,,948.0,12562.0,233 CPT,27893,"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve ",,,948.0,16330.72,233 CPT,27894,"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve ",,,948.0,12562.0,233 CPT,27899,"Unlisted procedure, leg or ankle ",,,249.03,13835.0,198 CPT,28001,"Incision and drainage, bursa, foot ",,,86.63,13835.0,233 CPT,28002,"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space ",,,622.69,12562.0,233 CPT,28003,"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas ",,,948.0,12562.0,233 CPT,28005,"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot ",,,948.0,12562.0,233 CPT,28008,"Fasciotomy, foot and/or toe ",,,1142.68,12562.0,213 CPT,28008,"Fasciotomy, foot and/or toe High Cost Surgery",,,2369.0,2369.0,20 CPT,28010,"Tenotomy, percutaneous, toe; single tendon ",,,105.53,13835.0,233 CPT,28011,"Tenotomy, percutaneous, toe; multiple tendons ",,,622.69,12562.0,233 CPT,28020,"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint ",,,948.0,7473.24,233 CPT,28022,"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint ",,,948.0,7473.24,233 CPT,28024,"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint ",,,622.69,5571.0,233 CPT,28030,REMOVAL OF FOOT NERVE ,,,3390.0,5841.0,16 CPT,28035,"Release, tarsal tunnel (posterior tibial nerve decompression) ",,,692.94,8234.0,233 CPT,28039,"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater ",,,855.96,6330.57,233 CPT,28041,"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater ",,,855.96,6330.57,233 CPT,28043,"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm ",,,510.77,3755.0,233 CPT,28045,"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm ",,,855.96,12562.0,233 CPT,28046,"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm ",,,855.96,12562.0,233 CPT,28047,"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater ",,,855.96,15059.0,233 CPT,28050,Arthrotomy with biopsy; intertarsal or tarsometatarsal joint ,,,948.0,7473.24,233 CPT,28052,Arthrotomy with biopsy; metatarsophalangeal joint ,,,948.0,7473.24,233 CPT,28054,Arthrotomy with biopsy; interphalangeal joint ,,,948.0,7473.24,233 CPT,28055,"Neurectomy, intrinsic musculature of foot ",,,692.94,8234.0,233 CPT,28060,"Fasciectomy, plantar fascia; partial (separate procedure) ",,,948.0,7473.24,233 CPT,28062,"Fasciectomy, plantar fascia; radical (separate procedure) ",,,948.0,12562.0,233 CPT,28070,"Synovectomy; intertarsal or tarsometatarsal joint, each ",,,948.0,16330.72,233 CPT,28072,"Synovectomy; metatarsophalangeal joint, each ",,,948.0,12562.0,233 CPT,28080,"Excision, interdigital (Morton) neuroma, single, each ",,,622.69,12562.0,233 CPT,28086,"Synovectomy, tendon sheath, foot; flexor ",,,948.0,7473.24,233 CPT,28088,"Synovectomy, tendon sheath, foot; extensor ",,,948.0,7473.24,233 CPT,28090,"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot ",,,622.69,12562.0,233 CPT,28092,"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each ",,,622.69,12562.0,233 CPT,28100,"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; ",,,948.0,7473.24,233 CPT,28102,"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,28103,"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft ",,,948.0,16330.72,233 CPT,28104,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; ",,,948.0,7473.24,233 CPT,28106,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft) ",,,948.0,16330.72,233 CPT,28107,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft ",,,948.0,16330.72,233 CPT,28108,"Excision or curettage of bone cyst or benign tumor, phalanges of foot ",,,622.69,5571.0,233 CPT,28110,"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) ",,,948.0,12562.0,233 CPT,28111,"Ostectomy, complete excision; first metatarsal head ",,,948.0,12562.0,233 CPT,28112,"Ostectomy, complete excision; other metatarsal head (second, third or fourth) ",,,948.0,12562.0,233 CPT,28113,"Ostectomy, complete excision; fifth metatarsal head ",,,948.0,12562.0,233 CPT,28114,"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, Clayton type procedure) ",,,948.0,12562.0,233 CPT,28116,"Ostectomy, excision of tarsal coalition ",,,948.0,12562.0,233 CPT,28118,"Ostectomy, calcaneus; ",,,948.0,8234.0,233 CPT,28119,"Ostectomy, calcaneus; for spur, with or without plantar fascial release ",,,948.0,8234.0,233 CPT,28120,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus ",,,948.0,12909.0,233 CPT,28122,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus ",,,948.0,12562.0,233 CPT,28124,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe ",,,250.29,12562.0,233 CPT,28126,"Resection, partial or complete, phalangeal base, each toe ",,,948.0,12562.0,233 CPT,28130,Talectomy (astragalectomy) ,,,948.0,16330.72,233 CPT,28140,Metatarsectomy ,,,948.0,12562.0,233 CPT,28150,"Phalangectomy, toe, each toe ",,,948.0,12562.0,233 CPT,28153,"Resection, condyle(s), distal end of phalanx, each toe ",,,948.0,12562.0,233 CPT,28160,"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each ",,,948.0,12562.0,233 CPT,28171,Radical resection of tumor; tarsal (except talus or calcaneus) ,,,948.0,12562.0,233 CPT,28173,Radical resection of tumor; metatarsal ,,,948.0,12562.0,233 CPT,28175,Radical resection of tumor; phalanx of toe ,,,622.69,12562.0,233 CPT,28190,"Removal of foreign body, foot; subcutaneous ",,,145.93,3249.0,233 CPT,28192,"Removal of foreign body, foot; deep ",,,510.77,3755.0,233 CPT,28193,"Removal of foreign body, foot; complicated ",,,510.77,8234.0,233 CPT,28200,"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon ",,,1142.68,12562.0,213 CPT,28200,"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon High Cost Surgery",,,2369.0,2369.0,20 CPT,28202,"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft) ",,,2699.0,16330.72,213 CPT,28202,"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft) High Cost Surgery",,,2369.0,2369.0,20 CPT,28208,"Repair, tendon, extensor, foot; primary or secondary, each tendon ",,,1142.68,12562.0,213 CPT,28208,"Repair, tendon, extensor, foot; primary or secondary, each tendon High Cost Surgery",,,2369.0,2369.0,20 CPT,28210,"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft) ",,,2699.0,16330.72,213 CPT,28210,"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft) High Cost Surgery",,,2369.0,2369.0,20 CPT,28220,"Tenolysis, flexor, foot; single tendon ",,,238.37,13835.0,213 CPT,28220,"Tenolysis, flexor, foot; single tendon High Cost Surgery",,,2369.0,2369.0,20 CPT,28222,"Tenolysis, flexor, foot; multiple tendons ",,,1142.68,7473.24,213 CPT,28222,"Tenolysis, flexor, foot; multiple tendons High Cost Surgery",,,2369.0,2369.0,20 CPT,28225,"Tenolysis, extensor, foot; single tendon ",,,1142.68,7473.24,213 CPT,28225,"Tenolysis, extensor, foot; single tendon High Cost Surgery",,,2369.0,2369.0,20 CPT,28226,"Tenolysis, extensor, foot; multiple tendons ",,,1142.68,7473.24,213 CPT,28226,"Tenolysis, extensor, foot; multiple tendons High Cost Surgery",,,2369.0,2369.0,20 CPT,28230,"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure) ",,,232.85,13835.0,213 CPT,28230,"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28232,"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) ",,,213.95,13835.0,213 CPT,28232,"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28234,"Tenotomy, open, extensor, foot or toe, each tendon ",,,622.69,5571.0,213 CPT,28234,"Tenotomy, open, extensor, foot or toe, each tendon High Cost Surgery",,,2369.0,2369.0,20 CPT,28238,"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure) ",,,2518.45,16330.72,213 CPT,28238,"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28240,"Tenotomy, lengthening, or release, abductor hallucis muscle ",,,1142.68,7473.24,213 CPT,28240,"Tenotomy, lengthening, or release, abductor hallucis muscle High Cost Surgery",,,2369.0,2369.0,20 CPT,28250,"Division of plantar fascia and muscle (eg, Steindler stripping) (separate procedure) ",,,1142.68,12562.0,213 CPT,28250,"Division of plantar fascia and muscle (eg, Steindler stripping) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28260,"Capsulotomy, midfoot; medial release only (separate procedure) ",,,1142.68,12562.0,213 CPT,28260,"Capsulotomy, midfoot; medial release only (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28261,"Capsulotomy, midfoot; with tendon lengthening ",,,622.69,12562.0,213 CPT,28261,"Capsulotomy, midfoot; with tendon lengthening High Cost Surgery",,,2369.0,2369.0,20 CPT,28262,"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity) ",,,2518.45,16330.72,213 CPT,28262,"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity) High Cost Surgery",,,2369.0,2369.0,20 CPT,28264,"Capsulotomy, midtarsal (eg, Heyman type procedure) ",,,622.69,9653.0,213 CPT,28264,"Capsulotomy, midtarsal (eg, Heyman type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28270,"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) ",,,1142.68,12562.0,213 CPT,28270,"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28272,"Capsulotomy; interphalangeal joint, each joint (separate procedure) ",,,206.1,13835.0,213 CPT,28272,"Capsulotomy; interphalangeal joint, each joint (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28280,"Syndactylization, toes (eg, webbing or Kelikian type procedure) ",,,1142.68,7473.24,213 CPT,28280,"Syndactylization, toes (eg, webbing or Kelikian type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) ",,,1142.68,12562.0,213 CPT,28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) High Cost Surgery",,,2369.0,2369.0,20 CPT,28286,"Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type procedure) ",,,1142.68,8234.0,213 CPT,28286,"Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head ",,,1142.68,12562.0,213 CPT,28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head High Cost Surgery",,,2369.0,2369.0,20 CPT,28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant ",,,1142.68,12562.0,213 CPT,28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant High Cost Surgery",,,2369.0,2369.0,20 CPT,28290,CORRECTION OF BUNION ,,,4988.0,7014.0,24 CPT,28291,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant ",,,2699.0,16330.72,205 CPT,28291,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant High Cost Surgery",,,2369.0,2369.0,20 CPT,28292,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method ",,,1142.68,7473.24,213 CPT,28292,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28293,CORRECTION OF BUNION ,,,4988.0,7014.0,24 CPT,28294,CORRECTION OF BUNION ,,,4988.0,7014.0,24 CPT,28295,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method ",,,1142.68,12562.0,205 CPT,28295,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28296,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method ",,,1142.68,12562.0,213 CPT,28296,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28297,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method ",,,2699.0,16330.72,213 CPT,28297,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28298,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method ",,,2699.0,16330.72,213 CPT,28298,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28299,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method ",,,3289.21,16330.72,213 CPT,28299,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method High Cost Surgery",,,2369.0,2369.0,20 CPT,28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation ",,,2195.0,16330.72,213 CPT,28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation High Cost Surgery",,,2369.0,2369.0,20 CPT,28302,Osteotomy; talus ,,,2195.0,16330.72,213 CPT,28302,Osteotomy; talus High Cost Surgery,,,2369.0,2369.0,20 CPT,28304,"Osteotomy, tarsal bones, other than calcaneus or talus; ",,,2195.0,16330.72,213 CPT,28304,"Osteotomy, tarsal bones, other than calcaneus or talus; High Cost Surgery",,,2369.0,2369.0,20 CPT,28305,"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, Fowler type) ",,,2699.0,16330.72,213 CPT,28305,"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, Fowler type) High Cost Surgery",,,2369.0,2369.0,20 CPT,28306,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal ",,,2518.45,16330.72,213 CPT,28306,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal High Cost Surgery",,,2369.0,2369.0,20 CPT,28307,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe) ",,,2518.45,16330.72,213 CPT,28307,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe) High Cost Surgery",,,2369.0,2369.0,20 CPT,28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each ",,,1142.68,7473.24,213 CPT,28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28309,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, Swanson type cavus foot procedure) ",,,2996.0,16330.72,213 CPT,28309,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, Swanson type cavus foot procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28310,"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure) ",,,2518.45,16330.72,213 CPT,28310,"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28312,"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe ",,,1142.68,12562.0,213 CPT,28312,"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe High Cost Surgery",,,2369.0,2369.0,20 CPT,28313,"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes) ",,,1142.68,7473.24,213 CPT,28313,"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes) High Cost Surgery",,,2369.0,2369.0,20 CPT,28315,"Sesamoidectomy, first toe (separate procedure) ",,,1142.68,8234.0,213 CPT,28315,"Sesamoidectomy, first toe (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28320,"Repair, nonunion or malunion; tarsal bones ",,,2996.0,32488.94,213 CPT,28320,"Repair, nonunion or malunion; tarsal bones High Cost Surgery",,,2369.0,2369.0,20 CPT,28322,"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft) ",,,2996.0,16330.72,213 CPT,28322,"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft) High Cost Surgery",,,2369.0,2369.0,20 CPT,28340,"Reconstruction, toe, macrodactyly; soft tissue resection ",,,2996.0,8234.0,186 CPT,28340,"Reconstruction, toe, macrodactyly; soft tissue resection High Cost Surgery",,,2369.0,2369.0,20 CPT,28341,"Reconstruction, toe, macrodactyly; requiring bone resection ",,,1142.68,8234.0,213 CPT,28341,"Reconstruction, toe, macrodactyly; requiring bone resection High Cost Surgery",,,2369.0,2369.0,20 CPT,28344,"Reconstruction, toe(s); polydactyly ",,,1142.68,8234.0,213 CPT,28344,"Reconstruction, toe(s); polydactyly High Cost Surgery",,,2369.0,2369.0,20 CPT,28345,"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web ",,,622.69,8234.0,213 CPT,28345,"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web High Cost Surgery",,,2369.0,2369.0,20 CPT,28360,"Reconstruction, cleft foot ",,,7325.73,16330.72,90 CPT,28360,"Reconstruction, cleft foot High Cost Surgery",,,2369.0,2369.0,20 CPT,28400,Closed treatment of calcaneal fracture; without manipulation ,,,89.59,5841.0,225 CPT,28405,Closed treatment of calcaneal fracture; with manipulation ,,,89.59,5841.0,225 CPT,28406,"Percutaneous skeletal fixation of calcaneal fracture, with manipulation ",,,948.0,16330.72,233 CPT,28415,"Open treatment of calcaneal fracture, includes internal fixation, when performed; ",,,948.0,16330.72,233 CPT,28420,"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft) ",,,948.0,32488.94,233 CPT,28430,Closed treatment of talus fracture; without manipulation ,,,89.59,5841.0,225 CPT,28435,Closed treatment of talus fracture; with manipulation ,,,622.69,3755.0,233 CPT,28436,"Percutaneous skeletal fixation of talus fracture, with manipulation ",,,948.0,16330.72,233 CPT,28445,"Open treatment of talus fracture, includes internal fixation, when performed ",,,948.0,16330.72,233 CPT,28446,"Open osteochondral autograft, talus (includes obtaining graftºs») ",,,948.0,16330.72,233 CPT,28450,"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each ",,,89.59,5841.0,225 CPT,28455,"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each ",,,146.22,5841.0,225 CPT,28456,"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each ",,,948.0,16330.72,206 CPT,28465,"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each ",,,2699.0,16330.72,213 CPT,28465,"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28470,"Closed treatment of metatarsal fracture; without manipulation, each ",,,89.59,5841.0,205 CPT,28470,"Closed treatment of metatarsal fracture; without manipulation, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28475,"Closed treatment of metatarsal fracture; with manipulation, each ",,,89.59,5841.0,205 CPT,28475,"Closed treatment of metatarsal fracture; with manipulation, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28476,"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each ",,,1142.68,7473.24,213 CPT,28476,"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each ",,,2996.0,16330.72,213 CPT,28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28490,"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation ",,,83.14,5841.0,205 CPT,28490,"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28495,"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation ",,,89.59,5841.0,205 CPT,28495,"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28496,"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation ",,,1142.68,7473.24,213 CPT,28496,"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28505,"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed ",,,1142.68,12562.0,213 CPT,28505,"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28510,"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each ",,,65.99,5841.0,205 CPT,28510,"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28515,"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each ",,,89.59,5841.0,205 CPT,28515,"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28525,"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each ",,,1142.68,12562.0,213 CPT,28525,"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each High Cost Surgery",,,2369.0,2369.0,20 CPT,28530,Closed treatment of sesamoid fracture ,,,249.03,5841.0,178 CPT,28530,Closed treatment of sesamoid fracture High Cost Surgery,,,2369.0,2369.0,20 CPT,28531,"Open treatment of sesamoid fracture, with or without internal fixation ",,,2518.45,16330.72,213 CPT,28531,"Open treatment of sesamoid fracture, with or without internal fixation High Cost Surgery",,,2369.0,2369.0,20 CPT,28540,"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia ",,,89.59,5841.0,205 CPT,28540,"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia High Cost Surgery",,,2369.0,2369.0,20 CPT,28545,"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia ",,,1142.68,7473.24,213 CPT,28545,"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia High Cost Surgery",,,2369.0,2369.0,20 CPT,28546,"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation ",,,622.69,5571.0,213 CPT,28546,"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28555,"Open treatment of tarsal bone dislocation, includes internal fixation, when performed ",,,2195.0,16330.72,213 CPT,28555,"Open treatment of tarsal bone dislocation, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28570,Closed treatment of talotarsal joint dislocation; without anesthesia ,,,89.59,5841.0,205 CPT,28570,Closed treatment of talotarsal joint dislocation; without anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28575,Closed treatment of talotarsal joint dislocation; requiring anesthesia ,,,1142.68,7473.24,213 CPT,28575,Closed treatment of talotarsal joint dislocation; requiring anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28576,"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation ",,,2518.45,16330.72,213 CPT,28576,"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28585,"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed ",,,2699.0,16330.72,213 CPT,28585,"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28600,Closed treatment of tarsometatarsal joint dislocation; without anesthesia ,,,89.59,5841.0,205 CPT,28600,Closed treatment of tarsometatarsal joint dislocation; without anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28605,Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia ,,,89.59,5841.0,205 CPT,28605,Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28606,"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation ",,,1142.68,7473.24,213 CPT,28606,"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28615,"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed ",,,2699.0,16330.72,213 CPT,28615,"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28630,Closed treatment of metatarsophalangeal joint dislocation; without anesthesia ,,,74.13,5841.0,205 CPT,28630,Closed treatment of metatarsophalangeal joint dislocation; without anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28635,Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia ,,,622.69,3700.21,213 CPT,28635,Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28636,"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation ",,,1142.68,12562.0,213 CPT,28636,"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28645,"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed ",,,1142.68,12562.0,213 CPT,28645,"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28660,Closed treatment of interphalangeal joint dislocation; without anesthesia ,,,62.21,5841.0,205 CPT,28660,Closed treatment of interphalangeal joint dislocation; without anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28665,Closed treatment of interphalangeal joint dislocation; requiring anesthesia ,,,104.85,5841.0,205 CPT,28665,Closed treatment of interphalangeal joint dislocation; requiring anesthesia High Cost Surgery,,,2369.0,2369.0,20 CPT,28666,"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation ",,,1142.68,12562.0,213 CPT,28666,"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,28675,"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed ",,,1142.68,12562.0,213 CPT,28675,"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,28705,Arthrodesis; pantalar ,,,2996.0,43532.8,213 CPT,28705,Arthrodesis; pantalar High Cost Surgery,,,2369.0,2369.0,20 CPT,28715,Arthrodesis; triple ,,,2996.0,32488.94,213 CPT,28715,Arthrodesis; triple High Cost Surgery,,,2369.0,2369.0,20 CPT,28725,Arthrodesis; subtalar ,,,2996.0,32488.94,213 CPT,28725,Arthrodesis; subtalar High Cost Surgery,,,2369.0,2369.0,20 CPT,28730,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; ",,,2996.0,32488.94,213 CPT,28730,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; High Cost Surgery",,,2369.0,2369.0,20 CPT,28735,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) ",,,2996.0,32488.94,213 CPT,28735,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) High Cost Surgery",,,2369.0,2369.0,20 CPT,28737,"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure) ",,,3293.0,32488.94,213 CPT,28737,"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint ",,,2996.0,16330.72,213 CPT,28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint High Cost Surgery",,,2369.0,2369.0,20 CPT,28750,"Arthrodesis, great toe; metatarsophalangeal joint ",,,2996.0,16330.72,213 CPT,28750,"Arthrodesis, great toe; metatarsophalangeal joint High Cost Surgery",,,2369.0,2369.0,20 CPT,28755,"Arthrodesis, great toe; interphalangeal joint ",,,948.0,16330.72,233 CPT,28760,"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, Jones type procedure) ",,,948.0,16330.72,233 CPT,28800,"Amputation, foot; midtarsal (eg, Chopart type procedure) ",,,948.0,16207.0,205 CPT,28805,"Amputation, foot; transmetatarsal ",,,948.0,13835.0,206 CPT,28810,"Amputation, metatarsal, with toe, single ",,,948.0,7473.24,233 CPT,28820,"Amputation, toe; metatarsophalangeal joint ",,,948.0,7473.24,233 CPT,28825,"Amputation, toe; interphalangeal joint ",,,948.0,7473.24,233 CPT,28890,"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the planta",,,948.0,13835.0,206 CPT,28899,"Unlisted procedure, foot or toes ",,,249.03,13835.0,198 CPT,29000,Application of halo type body cast (see 20661-20663 for insertion) ,,,104.85,5841.0,129 CPT,29010,"Application of Risser jacket, localizer, body; only ",,,104.85,5841.0,129 CPT,29015,"Application of Risser jacket, localizer, body; including head ",,,104.85,5841.0,129 CPT,29020,APPLICATION OF BODY CAST ,,,3390.0,5841.0,16 CPT,29025,APPLICATION OF BODY CAST ,,,3390.0,5841.0,16 CPT,29035,"Application of body cast, shoulder to hips; ",,,104.85,5841.0,129 CPT,29040,"Application of body cast, shoulder to hips; including head, Minerva type ",,,104.85,5841.0,129 CPT,29044,"Application of body cast, shoulder to hips; including 1 thigh ",,,61.4,5841.0,129 CPT,29046,"Application of body cast, shoulder to hips; including both thighs ",,,104.85,5841.0,129 CPT,29049,"Application, cast; figure-of-eight ",,,53.19,5841.0,129 CPT,29055,"Application, cast; shoulder spica ",,,104.85,5841.0,129 CPT,29058,"Application, cast; plaster Velpeau ",,,59.59,5841.0,129 CPT,29065,"Application, cast; shoulder to hand (long arm) ",,,51.74,5841.0,129 CPT,29075,"Application, cast; elbow to finger (short arm) ",,,47.39,5841.0,129 CPT,29085,"Application, cast; hand and lower forearm (gauntlet) ",,,51.17,5841.0,129 CPT,29086,"Application, cast; finger (eg, contracture) ",,,44.48,5841.0,129 CPT,29105,Application of long arm splint (shoulder to hand) ,,,42.15,5841.0,129 CPT,29125,Application of short arm splint (forearm to hand); static ,,,134.32,5841.0,102 CPT,29126,Application of short arm splint (forearm to hand); dynamic ,,,134.32,5841.0,102 CPT,29130,Application of finger splint; static ,,,112.77,5841.0,102 CPT,29131,Application of finger splint; dynamic ,,,59.56,5841.0,102 CPT,29200,Strapping; thorax ,,,16.57,5841.0,129 CPT,29220,STRAPPING OF LOW BACK ,,,3390.0,5841.0,16 CPT,29240,"Strapping; shoulder (eg, Velpeau) ",,,134.32,5841.0,102 CPT,29260,Strapping; elbow or wrist ,,,59.56,5841.0,102 CPT,29280,Strapping; hand or finger ,,,59.56,5841.0,102 CPT,29305,Application of hip spica cast; 1 leg ,,,104.85,5841.0,225 CPT,29325,Application of hip spica cast; 1 and one-half spica or both legs ,,,104.85,5841.0,225 CPT,29345,Application of long leg cast (thigh to toes); ,,,66.85,5841.0,225 CPT,29355,Application of long leg cast (thigh to toes); walker or ambulatory type ,,,68.02,5841.0,129 CPT,29358,Application of long leg cast brace ,,,86.04,5841.0,129 CPT,29365,Application of cylinder cast (thigh to ankle) ,,,63.37,5841.0,129 CPT,29405,Application of short leg cast (below knee to toes); ,,,40.98,5841.0,129 CPT,29425,Application of short leg cast (below knee to toes); walking or ambulatory type ,,,37.79,5841.0,129 CPT,29435,Application of patellar tendon bearing (PTB) cast ,,,55.52,5841.0,129 CPT,29440,Adding walker to previously applied cast ,,,18.03,5841.0,129 CPT,29445,Application of rigid total contact leg cast ,,,52.44,5841.0,129 CPT,29450,"Application of clubfoot cast with molding or manipulation, long or short leg ",,,56.68,5841.0,129 CPT,29505,Application of long leg splint (thigh to ankle or toes) ,,,50.87,5841.0,129 CPT,29515,Application of short leg splint (calf to foot) ,,,36.05,5841.0,129 CPT,29520,Strapping; hip ,,,112.77,5841.0,102 CPT,29530,Strapping; knee ,,,134.32,5841.0,102 CPT,29540,Strapping; ankle and/or foot ,,,11.34,5841.0,129 CPT,29550,Strapping; toes ,,,59.56,5841.0,102 CPT,29580,Strapping; Unna boot ,,,34.78,5841.0,129 CPT,29581,"Application of multi-layer compression system; leg (below knee), including ankle and foot ",,,54.34,5841.0,129 CPT,29582,"HApplication of multi-layer compression system; thigh and leg, including ankle and foot, when performed ",,,2358.0,5841.0,16 CPT,29583,HApplication of multi-layer compression system; upper arm and forearm ,,,2358.0,5841.0,16 CPT,29584,"Application of multi-layer compression system; upper arm, forearm, hand, and fingers ",,,61.05,5841.0,129 CPT,29590,APPLICATION OF FOOT SPLINT ,,,3390.0,5841.0,16 CPT,29700,"Removal or bivalving; gauntlet, boot or body cast ",,,33.14,5841.0,129 CPT,29705,Removal or bivalving; full arm or full leg cast ,,,28.49,5841.0,129 CPT,29710,"Removal or bivalving; shoulder or hip spica, Minerva, or Risser jacket, etc. ",,,56.97,5841.0,129 CPT,29715,REMOVAL/REVISION OF CAST ,,,3390.0,5841.0,16 CPT,29720,"Repair of spica, body cast or jacket ",,,48.54,5841.0,129 CPT,29730,Windowing of cast ,,,29.07,5841.0,129 CPT,29740,Wedging of cast (except clubfoot casts) ,,,45.06,5841.0,129 CPT,29750,Wedging of clubfoot cast ,,,282.37,5841.0,102 CPT,29799,"Unlisted procedure, casting or strapping ",,,164.06,5841.0,102 CPT,29800,"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure) ",,,1142.68,12562.0,129 CPT,29800,"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29804,"Arthroscopy, temporomandibular joint, surgical ",,,1142.68,12562.0,129 CPT,29804,"Arthroscopy, temporomandibular joint, surgical High Cost Surgery",,,2369.0,2369.0,20 CPT,29805,"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure) ",,,1142.68,12562.0,129 CPT,29805,"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29806,"Arthroscopy, shoulder, surgical; capsulorrhaphy ",,,2518.45,16330.72,129 CPT,29806,"Arthroscopy, shoulder, surgical; capsulorrhaphy High Cost Surgery",,,2369.0,2369.0,20 CPT,29807,"Arthroscopy, shoulder, surgical; repair of SLAP lesion ",,,2518.45,16330.72,129 CPT,29807,"Arthroscopy, shoulder, surgical; repair of SLAP lesion High Cost Surgery",,,2369.0,2369.0,20 CPT,29815,SHOULDER ARTHROSCOPY ,,,3390.0,5841.0,16 CPT,29819,"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body ",,,1142.68,12562.0,129 CPT,29819,"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,29820,"Arthroscopy, shoulder, surgical; synovectomy, partial ",,,2518.45,16330.72,129 CPT,29820,"Arthroscopy, shoulder, surgical; synovectomy, partial High Cost Surgery",,,2369.0,2369.0,20 CPT,29821,"Arthroscopy, shoulder, surgical; synovectomy, complete ",,,1142.68,12562.0,129 CPT,29821,"Arthroscopy, shoulder, surgical; synovectomy, complete High Cost Surgery",,,2369.0,2369.0,20 CPT,29822,"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps ancho",,,1142.68,12562.0,149 CPT,29823,"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps ",,,1142.68,12562.0,149 CPT,29824,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) ",,,1142.68,13394.0,129 CPT,29824,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29825,"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation ",,,1142.68,12562.0,129 CPT,29825,"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation High Cost Surgery",,,2369.0,2369.0,20 CPT,29826,"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for",,,1672.0,12562.0,77 CPT,29827,"Arthroscopy, shoulder, surgical; with rotator cuff repair ",,,2518.45,16330.72,129 CPT,29827,"Arthroscopy, shoulder, surgical; with rotator cuff repair High Cost Surgery",,,2369.0,2369.0,20 CPT,29828,"Arthroscopy, shoulder, surgical; biceps tenodesis ",,,2518.45,16330.72,129 CPT,29828,"Arthroscopy, shoulder, surgical; biceps tenodesis High Cost Surgery",,,2369.0,2369.0,20 CPT,29830,"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure) ",,,1142.68,12562.0,129 CPT,29830,"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29834,"Arthroscopy, elbow, surgical; with removal of loose body or foreign body ",,,1142.68,12562.0,129 CPT,29834,"Arthroscopy, elbow, surgical; with removal of loose body or foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,29835,"Arthroscopy, elbow, surgical; synovectomy, partial ",,,1142.68,12562.0,129 CPT,29835,"Arthroscopy, elbow, surgical; synovectomy, partial High Cost Surgery",,,2369.0,2369.0,20 CPT,29836,"Arthroscopy, elbow, surgical; synovectomy, complete ",,,2518.45,16330.72,129 CPT,29836,"Arthroscopy, elbow, surgical; synovectomy, complete High Cost Surgery",,,2369.0,2369.0,20 CPT,29837,"Arthroscopy, elbow, surgical; debridement, limited ",,,1142.68,12562.0,129 CPT,29837,"Arthroscopy, elbow, surgical; debridement, limited High Cost Surgery",,,2369.0,2369.0,20 CPT,29838,"Arthroscopy, elbow, surgical; debridement, extensive ",,,1142.68,12562.0,129 CPT,29838,"Arthroscopy, elbow, surgical; debridement, extensive High Cost Surgery",,,2369.0,2369.0,20 CPT,29840,"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure) ",,,1142.68,12562.0,129 CPT,29840,"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29843,"Arthroscopy, wrist, surgical; for infection, lavage and drainage ",,,1142.68,12562.0,129 CPT,29843,"Arthroscopy, wrist, surgical; for infection, lavage and drainage High Cost Surgery",,,2369.0,2369.0,20 CPT,29844,"Arthroscopy, wrist, surgical; synovectomy, partial ",,,1142.68,12562.0,129 CPT,29844,"Arthroscopy, wrist, surgical; synovectomy, partial High Cost Surgery",,,2369.0,2369.0,20 CPT,29845,"Arthroscopy, wrist, surgical; synovectomy, complete ",,,1142.68,12562.0,129 CPT,29845,"Arthroscopy, wrist, surgical; synovectomy, complete High Cost Surgery",,,2369.0,2369.0,20 CPT,29846,"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement ",,,1142.68,12562.0,129 CPT,29846,"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement High Cost Surgery",,,2369.0,2369.0,20 CPT,29847,"Arthroscopy, wrist, surgical; internal fixation for fracture or instability ",,,2518.45,16330.72,129 CPT,29847,"Arthroscopy, wrist, surgical; internal fixation for fracture or instability High Cost Surgery",,,2369.0,2369.0,20 CPT,29848,"Endoscopy, wrist, surgical, with release of transverse carpal ligament ",,,622.69,15059.0,129 CPT,29848,"Endoscopy, wrist, surgical, with release of transverse carpal ligament High Cost Surgery",,,2369.0,2369.0,20 CPT,29850,"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy) ",,,622.69,26654.0,111 CPT,29850,"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy) High Co",,,2369.0,2369.0,20 CPT,29851,"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy) ",,,622.69,26654.0,111 CPT,29851,"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy) High Cost ",,,2369.0,2369.0,20 CPT,29855,"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy) ",,,3813.28,26654.0,111 CPT,29855,"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy) High Cost Surgery",,,2369.0,2369.0,20 CPT,29856,"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy) ",,,5202.0,65905.0,111 CPT,29856,"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy) High Cost Surgery",,,2369.0,2369.0,20 CPT,29860,"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure) ",,,2518.45,26654.0,111 CPT,29860,"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29861,"Arthroscopy, hip, surgical; with removal of loose body or foreign body ",,,2518.45,26654.0,111 CPT,29861,"Arthroscopy, hip, surgical; with removal of loose body or foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,29862,"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum ",,,2518.45,26654.0,111 CPT,29862,"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum High Cost Surgery",,,2369.0,2369.0,20 CPT,29863,"Arthroscopy, hip, surgical; with synovectomy ",,,1142.68,14052.0,111 CPT,29863,"Arthroscopy, hip, surgical; with synovectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,29866,"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograftºs») ",,,2518.45,26654.0,111 CPT,29866,"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograftºs») High Cost Surgery",,,2369.0,2369.0,20 CPT,29867,"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) ",,,5202.0,65905.0,84 CPT,29867,"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) High Cost Surgery",,,2369.0,2369.0,20 CPT,29868,"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral ",,,5202.0,26654.0,84 CPT,29868,"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral High Cost Surgery",,,2369.0,2369.0,20 CPT,29870,"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) ",,,1142.68,14052.0,111 CPT,29870,"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29871,"Arthroscopy, knee, surgical; for infection, lavage and drainage ",,,1142.68,14052.0,111 CPT,29871,"Arthroscopy, knee, surgical; for infection, lavage and drainage High Cost Surgery",,,2369.0,2369.0,20 CPT,29873,"Arthroscopy, knee, surgical; with lateral release ",,,1142.68,14052.0,111 CPT,29873,"Arthroscopy, knee, surgical; with lateral release High Cost Surgery",,,2369.0,2369.0,20 CPT,29874,"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation) ",,,1142.68,14052.0,111 CPT,29874,"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation) High Cost Surgery",,,2369.0,2369.0,20 CPT,29875,"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) ",,,1142.68,14052.0,111 CPT,29875,"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29876,"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) ",,,1142.68,14052.0,111 CPT,29876,"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) High Cost Surgery",,,2369.0,2369.0,20 CPT,29877,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) ",,,1142.68,14052.0,111 CPT,29877,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) High Cost Surgery",,,2369.0,2369.0,20 CPT,29879,"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture ",,,1142.68,14052.0,111 CPT,29879,"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture High Cost Surgery",,,2369.0,2369.0,20 CPT,29880,"Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s",,,1142.68,14052.0,131 CPT,29881,"Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s)",,,1142.68,14052.0,131 CPT,29882,"Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) ",,,1142.68,14052.0,111 CPT,29882,"Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) High Cost Surgery",,,2369.0,2369.0,20 CPT,29883,"Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) ",,,1142.68,14052.0,111 CPT,29883,"Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) High Cost Surgery",,,2369.0,2369.0,20 CPT,29884,"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) ",,,1142.68,14052.0,111 CPT,29884,"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,29885,"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion) ",,,3259.05,26654.0,111 CPT,29885,"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion) High Cost Surgery",,,2369.0,2369.0,20 CPT,29886,"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion ",,,1142.68,14052.0,111 CPT,29886,"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion High Cost Surgery",,,2369.0,2369.0,20 CPT,29887,"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation ",,,2518.45,26654.0,111 CPT,29887,"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation High Cost Surgery",,,2369.0,2369.0,20 CPT,29888,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction ,,,3465.05,26654.0,111 CPT,29888,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction High Cost Surgery,,,2369.0,2369.0,20 CPT,29889,Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction ,,,5202.0,65905.0,111 CPT,29889,Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction High Cost Surgery,,,2369.0,2369.0,20 CPT,29891,"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect ",,,1142.68,12562.0,129 CPT,29891,"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect High Cost Surgery",,,2369.0,2369.0,20 CPT,29892,"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) ",,,2518.45,16330.72,129 CPT,29892,"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) High Cost Surgery",,,2369.0,2369.0,20 CPT,29893,Endoscopic plantar fasciotomy ,,,1142.68,15059.0,129 CPT,29893,Endoscopic plantar fasciotomy High Cost Surgery,,,2369.0,2369.0,20 CPT,29894,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body ",,,1142.68,12562.0,129 CPT,29894,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,29895,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial ",,,1142.68,12562.0,129 CPT,29895,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial High Cost Surgery",,,2369.0,2369.0,20 CPT,29897,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited ",,,1142.68,12562.0,129 CPT,29897,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited High Cost Surgery",,,2369.0,2369.0,20 CPT,29898,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive ",,,1142.68,12562.0,129 CPT,29898,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive High Cost Surgery",,,2369.0,2369.0,20 CPT,29899,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis ",,,3364.75,16330.72,129 CPT,29899,"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis High Cost Surgery",,,2369.0,2369.0,20 CPT,29900,"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy ",,,1142.68,12562.0,129 CPT,29900,"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy High Cost Surgery",,,2369.0,2369.0,20 CPT,29901,"Arthroscopy, metacarpophalangeal joint, surgical; with debridement ",,,1142.68,12562.0,129 CPT,29901,"Arthroscopy, metacarpophalangeal joint, surgical; with debridement High Cost Surgery",,,2369.0,2369.0,20 CPT,29902,"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, Stener lesion) ",,,622.69,12562.0,129 CPT,29902,"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, Stener lesion) High Cost Surgery",,,2369.0,2369.0,20 CPT,29904,"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body ",,,1142.68,15059.0,129 CPT,29904,"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,29905,"Arthroscopy, subtalar joint, surgical; with synovectomy ",,,3323.3,16330.72,129 CPT,29905,"Arthroscopy, subtalar joint, surgical; with synovectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,29906,"Arthroscopy, subtalar joint, surgical; with debridement ",,,1142.68,15059.0,129 CPT,29906,"Arthroscopy, subtalar joint, surgical; with debridement High Cost Surgery",,,2369.0,2369.0,20 CPT,29907,"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis ",,,5202.0,32488.94,129 CPT,29907,"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis High Cost Surgery",,,2369.0,2369.0,20 CPT,29909,ARTHROSCOPY OF JOINT ,,,3390.0,5841.0,16 CPT,29914,"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion) ",,,2518.45,26654.0,111 CPT,29914,"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion) High Cost Surgery",,,2369.0,2369.0,20 CPT,29915,"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion) ",,,2518.45,26654.0,111 CPT,29915,"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion) High Cost Surgery",,,2369.0,2369.0,20 CPT,29916,"Arthroscopy, hip, surgical; with labral repair ",,,2518.45,26654.0,111 CPT,29916,"Arthroscopy, hip, surgical; with labral repair High Cost Surgery",,,2369.0,2369.0,20 CPT,29999,"Unlisted procedure, arthroscopy ",,,249.03,13835.0,102 CPT,29999,"Unlisted procedure, arthroscopy High Cost Surgery",,,2369.0,2369.0,20 CPT,30000,"Drainage abscess or hematoma, nasal, internal approach ",,,91.96,5841.0,225 CPT,30020,"Drainage abscess or hematoma, nasal septum ",,,189.24,5841.0,225 CPT,30100,"Biopsy, intranasal ",,,93.31,3128.0,233 CPT,30110,"Excision, nasal polyp(s), simple ",,,161.92,13835.0,233 CPT,30115,"Excision, nasal polyp(s), extensive ",,,930.95,7150.66,233 CPT,30117,"Excision or destruction (eg, laser), intranasal lesion; internal approach ",,,930.95,12562.0,233 CPT,30118,"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy) ",,,930.95,12562.0,233 CPT,30120,Excision or surgical planing of skin of nose for rhinophyma ,,,930.95,7150.66,233 CPT,30124,"Excision dermoid cyst, nose; simple, skin, subcutaneous ",,,441.67,7684.11,233 CPT,30125,"Excision dermoid cyst, nose; complex, under bone or cartilage ",,,948.0,13241.95,233 CPT,30130,"Excision inferior turbinate, partial or complete, any method ",,,930.95,12562.0,233 CPT,30140,"Submucous resection inferior turbinate, partial or complete, any method ",,,930.95,7150.66,233 CPT,30150,Rhinectomy; partial ,,,948.0,13241.95,233 CPT,30160,Rhinectomy; total ,,,948.0,13241.95,233 CPT,30200,"Injection into turbinate(s), therapeutic ",,,70.63,3128.0,137 CPT,30210,Displacement therapy (Proetz type) ,,,93.89,3128.0,137 CPT,30220,"Insertion, nasal septal prosthesis (button) ",,,441.67,12562.0,233 CPT,30300,"Removal foreign body, intranasal; office type procedure ",,,134.32,5841.0,102 CPT,30310,"Removal foreign body, intranasal; requiring general anesthesia ",,,930.95,7150.66,233 CPT,30320,"Removal foreign body, intranasal; by lateral rhinotomy ",,,441.67,5571.0,233 CPT,30400,"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip ",,,948.0,13241.95,233 CPT,30410,"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip ",,,948.0,13394.0,233 CPT,30420,"Rhinoplasty, primary; including major septal repair ",,,2051.93,13394.0,213 CPT,30420,"Rhinoplasty, primary; including major septal repair High Cost Surgery",,,2369.0,2369.0,20 CPT,30430,"Rhinoplasty, secondary; minor revision (small amount of nasal tip work) ",,,2051.93,13241.95,213 CPT,30430,"Rhinoplasty, secondary; minor revision (small amount of nasal tip work) High Cost Surgery",,,2369.0,2369.0,20 CPT,30435,"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies) ",,,2051.93,13394.0,213 CPT,30435,"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies) High Cost Surgery",,,2369.0,2369.0,20 CPT,30450,"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies) ",,,2051.93,13241.95,213 CPT,30450,"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies) High Cost Surgery",,,2369.0,2369.0,20 CPT,30460,"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only ",,,2051.93,13241.95,213 CPT,30460,"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only High Cost Surgery",,,2369.0,2369.0,20 CPT,30462,"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies ",,,2051.93,15059.0,213 CPT,30462,"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies High Cost Surgery",,,2369.0,2369.0,20 CPT,30465,"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction) ",,,2051.93,15059.0,213 CPT,30465,"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction) High Cost Surgery",,,2369.0,2369.0,20 CPT,30468,Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s) ,,,2985.24,15059.0,205 CPT,30468,Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s) High Cost Surgery,,,2369.0,2369.0,20 CPT,30469,"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling ",,,2985.24,15059.0,205 CPT,30469,"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling High Cost Surgery",,,2369.0,2369.0,20 CPT,30520,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft ",,,930.95,8234.0,213 CPT,30520,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft High Cost Surgery",,,2369.0,2369.0,20 CPT,30540,Repair choanal atresia; intranasal ,,,2051.93,13394.0,213 CPT,30540,Repair choanal atresia; intranasal High Cost Surgery,,,2369.0,2369.0,20 CPT,30545,Repair choanal atresia; transpalatine ,,,2051.93,13394.0,213 CPT,30545,Repair choanal atresia; transpalatine High Cost Surgery,,,2369.0,2369.0,20 CPT,30560,Lysis intranasal synechia ,,,196.58,5841.0,205 CPT,30560,Lysis intranasal synechia High Cost Surgery,,,2369.0,2369.0,20 CPT,30580,Repair fistula; oromaxillary (combine with 31030 if antrotomy is included) ,,,2051.93,13241.95,213 CPT,30580,Repair fistula; oromaxillary (combine with 31030 if antrotomy is included) High Cost Surgery,,,2369.0,2369.0,20 CPT,30600,Repair fistula; oronasal ,,,2051.93,13241.95,213 CPT,30600,Repair fistula; oronasal High Cost Surgery,,,2369.0,2369.0,20 CPT,30620,Septal or other intranasal dermatoplasty (does not include obtaining graft) ,,,2051.93,13241.95,213 CPT,30620,Septal or other intranasal dermatoplasty (does not include obtaining graft) High Cost Surgery,,,2369.0,2369.0,20 CPT,30630,Repair nasal septal perforations ,,,930.95,12909.0,213 CPT,30630,Repair nasal septal perforations High Cost Surgery,,,2369.0,2369.0,20 CPT,30801,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial ",,,441.67,3683.7,233 CPT,30802,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal) ",,,441.67,3683.7,233 CPT,30901,"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method ",,,134.32,5841.0,198 CPT,30903,"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method ",,,49.01,5841.0,225 CPT,30905,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial ",,,49.01,5841.0,225 CPT,30906,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent ",,,91.96,5841.0,225 CPT,30915,Ligation arteries; ethmoidal ,,,948.0,7565.59,233 CPT,30920,"Ligation arteries; internal maxillary artery, transantral ",,,948.0,12562.0,233 CPT,30930,"Fracture nasal inferior turbinate(s), therapeutic ",,,930.95,8234.0,233 CPT,30999,"Unlisted procedure, nose ",,,239.12,13835.0,198 CPT,31000,Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium) ,,,91.96,5841.0,225 CPT,31002,Lavage by cannulation; sphenoid sinus ,,,622.42,7684.11,233 CPT,31020,"Sinusotomy, maxillary (antrotomy); intranasal ",,,930.95,7150.66,213 CPT,31020,"Sinusotomy, maxillary (antrotomy); intranasal High Cost Surgery",,,2369.0,2369.0,20 CPT,31030,"Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps ",,,2051.93,13241.95,213 CPT,31030,"Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps High Cost Surgery",,,2369.0,2369.0,20 CPT,31032,"Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps ",,,2051.93,13241.95,213 CPT,31032,"Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps High Cost Surgery",,,2369.0,2369.0,20 CPT,31040,"Pterygomaxillary fossa surgery, any approach ",,,2051.93,32170.6,117 CPT,31040,"Pterygomaxillary fossa surgery, any approach High Cost Surgery",,,2369.0,2369.0,20 CPT,31050,"Sinusotomy, sphenoid, with or without biopsy; ",,,2051.93,13241.95,213 CPT,31050,"Sinusotomy, sphenoid, with or without biopsy; High Cost Surgery",,,2369.0,2369.0,20 CPT,31051,"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s) ",,,2051.93,13241.95,213 CPT,31051,"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,31070,"Sinusotomy frontal; external, simple (trephine operation) ",,,2051.93,13241.95,213 CPT,31070,"Sinusotomy frontal; external, simple (trephine operation) High Cost Surgery",,,2369.0,2369.0,20 CPT,31075,"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type) ",,,2051.93,13241.95,213 CPT,31075,"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type) High Cost Surgery",,,2369.0,2369.0,20 CPT,31080,"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation) ",,,2051.93,13241.95,213 CPT,31080,"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation) High Cost Surgery",,,2369.0,2369.0,20 CPT,31081,"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation) ",,,2051.93,13241.95,213 CPT,31081,"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation) High Cost Surgery",,,2369.0,2369.0,20 CPT,31084,"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision ",,,2996.0,13241.95,186 CPT,31084,"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision High Cost Surgery",,,2369.0,2369.0,20 CPT,31085,"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision ",,,2905.52,13241.95,213 CPT,31085,"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision High Cost Surgery",,,2369.0,2369.0,20 CPT,31086,"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision ",,,2051.93,13241.95,213 CPT,31086,"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision High Cost Surgery",,,2369.0,2369.0,20 CPT,31087,"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision ",,,2051.93,13241.95,213 CPT,31087,"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision High Cost Surgery",,,2369.0,2369.0,20 CPT,31090,"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid) ",,,2051.93,13394.0,213 CPT,31090,"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid) High Cost Surgery",,,2369.0,2369.0,20 CPT,31200,"Ethmoidectomy; intranasal, anterior ",,,2051.93,13241.95,213 CPT,31200,"Ethmoidectomy; intranasal, anterior High Cost Surgery",,,2369.0,2369.0,20 CPT,31201,"Ethmoidectomy; intranasal, total ",,,441.67,13394.0,213 CPT,31201,"Ethmoidectomy; intranasal, total High Cost Surgery",,,2369.0,2369.0,20 CPT,31205,"Ethmoidectomy; extranasal, total ",,,930.95,12562.0,213 CPT,31205,"Ethmoidectomy; extranasal, total High Cost Surgery",,,2369.0,2369.0,20 CPT,31225,Maxillectomy; without orbital exenteration ,,,3390.0,22377.63,89 CPT,31225,Maxillectomy; without orbital exenteration High Cost Surgery,,,2369.0,2369.0,20 CPT,31230,Maxillectomy; with orbital exenteration (en bloc) ,,,3390.0,24729.87,89 CPT,31230,Maxillectomy; with orbital exenteration (en bloc) High Cost Surgery,,,2369.0,2369.0,20 CPT,31231,"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) ",,,71.55,5841.0,205 CPT,31231,"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,31233,"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture) ",,,163.37,5841.0,205 CPT,31233,"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture) High Cost Surgery",,,2369.0,2369.0,20 CPT,31235,"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium) ",,,552.0,3905.57,213 CPT,31235,"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium) High Cost Surgery",,,2369.0,2369.0,20 CPT,31237,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) ",,,552.0,3905.57,213 CPT,31237,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,31238,"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage ",,,552.0,3905.57,213 CPT,31238,"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage High Cost Surgery",,,2369.0,2369.0,20 CPT,31239,"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy ",,,1115.35,8234.0,213 CPT,31239,"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy High Cost Surgery",,,2369.0,2369.0,20 CPT,31240,"Nasal/sinus endoscopy, surgical; with concha bullosa resection ",,,552.0,5571.0,213 CPT,31240,"Nasal/sinus endoscopy, surgical; with concha bullosa resection High Cost Surgery",,,2369.0,2369.0,20 CPT,31241,"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery ",,,1796.95,13835.0,178 CPT,31241,"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery High Cost Surgery",,,2369.0,2369.0,20 CPT,31242,"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve ",,,2699.0,15232.61,170 CPT,31242,"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve High Cost Surgery",,,2369.0,2369.0,20 CPT,31243,"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve ",,,2699.0,15232.61,170 CPT,31243,"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve High Cost Surgery",,,2369.0,2369.0,20 CPT,31253,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed ",,,1711.63,15059.0,205 CPT,31253,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,31254,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior) ",,,1711.63,14852.18,213 CPT,31254,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior) High Cost Surgery",,,2369.0,2369.0,20 CPT,31255,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) ",,,1711.63,14852.18,213 CPT,31255,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) High Cost Surgery",,,2369.0,2369.0,20 CPT,31256,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; ",,,1115.35,12562.0,213 CPT,31256,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; High Cost Surgery",,,2369.0,2369.0,20 CPT,31257,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy ",,,1711.63,15059.0,205 CPT,31257,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy High Cost Surgery",,,2369.0,2369.0,20 CPT,31259,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus ",,,1711.63,15059.0,205 CPT,31259,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus High Cost Surgery",,,2369.0,2369.0,20 CPT,31267,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus ",,,1711.63,14852.18,213 CPT,31267,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus High Cost Surgery",,,2369.0,2369.0,20 CPT,31276,"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed ",,,1711.63,14852.18,213 CPT,31276,"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,31287,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; ",,,1711.63,14852.18,213 CPT,31287,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; High Cost Surgery",,,2369.0,2369.0,20 CPT,31288,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus ",,,1711.63,14852.18,213 CPT,31288,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus High Cost Surgery",,,2369.0,2369.0,20 CPT,31290,"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region ",,,2699.0,16207.0,185 CPT,31290,"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region High Cost Surgery",,,2369.0,2369.0,20 CPT,31291,"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region ",,,2699.0,16207.0,185 CPT,31291,"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region High Cost Surgery",,,2369.0,2369.0,20 CPT,31292,"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall ",,,2699.0,14852.18,186 CPT,31292,"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall High Cost Surgery",,,2369.0,2369.0,20 CPT,31293,"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall ",,,2699.0,14852.18,186 CPT,31293,"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall High Cost Surgery",,,2369.0,2369.0,20 CPT,31294,"Nasal/sinus endoscopy, surgical, with optic nerve decompression ",,,2699.0,14852.18,186 CPT,31294,"Nasal/sinus endoscopy, surgical, with optic nerve decompression High Cost Surgery",,,2369.0,2369.0,20 CPT,31295,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa ",,,1417.42,26083.02,213 CPT,31295,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa High Cost Surgery",,,2369.0,2369.0,20 CPT,31296,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium ",,,1426.13,26222.64,213 CPT,31296,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium High Cost Surgery",,,2369.0,2369.0,20 CPT,31297,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium ",,,1413.93,26015.86,213 CPT,31297,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium High Cost Surgery",,,2369.0,2369.0,20 CPT,31298,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia ",,,1711.63,27149.14,205 CPT,31298,"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia High Cost Surgery",,,2369.0,2369.0,20 CPT,31299,"Unlisted procedure, accessory sinuses ",,,239.12,13835.0,82 CPT,31299,"Unlisted procedure, accessory sinuses High Cost Surgery",,,2369.0,2369.0,20 CPT,31300,"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy ",,,930.95,13394.0,233 CPT,31320,"HLaryngotomy (thyrotomy, laryngofissure); diagnostic ",,,6326.0,9653.0,24 CPT,31360,"Laryngectomy; total, without radical neck dissection ",,,948.0,25344.45,109 CPT,31365,"Laryngectomy; total, with radical neck dissection ",,,948.0,31286.42,109 CPT,31367,"Laryngectomy; subtotal supraglottic, without radical neck dissection ",,,948.0,26798.1,109 CPT,31368,"Laryngectomy; subtotal supraglottic, with radical neck dissection ",,,948.0,29764.91,109 CPT,31370,Partial laryngectomy (hemilaryngectomy); horizontal ,,,948.0,25200.27,109 CPT,31375,Partial laryngectomy (hemilaryngectomy); laterovertical ,,,948.0,23877.97,109 CPT,31380,Partial laryngectomy (hemilaryngectomy); anterovertical ,,,948.0,23572.8,109 CPT,31382,Partial laryngectomy (hemilaryngectomy); antero-latero-vertical ,,,948.0,25861.53,109 CPT,31390,"Pharyngolaryngectomy, with radical neck dissection; without reconstruction ",,,948.0,34710.82,109 CPT,31395,"Pharyngolaryngectomy, with radical neck dissection; with reconstruction ",,,948.0,36626.52,109 CPT,31400,"Arytenoidectomy or arytenoidopexy, external approach ",,,948.0,13241.95,233 CPT,31420,Epiglottidectomy ,,,948.0,13241.95,233 CPT,31500,"Intubation, endotracheal, emergency procedure ",,,91.96,5841.0,225 CPT,31502,Tracheotomy tube change prior to establishment of fistula tract ,,,91.96,5841.0,225 CPT,31505,"Laryngoscopy, indirect; diagnostic (separate procedure) ",,,59.01,5841.0,129 CPT,31510,"Laryngoscopy, indirect; with biopsy ",,,948.0,8017.76,233 CPT,31511,"Laryngoscopy, indirect; with removal of foreign body ",,,71.55,5841.0,225 CPT,31512,"Laryngoscopy, indirect; with removal of lesion ",,,948.0,8017.76,233 CPT,31513,"Laryngoscopy, indirect; with vocal cord injection ",,,163.37,3755.0,233 CPT,31515,"Laryngoscopy direct, with or without tracheoscopy; for aspiration ",,,163.37,5841.0,225 CPT,31520,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn ",,,163.37,5841.0,225 CPT,31525,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn ",,,552.0,3905.57,233 CPT,31526,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope ",,,552.0,3905.57,233 CPT,31527,"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator ",,,948.0,8017.76,233 CPT,31528,"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial ",,,948.0,8017.76,233 CPT,31529,"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent ",,,948.0,8017.76,233 CPT,31530,"Laryngoscopy, direct, operative, with foreign body removal; ",,,552.0,3905.57,233 CPT,31531,"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope ",,,948.0,12562.0,233 CPT,31535,"Laryngoscopy, direct, operative, with biopsy; ",,,948.0,8017.76,233 CPT,31536,"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope ",,,948.0,12562.0,233 CPT,31540,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; ",,,948.0,12562.0,233 CPT,31541,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope ",,,948.0,8234.0,233 CPT,31545,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s) ",,,948.0,8234.0,233 CPT,31546,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft) ",,,948.0,14852.18,233 CPT,31551,"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age ",,,948.0,13835.0,225 CPT,31552,"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older ",,,948.0,13835.0,225 CPT,31553,"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age ",,,948.0,13835.0,225 CPT,31554,"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older ",,,948.0,13835.0,225 CPT,31560,"Laryngoscopy, direct, operative, with arytenoidectomy; ",,,948.0,14852.18,233 CPT,31561,"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope ",,,948.0,14852.18,233 CPT,31570,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; ",,,948.0,8017.76,233 CPT,31571,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope ",,,948.0,8017.76,233 CPT,31572,"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral ",,,948.0,12909.0,225 CPT,31573,"Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral ",,,168.89,12909.0,225 CPT,31574,"Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral ",,,552.0,12909.0,225 CPT,31575,"Laryngoscopy, flexible; diagnostic ",,,71.55,5841.0,225 CPT,31576,"Laryngoscopy, flexible; with biopsy(ies) ",,,552.0,3905.57,233 CPT,31577,"Laryngoscopy, flexible; with removal of foreign body(s) ",,,163.37,5841.0,225 CPT,31578,"Laryngoscopy, flexible; with removal of lesion(s), non-laser ",,,948.0,8017.76,233 CPT,31579,"Laryngoscopy, flexible or rigid telescopic, with stroboscopy ",,,109.88,5841.0,225 CPT,31580,"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion ",,,948.0,13394.0,233 CPT,31582,REVISION OF LARYNX ,,,6326.0,9653.0,24 CPT,31584,"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed ",,,948.0,13835.0,206 CPT,31585,TREAT LARYNX FRACTURE ,,,3390.0,5841.0,16 CPT,31586,TREAT LARYNX FRACTURE ,,,3390.0,5841.0,16 CPT,31587,"Laryngoplasty, cricoid split, without graft placement ",,,948.0,16207.0,206 CPT,31588,REVISION OF LARYNX ,,,6326.0,9653.0,24 CPT,31590,Laryngeal reinnervation by neuromuscular pedicle ,,,948.0,13394.0,233 CPT,31591,"Laryngoplasty, medialization, unilateral ",,,948.0,13835.0,225 CPT,31592,Cricotracheal resection ,,,948.0,13835.0,225 CPT,31595,"SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC (SEPARATE PROCEDURE), UNILATERAL ",,,6326.0,9653.0,24 CPT,31599,"Unlisted procedure, larynx ",,,239.12,13835.0,198 CPT,31600,"Tracheostomy, planned (separate procedure); ",,,948.0,7150.66,206 CPT,31601,"Tracheostomy, planned (separate procedure); younger than 2 years ",,,948.0,13835.0,110 CPT,31603,"Tracheostomy, emergency procedure; transtracheal ",,,441.67,3683.7,233 CPT,31605,"Tracheostomy, emergency procedure; cricothyroid membrane ",,,91.96,3128.0,233 CPT,31610,"Tracheostomy, fenestration procedure with skin flaps ",,,948.0,13835.0,110 CPT,31611,"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, Blom-Singer prosthesis) ",,,930.95,12562.0,233 CPT,31612,"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection ",,,930.95,7150.66,233 CPT,31613,"Tracheostoma revision; simple, without flap rotation ",,,930.95,7150.66,233 CPT,31614,"Tracheostoma revision; complex, with flap rotation ",,,948.0,13241.95,233 CPT,31615,Tracheobronchoscopy through established tracheostomy incision ,,,196.58,3128.0,233 CPT,31620,ENDOBRONCHIAL US ADD-ON ,,,3390.0,5841.0,16 CPT,31622,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure) ",,,552.0,3905.57,233 CPT,31623,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings ",,,552.0,3905.57,233 CPT,31624,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage ",,,552.0,3905.57,233 CPT,31625,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites ",,,552.0,3905.57,233 CPT,31626,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple ",,,948.0,14852.18,233 CPT,31627,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedureºs») ",,,948.0,5841.0,140 CPT,31628,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe ",,,948.0,8017.76,233 CPT,31629,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) ",,,948.0,8017.76,233 CPT,31630,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture ",,,948.0,8017.76,233 CPT,31631,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required) ",,,948.0,14852.18,233 CPT,31632,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (List separately in addition to code for primary procedure) ",,,948.0,5841.0,161 CPT,31633,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (List separately in addition to code for primary",,,948.0,5841.0,161 CPT,31634,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if ",,,948.0,14852.18,233 CPT,31635,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body ",,,552.0,3905.57,233 CPT,31636,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus ",,,948.0,14852.18,233 CPT,31637,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (List separately in addition to code for primary procedure) ",,,948.0,5841.0,161 CPT,31638,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as req",,,948.0,14852.18,233 CPT,31640,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor ",,,948.0,8017.76,233 CPT,31641,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy) ",,,948.0,8017.76,233 CPT,31643,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application ",,,552.0,25988.0,249 CPT,31645,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial ",,,552.0,3905.57,233 CPT,31646,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay ",,,163.37,5841.0,225 CPT,31647,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), in",,,948.0,14852.18,233 CPT,31648,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe ",,,948.0,12909.0,233 CPT,31649,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure) ",,,552.0,12562.0,233 CPT,31651,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), ea",,,948.0,12909.0,161 CPT,31652,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspirationºs»/biopsyºies",,,948.0,15059.0,233 CPT,31653,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspirationºs»/biopsyºies",,,948.0,15059.0,233 CPT,31654,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) fo",,,948.0,5841.0,161 CPT,31656,BRONCHOSCOPY INJ FOR X-RAY ,,,3390.0,5841.0,16 CPT,31660,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe ",,,948.0,15059.0,206 CPT,31661,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes ",,,948.0,15059.0,206 CPT,31700,INSERTION OF AIRWAY CATHETER ,,,3390.0,5841.0,16 CPT,31708,INSTILL AIRWAY CONTRAST DYE ,,,3390.0,5841.0,16 CPT,31710,INSERTION OF AIRWAY CATHETER ,,,3390.0,5841.0,16 CPT,31715,INJECTION FOR BRONCHUS X-RAY ,,,3390.0,5841.0,16 CPT,31717,Catheterization with bronchial brush biopsy ,,,163.37,5841.0,225 CPT,31720,Catheter aspiration (separate procedure); nasotracheal ,,,221.07,5841.0,198 CPT,31725,"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside ",,,756.8,16207.0,205 CPT,31730,Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy ,,,552.0,3905.57,233 CPT,31750,Tracheoplasty; cervical ,,,948.0,13394.0,233 CPT,31755,"Tracheoplasty; tracheopharyngeal fistulization, each stage ",,,948.0,13241.95,233 CPT,31760,Tracheoplasty; intrathoracic ,,,948.0,16774.82,109 CPT,31766,Carinal reconstruction ,,,948.0,21818.21,109 CPT,31770,Bronchoplasty; graft repair ,,,948.0,16228.09,109 CPT,31775,Bronchoplasty; excision stenosis and anastomosis ,,,948.0,17156.19,109 CPT,31780,Excision tracheal stenosis and anastomosis; cervical ,,,948.0,16207.0,109 CPT,31781,Excision tracheal stenosis and anastomosis; cervicothoracic ,,,948.0,16906.18,109 CPT,31785,Excision of tracheal tumor or carcinoma; cervical ,,,948.0,13241.95,206 CPT,31786,Excision of tracheal tumor or carcinoma; thoracic ,,,948.0,17690.22,109 CPT,31800,Suture of tracheal wound or injury; cervical ,,,948.0,13835.0,205 CPT,31805,Suture of tracheal wound or injury; intrathoracic ,,,948.0,16207.0,109 CPT,31820,Surgical closure tracheostomy or fistula; without plastic repair ,,,930.95,7150.66,233 CPT,31825,Surgical closure tracheostomy or fistula; with plastic repair ,,,930.95,7150.66,233 CPT,31830,Revision of tracheostomy scar ,,,930.95,7150.66,233 CPT,31899,"Unlisted procedure, trachea, bronchi ",,,201.52,13835.0,198 CPT,32000,DRAINAGE OF CHEST ,,,3390.0,5841.0,16 CPT,32001,Total lung lavage ,,,3390.0,5841.0,16 CPT,32002,TREATMENT OF COLLAPSED LUNG ,,,3390.0,5841.0,16 CPT,32005,TREAT LUNG LINING CHEMICALLY ,,,3390.0,5841.0,16 CPT,32019,INSERT PLEURAL CATHETER ,,,3390.0,5841.0,16 CPT,32020,INSERTION OF CHEST TUBE ,,,3390.0,5841.0,16 CPT,32035,Thoracostomy; with rib resection for empyema ,,,948.0,16207.0,109 CPT,32036,Thoracostomy; with open flap drainage for empyema ,,,948.0,16207.0,109 CPT,32095,BIOPSY THROUGH CHEST WALL ,,,3390.0,5841.0,16 CPT,32096,"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral ",,,948.0,16207.0,109 CPT,32097,"Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral ",,,948.0,16207.0,109 CPT,32098,"Thoracotomy, with biopsy(ies) of pleura ",,,948.0,16207.0,109 CPT,32100,Thoracotomy; with exploration ,,,948.0,16207.0,109 CPT,32110,Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear ,,,948.0,17986.92,109 CPT,32120,Thoracotomy; for postoperative complications ,,,948.0,16207.0,109 CPT,32124,Thoracotomy; with open intrapleural pneumonolysis ,,,948.0,16207.0,109 CPT,32140,"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed ",,,948.0,16207.0,109 CPT,32141,"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed ",,,948.0,18669.24,109 CPT,32150,Thoracotomy; with removal of intrapleural foreign body or fibrin deposit ,,,948.0,16207.0,109 CPT,32151,Thoracotomy; with removal of intrapulmonary foreign body ,,,948.0,16207.0,109 CPT,32160,Thoracotomy; with cardiac massage ,,,948.0,16207.0,109 CPT,32200,"Pneumonostomy, with open drainage of abscess or cyst ",,,948.0,16207.0,109 CPT,32201,DRAIN PERCUT LUNG LESION ,,,3390.0,5841.0,16 CPT,32215,Pleural scarification for repeat pneumothorax ,,,948.0,16207.0,109 CPT,32220,"Decortication, pulmonary (separate procedure); total ",,,948.0,19406.7,109 CPT,32225,"Decortication, pulmonary (separate procedure); partial ",,,948.0,16207.0,109 CPT,32310,"Pleurectomy, parietal (separate procedure) ",,,948.0,16207.0,109 CPT,32320,Decortication and parietal pleurectomy ,,,948.0,19550.76,109 CPT,32400,"Biopsy, pleura, percutaneous needle ",,,510.77,3747.2,233 CPT,32402,OPEN BIOPSY CHEST LINING ,,,3390.0,5841.0,16 CPT,32405,"BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE ",,,2431.0,2979.0,24 CPT,32408,"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed ",,,510.77,12909.0,225 CPT,32420,PUNCTURE/CLEAR LUNG ,,,3390.0,5841.0,16 CPT,32421,THORACENTESIS FOR ASPIRATION ,,,3390.0,5841.0,16 CPT,32422,THORACENTESIS W/TUBE INSERT ,,,3390.0,5841.0,16 CPT,32440,"Removal of lung, pneumonectomy; ",,,948.0,19143.99,109 CPT,32442,"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy) ",,,948.0,37677.63,109 CPT,32445,"Removal of lung, pneumonectomy; extrapleural ",,,948.0,43377.94,109 CPT,32480,"Removal of lung, other than pneumonectomy; single lobe (lobectomy) ",,,948.0,18084.41,109 CPT,32482,"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy) ",,,948.0,19338.85,109 CPT,32484,"Removal of lung, other than pneumonectomy; single segment (segmentectomy) ",,,948.0,17524.99,109 CPT,32486,"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy) ",,,948.0,28874.8,109 CPT,32488,"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy) ",,,948.0,29290.16,109 CPT,32491,"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any p",,,948.0,18008.09,109 CPT,32500,PARTIAL REMOVAL OF LUNG ,,,3390.0,5841.0,16 CPT,32501,Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,32503,"Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s) ",,,948.0,22004.72,109 CPT,32504,"Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction ",,,948.0,25107.13,109 CPT,32505,"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial ",,,948.0,16207.0,109 CPT,32506,"Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,32507,Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,32520,REMOVE LUNG & REVISE CHEST ,,,3390.0,5841.0,16 CPT,32522,REMOVE LUNG & REVISE CHEST ,,,3390.0,5841.0,16 CPT,32525,REMOVE LUNG & REVISE CHEST ,,,3390.0,5841.0,16 CPT,32540,Extrapleural enucleation of empyema (empyemectomy) ,,,948.0,21059.57,109 CPT,32550,INS TUNLD PLEURAL CATH,10816.79,10816.79,1514.35,9194.27,10 CPT,32550,Insertion of indwelling tunneled pleural catheter with cuff ,10816.79,10816.79,948.0,15059.0,233 CPT,32551,"Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure) ",,,948.0,4452.98,206 CPT,32552,REMVL PLEURL CATH W/CUFF,3154.36,3154.36,441.61,2681.21,10 CPT,32552,Removal of indwelling tunneled pleural catheter with cuff ,3154.36,3154.36,234.94,3244.0,233 CPT,32553,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple ",,,548.87,13394.0,233 CPT,32554,"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance ",,,234.94,3128.0,233 CPT,32555,THORACENTESIS W/ IMAG,16300.98,16300.98,2282.14,13855.83,10 CPT,32555,"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance ",16300.98,16300.98,234.94,3128.0,233 CPT,32556,"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance ",,,593.22,4251.7,233 CPT,32557,PERC PLEUR DRN W/ IMG,16300.98,16300.98,2282.14,13855.83,10 CPT,32557,"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance ",16300.98,16300.98,468.58,4452.98,233 CPT,32560,"Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax) ",,,633.31,3249.0,206 CPT,32561,"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day ",,,633.31,3128.0,206 CPT,32562,"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day ",,,633.31,3128.0,206 CPT,32601,"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy ",,,948.0,13835.0,206 CPT,32602,THORACOSCOPY DIAGNOSTIC ,,,3390.0,5841.0,16 CPT,32603,THORACOSCOPY DIAGNOSTIC ,,,3390.0,5841.0,16 CPT,32604,"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy ",,,948.0,13835.0,206 CPT,32605,THORACOSCOPY DIAGNOSTIC ,,,3390.0,5841.0,16 CPT,32606,"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy ",,,948.0,13835.0,206 CPT,32607,"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral ",,,948.0,15059.0,206 CPT,32608,"Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral ",,,948.0,15059.0,206 CPT,32609,Thoracoscopy; with biopsy(ies) of pleura ,,,948.0,15059.0,206 CPT,32650,"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical) ",,,948.0,13835.0,109 CPT,32651,"Thoracoscopy, surgical; with partial pulmonary decortication ",,,948.0,13835.0,109 CPT,32652,"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis ",,,948.0,20330.69,109 CPT,32653,"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit ",,,948.0,13835.0,109 CPT,32654,"Thoracoscopy, surgical; with control of traumatic hemorrhage ",,,948.0,16207.0,109 CPT,32655,"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed ",,,948.0,13835.0,109 CPT,32656,"Thoracoscopy, surgical; with parietal pleurectomy ",,,948.0,13835.0,109 CPT,32657,THORACOSCOPY SURGICAL ,,,3390.0,5841.0,16 CPT,32658,"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac ",,,948.0,16207.0,109 CPT,32659,"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage ",,,948.0,16207.0,109 CPT,32660,THORACOSCOPY SURGICAL ,,,3390.0,5841.0,16 CPT,32661,"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass ",,,948.0,16207.0,109 CPT,32662,"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass ",,,948.0,16207.0,109 CPT,32663,"Thoracoscopy, surgical; with lobectomy (single lobe) ",,,948.0,17130.79,109 CPT,32664,"Thoracoscopy, surgical; with thoracic sympathectomy ",,,948.0,13835.0,205 CPT,32665,"Thoracoscopy, surgical; with esophagomyotomy (Heller type) ",,,948.0,16207.0,109 CPT,32666,"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral ",,,948.0,16207.0,109 CPT,32667,"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,32668,"Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,32669,"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy) ",,,948.0,16440.01,109 CPT,32670,"Thoracoscopy, surgical; with removal of two lobes (bilobectomy) ",,,948.0,19614.39,109 CPT,32671,"Thoracoscopy, surgical; with removal of lung (pneumonectomy) ",,,948.0,21657.22,109 CPT,32672,"Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (LVRS), unilateral includes any pleural procedure, when performed ",,,948.0,18686.17,109 CPT,32673,"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral ",,,948.0,16207.0,109 CPT,32674,"Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,32701,"Thoracic target(s) delineation for stereotactic body radiation therapy (SRS/SBRT), (photon or particle beam), entire course of treatment ",,,948.0,5841.0,72 CPT,32800,Repair lung hernia through chest wall ,,,948.0,16207.0,109 CPT,32810,Closure of chest wall following open flap drainage for empyema (Clagett type procedure) ,,,948.0,16207.0,109 CPT,32815,Open closure of major bronchial fistula ,,,948.0,34350.61,109 CPT,32820,"Major reconstruction, chest wall (posttraumatic) ",,,948.0,16266.2,109 CPT,32850,"Donor pneumonectomy(s) (including cold preservation), from cadaver donor ",,,948.0,16207.0,109 CPT,32851,"Lung transplant, single; without cardiopulmonary bypass ",,,948.0,40411.24,109 CPT,32852,"Lung transplant, single; with cardiopulmonary bypass ",,,948.0,43933.13,109 CPT,32853,"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass ",,,948.0,56588.41,109 CPT,32854,"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass ",,,948.0,60059.5,109 CPT,32855,"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmon",,,948.0,26077.68,109 CPT,32856,"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmon",,,948.0,28561.16,109 CPT,32900,"Resection of ribs, extrapleural, all stages ",,,948.0,17325.77,109 CPT,32905,"Thoracoplasty, Schede type or extrapleural (all stages); ",,,948.0,16219.63,109 CPT,32906,"Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula ",,,948.0,20169.58,109 CPT,32940,"Pneumonolysis, extraperiosteal, including filling or packing procedures ",,,948.0,16207.0,109 CPT,32960,"Pneumothorax, therapeutic, intrapleural injection of air ",,,633.31,3128.0,110 CPT,32994,"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, ",,,948.0,13835.0,198 CPT,32997,Total lung lavage (unilateral) ,,,948.0,13835.0,109 CPT,32998,"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, ",,,948.0,15059.0,206 CPT,32999,"Unlisted procedure, lungs and pleura ",,,633.31,13835.0,110 CPT,33010,PERICARDIOCENTESIS; INITIAL ,,,2128.0,2315.0,24 CPT,33011,PERICARDIOCENTESIS; SUBSEQUENT ,,,2128.0,2315.0,24 CPT,33015,TUBE PERICARDIOSTOMY ,,,3390.0,16207.0,24 CPT,33016,PERICARD W GUIDANCE,6836.62,6836.62,957.13,5811.13,11 CPT,33016,"Pericardiocentesis, including imaging guidance, when performed ",6836.62,6836.62,468.58,12909.0,225 CPT,33017,PERICARD DRN=>6Y WO CHD,6899.33,6899.33,896.91,5864.43,21 CPT,33017,"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly ",6899.33,6899.33,948.0,13835.0,101 CPT,33018,PERICARD DRN<5Y OR W/CHD,6962.06,6962.06,905.07,5917.75,21 CPT,33018,"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital card",6962.06,6962.06,948.0,13835.0,101 CPT,33019,"Pericardial drainage with insertion of indwelling catheter, percutaneous, including CT guidance ",,,948.0,13835.0,101 CPT,33020,Pericardiotomy for removal of clot or foreign body (primary procedure) ,,,948.0,16207.0,109 CPT,33025,Creation of pericardial window or partial resection for drainage ,,,948.0,16207.0,109 CPT,33030,"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass ",,,948.0,24517.95,109 CPT,33031,"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass ",,,948.0,30332.8,109 CPT,33050,Resection of pericardial cyst or tumor ,,,948.0,16207.0,109 CPT,33120,"Excision of intracardiac tumor, resection with cardiopulmonary bypass ",,,948.0,25713.12,109 CPT,33130,Resection of external cardiac tumor ,,,948.0,16812.92,109 CPT,33140,"Transmyocardial laser revascularization, by thoracotomy; (separate procedure) ",,,948.0,19143.99,109 CPT,33141,"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33200,INSERTION OF HEART PACEMAKER ,,,3390.0,5841.0,16 CPT,33201,INSERTION OF HEART PACEMAKER ,,,3390.0,5841.0,16 CPT,33202,"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach) ",,,5841.0,24035.0,68 CPT,33202,"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach) High Cost Surgery",,,2369.0,2369.0,20 CPT,33203,"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy) ",,,5841.0,24035.0,68 CPT,33203,"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy) High Cost Surgery",,,2369.0,2369.0,20 CPT,33206,INS PACEMAKER ATRIAL,7049.72,7049.72,422.98,5992.26,20 CPT,33206,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial ,7049.72,7049.72,3673.0,41580.0,208 CPT,33206,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial High Cost Surgery,,,2369.0,2369.0,20 CPT,33207,INS PACEMAKER VENT,60031.13,60031.13,3601.87,51026.46,20 CPT,33207,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular ,60031.13,60031.13,3673.0,41580.0,208 CPT,33207,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular High Cost Surgery,,,2369.0,2369.0,20 CPT,33208,INS PACEMAKER ATR/VENT,60031.13,60031.13,3601.87,51026.46,20 CPT,33208,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular ,60031.13,60031.13,3673.0,41580.0,208 CPT,33208,Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular High Cost Surgery,,,2369.0,2369.0,20 CPT,33210,INS TEMP PACER SGL,61047.92,61047.92,3662.88,51890.73,20 CPT,33210,Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) ,61047.92,61047.92,2996.0,24035.0,192 CPT,33210,Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,33211,INS TEMP PACER DUAL,59937.96,59937.96,8391.31,50947.27,10 CPT,33211,Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) ,59937.96,59937.96,2996.0,24035.0,192 CPT,33211,Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) High Cost Surgery,59937.96,59937.96,2369.0,2369.0,20 CPT,33212,INS PPM GEN ONLY SGL LD,10861.39,10861.39,651.68,9232.18,20 CPT,33212,Insertion of pacemaker pulse generator only; with existing single lead ,10861.39,10861.39,2699.0,41580.0,208 CPT,33212,Insertion of pacemaker pulse generator only; with existing single lead High Cost Surgery,,,2369.0,2369.0,20 CPT,33213,INS PPM GEN ONLY DUAL LD,10861.39,10861.39,651.68,9232.18,20 CPT,33213,Insertion of pacemaker pulse generator only; with existing dual leads ,10861.39,10861.39,2699.0,41580.0,208 CPT,33213,Insertion of pacemaker pulse generator only; with existing dual leads High Cost Surgery,,,2369.0,2369.0,20 CPT,33214,UPGRADE PPM SGL TO DUAL,10861.39,10861.39,651.68,9232.18,20 CPT,33214,"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lea",10861.39,10861.39,2369.0,41580.0,228 CPT,33215,REPOS PACER/DEFIB LEAD,28624.78,28624.78,1717.49,24331.06,20 CPT,33215,Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode ,28624.78,28624.78,1174.13,24035.0,192 CPT,33215,Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode High Cost Surgery,,,2369.0,2369.0,20 CPT,33216,INS PACER/DEFIB LEAD SGL,6593.22,6593.22,395.59,5604.24,20 CPT,33216,"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator ",6593.22,6593.22,2996.0,24035.0,192 CPT,33216,"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator High Cost Surgery",,,2369.0,2369.0,20 CPT,33217,INS PACER/DEFIB 2 LEADS,8097.13,8097.13,485.83,6882.56,20 CPT,33217,"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator ",8097.13,8097.13,2996.0,24035.0,192 CPT,33217,"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator High Cost Surgery",,,2369.0,2369.0,20 CPT,33218,"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator ",,,1496.71,24035.0,192 CPT,33218,"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator High Cost Surgery",,,2369.0,2369.0,20 CPT,33220,Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator ,,,1999.81,24035.0,192 CPT,33220,Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator High Cost Surgery,,,2369.0,2369.0,20 CPT,33221,Insertion of pacemaker pulse generator only; with existing multiple leads ,,,2699.0,49995.09,208 CPT,33221,Insertion of pacemaker pulse generator only; with existing multiple leads High Cost Surgery,,,2369.0,2369.0,20 CPT,33222,RELOCATE PACER POCKET,12779.21,12779.21,766.75,10862.33,20 CPT,33222,Relocation of skin pocket for pacemaker ,12779.21,12779.21,744.46,24035.0,192 CPT,33222,Relocation of skin pocket for pacemaker High Cost Surgery,,,2369.0,2369.0,20 CPT,33223,RELOCATE ICD POCKET,10514.9,10514.9,630.89,8937.67,20 CPT,33223,Relocation of skin pocket for implantable defibrillator ,10514.9,10514.9,744.46,24035.0,192 CPT,33223,Relocation of skin pocket for implantable defibrillator High Cost Surgery,,,2369.0,2369.0,20 CPT,33224,INS LV LD W EXST PPM/ICD,60657.97,60657.97,3639.48,51559.27,20 CPT,33224,"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of po",60657.97,60657.97,2369.0,41580.0,228 CPT,33225,"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber syste",110294.84,110294.84,2369.0,41580.0,164 CPT,33225,LV LEAD NEW/UPGD PPM/ICD,110294.84,110294.84,6617.69,93750.61,30 CPT,33226,REPOS LV LD EXST PPM/ICD,17891.23,17891.23,2504.77,15207.55,10 CPT,33226,"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator) ",17891.23,17891.23,1174.13,24035.0,192 CPT,33226,"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator) High Cost Surgery",17891.23,17891.23,2369.0,2369.0,20 CPT,33227,REPL PACEMAKER GEN SGL,161039.02,161039.02,9662.34,136883.17,20 CPT,33227,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system ,161039.02,161039.02,2699.0,41580.0,208 CPT,33227,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system High Cost Surgery,,,2369.0,2369.0,20 CPT,33228,REPL PACEMAKER GEN DUAL,83563.92,83563.92,5013.84,71029.33,20 CPT,33228,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system ,83563.92,83563.92,2699.0,41580.0,208 CPT,33228,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system High Cost Surgery,,,2369.0,2369.0,20 CPT,33229,REPL PACEMAKER GEN MULTI,156121.38,156121.38,9367.28,132703.17,20 CPT,33229,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system ,156121.38,156121.38,2699.0,49995.09,208 CPT,33229,Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system High Cost Surgery,,,2369.0,2369.0,20 CPT,33230,INS ICD GEN ONLY DUAL LD,156717.96,156717.96,9403.08,133210.27,20 CPT,33230,Insertion of implantable defibrillator pulse generator only; with existing dual leads ,156717.96,156717.96,2699.0,98753.0,208 CPT,33230,Insertion of implantable defibrillator pulse generator only; with existing dual leads High Cost Surgery,,,2369.0,2369.0,20 CPT,33231,Insertion of implantable defibrillator pulse generator only; with existing multiple leads ,,,2699.0,98753.0,208 CPT,33231,Insertion of implantable defibrillator pulse generator only; with existing multiple leads High Cost Surgery,,,2369.0,2369.0,20 CPT,33233,REMOVE PACER GENERATOR,23090.95,23090.95,1385.46,19627.31,20 CPT,33233,Removal of permanent pacemaker pulse generator only ,23090.95,23090.95,2195.0,24035.0,192 CPT,33233,Removal of permanent pacemaker pulse generator only High Cost Surgery,,,2369.0,2369.0,20 CPT,33234,REM ELECTRODE SGL LD SYS,12779.21,12779.21,766.75,10862.33,20 CPT,33234,"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular ",12779.21,12779.21,2002.14,24035.0,192 CPT,33234,"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular High Cost Surgery",,,2369.0,2369.0,20 CPT,33235,REM ELECTRDE DUAL LD SYS,12779.21,12779.21,766.75,10862.33,20 CPT,33235,Removal of transvenous pacemaker electrode(s); dual lead system ,12779.21,12779.21,1964.11,24035.0,192 CPT,33235,Removal of transvenous pacemaker electrode(s); dual lead system High Cost Surgery,,,2369.0,2369.0,20 CPT,33236,"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular ",,,5841.0,24035.0,68 CPT,33236,"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular High Cost Surgery",,,2369.0,2369.0,20 CPT,33237,Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system ,,,5841.0,24035.0,68 CPT,33237,Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system High Cost Surgery,,,2369.0,2369.0,20 CPT,33238,Removal of permanent transvenous electrode(s) by thoracotomy ,,,5841.0,24035.0,68 CPT,33238,Removal of permanent transvenous electrode(s) by thoracotomy High Cost Surgery,,,2369.0,2369.0,20 CPT,33240,INS ICD GEN ONLY SGL LD,6593.22,6593.22,395.59,5604.24,20 CPT,33240,Insertion of implantable defibrillator pulse generator only; with existing single lead ,6593.22,6593.22,3673.0,98753.0,208 CPT,33240,Insertion of implantable defibrillator pulse generator only; with existing single lead High Cost Surgery,,,2369.0,2369.0,20 CPT,33241,REMOVE ICD GENERATOR,12779.21,12779.21,766.75,10862.33,20 CPT,33241,Removal of implantable defibrillator pulse generator only ,12779.21,12779.21,1496.71,24035.0,192 CPT,33241,Removal of implantable defibrillator pulse generator only High Cost Surgery,,,2369.0,2369.0,20 CPT,33242,REP ICD-generator/lead ,,,5841.0,5841.0,8 CPT,33243,Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy ,,,6326.0,24035.0,68 CPT,33243,Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy High Cost Surgery,,,2369.0,2369.0,20 CPT,33244,REMOVE ICD LEAD EXTRACT,12779.21,12779.21,766.75,10862.33,24 CPT,33244,Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction ,12779.21,12779.21,2996.0,24035.0,165 CPT,33244,Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction High Cost Surgery,,,2369.0,2369.0,20 CPT,33245,INSERT EPIC ELTRD PACE-DEFIB ,,,5841.0,5841.0,8 CPT,33246,INSERT EPIC ELTRD/GENERATOR ,,,5841.0,5841.0,8 CPT,33247,Insert ICD lead-oth appr ,,,5841.0,5841.0,8 CPT,33249,INS ICD LEAD/GENERATOR,216668.89,216668.89,13000.13,184168.56,20 CPT,33249,"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber ",216668.89,216668.89,3673.0,98753.0,208 CPT,33249,"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber High Cost Surgery",,,2369.0,2369.0,20 CPT,33250,"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass ",,,948.0,17711.38,109 CPT,33251,"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass ",,,948.0,19889.81,109 CPT,33253,RECONSTRUCT ATRIA ,,,3390.0,5841.0,16 CPT,33254,"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure) ",,,948.0,16588.3,109 CPT,33255,"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass ",,,948.0,20055.15,109 CPT,33256,"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass ",,,948.0,23814.47,109 CPT,33257,"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary proce",,,948.0,16207.0,109 CPT,33258,"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition ",,,948.0,16207.0,109 CPT,33259,"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to ",,,948.0,16207.0,109 CPT,33261,Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass ,,,948.0,19817.83,109 CPT,33262,REM/REPLACE ICD GEN SGL,179438.58,179438.58,10766.31,152522.79,20 CPT,33262,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system ,179438.58,179438.58,948.0,98753.0,241 CPT,33263,REM/REPLACE ICD GEN DUAL,174418.45,174418.45,10465.11,148255.68,20 CPT,33263,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system ,174418.45,174418.45,948.0,98753.0,241 CPT,33264,REM/REPLACE ICD GEN MULT,174418.45,174418.45,10465.11,148255.68,20 CPT,33264,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system ,174418.45,174418.45,948.0,98753.0,241 CPT,33265,"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass ",,,948.0,16656.16,109 CPT,33266,"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass ",,,948.0,22661.64,109 CPT,33267,"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) ",,,948.0,13835.0,101 CPT,33268,"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip",,,948.0,13835.0,101 CPT,33269,EXCL LAA THRSCP ANY METH,138872.61,138872.61,18053.44,118041.72,21 CPT,33269,"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) ",138872.61,138872.61,948.0,13835.0,101 CPT,33270,INS/REPL SQ ICD W/ ELEC,127611.06,127611.06,7656.66,108469.4,20 CPT,33270,"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of ",127611.06,127611.06,948.0,98753.0,241 CPT,33271,INS SQ ICD ELECTRODE,27103.57,27103.57,1626.21,23038.03,20 CPT,33271,Insertion of subcutaneous implantable defibrillator electrode ,27103.57,27103.57,948.0,98753.0,249 CPT,33272,REM SQ ICD ELECTRODE,36039.4,36039.4,2162.36,30633.49,24 CPT,33272,Removal of subcutaneous implantable defibrillator electrode ,36039.4,36039.4,948.0,98753.0,222 CPT,33273,REPOS PREV SQ ICD ELECTR,6498.73,6498.73,389.92,5523.92,20 CPT,33273,Repositioning of previously implanted subcutaneous implantable defibrillator electrode ,6498.73,6498.73,948.0,15059.0,233 CPT,33274,INS/REPL LDLS PPM VENT,66779.56,66779.56,4006.77,56762.63,25 CPT,33274,"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and dev",66779.56,66779.56,948.0,43516.12,190 CPT,33275,"Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed ",,,948.0,15059.0,198 CPT,33276,"Insertion of phrenic nerve stimulator system (pulse generator and stimulating leadºs»), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mod",,,948.0,122851.37,213 CPT,33277,Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure) ,,,948.0,5841.0,132 CPT,33278,"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s) ",,,948.0,15059.0,213 CPT,33279,"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only ",,,948.0,15059.0,213 CPT,33280,"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only ",,,948.0,15059.0,213 CPT,33281,Repositioning of phrenic nerve stimulator transvenous lead(s) ,,,948.0,15059.0,213 CPT,33282,IMPLANTATION OF PATIENT-ACTIVATED CARDIAC EVENT RECORDER ,,,9124.0,9653.0,24 CPT,33284,"REMOVAL OF AN IMPLANTABLE, PATIENT-ACTIVATED CARDIAC EVENT RECORDER ",,,2431.0,2979.0,24 CPT,33285,INS SQ CARD RHYTHM MONTR,45357.89,45357.89,2721.47,38554.21,21 CPT,33285,"Insertion, subcutaneous cardiac rhythm monitor, including programming ",45357.89,45357.89,948.0,20862.25,225 CPT,33286,REM SQ CARD RHYTHM MONTR,15926.76,15926.76,955.61,13537.75,21 CPT,33286,"Removal, subcutaneous cardiac rhythm monitor ",15926.76,15926.76,270.48,5841.0,225 CPT,33287,"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator ",,,948.0,80770.57,213 CPT,33288,"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(",,,948.0,35432.53,213 CPT,33289,IMP WRLS P-ART PRES SNSR,176106.8,176106.8,22893.88,149690.78,16 CPT,33289,"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective",176106.8,176106.8,948.0,77863.78,190 CPT,33300,Repair of cardiac wound; without bypass ,,,948.0,30099.72,109 CPT,33305,Repair of cardiac wound; with cardiopulmonary bypass ,,,948.0,50464.28,109 CPT,33310,"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass ",,,948.0,16207.0,109 CPT,33315,"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass ",,,948.0,23462.61,109 CPT,33320,Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass ,,,948.0,16207.0,109 CPT,33321,Suture repair of aorta or great vessels; with shunt bypass ,,,948.0,16207.0,109 CPT,33322,Suture repair of aorta or great vessels; with cardiopulmonary bypass ,,,948.0,16961.21,109 CPT,33330,"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass ",,,948.0,17520.75,109 CPT,33332,INSERT MAJOR VESSEL GRAFT ,,,3390.0,5841.0,16 CPT,33335,"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass ",,,948.0,23144.86,109 CPT,33340,CLOSURE LAA W/ IMPLANT,138872.61,138872.61,18053.44,118041.72,21 CPT,33340,"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appen",138872.61,138872.61,948.0,17009.0,113 CPT,33361,TAVR/TAVI PERC FEM APRCH,123061.64,123061.64,15998.01,104602.39,20 CPT,33361,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach ,123061.64,123061.64,948.0,16732.36,109 CPT,33362,TAVR/TAVI OPN FEM APRCH,116901.89,116901.89,15197.25,99366.61,20 CPT,33362,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach ,116901.89,116901.89,948.0,18266.69,109 CPT,33363,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach ,,,948.0,18919.37,109 CPT,33364,TAVR/TAVI OPEN ILI APRCH,123061.64,123061.64,15998.01,104602.39,20 CPT,33364,Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach ,123061.64,123061.64,948.0,19555.0,109 CPT,33365,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) ",,,948.0,21966.62,109 CPT,33366,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy) ",,,948.0,23746.62,109 CPT,33367,PERC CP BYPS SUP W/ TAVR,78401.52,78401.52,10192.2,66641.29,20 CPT,33367,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separa",78401.52,78401.52,948.0,16207.0,109 CPT,33368,OPEN CP BYPS SUP W/ TAVR,87025.69,87025.69,11313.34,73971.84,20 CPT,33368,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (Li",87025.69,87025.69,948.0,16207.0,109 CPT,33369,"Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List ",,,948.0,16207.0,109 CPT,33370,PLC/REM CEPD W/ TAVR,21756.43,21756.43,2828.34,18492.97,29 CPT,33370,"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutane",21756.43,21756.43,948.0,5841.0,140 CPT,33390,"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension) ",,,948.0,23682.99,101 CPT,33391,"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty) ",,,948.0,28027.26,101 CPT,33400,REPAIR OF AORTIC VALVE ,,,3390.0,16207.0,24 CPT,33401,VALVULOPLASTY OPEN ,,,3390.0,16207.0,24 CPT,33403,VALVULOPLASTY W/CP BYPASS ,,,3390.0,16207.0,24 CPT,33404,Construction of apical-aortic conduit ,,,948.0,21614.76,109 CPT,33405,"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve ",,,948.0,27840.74,109 CPT,33406,"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand) ",,,948.0,35261.77,109 CPT,33410,"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve ",,,948.0,31214.33,109 CPT,33411,"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus ",,,948.0,41258.9,109 CPT,33412,"Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure) ",,,948.0,38601.49,109 CPT,33413,"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) ",,,948.0,39313.56,109 CPT,33414,Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract ,,,948.0,26285.25,109 CPT,33415,Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis ,,,948.0,24912.15,109 CPT,33416,"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy) ",,,948.0,24835.83,109 CPT,33417,Aortoplasty (gusset) for supravalvular stenosis ,,,948.0,20411.13,109 CPT,33418,TMVR PERC INITIAL DEVICE,122226.67,122226.67,15889.47,103892.67,20 CPT,33418,"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis ",122226.67,122226.67,948.0,22203.94,109 CPT,33419,TMVR PERC ADDTL DEVICE,71298.34,71298.34,9268.78,60603.59,29 CPT,33419,"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (List separately in addition to code for primary ",71298.34,71298.34,948.0,5841.0,44 CPT,33420,"Valvotomy, mitral valve; closed heart ",,,948.0,17927.53,109 CPT,33422,"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass ",,,948.0,20343.39,109 CPT,33425,"Valvuloplasty, mitral valve, with cardiopulmonary bypass; ",,,948.0,33498.71,109 CPT,33426,"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring ",,,948.0,29230.89,109 CPT,33427,"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring ",,,948.0,30006.46,109 CPT,33430,"Replacement, mitral valve, with cardiopulmonary bypass ",,,948.0,34354.84,109 CPT,33440,"Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmo",,,948.0,41576.77,101 CPT,33460,"Valvectomy, tricuspid valve, with cardiopulmonary bypass ",,,948.0,29442.81,109 CPT,33463,"Valvuloplasty, tricuspid valve; without ring insertion ",,,948.0,37936.11,109 CPT,33464,"Valvuloplasty, tricuspid valve; with ring insertion ",,,948.0,29968.24,109 CPT,33465,"Replacement, tricuspid valve, with cardiopulmonary bypass ",,,948.0,33867.39,109 CPT,33468,Tricuspid valve repositioning and plication for Ebstein anomaly ,,,948.0,29620.74,109 CPT,33470,"VALVOTOMY, PULMONARY VALVE, CLOSED HEART; TRANSVENTRICULAR ",,,3390.0,16207.0,24 CPT,33471,"Valvotomy, pulmonary valve, closed heart, via pulmonary artery ",,,3390.0,16207.0,24 CPT,33472,REVISION OF PULMONARY VALVE ,,,3390.0,5841.0,16 CPT,33474,"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass ",,,948.0,26823.5,109 CPT,33475,"Replacement, pulmonary valve ",,,948.0,28650.18,109 CPT,33476,"Right ventricular resection for infundibular stenosis, with or without commissurotomy ",,,948.0,18313.26,109 CPT,33477,TPVI PERC APRCH,92827.4,92827.4,12067.56,78903.29,20 CPT,33477,"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed ",92827.4,92827.4,948.0,17009.0,121 CPT,33478,"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection ",,,948.0,19224.42,109 CPT,33496,Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure) ,,,948.0,20453.58,109 CPT,33500,Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass ,,,948.0,19101.53,109 CPT,33501,Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass ,,,948.0,16207.0,109 CPT,33502,Repair of anomalous coronary artery from pulmonary artery origin; by ligation ,,,948.0,16207.0,109 CPT,33503,"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass ",,,948.0,16291.6,109 CPT,33504,"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass ",,,948.0,17775.0,109 CPT,33505,Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (Takeuchi procedure) ,,,948.0,24776.56,109 CPT,33506,Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta ,,,948.0,24496.79,109 CPT,33507,"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation ",,,948.0,21068.04,109 CPT,33508,"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure) ",,,948.0,5841.0,44 CPT,33509,"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic ",,,948.0,13835.0,101 CPT,33510,"Coronary artery bypass, vein only; single coronary venous graft ",,,948.0,23712.75,109 CPT,33511,"Coronary artery bypass, vein only; 2 coronary venous grafts ",,,948.0,26043.7,109 CPT,33512,"Coronary artery bypass, vein only; 3 coronary venous grafts ",,,948.0,29654.72,109 CPT,33513,"Coronary artery bypass, vein only; 4 coronary venous grafts ",,,948.0,30540.48,109 CPT,33514,"Coronary artery bypass, vein only; 5 coronary venous grafts ",,,948.0,32112.8,109 CPT,33516,"Coronary artery bypass, vein only; 6 or more coronary venous grafts ",,,948.0,33112.98,109 CPT,33517,"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33518,"Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33519,"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33521,"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33522,"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33523,"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33530,"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33533,"Coronary artery bypass, using arterial graft(s); single arterial graft ",,,948.0,22924.36,109 CPT,33534,"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts ",,,948.0,26963.45,109 CPT,33535,"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts ",,,948.0,30082.79,109 CPT,33536,"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts ",,,948.0,32256.97,109 CPT,33542,"Myocardial resection (eg, ventricular aneurysmectomy) ",,,948.0,32299.31,109 CPT,33545,"Repair of postinfarction ventricular septal defect, with or without myocardial resection ",,,948.0,37864.02,109 CPT,33548,"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, Dor procedures) ",,,948.0,36338.28,109 CPT,33572,"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List sep",,,948.0,16207.0,109 CPT,33600,Closure of atrioventricular valve (mitral or tricuspid) by suture or patch ,,,948.0,20907.05,109 CPT,33602,Closure of semilunar valve (aortic or pulmonary) by suture or patch ,,,948.0,20284.0,109 CPT,33606,Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure) ,,,948.0,21869.13,109 CPT,33608,Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery ,,,948.0,22148.78,109 CPT,33610,"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect ",,,948.0,21839.38,109 CPT,33611,Repair of double outlet right ventricle with intraventricular tunnel repair; ,,,948.0,24034.85,109 CPT,33612,Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction ,,,948.0,24679.07,109 CPT,33615,"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure) ",,,948.0,24581.58,109 CPT,33617,"Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure ",,,948.0,25946.21,109 CPT,33619,"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure) ",,,948.0,33638.54,109 CPT,33620,"Application of right and left pulmonary artery bands (eg, hybrid approach stage 1) ",,,948.0,20220.5,109 CPT,33621,"Transthoracic insertion of catheter for stent placement with catheter removal and closure (eg, hybrid approach stage 1) ",,,948.0,16207.0,109 CPT,33622,"Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of c",,,948.0,42386.22,109 CPT,33641,"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch ",,,948.0,20080.55,109 CPT,33645,"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage ",,,948.0,21144.36,109 CPT,33647,"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure ",,,948.0,22102.21,109 CPT,33660,"Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair ",,,948.0,21436.83,109 CPT,33665,"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair ",,,948.0,23572.8,109 CPT,33670,"Repair of complete atrioventricular canal, with or without prosthetic valve ",,,948.0,24327.21,109 CPT,33675,Closure of multiple ventricular septal defects; ,,,948.0,23877.97,109 CPT,33676,Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic) ,,,948.0,24937.55,109 CPT,33677,"Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset ",,,948.0,25899.64,109 CPT,33681,"Closure of single ventricular septal defect, with or without patch; ",,,948.0,22475.12,109 CPT,33684,"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic) ",,,948.0,23263.51,109 CPT,33688,"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset ",,,948.0,23225.29,109 CPT,33690,Banding of pulmonary artery ,,,948.0,16207.0,109 CPT,33692,Complete repair tetralogy of Fallot without pulmonary atresia; ,,,948.0,24119.64,109 CPT,33694,Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch ,,,948.0,24034.85,109 CPT,33697,Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect ,,,948.0,25314.81,109 CPT,33702,"Repair sinus of Valsalva fistula, with cardiopulmonary bypass; ",,,948.0,18737.09,109 CPT,33710,"Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect ",,,948.0,25280.82,109 CPT,33720,"Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass ",,,948.0,18932.07,109 CPT,33722,CLOSURE OF AORTICO-LEFT VENTRICULAR TUNNEL ,,,3390.0,16207.0,24 CPT,33724,"Repair of isolated partial anomalous pulmonary venous return (eg, Scimitar Syndrome) ",,,948.0,18737.09,109 CPT,33726,Repair of pulmonary venous stenosis ,,,948.0,25047.74,109 CPT,33730,"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types) ",,,948.0,24051.79,109 CPT,33732,Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane ,,,948.0,19254.18,109 CPT,33735,Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation) ,,,948.0,16207.0,109 CPT,33736,Atrial septectomy or septostomy; open heart with cardiopulmonary bypass ,,,948.0,16791.75,109 CPT,33737,"Atrial septectomy or septostomy; open heart, with inflow occlusion ",,,3390.0,16207.0,24 CPT,33741,"Transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, Rashkind, S",,,948.0,13835.0,105 CPT,33745,"Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when ",,,948.0,13835.0,105 CPT,33746,"Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when ",,,948.0,13835.0,105 CPT,33750,Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) ,,,948.0,16207.0,109 CPT,33755,Shunt; ascending aorta to pulmonary artery (Waterston type operation) ,,,948.0,16207.0,109 CPT,33762,Shunt; descending aorta to pulmonary artery (Potts-Smith type operation) ,,,948.0,16207.0,109 CPT,33764,"Shunt; central, with prosthetic graft ",,,948.0,16207.0,109 CPT,33766,Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure) ,,,948.0,16393.32,109 CPT,33767,Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure) ,,,948.0,17508.05,109 CPT,33768,"Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure) ",,,948.0,16207.0,109 CPT,33770,Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect ,,,948.0,26094.62,109 CPT,33771,Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect ,,,948.0,26861.72,109 CPT,33774,"Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; ",,,948.0,22136.08,109 CPT,33775,"Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band ",,,948.0,22818.52,109 CPT,33776,"Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with closure of ventricular septal defect ",,,948.0,23293.15,109 CPT,33777,"Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction ",,,948.0,23293.15,109 CPT,33778,"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); ",,,948.0,28946.89,109 CPT,33779,"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with removal of pulmonary band ",,,948.0,28684.17,109 CPT,33780,"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with closure of ventricular septal defect ",,,948.0,28167.08,109 CPT,33781,"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with repair of subpulmonic obstruction ",,,948.0,28523.06,109 CPT,33782,"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium reimplantation ",,,948.0,39847.58,109 CPT,33783,"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia ",,,948.0,43085.46,109 CPT,33786,"Total repair, truncus arteriosus (Rastelli type operation) ",,,948.0,28061.12,109 CPT,33788,Reimplantation of an anomalous pulmonary artery ,,,948.0,18864.22,109 CPT,33800,"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure) ",,,948.0,16207.0,109 CPT,33802,Division of aberrant vessel (vascular ring); ,,,948.0,16207.0,109 CPT,33803,Division of aberrant vessel (vascular ring); with reanastomosis ,,,948.0,16207.0,109 CPT,33813,Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass ,,,3390.0,16207.0,24 CPT,33814,"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass ",,,948.0,18728.62,109 CPT,33820,Repair of patent ductus arteriosus; by ligation ,,,948.0,14108.0,109 CPT,33822,"Repair of patent ductus arteriosus; by division, younger than 18 years ",,,948.0,13835.0,109 CPT,33824,"Repair of patent ductus arteriosus; by division, 18 years and older ",,,948.0,14494.67,109 CPT,33840,"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis ",,,948.0,16207.0,109 CPT,33845,"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft ",,,948.0,16207.0,109 CPT,33851,"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement ",,,948.0,16207.0,109 CPT,33852,Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass ,,,948.0,16350.99,109 CPT,33853,Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass ,,,948.0,21979.32,109 CPT,33858,"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection ",,,948.0,41763.17,101 CPT,33859,"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm) ",,,948.0,29981.06,101 CPT,33860,"ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS, INCLUDES VALVE SUSPENSION, WHEN PERFORMED ",,,3390.0,16207.0,24 CPT,33861,ASCENDING AORTIC GRAFT ,,,3390.0,5841.0,16 CPT,33863,"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, Bentall) ",,,948.0,38732.85,109 CPT,33864,"Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, David Procedure, Yacoub Procedure) ",,,948.0,39678.0,109 CPT,33866,"Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isola",,,948.0,5841.0,44 CPT,33870,"TRANSVERSE ARCH GRAFT, WITH CARDIOPULMONARY BYPASS ",,,3390.0,16207.0,24 CPT,33871,"Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle",,,948.0,40152.64,101 CPT,33875,"Descending thoracic aorta graft, with or without bypass ",,,948.0,33786.95,109 CPT,33877,"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass ",,,948.0,44564.64,109 CPT,33880,EVAS RPR THOR AORTA,5976.81,5976.81,776.99,5080.29,20 CPT,33880,"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment o",5976.81,5976.81,948.0,22042.83,109 CPT,33881,EVAS RPR THR ARTA NO LSA,6428.93,6428.93,835.76,5464.59,20 CPT,33881,"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment o",6428.93,6428.93,948.0,18919.37,109 CPT,33882,Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s,,,948.0,21033.58,56 CPT,33883,"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and ",,,948.0,16207.0,109 CPT,33884,"Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disrupti",,,3390.0,16207.0,24 CPT,33886,"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure ",,,948.0,16207.0,109 CPT,33889,"Open subclavian to carotid artery transposition performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision, unilateral ",,,3390.0,16207.0,24 CPT,33891,"Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision ",,,3390.0,16207.0,24 CPT,33894,"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches ",,,948.0,13835.0,101 CPT,33895,"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches ",,,948.0,13835.0,101 CPT,33897,Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta ,,,948.0,13835.0,101 CPT,33900,"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral ",,,948.0,28979.8,225 CPT,33901,"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral ",,,948.0,28979.8,225 CPT,33902,"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral ",,,948.0,46894.85,225 CPT,33903,"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral ",,,948.0,28979.8,225 CPT,33904,"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure",,,948.0,5841.0,140 CPT,33910,Pulmonary artery embolectomy; with cardiopulmonary bypass ,,,948.0,32303.54,109 CPT,33915,Pulmonary artery embolectomy; without cardiopulmonary bypass ,,,948.0,16846.79,109 CPT,33916,"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass ",,,948.0,52201.93,109 CPT,33917,Repair of pulmonary artery stenosis by reconstruction with patch or graft ,,,948.0,17838.63,109 CPT,33918,REPAIR PULMONARY ATRESIA ,,,3390.0,5841.0,16 CPT,33919,REPAIR PULMONARY ATRESIA ,,,3390.0,5841.0,16 CPT,33920,"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery ",,,948.0,22297.2,109 CPT,33922,Transection of pulmonary artery with cardiopulmonary bypass ,,,948.0,16914.64,109 CPT,33924,"Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33925,Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass ,,,948.0,21152.83,109 CPT,33926,Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass ,,,948.0,29794.55,109 CPT,33927,Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy ,,,948.0,31477.05,101 CPT,33928,Removal and replacement of total replacement heart system (artificial heart) ,,,948.0,13835.0,101 CPT,33929,Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure) ,,,948.0,36872.3,101 CPT,33930,Donor cardiectomy-pneumonectomy (including cold preservation) ,,,948.0,16207.0,109 CPT,33933,"Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inf",,,948.0,32286.61,109 CPT,33935,Heart-lung transplant with recipient cardiectomy-pneumonectomy ,,,948.0,60987.71,109 CPT,33940,Donor cardiectomy (including cold preservation) ,,,948.0,16207.0,109 CPT,33944,"Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior",,,948.0,22352.23,109 CPT,33945,"Heart transplant, with or without recipient cardiectomy ",,,948.0,59902.74,109 CPT,33946,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; initiation, veno-venous ",,,948.0,16207.0,109 CPT,33947,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; initiation, veno-arterial ",,,948.0,16207.0,109 CPT,33948,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-venous ",,,948.0,16207.0,109 CPT,33949,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-arterial ",,,948.0,16207.0,109 CPT,33951,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of",,,948.0,16207.0,109 CPT,33952,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (inclu",,,948.0,16207.0,109 CPT,33953,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age ",,,948.0,16207.0,109 CPT,33954,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older ",,,948.0,16207.0,109 CPT,33955,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age ",,,948.0,16207.0,109 CPT,33956,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older ",,,948.0,16207.0,109 CPT,33957,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of a",,,948.0,16207.0,109 CPT,33958,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (include",,,948.0,16207.0,109 CPT,33959,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (incl",,,948.0,16207.0,109 CPT,33960,EXTERNAL CIRCULATION ASSIST ,,,3390.0,5841.0,16 CPT,33961,EXTERNAL CIRCULATION ASSIST ,,,3390.0,5841.0,16 CPT,33962,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes fluoro",,,948.0,16207.0,109 CPT,33963,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includ",,,948.0,16207.0,109 CPT,33964,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopi",,,948.0,16207.0,109 CPT,33965,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of a",,,948.0,16207.0,109 CPT,33966,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older ",,,948.0,16207.0,109 CPT,33967,"Insertion of intra-aortic balloon assist device, percutaneous ",,,948.0,20286.0,113 CPT,33968,"Removal of intra-aortic balloon assist device, percutaneous ",,,323.88,13835.0,197 CPT,33969,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age ",,,948.0,16207.0,109 CPT,33970,"Insertion of intra-aortic balloon assist device through the femoral artery, open approach ",,,948.0,16207.0,109 CPT,33971,"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft ",,,948.0,16207.0,109 CPT,33973,Insertion of intra-aortic balloon assist device through the ascending aorta ,,,948.0,16207.0,109 CPT,33974,"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft ",,,948.0,16207.0,109 CPT,33975,"Insertion of ventricular assist device; extracorporeal, single ventricle ",,,948.0,16207.0,109 CPT,33976,"Insertion of ventricular assist device; extracorporeal, biventricular ",,,948.0,19610.15,109 CPT,33977,"Removal of ventricular assist device; extracorporeal, single ventricle ",,,948.0,16207.0,109 CPT,33978,"Removal of ventricular assist device; extracorporeal, biventricular ",,,948.0,16486.58,109 CPT,33979,"Insertion of ventricular assist device, implantable intracorporeal, single ventricle ",,,948.0,24017.92,109 CPT,33980,"Removal of ventricular assist device, implantable intracorporeal, single ventricle ",,,948.0,21962.39,109 CPT,33981,"Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump ",,,948.0,16207.0,109 CPT,33982,"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass ",,,948.0,24170.45,109 CPT,33983,"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass ",,,948.0,28450.97,109 CPT,33984,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older ",,,948.0,16207.0,109 CPT,33985,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age ",,,948.0,16207.0,109 CPT,33986,"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older ",,,948.0,16207.0,109 CPT,33987,"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ECMO/ECLS (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,33988,"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ECMO/ECLS ",,,948.0,16207.0,109 CPT,33989,"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ECMO/ECLS ",,,948.0,16207.0,109 CPT,33990,INS LVAD PERC ARTERIAL,3282.41,3282.41,426.71,2790.05,20 CPT,33990,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only ",3282.41,3282.41,948.0,16207.0,109 CPT,33991,INS LVAD ART/VEN ACCESS,295544.98,295544.98,38420.85,251213.23,20 CPT,33991,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture ",295544.98,295544.98,948.0,16207.0,109 CPT,33992,REM LVAD PERC SEP SESS,4351.29,4351.29,565.67,3698.6,20 CPT,33992,"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion ",4351.29,4351.29,948.0,16207.0,109 CPT,33993,Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion ,,,948.0,16207.0,109 CPT,33995,INS RVAD PERC VENOUS,3626.07,3626.07,471.39,3082.16,21 CPT,33995,"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only ",3626.07,3626.07,948.0,13835.0,101 CPT,33997,REM RVAD PERC SEP SESS,11603.42,11603.42,1508.44,9862.91,21 CPT,33997,"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion ",11603.42,11603.42,948.0,13835.0,101 CPT,33999,TAVR/TAVI PERC CARTD APR,123061.64,123061.64,15998.01,104602.39,15 CPT,33999,"Unlisted procedure, cardiac surgery ",123061.64,123061.64,633.31,13835.0,110 CPT,34001,"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision ",,,948.0,16207.0,109 CPT,34051,"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision ",,,948.0,16207.0,109 CPT,34101,"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision ",,,948.0,12562.0,206 CPT,34111,"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision ",,,948.0,13835.0,110 CPT,34151,"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision ",,,948.0,17122.32,109 CPT,34201,ART THRMB FEMPOP/AOI-LEG,33580.42,33580.42,4365.45,28543.36,15 CPT,34201,"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision ",33580.42,33580.42,948.0,13835.0,110 CPT,34203,"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision ",,,948.0,13835.0,110 CPT,34401,"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision ",,,948.0,17969.99,109 CPT,34421,"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision ",,,948.0,13835.0,110 CPT,34451,"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision ",,,948.0,17414.8,109 CPT,34471,"Thrombectomy, direct or with catheter; subclavian vein, by neck incision ",,,633.31,13835.0,110 CPT,34490,"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision ",,,948.0,13835.0,137 CPT,34501,"Valvuloplasty, femoral vein ",,,948.0,13835.0,110 CPT,34502,"Reconstruction of vena cava, any method ",,,948.0,18936.3,109 CPT,34510,"Venous valve transposition, any vein donor ",,,948.0,13835.0,110 CPT,34520,Cross-over vein graft to venous system ,,,948.0,13835.0,110 CPT,34530,Saphenopopliteal vein anastomosis ,,,948.0,13835.0,110 CPT,34701,"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiolo",,,948.0,15193.92,197 CPT,34702,"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiolo",,,948.0,22691.27,197 CPT,34703,"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s),",,,948.0,17105.39,197 CPT,34704,"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s),",,,948.0,28506.12,197 CPT,34705,EVAS RPR A-BIILIAC NORUP,36712.82,36712.82,4772.67,31205.9,21 CPT,34705,"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), ",36712.82,36712.82,948.0,18813.41,197 CPT,34706,"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), ",,,948.0,28345.13,197 CPT,34707,"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological ",,,948.0,14172.56,197 CPT,34708,"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological ",,,948.0,22750.66,197 CPT,34709,EVAS RPR ABD AORT ADDL,47088.0,47088.0,6121.44,40024.8,21 CPT,34709,"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneury",47088.0,47088.0,948.0,13835.0,197 CPT,34710,"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, inc",,,948.0,13835.0,197 CPT,34711,"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, inc",,,948.0,13835.0,197 CPT,34712,"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation ",,,948.0,13835.0,197 CPT,34713,ACC/CLS FEM ART PERC ADD,24346.29,24346.29,3165.02,20694.35,29 CPT,34713,"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in ",24346.29,24346.29,948.0,5841.0,140 CPT,34714,"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition",,,948.0,5841.0,140 CPT,34715,"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,34716,CONDU OPEN AX/SC ART UNI,1306.69,1306.69,169.87,1110.69,29 CPT,34716,"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision",1306.69,1306.69,948.0,5841.0,140 CPT,34717,"Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilate",,,948.0,13835.0,101 CPT,34718,"Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing ",,,948.0,15291.41,101 CPT,34800,HEndovascular repair of infrarenal abdominal aortic aneurysm or dissection; using aorto-aortic tube prosthesis ,,,3390.0,16207.0,24 CPT,34802,HEndovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (1 docking limb) ,,,3390.0,16207.0,24 CPT,34803,HEndovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (2 docking limbs) ,,,3390.0,16207.0,24 CPT,34804,HEndovascular repair of infrarenal abdominal aortic aneurysm or dissection; using unibody bifurcated prosthesis ,,,3390.0,16207.0,24 CPT,34805,HEndovascular repair of infrarenal abdominal aortic aneurysm or dissection; using aorto-uniiliac or aorto-unifemoral prosthesis ,,,3390.0,16207.0,24 CPT,34806,"HTranscatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological supervision and interpretation, instrument calibration, and collection of ",,,3390.0,16207.0,24 CPT,34808,Endovascular placement of iliac artery occlusion device (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,34812,OPEN FEM ART EXPOSE UNI,39200.76,39200.76,5096.1,33320.65,20 CPT,34812,"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (List separately in addition to code for primary procedure) ",39200.76,39200.76,948.0,16207.0,109 CPT,34813,Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,34820,"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately in addition to ",,,948.0,16207.0,109 CPT,34825,"HPlacement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection; initial vessel ",,,3390.0,16207.0,24 CPT,34826,"HPlacement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection; each additional vessel (List separately ",,,3390.0,16207.0,24 CPT,34830,"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis ",,,948.0,21530.09,109 CPT,34831,"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis ",,,948.0,23729.68,109 CPT,34832,"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis ",,,948.0,22869.32,109 CPT,34833,"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List s",,,948.0,16207.0,205 CPT,34834,"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (List separately in addition to code for primary procedure) ",,,948.0,16207.0,205 CPT,34839,Physician planning of a patient-specific fenestrated visceral aortic endograft requiring a minimum of 90 minutes of physician time ,,,948.0,5841.0,72 CPT,34841,"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endogra",,,948.0,16207.0,109 CPT,34842,"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endogra",,,948.0,16207.0,109 CPT,34843,"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endogra",,,948.0,16207.0,109 CPT,34844,"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endogra",,,948.0,16207.0,109 CPT,34845,"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visc",,,948.0,16207.0,109 CPT,34846,"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visc",,,948.0,16207.0,109 CPT,34847,"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visc",,,948.0,16207.0,109 CPT,34848,"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visc",,,948.0,16207.0,109 CPT,34900,"HEndovascular repair of iliac artery (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using ilio-iliac tube endoprosthesis ",,,3390.0,16207.0,24 CPT,35001,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, b",,,948.0,16207.0,109 CPT,35002,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision ",,,948.0,16207.0,109 CPT,35005,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral ar",,,948.0,16207.0,109 CPT,35011,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by ",,,948.0,13835.0,110 CPT,35013,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision ",,,948.0,16207.0,109 CPT,35021,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, ",,,948.0,16207.0,109 CPT,35022,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision ",,,948.0,17236.75,109 CPT,35045,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ul",,,948.0,13835.0,110 CPT,35081,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal ao",,,948.0,21284.19,109 CPT,35082,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta ",,,948.0,26857.49,109 CPT,35091,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal ao",,,948.0,21962.39,109 CPT,35092,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteri",,,948.0,32011.07,109 CPT,35102,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal ao",,,948.0,23102.4,109 CPT,35103,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypo",,,948.0,27544.04,109 CPT,35111,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic arte",,,948.0,16207.0,109 CPT,35112,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery ",,,948.0,20004.35,109 CPT,35121,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, cel",,,948.0,20470.51,109 CPT,35122,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery ",,,948.0,23153.32,109 CPT,35131,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery",,,948.0,17046.0,109 CPT,35132,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external) ",,,948.0,19923.79,109 CPT,35141,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femor",,,948.0,16207.0,109 CPT,35142,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial ",,,948.0,16321.35,109 CPT,35151,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal ar",,,948.0,16207.0,109 CPT,35152,"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery ",,,948.0,16927.34,109 CPT,35161,REPAIR DEFECT OF ARTERY ,,,3390.0,5841.0,16 CPT,35162,REPAIR ARTERY RUPTURE ,,,3390.0,5841.0,16 CPT,35180,"Repair, congenital arteriovenous fistula; head and neck ",,,948.0,13835.0,110 CPT,35182,"Repair, congenital arteriovenous fistula; thorax and abdomen ",,,948.0,22000.49,109 CPT,35184,"Repair, congenital arteriovenous fistula; extremities ",,,948.0,13835.0,110 CPT,35188,"Repair, acquired or traumatic arteriovenous fistula; head and neck ",,,948.0,12547.6,233 CPT,35189,"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen ",,,948.0,18317.49,109 CPT,35190,"Repair, acquired or traumatic arteriovenous fistula; extremities ",,,948.0,13835.0,110 CPT,35201,"Repair blood vessel, direct; neck ",,,948.0,13835.0,206 CPT,35206,RPR UE BLDVSL DIRECT,17875.78,17875.78,2323.85,15194.41,15 CPT,35206,"Repair blood vessel, direct; upper extremity ",17875.78,17875.78,948.0,13835.0,206 CPT,35207,"Repair blood vessel, direct; hand, finger ",,,948.0,9653.0,233 CPT,35211,"Repair blood vessel, direct; intrathoracic, with bypass ",,,948.0,16969.8,109 CPT,35216,"Repair blood vessel, direct; intrathoracic, without bypass ",,,948.0,25306.23,109 CPT,35221,"Repair blood vessel, direct; intra-abdominal ",,,948.0,18003.85,109 CPT,35226,RPR LE BLDVSL DIRECT,4240.02,4240.02,551.2,3604.02,15 CPT,35226,"Repair blood vessel, direct; lower extremity ",4240.02,4240.02,714.92,13835.0,206 CPT,35231,Repair blood vessel with vein graft; neck ,,,948.0,13835.0,206 CPT,35236,Repair blood vessel with vein graft; upper extremity ,,,948.0,13835.0,206 CPT,35241,"Repair blood vessel with vein graft; intrathoracic, with bypass ",,,948.0,17669.05,109 CPT,35246,"Repair blood vessel with vein graft; intrathoracic, without bypass ",,,948.0,19182.09,109 CPT,35251,Repair blood vessel with vein graft; intra-abdominal ,,,948.0,21360.51,109 CPT,35256,Repair blood vessel with vein graft; lower extremity ,,,948.0,13835.0,206 CPT,35261,Repair blood vessel with graft other than vein; neck ,,,948.0,13835.0,206 CPT,35266,Repair blood vessel with graft other than vein; upper extremity ,,,948.0,13835.0,206 CPT,35271,"Repair blood vessel with graft other than vein; intrathoracic, with bypass ",,,948.0,16961.21,109 CPT,35276,"Repair blood vessel with graft other than vein; intrathoracic, without bypass ",,,948.0,17931.77,109 CPT,35281,Repair blood vessel with graft other than vein; intra-abdominal ,,,948.0,19847.47,109 CPT,35286,RPR LE BLDVSL NON VN GFT,33580.42,33580.42,4365.45,28543.36,15 CPT,35286,Repair blood vessel with graft other than vein; lower extremity ,33580.42,33580.42,948.0,13835.0,206 CPT,35301,"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision ",,,948.0,16207.0,109 CPT,35302,"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery ",,,948.0,16207.0,109 CPT,35303,"Thromboendarterectomy, including patch graft, if performed; popliteal artery ",,,948.0,16207.0,109 CPT,35304,"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery ",,,948.0,16207.0,109 CPT,35305,"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel ",,,948.0,16207.0,109 CPT,35306,"Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,35311,"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision ",,,948.0,19110.0,109 CPT,35321,"Thromboendarterectomy, including patch graft, if performed; axillary-brachial ",,,948.0,13835.0,206 CPT,35331,"Thromboendarterectomy, including patch graft, if performed; abdominal aorta ",,,948.0,17948.82,109 CPT,35341,"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal ",,,948.0,16927.34,109 CPT,35351,"Thromboendarterectomy, including patch graft, if performed; iliac ",,,948.0,16207.0,109 CPT,35355,"Thromboendarterectomy, including patch graft, if performed; iliofemoral ",,,948.0,16207.0,109 CPT,35361,"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac ",,,948.0,18563.28,109 CPT,35363,"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral ",,,948.0,19847.47,109 CPT,35371,THRMBOENDART COMMON FEM,18293.69,18293.69,2378.18,15549.64,20 CPT,35371,"Thromboendarterectomy, including patch graft, if performed; common femoral ",18293.69,18293.69,948.0,16207.0,109 CPT,35372,"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral ",,,948.0,16207.0,205 CPT,35381,RECHANNELING OF ARTERY ,,,3390.0,5841.0,16 CPT,35390,"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,35400,Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,35450,REPAIR ARTERIAL BLOCKAGE ,,,16207.0,16207.0,8 CPT,35452,REPAIR ARTERIAL BLOCKAGE ,,,16207.0,16207.0,8 CPT,35458,REPAIR ARTERIAL BLOCKAGE ,,,9493.0,9493.0,8 CPT,35460,REPAIR VENOUS BLOCKAGE ,,,9493.0,9493.0,8 CPT,35471,REPAIR ARTERIAL BLOCKAGE ,,,9493.0,9493.0,8 CPT,35472,REPAIR ARTERIAL BLOCKAGE ,,,9493.0,9493.0,8 CPT,35475,REPAIR ARTERIAL BLOCKAGE ,,,9493.0,9493.0,8 CPT,35476,REPAIR VENOUS BLOCKAGE ,,,9493.0,9493.0,8 CPT,35480,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35481,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35482,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35483,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35484,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35485,"ATHERECTOMY, OPEN ",,,3390.0,5841.0,16 CPT,35490,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35491,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35492,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35493,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35494,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35495,"ATHERECTOMY, PERCUTANEOUS ",,,3390.0,5841.0,16 CPT,35500,"Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure) ",,,948.0,5841.0,44 CPT,35501,"Bypass graft, with vein; common carotid-ipsilateral internal carotid ",,,948.0,18368.3,109 CPT,35506,"Bypass graft, with vein; carotid-subclavian or subclavian-carotid ",,,948.0,16207.0,109 CPT,35507,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35508,"Bypass graft, with vein; carotid-vertebral ",,,948.0,16207.0,109 CPT,35509,"Bypass graft, with vein; carotid-contralateral carotid ",,,948.0,17224.05,109 CPT,35510,"Bypass graft, with vein; carotid-brachial ",,,948.0,16207.0,109 CPT,35511,"Bypass graft, with vein; subclavian-subclavian ",,,948.0,16207.0,109 CPT,35512,"Bypass graft, with vein; subclavian-brachial ",,,948.0,16207.0,109 CPT,35515,"Bypass graft, with vein; subclavian-vertebral ",,,948.0,16207.0,109 CPT,35516,"Bypass graft, with vein; subclavian-axillary ",,,948.0,16207.0,109 CPT,35518,"Bypass graft, with vein; axillary-axillary ",,,948.0,16207.0,109 CPT,35521,"Bypass graft, with vein; axillary-femoral ",,,948.0,16207.0,109 CPT,35522,"Bypass graft, with vein; axillary-brachial ",,,948.0,16207.0,109 CPT,35523,"Bypass graft, with vein; brachial-ulnar or -radial ",,,948.0,16207.0,109 CPT,35525,"Bypass graft, with vein; brachial-brachial ",,,948.0,16207.0,109 CPT,35526,"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid ",,,948.0,21402.85,109 CPT,35531,"Bypass graft, with vein; aortoceliac or aortomesenteric ",,,948.0,23797.54,109 CPT,35533,"Bypass graft, with vein; axillary-femoral-femoral ",,,948.0,18368.3,109 CPT,35535,"Bypass graft, with vein; hepatorenal ",,,948.0,23305.85,109 CPT,35536,"Bypass graft, with vein; splenorenal ",,,948.0,20695.13,109 CPT,35537,"Bypass graft, with vein; aortoiliac ",,,948.0,25331.75,109 CPT,35538,"Bypass graft, with vein; aortobi-iliac ",,,948.0,28417.1,109 CPT,35539,"Bypass graft, with vein; aortofemoral ",,,948.0,26662.51,109 CPT,35540,"Bypass graft, with vein; aortobifemoral ",,,948.0,29955.54,109 CPT,35541,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35546,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35548,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35549,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35551,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35556,"Bypass graft, with vein; femoral-popliteal ",,,948.0,17173.13,109 CPT,35558,"Bypass graft, with vein; femoral-femoral ",,,948.0,16207.0,109 CPT,35560,"Bypass graft, with vein; aortorenal ",,,948.0,20584.94,109 CPT,35563,"Bypass graft, with vein; ilioiliac ",,,948.0,16207.0,109 CPT,35565,"Bypass graft, with vein; iliofemoral ",,,948.0,16207.0,109 CPT,35566,"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels ",,,948.0,20495.92,109 CPT,35570,"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial ",,,948.0,18533.64,109 CPT,35571,"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels ",,,948.0,16253.5,109 CPT,35572,"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,44 CPT,35582,VEIN BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35583,In-situ vein bypass; femoral-popliteal ,,,948.0,17732.67,109 CPT,35585,"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery ",,,948.0,20542.6,109 CPT,35587,"In-situ vein bypass; popliteal-tibial, peroneal ",,,948.0,16745.06,109 CPT,35600,"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open ",,,948.0,16207.0,109 CPT,35601,"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid ",,,948.0,17156.19,109 CPT,35602,"Bypass graft, with other than vein; carotid-contralateral carotid ",,,948.0,13788.6,56 CPT,35606,"Bypass graft, with other than vein; carotid-subclavian ",,,948.0,16207.0,109 CPT,35612,"Bypass graft, with other than vein; subclavian-subclavian ",,,948.0,16207.0,109 CPT,35616,"Bypass graft, with other than vein; subclavian-axillary ",,,948.0,16207.0,109 CPT,35621,"Bypass graft, with other than vein; axillary-femoral ",,,948.0,16207.0,109 CPT,35623,"Bypass graft, with other than vein; axillary-popliteal or -tibial ",,,948.0,16207.0,109 CPT,35626,"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid ",,,948.0,19499.96,109 CPT,35631,"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal ",,,948.0,22767.6,109 CPT,35632,"Bypass graft, with other than vein; ilio-celiac ",,,948.0,21919.93,109 CPT,35633,"Bypass graft, with other than vein; ilio-mesenteric ",,,948.0,24501.02,109 CPT,35634,"Bypass graft, with other than vein; iliorenal ",,,948.0,21555.49,109 CPT,35636,"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis) ",,,948.0,19516.9,109 CPT,35637,"Bypass graft, with other than vein; aortoiliac ",,,948.0,20241.66,109 CPT,35638,"Bypass graft, with other than vein; aortobi-iliac ",,,948.0,21580.89,109 CPT,35641,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35642,"Bypass graft, with other than vein; carotid-vertebral ",,,948.0,16207.0,109 CPT,35645,"Bypass graft, with other than vein; subclavian-vertebral ",,,948.0,16207.0,109 CPT,35646,"Bypass graft, with other than vein; aortobifemoral ",,,948.0,21080.74,109 CPT,35647,"Bypass graft, with other than vein; aortofemoral ",,,948.0,19084.6,109 CPT,35650,"Bypass graft, with other than vein; axillary-axillary ",,,948.0,16207.0,109 CPT,35651,ARTERY BYPASS GRAFT ,,,3390.0,5841.0,16 CPT,35654,"Bypass graft, with other than vein; axillary-femoral-femoral ",,,948.0,16812.92,109 CPT,35656,"Bypass graft, with other than vein; femoral-popliteal ",,,948.0,16207.0,109 CPT,35661,"Bypass graft, with other than vein; femoral-femoral ",,,948.0,16207.0,109 CPT,35663,"Bypass graft, with other than vein; ilioiliac ",,,948.0,16207.0,109 CPT,35665,"Bypass graft, with other than vein; iliofemoral ",,,948.0,16207.0,109 CPT,35666,"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery ",,,948.0,16207.0,109 CPT,35671,"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery ",,,948.0,16207.0,109 CPT,35681,"Bypass graft; composite, prosthetic and vein (List separately in addition to code for primary procedure) ",,,773.31,16207.0,109 CPT,35682,"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,35683,"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,35685,"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,44 CPT,35686,Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,44 CPT,35691,Transposition and/or reimplantation; vertebral to carotid artery ,,,948.0,16207.0,109 CPT,35693,Transposition and/or reimplantation; vertebral to subclavian artery ,,,948.0,16207.0,109 CPT,35694,Transposition and/or reimplantation; subclavian to carotid artery ,,,948.0,16207.0,109 CPT,35695,Transposition and/or reimplantation; carotid to subclavian artery ,,,948.0,16207.0,109 CPT,35697,"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,35700,"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (List separately in additi",,,948.0,16207.0,109 CPT,35701,"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian) ",,,948.0,16207.0,109 CPT,35702,"Exploration not followed by surgical repair, artery; upper extremity (eg, axillary, brachial, radial, ulnar) ",,,948.0,13835.0,197 CPT,35703,"Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal) ",,,948.0,13835.0,197 CPT,35721,"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; FEMORAL ARTERY ",,,3390.0,16207.0,24 CPT,35741,"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; POPLITEAL ARTERY ",,,3390.0,16207.0,24 CPT,35761,"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; OTHER VESSELS ",,,4988.0,7014.0,24 CPT,35800,"Exploration for postoperative hemorrhage, thrombosis or infection; neck ",,,948.0,16207.0,205 CPT,35820,"Exploration for postoperative hemorrhage, thrombosis or infection; chest ",,,948.0,24717.17,109 CPT,35840,"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen ",,,948.0,16207.0,109 CPT,35860,EXPLORE POSTOP EXTREMITY,16962.17,16962.17,2205.08,14417.84,15 CPT,35860,"Exploration for postoperative hemorrhage, thrombosis or infection; extremity ",16962.17,16962.17,948.0,13835.0,206 CPT,35870,Repair of graft-enteric fistula ,,,948.0,16207.0,109 CPT,35875,Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); ,,,948.0,15059.0,233 CPT,35876,Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft ,,,948.0,15059.0,233 CPT,35879,"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty ",,,948.0,13835.0,110 CPT,35881,"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition ",,,948.0,13835.0,110 CPT,35883,"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, polyester, ePTFE, bovine pericardium) ",,,948.0,15059.0,206 CPT,35884,"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft ",,,948.0,15059.0,206 CPT,35901,Excision of infected graft; neck ,,,948.0,16207.0,109 CPT,35903,Excision of infected graft; extremity ,,,948.0,13835.0,110 CPT,35905,Excision of infected graft; thorax ,,,948.0,20466.28,109 CPT,35907,Excision of infected graft; abdomen ,,,948.0,23416.04,109 CPT,36000,"Introduction of needle or intracatheter, vein ",,,948.0,1672.0,28 CPT,36002,INJ PERC EXTREM PSEAN BI,28622.44,28622.44,4007.14,24329.07,11 CPT,36002,INJ PERC EXTREM PSEAN LT,19081.62,19081.62,2671.43,16219.38,11 CPT,36002,INJ PERC EXTREM PSEAN RT,19081.62,19081.62,2671.43,16219.38,11 CPT,36002,"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm ",,,234.94,5841.0,225 CPT,36005,INJ VENOGRAM BI,1232.87,1232.87,160.27,1047.94,29 CPT,36005,INJ VENOGRAM LT,821.91,821.91,106.85,698.62,29 CPT,36005,INJ VENOGRAM RT,821.91,821.91,106.85,698.62,29 CPT,36005,Injection procedure for extremity venography (including introduction of needle or intracatheter) ,,,948.0,5841.0,140 CPT,36010,CATH IVC/SVC,2434.36,2434.36,316.47,2069.21,29 CPT,36010,CATH IVC/SVC BI,3651.54,3651.54,474.7,3103.81,29 CPT,36010,"Introduction of catheter, superior or inferior vena cava ",,,948.0,5841.0,140 CPT,36011,CATH 1ST ORDER VEN BI,1822.85,1822.85,236.97,1549.42,29 CPT,36011,CATH 1ST ORDER VEN LT,1215.23,1215.23,157.98,1032.95,29 CPT,36011,CATH 1ST ORDER VEN RT,1215.23,1215.23,157.98,1032.95,29 CPT,36011,"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein) ",,,948.0,5841.0,140 CPT,36012,CATH 2ND ORDER VEN BI,2061.96,2061.96,268.05,1752.67,29 CPT,36012,CATH 2ND ORDER VEN LT,1374.63,1374.63,178.7,1168.44,29 CPT,36012,CATH 2ND ORDER VEN RT,1374.63,1374.63,178.7,1168.44,29 CPT,36012,"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus) ",,,948.0,5841.0,140 CPT,36013,CATH RT HRT/PULM ART,2580.6,2580.6,154.84,2193.51,31 CPT,36013,"Introduction of catheter, right heart or main pulmonary artery ",2580.6,2580.6,948.0,5841.0,140 CPT,36014,CATH PULM ART UNI BI,4332.04,4332.04,259.92,3682.23,31 CPT,36014,CATH PULM ART UNI LT,2888.03,2888.03,173.28,2454.83,31 CPT,36014,CATH PULM ART UNI RT,2888.03,2888.03,173.28,2454.83,31 CPT,36014,"Selective catheter placement, left or right pulmonary artery ",,,948.0,5841.0,140 CPT,36015,CATH PLM ART SEG/SUB BI,5060.72,5060.72,303.64,4301.61,31 CPT,36015,CATH PLM ART SEG/SUB LT,3373.81,3373.81,202.43,2867.74,31 CPT,36015,CATH PLM ART SEG/SUB RT,3373.81,3373.81,202.43,2867.74,31 CPT,36015,"Selective catheter placement, segmental or subsegmental pulmonary artery ",,,948.0,5841.0,140 CPT,36100,"Introduction of needle or intracatheter, carotid or vertebral artery ",,,948.0,5841.0,140 CPT,36120,HIntroduction of needle or intracatheter; retrograde brachial artery ,,,2358.0,5841.0,16 CPT,36140,"Introduction of needle or intracatheter, upper or lower extremity artery ",,,948.0,5841.0,140 CPT,36140,NDL/INCATH EXT ART,1903.85,1903.85,247.5,1618.27,29 CPT,36140,NDL/INCATH EXT ART 59,1903.85,1903.85,247.5,1618.27,29 CPT,36145,ARTERY TO VEIN SHUNT ,,,3390.0,5841.0,16 CPT,36147,ACCESS AV DIAL GRFT FOR EVAL ,,,2431.0,2979.0,24 CPT,36148,ACCESS AV DIAL GRFT FOR PROC ,,,2358.0,5841.0,16 CPT,36160,"Introduction of needle or intracatheter, aortic, translumbar ",,,948.0,5841.0,140 CPT,36200,CATH AORTA,5975.7,5975.7,358.54,5079.35,31 CPT,36200,"Introduction of catheter, aorta ",5975.7,5975.7,948.0,5841.0,140 CPT,36215,CATH 1ST ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CPT,36215,CATH 1ST ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CPT,36215,"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,140 CPT,36216,CATH 2ND ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CPT,36216,CATH 2ND ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CPT,36216,"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,140 CPT,36217,CATH 3RD ORD UP ART LT,5973.03,5973.03,358.38,5077.08,31 CPT,36217,CATH 3RD ORD UP ART RT,5973.03,5973.03,358.38,5077.08,31 CPT,36217,"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,140 CPT,36218,CATH EA ADDL UP ART LT,14706.34,14706.34,882.38,12500.39,31 CPT,36218,CATH EA ADDL UP ART RT,14706.34,14706.34,882.38,12500.39,31 CPT,36218,"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial seco",,,948.0,5841.0,140 CPT,36221,NSP THOR AORT W/ ANGIO,14172.39,14172.39,1842.41,12046.53,15 CPT,36221,"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervi",14172.39,14172.39,948.0,13835.0,206 CPT,36222,SP EX CAROTID ANGIO BI,25221.51,25221.51,3278.8,21438.28,15 CPT,36222,SP EX CAROTID ANGIO LT,16814.51,16814.51,2185.89,14292.33,15 CPT,36222,SP EX CAROTID ANGIO RT,16814.51,16814.51,2185.89,14292.33,15 CPT,36222,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,206 CPT,36223,SP COM CAROTIDANGIO BI,21258.58,21258.58,2763.62,18069.79,15 CPT,36223,SP COM CAROTIDANGIO LT,14172.39,14172.39,1842.41,12046.53,15 CPT,36223,SP COM CAROTIDANGIO RT,14172.39,14172.39,1842.41,12046.53,15 CPT,36223,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,206 CPT,36224,SP INT CAROTID ANGIO BI,30251.69,30251.69,3932.72,25713.94,15 CPT,36224,SP INT CAROTID ANGIO LT,25511.86,25511.86,3316.54,21685.08,15 CPT,36224,SP INT CAROTID ANGIO RT,25511.86,25511.86,3316.54,21685.08,15 CPT,36224,"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, ",,,948.0,13835.0,206 CPT,36225,SP SUBCL ANGIO BI,21258.58,21258.58,2763.62,18069.79,15 CPT,36225,SP SUBCL ANGIO LT,14172.39,14172.39,1842.41,12046.53,15 CPT,36225,SP SUBCL ANGIO RT,14172.39,14172.39,1842.41,12046.53,15 CPT,36225,"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, inc",,,948.0,13835.0,206 CPT,36226,SP VERT ANGIO BI,38267.79,38267.79,4974.81,32527.62,15 CPT,36226,SP VERT ANGIO LT,25511.86,25511.86,3316.54,21685.08,15 CPT,36226,SP VERT ANGIO RT,25511.86,25511.86,3316.54,21685.08,15 CPT,36226,"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiograp",,,948.0,13835.0,206 CPT,36227,SP EX CARTIDANGIOUNI +LT,1419.07,1419.07,184.48,1206.21,26 CPT,36227,SP EX CARTIDANGIOUNI +RT,1419.07,1419.07,184.48,1206.21,26 CPT,36227,"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List",,,948.0,13835.0,161 CPT,36228,SP INCRAN ANGIO LT,5668.43,5668.43,736.9,4818.17,26 CPT,36228,SP INCRAN ANGIO RT,5668.43,5668.43,736.9,4818.17,26 CPT,36228,"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological su",,,948.0,13835.0,161 CPT,36245,CATH 1ST OD LOW ART BI,8800.9,8800.9,1144.12,7480.77,29 CPT,36245,CATH 1ST OD LOW ART LT,5867.05,5867.05,762.72,4986.99,29 CPT,36245,CATH 1ST OD LOW ART RT,5867.05,5867.05,762.72,4986.99,29 CPT,36245,"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,140 CPT,36246,CATH 2ND OD LOW ART BI,12542.29,12542.29,1630.5,10660.95,29 CPT,36246,CATH 2ND OD LOW ART LT,8361.52,8361.52,1087.0,7107.29,29 CPT,36246,CATH 2ND OD LOW ART RT,8361.52,8361.52,1087.0,7107.29,29 CPT,36246,"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,140 CPT,36247,CATH 3RD OD LOW ART BI,8796.65,8796.65,1143.56,7477.15,29 CPT,36247,CATH 3RD OD LOW ART LT,5864.43,5864.43,762.38,4984.77,29 CPT,36247,CATH 3RD OD LOW ART RT,5864.43,5864.43,762.38,4984.77,29 CPT,36247,"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,140 CPT,36248,"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code",,,948.0,5841.0,140 CPT,36251,CATH 1ST OD RENAL LT,10816.79,10816.79,1406.18,9194.27,15 CPT,36251,CATH 1ST OD RENAL RT,10816.79,10816.79,1406.18,9194.27,15 CPT,36251,"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast inje",,,948.0,13835.0,206 CPT,36252,CATH 1ST OD RENAL BIL,10816.79,10816.79,1406.18,9194.27,15 CPT,36252,"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast inje",10816.79,10816.79,948.0,13835.0,206 CPT,36253,CATH 1 OR M 2ND OD RNLLT,10816.79,10816.79,1406.18,9194.27,15 CPT,36253,CATH 1 OR M 2ND OD RNLRT,10816.79,10816.79,1406.18,9194.27,15 CPT,36253,"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheter",,,948.0,13835.0,206 CPT,36254,CATH 1 OR M 2ND OD RNLBI,10816.79,10816.79,1406.18,9194.27,15 CPT,36254,"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheter",10816.79,10816.79,948.0,13835.0,206 CPT,36260,"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver) ",,,948.0,41580.0,249 CPT,36261,Revision of implanted intra-arterial infusion pump ,,,948.0,8146.35,233 CPT,36262,Removal of implanted intra-arterial infusion pump ,,,948.0,8146.35,233 CPT,36299,"Unlisted procedure, vascular injection ",,,948.0,5841.0,44 CPT,36400,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein ",,,948.0,948.0,20 CPT,36405,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein ",,,948.0,948.0,20 CPT,36406,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein ",,,948.0,948.0,20 CPT,36410,VENIPUNCTURE 3+YRS DX/TX,248.53,248.53,32.31,211.25,32 CPT,36410,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",248.53,248.53,25.76,948.0,101 CPT,36415,Collection of venous blood by venipuncture ,,,7.29,948.0,147 CPT,36416,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,948.0,101 CPT,36420,"Venipuncture, cutdown; younger than age 1 year ",,,112.77,3244.0,182 CPT,36425,"Venipuncture, cutdown; age 1 or over ",,,451.0,3244.0,182 CPT,36430,BLOOD TRANSFUSION,3726.0,3726.0,223.56,3167.1,40 CPT,36430,"Transfusion, blood or blood components ",3726.0,3726.0,32.27,5841.0,225 CPT,36440,"Push transfusion, blood, 2 years or younger ",,,445.4,5841.0,198 CPT,36450,"Exchange transfusion, blood; newborn ",,,172.52,5841.0,225 CPT,36455,"Exchange transfusion, blood; other than newborn ",,,172.52,5841.0,225 CPT,36456,"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn ",,,445.4,5841.0,198 CPT,36460,"Transfusion, intrauterine, fetal ",,,445.4,5841.0,198 CPT,36465,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity t",,,744.46,15059.0,225 CPT,36466,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal v",,,744.46,15059.0,225 CPT,36468,"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk ",,,358.2,5841.0,198 CPT,36469,INJECTION(S) SPIDER VEINS ,,,3390.0,5841.0,16 CPT,36470,INJ SCLEROSANT SNGL VEIN,326.88,326.88,45.76,277.85,11 CPT,36470,Injection of sclerosant; single incompetent vein (other than telangiectasia) ,326.88,326.88,74.13,5841.0,225 CPT,36471,"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg ",,,122.09,5841.0,225 CPT,36473,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated ",,,948.0,18734.14,225 CPT,36474,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each thro",,,948.0,5841.0,140 CPT,36475,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated ",,,948.0,15059.0,233 CPT,36476,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each throu",,,948.0,5841.0,140 CPT,36478,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated ",,,948.0,15059.0,233 CPT,36479,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separa",,,948.0,5841.0,140 CPT,36481,Percutaneous portal vein catheterization by any method ,,,948.0,5841.0,140 CPT,36482,"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and moni",,,948.0,25767.84,198 CPT,36483,"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and moni",,,948.0,5841.0,140 CPT,36488,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,16 CPT,36489,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,16 CPT,36490,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,16 CPT,36491,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,16 CPT,36493,REPOSITIONING OF CVC ,,,3390.0,5841.0,16 CPT,36500,Venous catheterization for selective organ blood sampling ,,,948.0,5841.0,140 CPT,36510,"Catheterization of umbilical vein for diagnosis or therapy, newborn ",,,948.0,5841.0,44 CPT,36511,Therapeutic apheresis; for white blood cells ,,,592.85,13835.0,233 CPT,36512,Therapeutic apheresis; for red blood cells ,,,592.85,13835.0,233 CPT,36513,Therapeutic apheresis; for platelets ,,,172.52,13835.0,233 CPT,36514,Therapeutic apheresis; for plasma pheresis ,,,592.85,13835.0,233 CPT,36515,HTherapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion ,,,6326.0,8104.0,24 CPT,36516,"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion ",,,948.0,27628.58,233 CPT,36520,Plasma and/or cell exchange ,,,3390.0,5841.0,16 CPT,36521,Apheresis w/ adsorp/reinfuse ,,,3390.0,5841.0,16 CPT,36522,"Photopheresis, extracorporeal ",,,948.0,13835.0,233 CPT,36530,INSERTION OF INFUSION PUMP ,,,3390.0,5841.0,16 CPT,36531,REVISION OF INFUSION PUMP ,,,3390.0,5841.0,16 CPT,36532,REMOVAL OF INFUSION PUMP ,,,3390.0,5841.0,16 CPT,36533,INSERTION OF ACCESS DEVICE ,,,3390.0,5841.0,16 CPT,36534,REVISION OF ACCESS DEVICE ,,,3390.0,5841.0,16 CPT,36535,REMOVAL OF ACCESS DEVICE ,,,3390.0,5841.0,16 CPT,36540,COLLECT BLOOD VENOUS DEVICE ,,,3390.0,5841.0,16 CPT,36550,DECLOT VASCULAR DEVICE ,,,3390.0,5841.0,16 CPT,36555,Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age ,,,948.0,11153.0,242 CPT,36556,INS CVC NON-TUN CENT=>5Y,7500.42,7500.42,1050.06,6375.36,10 CPT,36556,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older ,7500.42,7500.42,948.0,11153.0,242 CPT,36557,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age ",,,948.0,12547.6,242 CPT,36558,INS TUN CVC CENT WO=>5Y,12736.33,12736.33,1783.09,10825.88,10 CPT,36558,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older ",12736.33,12736.33,948.0,11153.0,242 CPT,36560,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,242 CPT,36561,INS CVAD W PORT CENT=>5Y,24804.93,24804.93,3472.69,21084.19,10 CPT,36561,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older ",24804.93,24804.93,948.0,12562.0,242 CPT,36563,Insertion of tunneled centrally inserted central venous access device with subcutaneous pump ,,,948.0,12562.0,242 CPT,36565,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter) ",,,948.0,12562.0,242 CPT,36566,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s) ",,,948.0,12909.0,242 CPT,36568,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age ",,,468.58,11153.0,242 CPT,36569,INS PICC WO PORT/IMG=>5Y,7657.21,7657.21,1072.01,6508.63,10 CPT,36569,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older ",7657.21,7657.21,468.58,11153.0,242 CPT,36570,"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,242 CPT,36571,"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,948.0,12562.0,242 CPT,36572,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",,,234.94,12562.0,234 CPT,36573,INS PICC WO P W IMG=>5Y,6962.06,6962.06,974.69,5917.75,11 CPT,36573,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",6962.06,6962.06,468.58,11153.0,234 CPT,36575,"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site ",,,234.94,11153.0,242 CPT,36576,RPR CVAD W/ P-P,3155.66,3155.66,441.79,2682.31,10 CPT,36576,"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",3155.66,3155.66,468.58,11153.0,242 CPT,36578,"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,948.0,11153.0,242 CPT,36580,REPL NON-TUN CVC W/O P-P,3155.66,3155.66,441.79,2682.31,10 CPT,36580,"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",3155.66,3155.66,635.9,11153.0,242 CPT,36581,REPL TUN CV CATH W/O P-P,11587.74,11587.74,1622.28,9849.58,10 CPT,36581,"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",11587.74,11587.74,948.0,11153.0,242 CPT,36582,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,242 CPT,36583,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access ",,,948.0,12562.0,242 CPT,36584,"Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, an",,,468.58,11153.0,242 CPT,36585,"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,242 CPT,36589,REM TUN CV CATH WO/P-P,10816.79,10816.79,1514.35,9194.27,10 CPT,36589,"Removal of tunneled central venous catheter, without subcutaneous port or pump ",10816.79,10816.79,234.94,11153.0,242 CPT,36590,REM TUN CVAD W/P-P,5616.16,5616.16,786.26,4773.74,10 CPT,36590,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion ",5616.16,5616.16,468.58,11153.0,242 CPT,36591,Collection of blood specimen from a completely implantable venous access device ,,,134.32,11153.0,72 CPT,36592,"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified ",,,134.32,11153.0,72 CPT,36593,Declotting by thrombolytic agent of implanted vascular access device or catheter ,,,27.62,11153.0,234 CPT,36595,"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access ",,,948.0,11153.0,242 CPT,36596,Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen ,,,468.58,11153.0,242 CPT,36597,REPO PREV PLCD CVC FLURO,3486.25,3486.25,488.07,2963.31,10 CPT,36597,Repositioning of previously placed central venous catheter under fluoroscopic guidance ,3486.25,3486.25,468.58,11153.0,242 CPT,36598,"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report ",,,83.43,11153.0,234 CPT,36600,ARTERIAL PUNCTURE,175.4,175.4,10.52,149.09,37 CPT,36600,"Arterial puncture, withdrawal of blood for diagnosis ",175.4,175.4,134.32,11153.0,103 CPT,36620,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous ",,,948.0,11153.0,149 CPT,36625,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown ",,,948.0,11153.0,53 CPT,36640,"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown ",,,948.0,11153.0,242 CPT,36660,"Catheterization, umbilical artery, newborn, for diagnosis or therapy ",,,654.37,16207.0,118 CPT,36680,Placement of needle for intraosseous infusion ,,,451.0,11153.0,207 CPT,36800,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein ",,,2036.11,12562.0,222 CPT,36800,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein High Cost Surgery",,,2369.0,2369.0,20 CPT,36810,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) ",,,1174.13,12562.0,222 CPT,36810,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) High Cost Surgery",,,2369.0,2369.0,20 CPT,36815,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure ",,,2036.11,12562.0,222 CPT,36815,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure High Cost Surgery",,,2369.0,2369.0,20 CPT,36818,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition ",,,2036.11,12562.0,222 CPT,36818,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition High Cost Surgery",,,2369.0,2369.0,20 CPT,36819,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition ",,,2036.11,12562.0,222 CPT,36819,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition High Cost Surgery",,,2369.0,2369.0,20 CPT,36820,"Arteriovenous anastomosis, open; by forearm vein transposition ",,,2036.11,12562.0,222 CPT,36820,"Arteriovenous anastomosis, open; by forearm vein transposition High Cost Surgery",,,2369.0,2369.0,20 CPT,36821,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) ",,,1174.13,12562.0,222 CPT,36821,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,36822,INSERTION OF CANNULA(S) ,,,5841.0,5841.0,8 CPT,36823,"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) ",,,2369.0,17122.32,118 CPT,36825,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft ,,,2036.11,12547.6,222 CPT,36825,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft High Cost Surgery,,,2369.0,2369.0,20 CPT,36830,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) ",,,2036.11,12547.6,222 CPT,36830,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) High Cost Surgery",,,2369.0,2369.0,20 CPT,36831,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,15059.0,222 CPT,36831,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,36832,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,222 CPT,36832,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,36833,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,222 CPT,36833,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,36834,REPAIR A-V ANEURYSM ,,,5841.0,5841.0,8 CPT,36835,Insertion of Thomas shunt (separate procedure) ,,,1747.39,11153.0,222 CPT,36835,Insertion of Thomas shunt (separate procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,36836,"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angiopl",,,2036.11,46894.85,234 CPT,36837,"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angi",,,2036.11,46894.85,234 CPT,36838,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) ",,,2996.0,13835.0,195 CPT,36838,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) High Cost Surgery",,,2369.0,2369.0,20 CPT,36860,External cannula declotting (separate procedure); without balloon catheter ,,,468.58,11153.0,222 CPT,36860,External cannula declotting (separate procedure); without balloon catheter High Cost Surgery,,,2369.0,2369.0,20 CPT,36861,External cannula declotting (separate procedure); with balloon catheter ,,,2699.0,12562.0,222 CPT,36861,External cannula declotting (separate procedure); with balloon catheter High Cost Surgery,,,2369.0,2369.0,20 CPT,36870,PERCUT THROMBECT AV FISTULA ,,,6326.0,8104.0,16 CPT,36901,DIALYSIS CIRC DX ANGIO,2728.37,2728.37,381.97,2319.11,11 CPT,36901,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",2728.37,2728.37,468.58,8211.95,225 CPT,36902,DIALYSIS CIRC BLN ANGIOP,15377.15,15377.15,2152.8,13070.58,11 CPT,36902,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",15377.15,15377.15,1853.13,13835.0,215 CPT,36903,DIALYSIS CIRC INTRV STNT,29707.65,29707.65,4159.07,25251.5,11 CPT,36903,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",29707.65,29707.65,948.0,27050.15,225 CPT,36904,DIALYSIS CIRC THRMB,15377.15,15377.15,2152.8,13070.58,11 CPT,36904,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",15377.15,15377.15,948.0,13835.0,241 CPT,36905,DIALYSIS CIRC THRMB/BLN,29707.65,29707.65,4159.07,25251.5,11 CPT,36905,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",29707.65,29707.65,3673.0,27050.15,231 CPT,36906,DIALYSIS CIRC THRMB/STNT,97747.1,97747.1,13684.59,83085.04,11 CPT,36906,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",97747.1,97747.1,948.0,43516.12,233 CPT,36907,DIAL SEG CTRL BLN ANGIOP,31013.03,31013.03,4031.69,26361.08,29 CPT,36907,"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplast",31013.03,31013.03,1672.0,7818.0,130 CPT,36908,DIAL SEG CTRL INTRV STNT,31013.03,31013.03,4031.69,26361.08,29 CPT,36908,"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perfo",31013.03,31013.03,948.0,5841.0,140 CPT,36909,DIALYSIS CIRCUIT EMBOLJ,43510.23,43510.23,5656.33,36983.7,29 CPT,36909,"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation neces",43510.23,43510.23,948.0,5841.0,140 CPT,37140,"Venous anastomosis, open; portocaval ",,,948.0,28565.51,109 CPT,37145,"Venous anastomosis, open; renoportal ",,,948.0,26488.69,109 CPT,37160,"Venous anastomosis, open; caval-mesenteric ",,,948.0,27217.7,109 CPT,37180,"Venous anastomosis, open; splenorenal, proximal ",,,948.0,26162.35,109 CPT,37181,"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique) ",,,948.0,28565.51,109 CPT,37182,INS TRNVEN INTRHEP SHUNT,37351.79,37351.79,4855.73,31749.02,20 CPT,37182,"Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract format",37351.79,37351.79,948.0,16207.0,205 CPT,37183,REV TRNVEN INTRHEP SHUNT,18679.16,18679.16,2428.29,15877.29,15 CPT,37183,"Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannu",18679.16,18679.16,948.0,13835.0,206 CPT,37184,ART THRMB NCOR IN VSL BI,16760.28,16760.28,2346.44,14246.24,10 CPT,37184,ART THRMB NONCOR INI LT,11173.52,11173.52,1564.29,9497.49,10 CPT,37184,ART THRMB NONCOR INI RT,11173.52,11173.52,1564.29,9497.49,10 CPT,37184,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",,,948.0,27050.15,233 CPT,37185,ART THRMB NONCOR SUB VSL,4095.18,4095.18,532.37,3480.9,29 CPT,37185,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",4095.18,4095.18,948.0,5841.0,140 CPT,37186,SEC ART THRMB NONCOR,6145.37,6145.37,798.9,5223.56,29 CPT,37186,"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic ",6145.37,6145.37,948.0,5841.0,140 CPT,37187,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance ",,,948.0,15059.0,233 CPT,37187,VENOUS MECH THROMBECT BI,15764.6,15764.6,2207.04,13399.91,10 CPT,37187,VENOUS MECH THROMBECT LT,10509.73,10509.73,1471.36,8933.27,10 CPT,37187,VENOUS MECH THROMBECT RT,10509.73,10509.73,1471.36,8933.27,10 CPT,37188,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during cours",7508.26,7508.26,948.0,15059.0,233 CPT,37188,VEN THRMB REPEAT SUB DAY,7508.26,7508.26,1051.16,6382.02,10 CPT,37191,INSRT IVC FILTER W IMAG,24333.22,24333.22,3163.32,20683.24,15 CPT,37191,"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imagin",24333.22,24333.22,948.0,13835.0,206 CPT,37192,REPOS IVC FILTER W IMG,24333.22,24333.22,3163.32,20683.24,15 CPT,37192,"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and im",24333.22,24333.22,948.0,13835.0,206 CPT,37193,REMOVAL IVCF ENDO APRCH,24333.22,24333.22,3163.32,20683.24,15 CPT,37193,"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, ",24333.22,24333.22,948.0,13835.0,206 CPT,37195,"Thrombolysis, cerebral, by intravenous infusion ",,,333.47,5841.0,102 CPT,37197,TRANSCATH RTRV FB S&I,15876.31,15876.31,2222.68,13494.86,10 CPT,37197,"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound",15876.31,15876.31,948.0,15059.0,233 CPT,37200,Transcatheter biopsy ,,,948.0,12547.6,233 CPT,37201,TRANSCATHETER THERAPY INFUSE ,,,3390.0,5841.0,16 CPT,37202,TRANSCATHETER THERAPY INFUSE ,,,5841.0,5841.0,8 CPT,37203,TRANSCATHETER RETRIEVAL ,,,5841.0,5841.0,8 CPT,37204,TRANSCATHETER OCCLUSION ,,,5841.0,5841.0,8 CPT,37205,TRANSCATH IV STENT PERCUT ,,,5841.0,5841.0,8 CPT,37206,TRANSCATH IV STENT/PERC ADDL ,,,5841.0,5841.0,8 CPT,37207,TRANSCATH IV STENT OPEN ,,,5841.0,5841.0,8 CPT,37208,TRANSCATH IV STENT/OPEN ADDL ,,,5841.0,5841.0,8 CPT,37209,CHANGE IV CATH AT THROMB TX ,,,3390.0,5841.0,16 CPT,37210,EMBOLIZATION UTERINE FIBROID ,,,3390.0,5841.0,16 CPT,37211,TRNSCTH TX ART INI DAYLT,5195.4,5195.4,727.36,4416.09,10 CPT,37211,TRNSCTH TX ART INI DAYRT,5195.4,5195.4,727.36,4416.09,10 CPT,37211,TRNSCTH TX ART INI DY BI,7793.11,7793.11,1091.04,6624.14,10 CPT,37211,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day ",,,1986.0,12547.6,222 CPT,37211,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day High Cost Surger",,,2369.0,2369.0,20 CPT,37212,TRNSCTH TX VEN INI DAYLT,4556.43,4556.43,637.9,3872.97,10 CPT,37212,TRNSCTH TX VEN INI DAYRT,4556.43,4556.43,637.9,3872.97,10 CPT,37212,TRNSCTH TX VN INI DAY BI,6834.65,6834.65,956.85,5809.45,10 CPT,37212,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day ",,,1594.88,11153.0,222 CPT,37212,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day High Cost Surgery",,,2369.0,2369.0,20 CPT,37213,TRNSCTH TX ART/VEN SUB,3211.84,3211.84,417.54,2730.06,15 CPT,37213,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",3211.84,3211.84,2012.0,15059.0,215 CPT,37214,TRNSCTH TX ART/VEN FINAL,1767.95,1767.95,229.83,1502.76,15 CPT,37214,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",1767.95,1767.95,2012.0,15059.0,215 CPT,37215,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal em",,,2369.0,43890.0,224 CPT,37216,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal",,,2369.0,43890.0,224 CPT,37217,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angiop",,,2369.0,43890.0,215 CPT,37218,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiolo",,,2369.0,43890.0,205 CPT,37220,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty ",,,2454.04,9653.0,51 CPT,37221,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5352.25,11113.0,51 CPT,37222,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)",,,9124.0,9653.0,24 CPT,37223,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when p",,,9124.0,9653.0,24 CPT,37224,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty ",,,2638.63,9653.0,51 CPT,37225,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed ",,,5796.69,11113.0,51 CPT,37226,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5604.99,11113.0,51 CPT,37227,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when",,,8579.0,13313.0,51 CPT,37228,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty ",,,4988.47,9653.0,51 CPT,37229,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed ",,,9049.29,11113.0,51 CPT,37230,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf",,,8922.21,11113.0,51 CPT,37231,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same v",,,8579.0,13313.0,51 CPT,37232,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary proced",,,9124.0,9653.0,24 CPT,37233,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List s",,,10586.0,11113.0,24 CPT,37234,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, wh",,,9124.0,9653.0,24 CPT,37235,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the",,,9124.0,9653.0,24 CPT,37236,TRANSCTH STNT PLC IA BI,88944.57,88944.57,12452.24,75602.88,10 CPT,37236,TRANSCTH STNT PLC IA LT,59296.37,59296.37,8301.49,50401.91,10 CPT,37236,TRANSCTH STNT PLC IA RT,59296.37,59296.37,8301.49,50401.91,10 CPT,37236,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,2369.0,43890.0,259 CPT,37237,TRANSCTH STNT PLC AD BI,43022.85,43022.85,5592.97,36569.42,28 CPT,37237,TRANSCTH STNT PLC AD LT,28681.89,28681.89,3728.65,24379.61,28 CPT,37237,TRANSCTH STNT PLC AD RT,28681.89,28681.89,3728.65,24379.61,28 CPT,37237,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,1986.0,43890.0,164 CPT,37238,TRNSCTH STN PLC IN VN BI,88944.57,88944.57,12452.24,75602.88,10 CPT,37238,TRNSCTH STN PLC IN VN LT,59296.37,59296.37,8301.49,50401.91,10 CPT,37238,TRNSCTH STN PLC IN VN RT,59296.37,59296.37,8301.49,50401.91,10 CPT,37238,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; init",,,2369.0,43890.0,259 CPT,37239,TRNSCTH STN PLC EA VN BI,43022.85,43022.85,5592.97,36569.42,28 CPT,37239,TRNSCTH STN PLC EA VN LT,28681.89,28681.89,3728.65,24379.61,28 CPT,37239,TRNSCTH STN PLC EA VN RT,28681.89,28681.89,3728.65,24379.61,28 CPT,37239,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each",,,1986.0,43890.0,174 CPT,37241,VASC EMBOLIZ VENOUS,56971.77,56971.77,7976.05,48426.0,10 CPT,37241,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, othe",56971.77,56971.77,2369.0,59899.7,249 CPT,37242,VASC EMBOLIZ ARTERIAL,66956.21,66956.21,9373.87,56912.78,10 CPT,37242,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, ot",66956.21,66956.21,2369.0,27050.15,249 CPT,37243,VASC EMBOL TUM/ORG/INF,131851.76,131851.76,18459.25,112074.0,10 CPT,37243,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, ",131851.76,131851.76,2369.0,27050.15,249 CPT,37244,VASC EMBOL ART VEN HEM,56971.77,56971.77,7406.33,48426.0,15 CPT,37244,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial",56971.77,56971.77,2369.0,27050.15,222 CPT,37246,TRANS ANGIO SAME ART INT,20640.51,20640.51,2889.67,17544.43,11 CPT,37246,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",20640.51,20640.51,2369.0,13835.0,235 CPT,37247,TRANS ANGIO SAME ART EAD,24875.5,24875.5,3233.82,21144.17,29 CPT,37247,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",24875.5,24875.5,1672.0,7818.0,150 CPT,37248,TRANS BAL ANGIO EA IN LT,31226.02,31226.02,4371.64,26542.12,11 CPT,37248,TRANS BAL ANGIO EA IN RT,31226.02,31226.02,4371.64,26542.12,11 CPT,37248,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1853.13,13835.0,235 CPT,37249,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1672.0,7818.0,150 CPT,37250,IV US FIRST VESSEL ADD-ON ,,,3390.0,5841.0,16 CPT,37251,IV US EACH ADD VESSEL ADD-ON ,,,3390.0,5841.0,16 CPT,37252,INTVSC US NONCORN INIT,939.51,939.51,122.14,798.58,29 CPT,37252,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List sepa",939.51,939.51,1672.0,5841.0,140 CPT,37253,INTVSC US NONCORN EADD,939.51,939.51,122.14,798.58,29 CPT,37253,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (L",939.51,939.51,1672.0,5841.0,140 CPT,37254,RVSC IVT ANG SFL IN BI,121120.55,121120.55,15745.67,102952.47,27 CPT,37254,RVSC IVT ANG SFL IN LT,80747.03,80747.03,10497.11,68634.98,27 CPT,37254,RVSC IVT ANG SFL IN RT,80747.03,80747.03,10497.11,68634.98,27 CPT,37254,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,2369.0,15874.51,152 CPT,37255,RVSC IVT ANG SFL EA LT,25783.65,25783.65,3351.87,21916.1,32 CPT,37255,RVSC IVT ANG SFL EA RT,25783.65,25783.65,3351.87,21916.1,32 CPT,37255,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,1986.0,3083.0,116 CPT,37256,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,2369.0,15874.51,152 CPT,37257,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,1986.0,3083.0,116 CPT,37258,RVSC IVT STN SFL IN BI,110293.29,110293.29,14338.13,93749.3,27 CPT,37258,RVSC IVT STN SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CPT,37258,RVSC IVT STN SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CPT,37258,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,2369.0,32198.25,152 CPT,37259,RVSC IVT STNT SFL EA LT,49356.37,49356.37,6416.33,41952.91,32 CPT,37259,RVSC IVT STNT SFL EA RT,49356.37,49356.37,6416.33,41952.91,32 CPT,37259,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,1986.0,3083.0,116 CPT,37260,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,2369.0,32198.25,152 CPT,37261,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,1986.0,3083.0,116 CPT,37262,"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within ",,,1986.0,3083.0,116 CPT,37263,RVSC FPVT ANG SFL IN BI,123437.31,123437.31,16046.85,104921.71,27 CPT,37263,RVSC FPVT ANG SFL IN LT,82291.54,82291.54,10697.9,69947.81,27 CPT,37263,RVSC FPVT ANG SFL IN RT,82291.54,82291.54,10697.9,69947.81,27 CPT,37263,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,2369.0,15874.51,152 CPT,37264,RVSC FPVT ANG SFL EA LT,55135.33,55135.33,7167.59,46865.03,32 CPT,37264,RVSC FPVT ANG SFL EA RT,55135.33,55135.33,7167.59,46865.03,32 CPT,37264,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,1986.0,3083.0,116 CPT,37265,RVSC FPVT ANG CL IN LT,111488.57,111488.57,14493.51,94765.28,27 CPT,37265,RVSC FPVT ANG CL IN RT,111488.57,111488.57,14493.51,94765.28,27 CPT,37265,RVSCFPVT ANG CL IN BI,167232.85,167232.85,21740.27,142147.92,27 CPT,37265,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,2369.0,15874.51,152 CPT,37266,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,1986.0,3083.0,116 CPT,37267,RVSC FPVT STN SFL IN BI,110293.29,110293.29,14338.13,93749.3,27 CPT,37267,RVSC FPVT STN SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CPT,37267,RVSC FPVT STN SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CPT,37267,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,2369.0,32198.25,152 CPT,37268,RVSC FPVT STN SFL EA LT,49264.34,49264.34,6404.36,41874.69,32 CPT,37268,RVSC FPVT STN SFL EA RT,49264.34,49264.34,6404.36,41874.69,32 CPT,37268,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,1986.0,3083.0,116 CPT,37269,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,2369.0,32198.25,152 CPT,37270,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,1986.0,3083.0,116 CPT,37271,RVSC FPVT ATH SFL IN BI,73405.38,73405.38,9542.7,62394.57,27 CPT,37271,RVSC FPVT ATH SFL IN LT,48936.92,48936.92,6361.8,41596.38,27 CPT,37271,RVSC FPVT ATH SFL IN RT,48936.92,48936.92,6361.8,41596.38,27 CPT,37271,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,2369.0,51129.32,152 CPT,37272,RVSC FPVT ATH SFL EA LT,32787.74,32787.74,4262.41,27869.58,32 CPT,37272,RVSC FPVT ATH SFL EA RT,32787.74,32787.74,4262.41,27869.58,32 CPT,37272,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,1986.0,3083.0,116 CPT,37273,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,2369.0,51129.32,152 CPT,37274,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,1986.0,3083.0,116 CPT,37275,RV FPVT ST/ATH SFL IN BI,128386.41,128386.41,16690.23,109128.45,27 CPT,37275,RV FPVT ST/ATH SFL IN LT,85590.94,85590.94,11126.82,72752.3,27 CPT,37275,RV FPVT ST/ATH SFL IN RT,85590.94,85590.94,11126.82,72752.3,27 CPT,37275,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,2369.0,51129.32,152 CPT,37276,RV FPVT ST/ATH SFL EA LT,57345.93,57345.93,7454.97,48744.04,32 CPT,37276,RV FPVT ST/ATH SFL EA RT,57345.93,57345.93,7454.97,48744.04,32 CPT,37276,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,1986.0,3083.0,116 CPT,37277,RV FPVT ST/ATH CL IN BI,175067.7,175067.7,22758.8,148807.55,27 CPT,37277,RV FPVT ST/ATH CL IN LT,116711.8,116711.8,15172.53,99205.03,27 CPT,37277,RV FPVT ST/ATH CL IN RT,116711.8,116711.8,15172.53,99205.03,27 CPT,37277,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,2369.0,51129.32,152 CPT,37278,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,1986.0,3083.0,116 CPT,37279,"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotri",,,1986.0,3083.0,116 CPT,37280,RVSC TPVT ANG SFL IN BI,109687.64,109687.64,14259.39,93234.49,27 CPT,37280,RVSC TPVT ANG SFL IN LT,73125.09,73125.09,9506.26,62156.33,27 CPT,37280,RVSC TPVT ANG SFL IN RT,73125.09,73125.09,9506.26,62156.33,27 CPT,37280,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,2369.0,32198.25,152 CPT,37281,RVSC TPVT ANG SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CPT,37281,RVSC TPVT ANG SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CPT,37281,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,1986.0,3083.0,116 CPT,37282,RVSC TPVT ANG CL IN LT,91852.42,91852.42,11940.81,78074.56,27 CPT,37282,RVSC TPVT ANG CL IN RT,91852.42,91852.42,11940.81,78074.56,27 CPT,37282,RVSCTPVT ANG CL IN BI,137778.63,137778.63,17911.22,117111.84,27 CPT,37282,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,2369.0,32198.25,152 CPT,37283,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,1986.0,3083.0,116 CPT,37284,RVSC TPVT STNT SFL IN BL,110293.29,110293.29,14338.13,93749.3,27 CPT,37284,RVSC TPVT STNT SFL IN LT,73528.86,73528.86,9558.75,62499.53,27 CPT,37284,RVSC TPVT STNT SFL IN RT,73528.86,73528.86,9558.75,62499.53,27 CPT,37284,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,2369.0,51129.32,152 CPT,37285,RVSC TPVT STNT SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CPT,37285,RVSC TPVT STNT SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CPT,37285,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,1986.0,3083.0,116 CPT,37286,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,2369.0,51129.32,152 CPT,37287,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,1986.0,3083.0,116 CPT,37288,RVSC TPVT ATH SFL IN BI,241392.4,241392.4,31381.01,205183.54,27 CPT,37288,RVSC TPVT ATH SFL IN LT,160928.26,160928.26,20920.67,136789.02,27 CPT,37288,RVSC TPVT ATH SFL IN RT,160928.26,160928.26,20920.67,136789.02,27 CPT,37288,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,2369.0,51129.32,152 CPT,37289,RVSC TPVT ATH SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CPT,37289,RVSC TPVT ATH SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CPT,37289,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,1986.0,3083.0,116 CPT,37290,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,2369.0,51129.32,152 CPT,37291,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,1986.0,3083.0,116 CPT,37292,RV TPVT ST/ATH SFL IN BI,128386.41,128386.41,16690.23,109128.45,27 CPT,37292,RV TPVT ST/ATH SFL IN LT,85590.94,85590.94,11126.82,72752.3,27 CPT,37292,RV TPVT ST/ATH SFL IN RT,85590.94,85590.94,11126.82,72752.3,27 CPT,37292,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,2369.0,51129.32,152 CPT,37293,RV TPVT ST/ATH SFL EA LT,49356.37,49356.37,6416.33,41952.91,32 CPT,37293,RV TPVT ST/ATH SFL EA RT,49356.37,49356.37,6416.33,41952.91,32 CPT,37293,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,1986.0,3083.0,116 CPT,37294,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,2369.0,51129.32,152 CPT,37295,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,1986.0,3083.0,116 CPT,37296,RVSC IMVT ANG SFL IN BI,109687.64,109687.64,14259.39,93234.49,27 CPT,37296,RVSC IMVT ANG SFL IN LT,73125.09,73125.09,9506.26,62156.33,27 CPT,37296,RVSC IMVT ANG SFL IN RT,73125.09,73125.09,9506.26,62156.33,27 CPT,37296,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,2369.0,32198.25,152 CPT,37297,RVSC IMVT ANG SFL EA LT,33319.34,33319.34,4331.51,28321.44,32 CPT,37297,RVSC IMVT ANG SFL EA RT,33319.34,33319.34,4331.51,28321.44,32 CPT,37297,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,1986.0,3083.0,116 CPT,37298,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,2369.0,32198.25,152 CPT,37299,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,1986.0,3083.0,116 CPT,37500,"Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) ",,,2036.11,12562.0,72 CPT,37501,Unlisted vascular endoscopy procedure ,,,633.31,13835.0,110 CPT,37565,"Ligation, internal jugular vein ",,,948.0,13835.0,110 CPT,37600,Ligation; external carotid artery ,,,948.0,13835.0,110 CPT,37605,Ligation; internal or common carotid artery ,,,948.0,13835.0,110 CPT,37606,"Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield clamp ",,,948.0,13835.0,110 CPT,37607,Ligation or banding of angioaccess arteriovenous fistula ,,,948.0,12562.0,233 CPT,37609,"Ligation or biopsy, temporal artery ",,,510.77,3755.0,233 CPT,37615,"Ligation, major artery (eg, post-traumatic, rupture); neck ",,,948.0,13835.0,110 CPT,37616,"Ligation, major artery (eg, post-traumatic, rupture); chest ",,,948.0,16207.0,109 CPT,37617,"Ligation, major artery (eg, post-traumatic, rupture); abdomen ",,,948.0,16461.18,109 CPT,37618,"Ligation, major artery (eg, post-traumatic, rupture); extremity ",,,948.0,16207.0,109 CPT,37619,Ligation of inferior vena cava ,,,948.0,13835.0,206 CPT,37620,REVISION OF MAJOR VEIN ,,,3390.0,5841.0,16 CPT,37650,Ligation of femoral vein ,,,948.0,7565.59,233 CPT,37660,Ligation of common iliac vein ,,,948.0,16207.0,109 CPT,37700,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions ",,,1174.13,7565.59,213 CPT,37700,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions High Cost Surgery",,,2369.0,2369.0,20 CPT,37718,"Ligation, division, and stripping, short saphenous vein ",,,1174.13,12562.0,213 CPT,37718,"Ligation, division, and stripping, short saphenous vein High Cost Surgery",,,2369.0,2369.0,20 CPT,37720,REMOVAL OF LEG VEIN ,,,3390.0,5841.0,16 CPT,37722,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below ",,,1174.13,12562.0,213 CPT,37722,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below High Cost Surgery",,,2369.0,2369.0,20 CPT,37730,REMOVAL OF LEG VEINS ,,,3390.0,5841.0,16 CPT,37735,"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of de",,,1174.13,12562.0,233 CPT,37760,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg ",,,1174.13,12562.0,213 CPT,37760,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg High Cost Surgery",,,2369.0,2369.0,20 CPT,37761,"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg ",,,948.0,8304.31,233 CPT,37765,"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions ",,,204.65,12562.0,233 CPT,37766,"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions ",,,223.55,12562.0,233 CPT,37780,Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure) ,,,948.0,12562.0,233 CPT,37785,"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg ",,,948.0,12562.0,233 CPT,37788,"Penile revascularization, artery, with or without vein graft ",,,948.0,16207.0,109 CPT,37790,Penile venous occlusive procedure ,,,948.0,12562.0,206 CPT,37799,UL PROC VASC SURG,3603.85,3603.85,468.5,3063.27,15 CPT,37799,"Unlisted procedure, vascular surgery ",3603.85,3603.85,633.31,13835.0,206 CPT,38100,Splenectomy; total (separate procedure) ,,,948.0,16207.0,109 CPT,38101,Splenectomy; partial (separate procedure) ,,,948.0,16207.0,109 CPT,38102,"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,38115,Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy ,,,948.0,16207.0,109 CPT,38120,"Laparoscopy, surgical, splenectomy ",,,5202.0,22967.79,102 CPT,38120,"Laparoscopy, surgical, splenectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,38129,"Unlisted laparoscopy procedure, spleen ",,,5202.0,13835.0,102 CPT,38129,"Unlisted laparoscopy procedure, spleen High Cost Surgery",,,2369.0,2369.0,20 CPT,38200,Injection procedure for splenoportography ,,,948.0,5841.0,140 CPT,38204,Management of recipient hematopoietic progenitor cell donor search and cell acquisition ,,,948.0,5841.0,36 CPT,38205,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic ",,,786.51,13835.0,101 CPT,38206,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous ",,,592.85,13835.0,137 CPT,38207,Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage ,,,445.4,5841.0,102 CPT,38208,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor ",,,445.4,5841.0,102 CPT,38209,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor ",,,445.4,5841.0,102 CPT,38210,"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion ",,,445.4,3128.0,110 CPT,38211,Transplant preparation of hematopoietic progenitor cells; tumor cell depletion ,,,445.4,3128.0,110 CPT,38212,Transplant preparation of hematopoietic progenitor cells; red blood cell removal ,,,445.4,3128.0,110 CPT,38213,Transplant preparation of hematopoietic progenitor cells; platelet depletion ,,,445.4,3128.0,110 CPT,38214,Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion ,,,445.4,3128.0,110 CPT,38215,"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer ",,,445.4,3128.0,110 CPT,38220,Diagnostic bone marrow; aspiration(s) ,,,97.38,3128.0,233 CPT,38221,Diagnostic bone marrow; biopsy(ies) ,,,100.58,3128.0,233 CPT,38222,Diagnostic bone marrow; biopsy(ies) and aspiration(s) ,,,855.96,6330.57,225 CPT,38225,"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day ",,,229.95,3390.0,33 CPT,38226,"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage) ",,,92.78,3390.0,33 CPT,38227,Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration ,,,93.58,3390.0,33 CPT,38228,"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous ",,,333.47,3390.0,34 CPT,38230,Bone marrow harvesting for transplantation; allogeneic ,,,592.85,13835.0,233 CPT,38231,Stem cell collection ,,,3390.0,5841.0,16 CPT,38232,Bone marrow harvesting for transplantation; autologous ,,,948.0,15059.0,233 CPT,38240,Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor ,,,948.0,102199.95,206 CPT,38241,Hematopoietic progenitor cell (HPC); autologous transplantation ,,,592.85,13835.0,233 CPT,38242,Allogeneic lymphocyte infusions ,,,592.85,13835.0,137 CPT,38243,Hematopoietic progenitor cell (HPC); HPC boost ,,,592.85,9577.36,233 CPT,38300,Drainage of lymph node abscess or lymphadenitis; simple ,,,855.96,6330.57,233 CPT,38305,Drainage of lymph node abscess or lymphadenitis; extensive ,,,855.96,6330.57,233 CPT,38308,Lymphangiotomy or other operations on lymphatic channels ,,,948.0,8270.67,233 CPT,38380,Suture and/or ligation of thoracic duct; cervical approach ,,,948.0,16207.0,109 CPT,38381,Suture and/or ligation of thoracic duct; thoracic approach ,,,948.0,16207.0,109 CPT,38382,Suture and/or ligation of thoracic duct; abdominal approach ,,,948.0,16207.0,109 CPT,38500,"Biopsy or excision of lymph node(s); open, superficial ",,,948.0,8270.67,233 CPT,38505,"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary) ",,,510.77,3747.2,233 CPT,38510,"Biopsy or excision of lymph node(s); open, deep cervical node(s) ",,,1011.84,8270.67,213 CPT,38510,"Biopsy or excision of lymph node(s); open, deep cervical node(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,38520,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad ",,,1011.84,8270.67,213 CPT,38520,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad High Cost Surgery",,,2369.0,2369.0,20 CPT,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s) ",,,1011.84,8270.67,213 CPT,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,38530,"Biopsy or excision of lymph node(s); open, internal mammary node(s) ",,,948.0,8270.67,233 CPT,38531,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s) ",,,948.0,13835.0,198 CPT,38542,"Dissection, deep jugular node(s) ",,,948.0,13196.03,233 CPT,38550,"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection ",,,948.0,12562.0,233 CPT,38555,"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection ",,,948.0,14297.8,233 CPT,38562,Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic ,,,948.0,16207.0,109 CPT,38564,Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) ,,,948.0,16207.0,109 CPT,38570,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple ",,,1983.29,15059.0,129 CPT,38570,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,20 CPT,38571,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy ",,,3265.51,22967.79,129 CPT,38571,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,38572,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple ",,,3265.51,22967.79,129 CPT,38572,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,20 CPT,38573,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including ",,,2369.0,22967.79,141 CPT,38589,"Unlisted laparoscopy procedure, lymphatic system ",,,5202.0,13835.0,102 CPT,38589,"Unlisted laparoscopy procedure, lymphatic system High Cost Surgery",,,2369.0,2369.0,20 CPT,38700,Suprahyoid lymphadenectomy ,,,948.0,14297.8,233 CPT,38720,Cervical lymphadenectomy (complete) ,,,948.0,22210.08,206 CPT,38724,Cervical lymphadenectomy (modified radical neck dissection) ,,,948.0,17660.58,205 CPT,38740,Axillary lymphadenectomy; superficial ,,,948.0,13196.03,233 CPT,38745,Axillary lymphadenectomy; complete ,,,948.0,13196.03,233 CPT,38746,"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,38747,"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,38760,"Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) ",,,948.0,14297.8,233 CPT,38765,"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,109 CPT,38770,"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,109 CPT,38780,"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) ",,,948.0,16207.0,109 CPT,38790,Injection procedure; lymphangiography ,,,948.0,5841.0,140 CPT,38792,Injection procedure; radioactive tracer for identification of sentinel node ,,,403.6,5841.0,198 CPT,38794,"Cannulation, thoracic duct ",,,948.0,5841.0,44 CPT,38900,"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,38999,"Unlisted procedure, hemic or lymphatic system ",,,445.4,13835.0,198 CPT,39000,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach ",,,948.0,16207.0,109 CPT,39010,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy ",,,948.0,16207.0,109 CPT,39200,Resection of mediastinal cyst ,,,948.0,16207.0,109 CPT,39220,Resection of mediastinal tumor ,,,948.0,16207.0,109 CPT,39400,MEDIASTINOSCOPY INCL BIOPSY ,,,3390.0,5841.0,16 CPT,39401,"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed ",,,948.0,13835.0,206 CPT,39402,"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging) ",,,948.0,13835.0,206 CPT,39499,"Unlisted procedure, mediastinum ",,,948.0,16207.0,109 CPT,39501,"Repair, laceration of diaphragm, any approach ",,,948.0,16207.0,109 CPT,39502,REPAIR PARAESOPHAGEAL HERNIA ,,,3390.0,5841.0,16 CPT,39503,"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia ",,,948.0,73655.7,109 CPT,39520,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,16 CPT,39530,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,16 CPT,39531,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,16 CPT,39540,"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute ",,,948.0,16207.0,109 CPT,39541,"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic ",,,948.0,16207.0,109 CPT,39545,"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic ",,,948.0,16207.0,109 CPT,39560,"Resection, diaphragm; with simple repair (eg, primary suture) ",,,948.0,16207.0,109 CPT,39561,"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap) ",,,948.0,16207.0,109 CPT,39599,"Unlisted procedure, diaphragm ",,,948.0,16207.0,109 CPT,40490,Biopsy of lip ,,,67.44,5841.0,129 CPT,40500,"Vermilionectomy (lip shave), with mucosal advancement ",,,930.95,7150.66,233 CPT,40510,Excision of lip; transverse wedge excision with primary closure ,,,930.95,7150.66,233 CPT,40520,Excision of lip; V-excision with primary direct linear closure ,,,930.95,7150.66,233 CPT,40525,"Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) ",,,930.95,7150.66,233 CPT,40527,"Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) ",,,948.0,13241.95,233 CPT,40530,"Resection of lip, more than one-fourth, without reconstruction ",,,930.95,7150.66,233 CPT,40650,"Repair lip, full thickness; vermilion only ",,,196.58,12562.0,233 CPT,40652,"Repair lip, full thickness; up to half vertical height ",,,196.58,12562.0,233 CPT,40654,"Repair lip, full thickness; over one-half vertical height, or complex ",,,441.67,12562.0,233 CPT,40700,"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral ",,,948.0,13241.95,233 CPT,40701,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure ",,,948.0,13241.95,233 CPT,40702,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages ",,,948.0,32170.6,233 CPT,40720,"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure ",,,930.95,12909.0,233 CPT,40761,"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle ",,,948.0,13241.95,233 CPT,40799,"Unlisted procedure, lips ",,,239.12,13835.0,102 CPT,40800,"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple ",,,138.37,5841.0,129 CPT,40801,"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated ",,,196.58,3755.0,233 CPT,40804,"Removal of embedded foreign body, vestibule of mouth; simple ",,,915.67,5841.0,102 CPT,40805,"Removal of embedded foreign body, vestibule of mouth; complicated ",,,158.14,5571.0,233 CPT,40806,Incision of labial frenum (frenotomy) ,,,76.45,5841.0,225 CPT,40808,"Biopsy, vestibule of mouth ",,,113.09,5841.0,225 CPT,40810,"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair ",,,144.47,13835.0,233 CPT,40812,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair ",,,172.67,13835.0,233 CPT,40814,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair ",,,930.95,7150.66,233 CPT,40816,"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle ",,,930.95,7150.66,233 CPT,40818,Excision of mucosa of vestibule of mouth as donor graft ,,,196.58,5841.0,225 CPT,40819,"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) ",,,441.67,3683.7,233 CPT,40820,"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) ",,,187.2,3347.22,233 CPT,40830,"Closure of laceration, vestibule of mouth; 2.5 cm or less ",,,91.96,5841.0,129 CPT,40831,"Closure of laceration, vestibule of mouth; over 2.5 cm or complex ",,,196.58,3128.0,233 CPT,40840,Vestibuloplasty; anterior ,,,948.0,13241.95,233 CPT,40842,"Vestibuloplasty; posterior, unilateral ",,,948.0,13241.95,233 CPT,40843,"Vestibuloplasty; posterior, bilateral ",,,948.0,13241.95,233 CPT,40844,Vestibuloplasty; entire arch ,,,948.0,13394.0,233 CPT,40845,"Vestibuloplasty; complex (including ridge extension, muscle repositioning) ",,,948.0,13394.0,233 CPT,40899,"Unlisted procedure, vestibule of mouth ",,,239.12,13835.0,198 CPT,41000,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual ",,,87.5,3128.0,233 CPT,41005,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial ",,,91.96,5841.0,225 CPT,41006,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid ",,,441.67,5571.0,233 CPT,41007,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space ",,,441.67,5571.0,233 CPT,41008,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space ",,,930.95,7150.66,233 CPT,41009,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space ",,,196.58,5841.0,225 CPT,41010,Incision of lingual frenum (frenotomy) ,,,441.67,3683.7,233 CPT,41015,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual ",,,196.58,5841.0,225 CPT,41016,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental ",,,948.0,13241.95,233 CPT,41017,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular ",,,930.95,7150.66,233 CPT,41018,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space ",,,441.67,3683.7,233 CPT,41019,"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application ",,,948.0,13241.95,206 CPT,41100,Biopsy of tongue; anterior two-thirds ,,,116.86,3128.0,233 CPT,41105,Biopsy of tongue; posterior one-third ,,,115.11,3755.0,233 CPT,41108,Biopsy of floor of mouth ,,,110.18,3128.0,233 CPT,41110,Excision of lesion of tongue without closure ,,,149.42,3347.22,233 CPT,41112,Excision of lesion of tongue with closure; anterior two-thirds ,,,930.95,7150.66,233 CPT,41113,Excision of lesion of tongue with closure; posterior one-third ,,,930.95,7150.66,233 CPT,41114,Excision of lesion of tongue with closure; with local tongue flap ,,,930.95,7150.66,233 CPT,41115,Excision of lingual frenum (frenectomy) ,,,170.34,3128.0,233 CPT,41116,"Excision, lesion of floor of mouth ",,,930.95,7150.66,233 CPT,41120,Glossectomy; less than one-half tongue ,,,948.0,13394.0,233 CPT,41130,Glossectomy; hemiglossectomy ,,,948.0,16207.0,109 CPT,41135,"Glossectomy; partial, with unilateral radical neck dissection ",,,948.0,26666.74,109 CPT,41140,"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection ",,,948.0,26704.84,109 CPT,41145,"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection ",,,948.0,33829.29,109 CPT,41150,"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection ",,,948.0,26920.99,109 CPT,41153,"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection ",,,948.0,29179.97,109 CPT,41155,"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type) ",,,948.0,36969.79,109 CPT,41250,Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue ,,,223.51,5841.0,198 CPT,41251,Repair of laceration 2.5 cm or less; posterior one-third of tongue ,,,91.96,5841.0,225 CPT,41252,"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex ",,,91.96,3755.0,233 CPT,41500,"FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE) ",,,2431.0,2979.0,24 CPT,41510,Suture of tongue to lip for micrognathia (Douglas type procedure) ,,,930.95,7150.66,233 CPT,41512,"Tongue base suspension, permanent suture technique ",,,948.0,13241.95,206 CPT,41520,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty) ",,,930.95,9653.0,233 CPT,41530,"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session ",,,948.0,12909.0,206 CPT,41599,"Unlisted procedure, tongue, floor of mouth ",,,239.12,13835.0,102 CPT,41800,"Drainage of abscess, cyst, hematoma from dentoalveolar structures ",,,134.32,5841.0,198 CPT,41805,Removal of embedded foreign body from dentoalveolar structures; soft tissues ,,,231.98,5571.0,233 CPT,41806,Removal of embedded foreign body from dentoalveolar structures; bone ,,,272.38,4335.95,233 CPT,41820,"Gingivectomy, excision gingiva, each quadrant ",,,930.95,15108.46,233 CPT,41821,"Operculectomy, excision pericoronal tissues ",,,948.0,3683.7,206 CPT,41822,"Excision of fibrous tuberosities, dentoalveolar structures ",,,948.0,13835.0,206 CPT,41823,"Excision of osseous tuberosities, dentoalveolar structures ",,,948.0,13835.0,206 CPT,41825,"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair ",,,146.52,13835.0,233 CPT,41826,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair ",,,188.37,13835.0,233 CPT,41827,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair ",,,948.0,13241.95,233 CPT,41828,"Excision of hyperplastic alveolar mucosa, each quadrant (specify) ",,,198.25,13835.0,233 CPT,41830,"Alveolectomy, including curettage of osteitis or sequestrectomy ",,,289.82,13835.0,233 CPT,41850,"Destruction of lesion (except excision), dentoalveolar structures ",,,441.67,13835.0,233 CPT,41870,Periodontal mucosal grafting ,,,441.67,13835.0,233 CPT,41872,"Gingivoplasty, each quadrant (specify) ",,,304.35,13835.0,137 CPT,41874,"Alveoloplasty, each quadrant (specify) ",,,234.0,13835.0,233 CPT,41899,"Unlisted procedure, dentoalveolar structures ",,,239.12,13835.0,215 CPT,42000,"Drainage of abscess of palate, uvula ",,,91.96,5841.0,225 CPT,42100,"Biopsy of palate, uvula ",,,703.52,3128.0,206 CPT,42104,"Excision, lesion of palate, uvula; without closure ",,,133.14,3755.0,233 CPT,42106,"Excision, lesion of palate, uvula; with simple primary closure ",,,155.23,3755.0,233 CPT,42107,"Excision, lesion of palate, uvula; with local flap closure ",,,948.0,13241.95,233 CPT,42120,Resection of palate or extensive resection of lesion ,,,948.0,13241.95,233 CPT,42140,"Uvulectomy, excision of uvula ",,,930.95,7150.66,233 CPT,42145,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) ",,,2051.93,13394.0,213 CPT,42145,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) High Cost Surgery",,,2369.0,2369.0,20 CPT,42160,"Destruction of lesion, palate or uvula (thermal, cryo or chemical) ",,,142.44,3347.22,233 CPT,42180,"Repair, laceration of palate; up to 2 cm ",,,196.58,5841.0,225 CPT,42182,"Repair, laceration of palate; over 2 cm or complex ",,,948.0,13241.95,233 CPT,42200,"Palatoplasty for cleft palate, soft and/or hard palate only ",,,948.0,13394.0,233 CPT,42205,"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only ",,,930.95,13394.0,233 CPT,42210,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft) ",,,948.0,13394.0,233 CPT,42215,Palatoplasty for cleft palate; major revision ,,,948.0,13241.95,233 CPT,42220,Palatoplasty for cleft palate; secondary lengthening procedure ,,,948.0,13394.0,233 CPT,42225,Palatoplasty for cleft palate; attachment pharyngeal flap ,,,948.0,13394.0,233 CPT,42226,"Lengthening of palate, and pharyngeal flap ",,,948.0,13394.0,233 CPT,42227,"Lengthening of palate, with island flap ",,,948.0,13835.0,137 CPT,42235,"Repair of anterior palate, including vomer flap ",,,948.0,13394.0,233 CPT,42260,Repair of nasolabial fistula ,,,948.0,13241.95,233 CPT,42280,Maxillary impression for palatal prosthesis ,,,544.5,5841.0,198 CPT,42281,Insertion of pin-retained palatal prosthesis ,,,948.0,13241.95,233 CPT,42299,"Unlisted procedure, palate, uvula ",,,239.12,13835.0,102 CPT,42300,"Drainage of abscess; parotid, simple ",,,441.67,3683.7,233 CPT,42305,"Drainage of abscess; parotid, complicated ",,,930.95,7150.66,233 CPT,42310,"Drainage of abscess; submaxillary or sublingual, intraoral ",,,196.58,5841.0,225 CPT,42320,"Drainage of abscess; submaxillary, external ",,,196.58,5841.0,225 CPT,42325,CREATE SALIVARY CYST DRAIN ,,,3390.0,5841.0,16 CPT,42326,CREATE SALIVARY CYST DRAIN ,,,3390.0,5841.0,16 CPT,42330,"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral ",,,127.91,13835.0,233 CPT,42335,"Sialolithotomy; submandibular (submaxillary), complicated, intraoral ",,,265.4,12562.0,233 CPT,42340,"Sialolithotomy; parotid, extraoral or complicated intraoral ",,,930.95,7150.66,233 CPT,42400,Biopsy of salivary gland; needle ,,,60.46,3128.0,233 CPT,42405,Biopsy of salivary gland; incisional ,,,441.67,5571.0,233 CPT,42408,Excision of sublingual salivary cyst (ranula) ,,,930.95,12562.0,233 CPT,42409,Marsupialization of sublingual salivary cyst (ranula) ,,,930.95,12562.0,233 CPT,42410,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection ",,,948.0,13241.95,233 CPT,42415,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve ",,,948.0,13241.95,233 CPT,42420,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve ",,,948.0,13241.95,233 CPT,42425,"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve ",,,948.0,13241.95,233 CPT,42426,"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection ",,,948.0,16448.48,109 CPT,42440,Excision of submandibular (submaxillary) gland ,,,948.0,13241.95,233 CPT,42450,Excision of sublingual gland ,,,948.0,13241.95,233 CPT,42500,"Plastic repair of salivary duct, sialodochoplasty; primary or simple ",,,948.0,13241.95,233 CPT,42505,"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated ",,,948.0,13241.95,233 CPT,42507,"Parotid duct diversion, bilateral (Wilke type procedure); ",,,948.0,13241.95,233 CPT,42508,PAROTID DUCT DIVERSION ,,,3390.0,5841.0,16 CPT,42509,"Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands ",,,948.0,13241.95,233 CPT,42510,"Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts ",,,930.95,9653.0,233 CPT,42550,Injection procedure for sialography ,,,948.0,5841.0,140 CPT,42600,Closure salivary fistula ,,,930.95,7150.66,233 CPT,42650,Dilation salivary duct ,,,39.25,3128.0,233 CPT,42660,"Dilation and catheterization of salivary duct, with or without injection ",,,59.88,5841.0,225 CPT,42665,"Ligation salivary duct, intraoral ",,,930.95,12909.0,233 CPT,42699,"Unlisted procedure, salivary glands or ducts ",,,239.12,13835.0,198 CPT,42700,Incision and drainage abscess; peritonsillar ,,,91.96,5841.0,225 CPT,42720,"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach ",,,930.95,7150.66,233 CPT,42725,"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach ",,,948.0,13241.95,233 CPT,42800,Biopsy; oropharynx ,,,89.82,13835.0,233 CPT,42802,BIOPSY OF THROAT ,,,3390.0,5841.0,16 CPT,42804,"Biopsy; nasopharynx, visible lesion, simple ",,,930.95,7150.66,233 CPT,42806,"Biopsy; nasopharynx, survey for unknown primary lesion ",,,930.95,7150.66,233 CPT,42808,"Excision or destruction of lesion of pharynx, any method ",,,930.95,7150.66,233 CPT,42809,Removal of foreign body from pharynx ,,,451.0,5841.0,198 CPT,42810,"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ",,,930.95,12562.0,233 CPT,42815,"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx ",,,948.0,13394.0,233 CPT,42820,Tonsillectomy and adenoidectomy; younger than age 12 ,,,948.0,13241.95,233 CPT,42821,Tonsillectomy and adenoidectomy; age 12 or over ,,,930.95,13394.0,233 CPT,42825,"Tonsillectomy, primary or secondary; younger than age 12 ",,,948.0,13241.95,233 CPT,42826,"Tonsillectomy, primary or secondary; age 12 or over ",,,930.95,8234.0,233 CPT,42830,"Adenoidectomy, primary; younger than age 12 ",,,930.95,8234.0,233 CPT,42831,"Adenoidectomy, primary; age 12 or over ",,,930.95,8234.0,233 CPT,42835,"Adenoidectomy, secondary; younger than age 12 ",,,930.95,8234.0,233 CPT,42836,"Adenoidectomy, secondary; age 12 or over ",,,930.95,8234.0,233 CPT,42842,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure ",,,948.0,13835.0,110 CPT,42844,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal) ",,,948.0,13835.0,110 CPT,42845,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap ",,,948.0,27260.03,109 CPT,42860,Excision of tonsil tags ,,,930.95,12562.0,233 CPT,42870,"Excision or destruction lingual tonsil, any method (separate procedure) ",,,948.0,13241.95,233 CPT,42890,Limited pharyngectomy ,,,948.0,13241.95,233 CPT,42892,"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls ",,,948.0,13241.95,233 CPT,42894,"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis ",,,948.0,29052.84,109 CPT,42900,Suture pharynx for wound or injury ,,,783.57,5571.0,233 CPT,42950,Pharyngoplasty (plastic or reconstructive operation on pharynx) ,,,948.0,13241.95,233 CPT,42953,Pharyngoesophageal repair ,,,948.0,16207.0,109 CPT,42955,"Pharyngostomy (fistulization of pharynx, external for feeding) ",,,441.67,5571.0,233 CPT,42960,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple ",,,196.58,5841.0,225 CPT,42961,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization ",,,948.0,16207.0,109 CPT,42962,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention ",,,930.95,7150.66,233 CPT,42970,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery ",,,91.96,5841.0,225 CPT,42971,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization ",,,948.0,16207.0,109 CPT,42972,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention ",,,930.95,12562.0,233 CPT,42975,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic ",,,71.55,5841.0,225 CPT,42999,"Unlisted procedure, pharynx, adenoids, or tonsils ",,,239.12,13835.0,198 CPT,43020,"Esophagotomy, cervical approach, with removal of foreign body ",,,948.0,3683.7,110 CPT,43030,Cricopharyngeal myotomy ,,,948.0,13835.0,137 CPT,43045,"Esophagotomy, thoracic approach, with removal of foreign body ",,,948.0,16207.0,109 CPT,43100,"Excision of lesion, esophagus, with primary repair; cervical approach ",,,948.0,16207.0,109 CPT,43101,"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach ",,,948.0,16207.0,109 CPT,43107,"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) ",,,948.0,36660.39,109 CPT,43108,"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es) ",,,948.0,55066.91,109 CPT,43112,"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy) ",,,948.0,43081.23,109 CPT,43113,"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es) ",,,948.0,53753.08,109 CPT,43116,"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction ",,,948.0,61720.83,109 CPT,43117,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor ",,,948.0,40004.34,109 CPT,43118,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including ",,,948.0,44797.72,109 CPT,43121,"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty ",,,948.0,34880.4,109 CPT,43122,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty ",,,948.0,31409.31,109 CPT,43123,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, prepa",,,948.0,55100.77,109 CPT,43124,"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy ",,,948.0,46819.38,109 CPT,43130,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach ",,,948.0,13835.0,233 CPT,43135,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach ",,,948.0,18033.49,109 CPT,43180,"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope ",,,948.0,15059.0,233 CPT,43191,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) ",,,593.22,12562.0,233 CPT,43192,"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance ",,,593.22,13394.0,233 CPT,43193,"Esophagoscopy, rigid, transoral; with biopsy, single or multiple ",,,593.22,13394.0,233 CPT,43194,"Esophagoscopy, rigid, transoral; with removal of foreign body(s) ",,,593.22,13394.0,233 CPT,43195,"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter) ",,,948.0,13394.0,233 CPT,43196,"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire ",,,948.0,13394.0,233 CPT,43197,"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,117.44,12562.0,233 CPT,43198,"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple ",,,125.86,12562.0,233 CPT,43200,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,233 CPT,43201,"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,593.22,4251.7,233 CPT,43202,"Esophagoscopy, flexible, transoral; with biopsy, single or multiple ",,,593.22,4251.7,233 CPT,43204,"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices ",,,593.22,4251.7,233 CPT,43205,"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices ",,,593.22,4251.7,233 CPT,43206,"Esophagoscopy, flexible, transoral; with optical endomicroscopy ",,,593.22,13394.0,233 CPT,43210,"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed ",,,948.0,22967.79,233 CPT,43211,"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,233 CPT,43212,"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,233 CPT,43213,"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,233 CPT,43214,"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,233 CPT,43215,"Esophagoscopy, flexible, transoral; with removal of foreign body(s) ",,,593.22,4251.7,233 CPT,43216,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,5571.0,233 CPT,43217,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,233 CPT,43219,ESOPHAGUS ENDOSCOPY ,,,3390.0,5841.0,16 CPT,43220,"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) ",,,593.22,4251.7,233 CPT,43226,"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire ",,,593.22,4251.7,233 CPT,43227,"Esophagoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,233 CPT,43228,ESOPH ENDOSCOPY ABLATION ,,,3390.0,5841.0,16 CPT,43229,"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,233 CPT,43231,"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination ",,,593.22,4251.7,233 CPT,43232,"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) ",,,593.22,4251.7,233 CPT,43233,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,233 CPT,43234,UPPER GI ENDOSCOPY EXAM ,,,3390.0,5841.0,16 CPT,43235,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,233 CPT,43236,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,351.7,3755.0,233 CPT,43237,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures ",,,593.22,4251.7,233 CPT,43238,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,593.22,4251.7,233 CPT,43239,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple ",,,351.7,3755.0,233 CPT,43240,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterºs»/stentºs», when performed, and endoscopic ultrasound, when",,,948.0,8187.49,233 CPT,43241,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter ",,,593.22,4251.7,233 CPT,43242,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,593.22,4251.7,233 CPT,43243,"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices ",,,593.22,4251.7,233 CPT,43244,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices ",,,593.22,4251.7,233 CPT,43245,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie) ",,,593.22,4251.7,233 CPT,43246,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube ",,,593.22,14794.0,215 CPT,43247,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) ",,,351.7,3755.0,233 CPT,43248,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire ",,,351.7,3755.0,233 CPT,43249,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) ",,,593.22,4251.7,233 CPT,43250,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,4251.7,233 CPT,43251,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,233 CPT,43252,"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy ",,,948.0,13394.0,233 CPT,43253,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial ma",,,593.22,13394.0,233 CPT,43254,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,233 CPT,43255,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,233 CPT,43256,UPPR GI ENDOSCOPY W/STENT ,,,3390.0,5841.0,16 CPT,43257,"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease ",,,948.0,12562.0,206 CPT,43258,OPERATIVE UPPER GI ENDOSCOPY ,,,3390.0,5841.0,16 CPT,43259,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,593.22,12562.0,233 CPT,43260,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,948.0,8187.49,233 CPT,43261,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple ",,,948.0,8187.49,233 CPT,43262,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy ,,,948.0,8187.49,233 CPT,43263,Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi ,,,948.0,8187.49,233 CPT,43264,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) ,,,948.0,8187.49,233 CPT,43265,"Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) ",,,948.0,13051.67,212 CPT,43266,"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,233 CPT,43267,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,16 CPT,43268,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,16 CPT,43269,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,16 CPT,43270,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,593.22,13394.0,233 CPT,43271,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,16 CPT,43272,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,16 CPT,43273,Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (List separately in addition to code(s) for primary procedure) ,,,948.0,15059.0,161 CPT,43274,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,948.0,15059.0,233 CPT,43275,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) ,,,948.0,15059.0,233 CPT,43276,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,948.0,15059.0,233 CPT,43277,"Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, ",,,948.0,15059.0,233 CPT,43278,"Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed ",,,948.0,15059.0,233 CPT,43279,"Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed ",,,948.0,15846.6,121 CPT,43280,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) ",,,5202.0,22967.79,102 CPT,43280,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) High Cost Surgery",,,2369.0,2369.0,20 CPT,43281,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh ",,,5202.0,22967.79,102 CPT,43281,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh High Cost Surgery",,,2369.0,2369.0,20 CPT,43282,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh ",,,5202.0,22967.79,102 CPT,43282,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh High Cost Surgery",,,2369.0,2369.0,20 CPT,43283,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,1520.2,16207.0,101 CPT,43283,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,43284,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed ",,,5202.0,22967.79,94 CPT,43284,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,43285,Removal of esophageal sphincter augmentation device ,,,2996.0,13835.0,178 CPT,43285,Removal of esophageal sphincter augmentation device High Cost Surgery,,,2369.0,2369.0,20 CPT,43286,"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with ",,,2369.0,38563.39,113 CPT,43287,"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, w",,,2369.0,44136.57,113 CPT,43288,"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric dr",,,2369.0,45963.25,101 CPT,43289,"Unlisted laparoscopy procedure, esophagus ",,,5202.0,13835.0,102 CPT,43289,"Unlisted laparoscopy procedure, esophagus High Cost Surgery",,,2369.0,2369.0,20 CPT,43290,"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon ",,,948.0,12909.0,198 CPT,43291,"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s) ",,,915.67,13394.0,198 CPT,43300,"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula ",,,948.0,16207.0,109 CPT,43305,"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula ",,,948.0,16207.0,109 CPT,43310,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula ",,,948.0,18190.37,109 CPT,43312,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula ",,,948.0,19555.0,109 CPT,43313,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula ",,,948.0,33617.37,109 CPT,43314,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula ",,,948.0,34948.13,109 CPT,43320,"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach ",,,948.0,17147.73,109 CPT,43324,REVISE ESOPHAGUS & STOMACH ,,,3390.0,5841.0,16 CPT,43325,"Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) ",,,948.0,16681.56,109 CPT,43326,REVISE ESOPHAGUS & STOMACH ,,,3390.0,5841.0,16 CPT,43327,Esophagogastric fundoplasty partial or complete; laparotomy ,,,948.0,16207.0,109 CPT,43328,Esophagogastric fundoplasty partial or complete; thoracotomy ,,,948.0,16207.0,109 CPT,43330,Esophagomyotomy (Heller type); abdominal approach ,,,948.0,16401.79,109 CPT,43331,Esophagomyotomy (Heller type); thoracic approach ,,,948.0,16414.49,109 CPT,43332,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,109 CPT,43333,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16207.0,109 CPT,43334,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,109 CPT,43335,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16418.72,109 CPT,43336,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,18571.74,109 CPT,43337,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,18898.08,109 CPT,43338,"Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,43340,Esophagojejunostomy (without total gastrectomy); abdominal approach ,,,948.0,16897.71,109 CPT,43341,Esophagojejunostomy (without total gastrectomy); thoracic approach ,,,948.0,17207.11,109 CPT,43350,SURGICAL OPENING ESOPHAGUS ,,,3390.0,5841.0,16 CPT,43351,"Esophagostomy, fistulization of esophagus, external; thoracic approach ",,,948.0,16207.0,109 CPT,43352,"Esophagostomy, fistulization of esophagus, external; cervical approach ",,,948.0,16207.0,109 CPT,43360,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty ",,,948.0,27645.76,109 CPT,43361,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstructi",,,948.0,33197.77,109 CPT,43400,"Ligation, direct, esophageal varices ",,,948.0,18749.79,109 CPT,43401,"TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGEAL VARICES ",,,3390.0,16207.0,24 CPT,43405,Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation ,,,948.0,17796.17,109 CPT,43410,Suture of esophageal wound or injury; cervical approach ,,,948.0,16207.0,109 CPT,43415,Suture of esophageal wound or injury; transthoracic or transabdominal approach ,,,948.0,31642.4,109 CPT,43420,Closure of esophagostomy or fistula; cervical approach ,,,948.0,13835.0,206 CPT,43425,Closure of esophagostomy or fistula; transthoracic or transabdominal approach ,,,948.0,17647.88,109 CPT,43450,"Dilation of esophagus, by unguided sound or bougie, single or multiple passes ",,,351.7,3128.0,233 CPT,43453,"Dilation of esophagus, over guide wire ",,,593.22,4251.7,233 CPT,43456,DILATE ESOPHAGUS ,,,3390.0,5841.0,16 CPT,43458,DILATE ESOPHAGUS ,,,3390.0,5841.0,16 CPT,43460,"Esophagogastric tamponade, with balloon (Sengstaken type) ",,,948.0,16207.0,109 CPT,43496,Free jejunum transfer with microvascular anastomosis ,,,948.0,26721.9,109 CPT,43497,"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy ºPOEM») ",,,948.0,15059.0,198 CPT,43499,"Unlisted procedure, esophagus ",,,915.67,13835.0,206 CPT,43500,Gastrotomy; with exploration or foreign body removal ,,,948.0,16207.0,109 CPT,43501,Gastrotomy; with suture repair of bleeding ulcer ,,,948.0,16545.97,109 CPT,43502,"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) ",,,948.0,18648.07,109 CPT,43510,"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin) ",,,915.67,13835.0,110 CPT,43520,"Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) ",,,948.0,16207.0,109 CPT,43600,BIOPSY OF STOMACH ,,,3390.0,5841.0,16 CPT,43605,"Biopsy of stomach, by laparotomy ",,,948.0,13835.0,109 CPT,43610,"Excision, local; ulcer or benign tumor of stomach ",,,948.0,16207.0,109 CPT,43611,"Excision, local; malignant tumor of stomach ",,,948.0,16207.0,109 CPT,43620,"Gastrectomy, total; with esophagoenterostomy ",,,948.0,24157.74,109 CPT,43621,"Gastrectomy, total; with Roux-en-Y reconstruction ",,,948.0,27967.87,109 CPT,43622,"Gastrectomy, total; with formation of intestinal pouch, any type ",,,948.0,28395.93,109 CPT,43631,"Gastrectomy, partial, distal; with gastroduodenostomy ",,,948.0,17838.63,109 CPT,43632,"Gastrectomy, partial, distal; with gastrojejunostomy ",,,948.0,25039.27,109 CPT,43633,"Gastrectomy, partial, distal; with Roux-en-Y reconstruction ",,,948.0,23653.36,109 CPT,43634,"Gastrectomy, partial, distal; with formation of intestinal pouch ",,,948.0,26056.4,109 CPT,43635,Vagotomy when performed with partial distal gastrectomy (List separately in addition to codeºs» for primary procedure) ,,,948.0,16207.0,109 CPT,43638,"REMOVAL OF STOMACH, PARTIAL ",,,3390.0,5841.0,16 CPT,43639,"REMOVAL OF STOMACH, PARTIAL ",,,3390.0,5841.0,16 CPT,43640,"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective ",,,948.0,16207.0,109 CPT,43641,"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective) ",,,948.0,16207.0,109 CPT,43644,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) ",,,948.0,21292.66,83 CPT,43645,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption ",,,948.0,22788.76,83 CPT,43647,"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum ",,,948.0,16890.86,122 CPT,43648,"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum ",,,948.0,15059.0,122 CPT,43651,"Laparoscopy, surgical; transection of vagus nerves, truncal ",,,5202.0,13394.0,102 CPT,43651,"Laparoscopy, surgical; transection of vagus nerves, truncal High Cost Surgery",,,2369.0,2369.0,20 CPT,43652,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective ",,,5202.0,13394.0,102 CPT,43652,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective High Cost Surgery",,,2369.0,2369.0,20 CPT,43653,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,1983.29,15059.0,129 CPT,43653,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,43659,"Unlisted laparoscopy procedure, stomach ",,,5202.0,13835.0,102 CPT,43659,"Unlisted laparoscopy procedure, stomach High Cost Surgery",,,2369.0,2369.0,20 CPT,43750,PLACE GASTROSTOMY TUBE ,,,3390.0,5841.0,16 CPT,43752,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) ",695.16,695.16,117.96,5841.0,225 CPT,43752,PLACE NG/OG TUBE FLUORO,695.16,695.16,97.32,590.89,11 CPT,43753,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed ",,,217.99,5841.0,198 CPT,43754,"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) ",,,217.99,5841.0,198 CPT,43755,"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pent",,,129.91,5841.0,198 CPT,43756,"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture) ",,,915.67,5841.0,198 CPT,43757,"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes d",,,351.7,3128.0,233 CPT,43760,"CHANGE OF GASTROSTOMY TUBE, PERCUTANEOUS, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE ",,,2358.0,5841.0,16 CPT,43761,"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition ",,,115.66,3128.0,233 CPT,43762,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract ",,,115.66,5841.0,225 CPT,43763,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract ",,,115.66,5841.0,225 CPT,43770,"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) ",,,948.0,22967.79,100 CPT,43771,"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only ",,,948.0,22869.0,99 CPT,43772,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only ",,,948.0,22869.0,100 CPT,43773,"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only ",,,948.0,22869.0,100 CPT,43774,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components ",,,948.0,22869.0,100 CPT,43775,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) ",,,948.0,19600.0,110 CPT,43800,Pyloroplasty ,,,948.0,16207.0,109 CPT,43810,Gastroduodenostomy ,,,948.0,16207.0,109 CPT,43820,Gastrojejunostomy; without vagotomy ,,,948.0,16516.21,109 CPT,43825,"Gastrojejunostomy; with vagotomy, any type ",,,948.0,16207.0,109 CPT,43830,"Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,948.0,13835.0,110 CPT,43831,"Gastrostomy, open; neonatal, for feeding ",,,915.67,13835.0,110 CPT,43832,"Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) ",,,948.0,16207.0,109 CPT,43840,"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury ",,,948.0,16715.43,109 CPT,43842,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty ",,,948.0,16207.0,91 CPT,43843,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty ",,,948.0,19600.0,71 CPT,43845,"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal",,,948.0,23945.83,88 CPT,43846,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy ",,,948.0,19923.79,88 CPT,43847,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption ",,,948.0,22081.05,88 CPT,43848,"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) ",,,948.0,23695.81,70 CPT,43850,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITHOUT VAGOTOMY ,,,3390.0,16207.0,24 CPT,43855,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITH VAGOTOMY ,,,3390.0,16207.0,24 CPT,43860,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy ",,,948.0,20101.72,109 CPT,43865,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy ",,,948.0,20945.15,109 CPT,43870,"Closure of gastrostomy, surgical ",,,948.0,8187.49,233 CPT,43880,Closure of gastrocolic fistula ,,,948.0,19572.05,109 CPT,43881,"Implantation or replacement of gastric neurostimulator electrodes, antrum, open ",,,948.0,20491.68,109 CPT,43882,"Revision or removal of gastric neurostimulator electrodes, antrum, open ",,,948.0,21907.23,109 CPT,43886,"Gastric restrictive procedure, open; revision of subcutaneous port component only ",,,948.0,15000.0,216 CPT,43887,"Gastric restrictive procedure, open; removal of subcutaneous port component only ",,,744.46,15000.0,216 CPT,43888,"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ",,,948.0,15000.0,216 CPT,43889,"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed ",,,948.0,29647.99,152 CPT,43999,"Unlisted procedure, stomach ",,,915.67,17066.0,185 CPT,44005,Enterolysis (freeing of intestinal adhesion) (separate procedure) ,,,948.0,16207.0,205 CPT,44010,"Duodenotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,205 CPT,44015,"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure) ",,,948.0,16207.0,109 CPT,44020,"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,205 CPT,44021,"Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube) ",,,948.0,16207.0,109 CPT,44025,"Colotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,205 CPT,44050,"Reduction of volvulus, intussusception, internal hernia, by laparotomy ",,,948.0,16207.0,205 CPT,44055,"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure) ",,,948.0,18393.82,205 CPT,44100,"Biopsy of intestine by capsule, tube, peroral (1 or more specimens) ",,,351.7,3128.0,233 CPT,44110,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy ",,,948.0,16207.0,109 CPT,44111,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies ",,,948.0,16207.0,109 CPT,44120,"Enterectomy, resection of small intestine; single resection and anastomosis ",,,948.0,16207.0,109 CPT,44121,"Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,44125,"Enterectomy, resection of small intestine; with enterostomy ",,,948.0,16207.0,109 CPT,44126,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering ",,,948.0,30231.08,109 CPT,44127,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering ",,,948.0,35172.75,109 CPT,44128,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (List separately in addit",,,948.0,16207.0,109 CPT,44130,"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure) ",,,948.0,16207.0,109 CPT,44132,"Donor enterectomy (including cold preservation), open; from cadaver donor ",,,948.0,16207.0,109 CPT,44133,"Donor enterectomy (including cold preservation), open; partial, from living donor ",,,948.0,23742.38,109 CPT,44135,Intestinal allotransplantation; from cadaver donor ,,,948.0,37588.61,109 CPT,44136,Intestinal allotransplantation; from living donor ,,,948.0,42394.68,109 CPT,44137,"Removal of transplanted intestinal allograft, complete ",,,948.0,19220.19,109 CPT,44139,Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ,,,948.0,16207.0,109 CPT,44140,"Colectomy, partial; with anastomosis ",,,948.0,16495.05,109 CPT,44141,"Colectomy, partial; with skin level cecostomy or colostomy ",,,948.0,22428.55,109 CPT,44143,"Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) ",,,948.0,20457.81,109 CPT,44144,"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula ",,,948.0,21758.94,109 CPT,44145,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis) ",,,948.0,20364.56,109 CPT,44146,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy ",,,948.0,26005.59,109 CPT,44147,"Colectomy, partial; abdominal and transanal approach ",,,948.0,23882.21,109 CPT,44150,"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy ",,,948.0,22924.36,109 CPT,44151,"Colectomy, total, abdominal, without proctectomy; with continent ileostomy ",,,948.0,26556.55,109 CPT,44152,REMOVAL OF COLON/ILEOSTOMY ,,,3390.0,5841.0,16 CPT,44153,REMOVAL OF COLON/ILEOSTOMY ,,,3390.0,5841.0,16 CPT,44155,"Colectomy, total, abdominal, with proctectomy; with ileostomy ",,,948.0,25492.74,109 CPT,44156,"Colectomy, total, abdominal, with proctectomy; with continent ileostomy ",,,948.0,28196.72,109 CPT,44157,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,26954.98,109 CPT,44158,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,27671.16,109 CPT,44160,"Colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,948.0,16207.0,109 CPT,44180,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) ",,,948.0,13394.0,122 CPT,44186,"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) ",,,948.0,13394.0,122 CPT,44187,"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,121 CPT,44188,"Laparoscopy, surgical, colostomy or skin level cecostomy ",,,948.0,16207.0,121 CPT,44200,"LAPAROSCOPY, ENTEROLYSIS ",,,3390.0,5841.0,16 CPT,44201,"LAPAROSCOPY, JEJUNOSTOMY ",,,3390.0,5841.0,16 CPT,44202,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis ",,,5202.0,17007.9,101 CPT,44202,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis High Cost Surgery",,,2369.0,2369.0,20 CPT,44203,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) ",,,2300.11,13835.0,101 CPT,44203,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,44204,"Laparoscopy, surgical; colectomy, partial, with anastomosis ",,,5202.0,18906.55,101 CPT,44204,"Laparoscopy, surgical; colectomy, partial, with anastomosis High Cost Surgery",,,2369.0,2369.0,20 CPT,44205,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,3390.0,16427.31,101 CPT,44205,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy High Cost Surgery",,,2369.0,2369.0,20 CPT,44206,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) ",,,3390.0,21483.4,101 CPT,44206,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,44207,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) ",,,3390.0,22326.83,101 CPT,44207,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) High Cost Surgery",,,2369.0,2369.0,20 CPT,44208,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy ",,,3390.0,24331.44,101 CPT,44208,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy High Cost Surgery",,,2369.0,2369.0,20 CPT,44209,"Laparoscope proc, intestine ",,,3390.0,5841.0,16 CPT,44210,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy ",,,3390.0,21826.68,101 CPT,44210,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy High Cost Surgery",,,2369.0,2369.0,20 CPT,44211,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed ",,,948.0,26679.44,121 CPT,44212,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy ",,,948.0,25073.14,121 CPT,44213,"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ",,,948.0,16207.0,121 CPT,44227,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis ",,,948.0,20457.81,121 CPT,44238,"Unlisted laparoscopy procedure, intestine (except rectum) ",,,948.0,13835.0,122 CPT,44239,"LAPAROSCOPE PROC, RECTUM ",,,3390.0,5841.0,16 CPT,44300,"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure) ",,,948.0,16207.0,205 CPT,44310,"Ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,109 CPT,44312,Revision of ileostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,8128.0,233 CPT,44314,Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,16207.0,205 CPT,44316,Continent ileostomy (Kock procedure) (separate procedure) ,,,948.0,17410.56,109 CPT,44320,Colostomy or skin level cecostomy; ,,,948.0,16207.0,109 CPT,44322,"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure) ",,,948.0,16207.0,109 CPT,44340,Revision of colostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,12562.0,233 CPT,44345,Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,13835.0,205 CPT,44346,Revision of colostomy; with repair of paracolostomy hernia (separate procedure) ,,,948.0,14524.31,205 CPT,44360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedu",,,593.22,4251.7,233 CPT,44361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple ",,,593.22,4251.7,233 CPT,44363,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s) ",,,593.22,4251.7,233 CPT,44364,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,233 CPT,44365,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery ",,,593.22,4251.7,233 CPT,44366,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler",,,593.22,4251.7,233 CPT,44369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b",,,593.22,4251.7,233 CPT,44370,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,233 CPT,44372,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube ",,,593.22,4251.7,233 CPT,44373,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube ",,,593.22,4251.7,233 CPT,44376,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,593.22,4251.7,233 CPT,44377,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple ",,,593.22,4251.7,233 CPT,44378,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, pl",,,593.22,4251.7,233 CPT,44379,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,233 CPT,44380,"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,233 CPT,44381,"Ileoscopy, through stoma; with transendoscopic balloon dilation ",,,593.22,8234.0,233 CPT,44382,"Ileoscopy, through stoma; with biopsy, single or multiple ",,,351.7,3128.0,233 CPT,44383,ILEOSCOPY W/STENT ,,,3390.0,5841.0,16 CPT,44384,"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,206 CPT,44385,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,233 CPT,44386,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); with biopsy, single or multiple ",,,344.93,3128.0,233 CPT,44388,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,233 CPT,44389,"Colonoscopy through stoma; with biopsy, single or multiple ",,,450.72,3128.0,233 CPT,44390,Colonoscopy through stoma; with removal of foreign body(s) ,,,344.93,3128.0,233 CPT,44391,"Colonoscopy through stoma; with control of bleeding, any method ",,,450.72,3128.0,233 CPT,44392,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3128.0,233 CPT,44393,COLONOSCOPY LESION REMOVAL ,,,3390.0,5841.0,16 CPT,44394,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,233 CPT,44397,COLONOSCOPY W/STENT ,,,3390.0,5841.0,16 CPT,44401,"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,206 CPT,44402,"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,206 CPT,44403,Colonoscopy through stoma; with endoscopic mucosal resection ,,,450.72,8234.0,233 CPT,44404,"Colonoscopy through stoma; with directed submucosal injection(s), any substance ",,,450.72,8234.0,233 CPT,44405,Colonoscopy through stoma; with transendoscopic balloon dilation ,,,450.72,8234.0,233 CPT,44406,"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures ",,,450.72,8234.0,233 CPT,44407,"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descendi",,,450.72,8234.0,233 CPT,44408,"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,8234.0,233 CPT,44500,"Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) ",,,351.7,3128.0,137 CPT,44602,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation ",,,948.0,17359.64,109 CPT,44603,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations ",,,948.0,19923.79,109 CPT,44604,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy ",,,948.0,16207.0,109 CPT,44605,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy ",,,948.0,16207.0,109 CPT,44615,"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction ",,,948.0,16207.0,109 CPT,44620,"Closure of enterostomy, large or small intestine; ",,,948.0,16207.0,109 CPT,44625,"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal ",,,948.0,16207.0,109 CPT,44626,"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure) ",,,948.0,19678.01,109 CPT,44640,Closure of intestinal cutaneous fistula ,,,948.0,17228.28,109 CPT,44650,Closure of enteroenteric or enterocolic fistula ,,,948.0,17745.37,109 CPT,44660,Closure of enterovesical fistula; without intestinal or bladder resection ,,,948.0,16401.79,109 CPT,44661,Closure of enterovesical fistula; with intestine and/or bladder resection ,,,948.0,19063.43,109 CPT,44680,Intestinal plication (separate procedure) ,,,948.0,16207.0,109 CPT,44700,"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum) ",,,948.0,16207.0,109 CPT,44701,Intraoperative colonic lavage (List separately in addition to code for primary procedure) ,,,948.0,5841.0,44 CPT,44705,"Preparation of fecal microbiota for instillation, including assessment of donor specimen ",,,713.79,5841.0,168 CPT,44715,"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein ",,,948.0,16207.0,109 CPT,44720,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,109 CPT,44721,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,109 CPT,44799,"Unlisted procedure, small intestine ",,,915.67,13835.0,206 CPT,44800,Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct ,,,948.0,16207.0,109 CPT,44820,Excision of lesion of mesentery (separate procedure) ,,,948.0,16207.0,109 CPT,44850,Suture of mesentery (separate procedure) ,,,948.0,16207.0,109 CPT,44899,"Unlisted procedure, Meckel's diverticulum and the mesentery ",,,948.0,16207.0,109 CPT,44900,"Incision and drainage of appendiceal abscess, open ",,,948.0,16207.0,109 CPT,44901,DRAIN APP ABSCESS PERCUT ,,,3390.0,5841.0,16 CPT,44950,Appendectomy; ,,,948.0,13835.0,206 CPT,44955,Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,44 CPT,44960,Appendectomy; for ruptured appendix with abscess or generalized peritonitis ,,,948.0,16207.0,109 CPT,44970,"Laparoscopy, surgical, appendectomy ",,,5202.0,13196.03,84 CPT,44970,"Laparoscopy, surgical, appendectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,44979,"Unlisted laparoscopy procedure, appendix ",,,5202.0,13196.03,84 CPT,44979,"Unlisted laparoscopy procedure, appendix High Cost Surgery",,,2369.0,2369.0,20 CPT,45000,Transrectal drainage of pelvic abscess ,,,450.72,5571.0,233 CPT,45005,"Incision and drainage of submucosal abscess, rectum ",,,450.72,3755.0,233 CPT,45020,"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess ",,,948.0,6399.61,233 CPT,45100,"Biopsy of anorectal wall, anal approach (eg, congenital megacolon) ",,,948.0,6399.61,233 CPT,45108,Anorectal myomectomy ,,,948.0,6399.61,233 CPT,45110,"Proctectomy; complete, combined abdominoperineal, with colostomy ",,,948.0,22602.37,109 CPT,45111,"Proctectomy; partial resection of rectum, transabdominal approach ",,,948.0,16207.0,109 CPT,45112,"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) ",,,948.0,22894.72,109 CPT,45113,"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy ",,,948.0,23178.72,109 CPT,45114,"Proctectomy, partial, with anastomosis; abdominal and transsacral approach ",,,948.0,22297.2,109 CPT,45116,"Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) ",,,948.0,19122.7,109 CPT,45119,"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed ",,,948.0,23712.75,109 CPT,45120,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation) ",,,948.0,19512.66,109 CPT,45121,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies ",,,948.0,21178.23,109 CPT,45123,"Proctectomy, partial, without anastomosis, perineal approach ",,,948.0,13835.0,109 CPT,45126,"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or withou",,,948.0,34142.93,109 CPT,45130,"Excision of rectal procidentia, with anastomosis; perineal approach ",,,948.0,16207.0,109 CPT,45135,"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach ",,,948.0,16207.0,109 CPT,45136,Excision of ileoanal reservoir with ileostomy ,,,948.0,22623.54,109 CPT,45150,Division of stricture of rectum ,,,450.72,5571.0,233 CPT,45160,"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach ",,,948.0,6399.61,233 CPT,45170,EXCISION OF RECTAL LESION ,,,3390.0,5841.0,16 CPT,45171,"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) ",,,948.0,13394.0,233 CPT,45172,"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) ",,,948.0,15059.0,233 CPT,45190,"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ",,,948.0,15059.0,233 CPT,45300,"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,86.63,3128.0,233 CPT,45303,"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,7266.25,233 CPT,45305,"Proctosigmoidoscopy, rigid; with biopsy, single or multiple ",,,450.72,3128.0,233 CPT,45307,"Proctosigmoidoscopy, rigid; with removal of foreign body ",,,948.0,6399.61,233 CPT,45308,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,233 CPT,45309,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ",,,450.72,3128.0,233 CPT,45315,"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,450.72,3128.0,233 CPT,45317,"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,450.72,3390.0,233 CPT,45320,"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser) ",,,948.0,6399.61,233 CPT,45321,"Proctosigmoidoscopy, rigid; with decompression of volvulus ",,,948.0,6399.61,233 CPT,45327,"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation) ",,,948.0,13051.67,233 CPT,45330,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,137.2,3128.0,233 CPT,45331,"Sigmoidoscopy, flexible; with biopsy, single or multiple ",,,344.93,3128.0,233 CPT,45332,"Sigmoidoscopy, flexible; with removal of foreign body(s) ",,,450.72,3128.0,233 CPT,45333,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,344.93,3128.0,233 CPT,45334,"Sigmoidoscopy, flexible; with control of bleeding, any method ",,,450.72,3128.0,233 CPT,45335,"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance ",,,344.93,3128.0,233 CPT,45337,"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,3128.0,233 CPT,45338,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,233 CPT,45339,SIGMOIDOSCOPY W/ABLATE TUMR ,,,3390.0,5841.0,16 CPT,45340,"Sigmoidoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3128.0,233 CPT,45341,"Sigmoidoscopy, flexible; with endoscopic ultrasound examination ",,,344.93,3128.0,233 CPT,45342,"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) ",,,450.72,3128.0,233 CPT,45345,SIGMOIDOSCOPY W/STENT ,,,3390.0,5841.0,16 CPT,45346,"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,233 CPT,45347,"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,233 CPT,45349,"Sigmoidoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,233 CPT,45350,"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,233 CPT,45355,SURGICAL COLONOSCOPY ,,,3390.0,5841.0,16 CPT,45378,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3755.0,233 CPT,45379,"Colonoscopy, flexible; with removal of foreign body(s) ",,,450.72,3755.0,233 CPT,45380,"Colonoscopy, flexible; with biopsy, single or multiple ",,,450.72,3755.0,233 CPT,45381,"Colonoscopy, flexible; with directed submucosal injection(s), any substance ",,,450.72,3755.0,233 CPT,45382,"Colonoscopy, flexible; with control of bleeding, any method ",,,450.72,3755.0,233 CPT,45383,LESION REMOVAL COLONOSCOPY ,,,3390.0,5841.0,16 CPT,45384,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3755.0,233 CPT,45385,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3755.0,233 CPT,45386,"Colonoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3755.0,233 CPT,45387,COLONOSCOPY W/STENT ,,,3390.0,5841.0,16 CPT,45388,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,233 CPT,45389,"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,233 CPT,45390,"Colonoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,233 CPT,45391,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures ",,,450.72,3755.0,233 CPT,45392,"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, desc",,,450.72,3755.0,233 CPT,45393,"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,450.72,8234.0,233 CPT,45395,"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy ",,,948.0,24212.78,121 CPT,45397,"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when per",,,948.0,26340.4,121 CPT,45398,"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,233 CPT,45399,"Unlisted procedure, colon ",,,938.87,13394.0,206 CPT,45400,"Laparoscopy, surgical; proctopexy (for prolapse) ",,,948.0,16207.0,121 CPT,45402,"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection ",,,948.0,18575.98,121 CPT,45499,"Unlisted laparoscopy procedure, rectum ",,,948.0,13835.0,122 CPT,45500,Proctoplasty; for stenosis ,,,948.0,6399.61,233 CPT,45505,Proctoplasty; for prolapse of mucous membrane ,,,948.0,7014.0,233 CPT,45520,Perirectal injection of sclerosing solution for prolapse ,,,938.87,5841.0,198 CPT,45540,"Proctopexy (eg, for prolapse); abdominal approach ",,,948.0,16207.0,109 CPT,45541,"Proctopexy (eg, for prolapse); perineal approach ",,,948.0,13835.0,233 CPT,45550,"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach ",,,948.0,17974.22,109 CPT,45560,Repair of rectocele (separate procedure) ,,,948.0,7014.0,233 CPT,45562,"Exploration, repair, and presacral drainage for rectal injury; ",,,948.0,16207.0,109 CPT,45563,"Exploration, repair, and presacral drainage for rectal injury; with colostomy ",,,948.0,20228.96,109 CPT,45800,Closure of rectovesical fistula; ,,,948.0,16207.0,109 CPT,45805,Closure of rectovesical fistula; with colostomy ,,,948.0,18037.72,109 CPT,45820,Closure of rectourethral fistula; ,,,948.0,16207.0,109 CPT,45825,Closure of rectourethral fistula; with colostomy ,,,948.0,18834.58,109 CPT,45900,Reduction of procidentia (separate procedure) under anesthesia ,,,344.93,3128.0,233 CPT,45905,Dilation of anal sphincter (separate procedure) under anesthesia other than local ,,,450.72,3128.0,233 CPT,45910,Dilation of rectal stricture (separate procedure) under anesthesia other than local ,,,450.72,3128.0,233 CPT,45915,Removal of fecal impaction or foreign body (separate procedure) under anesthesia ,,,450.72,3128.0,233 CPT,45990,"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic ",,,948.0,6399.61,233 CPT,45999,"Unlisted procedure, rectum ",,,938.87,13835.0,110 CPT,46020,Placement of seton ,,,948.0,12562.0,233 CPT,46030,"Removal of anal seton, other marker ",,,450.72,3128.0,233 CPT,46040,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) ,,,450.72,12562.0,233 CPT,46045,"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia ",,,948.0,6399.61,233 CPT,46050,"Incision and drainage, perianal abscess, superficial ",,,344.93,3128.0,233 CPT,46060,"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton ",,,948.0,6399.61,233 CPT,46070,"Incision, anal septum (infant) ",,,948.0,13835.0,233 CPT,46080,"Sphincterotomy, anal, division of sphincter (separate procedure) ",,,948.0,12562.0,233 CPT,46083,"Incision of thrombosed hemorrhoid, external ",,,115.66,5841.0,225 CPT,46200,"Fissurectomy, including sphincterotomy, when performed ",,,948.0,6399.61,233 CPT,46210,REMOVAL OF ANAL CRYPT ,,,3390.0,5841.0,16 CPT,46211,REMOVAL OF ANAL CRYPTS ,,,3390.0,5841.0,16 CPT,46220,"Excision of single external papilla or tag, anus ",,,450.72,3128.0,233 CPT,46221,"Hemorrhoidectomy, internal, by rubber band ligation(s) ",,,171.8,3128.0,233 CPT,46230,"Excision of multiple external papillae or tags, anus ",,,948.0,6399.61,233 CPT,46250,"Hemorrhoidectomy, external, 2 or more columns/groups ",,,948.0,12562.0,233 CPT,46255,"Hemorrhoidectomy, internal and external, single column/group; ",,,948.0,12562.0,233 CPT,46257,"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy ",,,948.0,12562.0,233 CPT,46258,"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed ",,,948.0,12562.0,233 CPT,46260,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; ",,,948.0,12562.0,233 CPT,46261,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy ",,,948.0,8234.0,233 CPT,46262,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed ",,,948.0,8234.0,233 CPT,46270,Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous ,,,948.0,12562.0,233 CPT,46275,Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric ,,,948.0,12562.0,233 CPT,46280,"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed ",,,948.0,8234.0,233 CPT,46285,Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage ,,,948.0,6399.61,233 CPT,46288,Closure of anal fistula with rectal advancement flap ,,,948.0,8234.0,233 CPT,46320,"Excision of thrombosed hemorrhoid, external ",,,131.97,3128.0,233 CPT,46500,"Injection of sclerosing solution, hemorrhoids ",,,220.64,13835.0,137 CPT,46505,Chemodenervation of internal anal sphincter ,,,450.72,3128.0,233 CPT,46600,"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,134.32,5841.0,198 CPT,46601,"Anoscopy; diagnostic, with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when p",,,223.51,5841.0,198 CPT,46604,"Anoscopy; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,13835.0,233 CPT,46606,"Anoscopy; with biopsy, single or multiple ",,,211.33,13835.0,233 CPT,46607,"Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple ",,,948.0,8234.0,206 CPT,46608,Anoscopy; with removal of foreign body ,,,344.93,3128.0,233 CPT,46610,"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,233 CPT,46611,"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique ",,,344.93,3128.0,233 CPT,46612,"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,233 CPT,46614,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,115.98,13835.0,233 CPT,46615,"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,233 CPT,46700,"Anoplasty, plastic operation for stricture; adult ",,,948.0,12562.0,233 CPT,46705,"Anoplasty, plastic operation for stricture; infant ",,,948.0,16207.0,109 CPT,46706,Repair of anal fistula with fibrin glue ,,,948.0,6399.61,233 CPT,46707,"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa ºSIS») ",,,948.0,15059.0,137 CPT,46710,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach ",,,948.0,16207.0,205 CPT,46712,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach ",,,948.0,27438.08,205 CPT,46715,Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) ,,,948.0,16207.0,109 CPT,46716,Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula ,,,948.0,16207.0,109 CPT,46730,Repair of high imperforate anus without fistula; perineal or sacroperineal approach ,,,948.0,24178.91,109 CPT,46735,Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches ,,,948.0,27904.25,109 CPT,46740,Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach ,,,948.0,26425.19,109 CPT,46742,Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches ,,,948.0,30612.46,109 CPT,46744,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach ",,,948.0,42911.77,109 CPT,46746,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; ",,,948.0,47921.29,109 CPT,46748,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps ",,,948.0,52015.42,109 CPT,46750,"Sphincteroplasty, anal, for incontinence or prolapse; adult ",,,948.0,12562.0,233 CPT,46751,"Sphincteroplasty, anal, for incontinence or prolapse; child ",,,948.0,16207.0,109 CPT,46753,Graft (Thiersch operation) for rectal incontinence and/or prolapse ,,,948.0,12562.0,233 CPT,46754,"Removal of Thiersch wire or suture, anal canal ",,,948.0,6399.61,233 CPT,46760,"Sphincteroplasty, anal, for incontinence, adult; muscle transplant ",,,948.0,7014.0,233 CPT,46761,"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) ",,,948.0,12562.0,233 CPT,46762,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER ",,,4988.0,7014.0,24 CPT,46900,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,144.76,5841.0,225 CPT,46910,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,168.02,13835.0,233 CPT,46916,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,78.06,5841.0,225 CPT,46917,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,948.0,6399.61,233 CPT,46922,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,948.0,6399.61,233 CPT,46924,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6399.61,233 CPT,46930,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) ",,,137.5,13394.0,233 CPT,46934,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,16 CPT,46935,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,16 CPT,46936,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,16 CPT,46937,CRYOTHERAPY OF RECTAL LESION ,,,3390.0,5841.0,16 CPT,46938,CRYOTHERAPY OF RECTAL LESION ,,,3390.0,5841.0,16 CPT,46940,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial ",,,154.64,13835.0,233 CPT,46942,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent ",,,938.87,3128.0,206 CPT,46945,"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance ",,,948.0,15754.86,233 CPT,46946,"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance ",,,948.0,6399.61,233 CPT,46947,"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling ",,,948.0,12909.0,206 CPT,46948,"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed ",,,948.0,12909.0,225 CPT,46999,"Unlisted procedure, anus ",,,938.87,13835.0,206 CPT,47000,BX LIVER,3794.63,3794.63,531.25,3225.44,10 CPT,47000,"Biopsy of liver, needle; percutaneous ",3794.63,3794.63,510.77,3747.2,233 CPT,47001,"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,47010,"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages ",,,948.0,16207.0,109 CPT,47011,PERCUT DRAIN LIVER LESION ,,,3390.0,5841.0,16 CPT,47015,"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es) ",,,948.0,14320.86,109 CPT,47100,"Biopsy of liver, wedge ",,,948.0,16207.0,109 CPT,47120,"Hepatectomy, resection of liver; partial lobectomy ",,,948.0,28730.74,109 CPT,47122,"Hepatectomy, resection of liver; trisegmentectomy ",,,948.0,42242.16,109 CPT,47125,"Hepatectomy, resection of liver; total left lobectomy ",,,948.0,37948.81,109 CPT,47130,"Hepatectomy, resection of liver; total right lobectomy ",,,948.0,40771.45,109 CPT,47133,"Donor hepatectomy (including cold preservation), from cadaver donor ",,,948.0,22555.68,109 CPT,47134,"PARTIAL REMOVAL, DONOR LIVER ",,,3390.0,5841.0,16 CPT,47135,"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age ",,,948.0,66243.02,109 CPT,47136,TRANSPLANTATION OF LIVER ,,,3390.0,5841.0,16 CPT,47140,"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) ",,,948.0,43933.13,109 CPT,47141,"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV) ",,,948.0,52591.78,109 CPT,47142,"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII) ",,,948.0,57868.37,109 CPT,47143,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,948.0,28561.16,109 CPT,47144,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,948.0,27319.42,109 CPT,47145,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,948.0,26700.61,109 CPT,47146,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each ",,,948.0,16207.0,109 CPT,47147,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each ",,,948.0,16207.0,109 CPT,47300,Marsupialization of cyst or abscess of liver ,,,948.0,16207.0,109 CPT,47350,Management of liver hemorrhage; simple suture of liver wound or injury ,,,948.0,16825.62,109 CPT,47360,"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation ",,,948.0,23089.7,109 CPT,47361,"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver ",,,948.0,37296.13,109 CPT,47362,Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing ,,,948.0,17851.33,109 CPT,47370,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency ",,,948.0,22967.79,122 CPT,47371,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical ",,,948.0,22967.79,122 CPT,47379,"Unlisted laparoscopic procedure, liver ",,,948.0,13835.0,122 CPT,47380,"Ablation, open, of 1 or more liver tumor(s); radiofrequency ",,,948.0,17732.67,205 CPT,47381,"Ablation, open, of 1 or more liver tumor(s); cryosurgical ",,,948.0,17999.62,205 CPT,47382,"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency ",,,948.0,13835.0,233 CPT,47383,"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation ",,,948.0,15059.0,233 CPT,47384,"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,152 CPT,47399,"Unlisted procedure, liver ",,,714.92,13835.0,102 CPT,47400,"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus ",,,948.0,26539.62,109 CPT,47420,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16486.58,109 CPT,47425,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16829.85,109 CPT,47460,"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure) ",,,948.0,16207.0,109 CPT,47480,"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure) ",,,948.0,16207.0,109 CPT,47490,CHLECYSTOSTMY PERC,2720.53,2720.53,353.67,2312.45,15 CPT,47490,"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation ",2720.53,2720.53,948.0,13835.0,110 CPT,47500,INJECTION FOR LIVER X-RAYS ,,,3390.0,5841.0,16 CPT,47505,INJECTION FOR LIVER X-RAYS ,,,3390.0,5841.0,16 CPT,47510,INSERT CATHETER BILE DUCT ,,,3390.0,5841.0,16 CPT,47511,INSERT BILE DUCT DRAIN ,,,3390.0,5841.0,16 CPT,47525,CHANGE BILE DUCT CATHETER ,,,3390.0,5841.0,16 CPT,47530,REVISE/REINSERT BILE TUBE ,,,3390.0,5841.0,16 CPT,47531,INJ CHOLANGIO EXST ACCES,12001.96,12001.96,1560.25,10201.67,16 CPT,47531,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",12001.96,12001.96,948.0,8488.5,198 CPT,47532,INJ CHOLANGIO NEW ACCES,802.31,802.31,104.3,681.96,15 CPT,47532,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",802.31,802.31,948.0,15059.0,206 CPT,47533,PLCMT BILIARY CATH,14001.21,14001.21,1960.17,11901.03,10 CPT,47533,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",14001.21,14001.21,948.0,15059.0,233 CPT,47534,PLC BILIARY CATH INT/EXT,14001.21,14001.21,1960.17,11901.03,10 CPT,47534,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",14001.21,14001.21,948.0,15059.0,233 CPT,47535,"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), ",,,948.0,15059.0,233 CPT,47536,"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging",,,948.0,15059.0,233 CPT,47537,REMOVE BILIARY CATH,2199.16,2199.16,307.88,1869.29,10 CPT,47537,"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidan",2199.16,2199.16,351.7,3128.0,233 CPT,47538,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,948.0,15059.0,233 CPT,47539,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,948.0,15059.0,233 CPT,47540,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,948.0,15059.0,233 CPT,47541,"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when per",,,948.0,15059.0,233 CPT,47542,"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each d",,,948.0,5841.0,140 CPT,47543,"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and ",,,948.0,5841.0,140 CPT,47544,"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging ",,,948.0,5841.0,140 CPT,47550,"Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure) ",,,948.0,13835.0,109 CPT,47552,"Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) ",,,948.0,8488.5,233 CPT,47553,"Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple ",,,948.0,12562.0,233 CPT,47554,"Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi ",,,948.0,13196.03,233 CPT,47555,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent ",,,948.0,12562.0,233 CPT,47556,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent ",,,948.0,15059.0,233 CPT,47560,LAPAROSCOPY W/CHOLANGIO ,,,3390.0,5841.0,16 CPT,47561,LAPARO W/CHOLANGIO/BIOPSY ,,,3390.0,5841.0,16 CPT,47562,"Laparoscopy, surgical; cholecystectomy ",,,1983.29,13978.0,111 CPT,47562,"Laparoscopy, surgical; cholecystectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,47563,"Laparoscopy, surgical; cholecystectomy with cholangiography ",,,1983.29,13978.0,111 CPT,47563,"Laparoscopy, surgical; cholecystectomy with cholangiography High Cost Surgery",,,2369.0,2369.0,20 CPT,47564,"Laparoscopy, surgical; cholecystectomy with exploration of common duct ",,,1983.29,15059.0,129 CPT,47564,"Laparoscopy, surgical; cholecystectomy with exploration of common duct High Cost Surgery",,,2369.0,2369.0,20 CPT,47570,"Laparoscopy, surgical; cholecystoenterostomy ",,,3390.0,16207.0,101 CPT,47570,"Laparoscopy, surgical; cholecystoenterostomy High Cost Surgery",,,2369.0,2369.0,20 CPT,47579,"Unlisted laparoscopy procedure, biliary tract ",,,5202.0,13835.0,102 CPT,47579,"Unlisted laparoscopy procedure, biliary tract High Cost Surgery",,,2369.0,2369.0,20 CPT,47600,Cholecystectomy; ,,,2996.0,16207.0,185 CPT,47600,Cholecystectomy; High Cost Surgery,,,2369.0,2369.0,20 CPT,47605,Cholecystectomy; with cholangiography ,,,3293.0,16207.0,185 CPT,47605,Cholecystectomy; with cholangiography High Cost Surgery,,,2369.0,2369.0,20 CPT,47610,Cholecystectomy with exploration of common duct; ,,,948.0,16207.0,205 CPT,47612,Cholecystectomy with exploration of common duct; with choledochoenterostomy ,,,948.0,16207.0,205 CPT,47620,"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography ",,,948.0,16774.82,205 CPT,47630,REMOVE BILE DUCT STONE ,,,3390.0,5841.0,16 CPT,47700,"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography ",,,948.0,16207.0,109 CPT,47701,"Portoenterostomy (eg, Kasai procedure) ",,,948.0,21004.54,109 CPT,47711,"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic ",,,948.0,19126.93,109 CPT,47712,"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic ",,,948.0,24530.65,109 CPT,47715,Excision of choledochal cyst ,,,948.0,16300.07,109 CPT,47716,FUSION OF BILE DUCT CYST ,,,3390.0,5841.0,16 CPT,47719,FUSION OF BILE DUCT CYST ,,,3390.0,5841.0,16 CPT,47720,Cholecystoenterostomy; direct ,,,948.0,16207.0,109 CPT,47721,Cholecystoenterostomy; with gastroenterostomy ,,,948.0,16677.33,109 CPT,47740,Cholecystoenterostomy; Roux-en-Y ,,,948.0,16207.0,109 CPT,47741,Cholecystoenterostomy; Roux-en-Y with gastroenterostomy ,,,948.0,18126.75,109 CPT,47760,"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,27747.48,109 CPT,47765,"Anastomosis, of intrahepatic ducts and gastrointestinal tract ",,,948.0,37283.43,109 CPT,47780,"Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,30468.4,109 CPT,47785,"Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract ",,,948.0,40025.51,109 CPT,47800,"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis ",,,948.0,19304.98,109 CPT,47801,Placement of choledochal stent ,,,948.0,16207.0,109 CPT,47802,U-tube hepaticoenterostomy ,,,3390.0,16207.0,24 CPT,47900,Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) ,,,948.0,16846.79,109 CPT,47999,"Unlisted procedure, biliary tract ",,,915.67,13835.0,110 CPT,48000,"Placement of drains, peripancreatic, for acute pancreatitis; ",,,948.0,23178.72,109 CPT,48001,"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy ",,,948.0,28256.1,109 CPT,48005,RESECT/DEBRIDE PANCREAS ,,,3390.0,5841.0,16 CPT,48020,Removal of pancreatic calculus ,,,948.0,16207.0,109 CPT,48100,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,948.0,16207.0,109 CPT,48102,"Biopsy of pancreas, percutaneous needle ",,,510.77,3747.2,233 CPT,48105,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,948.0,34939.67,109 CPT,48120,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,948.0,16207.0,109 CPT,48140,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,948.0,19262.64,109 CPT,48145,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,948.0,20063.62,109 CPT,48146,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,948.0,23102.4,109 CPT,48148,Excision of ampulla of Vater ,,,948.0,16207.0,109 CPT,48150,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38398.05,109 CPT,48152,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35550.01,109 CPT,48153,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38220.12,109 CPT,48154,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35766.16,109 CPT,48155,"Pancreatectomy, total ",,,948.0,22322.6,109 CPT,48160,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,948.0,16207.0,88 CPT,48180,FUSE PANCREAS AND BOWEL ,,,3390.0,5841.0,16 CPT,48400,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,48500,Marsupialization of pancreatic cyst ,,,948.0,16207.0,109 CPT,48510,"External drainage, pseudocyst of pancreas, open ",,,948.0,16207.0,109 CPT,48511,DRAIN PANCREATIC PSEUDOCYST ,,,3390.0,5841.0,16 CPT,48520,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,948.0,16207.0,109 CPT,48540,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,948.0,16207.0,109 CPT,48545,Pancreatorrhaphy for injury ,,,948.0,16490.81,109 CPT,48547,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,948.0,21996.26,109 CPT,48548,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,948.0,20436.65,109 CPT,48550,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,948.0,16028.88,93 CPT,48551,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,948.0,22352.23,93 CPT,48552,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,948.0,13835.0,93 CPT,48554,Transplantation of pancreatic allograft ,,,948.0,31320.29,93 CPT,48556,Removal of transplanted pancreatic allograft ,,,948.0,15660.09,93 CPT,48999,"Unlisted procedure, pancreas ",,,714.92,13835.0,102 CPT,49000,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,948.0,13835.0,205 CPT,49002,Reopening of recent laparotomy ,,,948.0,16207.0,109 CPT,49010,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,948.0,16207.0,205 CPT,49013,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,948.0,13835.0,101 CPT,49014,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,948.0,13835.0,101 CPT,49020,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,948.0,19550.76,109 CPT,49021,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,16 CPT,49040,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,948.0,16207.0,109 CPT,49041,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,16 CPT,49060,"Drainage of retroperitoneal abscess, open ",,,948.0,16207.0,109 CPT,49061,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,16 CPT,49062,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,948.0,16207.0,109 CPT,49080,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,16 CPT,49081,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,16 CPT,49082,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,3249.0,233 CPT,49083,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,17380.31,17380.31,351.7,3249.0,233 CPT,49083,PARACENTESIS W IMAGE,17380.31,17380.31,2433.24,14773.26,10 CPT,49084,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,3249.0,233 CPT,49085,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,16 CPT,49180,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,3747.2,233 CPT,49185,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,948.0,12909.0,206 CPT,49186,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,948.0,15741.23,64 CPT,49187,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,948.0,20117.01,64 CPT,49188,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,948.0,24038.38,64 CPT,49189,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,948.0,27963.63,64 CPT,49190,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,948.0,34471.38,64 CPT,49200,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,16 CPT,49201,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,16 CPT,49203,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,24 CPT,49204,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,24 CPT,49205,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,24 CPT,49215,Excision of presacral or sacrococcygeal tumor ,,,948.0,27243.1,109 CPT,49220,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,24 CPT,49250,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,948.0,8488.5,233 CPT,49255,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,948.0,16207.0,205 CPT,49320,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,13196.03,129 CPT,49320,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,49321,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,13196.03,129 CPT,49321,"Laparoscopy, surgical; with biopsy (single or multiple) High Cost Surgery",,,2369.0,2369.0,20 CPT,49322,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,13196.03,129 CPT,49322,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) High Cost Surgery",,,2369.0,2369.0,20 CPT,49323,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,5202.0,13196.03,102 CPT,49323,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity High Cost Surgery",,,2369.0,2369.0,20 CPT,49324,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,15059.0,129 CPT,49324,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter High Cost Surgery",,,2369.0,2369.0,20 CPT,49325,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,15059.0,129 CPT,49325,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed High Cost Surgery",,,2369.0,2369.0,20 CPT,49326,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,15059.0,57 CPT,49326,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,49327,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,15059.0,77 CPT,49329,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,5202.0,13835.0,102 CPT,49329,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum High Cost Surgery",,,2369.0,2369.0,20 CPT,49400,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,948.0,5841.0,140 CPT,49402,Removal of peritoneal foreign body from peritoneal cavity ,,,948.0,8488.5,233 CPT,49405,IMG GD FLD COLL VISCERAL,7955.14,7955.14,1034.17,6761.87,15 CPT,49405,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",7955.14,7955.14,948.0,15059.0,206 CPT,49406,IMG GD FLD COLL PERI/RET,7955.14,7955.14,1113.72,6761.87,10 CPT,49406,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",7955.14,7955.14,510.77,15059.0,233 CPT,49407,IMG GD FLD COL PER TV/TR,6696.8,6696.8,937.55,5692.28,10 CPT,49407,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",6696.8,6696.8,510.77,12562.0,233 CPT,49411,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,5193.86,233 CPT,49412,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,796.41,16207.0,109 CPT,49418,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,948.0,15059.0,233 CPT,49419,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,948.0,12547.6,233 CPT,49420,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,16 CPT,49421,INS DIAL TUN IP CATH OPN,21374.09,21374.09,2992.37,18167.98,10 CPT,49421,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",21374.09,21374.09,948.0,8488.5,233 CPT,49422,Removal of tunneled intraperitoneal catheter ,,,948.0,7565.59,233 CPT,49423,EXCHG CATH ABS/CYS,20434.05,20434.05,2860.77,17368.94,10 CPT,49423,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,20434.05,20434.05,593.22,13835.0,233 CPT,49424,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,11587.74,11587.74,948.0,5841.0,140 CPT,49424,INJ CATH ABS/CYST,11587.74,11587.74,1506.41,9849.58,29 CPT,49425,Insertion of peritoneal-venous shunt ,,,948.0,13835.0,205 CPT,49426,Revision of peritoneal-venous shunt ,,,948.0,8488.5,233 CPT,49427,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,948.0,5841.0,140 CPT,49428,Ligation of peritoneal-venous shunt ,,,948.0,13835.0,109 CPT,49429,Removal of peritoneal-venous shunt ,,,948.0,13835.0,233 CPT,49435,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,948.0,3083.0,148 CPT,49436,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,12562.0,233 CPT,49440,INS GASTRO TUBE PERC,11587.74,11587.74,1622.28,9849.58,10 CPT,49440,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,593.22,4251.7,233 CPT,49441,INS DUO/JEJSTMT TUBE,11587.74,11587.74,1622.28,9849.58,10 CPT,49441,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,593.22,4251.7,233 CPT,49442,INS CEC/OTHR COL TUBE,9014.87,9014.87,1262.08,7662.64,10 CPT,49442,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",9014.87,9014.87,450.72,13394.0,233 CPT,49446,CVRT GASTR TO GSJEJ TUBE,4332.99,4332.99,606.62,3683.04,10 CPT,49446,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",4332.99,4332.99,593.22,4251.7,233 CPT,49450,RPLC GAST OR CECO TUBE,11587.74,11587.74,1622.28,9849.58,10 CPT,49450,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,351.7,3128.0,233 CPT,49451,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,233 CPT,49452,RPLC GASTROJEJNSTY TUBE,11587.74,11587.74,1622.28,9849.58,10 CPT,49452,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",11587.74,11587.74,351.7,3128.0,233 CPT,49460,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,3128.0,233 CPT,49465,CONT INJ GS/ DU/ JJ/ GJ/,615.45,615.45,80.01,523.13,16 CPT,49465,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",615.45,615.45,240.89,5841.0,198 CPT,49491,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,948.0,13835.0,206 CPT,49492,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,948.0,13835.0,206 CPT,49495,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,948.0,8488.5,233 CPT,49496,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,948.0,8488.5,233 CPT,49500,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,948.0,8488.5,233 CPT,49501,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,948.0,15059.0,233 CPT,49505,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,8488.5,213 CPT,49505,"Repair initial inguinal hernia, age 5 years or older; reducible High Cost Surgery",,,2369.0,2369.0,20 CPT,49507,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,15059.0,213 CPT,49507,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,20 CPT,49520,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,12909.0,213 CPT,49520,"Repair recurrent inguinal hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,20 CPT,49521,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,213 CPT,49521,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,20 CPT,49525,"Repair inguinal hernia, sliding, any age ",,,1209.12,8488.5,213 CPT,49525,"Repair inguinal hernia, sliding, any age High Cost Surgery",,,2369.0,2369.0,20 CPT,49540,Repair lumbar hernia ,,,1983.29,13196.03,213 CPT,49540,Repair lumbar hernia High Cost Surgery,,,2369.0,2369.0,20 CPT,49550,"Repair initial femoral hernia, any age; reducible ",,,1209.12,13394.0,213 CPT,49550,"Repair initial femoral hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,20 CPT,49553,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,213 CPT,49553,"Repair initial femoral hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,20 CPT,49555,Repair recurrent femoral hernia; reducible ,,,1209.12,13394.0,213 CPT,49555,Repair recurrent femoral hernia; reducible High Cost Surgery,,,2369.0,2369.0,20 CPT,49557,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,15059.0,213 CPT,49557,Repair recurrent femoral hernia; incarcerated or strangulated High Cost Surgery,,,2369.0,2369.0,20 CPT,49560,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,24 CPT,49561,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,24 CPT,49565,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,24 CPT,49566,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,24 CPT,49568,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,16 CPT,49570,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,24 CPT,49572,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,24 CPT,49580,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,24 CPT,49582,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,24 CPT,49585,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,24 CPT,49587,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,24 CPT,49590,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,24 CPT,49591,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,9669.47,225 CPT,49592,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,225 CPT,49593,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,9669.47,225 CPT,49594,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,225 CPT,49595,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,9669.47,225 CPT,49596,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,197 CPT,49600,"Repair of small omphalocele, with primary closure ",,,948.0,8488.5,233 CPT,49605,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,948.0,60402.77,205 CPT,49606,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,948.0,16207.0,109 CPT,49610,Repair of omphalocele (Gross type operation); first stage ,,,948.0,16207.0,109 CPT,49611,Repair of omphalocele (Gross type operation); second stage ,,,948.0,16207.0,109 CPT,49613,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,9669.47,225 CPT,49614,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15059.0,225 CPT,49615,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,9669.47,225 CPT,49616,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15059.0,197 CPT,49617,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,11180.35,197 CPT,49618,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15664.44,197 CPT,49621,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,948.0,9370.6,197 CPT,49622,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,948.0,15059.0,197 CPT,49623,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,948.0,5841.0,140 CPT,49650,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,13196.03,129 CPT,49650,"Laparoscopy, surgical; repair initial inguinal hernia High Cost Surgery",,,2369.0,2369.0,20 CPT,49651,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,13196.03,129 CPT,49651,"Laparoscopy, surgical; repair recurrent inguinal hernia High Cost Surgery",,,2369.0,2369.0,20 CPT,49652,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,24 CPT,49653,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,24 CPT,49654,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,24 CPT,49655,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,24 CPT,49656,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,24 CPT,49657,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,24 CPT,49659,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,5202.0,13835.0,102 CPT,49659,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy High Cost Surgery",,,2369.0,2369.0,20 CPT,49900,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,948.0,16207.0,109 CPT,49904,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,948.0,17359.64,109 CPT,49905,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,49906,Free omental flap with microvascular anastomosis ,,,948.0,19868.64,109 CPT,49999,"Unlisted procedure, abdomen, peritoneum and omentum ",,,915.67,13835.0,206 CPT,50010,"Renal exploration, not necessitating other specific procedures ",,,948.0,16207.0,109 CPT,50020,"Drainage of perirenal or renal abscess, open ",,,948.0,13835.0,206 CPT,50021,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,16 CPT,50040,"Nephrostomy, nephrotomy with drainage ",,,948.0,13835.0,205 CPT,50045,"Nephrotomy, with exploration ",,,948.0,16207.0,109 CPT,50060,Nephrolithotomy; removal of calculus ,,,948.0,16207.0,109 CPT,50065,Nephrolithotomy; secondary surgical operation for calculus ,,,948.0,16207.0,109 CPT,50070,Nephrolithotomy; complicated by congenital kidney abnormality ,,,948.0,16207.0,109 CPT,50075,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,948.0,17855.56,109 CPT,50080,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,948.0,22025.45,212 CPT,50081,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,948.0,22025.45,212 CPT,50100,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,948.0,16207.0,109 CPT,50120,Pyelotomy; with exploration ,,,948.0,16207.0,109 CPT,50125,"Pyelotomy; with drainage, pyelostomy ",,,948.0,16207.0,109 CPT,50130,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,948.0,16207.0,109 CPT,50135,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,24 CPT,50200,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,233 CPT,50205,Renal biopsy; by surgical exposure of kidney ,,,948.0,16207.0,109 CPT,50220,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,948.0,16207.0,109 CPT,50225,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,948.0,16207.0,109 CPT,50230,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,948.0,16207.0,109 CPT,50234,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,948.0,16207.0,109 CPT,50236,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,948.0,17974.22,109 CPT,50240,"Nephrectomy, partial ",,,948.0,16253.5,109 CPT,50250,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,948.0,16207.0,205 CPT,50280,Excision or unroofing of cyst(s) of kidney ,,,948.0,16207.0,109 CPT,50290,Excision of perinephric cyst ,,,948.0,16207.0,109 CPT,50300,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,948.0,16207.0,109 CPT,50320,"Donor nephrectomy (including cold preservation); open, from living donor ",,,948.0,18414.98,109 CPT,50323,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,948.0,17385.04,109 CPT,50325,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,948.0,18626.9,109 CPT,50327,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,109 CPT,50328,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,109 CPT,50329,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,948.0,16207.0,109 CPT,50340,Recipient nephrectomy (separate procedure) ,,,948.0,16207.0,109 CPT,50360,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,948.0,29697.06,109 CPT,50365,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,948.0,35181.33,109 CPT,50370,Removal of transplanted renal allograft ,,,948.0,16207.0,109 CPT,50380,"Renal autotransplantation, reimplantation of kidney ",,,948.0,24517.95,109 CPT,50382,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,233 CPT,50384,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,233 CPT,50385,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,233 CPT,50386,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,233 CPT,50387,REPLACE NEPHRO CATH W FL,21968.11,21968.11,3075.54,18672.89,10 CPT,50387,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",21968.11,21968.11,685.44,4836.33,233 CPT,50389,REM NEPHROS TUBE W FL,782.71,782.71,109.58,665.3,10 CPT,50389,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",782.71,782.71,250.06,3128.0,233 CPT,50390,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,233 CPT,50391,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,225 CPT,50392,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,16 CPT,50393,INSERT URETERAL TUBE ,,,3390.0,5841.0,16 CPT,50394,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,16 CPT,50395,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,24 CPT,50396,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,233 CPT,50398,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,16 CPT,50400,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,948.0,16207.0,109 CPT,50405,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,948.0,17109.62,109 CPT,50430,INJ NEPH NEW ACCESS BI,12877.44,12877.44,1674.07,10945.82,15 CPT,50430,INJ NEPH NEW ACCESS LT,8584.96,8584.96,1116.04,7297.22,15 CPT,50430,INJ NEPH NEW ACCESS RT,8584.96,8584.96,1116.04,7297.22,15 CPT,50430,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,703.98,12562.0,206 CPT,50431,INJ NEPH EXIST ACCESS BI,11705.34,11705.34,1521.69,9949.54,15 CPT,50431,INJ NEPH EXIST ACCESS LT,7803.56,7803.56,1014.46,6633.03,15 CPT,50431,INJ NEPH EXIST ACCESS RT,7803.56,7803.56,1014.46,6633.03,15 CPT,50431,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,703.98,12562.0,206 CPT,50432,PLCMT NEPH CATH BI,13361.59,13361.59,1870.62,11357.35,10 CPT,50432,PLCMT NEPH CATH LT,8907.72,8907.72,1247.08,7571.56,10 CPT,50432,PLCMT NEPH CATH RT,8907.72,8907.72,1247.08,7571.56,10 CPT,50432,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,233 CPT,50433,NEPHURETERAL CATH PLC BI,13218.51,13218.51,1850.59,11235.73,10 CPT,50433,NEPHURETERAL CATH PLC LT,8812.34,8812.34,1233.73,7490.49,10 CPT,50433,NEPHURETERAL CATH PLC RT,8812.34,8812.34,1233.73,7490.49,10 CPT,50433,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,948.0,12909.0,233 CPT,50434,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,233 CPT,50434,NEPH CATH CONV NEPURT BI,14949.22,14949.22,2092.89,12706.84,10 CPT,50434,NEPH CATH CONV NEPURT LT,9966.14,9966.14,1395.26,8471.22,10 CPT,50434,NEPH CATH CONV NEPURT RT,9966.14,9966.14,1395.26,8471.22,10 CPT,50435,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,233 CPT,50435,NEPH CATH EXCHANGE BI,13079.33,13079.33,1831.11,11117.43,10 CPT,50435,NEPH CATH EXCHANGE LT,8719.55,8719.55,1220.74,7411.62,10 CPT,50435,NEPH CATH EXCHANGE RT,8719.55,8719.55,1220.74,7411.62,10 CPT,50436,DIL EX TRCT ENDUR PRC BI,17848.11,17848.11,2498.74,15170.89,11 CPT,50436,DIL EX TRCT ENDUR PRC LT,11898.74,11898.74,1665.82,10113.93,11 CPT,50436,DIL EX TRCT ENDUR PRC RT,11898.74,11898.74,1665.82,10113.93,11 CPT,50436,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,948.0,15059.0,225 CPT,50437,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,948.0,13835.0,225 CPT,50500,"Nephrorrhaphy, suture of kidney wound or injury ",,,948.0,16207.0,109 CPT,50520,Closure of nephrocutaneous or pyelocutaneous fistula ,,,948.0,14240.3,205 CPT,50525,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,948.0,18071.71,109 CPT,50526,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,948.0,19372.84,109 CPT,50540,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,948.0,16207.0,109 CPT,50541,"Laparoscopy, surgical; ablation of renal cysts ",,,5202.0,13394.0,102 CPT,50541,"Laparoscopy, surgical; ablation of renal cysts High Cost Surgery",,,2369.0,2369.0,20 CPT,50542,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,5202.0,22967.79,102 CPT,50542,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,50543,"Laparoscopy, surgical; partial nephrectomy ",,,5202.0,22967.79,102 CPT,50543,"Laparoscopy, surgical; partial nephrectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,50544,"Laparoscopy, surgical; pyeloplasty ",,,5202.0,22967.79,102 CPT,50544,"Laparoscopy, surgical; pyeloplasty High Cost Surgery",,,2369.0,2369.0,20 CPT,50545,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,101 CPT,50545,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) High Cost Surgery",,,2369.0,2369.0,20 CPT,50546,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,101 CPT,50546,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,50547,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,101 CPT,50547,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor High Cost Surgery",,,2369.0,2369.0,20 CPT,50548,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,101 CPT,50548,"Laparoscopy, surgical; nephrectomy with total ureterectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,50549,"Unlisted laparoscopy procedure, renal ",,,5202.0,13835.0,102 CPT,50549,"Unlisted laparoscopy procedure, renal High Cost Surgery",,,2369.0,2369.0,20 CPT,50551,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,11552.32,233 CPT,50553,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,948.0,11552.32,233 CPT,50555,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,22025.45,233 CPT,50557,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,948.0,22025.45,233 CPT,50559,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,16 CPT,50561,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,948.0,11552.32,233 CPT,50562,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,948.0,22025.45,233 CPT,50570,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,233 CPT,50572,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,233 CPT,50574,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,4836.33,233 CPT,50575,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,948.0,13835.0,137 CPT,50576,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,948.0,13835.0,233 CPT,50578,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,16 CPT,50580,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,13835.0,233 CPT,50590,"Lithotripsy, extracorporeal shock wave ",,,1200.05,16878.0,90 CPT,50590,"Lithotripsy, extracorporeal shock wave Lithotripsy",,,2843.0,2843.0,10 CPT,50592,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,948.0,13196.03,233 CPT,50593,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,948.0,22967.79,233 CPT,50600,Ureterotomy with exploration or drainage (separate procedure) ,,,948.0,16207.0,205 CPT,50605,"Ureterotomy for insertion of indwelling stent, all types ",,,948.0,16207.0,205 CPT,50606,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,948.0,5841.0,140 CPT,50610,Ureterolithotomy; upper one-third of ureter ,,,948.0,16207.0,205 CPT,50620,Ureterolithotomy; middle one-third of ureter ,,,948.0,16207.0,205 CPT,50630,Ureterolithotomy; lower one-third of ureter ,,,948.0,16207.0,205 CPT,50650,"Ureterectomy, with bladder cuff (separate procedure) ",,,948.0,16207.0,205 CPT,50660,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,948.0,16207.0,205 CPT,50684,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,948.0,5841.0,140 CPT,50686,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,129 CPT,50688,CHG URETEROSTMY TB,2200.47,2200.47,308.07,1870.4,10 CPT,50688,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,2200.47,2200.47,685.44,4836.33,233 CPT,50690,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,948.0,5841.0,140 CPT,50693,PLCMT URETERAL STNT BI,17346.34,17346.34,2428.49,14744.39,10 CPT,50693,PLCMT URETERAL STNT LT,11564.23,11564.23,1618.99,9829.6,10 CPT,50693,PLCMT URETERAL STNT RT,11564.23,11564.23,1618.99,9829.6,10 CPT,50693,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,233 CPT,50694,PLCMT URETER STNT NEW BI,18402.8,18402.8,2576.39,15642.38,10 CPT,50694,PLCMT URETER STNT NEW LT,12268.53,12268.53,1717.59,10428.25,10 CPT,50694,PLCMT URETER STNT NEW RT,12268.53,12268.53,1717.59,10428.25,10 CPT,50694,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,233 CPT,50695,PLC URTR STNT SEP CTH BI,17775.58,17775.58,2488.58,15109.24,10 CPT,50695,PLC URTR STNT SEP CTH LT,11850.39,11850.39,1659.05,10072.83,10 CPT,50695,PLC URTR STNT SEP CTH RT,11850.39,11850.39,1659.05,10072.83,10 CPT,50695,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,233 CPT,50700,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,948.0,16207.0,109 CPT,50705,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,948.0,5841.0,140 CPT,50706,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,948.0,5841.0,140 CPT,50715,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,948.0,16207.0,109 CPT,50722,Ureterolysis for ovarian vein syndrome ,,,948.0,16207.0,109 CPT,50725,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,948.0,16207.0,109 CPT,50727,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,948.0,13835.0,137 CPT,50728,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,948.0,16207.0,109 CPT,50740,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,948.0,16207.0,109 CPT,50750,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,948.0,16207.0,109 CPT,50760,Ureteroureterostomy ,,,948.0,16207.0,109 CPT,50770,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,948.0,16207.0,109 CPT,50780,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,948.0,16207.0,109 CPT,50782,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,948.0,16207.0,109 CPT,50783,Ureteroneocystostomy; with extensive ureteral tailoring ,,,948.0,16207.0,109 CPT,50785,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,948.0,16207.0,109 CPT,50800,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,948.0,16207.0,109 CPT,50810,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,948.0,17194.41,109 CPT,50815,"Ureterocolon conduit, including intestine anastomosis ",,,948.0,16207.0,109 CPT,50820,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,948.0,16207.0,109 CPT,50825,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,948.0,20377.26,109 CPT,50830,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,948.0,22102.21,109 CPT,50840,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,948.0,16207.0,109 CPT,50845,Cutaneous appendico-vesicostomy ,,,948.0,16207.0,109 CPT,50860,"Ureterostomy, transplantation of ureter to skin ",,,948.0,16207.0,109 CPT,50900,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,948.0,16207.0,109 CPT,50920,Closure of ureterocutaneous fistula ,,,948.0,16207.0,109 CPT,50930,Closure of ureterovisceral fistula (including visceral repair) ,,,948.0,16207.0,109 CPT,50940,Deligation of ureter ,,,948.0,16207.0,109 CPT,50945,"Laparoscopy, surgical; ureterolithotomy ",,,5202.0,13394.0,102 CPT,50945,"Laparoscopy, surgical; ureterolithotomy High Cost Surgery",,,2369.0,2369.0,20 CPT,50947,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,129 CPT,50947,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,20 CPT,50948,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,129 CPT,50948,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,20 CPT,50949,"Unlisted laparoscopy procedure, ureter ",,,5202.0,13835.0,102 CPT,50949,"Unlisted laparoscopy procedure, ureter High Cost Surgery",,,2369.0,2369.0,20 CPT,50951,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,233 CPT,50953,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,948.0,8240.61,233 CPT,50955,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,233 CPT,50957,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,948.0,11552.32,233 CPT,50959,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,16 CPT,50961,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,233 CPT,50970,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,233 CPT,50972,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,948.0,8240.61,233 CPT,50974,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,233 CPT,50976,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,948.0,11552.32,233 CPT,50978,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,16 CPT,50980,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,233 CPT,51000,DRAINAGE OF BLADDER ,,,3390.0,5841.0,16 CPT,51005,DRAINAGE OF BLADDER ,,,3390.0,5841.0,16 CPT,51010,DRAINAGE OF BLADDER ,,,3390.0,5841.0,16 CPT,51020,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,948.0,8240.61,233 CPT,51030,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,60 CPT,51040,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,233 CPT,51045,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,233 CPT,51050,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,948.0,11552.32,233 CPT,51060,Transvesical ureterolithotomy ,,,948.0,13835.0,110 CPT,51065,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,948.0,8240.61,233 CPT,51080,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,233 CPT,51100,Aspiration of bladder; by needle ,,,38.37,3244.0,233 CPT,51101,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,233 CPT,51102,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,233 CPT,51500,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,948.0,13196.03,233 CPT,51520,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,948.0,8240.61,233 CPT,51525,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,948.0,13835.0,109 CPT,51530,Cystotomy; for excision of bladder tumor ,,,948.0,13835.0,109 CPT,51535,"Cystotomy for excision, incision, or repair of ureterocele ",,,948.0,13835.0,110 CPT,51550,"Cystectomy, partial; simple ",,,948.0,16207.0,109 CPT,51555,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,948.0,16207.0,109 CPT,51565,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,948.0,16207.0,109 CPT,51570,"Cystectomy, complete; (separate procedure) ",,,948.0,18071.71,109 CPT,51575,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,22360.7,109 CPT,51580,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,948.0,23212.59,109 CPT,51585,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,25874.23,109 CPT,51590,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,948.0,23721.21,109 CPT,51595,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,26849.02,109 CPT,51596,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,948.0,28891.85,109 CPT,51597,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,948.0,28124.63,109 CPT,51600,Injection procedure for cystography or voiding urethrocystography ,,,948.0,5841.0,44 CPT,51605,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,948.0,5841.0,44 CPT,51610,Injection procedure for retrograde urethrocystography ,,,948.0,5841.0,44 CPT,51700,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,225 CPT,51701,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,134.32,5841.0,198 CPT,51702,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,134.32,5841.0,198 CPT,51703,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,225 CPT,51705,Change of cystostomy tube; simple ,,,54.36,5841.0,225 CPT,51710,Change of cystostomy tube; complicated ,,,250.06,3390.0,233 CPT,51715,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,948.0,12562.0,233 CPT,51720,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,129 CPT,51721,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,948.0,3390.0,160 CPT,51725,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,225 CPT,51726,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,233 CPT,51727,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,233 CPT,51728,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,233 CPT,51729,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,233 CPT,51736,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,134.32,5841.0,102 CPT,51741,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,217.99,5841.0,102 CPT,51772,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,16 CPT,51784,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,129 CPT,51785,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,225 CPT,51792,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,59.56,5841.0,102 CPT,51795,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,16 CPT,51797,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,51798,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,59.56,5841.0,102 CPT,51800,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,948.0,16207.0,205 CPT,51820,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,948.0,16207.0,205 CPT,51840,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,948.0,13835.0,205 CPT,51841,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,948.0,13835.0,205 CPT,51845,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,948.0,13835.0,206 CPT,51860,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,948.0,13835.0,206 CPT,51865,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,948.0,13835.0,205 CPT,51880,Closure of cystostomy (separate procedure) ,,,948.0,8240.61,233 CPT,51900,"Closure of vesicovaginal fistula, abdominal approach ",,,948.0,13835.0,205 CPT,51920,Closure of vesicouterine fistula; ,,,948.0,13835.0,205 CPT,51925,Closure of vesicouterine fistula; with hysterectomy ,,,948.0,16207.0,109 CPT,51940,"Closure, exstrophy of bladder ",,,948.0,20139.94,109 CPT,51960,"Enterocystoplasty, including intestinal anastomosis ",,,948.0,16974.03,109 CPT,51980,Cutaneous vesicostomy ,,,948.0,13835.0,109 CPT,51990,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,5202.0,13394.0,102 CPT,51990,"Laparoscopy, surgical; urethral suspension for stress incontinence High Cost Surgery",,,2369.0,2369.0,20 CPT,51992,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,145 CPT,51992,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) High Cost Surgery",,,2369.0,2369.0,20 CPT,51999,"Unlisted laparoscopy procedure, bladder ",,,948.0,13835.0,122 CPT,52000,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,233 CPT,52001,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,948.0,8240.61,233 CPT,52005,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,233 CPT,52007,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,948.0,8240.61,233 CPT,52010,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,233 CPT,52204,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,233 CPT,52214,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,948.0,5571.0,233 CPT,52224,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,948.0,5571.0,233 CPT,52234,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,948.0,8240.61,233 CPT,52235,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,948.0,12562.0,233 CPT,52240,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,948.0,12562.0,233 CPT,52250,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,948.0,25988.0,249 CPT,52260,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,233 CPT,52265,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,233 CPT,52270,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,233 CPT,52275,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,233 CPT,52276,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,233 CPT,52277,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,948.0,8240.61,233 CPT,52281,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,233 CPT,52282,"Cystourethroscopy, with insertion of permanent urethral stent ",,,948.0,15059.0,233 CPT,52283,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,233 CPT,52284,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,948.0,15059.0,190 CPT,52285,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,233 CPT,52287,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,233 CPT,52290,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,233 CPT,52300,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,948.0,8240.61,233 CPT,52301,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,948.0,12562.0,233 CPT,52305,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,948.0,11552.32,233 CPT,52310,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,233 CPT,52315,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,233 CPT,52317,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,948.0,8240.61,233 CPT,52318,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,948.0,8240.61,233 CPT,52320,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,213 CPT,52320,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus High Cost Surgery,,,2369.0,2369.0,20 CPT,52325,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,213 CPT,52325,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) High Cost Surgery",,,2369.0,2369.0,20 CPT,52327,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,213 CPT,52327,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material High Cost Surgery,,,2369.0,2369.0,20 CPT,52330,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,213 CPT,52330,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus High Cost Surgery",,,2369.0,2369.0,20 CPT,52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,213 CPT,52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) High Cost Surgery",,,2369.0,2369.0,20 CPT,52334,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,213 CPT,52334,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde High Cost Surgery",,,2369.0,2369.0,20 CPT,52335,Cystourethroscopy ,,,3390.0,5841.0,16 CPT,52336,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,16 CPT,52337,Cysto w lithotripsy ,,,3390.0,5841.0,16 CPT,52338,Cysto w Bx/fulgur les ,,,3390.0,5841.0,16 CPT,52339,Cysto w tumor resection ,,,3390.0,5841.0,16 CPT,52340,TUR cong post valve/fold ,,,3390.0,5841.0,16 CPT,52341,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,213 CPT,52341,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52342,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,213 CPT,52342,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52343,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,213 CPT,52343,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52344,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,213 CPT,52344,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52345,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,213 CPT,52345,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52346,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,213 CPT,52346,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,20 CPT,52347,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,16 CPT,52351,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,213 CPT,52351,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic High Cost Surgery",,,2369.0,2369.0,20 CPT,52352,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,213 CPT,52352,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,20 CPT,52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,12436.0,192 CPT,52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,20 CPT,52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) Lithotripsy",,,2843.0,2843.0,10 CPT,52354,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,213 CPT,52354,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion High Cost Surgery",,,2369.0,2369.0,20 CPT,52355,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,213 CPT,52355,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor High Cost Surgery",,,2369.0,2369.0,20 CPT,52356,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,948.0,15059.0,233 CPT,52400,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,948.0,12562.0,233 CPT,52402,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,948.0,12562.0,206 CPT,52441,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,948.0,5841.0,176 CPT,52442,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,176 CPT,52443,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,948.0,26403.19,152 CPT,52450,Transurethral incision of prostate ,,,948.0,12562.0,233 CPT,52500,Transurethral resection of bladder neck (separate procedure) ,,,948.0,12562.0,233 CPT,52510,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,16 CPT,52597,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,948.0,26403.19,152 CPT,52601,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,233 CPT,52606,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,16 CPT,52612,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,16 CPT,52614,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,16 CPT,52620,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,16 CPT,52630,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,233 CPT,52640,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,213 CPT,52640,Transurethral resection; of postoperative bladder neck contracture High Cost Surgery,,,2369.0,2369.0,20 CPT,52647,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,72 CPT,52648,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,233 CPT,52649,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,948.0,15059.0,233 CPT,52700,Transurethral drainage of prostatic abscess ,,,948.0,8240.61,233 CPT,53000,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,233 CPT,53010,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,948.0,11552.32,233 CPT,53020,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,233 CPT,53025,"Meatotomy, cutting of meatus (separate procedure); infant ",,,948.0,13835.0,206 CPT,53040,Drainage of deep periurethral abscess ,,,948.0,5571.0,233 CPT,53060,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,206 CPT,53080,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,233 CPT,53085,Drainage of perineal urinary extravasation; complicated ,,,948.0,13835.0,110 CPT,53200,Biopsy of urethra ,,,685.44,5571.0,233 CPT,53210,"Urethrectomy, total, including cystostomy; female ",,,948.0,13394.0,233 CPT,53215,"Urethrectomy, total, including cystostomy; male ",,,948.0,13394.0,233 CPT,53220,Excision or fulguration of carcinoma of urethra ,,,948.0,8240.61,233 CPT,53230,Excision of urethral diverticulum (separate procedure); female ,,,948.0,11552.32,233 CPT,53235,Excision of urethral diverticulum (separate procedure); male ,,,948.0,12562.0,233 CPT,53240,"Marsupialization of urethral diverticulum, male or female ",,,948.0,8240.61,233 CPT,53250,Excision of bulbourethral gland (Cowper's gland) ,,,948.0,8240.61,233 CPT,53260,"Excision or fulguration; urethral polyp(s), distal urethra ",,,948.0,5571.0,233 CPT,53265,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,233 CPT,53270,Excision or fulguration; Skene's glands ,,,948.0,5571.0,233 CPT,53275,Excision or fulguration; urethral prolapse ,,,948.0,5571.0,233 CPT,53400,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,948.0,12562.0,233 CPT,53405,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,948.0,11552.32,233 CPT,53410,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,948.0,11552.32,233 CPT,53415,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,948.0,13858.92,109 CPT,53420,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,948.0,12562.0,233 CPT,53425,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,948.0,11552.32,233 CPT,53430,"Urethroplasty, reconstruction of female urethra ",,,948.0,11552.32,233 CPT,53431,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,948.0,11552.32,233 CPT,53440,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,948.0,22025.45,249 CPT,53442,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,948.0,11552.32,233 CPT,53443,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,16 CPT,53444,Insertion of tandem cuff (dual cuff) ,,,948.0,47976.91,249 CPT,53445,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,948.0,47976.91,249 CPT,53446,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,233 CPT,53447,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,948.0,47976.91,233 CPT,53448,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,948.0,15672.9,109 CPT,53449,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,233 CPT,53450,"Urethromeatoplasty, with mucosal advancement ",,,948.0,8240.61,233 CPT,53451,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,32022.79,198 CPT,53452,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,13835.0,198 CPT,53453,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,948.0,13835.0,198 CPT,53454,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,252.24,5841.0,198 CPT,53460,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,948.0,8240.61,233 CPT,53500,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,948.0,13835.0,206 CPT,53502,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,948.0,8240.61,233 CPT,53505,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,948.0,11552.32,233 CPT,53510,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,948.0,11552.32,233 CPT,53515,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,948.0,11552.32,233 CPT,53520,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,948.0,11552.32,233 CPT,53600,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,225 CPT,53601,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,225 CPT,53605,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,948.0,4836.33,233 CPT,53620,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,233 CPT,53621,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,225 CPT,53660,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,225 CPT,53661,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,129 CPT,53665,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,233 CPT,53670,Insert urinary catheter ,,,3390.0,5841.0,16 CPT,53675,Insert urinary catheter ,,,3390.0,5841.0,16 CPT,53850,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,948.0,19718.21,233 CPT,53852,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,948.0,18816.77,233 CPT,53853,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,16 CPT,53854,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,948.0,15059.0,225 CPT,53855,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,233 CPT,53860,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,948.0,12909.0,206 CPT,53865,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,948.0,25244.72,161 CPT,53866,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,252.24,3390.0,161 CPT,53899,"Unlisted procedure, urinary system ",,,252.24,13835.0,198 CPT,54000,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,948.0,8240.61,233 CPT,54001,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,233 CPT,54015,"Incision and drainage of penis, deep ",,,510.77,8234.0,233 CPT,54050,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,410.41,5841.0,102 CPT,54055,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,137 CPT,54056,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,202.56,5841.0,102 CPT,54057,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,233 CPT,54060,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,233 CPT,54065,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,233 CPT,54100,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,233 CPT,54105,Biopsy of penis; deep structures ,,,855.96,6330.57,233 CPT,54110,Excision of penile plaque (Peyronie disease); ,,,948.0,9653.0,233 CPT,54111,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,948.0,11552.32,233 CPT,54112,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,948.0,22025.45,233 CPT,54115,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,233 CPT,54120,Amputation of penis; partial ,,,948.0,8240.61,233 CPT,54125,Amputation of penis; complete ,,,948.0,13835.0,205 CPT,54130,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,948.0,16207.0,109 CPT,54135,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,18546.34,109 CPT,54150,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,233 CPT,54152,CIRCUMCISION ,,,3390.0,5841.0,16 CPT,54160,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,233 CPT,54161,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,233 CPT,54162,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,233 CPT,54163,Repair incomplete circumcision ,,,685.44,5571.0,233 CPT,54164,Frenulotomy of penis ,,,685.44,5571.0,233 CPT,54200,Injection procedure for Peyronie disease; ,,,63.08,5841.0,129 CPT,54205,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,948.0,11552.32,233 CPT,54220,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,225 CPT,54230,Injection procedure for corpora cavernosography ,,,948.0,5841.0,140 CPT,54231,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,252.24,13835.0,110 CPT,54235,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,129 CPT,54240,Penile plethysmography ,,,217.99,5841.0,198 CPT,54250,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,198 CPT,54300,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,948.0,12562.0,233 CPT,54304,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,948.0,12562.0,233 CPT,54308,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,948.0,12562.0,233 CPT,54312,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,948.0,12562.0,233 CPT,54316,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,948.0,12562.0,233 CPT,54318,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,948.0,12562.0,233 CPT,54322,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,948.0,12562.0,233 CPT,54324,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,948.0,12562.0,233 CPT,54326,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,948.0,12562.0,233 CPT,54328,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,948.0,12562.0,233 CPT,54332,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,206 CPT,54336,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,206 CPT,54340,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,948.0,12562.0,233 CPT,54344,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,948.0,12562.0,233 CPT,54348,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,948.0,12562.0,233 CPT,54352,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,948.0,12562.0,233 CPT,54360,Plastic operation on penis to correct angulation ,,,948.0,12562.0,233 CPT,54380,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,233 CPT,54385,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,233 CPT,54390,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,948.0,15227.79,109 CPT,54400,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,948.0,51975.0,222 CPT,54401,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,202 CPT,54401,Insertion of penile prosthesis; inflatable (self-contained) High Cost Surgery,,,2369.0,2369.0,20 CPT,54402,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,16 CPT,54405,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,202 CPT,54405,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir High Cost Surgery",,,2369.0,2369.0,20 CPT,54406,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,213 CPT,54406,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis High Cost Surgery",,,2369.0,2369.0,20 CPT,54407,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,16 CPT,54408,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,186 CPT,54408,"Repair of component(s) of a multi-component, inflatable penile prosthesis High Cost Surgery",,,2369.0,2369.0,20 CPT,54409,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,16 CPT,54410,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,202 CPT,54410,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session High Cost Surgery",,,2369.0,2369.0,20 CPT,54411,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,948.0,51975.0,214 CPT,54415,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,948.0,12562.0,233 CPT,54416,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,948.0,51975.0,222 CPT,54417,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,948.0,51975.0,222 CPT,54420,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,948.0,8234.0,233 CPT,54430,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,948.0,16207.0,109 CPT,54435,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,948.0,8240.61,233 CPT,54437,Repair of traumatic corporeal tear(s) ,,,948.0,12909.0,233 CPT,54438,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,24 CPT,54440,Plastic operation of penis for injury ,,,948.0,8240.61,233 CPT,54450,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,225 CPT,54500,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,233 CPT,54505,"Biopsy of testis, incisional (separate procedure) ",,,948.0,8240.61,233 CPT,54510,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,16 CPT,54512,Excision of extraparenchymal lesion of testis ,,,948.0,8240.61,233 CPT,54520,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,948.0,12562.0,233 CPT,54522,"Orchiectomy, partial ",,,948.0,12562.0,233 CPT,54530,"Orchiectomy, radical, for tumor; inguinal approach ",,,948.0,8488.5,233 CPT,54535,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,948.0,13835.0,110 CPT,54550,Exploration for undescended testis (inguinal or scrotal area) ,,,948.0,8488.5,233 CPT,54560,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,233 CPT,54600,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,948.0,8240.61,233 CPT,54620,Fixation of contralateral testis (separate procedure) ,,,948.0,12562.0,233 CPT,54640,"Orchiopexy, inguinal or scrotal approach ",,,948.0,8488.5,233 CPT,54650,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,948.0,13835.0,206 CPT,54660,Insertion of testicular prosthesis (separate procedure) ,,,948.0,11552.32,233 CPT,54670,Suture or repair of testicular injury ,,,948.0,12562.0,233 CPT,54680,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,948.0,12562.0,233 CPT,54690,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,129 CPT,54690,"Laparoscopy, surgical; orchiectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,54692,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,129 CPT,54692,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis High Cost Surgery",,,2369.0,2369.0,20 CPT,54699,"Unlisted laparoscopy procedure, testis ",,,5202.0,13835.0,102 CPT,54699,"Unlisted laparoscopy procedure, testis High Cost Surgery",,,2369.0,2369.0,20 CPT,54700,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,233 CPT,54800,"Biopsy of epididymis, needle ",,,510.77,3747.2,233 CPT,54820,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,16 CPT,54830,Excision of local lesion of epididymis ,,,948.0,12562.0,233 CPT,54840,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,233 CPT,54860,Epididymectomy; unilateral ,,,948.0,12562.0,233 CPT,54861,Epididymectomy; bilateral ,,,948.0,8240.61,233 CPT,54865,"Exploration of epididymis, with or without biopsy ",,,948.0,8240.61,233 CPT,54900,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,948.0,8234.0,206 CPT,54901,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,948.0,8240.61,206 CPT,55000,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,137 CPT,55040,Excision of hydrocele; unilateral ,,,948.0,12562.0,233 CPT,55041,Excision of hydrocele; bilateral ,,,948.0,13394.0,233 CPT,55060,Repair of tunica vaginalis hydrocele (Bottle type) ,,,948.0,8240.61,233 CPT,55100,Drainage of scrotal wall abscess ,,,510.77,3747.2,233 CPT,55110,Scrotal exploration ,,,948.0,8240.61,233 CPT,55120,Removal of foreign body in scrotum ,,,685.44,5571.0,233 CPT,55150,Resection of scrotum ,,,948.0,8240.61,233 CPT,55175,Scrotoplasty; simple ,,,948.0,8240.61,233 CPT,55180,Scrotoplasty; complicated ,,,948.0,11552.32,233 CPT,55200,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,948.0,8240.61,206 CPT,55250,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,233 CPT,55300,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,948.0,5841.0,140 CPT,55400,"Vasovasostomy, vasovasorrhaphy ",,,948.0,8240.61,206 CPT,55450,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,24 CPT,55500,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,948.0,12562.0,233 CPT,55520,Excision of lesion of spermatic cord (separate procedure) ,,,948.0,8240.61,233 CPT,55530,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,948.0,8240.61,233 CPT,55535,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,948.0,8488.5,233 CPT,55540,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,948.0,13394.0,233 CPT,55550,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,129 CPT,55550,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele High Cost Surgery",,,2369.0,2369.0,20 CPT,55559,"Unlisted laparoscopy procedure, spermatic cord ",,,5202.0,13835.0,102 CPT,55559,"Unlisted laparoscopy procedure, spermatic cord High Cost Surgery",,,2369.0,2369.0,20 CPT,55600,Vesiculotomy; ,,,685.44,11308.65,233 CPT,55605,Vesiculotomy; complicated ,,,948.0,13835.0,205 CPT,55650,"Vesiculectomy, any approach ",,,948.0,13835.0,205 CPT,55680,Excision of Mullerian duct cyst ,,,948.0,8240.61,233 CPT,55700,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,72 CPT,55705,"Biopsy, prostate, any approach, nonimaging-guided ",,,948.0,4836.33,233 CPT,55706,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,948.0,12562.0,233 CPT,55707,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,152 CPT,55708,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,948.0,9831.63,152 CPT,55709,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,152 CPT,55710,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,948.0,9831.63,152 CPT,55711,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,152 CPT,55712,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,152 CPT,55713,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,948.0,14954.75,152 CPT,55714,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,948.0,14954.75,152 CPT,55715,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,948.0,3083.0,116 CPT,55720,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,948.0,5571.0,233 CPT,55725,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,948.0,8240.61,233 CPT,55801,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,948.0,16207.0,109 CPT,55810,"Prostatectomy, perineal radical; ",,,948.0,16207.0,109 CPT,55812,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,19741.51,109 CPT,55815,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,21559.73,109 CPT,55821,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,948.0,16207.0,109 CPT,55831,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,948.0,16207.0,109 CPT,55840,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,948.0,16207.0,109 CPT,55842,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,16207.0,109 CPT,55845,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,16732.36,205 CPT,55859,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,16 CPT,55860,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,948.0,25988.0,249 CPT,55862,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,25988.0,125 CPT,55865,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,25988.0,125 CPT,55866,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,948.0,22967.79,83 CPT,55867,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,948.0,24808.33,198 CPT,55868,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,948.0,29647.99,152 CPT,55869,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,948.0,29647.99,152 CPT,55870,Electroejaculation ,,,560.2,3128.0,206 CPT,55873,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,948.0,24948.0,222 CPT,55874,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,948.0,15059.0,225 CPT,55875,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,229 CPT,55875,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy High Cost Surgery",,,2369.0,2369.0,20 CPT,55876,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,233 CPT,55877,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,152 CPT,55880,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,948.0,15059.0,198 CPT,55881,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,948.0,5802.38,160 CPT,55882,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,948.0,35469.31,161 CPT,55899,"Unlisted procedure, male genital system ",,,252.24,13835.0,198 CPT,55920,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,948.0,15059.0,206 CPT,55970,Intersex surgery; male to female ,,,948.0,13835.0,94 CPT,55980,Intersex surgery; female to male ,,,948.0,13835.0,94 CPT,56300,Diagnostic laparoscopy ,,,3390.0,5841.0,16 CPT,56301,Laparoscopic fulgur FALL ,,,3390.0,5841.0,16 CPT,56302,Laparoscopic occl FALL ,,,3390.0,5841.0,16 CPT,56303,Laparoscopic fulgur les ,,,3390.0,5841.0,16 CPT,56304,Laparoscopy w ADHESIO ,,,3390.0,5841.0,16 CPT,56305,Laparoscopy w biopsy ,,,3390.0,5841.0,16 CPT,56306,Laparoscopic aspiration ,,,3390.0,5841.0,16 CPT,56307,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,16 CPT,56308,LAVH ,,,3390.0,5841.0,16 CPT,56309,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,16 CPT,56310,Laparoscopic enterolysis ,,,3390.0,5841.0,16 CPT,56311,Lapscp retroperit LN Bx ,,,3390.0,5841.0,16 CPT,56312,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,16 CPT,56313,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,16 CPT,56314,Lapscp lymphocele drain ,,,3390.0,5841.0,16 CPT,56315,Laparoscopic APPY ,,,3390.0,5841.0,16 CPT,56316,Lapscp REP init IH ,,,3390.0,5841.0,16 CPT,56317,Lapscp REP recur IH ,,,3390.0,5841.0,16 CPT,56318,Laparoscopic orchiectomy ,,,3390.0,5841.0,16 CPT,56320,Lapscp lig sperm vein ,,,3390.0,5841.0,16 CPT,56321,Lapscp adrenalectomy ,,,3390.0,5841.0,16 CPT,56322,Lapscp truncal vagotomy ,,,3390.0,5841.0,16 CPT,56323,Lapscp select vagotomy ,,,3390.0,5841.0,16 CPT,56324,Lapscp cholcystentstmy ,,,3390.0,5841.0,16 CPT,56340,Lapscp cholecystectomy ,,,3390.0,5841.0,16 CPT,56341,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,16 CPT,56342,Lapscp CHOLE w CDE ,,,3390.0,5841.0,16 CPT,56343,Lapscp salpingostomy ,,,3390.0,5841.0,16 CPT,56344,Lapscp fimbrioplasty ,,,3390.0,5841.0,16 CPT,56345,Laparoscopic splenectomy ,,,3390.0,5841.0,16 CPT,56346,Lapscp temp gastrostomy ,,,3390.0,5841.0,16 CPT,56347,Laparoscopic jejunostomy ,,,3390.0,5841.0,16 CPT,56348,Lapscp intest resect ,,,3390.0,5841.0,16 CPT,56349,Lapscp EG fundoplasty ,,,3390.0,5841.0,16 CPT,56350,Diagnostic hysteroscopy ,,,3390.0,5841.0,16 CPT,56351,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,16 CPT,56352,Hystscp IU ADHESIO ,,,3390.0,5841.0,16 CPT,56353,Hystscp div IU septum ,,,3390.0,5841.0,16 CPT,56354,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,16 CPT,56355,Hystscp impacted FB rmvl ,,,3390.0,5841.0,16 CPT,56356,Hystscp w endomet ablat ,,,3390.0,5841.0,16 CPT,56362,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,16 CPT,56363,Pertnscp cholangram w bx ,,,3390.0,5841.0,16 CPT,56399,Unlist px-laparascopy ,,,3390.0,5841.0,16 CPT,56405,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,225 CPT,56420,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,225 CPT,56440,Marsupialization of Bartholin's gland cyst ,,,948.0,6819.81,233 CPT,56441,Lysis of labial adhesions ,,,948.0,6819.81,233 CPT,56442,"Hymenotomy, simple incision ",,,948.0,6819.81,233 CPT,56501,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,233 CPT,56515,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,233 CPT,56605,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,225 CPT,56606,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,56620,Vulvectomy simple; partial ,,,948.0,13394.0,233 CPT,56625,Vulvectomy simple; complete ,,,948.0,12909.0,233 CPT,56630,"Vulvectomy, radical, partial; ",,,948.0,16207.0,205 CPT,56631,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,948.0,14609.1,109 CPT,56632,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,948.0,17240.98,109 CPT,56633,"Vulvectomy, radical, complete; ",,,948.0,14986.24,109 CPT,56634,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,948.0,16058.52,109 CPT,56637,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,948.0,18618.43,109 CPT,56640,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,948.0,18478.49,109 CPT,56700,Partial hymenectomy or revision of hymenal ring ,,,948.0,6819.81,233 CPT,56720,INCISION OF HYMEN ,,,3390.0,5841.0,16 CPT,56740,Excision of Bartholin's gland or cyst ,,,948.0,12562.0,233 CPT,56800,Plastic repair of introitus ,,,948.0,12562.0,233 CPT,56805,Clitoroplasty for intersex state ,,,948.0,13835.0,137 CPT,56810,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,948.0,13394.0,233 CPT,56820,Colposcopy of the vulva; ,,,57.86,5841.0,225 CPT,56821,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,225 CPT,57000,Colpotomy; with exploration ,,,948.0,6819.81,233 CPT,57010,Colpotomy; with drainage of pelvic abscess ,,,948.0,6819.81,233 CPT,57020,Colpocentesis (separate procedure) ,,,948.0,11661.3,233 CPT,57022,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,233 CPT,57023,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,233 CPT,57061,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,233 CPT,57065,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6819.81,233 CPT,57100,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,233 CPT,57105,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,948.0,6819.81,233 CPT,57106,"Vaginectomy, partial removal of vaginal wall; ",,,948.0,13835.0,206 CPT,57107,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,13835.0,206 CPT,57109,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,948.0,13835.0,206 CPT,57110,"Vaginectomy, complete removal of vaginal wall; ",,,948.0,16207.0,205 CPT,57111,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,21606.3,205 CPT,57112,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,24 CPT,57120,Colpocleisis (Le Fort type) ,,,948.0,13835.0,233 CPT,57130,Excision of vaginal septum ,,,948.0,6819.81,233 CPT,57135,Excision of vaginal cyst or tumor ,,,948.0,6819.81,233 CPT,57150,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,59.56,5841.0,102 CPT,57155,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,948.0,25988.0,249 CPT,57156,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,225 CPT,57160,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,129 CPT,57170,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,129 CPT,57180,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,129 CPT,57200,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,948.0,6819.81,233 CPT,57210,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,948.0,6819.81,233 CPT,57220,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,948.0,12562.0,233 CPT,57230,Plastic repair of urethrocele ,,,948.0,12562.0,233 CPT,57240,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,948.0,13394.0,233 CPT,57250,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,948.0,13394.0,233 CPT,57260,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,948.0,13394.0,233 CPT,57265,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,948.0,12909.0,233 CPT,57267,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,57268,"Repair of enterocele, vaginal approach (separate procedure) ",,,948.0,12562.0,233 CPT,57270,"Repair of enterocele, abdominal approach (separate procedure) ",,,948.0,13835.0,109 CPT,57280,"Colpopexy, abdominal approach ",,,948.0,13835.0,205 CPT,57282,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,948.0,18300.83,206 CPT,57283,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,948.0,18300.83,206 CPT,57284,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,948.0,13835.0,206 CPT,57285,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,948.0,18300.83,206 CPT,57287,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,948.0,13835.0,233 CPT,57288,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,948.0,16632.0,249 CPT,57289,"Pereyra procedure, including anterior colporrhaphy ",,,948.0,18300.83,233 CPT,57291,Construction of artificial vagina; without graft ,,,948.0,13394.0,233 CPT,57292,Construction of artificial vagina; with graft ,,,948.0,13835.0,206 CPT,57295,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,948.0,12562.0,233 CPT,57296,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,948.0,16207.0,109 CPT,57300,Closure of rectovaginal fistula; vaginal or transanal approach ,,,948.0,12562.0,233 CPT,57305,Closure of rectovaginal fistula; abdominal approach ,,,948.0,16207.0,205 CPT,57307,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,948.0,16207.0,109 CPT,57308,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,948.0,13835.0,109 CPT,57310,Closure of urethrovaginal fistula; ,,,948.0,18300.83,233 CPT,57311,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,948.0,13835.0,205 CPT,57320,Closure of vesicovaginal fistula; vaginal approach ,,,948.0,12562.0,233 CPT,57330,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,948.0,18300.83,110 CPT,57335,Vaginoplasty for intersex state ,,,948.0,13835.0,206 CPT,57400,Dilation of vagina under anesthesia (other than local) ,,,948.0,6819.81,233 CPT,57410,Pelvic examination under anesthesia (other than local) ,,,948.0,6819.81,233 CPT,57415,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,948.0,6819.81,233 CPT,57420,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,225 CPT,57421,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,233 CPT,57423,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,948.0,22967.79,206 CPT,57425,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,948.0,22967.79,122 CPT,57426,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,948.0,18300.83,149 CPT,57452,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,225 CPT,57454,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,225 CPT,57455,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,225 CPT,57456,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,225 CPT,57460,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,233 CPT,57461,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,233 CPT,57465,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,107.1,5841.0,49 CPT,57500,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,233 CPT,57505,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,233 CPT,57510,Cautery of cervix; electro or thermal ,,,83.14,13835.0,233 CPT,57511,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,225 CPT,57513,Cautery of cervix; laser ablation ,,,948.0,6819.81,233 CPT,57520,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,948.0,6819.81,233 CPT,57522,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,948.0,6819.81,233 CPT,57530,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,948.0,12562.0,233 CPT,57531,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,948.0,20288.23,109 CPT,57540,"Excision of cervical stump, abdominal approach; ",,,948.0,16207.0,109 CPT,57545,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,948.0,16207.0,109 CPT,57550,"Excision of cervical stump, vaginal approach; ",,,948.0,12562.0,233 CPT,57555,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,948.0,13835.0,110 CPT,57556,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,948.0,13394.0,233 CPT,57558,Dilation and curettage of cervical stump ,,,948.0,12562.0,233 CPT,57700,"Cerclage of uterine cervix, nonobstetrical ",,,948.0,6819.81,206 CPT,57720,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,948.0,12562.0,233 CPT,57800,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,233 CPT,57820,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,16 CPT,58100,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,225 CPT,58110,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,58120,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,948.0,6819.81,233 CPT,58140,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,948.0,13835.0,205 CPT,58145,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,948.0,13394.0,233 CPT,58146,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,948.0,13835.0,109 CPT,58150,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,948.0,16207.0,205 CPT,58152,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,948.0,16207.0,205 CPT,58180,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,185 CPT,58180,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58200,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,185 CPT,58200,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58210,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,185 CPT,58210,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) High C",,,2369.0,2369.0,20 CPT,58240,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,2369.0,35948.44,109 CPT,58260,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,213 CPT,58260,"Vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,20 CPT,58262,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,948.0,15059.0,233 CPT,58263,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,948.0,15059.0,206 CPT,58267,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,948.0,13835.0,109 CPT,58270,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,948.0,15059.0,206 CPT,58275,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,948.0,13835.0,109 CPT,58280,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,948.0,13835.0,109 CPT,58285,"Vaginal hysterectomy, radical (Schauta type operation) ",,,948.0,17741.14,109 CPT,58290,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,948.0,18300.83,206 CPT,58291,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,13835.0,206 CPT,58292,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,948.0,18300.83,206 CPT,58293,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,24 CPT,58294,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,948.0,13835.0,206 CPT,58300,Insertion of intrauterine device (IUD) ,,,38.55,5841.0,199 CPT,58301,Removal of intrauterine device (IUD) ,,,53.78,5841.0,225 CPT,58321,Artificial insemination; intra-cervical ,,,307.65,5841.0,102 CPT,58322,Artificial insemination; intra-uterine ,,,204.11,5841.0,102 CPT,58323,Sperm washing for artificial insemination ,,,44.33,5841.0,114 CPT,58340,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,948.0,5841.0,140 CPT,58345,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,948.0,17689.64,206 CPT,58346,Insertion of Heyman capsules for clinical brachytherapy ,,,948.0,11661.3,233 CPT,58350,"Chromotubation of oviduct, including materials ",,,948.0,12562.0,206 CPT,58353,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,229 CPT,58353,"Endometrial ablation, thermal, without hysteroscopic guidance High Cost Surgery",,,2369.0,2369.0,20 CPT,58356,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,948.0,23059.78,249 CPT,58400,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,948.0,16207.0,205 CPT,58410,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,948.0,16207.0,109 CPT,58520,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,948.0,16207.0,205 CPT,58540,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,948.0,16207.0,205 CPT,58541,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,948.0,18353.0,110 CPT,58542,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,110 CPT,58543,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,948.0,22967.79,83 CPT,58544,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,83 CPT,58545,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,129 CPT,58545,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas High Cost Surgery",,,2369.0,2369.0,20 CPT,58546,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,129 CPT,58546,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g High Cost Surgery",,,2369.0,2369.0,20 CPT,58548,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,5202.0,23335.49,62 CPT,58548,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed High Cost",,,2369.0,2369.0,20 CPT,58550,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,18353.0,90 CPT,58550,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,20 CPT,58551,"Laparoscopy, remove myoma ",,,3390.0,3390.0,8 CPT,58552,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,90 CPT,58552,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58553,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,90 CPT,58553,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,20 CPT,58554,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,90 CPT,58554,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58555,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,7026.0,129 CPT,58555,"Hysteroscopy, diagnostic (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,129 CPT,58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C High Cost Surgery",,,2369.0,2369.0,20 CPT,58559,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,129 CPT,58559,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) High Cost Surgery",,,2369.0,2369.0,20 CPT,58560,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,129 CPT,58560,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) High Cost Surgery",,,2369.0,2369.0,20 CPT,58561,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,129 CPT,58561,"Hysteroscopy, surgical; with removal of leiomyomata High Cost Surgery",,,2369.0,2369.0,20 CPT,58562,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,129 CPT,58562,"Hysteroscopy, surgical; with removal of impacted foreign body High Cost Surgery",,,2369.0,2369.0,20 CPT,58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,129 CPT,58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) High Cost Surgery",,,2369.0,2369.0,20 CPT,58565,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,129 CPT,58565,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants High Cost Surgery",,,2369.0,2369.0,20 CPT,58570,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,90 CPT,58570,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,20 CPT,58571,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,90 CPT,58571,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58572,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,5202.0,22967.79,63 CPT,58572,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,20 CPT,58573,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,90 CPT,58573,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,20 CPT,58575,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,75 CPT,58575,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed High Cost Surgery",,,2369.0,2369.0,20 CPT,58578,"Unlisted laparoscopy procedure, uterus ",,,5202.0,13835.0,102 CPT,58578,"Unlisted laparoscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,20 CPT,58579,"Unlisted hysteroscopy procedure, uterus ",,,204.11,13835.0,94 CPT,58579,"Unlisted hysteroscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,20 CPT,58580,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,948.0,19655.45,190 CPT,58600,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,948.0,13394.0,233 CPT,58605,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,948.0,13835.0,205 CPT,58611,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,205 CPT,58615,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,948.0,13835.0,233 CPT,58660,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,129 CPT,58660,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,129 CPT,58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) High Cost Surgery",,,2369.0,2369.0,20 CPT,58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,129 CPT,58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method High Cost Surgery",,,2369.0,2369.0,20 CPT,58670,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,129 CPT,58670,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) High Cost Surgery",,,2369.0,2369.0,20 CPT,58671,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,129 CPT,58671,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) High Cost Surgery",,,2369.0,2369.0,20 CPT,58672,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,129 CPT,58672,"Laparoscopy, surgical; with fimbrioplasty High Cost Surgery",,,2369.0,2369.0,20 CPT,58673,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,129 CPT,58673,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) High Cost Surgery",,,2369.0,2369.0,20 CPT,58674,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,121 CPT,58674,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency High Cost Surgery",,,2369.0,2369.0,20 CPT,58679,"Unlisted laparoscopy procedure, oviduct, ovary ",,,5202.0,13835.0,102 CPT,58679,"Unlisted laparoscopy procedure, oviduct, ovary High Cost Surgery",,,2369.0,2369.0,20 CPT,58700,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,205 CPT,58720,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,205 CPT,58740,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,948.0,13835.0,205 CPT,58750,Tubotubal anastomosis ,,,948.0,13835.0,205 CPT,58752,Tubouterine implantation ,,,948.0,13835.0,205 CPT,58760,Fimbrioplasty ,,,948.0,13835.0,205 CPT,58770,Salpingostomy (salpingoneostomy) ,,,948.0,13835.0,206 CPT,58800,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,948.0,12562.0,233 CPT,58805,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,948.0,13835.0,233 CPT,58820,"Drainage of ovarian abscess; vaginal approach, open ",,,948.0,12562.0,233 CPT,58822,Drainage of ovarian abscess; abdominal approach ,,,948.0,13835.0,205 CPT,58823,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,16 CPT,58825,"Transposition, ovary(s) ",,,948.0,13835.0,205 CPT,58900,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,948.0,12562.0,233 CPT,58920,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,948.0,18300.83,206 CPT,58925,"Ovarian cystectomy, unilateral or bilateral ",,,948.0,13835.0,206 CPT,58940,"Oophorectomy, partial or total, unilateral or bilateral; ",,,948.0,13835.0,205 CPT,58943,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,948.0,14490.44,109 CPT,58950,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,948.0,13973.35,109 CPT,58951,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,948.0,17864.03,109 CPT,58952,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,948.0,20267.07,109 CPT,58953,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,948.0,24971.42,109 CPT,58954,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,948.0,27115.97,109 CPT,58956,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,948.0,16944.28,109 CPT,58957,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,24 CPT,58958,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,948.0,21716.49,109 CPT,58960,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,948.0,13835.0,205 CPT,58970,"Follicle puncture for oocyte retrieval, any method ",,,929.87,3128.0,206 CPT,58974,"Embryo transfer, intrauterine ",,,929.87,5841.0,198 CPT,58976,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,307.65,5841.0,198 CPT,58999,"Unlisted procedure, female genital system (nonobstetrical) ",,,204.11,13835.0,198 CPT,59000,Amniocentesis; diagnostic ,,,52.04,3083.0,215 CPT,59001,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,207 CPT,59012,"Cordocentesis (intrauterine), any method ",,,307.65,5841.0,102 CPT,59015,"Chorionic villus sampling, any method ",,,52.32,3244.0,137 CPT,59020,Fetal contraction stress test ,,,23.07,5841.0,100 CPT,59025,Fetal non-stress test ,,,16.57,5841.0,82 CPT,59030,Fetal scalp blood sampling ,,,307.65,5841.0,102 CPT,59050,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,78.61,5841.0,82 CPT,59051,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,50.92,16207.0,90 CPT,59070,"Transabdominal amnioinfusion, including ultrasound guidance ",,,307.65,5841.0,198 CPT,59072,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,307.65,5841.0,198 CPT,59074,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,225 CPT,59076,"Fetal shunt placement, including ultrasound guidance ",,,307.65,5841.0,198 CPT,59100,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,948.0,26010.28,110 CPT,59120,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,948.0,13835.0,205 CPT,59121,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,948.0,13835.0,205 CPT,59130,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,948.0,16207.0,109 CPT,59135,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,24 CPT,59136,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,948.0,16207.0,109 CPT,59140,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,948.0,16207.0,109 CPT,59150,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,129 CPT,59150,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,20 CPT,59151,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,129 CPT,59151,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,20 CPT,59160,"Curettage, postpartum ",,,948.0,12562.0,233 CPT,59200,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,307.65,5841.0,198 CPT,59300,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,206 CPT,59320,"Cerclage of cervix, during pregnancy; vaginal ",,,948.0,6819.81,233 CPT,59325,"Cerclage of cervix, during pregnancy; abdominal ",,,948.0,16207.0,205 CPT,59350,Hysterorrhaphy of ruptured uterus ,,,948.0,13835.0,93 CPT,59400,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,948.0,25611.4,72 CPT,59409,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,948.0,13835.0,206 CPT,59410,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,948.0,12689.16,168 CPT,59412,"External cephalic version, with or without tocolysis ",,,948.0,6819.81,110 CPT,59414,Delivery of placenta (separate procedure) ,,,948.0,13835.0,137 CPT,59425,Antepartum care only; 4-6 visits ,,,948.0,5841.0,72 CPT,59426,Antepartum care only; 7 or more visits ,,,948.0,7624.48,72 CPT,59430,Postpartum care only (separate procedure) ,,,948.0,5841.0,168 CPT,59510,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,948.0,28395.93,72 CPT,59514,Cesarean delivery only; ,,,948.0,13835.0,93 CPT,59515,Cesarean delivery only; including postpartum care ,,,948.0,15427.0,168 CPT,59525,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,948.0,13835.0,93 CPT,59610,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,948.0,26874.42,72 CPT,59612,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,948.0,13835.0,206 CPT,59614,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,948.0,13841.99,72 CPT,59618,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,948.0,28768.84,72 CPT,59620,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,948.0,13835.0,93 CPT,59622,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,948.0,15889.05,72 CPT,59812,"Treatment of incomplete abortion, any trimester, completed surgically ",,,948.0,13394.0,233 CPT,59820,"Treatment of missed abortion, completed surgically; first trimester ",,,948.0,13394.0,233 CPT,59821,"Treatment of missed abortion, completed surgically; second trimester ",,,948.0,13394.0,233 CPT,59830,"Treatment of septic abortion, completed surgically ",,,389.37,16207.0,207 CPT,59840,"Induced abortion, by dilation and curettage ",,,948.0,13394.0,233 CPT,59841,"Induced abortion, by dilation and evacuation ",,,948.0,13394.0,233 CPT,59850,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,205 CPT,59851,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,948.0,16207.0,205 CPT,59852,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,948.0,16207.0,205 CPT,59855,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,109 CPT,59856,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,948.0,16207.0,205 CPT,59857,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,948.0,16207.0,205 CPT,59866,Multifetal pregnancy reduction(s) (MPR) ,,,307.65,5841.0,102 CPT,59870,Uterine evacuation and curettage for hydatidiform mole ,,,948.0,13394.0,233 CPT,59871,Removal of cerclage suture under anesthesia (other than local) ,,,948.0,13394.0,233 CPT,59897,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,204.11,13835.0,198 CPT,59898,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,186 CPT,59898,"Unlisted laparoscopy procedure, maternity care and delivery High Cost Surgery",,,2369.0,2369.0,20 CPT,59899,"Unlisted procedure, maternity care and delivery ",,,204.11,13835.0,198 CPT,60000,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,233 CPT,60001,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,16 CPT,60100,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,233 CPT,60200,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,948.0,13196.03,233 CPT,60210,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13835.0,233 CPT,60212,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13835.0,233 CPT,60220,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13196.03,233 CPT,60225,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13196.03,233 CPT,60240,"Thyroidectomy, total or complete ",,,948.0,13835.0,233 CPT,60252,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,948.0,13835.0,206 CPT,60254,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,948.0,20402.66,205 CPT,60260,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,948.0,13835.0,206 CPT,60270,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,948.0,16715.43,109 CPT,60271,"Thyroidectomy, including substernal thyroid; cervical approach ",,,948.0,13835.0,206 CPT,60280,Excision of thyroglossal duct cyst or sinus; ,,,948.0,13196.03,233 CPT,60281,Excision of thyroglossal duct cyst or sinus; recurrent ,,,948.0,13196.03,233 CPT,60300,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,233 CPT,60500,Parathyroidectomy or exploration of parathyroid(s); ,,,948.0,13835.0,233 CPT,60502,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,948.0,15059.0,206 CPT,60505,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,948.0,17020.6,109 CPT,60512,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,60520,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,948.0,13835.0,206 CPT,60521,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,948.0,16207.0,109 CPT,60522,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,948.0,16745.06,109 CPT,60540,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,948.0,16207.0,205 CPT,60545,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,948.0,16207.0,109 CPT,60600,Excision of carotid body tumor; without excision of carotid artery ,,,948.0,16795.98,109 CPT,60605,Excision of carotid body tumor; with excision of carotid artery ,,,948.0,20326.45,109 CPT,60650,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,5202.0,14626.03,101 CPT,60650,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal High Cost Surgery",,,2369.0,2369.0,20 CPT,60659,"Unlisted laparoscopy procedure, endocrine system ",,,5202.0,13835.0,102 CPT,60659,"Unlisted laparoscopy procedure, endocrine system High Cost Surgery",,,2369.0,2369.0,20 CPT,60660,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,948.0,4423.26,161 CPT,60661,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,948.0,3390.0,124 CPT,60699,"Unlisted procedure, endocrine system ",,,948.0,13835.0,206 CPT,61000,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,233 CPT,61001,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,233 CPT,61020,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,233 CPT,61026,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,233 CPT,61050,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,233 CPT,61055,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,233 CPT,61070,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,233 CPT,61105,Twist drill hole for subdural or ventricular puncture ,,,948.0,16207.0,109 CPT,61107,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,948.0,16207.0,109 CPT,61108,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,948.0,16207.0,109 CPT,61120,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,948.0,16207.0,109 CPT,61140,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,948.0,16207.0,109 CPT,61150,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,948.0,16868.07,109 CPT,61151,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,948.0,16207.0,109 CPT,61154,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,948.0,16207.0,109 CPT,61156,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,948.0,16207.0,109 CPT,61210,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,948.0,16207.0,109 CPT,61215,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,948.0,41580.0,249 CPT,61250,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,948.0,16207.0,109 CPT,61253,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,948.0,16207.0,109 CPT,61304,"Craniectomy or craniotomy, exploratory; supratentorial ",,,948.0,20406.89,109 CPT,61305,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,948.0,24861.23,109 CPT,61312,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,948.0,25806.38,109 CPT,61313,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,948.0,24598.51,109 CPT,61314,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,948.0,22576.85,109 CPT,61315,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,948.0,25611.4,109 CPT,61316,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,205 CPT,61320,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,948.0,23547.4,109 CPT,61321,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,948.0,26149.65,109 CPT,61322,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,948.0,29561.46,109 CPT,61323,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,948.0,29586.87,109 CPT,61330,"Decompression of orbit only, transcranial approach ",,,948.0,13835.0,110 CPT,61332,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,24 CPT,61333,"Exploration of orbit (transcranial approach), with removal of lesion ",,,948.0,25276.59,109 CPT,61334,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,16 CPT,61340,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,948.0,17554.62,109 CPT,61343,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,948.0,27154.19,109 CPT,61345,"Other cranial decompression, posterior fossa ",,,948.0,25285.06,109 CPT,61440,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,16 CPT,61450,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,948.0,23733.91,109 CPT,61458,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,948.0,24954.48,109 CPT,61460,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,948.0,26158.12,109 CPT,61470,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,16 CPT,61480,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,24 CPT,61490,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,16 CPT,61500,Craniectomy; with excision of tumor or other bone lesion of skull ,,,948.0,16194.11,205 CPT,61501,Craniectomy; for osteomyelitis ,,,948.0,16207.0,109 CPT,61510,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,948.0,27162.66,109 CPT,61512,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,948.0,31706.02,109 CPT,61514,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,948.0,23716.98,109 CPT,61516,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,948.0,23081.23,109 CPT,61517,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,109 CPT,61518,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,948.0,34350.61,109 CPT,61519,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,948.0,36766.35,109 CPT,61520,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,948.0,46759.99,109 CPT,61521,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,948.0,39720.34,109 CPT,61522,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,948.0,26679.44,109 CPT,61524,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,948.0,25797.91,109 CPT,61526,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,948.0,41508.92,109 CPT,61530,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,948.0,38601.49,109 CPT,61531,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,948.0,14948.14,109 CPT,61533,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,948.0,18843.05,109 CPT,61534,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,948.0,20105.95,109 CPT,61535,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,948.0,16207.0,109 CPT,61536,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,948.0,31883.95,109 CPT,61537,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,948.0,30709.95,109 CPT,61538,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,948.0,33180.84,109 CPT,61539,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,948.0,29514.78,109 CPT,61540,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,948.0,26730.36,109 CPT,61541,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,948.0,26577.72,109 CPT,61542,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,16 CPT,61543,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,948.0,26158.12,109 CPT,61544,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,948.0,23733.91,109 CPT,61545,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,948.0,39423.75,109 CPT,61546,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,948.0,28586.68,109 CPT,61548,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,948.0,19432.11,109 CPT,61550,Craniectomy for craniosynostosis; single cranial suture ,,,948.0,16207.0,109 CPT,61552,Craniectomy for craniosynostosis; multiple cranial sutures ,,,948.0,18444.62,109 CPT,61556,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,948.0,21263.02,109 CPT,61557,Craniotomy for craniosynostosis; bifrontal bone flap ,,,948.0,20945.15,109 CPT,61558,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,948.0,23428.74,109 CPT,61559,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,948.0,28192.48,109 CPT,61563,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,948.0,24382.36,109 CPT,61564,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,948.0,30069.97,109 CPT,61566,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,948.0,27493.23,109 CPT,61567,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,948.0,30913.39,109 CPT,61570,Craniectomy or craniotomy; with excision of foreign body from brain ,,,948.0,23106.64,109 CPT,61571,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,948.0,24297.57,109 CPT,61575,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,948.0,31201.63,109 CPT,61576,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,948.0,51345.81,109 CPT,61580,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,948.0,29832.65,109 CPT,61581,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,948.0,32278.14,109 CPT,61582,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,948.0,37546.15,109 CPT,61583,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,948.0,35702.54,109 CPT,61584,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,948.0,35482.15,109 CPT,61585,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,948.0,40347.62,109 CPT,61586,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,948.0,29900.51,109 CPT,61590,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,948.0,37372.46,109 CPT,61591,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,948.0,37783.59,109 CPT,61592,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,948.0,39228.77,109 CPT,61595,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,948.0,28879.03,109 CPT,61596,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,948.0,29709.76,109 CPT,61597,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,948.0,36245.03,109 CPT,61598,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,948.0,35134.65,109 CPT,61600,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,948.0,26098.85,109 CPT,61601,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,948.0,29709.76,109 CPT,61605,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,948.0,26340.4,109 CPT,61606,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,948.0,36321.35,109 CPT,61607,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,948.0,32985.86,109 CPT,61608,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,948.0,40559.53,109 CPT,61609,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,16 CPT,61610,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,24 CPT,61611,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,61612,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,24 CPT,61613,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,948.0,41102.02,109 CPT,61615,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,948.0,34719.28,109 CPT,61616,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,948.0,41237.62,109 CPT,61618,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,948.0,16207.0,109 CPT,61619,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,948.0,17546.16,109 CPT,61623,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",64546.66,64546.66,948.0,27050.15,206 CPT,61623,OCCLUDE ART BLN HD/NCK,64546.66,64546.66,8391.07,54864.66,15 CPT,61624,EMBLZ INTRACRAN/SP,101444.19,101444.19,13187.74,86227.56,20 CPT,61624,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",101444.19,101444.19,948.0,16207.0,205 CPT,61626,EMBOLIZE EXTRACRAN,96566.33,96566.33,12553.62,82081.38,15 CPT,61626,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",96566.33,96566.33,948.0,27050.15,206 CPT,61630,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,948.0,17224.05,109 CPT,61635,INTRCRN STNT W ANGIOP,38698.99,38698.99,5030.87,32894.14,20 CPT,61635,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",38698.99,38698.99,948.0,18059.01,109 CPT,61640,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,948.0,16207.0,109 CPT,61641,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,61642,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,109 CPT,61645,INTRCRN ART THROMBECTOMY,5793.88,5793.88,753.2,4924.8,20 CPT,61645,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",5793.88,5793.88,948.0,16207.0,205 CPT,61650,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",5195.4,5195.4,948.0,16207.0,125 CPT,61650,INTRCRN ENDOV RX ADM INI,5195.4,5195.4,675.4,4416.09,20 CPT,61651,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",3211.84,3211.84,948.0,16207.0,125 CPT,61651,INTRCRN ENDOV RX ADM ADD,3211.84,3211.84,417.54,2730.06,20 CPT,61680,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,948.0,28014.44,109 CPT,61682,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,948.0,52341.76,109 CPT,61684,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,948.0,35240.6,109 CPT,61686,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,948.0,57821.69,109 CPT,61690,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,948.0,26984.61,109 CPT,61692,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,948.0,46115.78,109 CPT,61697,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,53176.72,109 CPT,61698,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,59338.96,109 CPT,61700,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,42699.85,109 CPT,61702,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,50133.7,109 CPT,61703,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,948.0,16537.5,109 CPT,61705,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,948.0,31193.16,109 CPT,61708,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,948.0,31862.78,109 CPT,61710,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,948.0,26865.96,109 CPT,61711,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,948.0,32129.73,109 CPT,61715,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,948.0,37410.93,130 CPT,61720,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,948.0,15039.6,110 CPT,61735,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,948.0,19834.77,109 CPT,61736,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,948.0,13835.0,101 CPT,61737,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,948.0,13835.0,101 CPT,61750,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,948.0,17554.62,109 CPT,61751,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,948.0,17156.19,109 CPT,61760,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,948.0,19516.9,109 CPT,61770,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,948.0,15059.0,110 CPT,61781,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,61782,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,61783,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,61790,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,233 CPT,61791,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,233 CPT,61793,FOCUS RADIATION BEAM ,,,3390.0,5841.0,16 CPT,61795,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,16 CPT,61796,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,10151.0,47591.0,62 CPT,61797,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,185.75,45307.0,67 CPT,61798,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,948.0,47591.0,79 CPT,61799,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,255.57,45307.0,67 CPT,61800,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,133.86,47591.0,79 CPT,61850,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,948.0,16207.0,109 CPT,61855,Impl subcort electrodes ,,,3390.0,5841.0,16 CPT,61860,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,948.0,19402.47,109 CPT,61862,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,16 CPT,61863,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,18639.6,109 CPT,61864,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,16207.0,109 CPT,61865,Impl cereb subcort elec ,,,3390.0,5841.0,16 CPT,61867,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,28345.13,109 CPT,61868,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,16207.0,109 CPT,61870,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,24 CPT,61875,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,16 CPT,61880,Revision or removal of intracranial neurostimulator electrodes ,,,948.0,13835.0,137 CPT,61885,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,948.0,87318.0,241 CPT,61886,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,948.0,87318.0,241 CPT,61888,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,948.0,16890.86,233 CPT,61889,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,948.0,15111.6,93 CPT,61891,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,948.0,56900.95,190 CPT,61892,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,948.0,15059.0,190 CPT,62000,"Elevation of depressed skull fracture; simple, extradural ",,,948.0,13835.0,110 CPT,62005,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,948.0,16207.0,109 CPT,62010,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,948.0,18957.47,109 CPT,62100,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,948.0,19673.77,109 CPT,62115,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,948.0,20856.12,109 CPT,62116,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,16 CPT,62117,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,948.0,24513.72,109 CPT,62120,"Repair of encephalocele, skull vault, including cranioplasty ",,,948.0,26255.61,109 CPT,62121,"Craniotomy for repair of encephalocele, skull base ",,,948.0,19381.3,109 CPT,62140,Cranioplasty for skull defect; up to 5 cm diameter ,,,948.0,16207.0,109 CPT,62141,Cranioplasty for skull defect; larger than 5 cm diameter ,,,948.0,16207.0,109 CPT,62142,Removal of bone flap or prosthetic plate of skull ,,,948.0,16207.0,109 CPT,62143,Replacement of bone flap or prosthetic plate of skull ,,,948.0,16207.0,109 CPT,62145,Cranioplasty for skull defect with reparative brain surgery ,,,948.0,17389.28,109 CPT,62146,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,948.0,16207.0,109 CPT,62147,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,948.0,17787.71,109 CPT,62148,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,948.0,16207.0,109 CPT,62160,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,62161,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,948.0,18707.46,109 CPT,62162,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,948.0,23458.38,109 CPT,62163,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,24 CPT,62164,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,948.0,25882.7,109 CPT,62165,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,948.0,18906.55,109 CPT,62180,Ventriculocisternostomy (Torkildsen type operation) ,,,948.0,19949.19,109 CPT,62190,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,948.0,16207.0,109 CPT,62192,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,948.0,16207.0,109 CPT,62194,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,233 CPT,62200,"Ventriculocisternostomy, third ventricle; ",,,948.0,17075.76,109 CPT,62201,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,948.0,16207.0,109 CPT,62220,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,948.0,16207.0,109 CPT,62223,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,948.0,16207.0,109 CPT,62225,"Replacement or irrigation, ventricular catheter ",,,948.0,15039.6,233 CPT,62230,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,948.0,15039.6,233 CPT,62252,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,129 CPT,62256,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,948.0,13835.0,205 CPT,62258,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,948.0,16207.0,109 CPT,62263,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,233 CPT,62264,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,3128.0,233 CPT,62267,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,233 CPT,62268,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,233 CPT,62269,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,233 CPT,62270,PUNCTURE LUMBAR DX,2758.43,2758.43,386.18,2344.67,10 CPT,62270,"Spinal puncture, lumbar, diagnostic; ",2758.43,2758.43,276.0,3128.0,233 CPT,62272,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,233 CPT,62273,INJ BLOOD PATCH,1498.78,1498.78,209.83,1273.96,10 CPT,62273,"Injection, epidural, of blood or clot patch ",1498.78,1498.78,276.0,3128.0,233 CPT,62274,1 inject anes-subarach ,,,3390.0,5841.0,16 CPT,62275,1 epidur inject-C/thor ,,,3390.0,5841.0,16 CPT,62276,1 subar inject anes-diff ,,,3390.0,5841.0,16 CPT,62277,1 subar inject anes-cont ,,,3390.0,5841.0,16 CPT,62278,1 epidural inject anes-L ,,,3390.0,5841.0,16 CPT,62279,Cont epidur inject-lumb ,,,3390.0,5841.0,16 CPT,62280,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,233 CPT,62281,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,233 CPT,62282,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,233 CPT,62284,"Injection procedure for myelography and/or computed tomography, lumbar ",,,948.0,5841.0,140 CPT,62287,DECMPRS DISC LUMB W/ NDL,4952.36,4952.36,693.33,4209.51,10 CPT,62287,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",4952.36,4952.36,692.94,15059.0,233 CPT,62288,Subarachnoid inject NEC ,,,3390.0,5841.0,16 CPT,62289,Lumbar/caudal inject NEC ,,,3390.0,5841.0,16 CPT,62290,"Injection procedure for discography, each level; lumbar ",,,948.0,5841.0,140 CPT,62291,"Injection procedure for discography, each level; cervical or thoracic ",,,948.0,5841.0,140 CPT,62292,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,948.0,11410.03,206 CPT,62294,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,892.95,12562.0,206 CPT,62298,Other spinal injection ,,,3390.0,5841.0,16 CPT,62302,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,791.43,8234.0,206 CPT,62303,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,791.43,8234.0,206 CPT,62304,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,791.43,8234.0,206 CPT,62305,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,791.43,8234.0,206 CPT,62310,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,24 CPT,62311,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,24 CPT,62318,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,24 CPT,62319,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,24 CPT,62320,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,225 CPT,62321,INJ EPI C/T W IMAGING,2260.58,2260.58,316.48,1921.49,11 CPT,62321,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",2260.58,2260.58,276.0,5841.0,225 CPT,62322,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,225 CPT,62323,INJ EPI L/S W IMAGING,3648.28,3648.28,510.76,3101.04,11 CPT,62323,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",3648.28,3648.28,276.0,5841.0,225 CPT,62324,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,225 CPT,62325,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,225 CPT,62326,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,225 CPT,62327,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,225 CPT,62328,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,225 CPT,62329,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,225 CPT,62330,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,948.0,20238.53,152 CPT,62331,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,948.0,3083.0,116 CPT,62350,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,948.0,15039.6,233 CPT,62351,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,948.0,16330.72,206 CPT,62355,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,233 CPT,62360,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,948.0,45089.88,249 CPT,62361,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,948.0,45089.88,241 CPT,62362,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,221 CPT,62362,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming High Cost Surgery",,,2369.0,2369.0,20 CPT,62365,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,948.0,15039.6,233 CPT,62367,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,52.42,5841.0,167 CPT,62368,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,73.53,5841.0,167 CPT,62369,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,310.08,5841.0,102 CPT,62370,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,310.08,5841.0,198 CPT,62380,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,948.0,16330.72,225 CPT,63001,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,948.0,16330.72,215 CPT,63003,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,948.0,16330.72,215 CPT,63005,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,948.0,16330.72,215 CPT,63011,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,948.0,16330.72,188 CPT,63012,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,948.0,16330.72,188 CPT,63015,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,948.0,16330.72,188 CPT,63016,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,948.0,16330.72,188 CPT,63017,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,948.0,16330.72,188 CPT,63020,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,948.0,16330.72,215 CPT,63030,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,195 CPT,63030,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar High Cost Surgery",,,2369.0,2369.0,20 CPT,63032,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,948.0,3083.0,152 CPT,63035,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,948.0,14908.0,143 CPT,63040,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,948.0,16330.72,188 CPT,63042,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,948.0,16330.72,212 CPT,63043,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,948.0,7014.0,148 CPT,63044,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,948.0,7014.0,148 CPT,63045,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,212 CPT,63046,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,212 CPT,63047,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,212 CPT,63048,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,5841.0,140 CPT,63050,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,948.0,18436.15,109 CPT,63051,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,948.0,21068.04,109 CPT,63052,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,948.0,5841.0,140 CPT,63053,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,948.0,5841.0,140 CPT,63055,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,948.0,16330.72,233 CPT,63056,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,948.0,16330.72,233 CPT,63057,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,948.0,5841.0,140 CPT,63064,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,948.0,16330.72,110 CPT,63066,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,948.0,5841.0,44 CPT,63075,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,948.0,16330.72,206 CPT,63076,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,948.0,5841.0,140 CPT,63077,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,948.0,18749.79,109 CPT,63078,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,948.0,16207.0,109 CPT,63081,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,948.0,21674.15,109 CPT,63082,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,948.0,16207.0,109 CPT,63085,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,948.0,23729.68,109 CPT,63086,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,948.0,16207.0,109 CPT,63087,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,948.0,29803.02,109 CPT,63088,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,948.0,16207.0,109 CPT,63090,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,948.0,24149.28,109 CPT,63091,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,948.0,16207.0,109 CPT,63101,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,28743.44,109 CPT,63102,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,28001.74,109 CPT,63103,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,16207.0,109 CPT,63170,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,948.0,19678.01,88 CPT,63172,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,948.0,17147.73,88 CPT,63173,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,948.0,21237.62,88 CPT,63180,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,24 CPT,63182,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,24 CPT,63185,Laminectomy with rhizotomy; 1 or 2 segments ,,,948.0,14087.77,88 CPT,63190,Laminectomy with rhizotomy; more than 2 segments ,,,948.0,15253.31,88 CPT,63191,Laminectomy with section of spinal accessory nerve ,,,948.0,17173.13,88 CPT,63194,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,24 CPT,63195,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,24 CPT,63196,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,24 CPT,63197,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,948.0,19563.47,91 CPT,63198,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,24 CPT,63199,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,24 CPT,63200,"Laminectomy, with release of tethered spinal cord, lumbar ",,,948.0,18949.01,91 CPT,63250,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,948.0,36291.71,91 CPT,63251,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,948.0,37902.24,91 CPT,63252,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,948.0,37686.1,91 CPT,63265,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,948.0,16330.72,188 CPT,63266,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,948.0,16330.72,188 CPT,63267,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,948.0,16330.72,188 CPT,63268,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,948.0,16330.72,188 CPT,63270,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,948.0,25611.4,91 CPT,63271,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,948.0,25611.4,91 CPT,63272,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,948.0,23386.41,91 CPT,63273,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,948.0,23085.47,91 CPT,63275,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,948.0,22297.2,91 CPT,63276,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,948.0,22153.02,91 CPT,63277,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,948.0,19224.42,91 CPT,63278,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,948.0,19618.62,91 CPT,63280,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,948.0,26255.61,91 CPT,63281,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,948.0,25950.44,91 CPT,63282,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,948.0,24454.45,91 CPT,63283,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,948.0,23454.14,91 CPT,63285,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,948.0,32557.8,91 CPT,63286,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,948.0,32066.23,91 CPT,63287,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,948.0,33960.65,91 CPT,63290,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,948.0,34473.5,91 CPT,63295,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,948.0,16207.0,91 CPT,63300,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,948.0,22725.26,109 CPT,63301,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,948.0,27196.53,109 CPT,63302,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,948.0,26832.09,109 CPT,63303,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,26781.17,109 CPT,63304,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,948.0,28616.31,109 CPT,63305,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,948.0,31277.95,109 CPT,63306,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,948.0,29773.38,109 CPT,63307,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,30091.25,109 CPT,63308,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,948.0,16207.0,109 CPT,63600,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,233 CPT,63610,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,948.0,12562.0,233 CPT,63615,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,24 CPT,63620,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,948.0,47591.0,77 CPT,63621,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,948.0,45307.0,65 CPT,63650,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,948.0,87318.0,249 CPT,63655,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,948.0,87318.0,231 CPT,63660,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,16 CPT,63661,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,233 CPT,63662,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,12909.0,233 CPT,63663,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,948.0,54750.0,233 CPT,63664,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,54750.0,233 CPT,63685,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,948.0,87318.0,241 CPT,63688,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,233 CPT,63700,Repair of meningocele; less than 5 cm diameter ,,,948.0,16207.0,109 CPT,63702,Repair of meningocele; larger than 5 cm diameter ,,,948.0,17728.44,109 CPT,63704,Repair of myelomeningocele; less than 5 cm diameter ,,,948.0,19758.45,109 CPT,63706,Repair of myelomeningocele; larger than 5 cm diameter ,,,948.0,21911.47,109 CPT,63707,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,948.0,16207.0,109 CPT,63709,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,948.0,16207.0,109 CPT,63710,"Dural graft, spinal ",,,948.0,16207.0,109 CPT,63740,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,948.0,16207.0,109 CPT,63741,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,948.0,15039.6,206 CPT,63744,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,948.0,15039.6,233 CPT,63746,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,233 CPT,64400,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,225 CPT,64402,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,16 CPT,64405,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,233 CPT,64408,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,198 CPT,64410,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,24 CPT,64412,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,16 CPT,64413,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,24 CPT,64415,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,233 CPT,64416,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,233 CPT,64417,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,233 CPT,64418,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,233 CPT,64420,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,233 CPT,64421,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,233 CPT,64425,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,233 CPT,64430,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,233 CPT,64435,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,233 CPT,64440,Inject anes 1 paravert N ,,,3390.0,5841.0,16 CPT,64441,Inject anes >1 paravert ,,,3390.0,5841.0,16 CPT,64442,Inject anes 1 L facet N ,,,3390.0,5841.0,16 CPT,64443,Inject anes L facet-ADDL ,,,3390.0,5841.0,16 CPT,64445,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,233 CPT,64446,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,137 CPT,64447,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,137 CPT,64448,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,137 CPT,64449,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,233 CPT,64450,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,233 CPT,64451,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,225 CPT,64454,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,225 CPT,64455,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,225 CPT,64461,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,233 CPT,64462,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,948.0,5841.0,140 CPT,64463,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,233 CPT,64466,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64467,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64468,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64469,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64470,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,16 CPT,64472,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,16 CPT,64473,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64474,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,124 CPT,64475,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,16 CPT,64476,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,16 CPT,64479,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,233 CPT,64480,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,948.0,5841.0,140 CPT,64483,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,233 CPT,64484,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,948.0,5841.0,140 CPT,64486,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,167 CPT,64487,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,167 CPT,64488,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,167 CPT,64489,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,167 CPT,64490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,233 CPT,64491,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,948.0,5841.0,140 CPT,64492,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,948.0,5841.0,140 CPT,64493,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,233 CPT,64494,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,948.0,5841.0,140 CPT,64495,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,948.0,5841.0,140 CPT,64505,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,225 CPT,64508,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,16 CPT,64510,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,233 CPT,64517,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,233 CPT,64520,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,233 CPT,64530,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,233 CPT,64550,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,16 CPT,64553,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,948.0,87318.0,249 CPT,64555,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,249 CPT,64560,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,16 CPT,64561,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,948.0,87318.0,249 CPT,64565,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,40 CPT,64566,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,309.89,5841.0,198 CPT,64567,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,948.0,3083.0,152 CPT,64568,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,87318.0,241 CPT,64569,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,948.0,16890.86,233 CPT,64570,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,15059.0,233 CPT,64573,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,16 CPT,64575,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,249 CPT,64577,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,16 CPT,64580,Open implantation of neurostimulator electrode array; neuromuscular ,,,948.0,87318.0,249 CPT,64581,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,948.0,16890.86,233 CPT,64582,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,82073.3,217 CPT,64583,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,948.0,31349.63,225 CPT,64584,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,15899.38,225 CPT,64585,Revision or removal of peripheral neurostimulator electrode array ,,,948.0,8595.41,233 CPT,64590,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,948.0,87318.0,241 CPT,64595,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,233 CPT,64596,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,948.0,35432.53,190 CPT,64597,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,948.0,5841.0,132 CPT,64598,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,948.0,27181.65,190 CPT,64600,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,233 CPT,64605,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,233 CPT,64610,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,233 CPT,64611,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,225 CPT,64612,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,225 CPT,64613,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,16 CPT,64614,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,16 CPT,64615,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,225 CPT,64616,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,233 CPT,64617,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,233 CPT,64620,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,233 CPT,64622,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,16 CPT,64623,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,16 CPT,64624,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,225 CPT,64625,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,225 CPT,64626,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,16 CPT,64627,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,16 CPT,64628,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,948.0,34379.68,225 CPT,64629,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64630,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,233 CPT,64632,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,225 CPT,64633,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,233 CPT,64634,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,948.0,5841.0,140 CPT,64635,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,233 CPT,64636,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,948.0,5841.0,140 CPT,64640,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,233 CPT,64642,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,233 CPT,64643,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64644,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,233 CPT,64645,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64646,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,233 CPT,64647,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,233 CPT,64650,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,225 CPT,64653,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,225 CPT,64654,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,948.0,122851.37,152 CPT,64655,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,948.0,9751.1,152 CPT,64656,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,948.0,86066.14,152 CPT,64657,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,948.0,9528.08,152 CPT,64658,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,948.0,9751.1,152 CPT,64659,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,948.0,9751.1,152 CPT,64680,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,233 CPT,64681,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,233 CPT,64702,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,233 CPT,64704,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,233 CPT,64708,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,233 CPT,64712,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,233 CPT,64713,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,233 CPT,64714,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,233 CPT,64716,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,233 CPT,64718,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,233 CPT,64719,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,233 CPT,64721,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,213 CPT,64721,Neuroplasty and/or transposition; median nerve at carpal tunnel High Cost Surgery,,,2369.0,2369.0,20 CPT,64722,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,233 CPT,64726,Decompression; plantar digital nerve ,,,692.94,5571.0,233 CPT,64727,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,948.0,5841.0,140 CPT,64728,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,948.0,5446.4,152 CPT,64732,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,233 CPT,64734,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,233 CPT,64736,Transection or avulsion of; mental nerve ,,,692.94,4693.83,233 CPT,64738,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,233 CPT,64740,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,233 CPT,64742,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,233 CPT,64744,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,233 CPT,64746,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,233 CPT,64752,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,16 CPT,64755,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,948.0,16207.0,109 CPT,64760,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,948.0,16207.0,109 CPT,64761,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,16 CPT,64763,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,137 CPT,64766,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,948.0,12562.0,110 CPT,64771,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,233 CPT,64772,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,233 CPT,64774,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,233 CPT,64776,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,233 CPT,64778,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64782,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,233 CPT,64783,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64784,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,233 CPT,64786,Excision of neuroma; sciatic nerve ,,,948.0,15039.6,233 CPT,64787,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,948.0,5841.0,140 CPT,64788,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,233 CPT,64790,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,233 CPT,64792,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,948.0,15039.6,233 CPT,64795,Biopsy of nerve ,,,692.94,5571.0,233 CPT,64802,"Sympathectomy, cervical ",,,692.94,4693.83,233 CPT,64804,"Sympathectomy, cervicothoracic ",,,948.0,13835.0,110 CPT,64809,"Sympathectomy, thoracolumbar ",,,948.0,16207.0,109 CPT,64818,"Sympathectomy, lumbar ",,,948.0,16207.0,109 CPT,64820,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,137 CPT,64821,Sympathectomy; radial artery ,,,948.0,8234.0,233 CPT,64822,Sympathectomy; ulnar artery ,,,948.0,12562.0,233 CPT,64823,Sympathectomy; superficial palmar arch ,,,948.0,7473.24,233 CPT,64831,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,233 CPT,64832,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64834,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,948.0,15039.6,233 CPT,64835,Suture of 1 nerve; median motor thenar ,,,948.0,15039.6,233 CPT,64836,Suture of 1 nerve; ulnar motor ,,,948.0,15039.6,233 CPT,64837,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64840,Suture of posterior tibial nerve ,,,948.0,15039.6,233 CPT,64856,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,948.0,15039.6,233 CPT,64857,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,948.0,15039.6,233 CPT,64858,Suture of sciatic nerve ,,,948.0,8104.0,233 CPT,64859,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,64861,Suture of; brachial plexus ,,,692.94,12562.0,233 CPT,64862,Suture of; lumbar plexus ,,,948.0,15039.6,233 CPT,64864,Suture of facial nerve; extracranial ,,,948.0,15039.6,233 CPT,64865,"Suture of facial nerve; infratemporal, with or without grafting ",,,948.0,15039.6,233 CPT,64866,Anastomosis; facial-spinal accessory ,,,948.0,16207.0,109 CPT,64868,Anastomosis; facial-hypoglossal ,,,948.0,16207.0,109 CPT,64870,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,16 CPT,64872,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,948.0,5841.0,140 CPT,64874,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,948.0,5841.0,140 CPT,64876,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,948.0,5841.0,140 CPT,64885,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,948.0,15039.6,233 CPT,64886,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,948.0,15039.6,233 CPT,64890,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,948.0,15039.6,233 CPT,64891,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,948.0,15039.6,233 CPT,64892,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,948.0,15039.6,233 CPT,64893,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,948.0,15039.6,233 CPT,64895,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,948.0,15039.6,233 CPT,64896,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,948.0,15039.6,233 CPT,64897,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,948.0,15039.6,233 CPT,64898,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,948.0,15039.6,233 CPT,64901,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64902,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64905,Nerve pedicle transfer; first stage ,,,948.0,15039.6,233 CPT,64907,Nerve pedicle transfer; second stage ,,,948.0,15039.6,233 CPT,64910,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,948.0,15039.6,233 CPT,64911,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,948.0,15039.6,206 CPT,64912,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,948.0,15039.6,225 CPT,64913,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,64999,"Unlisted procedure, nervous system ",,,309.89,13835.0,198 CPT,65091,Evisceration of ocular contents; without implant ,,,948.0,12562.0,233 CPT,65093,Evisceration of ocular contents; with implant ,,,948.0,12562.0,233 CPT,65101,Enucleation of eye; without implant ,,,948.0,12562.0,233 CPT,65103,"Enucleation of eye; with implant, muscles not attached to implant ",,,948.0,12562.0,233 CPT,65105,"Enucleation of eye; with implant, muscles attached to implant ",,,948.0,8536.87,233 CPT,65110,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,948.0,13394.0,233 CPT,65112,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,948.0,12909.0,233 CPT,65114,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,948.0,12909.0,233 CPT,65125,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,137 CPT,65130,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,948.0,12562.0,233 CPT,65135,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,948.0,8536.87,233 CPT,65140,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,948.0,12562.0,233 CPT,65150,Reinsertion of ocular implant; with or without conjunctival graft ,,,948.0,8536.87,233 CPT,65155,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,948.0,12562.0,233 CPT,65175,Removal of ocular implant ,,,948.0,8536.87,233 CPT,65205,"Removal of foreign body, external eye; conjunctival superficial ",,,134.32,5841.0,102 CPT,65210,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,451.0,5841.0,102 CPT,65220,"Removal of foreign body, external eye; corneal, without slit lamp ",,,451.0,5841.0,102 CPT,65222,"Removal of foreign body, external eye; corneal, with slit lamp ",,,134.32,5841.0,102 CPT,65235,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,233 CPT,65260,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,225 CPT,65265,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,233 CPT,65270,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,233 CPT,65272,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,233 CPT,65273,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,948.0,16207.0,205 CPT,65275,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,948.0,8536.87,233 CPT,65280,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,948.0,10424.04,233 CPT,65285,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,948.0,10424.04,233 CPT,65286,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,233 CPT,65290,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,948.0,12562.0,233 CPT,65400,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,233 CPT,65410,Biopsy of cornea ,,,733.22,5283.1,233 CPT,65420,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,233 CPT,65426,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,233 CPT,65430,"Scraping of cornea, diagnostic, for smear and/or culture ",,,451.0,5841.0,102 CPT,65435,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,233 CPT,65436,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,233 CPT,65450,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,225 CPT,65600,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,233 CPT,65710,Keratoplasty (corneal transplant); anterior lamellar ,,,948.0,12909.0,233 CPT,65730,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,948.0,12909.0,233 CPT,65750,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,948.0,12909.0,233 CPT,65755,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,948.0,12909.0,233 CPT,65756,Keratoplasty (corneal transplant); endothelial ,,,948.0,15059.0,233 CPT,65757,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,44 CPT,65760,Keratomileusis ,,,948.0,17897.9,205 CPT,65765,Keratophakia ,,,948.0,19576.28,205 CPT,65767,Epikeratoplasty ,,,948.0,15664.44,205 CPT,65770,Keratoprosthesis ,,,948.0,16924.12,206 CPT,65771,Radial keratotomy ,,,948.0,7836.39,205 CPT,65772,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,233 CPT,65775,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,233 CPT,65778,Placement of amniotic membrane on the ocular surface; without sutures ,,,948.0,3755.0,206 CPT,65779,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,948.0,8536.87,206 CPT,65780,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,948.0,13394.0,233 CPT,65781,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,948.0,13394.0,206 CPT,65782,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,948.0,13394.0,206 CPT,65785,Implantation of intrastromal corneal ring segments ,,,948.0,26289.23,233 CPT,65800,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,225 CPT,65805,DRAINAGE OF EYE ,,,3390.0,5841.0,16 CPT,65810,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,233 CPT,65815,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,233 CPT,65820,Goniotomy ,,,948.0,10424.04,233 CPT,65850,Trabeculotomy ab externo ,,,892.44,8234.0,233 CPT,65855,Trabeculoplasty by laser surgery ,,,114.82,3249.0,233 CPT,65860,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,233 CPT,65865,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,233 CPT,65870,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,233 CPT,65875,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,233 CPT,65880,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,948.0,10424.04,233 CPT,65900,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,233 CPT,65920,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,233 CPT,65930,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,233 CPT,66020,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,233 CPT,66030,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,233 CPT,66130,"Excision of lesion, sclera ",,,733.22,12909.0,233 CPT,66150,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,948.0,10424.04,233 CPT,66155,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,948.0,10424.04,233 CPT,66160,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,233 CPT,66165,GLAUCOMA SURGERY ,,,3390.0,5841.0,16 CPT,66170,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,233 CPT,66172,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,233 CPT,66174,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,948.0,13394.0,206 CPT,66175,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,948.0,13394.0,206 CPT,66179,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,948.0,15059.0,233 CPT,66180,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,948.0,13394.0,233 CPT,66183,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,948.0,15059.0,233 CPT,66184,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,233 CPT,66185,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,233 CPT,66220,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,24 CPT,66225,Repair of scleral staphyloma with graft ,,,948.0,10424.04,233 CPT,66250,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,233 CPT,66500,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,225 CPT,66505,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,233 CPT,66600,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,948.0,12562.0,233 CPT,66605,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,233 CPT,66625,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,233 CPT,66630,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,233 CPT,66635,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,233 CPT,66680,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,233 CPT,66682,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,233 CPT,66683,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,948.0,44816.88,161 CPT,66700,Ciliary body destruction; diathermy ,,,892.44,5519.68,233 CPT,66710,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,233 CPT,66711,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,233 CPT,66720,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,233 CPT,66740,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,233 CPT,66761,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,233 CPT,66762,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,233 CPT,66770,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,233 CPT,66820,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,225 CPT,66821,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,233 CPT,66825,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,233 CPT,66830,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,233 CPT,66840,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,233 CPT,66850,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,233 CPT,66852,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,948.0,10424.04,233 CPT,66920,Removal of lens material; intracapsular ,,,892.44,8234.0,233 CPT,66930,"Removal of lens material; intracapsular, for dislocated lens ",,,948.0,13394.0,233 CPT,66940,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,233 CPT,66982,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,5571.0,233 CPT,66983,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,233 CPT,66984,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,233 CPT,66985,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,233 CPT,66986,Exchange of intraocular lens ,,,892.44,5571.0,233 CPT,66987,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,948.0,15059.0,225 CPT,66988,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,948.0,15059.0,225 CPT,66989,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,948.0,11603.86,225 CPT,66990,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,66991,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,948.0,11603.86,225 CPT,66999,"Unlisted procedure, anterior segment of eye ",,,948.0,13835.0,206 CPT,67005,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,213 CPT,67005,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal High Cost Surgery",,,2369.0,2369.0,20 CPT,67010,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,213 CPT,67010,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,67015,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,213 CPT,67015,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) High Cost Surgery",,,2369.0,2369.0,20 CPT,67025,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,213 CPT,67025,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) High Cost Surgery",,,2369.0,2369.0,20 CPT,67027,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,213 CPT,67027,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous High Cost Surgery",,,2369.0,2369.0,20 CPT,67028,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,205 CPT,67028,Intravitreal injection of a pharmacologic agent (separate procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,67030,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,213 CPT,67030,"Discission of vitreous strands (without removal), pars plana approach High Cost Surgery",,,2369.0,2369.0,20 CPT,67031,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,213 CPT,67031,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) High Cost Surgery",,,2369.0,2369.0,20 CPT,67036,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,213 CPT,67036,"Vitrectomy, mechanical, pars plana approach; High Cost Surgery",,,2369.0,2369.0,20 CPT,67038,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,16 CPT,67039,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,213 CPT,67039,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67040,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,213 CPT,67040,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67041,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,213 CPT,67041,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) High Cost Surgery",,,2369.0,2369.0,20 CPT,67042,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,233 CPT,67043,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,233 CPT,67101,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,213 CPT,67101,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy High Cost Surgery",,,2369.0,2369.0,20 CPT,67105,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,213 CPT,67105,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67107,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,233 CPT,67108,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,233 CPT,67110,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,117 CPT,67110,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) High Cost Surgery",,,2369.0,2369.0,20 CPT,67112,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,16 CPT,67113,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,233 CPT,67115,Release of encircling material (posterior segment) ,,,1610.16,10424.04,213 CPT,67115,Release of encircling material (posterior segment) High Cost Surgery,,,2369.0,2369.0,20 CPT,67120,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,213 CPT,67120,"Removal of implanted material, posterior segment; extraocular High Cost Surgery",,,2369.0,2369.0,20 CPT,67121,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,213 CPT,67121,"Removal of implanted material, posterior segment; intraocular High Cost Surgery",,,2369.0,2369.0,20 CPT,67141,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,205 CPT,67141,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,20 CPT,67145,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,213 CPT,67145,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67208,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,205 CPT,67208,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,20 CPT,67210,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,213 CPT,67210,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67218,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,213 CPT,67218,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) High Cost Surgery",,,2369.0,2369.0,20 CPT,67220,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,213 CPT,67220,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions High Cost Surgery",,,2369.0,2369.0,20 CPT,67221,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,213 CPT,67221,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) High Cost Surgery",,,2369.0,2369.0,20 CPT,67225,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,120 CPT,67225,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) High ",,,2369.0,2369.0,20 CPT,67227,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,213 CPT,67227,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,20 CPT,67228,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,213 CPT,67228,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation High Cost Surgery",,,2369.0,2369.0,20 CPT,67229,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,233 CPT,67250,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,233 CPT,67255,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,233 CPT,67299,"Unlisted procedure, posterior segment ",,,948.0,13835.0,110 CPT,67311,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,233 CPT,67312,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,948.0,8536.87,233 CPT,67314,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,233 CPT,67316,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,233 CPT,67318,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,233 CPT,67320,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,67331,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,67332,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,948.0,5841.0,140 CPT,67334,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,67335,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,948.0,5841.0,140 CPT,67340,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,140 CPT,67343,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,233 CPT,67345,Chemodenervation of extraocular muscle ,,,107.27,5841.0,225 CPT,67346,Biopsy of extraocular muscle ,,,948.0,8536.87,233 CPT,67350,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,16 CPT,67399,"Unlisted procedure, extraocular muscle ",,,320.45,13835.0,102 CPT,67400,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,948.0,12562.0,233 CPT,67405,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,233 CPT,67412,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,233 CPT,67413,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,233 CPT,67414,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,948.0,13835.0,233 CPT,67415,Fine needle aspiration of orbital contents ,,,733.22,5571.0,233 CPT,67420,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,948.0,13394.0,233 CPT,67430,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,948.0,13394.0,233 CPT,67440,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,948.0,13394.0,233 CPT,67445,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,948.0,13394.0,233 CPT,67450,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,948.0,13394.0,233 CPT,67500,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,129 CPT,67505,Retrobulbar injection; alcohol ,,,36.62,5841.0,225 CPT,67515,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,225 CPT,67516,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,333.47,5841.0,94 CPT,67550,Orbital implant (implant outside muscle cone); insertion ,,,948.0,8536.87,233 CPT,67560,Orbital implant (implant outside muscle cone); removal or revision ,,,948.0,8536.87,233 CPT,67570,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,948.0,8536.87,233 CPT,67599,"Unlisted procedure, orbit ",,,320.45,13835.0,102 CPT,67700,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,225 CPT,67710,Severing of tarsorrhaphy ,,,179.07,3128.0,233 CPT,67715,Canthotomy (separate procedure) ,,,733.22,5571.0,233 CPT,67800,Excision of chalazion; single ,,,65.12,5841.0,225 CPT,67801,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,233 CPT,67805,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,225 CPT,67808,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,233 CPT,67810,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,225 CPT,67820,"Correction of trichiasis; epilation, by forceps only ",,,134.32,5841.0,102 CPT,67825,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,129 CPT,67830,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,233 CPT,67835,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,233 CPT,67840,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,233 CPT,67850,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,233 CPT,67875,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,233 CPT,67880,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,233 CPT,67882,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,233 CPT,67900,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,233 CPT,67901,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,233 CPT,67902,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,948.0,13394.0,233 CPT,67903,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,233 CPT,67904,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,233 CPT,67906,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,948.0,13394.0,233 CPT,67908,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,233 CPT,67909,Reduction of overcorrection of ptosis ,,,733.22,8234.0,233 CPT,67911,Correction of lid retraction ,,,733.22,12562.0,233 CPT,67912,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,233 CPT,67914,Repair of ectropion; suture ,,,733.22,12562.0,233 CPT,67915,Repair of ectropion; thermocauterization ,,,210.46,5571.0,233 CPT,67916,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,233 CPT,67917,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,233 CPT,67921,Repair of entropion; suture ,,,733.22,12562.0,233 CPT,67922,Repair of entropion; thermocauterization ,,,201.75,13835.0,233 CPT,67923,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,233 CPT,67924,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,233 CPT,67930,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,233 CPT,67935,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,233 CPT,67938,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,225 CPT,67950,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,233 CPT,67961,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,233 CPT,67966,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,233 CPT,67971,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,233 CPT,67973,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,233 CPT,67974,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,948.0,12562.0,233 CPT,67975,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,233 CPT,67999,"Unlisted procedure, eyelids ",,,320.45,13835.0,102 CPT,68020,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,233 CPT,68040,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,129 CPT,68100,Biopsy of conjunctiva ,,,113.96,12562.0,233 CPT,68110,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,233 CPT,68115,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,233 CPT,68130,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,233 CPT,68135,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,233 CPT,68200,Subconjunctival injection ,,,223.51,5841.0,102 CPT,68320,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,233 CPT,68325,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,948.0,8536.87,233 CPT,68326,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,948.0,8536.87,233 CPT,68328,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,233 CPT,68330,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,233 CPT,68335,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,948.0,8536.87,233 CPT,68340,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,233 CPT,68360,Conjunctival flap; bridge or partial (separate procedure) ,,,948.0,8536.87,233 CPT,68362,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,233 CPT,68371,"Harvesting conjunctival allograft, living donor ",,,948.0,5571.0,206 CPT,68399,"Unlisted procedure, conjunctiva ",,,320.45,13835.0,102 CPT,68400,"Incision, drainage of lacrimal gland ",,,948.0,3323.1,206 CPT,68420,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,233 CPT,68440,Snip incision of lacrimal punctum ,,,56.97,5841.0,225 CPT,68500,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,948.0,12562.0,233 CPT,68505,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,948.0,12562.0,233 CPT,68510,Biopsy of lacrimal gland ,,,733.22,5571.0,233 CPT,68520,Excision of lacrimal sac (dacryocystectomy) ,,,948.0,12562.0,233 CPT,68525,Biopsy of lacrimal sac ,,,733.22,5571.0,233 CPT,68530,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,225 CPT,68540,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,233 CPT,68550,Excision of lacrimal gland tumor; involving osteotomy ,,,948.0,12562.0,233 CPT,68700,Plastic repair of canaliculi ,,,733.22,5571.0,233 CPT,68705,"Correction of everted punctum, cautery ",,,113.7,5841.0,225 CPT,68720,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,948.0,8536.87,233 CPT,68745,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,948.0,8536.87,233 CPT,68750,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,948.0,8536.87,233 CPT,68760,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,225 CPT,68761,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,225 CPT,68770,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,233 CPT,68801,"Dilation of lacrimal punctum, with or without irrigation ",,,451.0,5841.0,102 CPT,68810,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,225 CPT,68811,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,233 CPT,68815,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,233 CPT,68816,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,233 CPT,68840,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,225 CPT,68841,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,198 CPT,68850,Injection of contrast medium for dacryocystography ,,,948.0,5841.0,140 CPT,68899,"Unlisted procedure, lacrimal system ",,,320.45,13835.0,102 CPT,69000,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,225 CPT,69005,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,233 CPT,69020,"Drainage external auditory canal, abscess ",,,154.94,5841.0,225 CPT,69090,Ear piercing ,,,370.1,16207.0,88 CPT,69100,Biopsy external ear ,,,57.56,5841.0,129 CPT,69105,Biopsy external auditory canal ,,,99.71,13835.0,137 CPT,69110,"Excision external ear; partial, simple repair ",,,855.96,6330.57,233 CPT,69120,Excision external ear; complete amputation ,,,948.0,13241.95,233 CPT,69140,"Excision exostosis(es), external auditory canal ",,,948.0,13241.95,233 CPT,69145,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,233 CPT,69150,Radical excision external auditory canal lesion; without neck dissection ,,,948.0,13241.95,233 CPT,69155,Radical excision external auditory canal lesion; with neck dissection ,,,948.0,19932.26,109 CPT,69200,Removal foreign body from external auditory canal; without general anesthesia ,,,134.32,5841.0,102 CPT,69205,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,233 CPT,69209,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,59.56,5841.0,198 CPT,69210,"Removal impacted cerumen requiring instrumentation, unilateral ",,,59.56,5841.0,198 CPT,69220,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,202.56,5841.0,102 CPT,69222,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,233 CPT,69300,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,233 CPT,69310,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,948.0,13241.95,233 CPT,69320,"Reconstruction external auditory canal for congenital atresia, single stage ",,,948.0,13241.95,233 CPT,69399,"Unlisted procedure, external ear ",,,239.12,5841.0,102 CPT,69400,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,16 CPT,69401,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,16 CPT,69405,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,16 CPT,69410,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,16 CPT,69420,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,225 CPT,69421,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,233 CPT,69424,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,233 CPT,69433,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,225 CPT,69436,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,233 CPT,69440,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,233 CPT,69450,"Tympanolysis, transcanal ",,,930.95,9653.0,233 CPT,69501,Transmastoid antrotomy (simple mastoidectomy) ,,,948.0,13241.95,233 CPT,69502,Mastoidectomy; complete ,,,948.0,13241.95,233 CPT,69505,Mastoidectomy; modified radical ,,,948.0,13241.95,233 CPT,69511,Mastoidectomy; radical ,,,948.0,13241.95,233 CPT,69530,Petrous apicectomy including radical mastoidectomy ,,,948.0,13241.95,233 CPT,69535,"Resection temporal bone, external approach ",,,948.0,32511.23,109 CPT,69540,Excision aural polyp ,,,143.6,13835.0,233 CPT,69550,Excision aural glomus tumor; transcanal ,,,948.0,13394.0,233 CPT,69552,Excision aural glomus tumor; transmastoid ,,,948.0,13241.95,233 CPT,69554,Excision aural glomus tumor; extended (extratemporal) ,,,948.0,30451.46,109 CPT,69601,Revision mastoidectomy; resulting in complete mastoidectomy ,,,948.0,13241.95,233 CPT,69602,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,948.0,13241.95,233 CPT,69603,Revision mastoidectomy; resulting in radical mastoidectomy ,,,948.0,13241.95,233 CPT,69604,Revision mastoidectomy; resulting in tympanoplasty ,,,948.0,13241.95,233 CPT,69605,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,24 CPT,69610,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,233 CPT,69620,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,233 CPT,69631,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,213 CPT,69631,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69632,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,213 CPT,69632,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) High Cost Surgery",,,2369.0,2369.0,20 CPT,69633,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,233 CPT,69635,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69635,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69636,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69636,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69637,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,233 CPT,69641,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69641,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69642,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69642,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69643,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69643,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69644,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69644,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69645,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69645,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69646,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,213 CPT,69646,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,20 CPT,69650,Stapes mobilization ,,,930.95,12909.0,213 CPT,69650,Stapes mobilization High Cost Surgery,,,2369.0,2369.0,20 CPT,69660,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,213 CPT,69660,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; High Cost Surgery",,,2369.0,2369.0,20 CPT,69661,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,213 CPT,69661,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out High Cost Surgery",,,2369.0,2369.0,20 CPT,69662,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,213 CPT,69662,Revision of stapedectomy or stapedotomy High Cost Surgery,,,2369.0,2369.0,20 CPT,69666,Repair oval window fistula ,,,930.95,8234.0,213 CPT,69666,Repair oval window fistula High Cost Surgery,,,2369.0,2369.0,20 CPT,69667,Repair round window fistula ,,,930.95,8234.0,213 CPT,69667,Repair round window fistula High Cost Surgery,,,2369.0,2369.0,20 CPT,69670,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,213 CPT,69670,Mastoid obliteration (separate procedure) High Cost Surgery,,,2369.0,2369.0,20 CPT,69676,Tympanic neurectomy ,,,930.95,12562.0,213 CPT,69676,Tympanic neurectomy High Cost Surgery,,,2369.0,2369.0,20 CPT,69700,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,233 CPT,69705,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,948.0,15059.0,225 CPT,69706,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,948.0,15059.0,225 CPT,69710,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,948.0,12562.0,205 CPT,69711,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,233 CPT,69714,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,32488.94,233 CPT,69715,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,24 CPT,69716,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,948.0,34379.68,225 CPT,69717,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,16330.72,233 CPT,69718,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,24 CPT,69719,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,948.0,34379.68,225 CPT,69720,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,948.0,13394.0,233 CPT,69725,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,948.0,13835.0,206 CPT,69726,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,7895.92,225 CPT,69727,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,948.0,7895.92,225 CPT,69728,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,948.0,13835.0,225 CPT,69729,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,948.0,35621.26,225 CPT,69730,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,948.0,35621.26,225 CPT,69740,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,948.0,13394.0,233 CPT,69745,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,948.0,13394.0,233 CPT,69799,"Unlisted procedure, middle ear ",,,239.12,13835.0,198 CPT,69801,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,233 CPT,69802,INCISE INNER EAR ,,,3390.0,5841.0,16 CPT,69805,Endolymphatic sac operation; without shunt ,,,948.0,13241.95,233 CPT,69806,Endolymphatic sac operation; with shunt ,,,948.0,13241.95,233 CPT,69820,HFenestration semicircular canal ,,,6326.0,9653.0,24 CPT,69840,HRevision fenestration operation ,,,6326.0,9653.0,24 CPT,69905,Labyrinthectomy; transcanal ,,,948.0,13241.95,233 CPT,69910,Labyrinthectomy; with mastoidectomy ,,,948.0,13241.95,233 CPT,69915,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,233 CPT,69930,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,221 CPT,69930,"Cochlear device implantation, with or without mastoidectomy High Cost Surgery",,,2369.0,2369.0,20 CPT,69949,"Unlisted procedure, inner ear ",,,239.12,13835.0,198 CPT,69950,"Vestibular nerve section, transcranial approach ",,,948.0,21449.53,109 CPT,69955,Total facial nerve decompression and/or repair (may include graft) ,,,948.0,13835.0,206 CPT,69960,Decompression internal auditory canal ,,,948.0,13835.0,110 CPT,69970,"Removal of tumor, temporal bone ",,,948.0,13835.0,206 CPT,69979,"Unlisted procedure, temporal bone, middle fossa approach ",,,239.12,13835.0,198 CPT,69990,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,948.0,5841.0,140 CPT,70010,"Myelography, posterior fossa, radiological supervision and interpretation ",,,57.48,1477.76,152 CPT,70015,"Cisternography, positive contrast, radiological supervision and interpretation ",,,166.4,2634.77,152 CPT,70030,"Radiologic examination, eye, for detection of foreign body ",1687.26,1687.26,32.75,308.86,152 CPT,70030,XR EYE FOREIGN BODY RT,1687.26,1687.26,101.24,1434.17,17 CPT,70100,"Radiologic examination, mandible; partial, less than 4 views ",,,38.76,332.75,152 CPT,70100,XR MANDIBLE < 4 V,1504.6,1504.6,90.28,1278.92,34 CPT,7010F,Patient information entered into a recall system that includes: target date for the next exam specified and a process to follow up with patients regarding missed or unscheduled appointments (ML) ,,,0.1,0.13,12 CPT,70110,"Radiologic examination, mandible; complete, minimum of 4 views ",,,43.44,433.75,152 CPT,70110,XR MANDIBLE 4 + V,2702.4300000000003,2702.4300000000003,162.13,2297.29,34 CPT,70120,"Radiologic examination, mastoids; less than 3 views per side ",,,38.43,433.75,152 CPT,70130,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,62.15,520.02,152 CPT,70134,"Radiologic examination, internal auditory meati, complete ",,,61.81,1863.71,152 CPT,70140,"Radiologic examination, facial bones; less than 3 views ",,,32.08,308.86,152 CPT,70140,XR FACIAL BONES < 3 V,2908.365,2908.365,174.5,2472.15,34 CPT,70150,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,47.11,433.75,152 CPT,70150,XR FACIAL BONES 3 + V,2213.515,2213.515,132.81,1881.51,34 CPT,70160,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,37.76,332.75,152 CPT,70160,XR NASAL BONES COMP,1821.18,1821.18,109.26,1548.17,34 CPT,70170,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,57.57,2541.94,152 CPT,70190,Radiologic examination; optic foramina ,,,37.76,308.86,152 CPT,70200,"Radiologic examination; orbits, complete, minimum of 4 views ",2771.66,2771.66,48.11,433.75,152 CPT,70200,XR ORBITS 4 + V,2771.66,2771.66,166.3,2355.91,17 CPT,7020F,"Mammogram assessment category (eg, Mammography Quality Standards Act ºMQSA», Breast Imaging Reporting and Data System ºBI-RADS», or FDA approved equivalent categories) entered into an internal databas",,,0.1,0.13,12 CPT,70210,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,32.41,308.86,152 CPT,70210,XR SINUSES < 3 V,2185.3999999999996,2185.3999999999996,131.12,1857.6,34 CPT,70220,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,37.76,308.86,152 CPT,70220,XR SINUSES 3 + V,3570.215,3570.215,214.2,3034.91,34 CPT,70240,"Radiologic examination, sella turcica ",,,33.08,308.86,152 CPT,70250,"Radiologic examination, skull; less than 4 views ",,,36.09,433.75,152 CPT,70250,XR SKULL < 4 V,2140.785,2140.785,128.44,1819.75,34 CPT,7025F,Patient information entered into a reminder system with a target due date for the next mammogram (RAD) ,,,0.1,0.13,12 CPT,70260,"Radiologic examination, skull; complete, minimum of 4 views ",,,44.78,433.75,152 CPT,70260,XR SKULL 4 + V,3995.5600000000004,3995.5600000000004,239.72,3396.46,34 CPT,70300,"Radiologic examination, teeth; single view ",,,13.03,308.86,152 CPT,70310,"Radiologic examination, teeth; partial examination, less than full mouth ",,,39.43,901.86,152 CPT,70320,"Radiologic examination, teeth; complete, full mouth ",,,52.79,901.86,152 CPT,70328,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,34.75,308.86,152 CPT,70330,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",3263.4,3263.4,53.13,471.31,152 CPT,70330,XR TMJ BI,3263.4,3263.4,195.8,2773.89,17 CPT,70332,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,82.86,901.86,152 CPT,70336,MRI TMJ,16191.69,16191.69,971.5,13762.94,14 CPT,70336,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",16191.69,16191.69,233.47,2739.0,95 CPT,70350,"Cephalogram, orthodontic ",,,16.38,308.86,152 CPT,70355,"Orthopantogram (eg, panoramic x-ray) ",,,18.04,308.86,152 CPT,70360,"Radiologic examination; neck, soft tissue ",,,31.41,308.86,152 CPT,70360,XR NECK SOFT TISSUE,1729.495,1729.495,103.76,1470.14,34 CPT,70370,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,86.58,894.43,152 CPT,70371,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,108.59,901.86,152 CPT,70380,"Radiologic examination, salivary gland for calculus ",,,37.76,332.75,152 CPT,70390,"Sialography, radiological supervision and interpretation ",,,115.94,1149.05,152 CPT,70450,CT HEAD/BRAIN W/O CONT,10014.155,10014.155,600.83,8512.27,28 CPT,70450,"Computed tomography, head or brain; without contrast material ",,,104.75,2106.0,83 CPT,70460,CT HEAD/BRAIN W/CONT,15400.935000000001,15400.935000000001,924.04,13091.01,28 CPT,70460,"Computed tomography, head or brain; with contrast material(s) ",,,152.36,2106.0,83 CPT,70470,CT HD/BR W&W/O CONT,17300.325,17300.325,1038.0,14705.49,28 CPT,70470,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,70471,CTA H&N W/CON+NONCON IMG,31670.0,31670.0,1900.2,26919.5,80 CPT,70471,"Computed tomographic angiography (CTA), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing ",,,766.32,1518.39,5 CPT,70472,"Computed tomographic (CT) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent CT or CT angiography of the same anatomy (List separately in a",,,261.57,518.27,5 CPT,70473,"Computed tomographic (CT) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent CT or CT angiography of the same anatomy ",,,385.28,763.39,5 CPT,70480,CT ORBIT/SELLA/IAC WO,15775.75,15775.75,946.54,13409.39,14 CPT,70480,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",15775.75,15775.75,104.75,2106.0,83 CPT,70481,CT ORBIT/SELLA/IAC W,17005.370000000003,17005.370000000003,1020.31,14454.71,28 CPT,70481,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,175.06,2106.0,83 CPT,70482,CT ORBIT/SELLA/IAC W&WO,18451.465,18451.465,1107.07,15683.96,28 CPT,70482,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,70486,CT MAXIFAC W/O CNT,12010.89,12010.89,720.64,10209.48,28 CPT,70486,"Computed tomography, maxillofacial area; without contrast material ",,,104.75,2106.0,83 CPT,70487,CT MAXIFAC W/CONTRAST,13169.64,13169.64,790.17,11194.31,28 CPT,70487,"Computed tomography, maxillofacial area; with contrast material(s) ",,,156.38,2106.0,83 CPT,70488,CT MAXIFAC W&W/O CONT,13889.755000000001,13889.755000000001,833.37,11806.44,28 CPT,70488,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,70490,CT NECK W/O CONTRAST,14652.685000000001,14652.685000000001,879.15,12455.0,28 CPT,70490,"Computed tomography, soft tissue neck; without contrast material ",,,104.75,2106.0,83 CPT,70491,CT NECK W/CONTRAST,15677.145,15677.145,940.63,13325.59,28 CPT,70491,"Computed tomography, soft tissue neck; with contrast material(s) ",,,175.06,2106.0,83 CPT,70492,CT NECK W&W/O CONT,15820.23,15820.23,949.21,13447.2,28 CPT,70492,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,70496,CTA HEAD,12961.470000000001,12961.470000000001,777.68,11017.3,28 CPT,70496,CTA HEAD VIZ AI TECH,14224.01,14224.01,853.43,12090.6,28 CPT,70496,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,70498,CTA NECK,12961.470000000001,12961.470000000001,777.68,11017.3,28 CPT,70498,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,70540,MRI OR/FCE/NCK W/O CONT,17691.97,17691.97,1061.52,15038.17,14 CPT,70540,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",17691.97,17691.97,233.23,2739.0,95 CPT,70542,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,276.66,2739.0,95 CPT,70543,MRI OR/FCE/NCK W&WO,26021.63,26021.63,1561.3,22118.39,14 CPT,70543,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",26021.63,26021.63,349.16,2739.0,95 CPT,70544,MRA HD W/O CONT,18939.79,18939.79,1136.39,16098.82,14 CPT,70544,"Magnetic resonance angiography, head; without contrast material(s) ",18939.79,18939.79,222.2,2739.0,95 CPT,70545,"Magnetic resonance angiography, head; with contrast material(s) ",,,234.23,2739.0,95 CPT,70546,MRA HD W&WO CONTRAST,21079.61,21079.61,1264.78,17917.67,14 CPT,70546,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",21079.61,21079.61,340.15,2739.0,95 CPT,70547,MRA NECK W/O CONT,18939.79,18939.79,1136.39,16098.82,14 CPT,70547,"Magnetic resonance angiography, neck; without contrast material(s) ",18939.79,18939.79,222.54,2739.0,95 CPT,70548,"Magnetic resonance angiography, neck; with contrast material(s) ",,,253.6,2739.0,95 CPT,70549,MRA NECK W&WO CONT,28512.47,28512.47,1710.75,24235.6,14 CPT,70549,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",28512.47,28512.47,356.19,2739.0,95 CPT,70551,MRI BRAIN W/O CONTRAST,17453.95,17453.95,1047.24,14835.86,14 CPT,70551,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",17453.95,17453.95,202.15,2739.0,95 CPT,70552,MRI BRAIN W/CONTRAST,18326.7,18326.7,1099.6,15577.69,14 CPT,70552,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",18326.7,18326.7,278.66,2739.0,95 CPT,70553,MRI BRAIN W&WO CONT,32201.85,32201.85,1932.11,27371.57,14 CPT,70553,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",32201.85,32201.85,328.11,2739.0,95 CPT,70554,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,233.47,2739.0,95 CPT,70555,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,277.39,2739.0,41 CPT,70557,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,875.32,2739.0,41 CPT,70558,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,355.2,2739.0,41 CPT,70559,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,355.2,2739.0,41 CPT,71045,CHEST XRAY 1 V,1716.665,1716.665,103.0,1459.19,34 CPT,71045,"Radiologic examination, chest; single view ",,,25.73,308.86,152 CPT,71046,CHEST XRAY 2 V,1933.62,1933.62,116.01,1643.7,34 CPT,71046,"Radiologic examination, chest; 2 views ",,,33.75,308.86,152 CPT,71047,CHEST XRAY 3 V,2107.775,2107.775,126.45,1791.86,34 CPT,71047,"Radiologic examination, chest; 3 views ",,,42.44,329.02,152 CPT,71048,CHEST XRAY 4+,2209.66,2209.66,132.58,1878.21,17 CPT,71048,"Radiologic examination, chest; 4 or more views ",2209.66,2209.66,45.78,433.75,152 CPT,71100,"Radiologic examination, ribs, unilateral; 2 views ",,,36.75,308.86,152 CPT,71100,XR RIBS UNI 2 V LT,2356.525,2356.525,141.39,2003.07,34 CPT,71100,XR RIBS UNI 2 V RT,2356.525,2356.525,141.39,2003.07,34 CPT,71101,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,42.44,433.75,152 CPT,71101,XR RIBS UNI W/CXR 3+V LT,4878.035,4878.035,292.67,4146.48,34 CPT,71101,XR RIBS UNI W/CXR 3+V RT,4878.035,4878.035,292.67,4146.48,34 CPT,71110,"Radiologic examination, ribs, bilateral; 3 views ",,,44.1,433.75,152 CPT,71110,XR RIBS BI 3 V,4878.035,4878.035,292.67,4146.48,34 CPT,71111,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,52.79,433.75,152 CPT,71111,XR RIBS BI W/CXR 4 + V,2487.92,2487.92,149.26,2114.89,34 CPT,71120,"Radiologic examination; sternum, minimum of 2 views ",,,33.75,308.86,152 CPT,71120,XR STERNUM 2 + V,2137.11,2137.11,128.21,1816.76,34 CPT,71130,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",2290.13,2290.13,41.44,347.79,152 CPT,71130,XR SC JOINTS 3 + V,2290.13,2290.13,137.41,1946.61,17 CPT,71250,CT CHEST W/O CONTRAST,12981.994999999999,12981.994999999999,778.92,11034.72,28 CPT,71250,"Computed tomography, thorax, diagnostic; without contrast material ",,,104.75,2106.0,83 CPT,71260,CT CHEST W/CONTRAST,13662.235,13662.235,819.73,11613.02,28 CPT,71260,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,171.74,2106.0,83 CPT,71270,CT CHEST W&W/O CONT,13798.275,13798.275,827.89,11728.58,28 CPT,71270,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,71271,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,104.75,1361.0,71 CPT,71271,LUNG CA SCREEN WO CON,1363.405,1363.405,81.79,1159.04,34 CPT,71275,CTA CHEST,20534.985,20534.985,1232.1,17454.78,28 CPT,71275,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,71550,MRI CHEST W/O CONT,18791.93,18791.93,1127.52,15973.14,14 CPT,71550,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",18791.93,18791.93,233.47,2739.0,95 CPT,71551,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,385.25,2900.29,95 CPT,71552,MRI CHEST W&WO CONT,23100.42,23100.42,1386.03,19635.36,14 CPT,71552,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",23100.42,23100.42,366.42,2739.0,95 CPT,71555,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,250.58,2739.0,43 CPT,72020,"Radiologic examination, spine, single view, specify level ",890.25,890.25,24.39,308.86,152 CPT,72020,XR SPINE 1 V SPEC LEVEL,890.25,890.25,53.41,756.71,17 CPT,72040,"Radiologic examination, spine, cervical; 2 or 3 views ",,,39.76,321.57,152 CPT,72040,XR C-SPINE 2-3 VIEWS,2172.575,2172.575,130.35,1846.74,34 CPT,72050,"Radiologic examination, spine, cervical; 4 or 5 views ",4062.97,4062.97,53.46,448.81,152 CPT,72050,XR C-SPINE 4-5 V,4062.97,4062.97,243.78,3453.52,17 CPT,72052,"Radiologic examination, spine, cervical; 6 or more views ",,,62.49,534.93,152 CPT,72052,XR C-SPINE 6 + V,4506.46,4506.46,270.37,3830.73,34 CPT,72070,"Radiologic examination, spine; thoracic, 2 views ",,,33.08,433.75,152 CPT,72072,"Radiologic examination, spine; thoracic, 3 views ",,,39.43,433.75,152 CPT,72072,XR T-SPINE 3 VIEWS,3563.505,3563.505,213.81,3029.03,34 CPT,72074,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,44.44,433.75,152 CPT,72080,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,34.75,308.86,152 CPT,72080,XR T-L-SPINE 2 VIEWS,3998.005,3998.005,239.87,3398.45,34 CPT,72081,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",931.12,931.12,42.78,336.48,152 CPT,72081,XR SPINE 1 VIEW,931.12,931.12,55.87,791.45,17 CPT,72082,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,70.5,617.32,152 CPT,72082,XR SPINE 2 OR 3 VIEWS,1913.445,1913.445,114.8,1626.52,34 CPT,72083,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",3523.96,3523.96,79.19,688.53,152 CPT,72083,XR SPINE 4 OR 5 VIEWS,3523.96,3523.96,211.44,2995.37,17 CPT,72084,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,98.9,879.39,152 CPT,72100,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.1,433.75,152 CPT,72100,XR L-SPINE 2/3 VIEWS,2222.67,2222.67,133.35,1889.47,34 CPT,72110,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,51.45,433.91,152 CPT,72110,XR L-SPINE 4 + VIEWS,4139.79,4139.79,248.38,3518.97,34 CPT,72114,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,61.48,531.2,152 CPT,72120,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,40.76,433.75,152 CPT,72125,CT C-SPINE W/O CONTRAST,15400.935000000001,15400.935000000001,924.04,13091.01,28 CPT,72125,"Computed tomography, cervical spine; without contrast material ",,,104.75,2106.0,83 CPT,72126,CT C-SPINE W/CONTRAST,18746.42,18746.42,1124.78,15934.6,28 CPT,72126,"Computed tomography, cervical spine; with contrast material ",,,173.41,2106.0,83 CPT,72127,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,72128,CT T-SPINE W/O CONTRAST,17524.925,17524.925,1051.49,14896.23,28 CPT,72128,"Computed tomography, thoracic spine; without contrast material ",,,104.75,2106.0,83 CPT,72129,CT T-SPINE W/CONTRAST,15868.31,15868.31,952.1,13488.06,14 CPT,72129,"Computed tomography, thoracic spine; with contrast material ",15868.31,15868.31,174.75,2106.0,83 CPT,72130,CT T-SPINE W&W/O CONT,18492.51,18492.51,1109.55,15718.71,28 CPT,72130,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,72131,CT L-SPINE W/O CONTRAST,13909.105,13909.105,834.53,11822.98,28 CPT,72131,"Computed tomography, lumbar spine; without contrast material ",,,104.75,2106.0,83 CPT,72132,CT L-SPINE W/CONTRAST,15400.935000000001,15400.935000000001,924.04,13091.01,28 CPT,72132,"Computed tomography, lumbar spine; with contrast material ",,,173.75,2106.0,83 CPT,72133,CT L-SPINE W&W/O CONT,19844.78,19844.78,1190.67,16868.26,28 CPT,72133,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,72141,MRI C-SPINE W/O CONT,18977.06,18977.06,1138.62,16130.5,14 CPT,72141,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",18977.06,18977.06,196.48,2739.0,95 CPT,72142,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,284.01,2739.0,95 CPT,72146,MRI T-SPINE W/O CONT,18442.1,18442.1,1106.53,15675.78,14 CPT,72146,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",18442.1,18442.1,196.14,2739.0,95 CPT,72147,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,281.34,2739.0,95 CPT,72148,MRI L-SPINE W/O CONT,18235.34,18235.34,1094.12,15500.04,14 CPT,72148,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",18235.34,18235.34,197.14,2739.0,95 CPT,72149,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,279.0,2739.0,95 CPT,72156,MRI C-SPINE W&W/O CONT,34340.47,34340.47,2060.43,29189.4,14 CPT,72156,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",34340.47,34340.47,329.79,2739.0,95 CPT,72157,MRI T-SPINE W&W/O CONT,33586.73,33586.73,2015.2,28548.72,14 CPT,72157,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",33586.73,33586.73,330.45,2739.0,95 CPT,72158,MRI L-SPINE W&W/O CONT,33304.22,33304.22,1998.25,28308.59,14 CPT,72158,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",33304.22,33304.22,329.13,2739.0,95 CPT,72159,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,687.29,2739.0,41 CPT,72170,"Radiologic examination, pelvis; 1 or 2 views ",,,28.06,433.75,152 CPT,72170,XR PELVIS 1/2 VIEWS,2003.905,2003.905,120.23,1703.43,34 CPT,72190,"Radiologic examination, pelvis; complete, minimum of 3 views ",2585.17,2585.17,42.44,433.75,152 CPT,72190,XR PELVIS 3 + V,2585.17,2585.17,155.11,2197.39,17 CPT,72191,CTA PELVIS,20534.985,20534.985,1232.1,17454.78,28 CPT,72191,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,72192,CT PELVIS W/O CONTRAST,12264.23,12264.23,735.85,10424.65,28 CPT,72192,"Computed tomography, pelvis; without contrast material ",,,104.75,2106.0,83 CPT,72193,CT PELVIS W/CONTRAST,16066.525,16066.525,963.98,13656.67,28 CPT,72193,"Computed tomography, pelvis; with contrast material(s) ",,,175.06,2106.0,83 CPT,72194,CT PELVIS W&W/O CONT,16922.684999999998,16922.684999999998,1015.36,14384.35,28 CPT,72194,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,72195,MRI PELVIS W/O CONT,15576.19,15576.19,934.57,13239.76,14 CPT,72195,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",15576.19,15576.19,233.47,2739.0,95 CPT,72196,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,276.66,2739.0,95 CPT,72197,MRI PELVIS W&WO CONT,21416.21,21416.21,1284.97,18203.78,14 CPT,72197,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",21416.21,21416.21,347.16,2739.0,95 CPT,72198,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,252.91,2739.0,43 CPT,72200,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.08,433.75,152 CPT,72202,"Radiologic examination, sacroiliac joints; 3 or more views ",2246.7,2246.7,39.43,433.75,152 CPT,72202,XR SI JOINTS 3 + V,2246.7,2246.7,134.8,1909.69,17 CPT,72220,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,32.75,308.86,152 CPT,72220,XR SACRUM/COCCYX 2 + V,2075.405,2075.405,124.52,1764.22,34 CPT,72240,"Myelography, cervical, radiological supervision and interpretation ",9283.14,9283.14,112.26,2634.77,152 CPT,72240,XR MYELOGRAM C-SPINE,9283.14,9283.14,556.99,7890.67,17 CPT,72255,"Myelography, thoracic, radiological supervision and interpretation ",6797.58,6797.58,107.93,2634.77,152 CPT,72255,XR MYELOGRAM T-SPINE,6797.58,6797.58,407.85,5777.94,17 CPT,72265,"Myelography, lumbosacral, radiological supervision and interpretation ",5479.46,5479.46,109.26,2634.77,152 CPT,72265,XR MYELOGRAM L-SPINE,5479.46,5479.46,328.77,4657.54,17 CPT,72270,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",14318.11,14318.11,153.04,2634.77,152 CPT,72270,XR MYELOGR SPINE 2/M REG,14318.11,14318.11,859.09,12170.39,17 CPT,72285,"Discography, cervical or thoracic, radiological supervision and interpretation ",20775.94,20775.94,128.98,6653.88,152 CPT,72285,XR DISKGRPHY CERV/THOR,20775.94,20775.94,1246.56,17659.55,17 CPT,72295,"Discography, lumbar, radiological supervision and interpretation ",8109.33,8109.33,111.26,6653.88,152 CPT,72295,XR DISKOGRAPHY LUMBAR,8109.33,8109.33,486.56,6892.93,17 CPT,73000,"Radiologic examination; clavicle, complete ",,,32.41,308.86,152 CPT,73000,XR CLAVICLE COMP LT,1922.0149999999999,1922.0149999999999,115.31,1633.94,34 CPT,73000,XR CLAVICLE COMP RT,1922.0149999999999,1922.0149999999999,115.31,1633.94,34 CPT,73010,"Radiologic examination; scapula, complete ",,,23.73,433.75,152 CPT,73010,XR SCAPULA COMP BI,2044.8,2044.8,122.69,1738.08,17 CPT,73010,XR SCAPULA COMP LT,2044.845,2044.845,122.69,1738.16,34 CPT,73010,XR SCAPULA COMP RT,2044.845,2044.845,122.69,1738.16,34 CPT,73020,"Radiologic examination, shoulder; 1 view ",,,21.71,308.86,152 CPT,73020,XR SHOULDER 1 V LT,1871.28,1871.28,112.27,1590.66,34 CPT,73020,XR SHOULDER 1 V RT,1871.28,1871.28,112.27,1590.66,34 CPT,73030,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,34.75,308.86,152 CPT,73030,XR SHOULDER 2 + V BI,4784.63,4784.63,287.08,4066.94,17 CPT,73030,XR SHOULDER 2 + V LT,2393.79,2393.79,143.62,2034.89,34 CPT,73030,XR SHOULDER 2 + V RT,2393.79,2393.79,143.62,2034.89,34 CPT,73040,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,131.99,1477.76,152 CPT,73040,XR ARTHROGRAM SHLDR BI,4580.26,4580.26,274.82,3893.22,17 CPT,73040,XR ARTHROGRAM SHLDR LT,4580.26,4580.26,274.82,3893.22,17 CPT,73040,XR ARTHROGRAM SHLDR RT,4580.26,4580.26,274.82,3893.22,17 CPT,73050,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,28.74,308.86,152 CPT,73060,"Radiologic examination; humerus, minimum of 2 views ",,,32.08,308.86,152 CPT,73060,XR HUMERUS 2 + V LT,1922.0149999999999,1922.0149999999999,115.31,1633.94,34 CPT,73060,XR HUMERUS 2 + V RT,1922.0149999999999,1922.0149999999999,115.31,1633.94,34 CPT,73070,"Radiologic examination, elbow; 2 views ",,,29.4,308.86,152 CPT,73070,XR ELBOW 2 VIEWS LT,1774.1149999999998,1774.1149999999998,106.45,1508.0,34 CPT,73070,XR ELBOW 2 VIEWS RT,1774.1149999999998,1774.1149999999998,106.45,1508.0,34 CPT,73080,"Radiologic examination, elbow; complete, minimum of 3 views ",,,32.75,308.86,152 CPT,73080,XR ELBOW 3 + V LT,2042.395,2042.395,122.54,1736.08,34 CPT,73080,XR ELBOW 3 + V RT,2042.395,2042.395,122.54,1736.08,34 CPT,73085,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,100.24,1477.76,152 CPT,73085,XR ARTHROGRAM ELBOW BI,3047.54,3047.54,182.85,2590.41,17 CPT,73085,XR ARTHROGRAM ELBOW LT,3047.54,3047.54,182.85,2590.41,17 CPT,73085,XR ARTHROGRAM ELBOW RT,3047.54,3047.54,182.85,2590.41,17 CPT,73090,"Radiologic examination; forearm, 2 views ",,,29.4,308.86,152 CPT,73090,XR FOREARM 2 VIEWS LT,2038.72,2038.72,122.31,1733.09,34 CPT,73090,XR FOREARM 2 VIEWS RT,2038.72,2038.72,122.31,1733.09,34 CPT,73092,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,433.75,152 CPT,73092,XR UP EXTREM INFANT2V BI,2839.28,2839.28,170.36,2413.39,17 CPT,73092,XR UP EXTREM INFANT2V LT,1899.29,1899.29,113.96,1614.4,17 CPT,73092,XR UP EXTREM INFANT2V RT,1899.29,1899.29,113.96,1614.4,17 CPT,73100,"Radiologic examination, wrist; 2 views ",,,34.09,308.86,152 CPT,73100,XR WRIST 2 VIEWS LT,2860.08,2860.08,171.59,2431.31,34 CPT,73100,XR WRIST 2 VIEWS RT,2860.08,2860.08,171.59,2431.31,34 CPT,73110,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.1,362.7,152 CPT,73110,XR WRIST 3 + V LT,1915.9,1915.9,114.95,1628.52,34 CPT,73110,XR WRIST 3 + V RT,1915.9,1915.9,114.95,1628.52,34 CPT,73115,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,135.33,1477.76,152 CPT,73115,XR ARTHROGRAM WRIST BI,4580.26,4580.26,274.82,3893.22,17 CPT,73115,XR ARTHROGRAM WRIST LT,4580.26,4580.26,274.82,3893.22,17 CPT,73115,XR ARTHROGRAM WRIST RT,4580.26,4580.26,274.82,3893.22,17 CPT,73120,"Radiologic examination, hand; 2 views ",,,31.41,433.75,152 CPT,73120,XR HAND 2 V LT,1891.455,1891.455,113.48,1607.88,34 CPT,73120,XR HAND 2 V RT,1891.455,1891.455,113.48,1607.88,34 CPT,73130,"Radiologic examination, hand; minimum of 3 views ",,,37.09,314.12,152 CPT,73130,XR HAND 3 + V LT,2066.835,2066.835,124.0,1757.0,34 CPT,73130,XR HAND 3 + V RT,2066.835,2066.835,124.0,1757.0,34 CPT,73140,"Radiologic examination, finger(s), minimum of 2 views ",,,38.09,344.06,152 CPT,73140,XR FINGER(S) 2 + V LT,1594.2199999999998,1594.2199999999998,91.99,1407.03,34 CPT,73140,XR FINGER(S) 2 + V RT,1594.2199999999998,1594.2199999999998,91.99,1407.03,34 CPT,73200,CT UP EXTREM W/O CONT LT,12007.965,12007.965,720.46,10206.99,28 CPT,73200,CT UP EXTREM W/O CONT RT,12007.965,12007.965,720.46,10206.99,28 CPT,73200,"Computed tomography, upper extremity; without contrast material ",,,104.75,2106.0,83 CPT,73201,CT UP EXTREM W/CONT LT,6515.63,6515.63,390.94,5538.29,28 CPT,73201,CT UP EXTREM W/CONT RT,6515.63,6515.63,390.94,5538.29,28 CPT,73201,"Computed tomography, upper extremity; with contrast material(s) ",,,206.49,2106.0,83 CPT,73202,CT UP EXTRM W&W/O CON LT,12653.78,12653.78,759.23,10755.71,14 CPT,73202,CT UP EXTRM W&W/O CON RT,12653.78,12653.78,759.23,10755.71,14 CPT,73202,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,73206,CTA UPPER EXTREMITY LT,17863.225,17863.225,1035.55,15697.25,28 CPT,73206,CTA UPPER EXTREMITY RT,17863.225,17863.225,1035.55,15697.25,28 CPT,73206,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,73218,MRI UPPER EX W/O CONT LT,10003.04,10003.04,600.18,8502.58,14 CPT,73218,MRI UPPER EX W/O CONT RT,10003.04,10003.04,600.18,8502.58,14 CPT,73218,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,233.47,2739.0,95 CPT,73219,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,341.81,2739.0,95 CPT,73220,MRI UP EX W&WO CONT LT,14543.55,14543.55,872.61,12362.02,14 CPT,73220,MRI UP EX W&WO CONT RT,14543.55,14543.55,872.61,12362.02,14 CPT,73220,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,366.42,2739.0,95 CPT,73221,MRI UP JNT W/O CONT LT,19145.36,19145.36,1148.72,16273.56,14 CPT,73221,MRI UP JNT W/O CONT RT,19145.36,19145.36,1148.72,16273.56,14 CPT,73221,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,209.16,2739.0,95 CPT,73222,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,323.1,2900.29,95 CPT,73223,MRI UP JNT W&WO CONT LT,21415.01,21415.01,1284.9,18202.76,14 CPT,73223,MRI UP JNT W&WO CONT RT,21415.01,21415.01,1284.9,18202.76,14 CPT,73223,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,366.42,2739.0,95 CPT,73225,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,661.71,2739.0,41 CPT,73501,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.08,308.86,152 CPT,73501,XR HIP W PEL UNI 1 V LT,1880.815,1880.815,108.52,1659.99,34 CPT,73501,XR HIP W PEL UNI 1 V RT,1952.93,1952.93,117.18,1659.99,17 CPT,73502,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,47.11,403.96,152 CPT,73502,XR HIP W PEL UN 2-3 V LT,2121.54,2121.54,122.39,1872.79,34 CPT,73502,XR HIP W PEL UN 2-3 V RT,2121.54,2121.54,122.39,1872.79,34 CPT,73503,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,59.48,512.57,152 CPT,73521,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,41.44,433.75,152 CPT,73522,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,53.8,441.36,152 CPT,73522,XR HIP W PEL BI 3-4 VIEW,2429.25,2429.25,145.75,2064.95,34 CPT,73523,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,62.15,520.02,152 CPT,73523,XR HIP W PEL BI MIN5 VW,3001.86,3001.86,180.09,2551.83,34 CPT,73525,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,129.31,1477.76,152 CPT,73525,XR ARTHROGRAM HIP BI,4580.26,4580.26,274.82,3893.22,17 CPT,73525,XR ARTHROGRAM HIP LT,4580.26,4580.26,274.82,3893.22,17 CPT,73525,XR ARTHROGRAM HIP RT,4580.26,4580.26,274.82,3893.22,17 CPT,73551,"Radiologic examination, femur; 1 view ",,,29.4,308.86,152 CPT,73551,XR FEMUR 1 VIEW LT,1449.69,1449.69,86.98,1232.24,17 CPT,73551,XR FEMUR 1 VIEW RT,1449.69,1449.69,86.98,1232.24,17 CPT,73552,"Radiologic examination, femur; minimum 2 views ",,,35.75,308.86,152 CPT,73552,XR FEMUR MIN 2 V LT,1953.165,1953.165,117.18,1660.39,34 CPT,73552,XR FEMUR MIN 2 V RT,1953.165,1953.165,117.18,1660.39,34 CPT,73560,"Radiologic examination, knee; 1 or 2 views ",,,34.41,308.86,152 CPT,73560,XR KNEE 1 OR 2 V LT,1838.27,1838.27,110.28,1562.78,34 CPT,73560,XR KNEE 1 OR 2 V RT,1838.27,1838.27,110.28,1562.78,34 CPT,73562,"Radiologic examination, knee; 3 views ",,,40.76,355.24,152 CPT,73562,XR KNEE 3 V LT,2246.5249999999996,2246.5249999999996,134.78,1909.69,34 CPT,73562,XR KNEE 3 V RT,2246.5249999999996,2246.5249999999996,134.78,1909.69,34 CPT,73564,"Radiologic examination, knee; complete, 4 or more views ",,,46.78,433.75,152 CPT,73564,XR KNEE 4 + V LT,2919.9750000000004,2919.9750000000004,175.19,2482.11,34 CPT,73564,XR KNEE 4 + V RT,2919.9750000000004,2919.9750000000004,175.19,2482.11,34 CPT,73565,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.1,358.97,152 CPT,73565,XR KNEE AP STAND BI,4026.115,4026.115,241.56,3422.36,34 CPT,73580,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,110.94,1477.76,152 CPT,73580,XR ARTHROGRAM KNEE BI,8796.5,8796.5,527.79,7477.02,17 CPT,73580,XR ARTHROGRAM KNEE LT,4580.26,4580.26,274.82,3893.22,17 CPT,73580,XR ARTHROGRAM KNEE RT,4580.26,4580.26,274.82,3893.22,17 CPT,73590,"Radiologic examination; tibia and fibula, 2 views ",,,31.74,308.86,152 CPT,73590,XR TIBIA/FIBULA 2 V BI,4368.23,4368.23,262.09,3713.0,17 CPT,73590,XR TIBIA/FIBULA 2 V LT,2185.3999999999996,2185.3999999999996,131.12,1857.6,34 CPT,73590,XR TIBIA/FIBULA 2 V RT,2185.3999999999996,2185.3999999999996,131.12,1857.6,34 CPT,73592,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,80.9,308.86,152 CPT,73592,XR TIB/FIB INFANT 2V BI,2098.62,2098.62,125.91,1783.89,34 CPT,73592,XR TIB/FIB INFNT 2V LT,1711.53,1711.53,102.69,1454.8,17 CPT,73592,XR TIB/FIB INFNT 2V RT,1711.53,1711.53,102.69,1454.8,17 CPT,73600,"Radiologic examination, ankle; 2 views ",,,32.41,308.86,152 CPT,73600,XR ANKLE 2 VIEWS LT,1890.235,1890.235,113.41,1606.8,34 CPT,73600,XR ANKLE 2 VIEWS RT,1890.235,1890.235,113.41,1606.8,34 CPT,73610,"Radiologic examination, ankle; complete, minimum of 3 views ",,,36.75,317.84,152 CPT,73610,XR ANKLE 3 + V LT,2315.575,2315.575,138.93,1968.32,34 CPT,73610,XR ANKLE 3 + V RT,2315.575,2315.575,138.93,1968.32,34 CPT,73615,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,128.31,1477.76,152 CPT,73620,"Radiologic examination, foot; 2 views ",,,28.4,308.86,152 CPT,73620,XR FOOT 2 VIEWS LT,1975.785,1975.785,118.54,1679.53,34 CPT,73620,XR FOOT 2 VIEWS RT,1975.785,1975.785,118.54,1679.53,34 CPT,73630,"Radiologic examination, foot; complete, minimum of 3 views ",,,34.41,308.86,152 CPT,73630,XR FOOT 3 + V LT,2383.4049999999997,2383.4049999999997,143.0,2025.92,34 CPT,73630,XR FOOT 3 + V RT,2383.4049999999997,2383.4049999999997,143.0,2025.92,34 CPT,73650,"Radiologic examination; calcaneus, minimum of 2 views ",,,28.74,308.86,152 CPT,73650,XR CALCANEUS 2 + V LT,1891.455,1891.455,113.48,1607.88,34 CPT,73650,XR CALCANEUS 2 + V RT,1891.455,1891.455,113.48,1607.88,34 CPT,73660,"Radiologic examination; toe(s), minimum of 2 views ",,,29.4,308.86,152 CPT,73660,XR TOE(S) 2 + V LT,1847.3000000000002,1847.3000000000002,106.57,1630.68,34 CPT,73660,XR TOE(S) 2 + V RT,1847.3000000000002,1847.3000000000002,106.57,1630.68,34 CPT,73700,CT LOWER EXTRM W/O C LT,6515.63,6515.63,390.94,5538.29,28 CPT,73700,CT LOWER EXTRM W/O C RT,6515.63,6515.63,390.94,5538.29,28 CPT,73700,"Computed tomography, lower extremity; without contrast material ",,,104.75,2106.0,83 CPT,73701,CT LOWER EXTRM W/CON BI,21967.0,21967.0,1318.01,18672.12,28 CPT,73701,CT LOWER EXTRM W/CON LT,10985.26,10985.26,659.11,9337.52,28 CPT,73701,CT LOWER EXTRM W/CON RT,10985.26,10985.26,659.11,9337.52,28 CPT,73701,"Computed tomography, lower extremity; with contrast material(s) ",,,171.41,2106.0,83 CPT,73702,CT LW EXTRM W&W/O CON LT,12653.605,12653.605,759.21,10755.71,28 CPT,73702,CT LW EXTRM W&W/O CON RT,12653.605,12653.605,759.21,10755.71,28 CPT,73702,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,73706,CTA LOW EXTREMITY BI,19079.5,19079.5,1144.75,16217.8,28 CPT,73706,CTA LOW EXTREMITY LT,19079.5,19079.5,1144.75,16217.8,28 CPT,73706,CTA LOW EXTREMITY RT,19079.5,19079.5,1144.75,16217.8,28 CPT,73706,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,73718,MRI LOW EXT W/O CONT LT,10003.04,10003.04,600.18,8502.58,14 CPT,73718,MRI LOW EXT W/O CONT RT,10003.04,10003.04,600.18,8502.58,14 CPT,73718,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,230.21,2739.0,95 CPT,73719,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,271.31,2739.0,95 CPT,73720,MRI LOW EXT W&WO CONT LT,14024.22,14024.22,841.45,11920.59,14 CPT,73720,MRI LOW EXT W&WO CONT RT,14024.22,14024.22,841.45,11920.59,14 CPT,73720,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,347.5,2739.0,95 CPT,73721,MRI LW JNT W/O CONT BI,31159.6,31159.6,1869.58,26485.66,14 CPT,73721,MRI LW JNT W/O CONT LT,18384.41,18384.41,1103.06,15626.75,14 CPT,73721,MRI LW JNT W/O CONT RT,18384.41,18384.41,1103.06,15626.75,14 CPT,73721,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,208.84,2739.0,95 CPT,73722,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,323.44,2900.29,95 CPT,73723,MRI LW JNT W&WO CONT LT,19719.98,19719.98,1183.2,16761.98,14 CPT,73723,MRI LW JNT W&WO CONT RT,19719.98,19719.98,1183.2,16761.98,14 CPT,73723,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,366.42,2739.0,95 CPT,73725,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,252.93,2739.0,43 CPT,74018,ABD XR 1V,1423.94,1423.94,85.42,1210.52,34 CPT,74018,"Radiologic examination, abdomen; 1 view ",,,30.08,308.86,152 CPT,74019,ABD XR 2V,1896.9450000000002,1896.9450000000002,113.8,1612.58,34 CPT,74019,"Radiologic examination, abdomen; 2 views ",,,36.75,433.75,152 CPT,74021,ABD XR 3+V,1995.33,1995.33,119.7,1696.24,34 CPT,74021,"Radiologic examination, abdomen; 3 or more views ",,,43.1,433.75,152 CPT,74022,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,50.13,433.75,152 CPT,74022,XR ABD ACUTE W/CHEST,3507.2799999999997,3507.2799999999997,210.43,2981.26,34 CPT,74150,CT ABDOMEN W/O CONT,16054.785,16054.785,963.28,13646.69,28 CPT,74150,"Computed tomography, abdomen; without contrast material ",,,104.75,2106.0,83 CPT,74160,CT ABDOMEN W/CONT,17161.940000000002,17161.940000000002,1029.71,14587.74,28 CPT,74160,"Computed tomography, abdomen; with contrast material(s) ",,,175.06,2106.0,83 CPT,74170,CT ABDOMEN W&WO CONT,18010.48,18010.48,1080.63,15308.96,28 CPT,74170,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,175.06,2106.0,83 CPT,74174,CTA ABD&PEL W CONT,25742.905,25742.905,1544.56,21881.62,28 CPT,74174,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,366.42,2106.0,83 CPT,74175,CTA ABDOMEN,1603.83,1603.83,96.22,1363.4,28 CPT,74175,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,74176,CT ABD&PELVIS W/O CONT,28317.845,28317.845,1699.06,24070.27,28 CPT,74176,"Computed tomography, abdomen and pelvis; without contrast material ",,,188.11,2106.0,83 CPT,74177,CT ABD&PELVIS W/CONT,33231.979999999996,33231.979999999996,1993.91,28247.28,28 CPT,74177,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,312.08,2106.0,83 CPT,74178,CT ABD&PELVIS W&WO CONT,34935.505000000005,34935.505000000005,2096.13,29695.2,28 CPT,74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,350.18,2106.0,83 CPT,74181,MRI ABDOMEN W/O CONT,26401.51,26401.51,1584.09,22441.28,14 CPT,74181,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",26401.51,26401.51,201.81,2739.0,95 CPT,74182,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,311.75,2739.0,95 CPT,74183,MRI ABDOMEN W&WO CONT,28516.08,28516.08,1710.96,24238.67,14 CPT,74183,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",28516.08,28516.08,348.5,2739.0,95 CPT,74185,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,251.92,2739.0,43 CPT,74190,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",1352.5,1352.5,81.04,5338.91,152 CPT,74190,XR PERITONEOGRAM,1352.5,1352.5,81.15,1149.63,17 CPT,74210,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,94.89,800.86,152 CPT,74220,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",4121.72,4121.72,97.56,808.32,152 CPT,74220,XR ESOPHAGUS,4121.72,4121.72,247.3,3503.46,17 CPT,74221,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,109.93,898.16,152 CPT,74230,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",3925.02,3925.02,124.96,1175.27,152 CPT,74230,XR SWLW FUNC W/C&V,3925.02,3925.02,235.5,3336.27,17 CPT,74235,"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation ",,,107.84,1168.22,17 CPT,74240,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5225.28,5225.28,122.96,988.0,152 CPT,74240,XR UGI SNGL CONTRAST,5225.28,5225.28,313.52,4441.49,17 CPT,74246,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",6364.59,6364.59,139.34,1137.87,152 CPT,74246,XR UGI DBL CONTRAST,6364.59,6364.59,381.88,5409.9,17 CPT,74248,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,82.53,579.92,71 CPT,74250,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",5600.79,5600.79,121.96,980.55,152 CPT,74250,XR SMALL INTESTINE,5600.79,5600.79,336.05,4760.67,17 CPT,74251,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",6404.19,6404.19,175.06,1976.54,152 CPT,74251,XR SMALL BOWEL/ENTERO,6404.19,6404.19,384.25,5443.56,17 CPT,74261,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,104.75,2106.0,83 CPT,74262,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,175.06,2106.0,83 CPT,74263,"Computed tomographic (CT) colonography, screening, including image postprocessing ",,,1007.0,2775.77,29 CPT,74270,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5055.4,5055.4,153.7,1223.99,152 CPT,74270,XR CONT ENEMA W/WO KUB,5055.4,5055.4,303.32,4297.09,17 CPT,74280,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",6608.55,6608.55,175.06,1886.69,152 CPT,74280,XR ENEMA W/ AIR,6608.55,6608.55,396.51,5617.27,17 CPT,74283,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,175.06,1815.48,152 CPT,74290,"Cholecystography, oral contrast ",,,85.2,823.22,152 CPT,74300,"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation ",5190.79,5190.79,32.98,267.66,17 CPT,74300,XR CHOLANG INTRAOP,5190.79,5190.79,311.45,4412.17,31 CPT,74301,"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (List separately in addition to code for primary procedure) ",,,19.03,208.3,17 CPT,74328,"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation ",,,64.06,591.63,17 CPT,74329,"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation ",,,64.06,468.91,17 CPT,74330,"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation ",5665.94,5665.94,81.82,859.29,17 CPT,74330,XR ERCP,5665.94,5665.94,339.96,4816.05,31 CPT,74340,"Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation ",1376.89,1376.89,48.84,859.29,17 CPT,74340,XR INTRO LONG GI TUBE,1376.89,1376.89,82.61,1170.36,31 CPT,74355,"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation ",2826.58,2826.58,68.5,1086.36,17 CPT,74355,XR PLACE ENTERO TUBE,2826.58,2826.58,169.59,2402.59,31 CPT,74360,"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation ",,,50.74,941.15,17 CPT,74363,"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation ",,,77.39,848.51,17 CPT,74400,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,135.33,1291.34,152 CPT,74410,"Urography, infusion, drip technique and/or bolus technique; ",,,142.0,1343.78,152 CPT,74415,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,151.36,1512.28,152 CPT,74420,"Urography, retrograde, with or without KUB ",10289.62,10289.62,77.19,587.37,152 CPT,74420,XR UROGRAM RETRO,10289.62,10289.62,617.38,8746.18,17 CPT,74425,"Urography, antegrade, radiological supervision and interpretation ",,,135.99,1477.76,152 CPT,74430,"Cystography, minimum of 3 views, radiological supervision and interpretation ",5539.48,5539.48,41.44,1477.76,152 CPT,74430,XR CYSTOGRAM 3 + V,5539.48,5539.48,332.37,4708.56,17 CPT,74440,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,97.56,913.2,152 CPT,74445,"Corpora cavernosography, radiological supervision and interpretation ",,,104.75,1201.49,152 CPT,74450,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,81.38,2541.94,152 CPT,74455,"Urethrocystography, voiding, radiological supervision and interpretation ",5086.05,5086.05,104.25,1021.68,152 CPT,74455,XR CYSTOURETHRO VDNG,5086.05,5086.05,305.16,4323.14,17 CPT,74470,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,81.35,5338.91,152 CPT,74485,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,119.63,6855.9,152 CPT,74710,"PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION ",,,40.1,40.1,4 CPT,74712,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,233.47,2739.0,95 CPT,74713,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,204.49,2739.0,95 CPT,74740,"Hysterosalpingography, radiological supervision and interpretation ",4658.17,4658.17,66.83,901.86,152 CPT,74740,XR HYSTROSALPNGOGRAM,4658.17,4658.17,279.49,3959.44,17 CPT,74742,"Transcervical catheterization of fallopian tube, radiological supervision and interpretation ",,,55.81,602.81,17 CPT,74775,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,2541.94,152 CPT,75557,CAR MRI MORPH FUNC WO CM,25316.0,25316.0,1518.96,21518.6,14 CPT,75557,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,25316.0,25316.0,233.47,2739.0,95 CPT,75559,CAR MRI MRP FN WO CM STR,12856.0,12856.0,771.36,10927.6,14 CPT,75559,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,12856.0,12856.0,385.59,2739.0,95 CPT,75561,CAR MRI MRP FN WO/W CM,27685.0,27685.0,1661.1,23532.25,14 CPT,75561,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",27685.0,27685.0,366.42,2739.0,95 CPT,75563,CAR MRI MR FN WO/W CM ST,8285.0,8285.0,497.1,7042.25,14 CPT,75563,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",8285.0,8285.0,436.71,2739.0,95 CPT,75565,CAR MRI VELOCITY FLW MAP,5692.0,5692.0,341.52,4838.2,25 CPT,75565,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,5692.0,5692.0,73.59,2739.0,41 CPT,75571,CT HEART WO CN W QUAN CA,818.66,818.66,49.12,695.86,14 CPT,75571,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",818.66,818.66,86.58,2106.0,83 CPT,75572,CTHEART W CN STR MOR FNC,24558.62,24558.62,1473.52,20874.83,14 CPT,75572,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",24558.62,24558.62,175.06,2106.0,83 CPT,75573,CTHEART CONGENITL DISEAS,24558.62,24558.62,1473.52,20874.83,14 CPT,75573,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",24558.62,24558.62,175.06,2106.0,83 CPT,75574,CT HEART W CN ART/GRAFTS,1603.66,1603.66,96.22,1363.11,14 CPT,75574,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",1603.66,1603.66,175.06,2106.0,83 CPT,75577,"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomo",,,1672.88,3678.43,5 CPT,75580,NINVS CFFR SW ANLYS CTA,13107.5,13107.5,786.45,11141.38,35 CPT,75580,"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and repo",13107.5,13107.5,1753.28,3855.22,5 CPT,75600,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,182.78,10724.85,152 CPT,75600,SP AORTOGM TH W/O FILM,7599.71,7599.71,455.98,6459.75,34 CPT,75605,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,120.63,17787.26,152 CPT,75605,SP AORTOGM TH W/FILM,9488.14,9488.14,537.06,8521.45,34 CPT,75625,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,126.3,10724.85,152 CPT,75625,SP AORTOGM ABD W/FILM,12082.9,12082.9,724.97,10270.47,34 CPT,75625,SP AORTOGM ABD W/FILM 59,12082.9,12082.9,724.97,10270.47,17 CPT,75630,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,156.71,10724.85,152 CPT,75630,SP AORTOGM ABD W/RNF,12082.9,12082.9,724.97,10270.47,34 CPT,75630,SP AORTOGM ABD W/RNF 59,12082.9,12082.9,724.97,10270.47,17 CPT,75635,CTA ABD AORTA IF LWEX RO,18984.5,18984.5,1139.06,16137.02,28 CPT,75635,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,175.06,2106.0,83 CPT,75705,"Angiography, spinal, selective, radiological supervision and interpretation ",8922.95,8922.95,248.59,17787.26,152 CPT,75705,SP ANGIO SPINAL SELECT,8922.95,8922.95,535.38,7584.51,17 CPT,75710,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,150.36,10724.85,152 CPT,75710,SP ANGIO EXT UNI LT,11363.8,11363.8,447.55,12978.13,34 CPT,75710,SP ANGIO EXT UNI LT 59,7459.21,7459.21,447.55,6340.33,17 CPT,75710,SP ANGIO EXT UNI RT,11363.8,11363.8,447.55,12978.13,34 CPT,75710,SP ANGIO EXT UNI RT 59,7459.21,7459.21,447.55,6340.33,17 CPT,75716,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,162.39,10724.85,152 CPT,75716,SP ANGIO EXT BI,9160.525,9160.525,430.69,9471.41,34 CPT,75716,SP ANGIO EXT BI 59,11142.84,11142.84,668.57,9471.41,17 CPT,75726,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,170.08,17787.26,152 CPT,75726,SP ANG VISC SEL W/WO F,7599.71,7599.71,455.98,6459.75,34 CPT,75731,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,153.36,1084.9,152 CPT,75733,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,169.08,10724.85,152 CPT,75736,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",10608.94,10608.94,143.01,17787.26,152 CPT,75736,SP ANGIO PELVIC,10608.94,10608.94,636.54,9017.6,17 CPT,75741,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,129.98,10724.85,152 CPT,75741,SP ANGIO PULM SEL UNI LT,6138.0,6138.0,368.28,5217.3,17 CPT,75741,SP ANGIO PULM SEL UNI RT,6138.0,6138.0,368.28,5217.3,17 CPT,75743,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,147.69,10724.85,152 CPT,75743,SP ANGIO PULM SEL BI,12298.115,12298.115,726.2,10618.97,34 CPT,75743,SP ANGIO PULM SEL BI 59,12492.9,12492.9,749.57,10618.97,17 CPT,75746,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,134.99,905.21,152 CPT,75756,"Angiography, internal mammary, radiological supervision and interpretation ",,,161.73,10724.85,152 CPT,75774,"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List separately in addition to code for primary procedure) ",,,116.71,576.19,17 CPT,75774,SP ANGIO ADDL VESSEL,4016.355,4016.355,165.99,4476.24,62 CPT,75801,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,284.65,5971.8,152 CPT,75803,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,299.6,15538.49,152 CPT,75805,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,313.39,31631.61,152 CPT,75807,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,146.54,31631.61,152 CPT,75809,SP SHUNTOGM NONVASC,2550.69,2550.69,153.04,2168.09,17 CPT,75809,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",2550.69,2550.69,81.86,666.03,152 CPT,75810,"Splenoportography, radiological supervision and interpretation ",,,612.59,31631.61,152 CPT,75820,SP VENOGRAM EXT UNI LT,11035.55,11035.55,662.13,9380.22,17 CPT,75820,SP VENOGRAM EXT UNI LT59,11035.55,11035.55,662.13,9380.22,17 CPT,75820,SP VENOGRAM EXT UNI RT,11035.55,11035.55,662.13,9380.22,17 CPT,75820,SP VENOGRAM EXT UNI RT59,11035.55,11035.55,662.13,9380.22,17 CPT,75820,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,107.93,2440.07,152 CPT,75822,SP VENOGRAM EXT BI,8168.735000000001,8168.735000000001,438.13,7680.06,34 CPT,75822,SP VENOGRAM EXT BI 59,7302.11,7302.11,438.13,6206.79,17 CPT,75822,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,132.99,737.11,152 CPT,75825,SP VENOCAVAGM INF,8907.625,8907.625,439.35,8918.8,34 CPT,75825,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,114.28,10724.85,152 CPT,75827,SP VENOCAVAGM SUP,4197.08,4197.08,64.3,6224.16,34 CPT,75827,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,118.95,2440.07,152 CPT,75831,SP VENOGM RENAL UNI LT,6138.0,6138.0,368.28,5217.3,17 CPT,75831,SP VENOGM RENAL UNI RT,6138.0,6138.0,368.28,5217.3,17 CPT,75831,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,119.63,10724.85,152 CPT,75833,SP VENOGM RENAL BI,15144.49,15144.49,908.67,12872.82,17 CPT,75833,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",15144.49,15144.49,147.01,10724.85,152 CPT,75840,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,128.64,10724.85,152 CPT,75842,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,159.05,198.81,54 CPT,75860,SP VENOGM SIN/JUG CATH,7395.34,7395.34,443.72,6286.04,17 CPT,75860,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",7395.34,7395.34,125.64,10724.85,152 CPT,75870,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,155.7,1149.05,152 CPT,75872,"Venography, epidural, radiological supervision and interpretation ",,,128.64,2440.07,152 CPT,75880,"Venography, orbital, radiological supervision and interpretation ",,,107.93,2440.07,152 CPT,75885,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",2454.89,2454.89,136.66,10724.85,152 CPT,75885,SP PORTOGM W/HEMODYN,2454.89,2454.89,147.29,2086.66,17 CPT,75887,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,137.66,815.77,152 CPT,75889,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,123.63,10724.85,152 CPT,75891,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,124.3,10724.85,152 CPT,75893,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,103.91,17787.26,152 CPT,75894,SP TRANSCTH THPY EMBL,18089.855,18089.855,542.27,23070.54,62 CPT,75894,"Transcatheter therapy, embolization, any method, radiological supervision and interpretation ",,,130.66,10235.92,17 CPT,75898,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,133.71,31631.61,152 CPT,75898,SP TRANSCATH ANGIO F/U,3813.2599999999998,3813.2599999999998,164.92,4146.18,34 CPT,75901,"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation ",,,313.97,2432.93,17 CPT,75902,"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation ",,,106.57,845.72,17 CPT,75970,SP TRANSCATH BIOPSY,5848.58,5848.58,350.91,4971.29,31 CPT,75970,"Transcatheter biopsy, radiological supervision and interpretation ",5848.58,5848.58,71.67,4174.81,17 CPT,75984,"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation ",,,120.51,673.49,17 CPT,75984,SP CHG TUBE/DRN W/C,2763.3500000000004,2763.3500000000004,36.25,4184.18,62 CPT,75989,"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and inte",9497.73,9497.73,112.27,1361.0,17 CPT,75989,SP PERC DRAIN,9497.73,9497.73,569.86,8073.07,31 CPT,76000,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",3789.63,3789.63,42.78,310.26,152 CPT,76000,XR FLUOROSCOPY 0-60 MIN,3789.63,3789.63,227.38,3221.19,17 CPT,76010,"Radiologic examination from nose to rectum for foreign body, single view, child ",2125.36,2125.36,77.44,308.86,152 CPT,76010,XR WHOLE BODY FB 1 V,2125.36,2125.36,127.52,1806.56,17 CPT,76014,"MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging repo",,,43.1,94.78,5 CPT,76015,"MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging repo",,,94.83,208.52,5 CPT,76016,"MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examinatio",,,154.97,340.75,5 CPT,76017,"MR safety medical physics examination customization, planning and performance monitoring by medical physicist or MR safety expert, with review and analysis by physician or other qualified health care ",,,425.43,935.46,5 CPT,76018,"MR safety implant electronics preparation under supervision of physician or other qualified health care professional, including MR-specific programming of pulse generator and/or transmitter to verify ",,,161.55,355.23,5 CPT,76019,"MR safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medica",,,104.54,229.88,5 CPT,76080,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",3820.29,3820.29,59.81,1863.71,152 CPT,76080,XR ABSCESS/FIST/SIN,3820.29,3820.29,229.22,3247.25,17 CPT,76098,"Radiological examination, surgical specimen ",1549.31,1549.31,42.1,1863.71,152 CPT,76098,XR SURGICAL SPECIMEN,1549.31,1549.31,92.96,1316.91,17 CPT,76100,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,89.55,695.98,152 CPT,76120,"Cineradiography/videoradiography, except where specifically included ",,,104.75,1089.16,152 CPT,76125,Cineradiography/videoradiography to complement routine examination (List separately in addition to code for primary procedure) ,,,25.38,316.38,17 CPT,76140,"Consultation on X-ray examination made elsewhere, written report ",,,29.18,844.92,19 CPT,76145,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1578.1,3470.04,86 CPT,76376,"3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not",,,23.46,185.28,17 CPT,76377,3D OTH W POST IMG IND,1738.35,1738.35,30.96,2516.59,62 CPT,76377,"3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; req",,,55.81,473.17,17 CPT,76380,"Computed tomography, limited or localized follow-up study ",,,86.58,2106.0,83 CPT,76390,Magnetic resonance spectroscopy ,,,800.4,2739.0,41 CPT,76391,"Magnetic resonance (eg, vibration) elastography ",,,207.16,2739.0,95 CPT,76496,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,80.9,894.43,152 CPT,76497,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,80.9,2106.0,83 CPT,76498,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,80.9,2739.0,95 CPT,76499,Unlisted diagnostic radiographic procedure ,,,80.9,382.33,140 CPT,76506,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,104.75,958.05,72 CPT,76510,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,68.83,421.95,72 CPT,76511,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,56.8,433.75,72 CPT,76512,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,47.78,433.75,72 CPT,76513,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,74.85,486.35,72 CPT,76514,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.36,213.0,72 CPT,76516,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,46.45,433.75,72 CPT,76519,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,67.16,433.75,72 CPT,76529,Ophthalmic ultrasonic foreign body localization ,,,85.54,602.41,72 CPT,76536,US HEAD AND NECK,3587.25,3587.25,215.22,3049.35,32 CPT,76536,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,104.75,958.05,72 CPT,76604,US CHST W/MEDIASTINUM,5319.594999999999,5319.594999999999,319.16,4521.82,32 CPT,76604,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,56.8,433.75,72 CPT,76641,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,102.91,774.64,72 CPT,76642,US BRST BI W AX LTD,5958.12,5958.12,357.49,5064.4,16 CPT,76642,US BRST UNI LT W AX LTD,5892.62,5892.62,353.56,5008.73,16 CPT,76642,US BRST UNI RT W AX LTD,5892.62,5892.62,353.56,5008.73,16 CPT,76642,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,85.2,591.1,72 CPT,76700,US ABDOMEN COMPLETE,5487.485000000001,5487.485000000001,329.24,4664.55,32 CPT,76700,"Ultrasound, abdominal, real time with image documentation; complete ",,,104.75,894.43,72 CPT,76705,US ABDOMEN LTD,2624.65,2624.65,157.47,2231.05,32 CPT,76705,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,87.21,673.49,72 CPT,76706,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,104.75,909.34,72 CPT,76770,US RETROPERITONEAL COM,4506.29,4506.29,270.37,3830.44,32 CPT,76770,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,104.75,834.54,72 CPT,76775,US RETRO LTD,4926.875,4926.875,295.61,4187.92,32 CPT,76775,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,59.14,433.75,72 CPT,76776,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,104.75,1279.62,72 CPT,76800,US SPINAL CANAL,4966.09,4966.09,297.97,4221.18,16 CPT,76800,"Ultrasound, spinal canal and contents ",4966.09,4966.09,104.75,984.27,72 CPT,76801,US PREG 1ST TRIMTR,3817.89,3817.89,229.06,3245.35,32 CPT,76801,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,104.75,797.14,72 CPT,76802,US PRG 1ST TRI EA ADD,3071.36,3071.36,184.28,2610.66,21 CPT,76802,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",3071.36,3071.36,38.68,239.58,72 CPT,76805,US PREG AFTER 1ST TRI,4311.09,4311.09,258.67,3664.43,32 CPT,76805,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,104.75,991.73,72 CPT,76810,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,76.12,467.58,72 CPT,76811,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,149.05,934.23,72 CPT,76812,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,192.13,1216.0,72 CPT,76813,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,104.75,695.98,72 CPT,76814,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,51.37,317.84,72 CPT,76815,US PREGNANCY LTD,3022.585,3022.585,181.35,2569.24,32 CPT,76815,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,81.2,568.6,72 CPT,76816,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,104.75,778.37,72 CPT,76817,US PREG UT TRANSVAGINAL,2992.955,2992.955,179.57,2544.18,32 CPT,76817,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,92.89,643.54,72 CPT,76818,Fetal biophysical profile; with non-stress testing ,4989.91,4989.91,104.75,721.67,72 CPT,76818,US FETAL BIOPHYS PROF,4989.91,4989.91,299.39,4241.42,16 CPT,76819,Fetal biophysical profile; without non-stress testing ,,,84.2,523.75,72 CPT,76820,"Doppler velocimetry, fetal; umbilical artery ",,,44.78,433.75,72 CPT,76821,"Doppler velocimetry, fetal; middle cerebral artery ",,,88.88,621.04,72 CPT,76825,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,213.0,2087.41,72 CPT,76826,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,157.04,1343.25,72 CPT,76827,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,69.84,486.35,72 CPT,76828,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,48.79,433.75,72 CPT,76830,US TRANSVAGINAL,2568.875,2568.875,154.13,2183.62,32 CPT,76830,"Ultrasound, transvaginal ",,,104.75,984.27,72 CPT,76831,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,116.61,928.11,72 CPT,76856,US PELVIC COMPLETE,4793.275,4793.275,287.59,4074.41,32 CPT,76856,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,96.28,827.08,72 CPT,76857,US PELVIC LTD OR FU,1050.33,1050.33,63.02,892.83,32 CPT,76857,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,50.79,433.75,72 CPT,76870,US SCROTUM AND CNTS,3666.8450000000003,3666.8450000000003,220.01,3116.84,32 CPT,76870,"Ultrasound, scrotum and contents ",,,100.24,797.14,72 CPT,76872,US TRANSRECTAL,2252.01,2252.01,135.12,1914.21,16 CPT,76872,"Ultrasound, transrectal; ",2252.01,2252.01,104.75,1201.49,72 CPT,76873,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,104.75,1104.06,72 CPT,76881,US JOINT COMP,3435.78,3435.78,206.15,2920.41,16 CPT,76881,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",3435.78,3435.78,96.28,317.84,72 CPT,76882,US EXTREM NON VASC LTD,2870.375,2870.375,172.21,2440.06,32 CPT,76882,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.35,433.75,72 CPT,76883,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,58.48,413.63,60 CPT,76885,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,80.9,893.9,72 CPT,76886,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,80.9,804.59,72 CPT,76932,"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation ",,,59.63,666.03,17 CPT,76936,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,259.29,1892.82,71 CPT,76937,IMAGE GUIDE VASC ACCESS,4596.91,4596.91,275.81,3907.37,28 CPT,76937,US GUIDANCE VASC ACCESS,4596.91,4596.91,275.81,3907.37,28 CPT,76937,"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular ne",,,34.88,288.29,17 CPT,76940,"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation ",,,185.84,669.76,17 CPT,76941,"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation ",,,124.96,599.08,17 CPT,76942,USG NDL PLACEMENT,11055.22,11055.22,663.31,9396.94,28 CPT,76942,"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation ",11055.22,11055.22,44.4,306.53,17 CPT,76945,"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation ",,,62.8,621.58,17 CPT,76946,"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation ",,,23.46,156.79,17 CPT,76948,"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation ",,,71.67,542.52,17 CPT,76965,Ultrasonic guidance for interstitial radioelement application ,,,44.4,291.62,17 CPT,76975,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,110.34,2541.94,71 CPT,76977,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.01,48.18,71 CPT,76978,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,175.06,2489.1,71 CPT,76979,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,143.01,1766.9,71 CPT,76981,US ELASTO EACH ORG,697.88,697.88,41.87,593.2,17 CPT,76981,"Ultrasound, elastography; parenchyma (eg, organ) ",697.88,697.88,104.59,853.3,71 CPT,76982,"Ultrasound, elastography; first target lesion ",,,93.56,737.11,71 CPT,76983,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,60.26,415.14,71 CPT,76984,"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic ",,,54.88,120.67,5 CPT,76987,"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and ",,,167.59,368.5,5 CPT,76988,"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only ",,,106.76,234.75,5 CPT,76989,"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only ",,,62.62,137.69,5 CPT,76998,US INTRAOPERATIVE,2346.09,2346.09,140.77,1994.18,28 CPT,76998,"Ultrasonic guidance, intraoperative ",2346.09,2346.09,114.8,669.23,17 CPT,76999,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,80.9,308.86,59 CPT,77001,FLUORO GUID CTRL ACC DEV,13882.56,13882.56,832.95,11800.18,31 CPT,77001,"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any",13882.56,13882.56,128.13,950.6,17 CPT,77002,"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure) ",,,131.3,1006.77,17 CPT,77002,XR FLUORO NDL,8565.955,8565.955,262.32,10845.86,62 CPT,77003,Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code,6824.41,6824.41,121.14,864.48,17 CPT,77003,XR FLUORO FOR SPINE INJ,6824.41,6824.41,409.46,5800.75,31 CPT,77011,Computed tomography guidance for stereotactic localization ,,,296.84,1361.0,17 CPT,77012,CT GUID NDL PLCMT,10480.3,10480.3,628.82,8908.25,28 CPT,77012,"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation ",10480.3,10480.3,137.63,1361.0,17 CPT,77013,CT GUIDANCE TISSUE ABLAT,6267.0,6267.0,376.02,5326.95,28 CPT,77013,"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation ",6267.0,6267.0,346.32,1361.0,17 CPT,77021,"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation ",,,720.54,2268.0,17 CPT,77022,"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation ",,,390.09,2268.0,17 CPT,77046,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,501.04,2739.0,41 CPT,77047,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,501.04,2739.0,41 CPT,77048,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,633.05,2739.0,41 CPT,77049,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,629.95,2739.0,41 CPT,77053,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,53.46,901.86,152 CPT,77054,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,69.16,901.86,152 CPT,77061,Diagnostic digital breast tomosynthesis; unilateral ,,,98.29,980.55,25 CPT,77062,Diagnostic digital breast tomosynthesis; bilateral ,,,124.02,1250.08,25 CPT,77063,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,22.76,665.0,122 CPT,77065,"Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral ",,,83.99,980.55,69 CPT,77066,"Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral ",,,107.84,1250.08,69 CPT,77067,"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed ",,,88.86,1032.99,69 CPT,77071,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,55.73,614.52,152 CPT,77072,Bone age studies ,1455.38,1455.38,26.06,433.75,152 CPT,77072,XR BONE AGE STUDIES,1455.38,1455.38,87.32,1237.07,17 CPT,77073,"Bone length studies (orthoroentgenogram, scanogram) ",2628.6,2628.6,45.11,433.75,152 CPT,77073,XR BONE LENGTH STUDIES,2628.6,2628.6,157.72,2234.31,17 CPT,77074,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,65.15,497.53,152 CPT,77075,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",6065.71,6065.71,99.9,819.5,152 CPT,77075,XR BONE SURVEY COMP,6065.71,6065.71,363.94,5155.85,17 CPT,77076,"Radiologic examination, osseous survey, infant ",,,104.75,827.08,152 CPT,77077,"Joint survey, single view, 2 or more joints (specify) ",,,47.11,433.75,152 CPT,77078,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,86.58,2106.0,83 CPT,77080,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.09,306.53,152 CPT,77081,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,31.41,235.45,152 CPT,77084,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,233.47,2739.0,95 CPT,77085,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,51.79,433.75,152 CPT,77086,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.08,308.86,152 CPT,77089,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual X-ray absorptiometry (DXA) or other imaging data on gray-scale variogram, calculation, with interpretation a",,,76.12,167.38,5 CPT,77090,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,150.96,382.33,86 CPT,77091,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,151.59,382.33,86 CPT,77092,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional ",,,19.03,41.83,5 CPT,77261,Therapeutic radiology treatment planning; simple ,,,60.23,697.44,19 CPT,77262,Therapeutic radiology treatment planning; intermediate ,,,92.63,1056.95,19 CPT,77263,Therapeutic radiology treatment planning; complex ,,,146.0,1648.98,19 CPT,77280,Therapeutic radiology simulation-aided field setting; simple ,,,447.16,2304.76,17 CPT,77285,Therapeutic radiology simulation-aided field setting; intermediate ,,,749.2,3869.08,17 CPT,77290,Therapeutic radiology simulation-aided field setting; complex ,,,798.01,3751.29,17 CPT,77293,Respiratory motion management simulation (List separately in addition to code for primary procedure) ,,,664.13,3124.52,17 CPT,77295,"3-dimensional radiotherapy plan, including dose-volume histograms ",,,497.27,2477.12,17 CPT,77299,"Unlisted procedure, therapeutic radiology clinical treatment planning ",,,231.66,379.77,5 CPT,77300,"Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and ",,,63.32,322.63,17 CPT,77301,"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications ",,,2844.5,13996.13,17 CPT,77306,"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s) ",,,142.45,719.27,17 CPT,77307,"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s) ",,,257.21,1303.98,17 CPT,77316,"Brachytherapy isodose plan; simple (calculationºs» made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s) ",,,242.69,1670.8,17 CPT,77317,"Brachytherapy isodose plan; intermediate (calculationºs» made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s) ",,,319.21,2211.32,17 CPT,77318,"Brachytherapy isodose plan; complex (calculationºs» made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s) ",,,432.65,2987.83,17 CPT,77321,"Special teletherapy port plan, particles, hemibody, total body ",,,81.78,430.31,17 CPT,77331,"Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by the treating physician ",,,35.61,184.61,17 CPT,77332,"Treatment devices, design and construction; simple (simple block, simple bolus) ",,,53.42,144.28,17 CPT,77333,"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus) ",,,130.59,992.26,17 CPT,77334,"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts) ",,,126.64,632.23,17 CPT,77336,"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation onc",,,149.05,814.31,17 CPT,77338,"Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan ",,,511.78,2314.74,17 CPT,77370,Special medical radiation physics consultation ,,,232.15,1297.19,17 CPT,77371,"Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based ",,,1994.37,45307.0,31 CPT,77372,"Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based ",,,1994.37,45307.0,25 CPT,77373,"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions ",,,2414.48,45307.0,26 CPT,77387,"Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed ",,,215.67,1002.38,17 CPT,77399,"Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services ",,,231.66,379.77,5 CPT,77402,"Radiation treatment delivery; Level 1 (eg, single-electron field, multiple-electron fields, or 2D photons), including imaging guidance, when performed ",,,257.87,1315.29,17 CPT,77407,"Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed ",,,721.11,1803.24,17 CPT,77412,"Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (eg, 2D, 3D, or IMRT) or a single-isocenter photon therapy (eg, 3D or IMRT) with active motion management, or total skin ",,,1033.05,2395.13,17 CPT,77417,Therapeutic radiology port image(s) ,,,21.1,124.05,17 CPT,77423,"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s) ",,,120.69,877.0,17 CPT,77424,"Intraoperative radiation treatment delivery, x-ray, single treatment session ",,,441.87,3923.39,17 CPT,77425,"Intraoperative radiation treatment delivery, electrons, single treatment session ",,,478.8,2768.61,17 CPT,77427,"Radiation treatment management, 5 treatments ",,,169.19,1867.13,19 CPT,77431,Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only ,,,92.21,1046.7,19 CPT,77432,Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session) ,,,367.96,45307.0,22 CPT,77435,"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions ",,,1198.34,6283.78,17 CPT,77436,"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting ",,,69.83,114.48,5 CPT,77437,"Surface radiation therapy; superficial, delivery, 150-500 kV, per fraction ",,,190.76,312.72,5 CPT,77439,"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (List separately",,,29.77,48.81,5 CPT,77469,Intraoperative radiation treatment management ,,,593.56,3117.47,17 CPT,77470,"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation) ",,,47.49,285.63,17 CPT,77520,"Proton treatment delivery; simple, without compensation ",,,986.06,8711.53,17 CPT,77522,"Proton treatment delivery; simple, with compensation ",,,2281.57,8735.09,17 CPT,77523,Proton treatment delivery; intermediate ,,,2281.57,10146.75,17 CPT,77525,Proton treatment delivery; complex ,,,2281.57,11225.65,17 CPT,77600,"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less) ",,,708.32,4382.72,17 CPT,77605,"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) ",,,1261.66,8998.89,17 CPT,77610,Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators ,,,1164.7,6273.14,17 CPT,77615,Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators ,,,1804.43,9872.16,17 CPT,77620,Hyperthermia generated by intracavitary probe(s) ,,,640.69,5700.94,19 CPT,77750,Infusion or instillation of radioelement solution (includes 3-month follow-up care) ,,,220.28,1263.25,17 CPT,77761,Intracavitary radiation source application; simple ,,,368.01,2093.13,17 CPT,77762,Intracavitary radiation source application; intermediate ,,,421.43,2382.09,17 CPT,77763,Intracavitary radiation source application; complex ,,,554.0,3071.15,17 CPT,77767,"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel ",,,331.74,1909.72,17 CPT,77768,"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions ",,,530.24,2850.74,17 CPT,77770,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel ",,,426.04,2410.71,17 CPT,77771,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels ",,,751.86,3930.04,17 CPT,77772,"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels ",,,1176.58,5987.5,17 CPT,77778,"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed ",,,725.47,4372.2,17 CPT,77789,Surface application of low dose rate radionuclide source ,,,117.39,719.27,17 CPT,77790,"Supervision, handling, loading of radiation source ",,,28.37,63.89,17 CPT,77799,"Unlisted procedure, clinical brachytherapy ",,,224.56,368.13,5 CPT,78012,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,80.86,795.67,71 CPT,78013,"Thyroid imaging (including vascular flow, when performed); ",,,171.74,1866.59,71 CPT,78014,NM THYROID SCN UP/STIM V,7601.59,7601.59,456.1,6461.35,17 CPT,78014,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",7601.59,7601.59,218.19,2267.23,71 CPT,78015,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,216.19,2079.95,71 CPT,78016,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,258.29,2629.92,71 CPT,78018,Thyroid carcinoma metastases imaging; whole body ,,,290.7,2884.54,71 CPT,78020,Thyroid carcinoma metastases uptake (List separately in addition to code for primary procedure) ,,,102.75,586.97,17 CPT,78070,NM PLANAR PARATHYROID,7185.14,7185.14,431.11,6107.37,17 CPT,78070,"Parathyroid planar imaging (including subtraction, when performed); ",7185.14,7185.14,273.65,2690.35,71 CPT,78071,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,326.78,3090.45,71 CPT,78072,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (CT) for anatomical localization ",,,572.12,4776.69,17 CPT,78075,"Adrenal imaging, cortex and/or medulla ",,,415.33,4321.36,71 CPT,78099,"Unlisted endocrine procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78102,Bone marrow imaging; limited area ,,,162.39,1552.08,71 CPT,78103,Bone marrow imaging; multiple areas ,,,174.41,1679.32,71 CPT,78104,Bone marrow imaging; whole body ,,,234.56,2241.0,71 CPT,78110,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,68.83,687.06,71 CPT,78111,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,73.18,720.74,71 CPT,78120,Red cell volume determination (separate procedure); single sampling ,,,70.5,687.06,71 CPT,78121,Red cell volume determination (separate procedure); multiple samplings ,,,76.85,720.74,71 CPT,78122,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,95.56,855.57,71 CPT,78130,Red cell survival study ,,,123.3,1113.51,71 CPT,78140,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,108.93,956.72,71 CPT,78185,"Spleen imaging only, with or without vascular flow ",,,158.38,1649.38,71 CPT,78191,Platelet survival study ,,,123.3,1113.51,71 CPT,78195,Lymphatics and lymph nodes imaging ,6123.03,6123.03,329.79,3135.44,71 CPT,78195,NM LYMPHIMAG,6123.03,6123.03,367.38,5204.58,17 CPT,78199,"Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78201,Liver imaging; static only ,,,179.1,1799.11,71 CPT,78202,Liver imaging; with vascular flow ,,,195.46,1982.66,71 CPT,78215,Liver and spleen imaging; static only ,6742.6,6742.6,184.44,1829.06,71 CPT,78215,NM LIVER & SPLEEN,6742.6,6742.6,404.56,5731.21,17 CPT,78216,Liver and spleen imaging; with vascular flow ,5721.34,5721.34,126.98,1132.68,71 CPT,78216,NM LVR & SPLN W/FLOW,5721.34,5721.34,343.28,4863.14,17 CPT,78226,HEPA IMAG INCL GB,9898.29,9898.29,593.9,8413.55,17 CPT,78226,"Hepatobiliary system imaging, including gallbladder when present; ",9898.29,9898.29,303.06,3060.5,71 CPT,78227,HEPA IMAG INCL GB W PHA,12147.34,12147.34,728.84,10325.24,17 CPT,78227,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",12147.34,12147.34,407.3,4167.89,71 CPT,78230,Salivary gland imaging; ,,,166.4,1634.33,71 CPT,78231,Salivary gland imaging; with serial images ,,,103.58,934.23,71 CPT,78232,Salivary gland function study ,,,101.91,937.96,71 CPT,78258,Esophageal motility ,,,200.81,1900.27,71 CPT,78261,Gastric mucosa imaging ,,,188.11,1870.32,71 CPT,78262,Gastroesophageal reflux study ,,,230.55,2241.0,71 CPT,78264,"Gastric emptying imaging study (eg, solid, liquid, or both); ",5239.07,5239.07,308.08,3090.45,71 CPT,78264,NM GASTRIC EMPTYING,5239.07,5239.07,314.34,4453.21,17 CPT,78265,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,364.54,3639.89,71 CPT,78266,GASTRIC EMPTY W SB MULT,6798.2,6798.2,407.89,5778.47,17 CPT,78266,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",6798.2,6798.2,414.33,4115.05,71 CPT,78267,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.29,111.94,92 CPT,78268,"Urea breath test, C-14 (isotopic); analysis ",,,79.3,954.99,92 CPT,78278,Acute gastrointestinal blood loss imaging ,3376.98,3376.98,324.78,3176.56,71 CPT,78278,NM ACUTE GI BLOOD LOSS,3376.98,3376.98,202.62,2870.43,17 CPT,78282,Gastrointestinal protein loss ,,,45.21,4163.23,71 CPT,78290,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",6689.26,6689.26,307.74,3139.16,71 CPT,78290,NM INTESTINE IMAGING,6689.26,6689.26,401.36,5685.87,17 CPT,78291,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,245.93,2315.81,71 CPT,78299,"Unlisted gastrointestinal procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78300,Bone and/or joint imaging; limited area ,6338.63,6338.63,212.18,2091.27,71 CPT,78300,NM BONE LIMITED,6338.63,6338.63,380.32,5387.84,17 CPT,78305,Bone and/or joint imaging; multiple areas ,,,257.95,2488.04,71 CPT,78306,Bone and/or joint imaging; whole body ,8663.7,8663.7,275.66,2697.8,71 CPT,78306,NM BONE WHOLE BODY,8663.7,8663.7,519.82,7364.15,17 CPT,78315,Bone and/or joint imaging; 3 phase study ,7657.19,7657.19,322.78,3139.16,71 CPT,78315,NM BONE 3 PHASE,7657.19,7657.19,459.43,6508.61,17 CPT,78350,"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry ",,,38.68,228.0,17 CPT,78351,"Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites ",,,22.35,112.07,19 CPT,78399,"Unlisted musculoskeletal procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78414,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,39.95,547.17,71 CPT,78428,Cardiac shunt detection ,,,175.75,1596.93,71 CPT,78429,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; with concurrently a",,,150.32,5672.0,20 CPT,78430,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); single study, at rest or stress (exercise or",,,142.72,5672.0,20 CPT,78431,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); multiple studies at rest and stress (exercis",,,166.18,5672.0,20 CPT,78432,"Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), dual radi",,,176.97,5672.0,20 CPT,78433,"Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), dual radi",,,193.46,5672.0,20 CPT,78434,"Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (List separately in addition to code for primary procedure) ",,,55.81,5480.0,8 CPT,78434,"Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (List separately in addition to code for primary procedure) PET Scan",,,2268.0,5672.0,12 CPT,78445,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,196.8,1960.16,71 CPT,78451,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",16883.73,16883.73,315.75,2892.0,71 CPT,78451,NM MYOCRD SPECT R/S SGL,16883.73,16883.73,1013.02,14351.17,17 CPT,78452,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",15906.71,15906.71,438.05,4178.67,71 CPT,78452,NM MYOCRD SPECT R/S MULT,15906.71,15906.71,954.4,13520.7,17 CPT,78453,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",16883.73,16883.73,272.65,2611.69,71 CPT,78453,NM MYOCRD PERF R/S SGL,16883.73,16883.73,1013.02,14351.17,17 CPT,78454,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",17522.58,17522.58,406.64,3894.51,71 CPT,78454,NM MYOCRD PERF R/S MULT,17522.58,17522.58,1051.35,14894.19,17 CPT,78456,"Acute venous thrombosis imaging, peptide ",,,290.7,2805.88,71 CPT,78457,"Venous thrombosis imaging, venogram; unilateral ",,,157.04,1518.27,71 CPT,78458,"Venous thrombosis imaging, venogram; bilateral ",,,195.46,1720.45,71 CPT,78459,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; ",,,2163.55,5480.0,8 CPT,78459,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; PET Scan",,,2268.0,5672.0,12 CPT,78466,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,174.09,1694.36,71 CPT,78468,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,183.1,1675.6,71 CPT,78469,"Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification ",4410.71,4410.71,330.46,1874.05,17 CPT,78469,NM MYOCARD SPECT IMG,4410.71,4410.71,264.64,3749.1,23 CPT,78472,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",7418.89,7418.89,212.84,1915.18,71 CPT,78472,NM MUGA R/S SINGLE,7418.89,7418.89,445.13,6306.06,17 CPT,78473,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,269.98,2319.67,71 CPT,78481,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,166.74,1387.3,71 CPT,78483,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,224.54,1821.61,71 CPT,78491,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); single study, at rest or stress (exercise or",,,2268.0,5672.0,20 CPT,78492,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); multiple studies at rest and stress (exercis",,,2268.0,5672.0,20 CPT,78494,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,214.18,1821.61,71 CPT,78496,"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (List separately in addition to code for primary procedure) ",,,35.52,209.23,17 CPT,78499,"Unlisted cardiovascular procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78579,PULM VENT IMAGING,8596.76,8596.76,515.81,7307.25,17 CPT,78579,"Pulmonary ventilation imaging (eg, aerosol or gas) ",8596.76,8596.76,176.43,1731.76,71 CPT,78580,NM PULM PERF PARTIC,4474.26,4474.26,268.46,3803.12,17 CPT,78580,"Pulmonary perfusion imaging (eg, particulate) ",4474.26,4474.26,221.2,2121.21,71 CPT,78582,PULM VENT & PERF IMAG,6864.01,6864.01,411.84,5834.41,17 CPT,78582,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",6864.01,6864.01,309.4,2970.66,71 CPT,78597,QUANT DIF PULM PERF,15331.41,15331.41,919.88,13031.7,17 CPT,78597,"Quantitative differential pulmonary perfusion, including imaging when performed ",15331.41,15331.41,188.11,1765.44,71 CPT,78598,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,282.01,2783.92,71 CPT,78599,"Unlisted respiratory procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78600,"Brain imaging, less than 4 static views; ",,,170.41,1720.45,71 CPT,78601,"Brain imaging, less than 4 static views; with vascular flow ",,,202.81,2023.79,71 CPT,78605,"Brain imaging, minimum 4 static views; ",9961.84,9961.84,189.11,1847.83,71 CPT,78605,NM BRAIN MIN 4 STATIC,9961.84,9961.84,597.71,8467.56,17 CPT,78606,"Brain imaging, minimum 4 static views; with vascular flow ",,,304.73,3139.16,71 CPT,78608,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1425.21,5860.1,62 CPT,78608,"Brain imaging, positron emission tomography (PET); metabolic evaluation PET Scan",,,2268.0,5672.0,12 CPT,78609,"Brain imaging, positron emission tomography (PET); perfusion evaluation ",,,164.26,1518.82,7 CPT,78609,"Brain imaging, positron emission tomography (PET); perfusion evaluation PET Scan",,,2268.0,5672.0,12 CPT,78610,"Brain imaging, vascular flow only ",,,165.06,1701.82,71 CPT,78630,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",6225.16,6225.16,314.09,3225.28,71 CPT,78630,NM CISTERNOGRAM,6225.16,6225.16,373.51,5291.39,17 CPT,78635,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,314.75,3247.77,71 CPT,78645,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,300.39,3131.71,71 CPT,78650,Cerebrospinal fluid leakage detection and localization ,,,252.6,2667.32,71 CPT,78660,Radiopharmaceutical dacryocystography ,,,144.01,1698.09,71 CPT,78699,"Unlisted nervous system procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78700,Kidney imaging morphology; ,,,160.71,1582.03,71 CPT,78701,Kidney imaging morphology; with vascular flow ,8305.13,8305.13,211.18,2091.27,71 CPT,78701,NM KIDNEY SCAN W/FLOW,8305.13,8305.13,498.31,7059.36,17 CPT,78707,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",5060.92,5060.92,218.53,1975.07,71 CPT,78707,NM KDNEY SCAN FLW&FNC,5060.92,5060.92,303.66,4301.78,17 CPT,78708,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",12267.62,12267.62,173.41,1315.69,71 CPT,78708,NM KDNEY FLW&FNC W/RX,12267.62,12267.62,736.06,10427.48,17 CPT,78709,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,345.49,3191.6,71 CPT,78725,"Kidney function study, non-imaging radioisotopic study ",,,110.6,1050.29,71 CPT,78730,Urinary bladder residual study (List separately in addition to code for primary procedure) ,,,126.23,718.47,17 CPT,78740,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,203.83,2023.79,71 CPT,78761,Testicular imaging with vascular flow ,,,200.15,1877.77,71 CPT,78799,"Unlisted genitourinary procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,78800,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,235.56,2349.61,71 CPT,78801,NM TUMOR LOCAL MULT,6338.63,6338.63,380.32,5387.84,17 CPT,78801,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",6338.63,6338.63,255.61,2544.21,71 CPT,78802,NM TUMOR LC WHBD SGL DAY,11076.14,11076.14,664.57,9414.72,17 CPT,78802,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",11076.14,11076.14,288.69,2877.49,71 CPT,78803,NM TUMOR LCL SPECT,8761.29,8761.29,525.68,7447.1,17 CPT,78803,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",8761.29,8761.29,355.19,3513.57,71 CPT,78804,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,602.44,6402.38,71 CPT,78808,"Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma) ",,,328.85,1424.66,17 CPT,78811,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1305.94,5480.0,62 CPT,78811,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) PET Scan",,,2268.0,5672.0,12 CPT,78812,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1480.34,5860.1,62 CPT,78812,Positron emission tomography (PET) imaging; skull base to mid-thigh PET Scan,,,2268.0,5672.0,12 CPT,78813,Positron emission tomography (PET) imaging; whole body ,,,1480.34,5860.1,62 CPT,78813,Positron emission tomography (PET) imaging; whole body PET Scan,,,2268.0,5672.0,12 CPT,78814,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1480.34,5860.1,62 CPT,78814,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) PET Scan",,,2268.0,5672.0,12 CPT,78815,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1480.34,5860.1,62 CPT,78815,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh PET Scan,,,2268.0,5672.0,12 CPT,78816,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1480.34,5860.1,62 CPT,78816,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body PET Scan,,,2268.0,5672.0,12 CPT,78830,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,436.04,4382.32,71 CPT,78831,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,652.23,6555.84,71 CPT,78832,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,823.96,8663.48,71 CPT,78835,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,89.21,823.22,71 CPT,78999,"Unlisted miscellaneous procedure, diagnostic nuclear medicine ",,,647.91,1424.66,5 CPT,79005,RADIOPHM THPY ORAL ADMIN,1373.03,1373.03,82.38,1167.08,17 CPT,79005,"Radiopharmaceutical therapy, by oral administration ",1373.03,1373.03,89.44,564.48,71 CPT,79101,"Radiopharmaceutical therapy, by intravenous administration ",,,88.79,586.97,71 CPT,79200,"Radiopharmaceutical therapy, by intracavitary administration ",,,93.24,598.15,71 CPT,79300,"Radiopharmaceutical therapy, by interstitial radioactive colloid administration ",,,121.14,468.91,17 CPT,79403,"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion ",,,147.79,758.27,17 CPT,79440,"Radiopharmaceutical therapy, by intra-articular administration ",,,69.13,452.14,71 CPT,79445,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,201.48,974.96,71 CPT,79999,"Radiopharmaceutical therapy, unlisted procedure ",,,417.82,918.74,5 CPT,80047,BASIC METABOLIC CALC ION,2325.0,2325.0,139.5,1976.25,28 CPT,80047,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.74,94.39,173 CPT,80048,BMP TOTAL CALCIUM,2156.23,2156.23,129.37,1832.8,14 CPT,80048,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",2156.23,2156.23,8.29,58.19,173 CPT,80050,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,71.03,291.5,100 CPT,80051,ELECTROLYTE PANEL,1761.0,1761.0,105.66,1496.85,14 CPT,80051,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,1761.0,1761.0,6.87,48.24,173 CPT,80053,COMP METABOLIC PANEL,2234.03,2234.03,134.04,1898.93,28 CPT,80053,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.42,72.67,173 CPT,80055,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,46.85,328.88,145 CPT,80061,LIPID PANEL,1565.0,1565.0,93.9,1330.25,14 CPT,80061,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",1565.0,1565.0,7.66,92.13,173 CPT,80069,RENAL FUNCTION PANEL,2686.0,2686.0,161.16,2283.1,14 CPT,80069,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",2686.0,2686.0,6.01,59.73,173 CPT,80074,ACUTE HEPATITIS PANEL,1547.0,1547.0,92.82,1314.95,14 CPT,80074,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",1547.0,1547.0,8.08,327.61,173 CPT,80076,HEPATIC FUNCTION PANEL,2201.0,2201.0,132.06,1870.85,14 CPT,80076,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",2201.0,2201.0,6.01,56.2,173 CPT,80081,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,62.88,514.85,173 CPT,80143,ACETAMINOPHEN QN,1304.28,1304.28,78.26,1108.64,27 CPT,80143,Acetaminophen ,1304.28,1304.28,15.66,98.82,160 CPT,80145,Adalimumab ,,,32.4,265.26,172 CPT,80150,AMIKACIN PEAK QN,735.88,735.88,44.15,625.5,14 CPT,80150,AMIKACIN QUANT,736.0,736.0,44.16,625.6,14 CPT,80150,AMIKACIN TROUGH QN,398.28,398.28,23.9,338.54,14 CPT,80150,Amikacin ,,,12.67,103.71,173 CPT,80151,AMIODARONE QN,1547.0,1547.0,92.82,1314.95,27 CPT,80151,Amiodarone ,1547.0,1547.0,15.66,98.82,160 CPT,80155,Caffeine ,,,32.4,265.26,173 CPT,80156,CARBAMAZEPINE TOTAL,1109.0,1109.0,66.54,942.65,14 CPT,80156,Carbamazepine; total ,1109.0,1109.0,12.24,100.18,173 CPT,80157,Carbamazepine; free ,,,11.13,91.13,173 CPT,80158,CYCLOSPORINE QUANT,475.0,475.0,28.5,403.75,14 CPT,80158,Cyclosporine ,475.0,475.0,15.16,124.17,173 CPT,80159,Clozapine ,,,16.93,138.56,173 CPT,80161,"Carbamazepine; -10,11-epoxide ",,,15.66,98.82,160 CPT,80162,DIGOXIN QN,582.0,582.0,34.92,494.7,14 CPT,80162,Digoxin; total ,582.0,582.0,11.16,91.31,173 CPT,80163,Digoxin; free ,,,11.16,91.31,173 CPT,80164,VALPROIC ACID (DEPAKENE),1060.0,1060.0,63.6,901.0,14 CPT,80164,Valproic acid (dipropylacetic acid); total ,1060.0,1060.0,11.37,93.12,173 CPT,80165,Valproic acid (dipropylacetic acid); free ,,,11.37,93.12,173 CPT,80167,Felbamate ,,,15.66,98.82,160 CPT,80168,Ethosuximide ,,,13.73,112.4,173 CPT,80169,Everolimus ,,,11.53,94.39,173 CPT,80170,GENTAMICIN (GARAMYCIN)QN,1332.0,1332.0,79.92,1132.2,14 CPT,80170,GENTAMICIN PEAK QN,1331.98,1331.98,79.92,1132.18,14 CPT,80170,GENTAMICIN TROUGH QN,1331.98,1331.98,79.92,1132.18,14 CPT,80170,Gentamicin ,,,13.76,112.67,173 CPT,80171,GABAPENTIN NEURONTIN QN,900.73,900.73,54.04,765.62,14 CPT,80171,"Gabapentin, whole blood, serum, or plasma ",900.73,900.73,18.2,149.05,173 CPT,80173,Haloperidol ,,,13.26,108.51,173 CPT,80175,Lamotrigine ,,,11.13,91.13,173 CPT,80176,LIDOCAINE QN,377.17,377.17,22.63,320.59,14 CPT,80176,Lidocaine ,377.17,377.17,12.34,101.0,173 CPT,80177,LEVETIRACETAM QN,591.0,591.0,35.46,502.35,14 CPT,80177,Levetiracetam ,591.0,591.0,11.13,91.13,173 CPT,80178,LITHIUM QN,820.0,820.0,49.2,697.0,14 CPT,80178,Lithium ,820.0,820.0,5.55,45.43,173 CPT,80179,SALICYLATE QN,896.78,896.78,53.81,762.26,27 CPT,80179,Salicylate ,896.78,896.78,15.66,98.82,160 CPT,80180,Mycophenolate (mycophenolic acid) ,,,15.16,124.17,173 CPT,80181,FLECAINIDE TAMBOCOR QN,357.39,357.39,21.44,303.78,27 CPT,80181,Flecainide ,357.39,357.39,15.66,98.82,160 CPT,80183,Oxcarbazepine ,,,11.13,91.13,173 CPT,80184,PHENOBARBITAL LUMINAL QN,636.0,636.0,38.16,540.6,14 CPT,80184,Phenobarbital ,636.0,636.0,12.85,105.25,173 CPT,80185,PHENYTOIN DILANT TOT QN,1067.0,1067.0,64.02,906.95,14 CPT,80185,Phenytoin; total ,1067.0,1067.0,11.13,91.13,173 CPT,80186,PHENYTOIN DILANTIN FR QN,1720.0,1720.0,103.2,1462.0,14 CPT,80186,Phenytoin; free ,1720.0,1720.0,11.56,94.66,173 CPT,80187,Posaconazole ,,,22.77,186.43,172 CPT,80188,Primidone ,,,13.94,114.12,173 CPT,80189,Itraconazole ,,,22.77,143.69,160 CPT,80190,Procainamide; ,,,50.4,412.68,173 CPT,80192,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.07,115.21,173 CPT,80193,Leflunomide ,,,32.4,204.79,160 CPT,80194,Quinidine ,,,12.26,100.45,173 CPT,80195,SIROLIMUS RAPAMUNE QN,510.37,510.37,30.62,433.81,14 CPT,80195,Sirolimus ,510.37,510.37,11.53,94.39,173 CPT,80197,TACROLIMUS QUANT,736.0,736.0,44.16,625.6,14 CPT,80197,Tacrolimus ,736.0,736.0,11.53,94.39,173 CPT,80198,THEOPHYLLINE QUANT,524.0,524.0,31.44,445.4,14 CPT,80198,Theophylline ,524.0,524.0,11.88,97.29,173 CPT,80199,Tiagabine ,,,22.77,186.43,173 CPT,80200,TOBRAMYCIN PEAK,792.59,792.59,47.56,673.7,14 CPT,80200,TOBRAMYCIN QUANT,573.68,573.68,34.42,487.63,14 CPT,80200,TOBRAMYCIN TROUGH,792.59,792.59,47.56,673.7,14 CPT,80200,Tobramycin ,,,13.55,110.95,173 CPT,80201,Topiramate ,,,10.01,81.99,173 CPT,80202,VANCOMYCIN PEAK,499.0,499.0,29.94,424.15,14 CPT,80202,VANCOMYCIN QUANT,499.0,499.0,29.94,424.15,14 CPT,80202,VANCOMYCIN TROUGH,499.0,499.0,29.94,424.15,14 CPT,80202,Vancomycin ,,,11.37,93.12,173 CPT,80203,Zonisamide ,,,11.13,91.13,173 CPT,80204,METHOTREXATE RHEUMAT QN,1346.49,1346.49,80.79,1144.52,27 CPT,80204,Methotrexate ,1346.49,1346.49,32.4,204.79,160 CPT,80210,Rufinamide ,,,22.77,143.69,160 CPT,80220,Hydroxychloroquine ,,,15.66,98.82,160 CPT,80230,Infliximab ,,,32.4,265.26,172 CPT,80235,Lacosamide ,,,22.77,186.43,172 CPT,80280,Vedolizumab ,,,32.4,265.26,172 CPT,80285,VORICONAZOLE,491.81,491.81,29.51,418.04,15 CPT,80285,Voriconazole ,491.81,491.81,22.77,186.43,172 CPT,80299,DIGITOXIN QN,621.15,621.15,37.27,527.98,14 CPT,80299,FUROSEMIDE LASIX QN,57.0,57.0,3.42,48.45,14 CPT,80299,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.66,128.24,173 CPT,80305,DRUG SCR DOO MANUAL READ,223.45,223.45,13.41,189.93,14 CPT,80305,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",223.45,223.45,10.58,86.7,173 CPT,80306,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.4,117.92,173 CPT,80307,DRUG SCR ANY NBR PER DOS,2822.0,2822.0,169.32,2398.7,28 CPT,80307,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,52.2,427.43,173 CPT,80320,Alcohols ,200.0,200.0,0.07,127.56,121 CPT,80320,DEF DRUG ALCOHOLS,200.0,200.0,12.0,170.0,27 CPT,80321,Alcohol biomarkers; 1 or 2 ,,,0.07,14.14,40 CPT,80322,Alcohol biomarkers; 3 or more ,,,0.07,11.97,40 CPT,80323,"Alkaloids, not otherwise specified ",494.54,494.54,0.07,127.56,121 CPT,80323,NICOTINE BLD,494.54,494.54,29.67,420.36,27 CPT,80324,Amphetamines; 1 or 2 ,1168.71,1168.71,0.07,127.56,121 CPT,80324,DEF DRUG AMPHETAM 1 OR 2,1168.71,1168.71,70.12,993.4,27 CPT,80325,Amphetamines; 3 or 4 ,,,0.07,13.65,40 CPT,80326,Amphetamines; 5 or more ,,,0.07,9.69,40 CPT,80327,Anabolic steroids; 1 or 2 ,,,0.07,127.56,121 CPT,80328,Anabolic steroids; 3 or more ,,,0.07,26.11,40 CPT,80329,"Analgesics, non-opioid; 1 or 2 ",,,0.07,127.56,121 CPT,80330,"Analgesics, non-opioid; 3-5 ",,,0.07,5.35,40 CPT,80331,"Analgesics, non-opioid; 6 or more ",,,0.07,8.56,40 CPT,80332,"Antidepressants, serotonergic class; 1 or 2 ",,,0.07,127.56,121 CPT,80333,"Antidepressants, serotonergic class; 3-5 ",,,0.07,15.65,40 CPT,80334,"Antidepressants, serotonergic class; 6 or more ",,,0.07,10.01,40 CPT,80335,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",100.0,100.0,0.07,127.56,121 CPT,80335,DEF DRUG ANTIDEP TRI 1-2,100.0,100.0,6.0,85.0,27 CPT,80336,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,0.07,21.31,40 CPT,80337,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,0.07,10.86,40 CPT,80338,"Antidepressants, not otherwise specified ",,,0.07,13.39,40 CPT,80339,"Antiepileptics, not otherwise specified; 1-3 ",,,0.07,127.56,121 CPT,80340,"Antiepileptics, not otherwise specified; 4-6 ",,,0.07,8.04,40 CPT,80341,"Antiepileptics, not otherwise specified; 7 or more ",,,0.07,6.95,40 CPT,80342,"Antipsychotics, not otherwise specified; 1-3 ",,,0.07,127.56,121 CPT,80343,"Antipsychotics, not otherwise specified; 4-6 ",,,0.07,33.95,40 CPT,80344,"Antipsychotics, not otherwise specified; 7 or more ",,,0.07,8.66,40 CPT,80345,Barbiturates ,583.17,583.17,0.07,127.56,121 CPT,80345,DEF DRUG BARBITURATES,583.17,583.17,34.99,495.69,27 CPT,80346,Benzodiazepines; 1-12 ,,,0.07,127.56,121 CPT,80347,Benzodiazepines; 13 or more ,583.17,583.17,0.07,24.19,40 CPT,80347,DEF DRUG BENZODIAZ 13+,583.17,583.17,34.99,495.69,30 CPT,80348,Buprenorphine ,,,0.07,17.18,40 CPT,80349,"Cannabinoids, natural ",583.17,583.17,0.07,127.56,121 CPT,80349,DEF DRUG CANNABINOID NAT,583.17,583.17,34.99,495.69,27 CPT,80350,"Cannabinoids, synthetic; 1-3 ",,,0.07,127.56,121 CPT,80351,"Cannabinoids, synthetic; 4-6 ",,,0.07,17.32,40 CPT,80352,"Cannabinoids, synthetic; 7 or more ",,,0.07,16.9,40 CPT,80353,Cocaine ,583.17,583.17,0.07,127.56,121 CPT,80353,DEF DRUG COCAINE,583.17,583.17,34.99,495.69,27 CPT,80354,DEF DRUG FENTANYL,247.99,247.99,14.88,210.79,27 CPT,80354,Fentanyl ,247.99,247.99,0.07,127.56,121 CPT,80355,"Gabapentin, non-blood ",,,0.07,127.56,121 CPT,80356,DEF DRUG HEROIN METABOL,583.17,583.17,34.99,495.69,27 CPT,80356,Heroin metabolite ,583.17,583.17,0.07,127.56,121 CPT,80357,Ketamine and norketamine ,,,0.07,127.56,121 CPT,80358,DEF DRUG METHADONE,624.31,624.31,37.46,530.66,27 CPT,80358,Methadone ,624.31,624.31,0.07,127.56,121 CPT,80359,DEF DRUG MDA MDEA MDMA,624.31,624.31,37.46,530.66,27 CPT,80359,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",624.31,624.31,0.07,127.56,121 CPT,80360,Methylphenidate ,,,0.07,127.56,121 CPT,80361,DEF DRUG OPIATES 1 OR MR,752.56,752.56,45.15,639.68,27 CPT,80361,"Opiates, 1 or more ",752.56,752.56,0.07,127.56,121 CPT,80362,Opioids and opiate analogs; 1 or 2 ,,,0.07,127.56,121 CPT,80363,Opioids and Opiate analogs; 3 or 4 ,,,0.07,22.29,40 CPT,80364,Opioids and Opiate analogs; 5 or more ,,,0.07,16.73,40 CPT,80365,DEF DRUG OXYCODONE,752.56,752.56,45.15,639.68,27 CPT,80365,Oxycodone ,752.56,752.56,0.07,127.56,121 CPT,80366,Pregabalin ,,,0.07,127.56,121 CPT,80367,DEF DRUG PROPOXYPHENE,752.56,752.56,45.15,639.68,27 CPT,80367,Propoxyphene ,752.56,752.56,0.07,127.56,121 CPT,80368,Sedative hypnotics (non-benzodiazepines) ,,,0.07,127.56,121 CPT,80369,Skeletal muscle relaxants; 1 or 2 ,,,0.07,127.56,121 CPT,80370,Skeletal muscle relaxants; 3 or more ,,,0.07,12.38,40 CPT,80371,"Stimulants, synthetic ",,,0.07,127.56,121 CPT,80372,Tapentadol ,,,0.07,127.56,121 CPT,80373,Tramadol ,,,0.07,127.56,121 CPT,80374,"Stereoisomer (enantiomer) analysis, single drug class ",,,0.07,127.56,121 CPT,80375,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,0.07,127.56,121 CPT,80376,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,0.07,127.56,121 CPT,80377,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,0.07,127.56,121 CPT,80400,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.4,224.35,173 CPT,80402,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,73.05,598.11,173 CPT,80406,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,65.74,538.29,173 CPT,80408,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,105.42,863.19,173 CPT,80410,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,67.51,552.77,173 CPT,80412,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,673.36,5513.53,173 CPT,80414,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,43.38,355.21,173 CPT,80415,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,46.95,384.44,173 CPT,80416,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,175.83,1439.67,173 CPT,80417,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,36.95,302.54,173 CPT,80418,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,486.76,3985.62,173 CPT,80420,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,135.98,1113.42,173 CPT,80422,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,38.7,316.84,173 CPT,80424,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,42.42,347.34,173 CPT,80426,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,124.66,1020.75,173 CPT,80428,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,56.03,458.74,173 CPT,80430,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,108.64,889.52,173 CPT,80432,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,139.11,1139.03,173 CPT,80434,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,239.43,1960.41,173 CPT,80435,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,86.52,708.43,173 CPT,80436,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,76.57,626.98,173 CPT,80438,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,42.34,346.71,173 CPT,80439,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,56.46,462.27,173 CPT,80503,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,161.89,86 CPT,80504,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,485.9,86 CPT,80505,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,485.9,86 CPT,80506,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,91.0,156.07,86 CPT,81000,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,3.38,27.69,173 CPT,81001,UA W MICRO AUTO,708.0,708.0,42.48,601.8,14 CPT,81001,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",708.0,708.0,2.66,21.81,173 CPT,81002,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.92,23.89,173 CPT,81003,UA W O MICRO AUTO,345.0,345.0,20.7,293.25,28 CPT,81003,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.89,15.48,173 CPT,81005,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.82,14.93,173 CPT,81007,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.18,206.16,173 CPT,81015,Urinalysis; microscopic only ,,,2.56,21.0,173 CPT,81020,Urinalysis; 2 or 3 glass test ,,,3.95,32.31,173 CPT,81025,PREG URINE QUAL BY DOO,573.68,573.68,34.42,487.63,14 CPT,81025,"Urine pregnancy test, by visual color comparison methods ",573.68,573.68,7.23,59.19,173 CPT,81050,VOLUME MEASUREMENT UR,32.7,32.7,1.96,27.8,14 CPT,81050,"Volume measurement for timed collection, each ",32.7,32.7,3.06,25.07,173 CPT,81099,Unlisted urinalysis procedure ,,,99.55,128.28,81 CPT,81105,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,102.66,840.65,171 CPT,81106,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,102.66,840.65,171 CPT,81107,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,102.66,840.65,171 CPT,81108,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,102.66,840.65,171 CPT,81109,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,102.66,840.65,171 CPT,81110,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,102.66,840.65,171 CPT,81111,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,102.66,840.65,171 CPT,81112,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,102.66,840.65,171 CPT,81120,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,162.33,1329.17,171 CPT,81121,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,248.46,2034.44,171 CPT,81161,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,234.36,1918.96,171 CPT,81162,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1532.9,12551.54,173 CPT,81163,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,393.12,3218.9,170 CPT,81164,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,490.75,4018.29,170 CPT,81165,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,237.62,1945.66,170 CPT,81166,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,253.13,2072.72,170 CPT,81167,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,237.62,1945.66,170 CPT,81168,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,203.16,1099.37,130 CPT,81170,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",71.68,71.68,252.0,2063.4,171 CPT,81170,ABL1 VARS KINASE DOMAIN,71.68,71.68,4.3,60.93,15 CPT,81171,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81172,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,269.33,1890.27,142 CPT,81173,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,295.32,2072.72,142 CPT,81174,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,181.5,1273.79,142 CPT,81175,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,662.97,4652.97,143 CPT,81176,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,237.06,1663.75,143 CPT,81177,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81178,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81179,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81180,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81181,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81182,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81183,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81184,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,115.08,942.29,170 CPT,81185,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,710.87,5820.69,170 CPT,81186,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,155.57,1273.79,170 CPT,81187,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81188,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81189,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,269.33,1890.27,142 CPT,81190,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,181.5,1273.79,142 CPT,81191,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,203.16,1099.37,130 CPT,81192,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,203.16,1099.37,130 CPT,81193,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,203.16,1099.37,130 CPT,81194,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,507.91,2746.64,130 CPT,81195,"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (OGM) ",,,1825.96,5384.71,49 CPT,81200,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,39.69,324.99,171 CPT,81201,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,655.2,5364.84,171 CPT,81202,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,235.2,1925.84,171 CPT,81203,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,168.0,1375.6,171 CPT,81204,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,134.26,942.29,142 CPT,81205,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,79.79,653.32,171 CPT,81206,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,137.73,1127.72,171 CPT,81207,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,121.67,996.22,171 CPT,81208,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,180.28,1476.15,171 CPT,81209,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.02,270.41,171 CPT,81210,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",1148.66,1148.66,147.34,1206.37,171 CPT,81210,BRAF V600 VARIANTS,1148.66,1148.66,68.92,976.36,15 CPT,81212,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,369.6,3026.32,171 CPT,81215,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,315.21,2580.97,171 CPT,81216,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,155.5,1273.24,171 CPT,81217,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,315.21,2580.97,171 CPT,81218,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,203.2,1663.75,171 CPT,81219,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,102.17,836.58,171 CPT,81220,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,467.54,3828.33,173 CPT,81221,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,81.66,668.7,173 CPT,81222,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,365.46,2992.38,173 CPT,81223,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,419.16,3432.12,173 CPT,81224,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,141.75,1160.66,173 CPT,81225,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,244.74,2003.94,171 CPT,81226,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,378.76,3101.34,171 CPT,81227,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,146.84,1202.38,171 CPT,81228,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,882.0,6190.2,143 CPT,81229,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,974.4,7978.48,171 CPT,81230,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,171.31,1202.38,143 CPT,81231,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,171.31,1202.38,143 CPT,81232,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,171.31,1202.38,143 CPT,81233,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,147.34,1206.37,170 CPT,81234,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,134.26,942.29,142 CPT,81235,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",2545.27,2545.27,272.65,2232.45,171 CPT,81235,EGFR COMMON VARIANTS,2545.27,2545.27,152.72,2163.48,15 CPT,81236,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,277.22,1945.66,142 CPT,81237,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,147.34,1206.37,170 CPT,81238,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,504.0,4126.8,171 CPT,81239,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,269.33,1890.27,142 CPT,81240,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",2215.57,2215.57,55.18,451.78,173 CPT,81240,F2 GENE 20210G>A VARIANT,2215.57,2215.57,132.93,1883.23,14 CPT,81241,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",2216.0,2216.0,61.63,504.63,173 CPT,81241,F5 GENE LEIDEN VARIANT,2216.0,2216.0,132.96,1883.6,14 CPT,81242,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,30.76,251.86,171 CPT,81243,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,47.91,392.32,171 CPT,81244,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,37.71,308.79,171 CPT,81245,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,139.03,1138.4,171 CPT,81246,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,69.72,570.87,171 CPT,81247,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,146.84,1202.38,171 CPT,81248,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,315.21,2580.97,171 CPT,81249,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,504.0,4126.8,171 CPT,81250,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,49.13,402.27,171 CPT,81251,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,39.69,324.99,171 CPT,81252,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,84.94,695.49,171 CPT,81253,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,51.68,423.18,171 CPT,81254,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.4,240.73,171 CPT,81255,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,43.22,353.86,171 CPT,81256,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,54.9,449.51,171 CPT,81257,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,85.9,703.37,171 CPT,81258,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,315.21,2580.97,171 CPT,81259,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,504.0,4126.8,171 CPT,81260,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.02,270.41,171 CPT,81261,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,166.31,1361.75,171 CPT,81262,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,57.58,471.51,171 CPT,81263,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,247.4,2025.75,171 CPT,81264,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,145.09,1187.99,171 CPT,81265,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,195.78,1603.03,171 CPT,81266,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,256.04,2096.52,171 CPT,81267,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,174.27,1426.91,171 CPT,81268,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,219.06,1793.71,171 CPT,81269,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,170.02,1392.07,171 CPT,81270,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",1747.0,1747.0,76.99,630.42,171 CPT,81270,JAK2 V617F VARIANT,1747.0,1747.0,104.82,1484.95,15 CPT,81271,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81272,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,276.79,2266.39,171 CPT,81273,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,104.89,858.85,171 CPT,81274,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,269.33,1890.27,142 CPT,81275,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",2484.6,2484.6,162.33,1329.17,173 CPT,81275,KRAS VAR EXN2 CODON12&13,2484.6,2484.6,149.08,2111.91,14 CPT,81276,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,162.33,1329.17,173 CPT,81277,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,1136.8,7978.48,142 CPT,81278,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,174.14,1099.37,158 CPT,81279,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,181.5,982.58,130 CPT,81283,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,71.9,504.63,143 CPT,81284,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,134.26,942.29,142 CPT,81285,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,269.33,1890.27,142 CPT,81286,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,269.33,1890.27,142 CPT,81287,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,104.7,857.31,171 CPT,81288,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,161.55,1322.75,171 CPT,81289,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,181.5,1273.79,142 CPT,81290,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.02,270.41,171 CPT,81291,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,54.89,449.42,171 CPT,81292,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,567.34,4645.36,171 CPT,81293,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,278.04,2276.62,171 CPT,81294,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,170.02,1392.07,171 CPT,81295,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,320.63,2625.31,171 CPT,81296,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.69,2322.86,171 CPT,81297,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,179.17,1467.1,171 CPT,81298,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,539.15,4414.68,171 CPT,81299,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,258.72,2118.42,171 CPT,81300,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,199.92,1636.96,171 CPT,81301,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,292.79,2397.44,171 CPT,81302,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,443.41,3630.68,171 CPT,81303,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,100.8,825.36,171 CPT,81304,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,126.0,1031.7,171 CPT,81305,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,171.89,1206.37,142 CPT,81306,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,285.53,2003.94,142 CPT,81307,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,571.42,4652.97,142 CPT,81308,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,295.32,2072.72,142 CPT,81309,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,269.33,1890.27,142 CPT,81310,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,207.08,1695.61,171 CPT,81311,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,289.87,2034.44,143 CPT,81312,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81313,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,214.24,1754.25,173 CPT,81314,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,276.79,2266.39,171 CPT,81315,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,174.14,1425.92,171 CPT,81316,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,174.14,1425.92,171 CPT,81317,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,568.26,4652.97,171 CPT,81318,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,278.04,2276.62,171 CPT,81319,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,170.94,1399.67,171 CPT,81320,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,285.53,2003.94,142 CPT,81321,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,504.0,4126.8,171 CPT,81322,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.14,320.55,171 CPT,81323,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,252.0,2063.4,171 CPT,81324,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,637.02,5215.97,171 CPT,81325,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,646.45,5293.16,171 CPT,81326,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.14,320.55,171 CPT,81327,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,161.28,1320.58,170 CPT,81328,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,171.31,1202.38,143 CPT,81329,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,115.08,942.29,170 CPT,81330,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,39.48,323.27,171 CPT,81331,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,42.9,351.23,171 CPT,81332,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,36.67,300.19,171 CPT,81333,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,134.26,942.29,142 CPT,81334,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,276.79,2266.39,171 CPT,81335,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,171.31,1202.38,143 CPT,81336,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,253.13,2072.72,170 CPT,81337,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,155.57,1273.79,170 CPT,81338,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,147.32,797.61,130 CPT,81339,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,181.5,982.58,130 CPT,81340,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,175.49,1436.96,171 CPT,81341,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,41.66,341.09,171 CPT,81342,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,169.26,1385.92,171 CPT,81343,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81344,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,134.26,942.29,142 CPT,81345,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,181.5,1273.79,142 CPT,81346,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,171.31,1202.38,143 CPT,81347,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,189.38,2422.9,130 CPT,81348,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,171.89,2422.9,130 CPT,81349,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,622.16,6148.94,160 CPT,81350,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,196.56,1609.45,171 CPT,81351,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,539.15,3402.29,158 CPT,81352,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,276.79,1746.04,158 CPT,81353,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,258.72,1632.88,158 CPT,81354,CYTOG ALYS CHRML ABN OGM,227.45,227.45,13.65,193.33,37 CPT,81354,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (OGM) ",227.45,227.45,1238.26,4030.66,49 CPT,81355,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,74.09,606.62,171 CPT,81357,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,189.38,2422.9,130 CPT,81360,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,189.38,2422.9,130 CPT,81361,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,146.84,1202.38,171 CPT,81362,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,315.21,2580.97,171 CPT,81363,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,170.02,1392.07,171 CPT,81364,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,272.65,2232.45,171 CPT,81370,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,337.78,2765.77,173 CPT,81371,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,339.8,2782.33,173 CPT,81372,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,339.02,2775.91,173 CPT,81373,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,107.04,876.49,173 CPT,81374,HLA 1 TYP 1 AG EQV LR EA,154.3,154.3,9.26,131.16,14 CPT,81374,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",154.3,154.3,62.44,511.23,173 CPT,81375,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,185.42,1518.23,173 CPT,81376,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,102.66,840.65,173 CPT,81377,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,79.58,651.6,173 CPT,81378,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,290.28,2376.8,173 CPT,81379,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,281.72,2306.75,173 CPT,81380,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,148.89,1219.13,173 CPT,81381,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,142.72,1168.54,173 CPT,81382,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,103.89,850.7,173 CPT,81383,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,91.67,750.61,173 CPT,81400,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,53.73,439.92,171 CPT,81401,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,115.08,942.29,171 CPT,81402,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,126.28,1033.96,171 CPT,81403,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,155.57,1273.79,171 CPT,81404,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,230.86,1890.27,171 CPT,81405,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,253.13,2072.72,171 CPT,81406,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,237.62,1945.66,171 CPT,81407,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,710.87,5820.69,171 CPT,81408,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1680.0,13756.0,171 CPT,81410,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,423.36,3466.51,171 CPT,81411,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1134.16,9286.57,171 CPT,81412,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,2399.59,16841.24,143 CPT,81413,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,573.2,4022.91,143 CPT,81414,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,573.2,4022.91,143 CPT,81415,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,4684.4,32876.84,145 CPT,81416,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,11760.0,82536.0,145 CPT,81417,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,313.6,2200.96,145 CPT,81418,"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including CYP2C19, CYP2D6, and CYP2D6 duplication/deletion analysis ",,,898.74,2650.36,51 CPT,81419,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,51.81,12980.48,130 CPT,81420,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,637.6,5220.76,171 CPT,81422,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,743.87,5220.76,143 CPT,81425,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,0.07,26670.56,144 CPT,81426,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,0.07,14365.49,144 CPT,81427,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,0.07,12391.28,144 CPT,81430,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,1592.5,11176.75,143 CPT,81431,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,665.98,4674.05,143 CPT,81432,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,1277.87,4670.52,143 CPT,81434,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,585.95,4112.41,143 CPT,81435,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,1181.5,4022.91,143 CPT,81437,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,886.64,3768.42,143 CPT,81439,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,573.2,4022.91,143 CPT,81440,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,3257.52,22862.47,143 CPT,81441,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,2399.59,12980.48,130 CPT,81442,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,2100.73,14743.72,143 CPT,81443,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,2399.59,16841.24,142 CPT,81445,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,585.95,4112.41,143 CPT,81448,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,573.2,4022.91,143 CPT,81449,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,502.24,3168.77,158 CPT,81450,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,638.01,5224.02,171 CPT,81451,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,638.01,4025.64,158 CPT,81455,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2452.46,20081.05,171 CPT,81456,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2452.46,15477.47,158 CPT,81457,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,502.24,2591.95,73 CPT,81458,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,502.24,3023.95,73 CPT,81459,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,502.24,8639.8,73 CPT,81460,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,1261.26,8851.99,143 CPT,81462,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,502.24,3455.95,73 CPT,81463,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,502.24,3887.95,73 CPT,81464,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,502.24,9503.79,73 CPT,81465,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,917.28,6437.81,143 CPT,81470,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,895.72,6286.49,142 CPT,81471,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,0.07,4844.78,142 CPT,81479,Unlisted molecular pathology procedure ,,,51.81,609.5,86 CPT,81490,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,823.84,5781.95,143 CPT,81493,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,1029.0,7221.9,143 CPT,81500,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,255.29,1791.72,138 CPT,81503,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,879.06,6169.57,140 CPT,81504,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,509.6,3576.56,138 CPT,81506,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,67.54,474.04,138 CPT,81507,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,667.8,5468.01,171 CPT,81508,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,53.21,373.49,140 CPT,81509,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,1457.62,10230.12,140 CPT,81510,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,54.43,382.0,140 CPT,81511,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,150.43,1055.77,140 CPT,81512,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,68.13,478.2,140 CPT,81513,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,119.81,756.26,160 CPT,81514,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,220.91,1394.0,158 CPT,81515,"Infectious disease, bacterial vaginosis and vaginitis, real-time PCR amplification of DNA markers for Atopobium vaginae, Atopobium species, Megasphaera type 1, and Bacterial Vaginosis Associated Bacte",,,220.91,838.94,56 CPT,81517,"Liver disease, analysis of 3 biomarkers (hyaluronic acid ºHA», procollagen III amino terminal peptide ºPIIINP», tissue inhibitor of metalloproteinase 1 ºTIMP-1»), using immunoassays, utilizing serum, ",,,172.67,1605.85,51 CPT,81518,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,3795.54,26638.49,142 CPT,81519,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3253.32,26638.49,171 CPT,81520,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2108.58,17265.23,171 CPT,81521,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,3795.54,26638.49,143 CPT,81522,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,3795.54,26638.49,142 CPT,81523,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,3795.54,20530.61,130 CPT,81524,ONC CNS TUM DNA MTH10000,1950.0,1950.0,117.0,1657.5,42 CPT,81524,"Oncology (central nervous system tumor), DNA methylation analysis of at least 10,000 methylation sites, utilizing DNA extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability o",1950.0,1950.0,251.77,397.6,5 CPT,81525,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,3053.68,21431.85,143 CPT,81528,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,427.45,3500.0,173 CPT,81529,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,7049.14,38129.54,130 CPT,81535,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,567.87,3985.53,143 CPT,81536,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,174.01,1221.3,143 CPT,81538,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,2813.58,19746.74,143 CPT,81539,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,744.8,5227.28,143 CPT,81540,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,3675.0,25792.5,143 CPT,81541,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,3795.54,26638.49,143 CPT,81542,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,3795.54,20530.61,130 CPT,81546,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,3528.0,19082.76,130 CPT,81551,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,1989.4,13962.34,142 CPT,81552,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,3939.0,41221.08,130 CPT,81554,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,5301.41,29260.91,130 CPT,81558,"Transplantation medicine (allograft rejection, kidney), mRNA, gene expression profiling by quantitative polymerase chain reaction (qPCR) of 139 genes, utilizing whole blood, algorithm reported as a bi",,,3175.2,10335.6,49 CPT,81560,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,627.92,10335.6,132 CPT,81595,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,3175.2,22284.72,145 CPT,81596,CHR HCV 6 BIOCHEM ALG,691.61,691.61,41.5,587.87,22 CPT,81596,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",691.61,691.61,70.75,496.48,142 CPT,81599,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,81 CPT,82009,ACETONE BLD QL,6.0,6.0,0.36,5.1,14 CPT,82009,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",6.0,6.0,3.8,31.13,173 CPT,82010,BETA HYDROXYBUTYRATE,134.52,134.52,8.07,114.34,14 CPT,82010,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",134.52,134.52,6.86,56.2,173 CPT,82013,Acetylcholinesterase ,,,10.32,84.53,173 CPT,82016,"Acylcarnitines; qualitative, each specimen ",,,13.85,113.4,173 CPT,82017,"Acylcarnitines; quantitative, each specimen ",,,14.17,116.02,173 CPT,82024,ACTH QN,2142.0,2142.0,128.52,1820.7,14 CPT,82024,Adrenocorticotropic hormone (ACTH) ,2142.0,2142.0,32.44,265.62,173 CPT,82030,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,21.67,177.47,173 CPT,82040,ALBUMIN SERUM QN,346.0,346.0,20.76,294.1,14 CPT,82040,"Albumin; serum, plasma or whole blood ",346.0,346.0,4.16,34.03,173 CPT,82042,ALBUMIN OTHER QN,948.0,948.0,56.88,805.8,14 CPT,82042,"Albumin; other source, quantitative, each specimen ",948.0,948.0,6.54,53.49,173 CPT,82043,"Albumin; urine (eg, microalbumin), quantitative ",146.0,146.0,4.86,39.73,173 CPT,82043,MICROALBUMIN QN,146.0,146.0,8.76,124.1,14 CPT,82044,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.23,42.81,173 CPT,82045,Albumin; ischemia modified ,,,28.51,233.4,173 CPT,82075,Alcohol (ethanol); breath ,,,0.07,159.87,173 CPT,82077,ALCOHOL QN EXC UA OR BRE,1027.34,1027.34,61.64,873.24,28 CPT,82077,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",1027.34,1027.34,14.51,91.62,158 CPT,82085,ALDOLASE,992.0,992.0,59.52,843.2,14 CPT,82085,Aldolase ,992.0,992.0,8.16,66.79,173 CPT,82088,ALDOSTERONE QN,2531.0,2531.0,151.86,2151.35,14 CPT,82088,ALDOSTERONE UR QN,2530.76,2530.76,151.85,2151.15,14 CPT,82088,Aldosterone ,,,34.23,280.28,173 CPT,82103,A-1-ANTITRYPSIN TOT,410.0,410.0,24.6,348.5,14 CPT,82103,Alpha-1-antitrypsin; total ,410.0,410.0,11.29,92.4,173 CPT,82104,Alpha-1-antitrypsin; phenotype ,,,12.15,99.46,173 CPT,82105,ALPHA FETOPROT SERUM,1401.0,1401.0,84.06,1190.85,14 CPT,82105,Alpha-fetoprotein (AFP); serum ,1401.0,1401.0,14.09,115.39,173 CPT,82106,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.28,116.93,173 CPT,82107,AFP-L3 FRA ISO + TOT AFP,300.0,300.0,18.0,255.0,14 CPT,82107,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,300.0,300.0,54.1,443.0,173 CPT,82108,Aluminum ,,,21.4,175.21,173 CPT,82120,"Amines, vaginal fluid, qualitative ",,,5.03,41.18,173 CPT,82127,"Amino acids; single, qualitative, each specimen ",,,11.91,97.56,173 CPT,82128,"Amino acids; multiple, qualitative, each specimen ",,,11.65,95.39,173 CPT,82131,"Amino acids; single, quantitative, each specimen ",,,19.3,158.01,173 CPT,82135,"Aminolevulinic acid, delta (ALA) ",,,13.82,113.13,173 CPT,82136,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.47,134.85,173 CPT,82139,AMINO ACIDS QN 6 OR MORE,1772.46,1772.46,106.35,1506.59,14 CPT,82139,"Amino acids, 6 or more amino acids, quantitative, each specimen ",1772.46,1772.46,14.17,116.02,173 CPT,82140,AMMONIA,597.0,597.0,35.82,507.45,14 CPT,82140,Ammonia ,597.0,597.0,12.24,100.18,173 CPT,82143,Amniotic fluid scan (spectrophotometric) ,,,7.85,64.35,173 CPT,82150,AMYLASE BLD,1033.93,1033.93,62.04,878.84,28 CPT,82150,AMYLASE FL,826.88,826.88,49.61,702.85,14 CPT,82150,AMYLASE UR,625.1,625.1,37.51,531.34,14 CPT,82150,Amylase ,,,5.44,44.53,173 CPT,82154,Androstanediol glucuronide ,,,24.22,198.29,173 CPT,82157,Androstenedione ,,,24.6,201.36,173 CPT,82160,Androsterone ,,,21.46,175.75,173 CPT,82163,Angiotensin II ,,,17.24,141.18,173 CPT,82164,ANGIOTENSIN I CONV ENZ,1350.44,1350.44,81.03,1147.87,14 CPT,82164,Angiotensin I - converting enzyme (ACE) ,1350.44,1350.44,12.26,100.45,173 CPT,82166,Anti-mullerian hormone (AMH) ,,,32.44,123.2,75 CPT,82172,"Apolipoprotein, each ",,,17.72,145.07,173 CPT,82175,ARSENIC BLD,873.04,873.04,52.38,742.08,14 CPT,82175,Arsenic ,873.04,873.04,15.93,130.5,173 CPT,82180,"Ascorbic acid (Vitamin C), blood ",1308.24,1308.24,8.31,68.06,173 CPT,82180,VIT C ASCORBIC ACID,1308.24,1308.24,78.49,1112.0,14 CPT,82190,"Atomic absorption spectroscopy, each analyte ",,,13.36,109.32,173 CPT,82232,BETA 2 MICROGLOBULIN,594.77,594.77,35.69,505.55,14 CPT,82232,Beta-2 microglobulin ,594.77,594.77,13.59,111.32,173 CPT,82233,Beta-amyloid; 1-40 (Abeta 40) ,,,11.86,372.58,56 CPT,82234,Beta-amyloid; 1-42 (Abeta 42) ,,,11.86,372.58,56 CPT,82239,Bile acids; total ,,,14.38,117.74,173 CPT,82240,Bile acids; cholylglycine ,,,22.33,182.81,173 CPT,82247,BILIRUBIN TOT BLD,840.0,840.0,50.4,714.0,14 CPT,82247,BILIRUBIN TOT FL,840.07,840.07,50.4,714.06,14 CPT,82247,Bilirubin; total ,,,4.22,34.57,173 CPT,82248,BILIRUBIN DIRECT,702.0,702.0,42.12,596.7,14 CPT,82248,Bilirubin; direct ,702.0,702.0,4.22,34.57,173 CPT,82252,"Bilirubin; feces, qualitative ",,,3.83,31.4,173 CPT,82261,"Biotinidase, each specimen ",,,14.17,116.02,173 CPT,82270,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",385.0,385.0,3.68,30.14,173 CPT,82270,OCCULT BLD SCN 3 SPEC,385.0,385.0,23.1,327.25,14 CPT,82271,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.47,36.56,173 CPT,82271,OCC BLD PEROX OTH SOURCE,385.04499999999996,385.04499999999996,23.1,327.33,28 CPT,82272,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.55,29.05,173 CPT,82272,OCCBLD PEROX 1-3 DIAG,385.09,385.09,23.11,327.33,28 CPT,82274,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.37,109.51,173 CPT,82286,Bradykinin ,,,4.33,35.48,173 CPT,82300,Cadmium ,,,19.86,162.63,173 CPT,82306,VITAMIN D 25OH W/WO FRAC,172.77,172.77,10.37,146.85,14 CPT,82306,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",172.77,172.77,24.86,203.63,173 CPT,82308,CALCITONIN,1001.0,1001.0,60.06,850.85,14 CPT,82308,Calcitonin ,1001.0,1001.0,22.5,184.26,173 CPT,82310,CALCIUM TOTAL,636.0,636.0,38.16,540.6,14 CPT,82310,CALCIUM UR RANDOM QN,635.66,635.66,38.14,540.31,14 CPT,82310,Calcium; total ,,,4.33,35.48,173 CPT,82330,CALCIUM IONIZED,1817.0,1817.0,109.02,1544.45,14 CPT,82330,Calcium; ionized ,1817.0,1817.0,11.49,94.12,173 CPT,82331,Calcium; after calcium infusion test ,,,11.21,91.77,173 CPT,82340,CALCIUM UR TIMED QN,532.79,532.79,31.97,452.87,14 CPT,82340,"Calcium; urine quantitative, timed specimen ",532.79,532.79,5.07,41.45,173 CPT,82355,Calculus; qualitative analysis ,,,9.73,79.64,173 CPT,82360,"Calculus; quantitative analysis, chemical ",,,10.81,88.51,173 CPT,82365,Calculus; infrared spectroscopy ,205.21,205.21,10.84,88.69,173 CPT,82365,STONE ANALYSIS INFRARED,205.21,205.21,12.31,174.43,14 CPT,82370,Calculus; X-ray diffraction ,,,10.52,86.16,173 CPT,82373,Carbohydrate deficient transferrin ,,,15.17,124.26,173 CPT,82374,CARBON DIOXIDE BLD,736.0,736.0,44.16,625.6,14 CPT,82374,Carbon dioxide (bicarbonate) ,736.0,736.0,4.1,33.58,173 CPT,82375,CARBOXYHEMOGLOBIN QN,1024.7,1024.7,61.48,871.0,14 CPT,82375,Carboxyhemoglobin; quantitative ,1024.7,1024.7,10.35,84.71,173 CPT,82376,Carboxyhemoglobin; qualitative ,,,11.82,96.74,173 CPT,82378,CEA,1252.0,1252.0,75.12,1064.2,14 CPT,82378,Carcinoembryonic antigen (CEA) ,1252.0,1252.0,15.93,130.41,173 CPT,82379,"Carnitine (total and free), quantitative, each specimen ",,,14.17,116.02,173 CPT,82380,Carotene ,,,7.74,63.44,173 CPT,82382,Catecholamines; total urine ,,,22.93,187.79,173 CPT,82383,Catecholamines; blood ,,,24.43,200.01,173 CPT,82384,CATECHOL FRACTION BLD,374.53,374.53,22.47,318.35,14 CPT,82384,CATECHOL FRACTION UR,1020.74,1020.74,61.24,867.63,14 CPT,82384,Catecholamines; fractionated ,,,21.21,173.67,173 CPT,82387,Cathepsin-D ,,,15.17,124.26,173 CPT,82390,CERULOPLASMIN,564.0,564.0,33.84,479.4,14 CPT,82390,Ceruloplasmin ,564.0,564.0,9.02,73.85,173 CPT,82397,Chemiluminescent assay ,171.96,171.96,11.86,97.11,173 CPT,82397,PTH-RELATED PEPTIDE CA,171.96,171.96,10.32,146.17,14 CPT,82415,Chloramphenicol ,,,10.64,87.15,173 CPT,82435,CHLORIDE BLD,597.0,597.0,35.82,507.45,14 CPT,82435,Chloride; blood ,597.0,597.0,3.86,31.68,173 CPT,82436,CHLORIDE UR,467.0,467.0,28.02,396.95,14 CPT,82436,Chloride; urine ,467.0,467.0,4.83,39.55,173 CPT,82438,Chloride; other source ,,,4.2,34.39,173 CPT,82441,"Chlorinated hydrocarbons, screen ",,,5.05,41.36,173 CPT,82465,CHOLESTEROL BLD,707.0,707.0,42.42,600.95,14 CPT,82465,"Cholesterol, serum or whole blood, total ",707.0,707.0,3.65,29.96,173 CPT,82480,Cholinesterase; serum ,,,6.61,54.12,173 CPT,82482,Cholinesterase; RBC ,,,8.24,67.51,173 CPT,82485,"Chondroitin B sulfate, quantitative ",,,17.35,141.99,173 CPT,82495,Chromium ,,,17.04,139.46,173 CPT,82507,Citrate ,,,23.35,191.23,173 CPT,82523,"Collagen cross links, any method ",,,15.69,128.51,173 CPT,82525,COPPER BLD,651.0,651.0,39.06,553.35,14 CPT,82525,COPPER URINE,625.1,625.1,37.51,531.34,14 CPT,82525,Copper ,,,10.42,85.34,173 CPT,82528,Corticosterone ,,,18.92,154.94,173 CPT,82530,CORTISOL FREE URINE,1447.0,1447.0,86.82,1229.95,14 CPT,82530,Cortisol; free ,1447.0,1447.0,14.04,114.94,173 CPT,82533,CORTISOL TOTAL,1565.0,1565.0,93.9,1330.25,14 CPT,82533,CORTISOL TOTAL AM,1565.0,1565.0,93.9,1330.25,14 CPT,82533,CORTISOL TOTAL PM,1565.0,1565.0,93.9,1330.25,14 CPT,82533,Cortisol; total ,,,13.69,112.13,173 CPT,82540,Creatine ,,,3.9,31.95,173 CPT,82542,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",1047.22,1047.22,20.24,165.71,173 CPT,82542,HPLC MS QUANTITATIVE,1047.22,1047.22,62.83,890.14,14 CPT,82550,CREAT KINASE (CK) TOTAL,1009.0,1009.0,60.54,857.65,14 CPT,82550,"Creatine kinase (CK), (CPK); total ",1009.0,1009.0,5.47,44.8,173 CPT,82552,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.25,92.13,173 CPT,82553,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.7,79.46,173 CPT,82554,"Creatine kinase (CK), (CPK); isoforms ",,,9.97,81.63,173 CPT,82565,CREATININE BLD,604.0,604.0,36.24,513.4,14 CPT,82565,Creatinine; blood ,604.0,604.0,4.3,35.2,173 CPT,82570,CREATININE OTHER,540.71,540.71,32.44,459.6,14 CPT,82570,CREATININE UR,675.0,675.0,40.5,573.75,14 CPT,82570,Creatinine; other source ,,,4.35,35.66,173 CPT,82575,CREATININE CLEARANCE,981.0,981.0,58.86,833.85,14 CPT,82575,Creatinine; clearance ,981.0,981.0,7.95,65.07,173 CPT,82585,Cryofibrinogen ,,,11.88,97.29,173 CPT,82595,CRYOGLOBULINS QL SQN,410.15,410.15,24.61,348.63,14 CPT,82595,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",410.15,410.15,5.43,44.53,173 CPT,82600,Cyanide ,,,16.3,133.4,173 CPT,82607,Cyanocobalamin (Vitamin B-12); ,1932.0,1932.0,12.67,103.71,173 CPT,82607,VITAMIN B12,1932.0,1932.0,115.92,1642.2,14 CPT,82608,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.03,98.46,173 CPT,82610,Cystatin C ,,,15.56,127.42,173 CPT,82615,"Cystine and homocystine, urine, qualitative ",,,8.02,65.7,173 CPT,82626,DHEA,1569.36,1569.36,94.16,1333.96,14 CPT,82626,Dehydroepiandrosterone (DHEA) ,1569.36,1569.36,21.23,173.85,173 CPT,82627,DHEA-S,1569.0,1569.0,94.14,1333.65,14 CPT,82627,Dehydroepiandrosterone-sulfate (DHEA-S) ,1569.0,1569.0,18.67,152.85,173 CPT,82633,"Desoxycorticosterone, 11- ",,,26.02,213.04,173 CPT,82634,"Deoxycortisol, 11- ",,,24.6,201.36,173 CPT,82638,Dibucaine number ,,,10.29,84.26,173 CPT,82642,Dihydrotestosterone (DHT) ,,,24.6,201.36,172 CPT,82652,VITAMIN D 1-25 W/WO FRAC,2586.0,2586.0,155.16,2198.1,14 CPT,82652,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",2586.0,2586.0,32.34,264.8,173 CPT,82653,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.29,122.15,160 CPT,82656,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.69,79.28,173 CPT,82657,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.62,152.49,173 CPT,82658,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,36.99,302.81,173 CPT,82664,"Electrophoretic technique, not elsewhere specified ",,,51.66,423.0,173 CPT,82668,ERYTHROPOIETIN QN,1577.0,1577.0,94.62,1340.45,14 CPT,82668,Erythropoietin ,1577.0,1577.0,15.78,129.23,173 CPT,82670,ESTRADIOL TOTAL,1736.0,1736.0,104.16,1475.6,14 CPT,82670,Estradiol; total ,1736.0,1736.0,23.47,192.13,173 CPT,82671,Estrogens; fractionated ,,,27.13,222.18,173 CPT,82672,ESTROGEN TOTAL,1947.85,1947.85,116.87,1655.67,14 CPT,82672,Estrogens; total ,1947.85,1947.85,18.23,149.23,173 CPT,82677,ESTRIOL,1008.87,1008.87,60.53,857.54,14 CPT,82677,Estriol ,1008.87,1008.87,20.31,166.34,173 CPT,82679,ESTRONE,523.56,523.56,31.41,445.03,14 CPT,82679,Estrone ,523.56,523.56,20.96,171.59,173 CPT,82681,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.47,147.31,158 CPT,82693,ETHYLENE GLYCOL,658.08,658.08,39.48,559.37,14 CPT,82693,Ethylene glycol ,658.08,658.08,12.52,102.45,173 CPT,82696,Etiocholanolone ,,,22.04,180.46,173 CPT,82705,FECAL FAT QUAL,489.0,489.0,29.34,415.65,14 CPT,82705,"Fat or lipids, feces; qualitative ",489.0,489.0,4.28,35.11,173 CPT,82710,FECAL FAT QUANT,507.73,507.73,30.46,431.57,14 CPT,82710,"Fat or lipids, feces; quantitative ",507.73,507.73,14.11,115.57,173 CPT,82715,"Fat differential, feces, quantitative ",,,19.29,158.01,173 CPT,82725,"Fatty acids, nonesterified ",,,15.77,129.14,173 CPT,82726,Very long chain fatty acids ,,,16.59,135.84,173 CPT,82728,FERRITIN,1325.0,1325.0,79.5,1126.25,14 CPT,82728,Ferritin ,1325.0,1325.0,11.45,93.76,173 CPT,82731,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,54.1,443.0,173 CPT,82735,Fluoride ,,,15.57,127.51,173 CPT,82746,FOLATE (FOLIC ACID) SER,1304.0,1304.0,78.24,1108.4,14 CPT,82746,Folic acid; serum ,1304.0,1304.0,12.35,101.09,173 CPT,82747,Folic acid; RBC ,,,14.83,121.36,173 CPT,82757,"Fructose, semen ",,,14.57,119.28,173 CPT,82759,"Galactokinase, RBC ",,,18.04,147.7,173 CPT,82760,Galactose ,,,9.41,77.02,173 CPT,82775,Galactose-1-phosphate uridyl transferase; quantitative ,,,17.7,144.89,173 CPT,82776,Galactose-1-phosphate uridyl transferase; screen ,,,9.86,80.73,173 CPT,82777,Galectin-3 ,,,43.37,304.35,145 CPT,82784,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.81,63.98,173 CPT,82784,IGA EA,1015.47,1015.47,60.93,863.15,14 CPT,82784,IGG CSF EA,1027.0,1027.0,61.62,872.95,14 CPT,82784,IGG EA,1027.0,1027.0,61.62,872.95,14 CPT,82784,IGM EA,1027.0,1027.0,61.62,872.95,14 CPT,82785,Gammaglobulin (immunoglobulin); IgE ,1226.0,1226.0,13.83,113.22,173 CPT,82785,IGE,1226.0,1226.0,73.56,1042.1,14 CPT,82787,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",1252.0,1252.0,6.74,55.2,173 CPT,82787,IGG SUBCLASSES EA,1252.0,1252.0,75.12,1064.2,14 CPT,82800,"Gases, blood, pH only ",,,9.24,75.66,173 CPT,82803,BG WITH CALC O2 SAT,429.51,429.51,25.77,365.08,28 CPT,82803,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,21.9,179.28,173 CPT,82805,BG WITH MEAS O2 SAT,2650.0,2650.0,159.0,2252.5,14 CPT,82805,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",2650.0,2650.0,66.17,541.82,173 CPT,82810,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.21,67.24,173 CPT,82820,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.21,91.77,173 CPT,82930,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.64,46.16,173 CPT,82938,Gastrin after secretin stimulation ,,,14.86,121.63,173 CPT,82941,GASTRIN,1265.0,1265.0,75.9,1075.25,14 CPT,82941,Gastrin ,1265.0,1265.0,14.81,121.27,173 CPT,82943,Glucagon ,,,12.0,98.28,173 CPT,82945,GLUCOSE BODY FLD QN,207.0,207.0,12.42,175.95,14 CPT,82945,GLUCOSE CSF QN,207.0,207.0,12.42,175.95,14 CPT,82945,"Glucose, body fluid, other than blood ",,,3.3,27.06,173 CPT,82946,Glucagon tolerance test ,,,14.93,122.27,173 CPT,82947,GLUCOSE BLD QN,199.0,199.0,11.94,169.15,14 CPT,82947,"Glucose; quantitative, blood (except reagent strip) ",199.0,199.0,3.3,27.06,173 CPT,82948,"Glucose; blood, reagent strip ",,,4.23,34.66,173 CPT,82950,Glucose; post glucose dose (includes glucose) ,,,3.99,32.67,173 CPT,82951,GTT 1ST 3 SPECIMENS,832.16,832.16,49.93,707.34,14 CPT,82951,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",832.16,832.16,10.81,88.51,173 CPT,82952,GTT EA ADDTL >3 SPEC,257.16,257.16,15.43,218.59,14 CPT,82952,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",257.16,257.16,3.29,26.97,173 CPT,82955,G-6-PD QUANT,865.0,865.0,51.9,735.25,14 CPT,82955,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,865.0,865.0,8.15,66.7,173 CPT,82960,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.08,41.63,173 CPT,82962,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,3.21,22.53,145 CPT,82963,"Glucosidase, beta ",,,18.04,147.7,173 CPT,82965,Glutamate dehydrogenase ,,,11.05,90.41,173 CPT,82977,GAMMA GT,940.0,940.0,56.4,799.0,14 CPT,82977,"Glutamyltransferase, gamma (GGT) ",940.0,940.0,6.05,49.5,173 CPT,82978,Glutathione ,,,12.98,106.25,173 CPT,82979,"Glutathione reductase, RBC ",,,7.93,64.89,173 CPT,82985,FRUCTOSAMINE,895.46,895.46,53.73,761.14,14 CPT,82985,Glycated protein ,895.46,895.46,14.08,115.3,173 CPT,83001,FSH,1654.0,1654.0,99.24,1405.9,14 CPT,83001,Gonadotropin; follicle stimulating hormone (FSH) ,1654.0,1654.0,15.61,127.79,173 CPT,83002,Gonadotropin; luteinizing hormone (LH) ,1952.0,1952.0,15.56,127.42,173 CPT,83002,LH,1952.0,1952.0,117.12,1659.2,14 CPT,83003,GROWTH HORMONE (HGH),820.29,820.29,49.22,697.25,14 CPT,83003,"Growth hormone, human (HGH) (somatotropin) ",820.29,820.29,14.0,114.66,173 CPT,83006,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,63.5,520.01,171 CPT,83009,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,56.58,463.27,173 CPT,83010,HAPTOGLOBIN QUANT,533.0,533.0,31.98,453.05,14 CPT,83010,Haptoglobin; quantitative ,533.0,533.0,10.57,86.52,173 CPT,83012,Haptoglobin; phenotypes ,,,22.59,184.98,173 CPT,83013,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,56.58,463.27,173 CPT,83014,Helicobacter pylori; drug administration ,,,6.6,54.03,173 CPT,83015,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.59,143.99,173 CPT,83018,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.45,151.04,173 CPT,83020,HEMOGLOBIN ELECTRO,717.43,717.43,43.05,609.82,14 CPT,83020,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",717.43,717.43,10.81,88.51,173 CPT,83021,HEMOGLOBIN FRACT HPLC,133.2,133.2,7.99,113.22,14 CPT,83021,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",133.2,133.2,15.17,124.26,173 CPT,83026,"Hemoglobin; by copper sulfate method, non-automated ",,,3.37,27.6,173 CPT,83030,"Hemoglobin; F (fetal), chemical ",,,9.02,73.85,173 CPT,83033,"Hemoglobin; F (fetal), qualitative ",,,6.72,55.02,173 CPT,83036,HEMOGLOBIN A1C,566.0,566.0,33.96,481.1,14 CPT,83036,Hemoglobin; glycosylated (A1C) ,566.0,566.0,8.16,66.79,173 CPT,83037,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.16,66.79,173 CPT,83045,"Hemoglobin; methemoglobin, qualitative ",,,5.45,44.62,173 CPT,83050,"Hemoglobin; methemoglobin, quantitative ",316.51,316.51,6.89,56.38,173 CPT,83050,METHEMOGLOBIN QUANT,316.51,316.51,18.99,269.03,14 CPT,83051,HEMOGLOBIN PLASMA,1132.84,1132.84,67.97,962.91,14 CPT,83051,Hemoglobin; plasma ,1132.84,1132.84,6.14,50.32,173 CPT,83060,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.39,60.54,173 CPT,83065,Hemoglobin; thermolabile ,,,7.56,61.9,173 CPT,83068,"Hemoglobin; unstable, screen ",,,7.95,65.16,173 CPT,83069,Hemoglobin; urine ,,,3.32,27.15,173 CPT,83070,"Hemosiderin, qualitative ",,,3.99,32.67,173 CPT,83080,"b-Hexosaminidase, each assay ",,,14.17,116.02,173 CPT,83088,HISTAMINE BLOOD,1047.12,1047.12,62.83,890.05,14 CPT,83088,Histamine ,1047.12,1047.12,24.81,203.08,173 CPT,83090,HOMOCYSTEINE QN,1569.0,1569.0,94.14,1333.65,14 CPT,83090,Homocysteine ,1569.0,1569.0,15.05,123.26,173 CPT,83150,Homovanillic acid (HVA) ,,,18.82,154.12,173 CPT,83491,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.04,123.08,173 CPT,83497,5 HIAA,754.0,754.0,45.24,640.9,14 CPT,83497,"Hydroxyindolacetic acid, 5-(HIAA) ",754.0,754.0,10.84,88.69,173 CPT,83498,HYDROXYPROG 17D,466.85,466.85,28.01,396.82,14 CPT,83498,"Hydroxyprogesterone, 17-d ",466.85,466.85,22.82,186.88,173 CPT,83500,Hydroxyproline; free ,,,19.03,155.75,173 CPT,83505,Hydroxyproline; total ,,,20.41,167.15,173 CPT,83516,ANTI-MPO AB ANCA,108.14,108.14,6.49,91.92,14 CPT,83516,ANTI-PR3 AB ANCA,108.14,108.14,6.49,91.92,14 CPT,83516,ANTIGLOMERULAR B MIA QL,741.16,741.16,44.47,629.99,14 CPT,83516,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.69,79.28,173 CPT,83516,MDA5 (CADM-140) AB IA QL,30.0,30.0,1.8,25.5,14 CPT,83516,MYOSITIS EJ AB QL IA,595.0,595.0,35.7,505.75,14 CPT,83516,MYOSITIS KU AB QL IA,595.0,595.0,35.7,505.75,14 CPT,83516,MYOSITIS MI-2 AB QL IA,595.0,595.0,35.7,505.75,14 CPT,83516,MYOSITIS NXP-2 AB QL IA,595.0,595.0,35.7,505.75,14 CPT,83516,MYOSITIS OJ AB QL IA,595.0,595.0,35.7,505.75,14 CPT,83516,MYOSITIS PL-12 AB QL IA,30.0,30.0,1.8,25.5,14 CPT,83516,MYOSITIS PL-7 AB QL IA,36.97,36.97,2.22,31.42,14 CPT,83516,PARIETAL CELL AB IA QL,60.67,60.67,3.64,51.57,14 CPT,83516,SAE1 (SUMO ACT ENZ) AB,140.0,140.0,8.4,119.0,14 CPT,83516,SRP AB QL RIPA IA,39.12,39.12,2.35,33.25,14 CPT,83518,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.1,66.34,173 CPT,83519,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.46,126.52,173 CPT,83520,ADAMTS 13 AB IA QN,806.87,806.87,48.41,685.84,14 CPT,83520,FACTOR VIII ANTIGEN IA,532.0,532.0,31.92,452.2,14 CPT,83520,GM1 AB IA QN IGG,400.12,400.12,24.01,340.1,14 CPT,83520,GM1 AB IA QN IGM,331.14,331.14,19.87,281.47,14 CPT,83520,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.51,118.83,173 CPT,83520,MAG IGM AB IA QN,50.0,50.0,3.0,42.5,14 CPT,83520,VEGF IA QN,915.0,915.0,54.9,777.75,14 CPT,83521,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.51,91.62,160 CPT,83521,LIGHT CHAINS KAP FREE,545.0,545.0,32.7,463.25,27 CPT,83521,LIGHT CHAINS LAM FREE,545.0,545.0,32.7,463.25,27 CPT,83525,INSULIN TOTAL,675.0,675.0,40.5,573.75,14 CPT,83525,Insulin; total ,675.0,675.0,9.6,78.64,173 CPT,83527,Insulin; free ,,,10.88,89.05,173 CPT,83528,Intrinsic factor ,,,16.65,136.29,173 CPT,83529,INTERLEUKIN 6 IA QN,718.75,718.75,43.13,610.94,27 CPT,83529,Interleukin-6 (IL-6) ,718.75,718.75,14.51,91.62,160 CPT,83540,IRON,795.0,795.0,47.7,675.75,14 CPT,83540,Iron ,795.0,795.0,5.43,44.53,173 CPT,83550,IRON BINDING,979.0,979.0,58.74,832.15,14 CPT,83550,Iron binding capacity ,979.0,979.0,7.34,60.09,173 CPT,83570,Isocitric dehydrogenase (IDH) ,,,7.43,60.91,173 CPT,83582,"Ketogenic steroids, fractionation ",,,12.99,106.43,173 CPT,83586,"Ketosteroids, 17- (17-KS); total ",,,10.75,88.06,173 CPT,83593,"Ketosteroids, 17- (17-KS); fractionation ",,,23.94,196.02,173 CPT,83605,LACTIC ACID,632.0,632.0,37.92,537.2,28 CPT,83605,LACTIC ACID BODY FL,905.0,905.0,54.3,769.25,14 CPT,83605,Lactate (lactic acid) ,,,9.72,79.55,173 CPT,83615,LDH (LD),1021.0,1021.0,61.26,867.85,14 CPT,83615,LDH (LD) BODY FLUID,443.12,443.12,26.59,376.65,14 CPT,83615,"Lactate dehydrogenase (LD), (LDH); ",,,5.07,41.54,173 CPT,83625,LDH ISOENZYMES,545.0,545.0,32.7,463.25,14 CPT,83625,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",545.0,545.0,10.74,87.97,173 CPT,83630,"Lactoferrin, fecal; qualitative ",,,16.55,135.48,173 CPT,83631,"Lactoferrin, fecal; quantitative ",,,16.49,135.03,173 CPT,83632,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,16.98,139.1,173 CPT,83633,"Lactose, urine, qualitative ",,,9.45,77.38,173 CPT,83655,LEAD BLOOD,741.16,741.16,44.47,629.99,14 CPT,83655,Lead ,741.16,741.16,10.17,83.26,173 CPT,83661,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.47,151.23,173 CPT,83662,Fetal lung maturity assessment; foam stability test ,,,15.88,130.05,173 CPT,83663,Fetal lung maturity assessment; fluorescence polarization ,,,15.88,130.05,173 CPT,83664,Fetal lung maturity assessment; lamellar body density ,,,16.23,132.85,173 CPT,83670,Leucine aminopeptidase (LAP) ,,,8.24,67.51,173 CPT,83690,LIPASE,865.0,865.0,51.9,735.25,14 CPT,83690,Lipase ,865.0,865.0,5.79,47.42,173 CPT,83695,LIPOPROTEIN (A),594.77,594.77,35.69,505.55,14 CPT,83695,Lipoprotein (a) ,594.77,594.77,12.03,98.46,173 CPT,83698,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,38.9,318.56,173 CPT,83700,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.46,77.47,173 CPT,83701,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,28.44,232.86,173 CPT,83704,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,28.72,235.12,173 CPT,83718,HDL CHOLESTEROL DM,1109.0,1109.0,66.54,942.65,14 CPT,83718,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",1109.0,1109.0,6.88,56.29,173 CPT,83719,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.71,87.69,173 CPT,83721,"Lipoprotein, direct measurement; LDL cholesterol ",,,8.82,72.22,173 CPT,83722,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,28.72,235.12,172 CPT,83727,Luteinizing releasing factor (LRH) ,,,14.44,118.19,173 CPT,83735,MAGNESIUM BLD,925.79,925.79,55.55,786.92,28 CPT,83735,Magnesium ,,,5.63,46.06,173 CPT,83775,Malate dehydrogenase ,,,6.19,50.68,173 CPT,83785,Manganese ,,,22.39,183.26,173 CPT,83789,IODINE MS QN EACH SPEC,1908.0,1908.0,114.48,1621.8,14 CPT,83789,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",1908.0,1908.0,20.25,165.8,173 CPT,83825,MERCURY BLD QUANT,873.04,873.04,52.38,742.08,14 CPT,83825,"Mercury, quantitative ",873.04,873.04,13.66,111.86,173 CPT,83835,METANEPHRINES FRACT,1580.0,1580.0,94.8,1343.0,14 CPT,83835,Metanephrines ,1580.0,1580.0,14.23,116.47,173 CPT,83857,Methemalbumin ,,,9.02,73.85,173 CPT,83861,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,18.88,154.57,173 CPT,83864,"Mucopolysaccharides, acid, quantitative ",,,23.94,196.02,173 CPT,83872,"Mucin, synovial fluid (Ropes test) ",,,4.92,40.27,173 CPT,83873,"Myelin basic protein, cerebrospinal fluid ",,,14.45,118.28,173 CPT,83874,MYOGLOBIN BLD,466.85,466.85,28.01,396.82,14 CPT,83874,MYOGLOBIN URINE,467.0,467.0,28.02,396.95,14 CPT,83874,Myoglobin ,,,10.85,88.87,173 CPT,83876,Myeloperoxidase (MPO) ,,,49.84,349.78,145 CPT,83880,NATRIURETIC PEPTIDE,1958.0,1958.0,117.48,1664.3,28 CPT,83880,Natriuretic peptide ,,,32.98,270.05,173 CPT,83880,PRO-BNP QT,1958.4,1958.4,117.5,1664.64,14 CPT,83883,"Nephelometry, each analyte not elsewhere specified ",,,11.42,93.58,173 CPT,83884,Neurofilament light chain (NfL) ,,,14.51,335.9,56 CPT,83885,Nickel ,,,20.59,168.6,173 CPT,83915,Nucleotidase 5'- ,,,9.37,76.65,173 CPT,83916,OLIGOCLONAL BANDS,1337.0,1337.0,80.22,1136.45,14 CPT,83916,Oligoclonal immune (oligoclonal bands) ,1337.0,1337.0,23.01,188.42,173 CPT,83918,"Organic acids; total, quantitative, each specimen ",,,19.82,162.36,173 CPT,83919,"Organic acids; qualitative, each specimen ",,,13.82,113.13,173 CPT,83921,METHYLMALONIC ACID QN,1906.98,1906.98,114.42,1620.93,14 CPT,83921,"Organic acid, single, quantitative ",1906.98,1906.98,17.82,145.89,173 CPT,83930,OSMOLALITY BLD,843.0,843.0,50.58,716.55,14 CPT,83930,Osmolality; blood ,843.0,843.0,5.55,45.43,173 CPT,83935,OSMOLALITY UR,843.0,843.0,50.58,716.55,14 CPT,83935,Osmolality; urine ,843.0,843.0,5.73,46.88,173 CPT,83937,Osteocalcin (bone g1a protein) ,,,25.07,205.34,173 CPT,83945,OXALATE,1151.0,1151.0,69.06,978.35,14 CPT,83945,Oxalate ,1151.0,1151.0,12.14,99.37,173 CPT,83950,Oncoprotein; HER-2/neu ,,,54.1,443.0,173 CPT,83951,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,54.1,443.0,173 CPT,83970,PTH INTACT,2311.84,2311.84,138.71,1965.06,14 CPT,83970,Parathormone (parathyroid hormone) ,2311.84,2311.84,34.68,283.9,173 CPT,83986,PH BODY FLUID,427.0,427.0,25.62,362.95,14 CPT,83986,"pH; body fluid, not otherwise specified ",427.0,427.0,3.01,24.62,173 CPT,83987,pH; exhaled breath condensate ,,,3.51,24.62,143 CPT,83992,PHENCYCLIDINE QUANT,752.56,752.56,45.15,639.68,22 CPT,83992,Phencyclidine (PCP) ,752.56,752.56,0.07,195.8,126 CPT,83993,CALPROTECTIN FECAL,1657.72,1657.72,99.46,1409.06,14 CPT,83993,"Calprotectin, fecal ",1657.72,1657.72,16.49,135.03,173 CPT,84030,"Phenylalanine (PKU), blood ",,,4.62,37.83,173 CPT,84035,"Phenylketones, qualitative ",,,3.34,27.33,173 CPT,84060,"Phosphatase, acid; total ",,,6.42,52.58,173 CPT,84066,"Phosphatase, acid; prostatic ",,,8.11,66.43,173 CPT,84075,ALK PHOS (ALP),808.0,808.0,48.48,686.8,14 CPT,84075,"Phosphatase, alkaline; ",808.0,808.0,4.35,35.66,173 CPT,84078,"Phosphatase, alkaline; heat stable (total not included) ",,,6.94,56.83,173 CPT,84080,ALK PHOS ISOENZYMES,1612.88,1612.88,96.77,1370.95,14 CPT,84080,"Phosphatase, alkaline; isoenzymes ",1612.88,1612.88,12.42,101.63,173 CPT,84081,Phosphatidylglycerol ,,,13.88,113.67,173 CPT,84085,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,7.93,64.89,173 CPT,84087,Phosphohexose isomerase ,,,9.01,73.76,173 CPT,84100,PHOSPHORUS BLD,738.76,738.76,44.31,628.15,28 CPT,84100,Phosphorus inorganic (phosphate); ,,,3.98,32.58,173 CPT,84105,PHOSPHORUS UR,738.52,738.52,44.31,627.74,14 CPT,84105,Phosphorus inorganic (phosphate); urine ,738.52,738.52,4.86,39.73,173 CPT,84106,"Porphobilinogen, urine; qualitative ",,,4.89,40.0,173 CPT,84110,"Porphobilinogen, urine; quantitative ",,,7.09,58.01,173 CPT,84112,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",377.17,377.17,82.41,674.77,173 CPT,84112,PAMG-1 CVS QL,377.17,377.17,22.63,320.59,14 CPT,84119,"Porphyrins, urine; qualitative ",,,11.22,91.86,173 CPT,84120,"Porphyrins, urine; quantitation and fractionation ",,,12.36,101.18,173 CPT,84126,"Porphyrins, feces, quantitative ",,,32.85,268.97,173 CPT,84132,POTASSIUM BLD,574.0,574.0,34.44,487.9,14 CPT,84132,"Potassium; serum, plasma or whole blood ",574.0,574.0,4.0,32.76,173 CPT,84133,POTASSIUM UR,574.0,574.0,34.44,487.9,14 CPT,84133,Potassium; urine ,574.0,574.0,3.97,32.49,173 CPT,84134,PREALBUMIN,915.0,915.0,54.9,777.75,14 CPT,84134,Prealbumin ,915.0,915.0,12.26,100.36,173 CPT,84135,Pregnanediol ,,,17.87,146.34,173 CPT,84138,Pregnanetriol ,,,17.68,144.8,173 CPT,84140,Pregnenolone ,,,17.36,142.18,173 CPT,84143,17-hydroxypregnenolone ,,,19.16,156.93,173 CPT,84144,PROGESTERONE,936.0,936.0,56.16,795.6,14 CPT,84144,Progesterone ,936.0,936.0,17.52,143.44,173 CPT,84145,Procalcitonin (PCT) ,,,22.86,187.24,173 CPT,84146,PROLACTIN,1597.0,1597.0,95.82,1357.45,14 CPT,84146,Prolactin ,1597.0,1597.0,16.28,133.31,173 CPT,84150,"Prostaglandin, each ",,,35.09,287.34,173 CPT,84152,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.45,126.52,173 CPT,84153,PROS SPEC AG (PSA) TOTAL,1274.0,1274.0,76.44,1082.9,14 CPT,84153,Prostate specific antigen (PSA); total ,1274.0,1274.0,15.45,126.52,173 CPT,84154,PROS SPEC AG FREE,798.0,798.0,47.88,678.3,14 CPT,84154,Prostate specific antigen (PSA); free ,798.0,798.0,15.45,126.52,173 CPT,84155,"Protein, total, except by refractometry; serum, plasma or whole blood ",782.0,782.0,3.08,25.25,173 CPT,84155,TOTAL PROTEIN BLD,782.0,782.0,46.92,664.7,14 CPT,84156,"Protein, total, except by refractometry; urine ",798.0,798.0,3.08,25.25,173 CPT,84156,TOTAL PROTEIN URINE QN,798.0,798.0,47.88,678.3,14 CPT,84157,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.36,27.51,173 CPT,84157,TOT PROTEIN BODY FLDS QN,798.0,798.0,47.88,678.3,14 CPT,84157,TOTAL PROTEIN CSF QN,797.87,797.87,47.87,678.19,14 CPT,84160,"Protein, total, by refractometry, any source ",,,4.71,38.55,173 CPT,84163,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.64,103.53,173 CPT,84165,PROTEIN ELECTRO SER,1689.0,1689.0,101.34,1435.65,14 CPT,84165,"Protein; electrophoretic fractionation and quantitation, serum ",1689.0,1689.0,9.02,73.85,173 CPT,84166,PROTEIN ELECTRO CSF,1604.0,1604.0,96.24,1363.4,14 CPT,84166,PROTEIN ELECTRO URINE,1689.0,1689.0,101.34,1435.65,14 CPT,84166,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,14.98,122.63,173 CPT,84181,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.31,117.11,173 CPT,84182,AGNA-1/SOX1 AB IB,525.0,525.0,31.5,446.25,14 CPT,84182,AMPHIPHYSIN AB IB,250.0,250.0,15.0,212.5,14 CPT,84182,CRMP5 IGG BY WB,170.0,170.0,10.2,144.5,14 CPT,84182,DNER LINE BLOT,720.0,720.0,43.2,612.0,14 CPT,84182,MA TA AB WB-BD,425.0,425.0,25.5,361.25,14 CPT,84182,NEUR NUC AB 1 HU WB&BAND,100.0,100.0,6.0,85.0,14 CPT,84182,PCA-TR/DNER AB IB,720.0,720.0,43.2,612.0,14 CPT,84182,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,24.54,200.91,173 CPT,84182,RI AB WB BAND ID,175.0,175.0,10.5,148.75,14 CPT,84182,YO AB WB BAND ID,175.0,175.0,10.5,148.75,14 CPT,84182,ZIC4 AB WB BAND ID,720.0,720.0,43.2,612.0,14 CPT,84202,"Protoporphyrin, RBC; quantitative ",,,12.05,98.74,173 CPT,84203,"Protoporphyrin, RBC; screen ",,,8.18,66.97,173 CPT,84206,Proinsulin ,,,22.42,183.53,173 CPT,84207,PYRIDOXAL 5 PHOS VIT B6,4045.0,4045.0,242.7,3438.25,14 CPT,84207,Pyridoxal phosphate (Vitamin B-6) ,4045.0,4045.0,23.6,193.31,173 CPT,84210,Pyruvate ,,,12.16,99.55,173 CPT,84220,Pyruvate kinase ,,,7.93,64.89,173 CPT,84228,Quinine ,,,9.77,80.0,173 CPT,84233,Receptor assay; estrogen ,,,73.82,604.45,173 CPT,84234,Receptor assay; progesterone ,,,54.5,446.26,173 CPT,84235,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,59.83,489.88,173 CPT,84238,Receptor assay; non-endocrine (specify receptor) ,400.0,400.0,30.72,251.5,173 CPT,84238,SOLUBLE TRANSFER REC QN,400.0,400.0,24.0,340.0,14 CPT,84244,RENIN,1660.0,1660.0,99.6,1411.0,14 CPT,84244,Renin ,1660.0,1660.0,18.47,151.23,173 CPT,84252,Riboflavin (Vitamin B-2) ,3272.0,3272.0,17.0,139.19,173 CPT,84252,VITAMIN B2 (RIBOFL),3272.0,3272.0,196.32,2781.2,14 CPT,84255,Selenium ,,,21.45,175.57,173 CPT,84260,SEROTONIN,1565.0,1565.0,93.9,1330.25,14 CPT,84260,Serotonin ,1565.0,1565.0,26.02,213.04,173 CPT,84270,Sex hormone binding globulin (SHBG) ,,,18.25,149.42,173 CPT,84275,Sialic acid ,,,11.29,92.4,173 CPT,84285,Silica ,,,21.18,173.4,173 CPT,84295,SODIUM BLD,625.0,625.0,37.5,531.25,14 CPT,84295,"Sodium; serum, plasma or whole blood ",625.0,625.0,4.04,33.12,173 CPT,84300,SODIUM UR,625.0,625.0,37.5,531.25,14 CPT,84300,Sodium; urine ,625.0,625.0,4.25,34.84,173 CPT,84302,Sodium; other source ,,,4.08,33.39,173 CPT,84305,SOMATOMEDIN C IGF-1,1976.87,1976.87,118.61,1680.34,14 CPT,84305,Somatomedin ,1976.87,1976.87,17.86,146.25,173 CPT,84307,Somatostatin ,,,15.36,125.7,173 CPT,84311,"Spectrophotometry, analyte not elsewhere specified ",,,6.8,55.75,173 CPT,84315,Specific gravity (except urine) ,,,2.76,22.53,173 CPT,84375,"Sugars, chromatographic, TLC or paper chromatography ",,,32.76,268.24,173 CPT,84376,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.62,37.83,173 CPT,84377,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.62,37.83,173 CPT,84378,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.69,79.28,173 CPT,84379,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.69,79.28,173 CPT,84392,"Sulfate, urine ",,,4.61,37.74,173 CPT,84393,"Tau, phosphorylated (eg, pTau 181, pTau 217), each ",,,34.89,372.58,56 CPT,84394,"Tau, total (tTau) ",,,34.89,372.58,56 CPT,84402,TESTOSTERONE FREE,2531.0,2531.0,151.86,2151.35,14 CPT,84402,Testosterone; free ,2531.0,2531.0,21.39,175.21,173 CPT,84403,TESTOSTERONE TOTAL,1898.0,1898.0,113.88,1613.3,14 CPT,84403,Testosterone; total ,1898.0,1898.0,21.68,177.56,173 CPT,84410,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,50.25,352.68,145 CPT,84425,Thiamine (Vitamin B-1) ,1025.0,1025.0,17.83,145.98,173 CPT,84425,VITAMIN B1 THIAMINE,1025.0,1025.0,61.5,871.25,14 CPT,84430,Thiocyanate ,,,9.77,80.0,173 CPT,84431,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,29.49,241.45,173 CPT,84432,THYROGLOBULIN,658.08,658.08,39.48,559.37,14 CPT,84432,Thyroglobulin ,658.08,658.08,13.49,110.5,173 CPT,84433,Thiopurine S-methyltransferase (TPMT) ,,,18.62,212.28,160 CPT,84436,THYROXINE T4 TOTAL,1039.0,1039.0,62.34,883.15,14 CPT,84436,Thyroxine; total ,1039.0,1039.0,5.77,47.24,173 CPT,84437,"Thyroxine; requiring elution (eg, neonatal) ",,,5.43,44.53,173 CPT,84439,T4 FREE,741.0,741.0,44.46,629.85,14 CPT,84439,Thyroxine; free ,741.0,741.0,7.58,62.08,173 CPT,84442,THYROXINE BG (TBG),978.55,978.55,58.71,831.77,14 CPT,84442,Thyroxine binding globulin (TBG) ,978.55,978.55,12.42,101.63,173 CPT,84443,TSH,1736.0,1736.0,104.16,1475.6,14 CPT,84443,Thyroid stimulating hormone (TSH) ,1736.0,1736.0,14.11,115.57,173 CPT,84445,THYROID STIM IMMUNO TSI,639.61,639.61,38.38,543.67,14 CPT,84445,Thyroid stimulating immune globulins (TSI) ,639.61,639.61,42.72,349.78,173 CPT,84446,Tocopherol alpha (Vitamin E) ,1040.52,1040.52,11.91,97.56,173 CPT,84446,VITAMIN E,1040.52,1040.52,62.43,884.44,14 CPT,84449,Transcortin (cortisol binding globulin) ,,,15.12,123.8,173 CPT,84450,AST (SGOT),1029.0,1029.0,61.74,874.65,14 CPT,84450,Transferase; aspartate amino (AST) (SGOT) ,1029.0,1029.0,4.35,35.66,173 CPT,84460,ALT (SGPT),1029.0,1029.0,61.74,874.65,14 CPT,84460,Transferase; alanine amino (ALT) (SGPT) ,1029.0,1029.0,4.45,36.47,173 CPT,84466,TRANSFERRIN,798.0,798.0,47.88,678.3,14 CPT,84466,Transferrin ,798.0,798.0,10.72,87.78,173 CPT,84478,TRIGLYCERIDES,1149.0,1149.0,68.94,976.65,14 CPT,84478,TRIGLYCERIDES OTHER,1148.66,1148.66,68.92,976.36,14 CPT,84478,Triglycerides ,,,4.82,39.46,173 CPT,84479,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.43,44.53,173 CPT,84480,T3 TOTAL,1761.0,1761.0,105.66,1496.85,14 CPT,84480,Triiodothyronine T3; total (TT-3) ,1761.0,1761.0,11.91,97.56,173 CPT,84481,T3 FREE,979.0,979.0,58.74,832.15,14 CPT,84481,Triiodothyronine T3; free ,979.0,979.0,14.23,116.47,173 CPT,84482,Triiodothyronine T3; reverse ,,,13.24,108.42,173 CPT,84484,TROPONIN QUANT,1328.0,1328.0,79.68,1128.8,28 CPT,84484,"Troponin, quantitative ",,,10.47,85.79,173 CPT,84485,Trypsin; duodenal fluid ,,,6.05,49.5,173 CPT,84488,"Trypsin; feces, qualitative ",,,6.13,50.23,173 CPT,84490,"Trypsin; feces, quantitative, 24-hour collection ",,,8.34,68.33,173 CPT,84510,Tyrosine ,,,8.93,73.12,173 CPT,84512,"Troponin, qualitative ",,,8.48,69.41,173 CPT,84520,BUN,622.47,622.47,37.35,529.1,14 CPT,84520,UREA NITROGEN OTHER,334.97,334.97,20.1,284.72,14 CPT,84520,Urea nitrogen; quantitative ,,,3.32,27.15,173 CPT,84525,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.31,35.3,173 CPT,84540,URINE UREA NITROGEN,791.0,791.0,47.46,672.35,14 CPT,84540,"Urea nitrogen, urine ",791.0,791.0,4.67,38.28,173 CPT,84545,"Urea nitrogen, clearance ",,,6.05,49.5,173 CPT,84550,URIC ACID BLD,622.0,622.0,37.32,528.7,14 CPT,84550,Uric acid; blood ,622.0,622.0,3.8,31.13,173 CPT,84560,URIC ACID BODY FLD,622.47,622.47,37.35,529.1,14 CPT,84560,URIC ACID UR,622.0,622.0,37.32,528.7,14 CPT,84560,Uric acid; other source ,,,4.27,34.93,173 CPT,84577,"Urobilinogen, feces, quantitative ",,,14.11,115.57,173 CPT,84578,"Urobilinogen, urine; qualitative ",,,3.75,30.77,173 CPT,84580,"Urobilinogen, urine; quantitative, timed specimen ",,,8.02,65.7,173 CPT,84583,"Urobilinogen, urine; semiquantitative ",,,5.08,41.63,173 CPT,84585,VMA URINE,1265.0,1265.0,75.9,1075.25,14 CPT,84585,"Vanillylmandelic acid (VMA), urine ",1265.0,1265.0,13.02,106.61,173 CPT,84586,Vasoactive intestinal peptide (VIP) ,,,29.68,242.99,173 CPT,84588,ADH (VASOPRESSIN),498.5,498.5,29.91,423.73,14 CPT,84588,"Vasopressin (antidiuretic hormone, ADH) ",498.5,498.5,28.51,233.4,173 CPT,84590,VITAMIN A,1982.0,1982.0,118.92,1684.7,14 CPT,84590,Vitamin A ,1982.0,1982.0,9.75,79.82,173 CPT,84591,"Vitamin, not otherwise specified ",,,14.33,117.38,173 CPT,84597,VITAMIN K,749.07,749.07,44.94,636.71,14 CPT,84597,Vitamin K ,749.07,749.07,11.52,94.39,173 CPT,84600,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.37,117.65,173 CPT,84620,"Xylose absorption test, blood and/or urine ",,,10.84,88.78,173 CPT,84630,ZINC BLOOD,450.0,450.0,27.0,382.5,14 CPT,84630,Zinc ,450.0,450.0,9.57,78.37,173 CPT,84681,C-PEPTIDE,673.0,673.0,40.38,572.05,14 CPT,84681,C-peptide ,673.0,673.0,17.48,143.17,173 CPT,84702,"Gonadotropin, chorionic (hCG); quantitative ",,,12.64,103.53,173 CPT,84702,HCG BETA QUANTITATIVE,930.0,930.0,55.8,790.5,14 CPT,84702,HCG QUANT TUMOR,929.75,929.75,55.78,790.29,14 CPT,84703,"Gonadotropin, chorionic (hCG); qualitative ",,,6.32,51.77,173 CPT,84703,HCG QL SERUM/URINE INSTR,207.05,207.05,12.42,175.99,14 CPT,84703,HCG QUALITATIVE SERUM,901.0,901.0,54.06,765.85,14 CPT,84704,"Gonadotropin, chorionic (hCG); free beta chain ",,,12.84,105.16,173 CPT,84830,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,12.45,87.33,145 CPT,84999,Unlisted chemistry procedure ,,,99.55,128.28,81 CPT,85002,Bleeding time ,,,4.05,33.12,173 CPT,85004,Blood count; automated differential WBC count ,,,5.43,44.53,173 CPT,85007,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.19,26.15,173 CPT,85008,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.88,23.62,173 CPT,85009,"Blood count; manual differential WBC count, buffy coat ",,,4.26,34.84,173 CPT,85013,Blood count; spun microhematocrit ,,,5.88,48.15,173 CPT,85014,Blood count; hematocrit (Hct) ,348.0,348.0,1.99,16.29,173 CPT,85014,HEMATOCRIT,348.0,348.0,20.88,295.8,14 CPT,85018,Blood count; hemoglobin (Hgb) ,398.0,398.0,1.99,16.29,173 CPT,85018,HEMOGLOBIN,398.0,398.0,23.88,338.3,14 CPT,85025,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.53,53.49,173 CPT,85027,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.43,44.53,173 CPT,85027,CBC AUTOMATED,901.0,901.0,54.06,765.85,28 CPT,85032,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.62,29.68,173 CPT,85041,"Blood count; red blood cell (RBC), automated ",203.09,203.09,2.54,20.82,173 CPT,85041,RBC COUNT BLD AUTO,203.09,203.09,12.19,172.63,14 CPT,85044,"Blood count; reticulocyte, manual ",,,3.62,29.68,173 CPT,85045,"Blood count; reticulocyte, automated ",,,3.35,27.42,173 CPT,85046,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",534.11,534.11,4.68,38.28,173 CPT,85046,RETIC CT AUTO W/RET-HE,534.11,534.11,32.05,453.99,14 CPT,85048,"Blood count; leukocyte (WBC), automated ",,,2.13,17.47,173 CPT,85049,"Blood count; platelet, automated ",427.0,427.0,3.76,30.77,173 CPT,85049,PLATELET AUTOMATED,427.0,427.0,25.62,362.95,14 CPT,85055,Reticulated platelet assay ,,,30.02,245.8,173 CPT,85060,"Blood smear, peripheral, interpretation by physician with written report ",,,50.96,172.95,98 CPT,85097,BONE MARROW TECH ASSIST,1499.0,1499.0,89.94,1274.15,23 CPT,85097,"Bone marrow, smear interpretation ",1499.0,1499.0,134.49,2003.96,98 CPT,85130,Chromogenic substrate assay ,,,9.99,81.81,173 CPT,85170,Clot retraction ,,,13.69,112.13,173 CPT,85175,"Clot lysis time, whole blood dilution ",,,17.11,140.09,173 CPT,85210,"Clotting; factor II, prothrombin, specific ",2199.74,2199.74,10.9,89.23,173 CPT,85210,FACTOR 2 PROTHROMBIN,2199.74,2199.74,131.98,1869.78,14 CPT,85220,"Clotting; factor V (AcG or proaccelerin), labile factor ",1761.0,1761.0,14.83,121.36,173 CPT,85220,FACTOR 5 LABILE,1761.0,1761.0,105.66,1496.85,14 CPT,85230,"Clotting; factor VII (proconvertin, stable factor) ",1966.32,1966.32,15.04,123.08,173 CPT,85230,FACTOR 7 STABLE,1966.32,1966.32,117.98,1671.37,14 CPT,85240,"Clotting; factor VIII (AHG), 1-stage ",2102.0,2102.0,15.04,123.08,173 CPT,85240,FACTOR 8 ACTIVITY 1STAGE,2102.0,2102.0,126.12,1786.7,14 CPT,85244,Clotting; factor VIII related antigen ,,,17.15,140.46,173 CPT,85245,"Clotting; factor VIII, VW factor, ristocetin cofactor ",3013.44,3013.44,19.27,157.74,173 CPT,85245,FACTOR 8 RISTOCETIN,3013.44,3013.44,180.81,2561.42,14 CPT,85246,"Clotting; factor VIII, VW factor antigen ",1515.3,1515.3,19.27,157.74,173 CPT,85246,FACTOR 8 VW AG,1515.3,1515.3,90.92,1288.01,14 CPT,85247,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.27,157.74,173 CPT,85250,Clotting; factor IX (PTC or Christmas) ,1815.97,1815.97,15.99,130.95,173 CPT,85250,FACTOR 9 ACTIVITY,1815.97,1815.97,108.96,1543.57,14 CPT,85260,Clotting; factor X (Stuart-Prower) ,1815.97,1815.97,15.04,123.08,173 CPT,85260,FACTOR 10 ASSAY,1815.97,1815.97,108.96,1543.57,14 CPT,85270,Clotting; factor XI (PTA) ,1815.97,1815.97,15.04,123.08,173 CPT,85270,FACTOR 11 ACTIVITY,1815.97,1815.97,108.96,1543.57,14 CPT,85280,Clotting; factor XII (Hageman) ,1815.97,1815.97,16.25,133.13,173 CPT,85280,FACTOR 12 ASSAY,1815.97,1815.97,108.96,1543.57,14 CPT,85290,Clotting; factor XIII (fibrin stabilizing) ,1565.4,1565.4,13.73,112.4,173 CPT,85290,FACTOR 13 ACTIVITY QN,1565.4,1565.4,93.92,1330.59,14 CPT,85291,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.65,62.63,173 CPT,85292,Clotting; prekallikrein assay (Fletcher factor assay) ,,,15.9,130.23,173 CPT,85293,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,15.9,130.23,173 CPT,85300,ANTITHROMBIN 3 ACT,1395.28,1395.28,83.72,1185.99,14 CPT,85300,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",1395.28,1395.28,9.95,81.54,173 CPT,85301,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.08,74.39,173 CPT,85302,"Clotting inhibitors or anticoagulants; protein C, antigen ",2850.0,2850.0,10.09,82.63,173 CPT,85302,PROTEIN C AG,2850.0,2850.0,171.0,2422.5,14 CPT,85303,"Clotting inhibitors or anticoagulants; protein C, activity ",1540.34,1540.34,11.63,95.21,173 CPT,85303,PROTEIN C ACTIVITY,1540.34,1540.34,92.42,1309.29,14 CPT,85305,"Clotting inhibitors or anticoagulants; protein S, total ",1540.0,1540.0,9.75,79.82,173 CPT,85305,PROTEIN S ANTIGEN TOTAL,1540.0,1540.0,92.4,1309.0,14 CPT,85306,"Clotting inhibitors or anticoagulants; protein S, free ",,,12.87,105.34,173 CPT,85306,PROTEIN S FREE,1540.34,1540.34,92.42,1309.29,14 CPT,85306,PROTEIN S FUNCTIONAL,258.48,258.48,15.51,219.71,14 CPT,85307,APC RESISTANCE,2356.68,2356.68,141.4,2003.18,14 CPT,85307,Activated Protein C (APC) resistance assay ,2356.68,2356.68,12.87,105.34,173 CPT,85335,Factor inhibitor test ,,,10.81,88.51,173 CPT,85337,Thrombomodulin ,,,14.51,118.83,173 CPT,85345,Coagulation time; Lee and White ,,,3.94,32.22,173 CPT,85347,Coagulation time; activated ,,,3.6,29.41,173 CPT,85348,Coagulation time; other methods ,,,3.77,30.86,173 CPT,85360,Euglobulin lysis ,,,7.06,57.83,173 CPT,85362,FDP SEMIQUANT,1194.0,1194.0,71.64,1014.9,14 CPT,85362,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",1194.0,1194.0,5.79,47.42,173 CPT,85366,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,67.59,553.41,173 CPT,85370,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.44,85.52,173 CPT,85378,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.16,66.88,173 CPT,85379,D-DIMER QUANT,1060.0,1060.0,63.6,901.0,28 CPT,85379,"Fibrin degradation products, D-dimer; quantitative ",,,8.55,70.05,173 CPT,85380,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.55,70.05,173 CPT,85384,FIBRINOGEN ACTIVITY,960.0,960.0,57.6,816.0,14 CPT,85384,Fibrinogen; activity ,960.0,960.0,8.16,66.88,173 CPT,85385,Fibrinogen; antigen ,,,12.15,99.46,173 CPT,85390,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.0,106.43,173 CPT,85396,COAG/FIBRIN WB VCA ROTEM,1210.5,1210.5,72.63,1028.92,28 CPT,85396,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",1210.5,1210.5,42.22,139.28,98 CPT,85397,ADAMTS-13,806.87,806.87,48.41,685.84,14 CPT,85397,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",806.87,806.87,25.92,212.22,173 CPT,85400,Fibrinolytic factors and inhibitors; plasmin ,,,6.48,53.03,173 CPT,85410,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.48,53.03,173 CPT,85415,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.44,118.19,173 CPT,85420,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.49,44.89,173 CPT,85421,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.55,70.05,173 CPT,85441,Heinz bodies; direct ,,,3.53,28.87,173 CPT,85445,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.73,46.88,173 CPT,85460,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.49,53.12,173 CPT,85461,FETAL SCREEN (ROSETTE),1047.12,1047.12,62.83,890.05,14 CPT,85461,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",1047.12,1047.12,7.86,64.35,173 CPT,85475,"Hemolysin, acid ",,,7.45,61.0,173 CPT,85520,HEPARIN ANTI XA,1226.0,1226.0,73.56,1042.1,14 CPT,85520,Heparin assay ,1226.0,1226.0,11.0,90.05,173 CPT,85525,Heparin neutralization ,,,9.95,81.45,173 CPT,85530,Heparin-protamine tolerance test ,,,11.0,90.05,173 CPT,85536,"Iron stain, peripheral blood ",,,5.78,47.33,173 CPT,85540,Leukocyte alkaline phosphatase with count ,,,7.22,59.19,173 CPT,85547,"Mechanical fragility, RBC ",,,7.22,59.19,173 CPT,85549,Muramidase ,,,15.75,128.96,173 CPT,85555,"Osmotic fragility, RBC; unincubated ",,,6.27,51.4,173 CPT,85557,"Osmotic fragility, RBC; incubated ",,,11.22,91.86,173 CPT,85576,PLT AGGREGATE COLL/ADP,377.17,377.17,22.63,320.59,14 CPT,85576,PLT AGGREGATE COLL/EPI,377.0,377.0,22.62,320.45,14 CPT,85576,PLT AGGREGATE P2Y12,4134.41,4134.41,248.06,3514.25,14 CPT,85576,"Platelet, aggregation (in vitro), each agent ",,,20.92,171.32,173 CPT,85597,Phospholipid neutralization; platelet ,,,15.1,123.62,173 CPT,85598,HEXAGONAL PHOSPHOLIPID,191.27,191.27,11.48,162.58,14 CPT,85598,Phospholipid neutralization; hexagonal phospholipid ,191.27,191.27,15.1,123.62,173 CPT,85610,PROTIME,798.0,798.0,47.88,678.3,28 CPT,85610,Prothrombin time; ,,,3.6,29.5,173 CPT,85611,PT SUBSTITUTION MIXING,1255.48,1255.48,75.33,1067.16,14 CPT,85611,"Prothrombin time; substitution, plasma fractions, each ",1255.48,1255.48,3.31,27.06,173 CPT,85612,Russell viper venom time (includes venom); undiluted ,,,14.69,120.27,173 CPT,85613,RUSSELL VIPER DILUTED,820.0,820.0,49.2,697.0,14 CPT,85613,Russell viper venom time (includes venom); diluted ,820.0,820.0,8.05,65.88,173 CPT,85635,Reptilase test ,,,8.27,67.78,173 CPT,85651,SED RATE MANUAL,648.0,648.0,38.88,550.8,14 CPT,85651,"Sedimentation rate, erythrocyte; non-automated ",648.0,648.0,3.59,29.41,173 CPT,85652,"Sedimentation rate, erythrocyte; automated ",,,2.27,18.55,173 CPT,85660,SICKLE CELL SCREEN,393.0,393.0,23.58,334.05,14 CPT,85660,"Sickling of RBC, reduction ",393.0,393.0,4.63,37.92,173 CPT,85670,THROMBIN TIME,924.0,924.0,55.44,785.4,14 CPT,85670,Thrombin time; plasma ,924.0,924.0,4.85,39.73,173 CPT,85675,Thrombin time; titer ,,,5.75,47.15,173 CPT,85705,TISSUE THROMBO INHIB,792.59,792.59,47.56,673.7,14 CPT,85705,"Thromboplastin inhibition, tissue ",792.59,792.59,8.09,66.25,173 CPT,85730,PTT,924.0,924.0,55.44,785.4,28 CPT,85730,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.05,41.36,173 CPT,85732,PTT SUBSTITUTION MIXING,924.0,924.0,55.44,785.4,14 CPT,85732,PTT-LA MIXING STUDY,1004.91,1004.91,60.29,854.17,14 CPT,85732,SILICA CLOTTING TIME,1004.91,1004.91,60.29,854.17,14 CPT,85732,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.43,44.53,173 CPT,85810,Viscosity ,,,9.8,80.27,173 CPT,85999,Unlisted hematology and coagulation procedure ,,,99.55,128.28,81 CPT,86000,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.86,47.97,173 CPT,86001,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.57,53.76,173 CPT,86003,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.38,35.93,173 CPT,86005,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.69,54.84,173 CPT,86008,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.06,123.35,173 CPT,86015,ACTIN ASMA AB IGG QN IA,920.52,920.52,55.23,782.44,27 CPT,86015,"Actin (smooth muscle) antibody (ASMA), each ",920.52,920.52,9.69,64.67,160 CPT,86021,Antibody identification; leukocyte antibodies ,895.46,895.46,12.64,103.53,173 CPT,86021,NEUTROPHIL AB,895.46,895.46,53.73,761.14,14 CPT,86022,Antibody identification; platelet antibodies ,,,15.43,126.34,173 CPT,86022,PLATELET ANTIBODIES,2193.15,2193.15,131.59,1864.18,14 CPT,86022,PLT AB HEPARIN INDUCED,764.9,764.9,45.89,650.16,14 CPT,86023,Antibody identification; platelet associated immunoglobulin assay ,,,10.47,85.7,173 CPT,86036,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.12,64.67,160 CPT,86037,ANCA CYTOPLASMIC TITER,762.38,762.38,45.74,648.02,27 CPT,86037,ANCA PERINUCLEAR TITER,762.38,762.38,45.74,648.02,27 CPT,86037,ANCA-P ATYPICAL AB TITER,762.38,762.38,45.74,648.02,27 CPT,86037,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.12,64.67,160 CPT,86038,ANA QUAL SCREEN,1170.0,1170.0,70.2,994.5,14 CPT,86038,Antinuclear antibodies (ANA); ,1170.0,1170.0,10.16,83.17,173 CPT,86039,Antinuclear antibodies (ANA); titer ,,,9.37,76.74,173 CPT,86041,ACHR RCPT BND AB,145.75,145.75,8.74,123.89,34 CPT,86041,Acetylcholine receptor (AChR); binding antibody ,145.75,145.75,15.46,58.7,75 CPT,86042,Acetylcholine receptor (AChR); blocking antibody ,,,15.46,58.7,75 CPT,86043,Acetylcholine receptor (AChR); modulating antibody ,,,10.12,38.44,75 CPT,86051,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.69,61.1,160 CPT,86052,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.12,64.67,160 CPT,86053,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.12,199.37,160 CPT,86060,ANTISTREPTOLYSIN O QN,716.11,716.11,42.97,608.69,14 CPT,86060,Antistreptolysin 0; titer ,716.11,716.11,6.13,50.23,173 CPT,86063,Antistreptolysin 0; screen ,,,4.85,39.73,173 CPT,86077,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,46.44,351.86,98 CPT,86078,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,457.76,98 CPT,86079,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,99.93,351.86,98 CPT,86140,C-REACTIVE PROTEIN,253.0,253.0,15.18,215.05,14 CPT,86140,C-reactive protein; ,253.0,253.0,4.35,35.66,173 CPT,86141,C-REACTIVE PROTEIN HS,298.0,298.0,17.88,253.3,14 CPT,86141,C-reactive protein; high sensitivity (hsCRP) ,298.0,298.0,10.88,89.05,173 CPT,86146,BETA 2 GLYCOPROT1 AB IGA,984.0,984.0,59.04,836.4,14 CPT,86146,BETA 2 GLYCOPROT1 AB IGG,734.56,734.56,44.07,624.38,14 CPT,86146,BETA 2 GLYCOPROT1 AB IGM,1047.12,1047.12,62.83,890.05,14 CPT,86146,"Beta 2 Glycoprotein I antibody, each ",,,21.38,175.03,173 CPT,86147,CARDIOLIPIN AB IGA,1284.0,1284.0,77.04,1091.4,14 CPT,86147,CARDIOLIPIN AB IGG,1284.0,1284.0,77.04,1091.4,14 CPT,86147,CARDIOLIPIN AB IGM,1284.0,1284.0,77.04,1091.4,14 CPT,86147,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.38,175.03,173 CPT,86148,Anti-phosphatidylserine (phospholipid) antibody ,,,13.5,110.5,173 CPT,86148,PHOSPHATIDYLSER AB IGA,124.75,124.75,7.49,106.04,14 CPT,86148,PHOSPHATIDYLSER AB IGG,688.41,688.41,41.3,585.15,14 CPT,86148,PHOSPHATIDYLSER AB IGM,526.2,526.2,31.57,447.27,14 CPT,86152,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,245.76,1724.84,145 CPT,86153,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required ",,,71.35,244.17,17 CPT,86155,"Chemotaxis assay, specify method ",,,13.43,109.96,173 CPT,86156,Cold agglutinin; screen ,,,6.78,55.48,173 CPT,86157,COLD AGGLUTININ TITER,672.58,672.58,40.35,571.69,14 CPT,86157,Cold agglutinin; titer ,672.58,672.58,6.77,55.48,173 CPT,86160,C1 ESTERASE INHIBITOR IA,1359.68,1359.68,81.58,1155.73,14 CPT,86160,COMPLEMENT C3,467.0,467.0,28.02,396.95,14 CPT,86160,COMPLEMENT C4,467.0,467.0,28.02,396.95,14 CPT,86160,"Complement; antigen, each component ",,,10.08,82.54,173 CPT,86161,"Complement; functional activity, each component ",,,10.08,82.54,173 CPT,86162,COMPLEMENT TOT CH50,658.0,658.0,39.48,559.3,14 CPT,86162,Complement; total hemolytic (CH50) ,658.0,658.0,17.07,139.73,173 CPT,86171,"Complement fixation tests, each antigen ",,,8.41,68.87,173 CPT,86200,ANTI-CCP,454.0,454.0,27.24,385.9,14 CPT,86200,"Cyclic citrullinated peptide (CCP), antibody ",454.0,454.0,10.88,89.05,173 CPT,86215,"Deoxyribonuclease, antibody ",,,11.13,91.13,173 CPT,86225,DS DNA AB,553.0,553.0,33.18,470.05,14 CPT,86225,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,553.0,553.0,11.54,94.48,173 CPT,86226,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.17,83.26,173 CPT,86231,ENDOMYSIAL FA AB QL,310.65,310.65,18.64,264.05,27 CPT,86231,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",310.65,310.65,10.16,64.67,160 CPT,86235,ANTI-TIF-1GAMMA AB,30.0,30.0,1.8,25.5,14 CPT,86235,ANTI-U3 RNP FIBRILLARIN,30.0,30.0,1.8,25.5,14 CPT,86235,CENTROMERE B AB IA,1367.59,1367.59,82.06,1162.45,14 CPT,86235,CHROMATIN AB,499.49,499.49,29.97,424.57,14 CPT,86235,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.06,123.35,173 CPT,86235,JO-1 ANTIBODY,1283.0,1283.0,76.98,1090.55,14 CPT,86235,PM SCL (PM1) AB,34.43,34.43,2.07,29.27,14 CPT,86235,RNP ANTIBODY,958.76,958.76,57.53,814.95,14 CPT,86235,SCLERODERMA 70 AB,1283.0,1283.0,76.98,1090.55,14 CPT,86235,SJOGRENS A AB (SSA),1283.18,1283.18,76.99,1090.7,14 CPT,86235,SJOGRENS B AB (SSB),1283.0,1283.0,76.98,1090.55,14 CPT,86235,SMITH ANTIBODY,574.0,574.0,34.44,487.9,14 CPT,86235,SSA-52 (RO52) ENA IGG AB,65.0,65.0,3.9,55.25,14 CPT,86235,U1 RNP ENA IGG AB,34.0,34.0,2.04,28.9,14 CPT,86235,U2 RNP ENA AB,36.97,36.97,2.22,31.42,14 CPT,86255,AGNA-1 AB BY FA,35.0,35.0,2.1,29.75,14 CPT,86255,AMPA-R-1 CBA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,AMPA-R-2 CBA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,AMPHIPHYSIN AB FA,245.0,245.0,14.7,208.25,14 CPT,86255,ANNA-1 (ANTI-HU) SCR FA,175.0,175.0,10.5,148.75,14 CPT,86255,ANNA-3 SCR BY IFA,175.0,175.0,10.5,148.75,14 CPT,86255,ANTI-RI AB FA QL,175.0,175.0,10.5,148.75,14 CPT,86255,CASPR2-IGG AB CBA-IF,300.0,300.0,18.0,255.0,14 CPT,86255,CRMP-5 IGG BY FA,450.0,450.0,27.0,382.5,14 CPT,86255,DNER AB,720.0,720.0,43.2,612.0,14 CPT,86255,DPPX AB BY CBA-IFA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,DPPX AB BY IFA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.12,82.9,173 CPT,86255,GABA-B-R AB CBA-IFA,450.0,450.0,27.0,382.5,14 CPT,86255,IGLON5 AB,2900.0,2900.0,174.0,2465.0,14 CPT,86255,IGLON5-IGG AB BY CBA,2900.0,2900.0,174.0,2465.0,14 CPT,86255,ITPR1 AB,1550.0,1550.0,93.0,1317.5,14 CPT,86255,ITPR1 CB IFA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,LGI1-IGG AB CBA-IFA,2900.0,2900.0,174.0,2465.0,14 CPT,86255,MA2-TA AB,450.0,450.0,27.0,382.5,14 CPT,86255,MGLUR1-IGG AB CBA-IF,1550.0,1550.0,93.0,1317.5,14 CPT,86255,MGLUR1-IGG IFA,1550.0,1550.0,93.0,1317.5,14 CPT,86255,NMDA-RCPT AB CBA,2900.0,2900.0,174.0,2465.0,14 CPT,86255,PCA-2 AB BY FA,450.0,450.0,27.0,382.5,14 CPT,86255,PCA-TR AB BY FA,450.0,450.0,27.0,382.5,14 CPT,86255,PURK CELL (YO) FA AB QL,450.0,450.0,27.0,382.5,14 CPT,86255,STRIATED MUSC FA AB SCR,76.49,76.49,4.59,65.02,14 CPT,86255,ZIC4 AB,720.0,720.0,43.2,612.0,14 CPT,86256,AMPA-R-1 IF TITER,40.0,40.0,2.4,34.0,14 CPT,86256,AMPA-R-2 IF TITER,40.0,40.0,2.4,34.0,14 CPT,86256,ANTI-GAD65 AB TITER,50.0,50.0,3.0,42.5,14 CPT,86256,ANTI-LGI1 AB TIT,2900.0,2900.0,174.0,2465.0,14 CPT,86256,CASPR2 IGG AB TITER IFA,595.0,595.0,35.7,505.75,14 CPT,86256,DPPX AB BY IFA TIT,1550.0,1550.0,93.0,1317.5,14 CPT,86256,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.12,82.9,173 CPT,86256,GABA-B-R AB IFA TIT,35.0,35.0,2.1,29.75,14 CPT,86256,IGLON5 AB BY IFA TIT,2900.0,2900.0,174.0,2465.0,14 CPT,86256,ITPR1 IF TITER,1550.0,1550.0,93.0,1317.5,14 CPT,86256,MGLUR1-IGGAB IFA TIT,1550.0,1550.0,93.0,1317.5,14 CPT,86256,NMDA RECEPTOR AB TIT FA,2900.0,2900.0,174.0,2465.0,14 CPT,86258,GLIADIN AB IGA IA QN,180.94,180.94,10.86,153.8,27 CPT,86258,GLIADIN AB IGG IA QN,180.94,180.94,10.86,153.8,27 CPT,86258,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.69,64.67,160 CPT,86277,"Growth hormone, human (HGH), antibody ",,,13.22,108.24,173 CPT,86280,Hemagglutination inhibition test (HAI) ,,,6.88,56.29,173 CPT,86294,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.48,175.84,173 CPT,86300,CA 15-3 QN,688.0,688.0,41.28,584.8,14 CPT,86300,CA 27-29 QN,1152.62,1152.62,69.16,979.73,14 CPT,86300,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.48,143.17,173 CPT,86301,CA 19-9 QN,1423.0,1423.0,85.38,1209.55,14 CPT,86301,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",1423.0,1423.0,17.48,143.17,173 CPT,86304,CA 125 QN,960.0,960.0,57.6,816.0,14 CPT,86304,"Immunoassay for tumor antigen, quantitative; CA 125 ",960.0,960.0,17.48,143.17,173 CPT,86305,Human epididymis protein 4 (HE4) ,,,17.48,143.17,173 CPT,86308,Heterophile antibodies; screening ,736.0,736.0,4.35,35.66,173 CPT,86308,MONO SCR (HETEROPHILE),736.0,736.0,44.16,625.6,14 CPT,86309,Heterophile antibodies; titer ,,,5.43,44.53,173 CPT,86310,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.19,50.68,173 CPT,86316,CHROMOGRANIN A IA QN,680.5,680.5,40.83,578.42,14 CPT,86316,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.48,143.17,173 CPT,86316,NEURON SPEC ENOLASE QN,24.73,24.73,1.48,21.02,14 CPT,86317,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.59,103.08,173 CPT,86318,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.2,124.44,173 CPT,86320,Immunoelectrophoresis; serum ,,,25.13,205.8,173 CPT,86325,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.43,159.1,173 CPT,86327,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.13,27.14,21 CPT,86328,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,38.04,144.44,79 CPT,86329,Immunodiffusion; not elsewhere specified ,,,11.8,96.65,173 CPT,86331,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.06,82.36,173 CPT,86332,C1Q BINDING IMM COMP,775.45,775.45,46.53,659.13,14 CPT,86332,Immune complex assay ,775.45,775.45,20.47,167.61,173 CPT,86334,IMMUNOFIX ELECTRO SER,44.84,44.84,2.69,38.11,14 CPT,86334,Immunofixation electrophoresis; serum ,44.84,44.84,18.77,153.67,173 CPT,86335,IMMUNOFIX ELECTRO CSF,778.09,778.09,46.69,661.38,14 CPT,86335,IMMUNOFIX ELECTRO UR,196.51,196.51,11.79,167.03,14 CPT,86335,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,24.65,201.91,173 CPT,86336,Inhibin A ,,,13.1,107.24,173 CPT,86337,INSULIN AB,981.0,981.0,58.86,833.85,14 CPT,86337,Insulin antibodies ,981.0,981.0,17.98,147.24,173 CPT,86340,Intrinsic factor antibodies ,,,12.67,103.71,173 CPT,86341,GLUTAMIC ACID DECARB A,318.79,318.79,19.13,270.97,14 CPT,86341,Islet cell antibody ,318.79,318.79,19.8,162.09,173 CPT,86343,Leukocyte histamine release test (LHR) ,,,10.47,85.7,173 CPT,86344,Leukocyte phagocytosis ,,,8.73,71.5,173 CPT,86352,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,114.12,934.41,173 CPT,86353,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,41.19,337.2,173 CPT,86355,"B cells, total count ",,,31.69,259.46,173 CPT,86356,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.5,184.17,173 CPT,86357,"Natural killer (NK) cells, total count ",,,31.69,259.46,173 CPT,86359,T CELLS TOTAL,210.68,210.68,12.64,179.08,14 CPT,86359,T cells; total count ,210.68,210.68,31.69,259.46,173 CPT,86360,T CELLS CD4 8 RATIO,1966.0,1966.0,117.96,1671.1,14 CPT,86360,"T cells; absolute CD4 and CD8 count, including ratio ",1966.0,1966.0,39.46,323.09,173 CPT,86361,T CELLS CD4 COUNT,212.58,212.58,12.75,180.69,14 CPT,86361,T cells; absolute CD4 count ,212.58,212.58,22.5,184.17,173 CPT,86362,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.12,64.67,160 CPT,86363,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.12,199.37,160 CPT,86364,TRANSGLUTAMIN AB IGA QN,180.94,180.94,10.86,153.8,27 CPT,86364,TRANSGLUTAMIN AB IGG QN,180.94,180.94,10.86,153.8,27 CPT,86364,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.69,61.1,160 CPT,86366,MUSK AB,2633.99,2633.99,158.04,2238.89,34 CPT,86366,Muscle-specific kinase (MuSK) antibody ,2633.99,2633.99,15.46,58.7,75 CPT,86367,"Stem cells (ie, CD34), total count ",,,65.34,534.95,173 CPT,86376,LIVER-KIDNEY MICRO AB,878.0,878.0,52.68,746.3,14 CPT,86376,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.22,100.09,173 CPT,86376,THYROID PEROXIDASE AB,759.62,759.62,45.58,645.68,14 CPT,86381,MITOCHONDRIAL M2 AB IA,718.75,718.75,43.13,610.94,27 CPT,86381,"Mitochondrial antibody (eg, M2), each ",718.75,718.75,21.38,134.7,160 CPT,86382,"Neutralization test, viral ",,,14.2,116.29,173 CPT,86384,Nitroblue tetrazolium dye test (NTD) ,,,11.43,93.58,173 CPT,86386,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.3,149.78,173 CPT,86403,"Particle agglutination; screen, each antibody ",,,9.69,79.37,173 CPT,86406,"Particle agglutination; titer, each antibody ",,,8.94,73.21,173 CPT,86408,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,35.39,134.39,79 CPT,86409,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,66.87,336.0,77 CPT,86413,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.13,148.63,79 CPT,86430,Rheumatoid factor; qualitative ,,,5.16,42.26,173 CPT,86431,RA QN,669.95,669.95,40.2,569.46,14 CPT,86431,Rheumatoid factor; quantitative ,669.95,669.95,4.76,39.01,173 CPT,86480,TB GAMMA INTERFERON RESP,733.24,733.24,43.99,623.25,14 CPT,86480,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",733.24,733.24,52.06,426.26,173 CPT,86481,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,84.0,687.8,173 CPT,86485,Skin test; candida ,,,46.44,142.09,98 CPT,86486,"Skin test; unlisted antigen, each ",,,26.2,73.34,98 CPT,86510,Skin test; histoplasmosis ,,,30.4,175.48,98 CPT,86580,"Skin test; tuberculosis, intradermal ",,,41.52,75.66,98 CPT,86581,STRPTCS PNEUM AB IA,190.0,190.0,11.4,161.5,35 CPT,86581,"Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative ",190.0,190.0,29.68,265.97,56 CPT,86590,"Streptokinase, antibody ",,,10.63,87.06,173 CPT,86592,RPR QUAL,659.0,659.0,39.54,560.15,14 CPT,86592,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.59,29.41,173 CPT,86592,VDRL CSF QUAL,659.0,659.0,39.54,560.15,14 CPT,86593,RPR QUANT,924.0,924.0,55.44,785.4,14 CPT,86593,"Syphilis test, non-treponemal antibody; quantitative ",,,3.7,30.23,173 CPT,86593,VDRL CSF QN,924.47,924.47,55.47,785.8,14 CPT,86596,"Voltage-gated calcium channel antibody, each ",,,10.12,64.67,160 CPT,86602,Antibody; actinomyces ,,,8.55,70.05,173 CPT,86603,Antibody; adenovirus ,,,10.81,88.51,173 CPT,86606,Antibody; Aspergillus ,,,12.64,103.53,173 CPT,86609,"Antibody; bacterium, not elsewhere specified ",,,10.82,88.6,173 CPT,86611,Antibody; Bartonella ,,,8.55,70.05,173 CPT,86611,BARTONELLA H IGG,98.91,98.91,5.93,84.07,14 CPT,86611,BARTONELLA H IGM,98.91,98.91,5.93,84.07,14 CPT,86611,BARTONELLA Q IGG,98.91,98.91,5.93,84.07,14 CPT,86611,BARTONELLA Q IGM,98.91,98.91,5.93,84.07,14 CPT,86612,Antibody; Blastomyces ,775.0,775.0,10.84,88.69,173 CPT,86612,BLASTOMYCES AB QUAL,775.0,775.0,46.5,658.75,14 CPT,86615,Antibody; Bordetella ,,,11.08,90.68,173 CPT,86617,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.01,106.52,173 CPT,86617,LYME AB IGG WESTERN BLOT,89.67,89.67,5.38,76.22,14 CPT,86617,LYME AB IGM WESTERN BLOT,176.72,176.72,10.6,150.21,14 CPT,86618,Antibody; Borrelia burgdorferi (Lyme disease) ,495.86,495.86,14.31,117.11,173 CPT,86618,LYME DISEASE AB QL,495.86,495.86,29.75,421.48,14 CPT,86619,Antibody; Borrelia (relapsing fever) ,,,11.24,92.04,173 CPT,86622,Antibody; Brucella ,,,7.5,61.45,173 CPT,86622,BRUCELLA AB QL IGG,261.12,261.12,15.67,221.95,14 CPT,86622,BRUCELLA AB QL IGM,460.26,460.26,27.62,391.22,14 CPT,86625,Antibody; Campylobacter ,,,11.02,90.23,173 CPT,86628,Antibody; Candida ,,,10.09,82.63,173 CPT,86631,Antibody; Chlamydia ,,,9.93,81.27,173 CPT,86632,"Antibody; Chlamydia, IgM ",,,10.65,87.24,173 CPT,86635,Antibody; Coccidioides ,1091.96,1091.96,9.63,78.92,173 CPT,86635,COCCIDIOID AB QUAL,1091.96,1091.96,65.52,928.17,14 CPT,86638,Antibody; Coxiella burnetii (Q fever) ,1325.39,1325.39,10.18,83.35,173 CPT,86638,Q FEVER AB QUAL,1325.39,1325.39,79.52,1126.58,14 CPT,86641,Antibody; Cryptococcus ,,,12.1,99.1,173 CPT,86644,Antibody; cytomegalovirus (CMV) ,,,12.09,99.01,173 CPT,86644,CMV AB QL SQN,75.0,75.0,4.5,63.75,14 CPT,86644,CMV IGG QUAL,1175.0,1175.0,70.5,998.75,14 CPT,86645,"Antibody; cytomegalovirus (CMV), IgM ",1175.0,1175.0,14.15,115.93,173 CPT,86645,CMV IGM QUAL,1175.0,1175.0,70.5,998.75,14 CPT,86648,Antibody; Diphtheria ,,,12.78,104.62,173 CPT,86651,"Antibody; encephalitis, California (La Crosse) ",510.37,510.37,11.08,90.68,173 CPT,86651,ENCEPH LACROSSE AB QUAL,510.37,510.37,30.62,433.81,14 CPT,86652,"Antibody; encephalitis, Eastern equine ",510.37,510.37,11.08,90.68,173 CPT,86652,ENCEPH E EQUINE AB QUAL,510.37,510.37,30.62,433.81,14 CPT,86653,"Antibody; encephalitis, St. Louis ",510.37,510.37,11.08,90.68,173 CPT,86653,ENCEPH ST LOUIS AB QUAL,510.37,510.37,30.62,433.81,14 CPT,86654,"Antibody; encephalitis, Western equine ",510.37,510.37,11.08,90.68,173 CPT,86654,ENCEPH W EQUINE AB QUAL,510.37,510.37,30.62,433.81,14 CPT,86658,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,10.95,89.6,173 CPT,86658,COXSACKIE A AB QL,177.35,177.35,10.64,150.75,14 CPT,86658,COXSACKIE B AB QL,235.0,235.0,14.1,199.75,14 CPT,86663,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",736.0,736.0,11.02,90.23,173 CPT,86663,EBV EARLY AB QUAL,736.0,736.0,44.16,625.6,14 CPT,86664,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",735.88,735.88,12.84,105.16,173 CPT,86664,EBV NUCLEAR AG AB QUAL,735.88,735.88,44.15,625.5,14 CPT,86665,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.24,124.8,173 CPT,86665,EBV CAPSID IGG QUAL,735.88,735.88,44.15,625.5,14 CPT,86665,EBV CAPSID IGM QUAL,83.08,83.08,4.98,70.62,14 CPT,86666,Antibody; Ehrlichia ,,,8.55,70.05,173 CPT,86668,Antibody; Francisella tularensis ,,,11.89,97.38,173 CPT,86671,"Antibody; fungus, not elsewhere specified ",,,10.29,84.26,173 CPT,86674,Antibody; Giardia lamblia ,,,12.36,101.27,173 CPT,86677,Antibody; Helicobacter pylori ,,,14.15,115.93,173 CPT,86682,"Antibody; helminth, not elsewhere specified ",,,10.93,89.5,173 CPT,86684,Antibody; Haemophilus influenza ,,,13.31,108.96,173 CPT,86687,Antibody; HTLV-I ,,,7.64,62.54,173 CPT,86688,Antibody; HTLV-II ,,,11.76,96.29,173 CPT,86689,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.25,133.13,173 CPT,86692,"Antibody; hepatitis, delta agent ",2673.19,2673.19,14.41,118.01,173 CPT,86692,HEPATITIS DELTA AB QUAL,2673.19,2673.19,160.39,2272.21,14 CPT,86694,"Antibody; herpes simplex, non-specific type test ",,,12.09,99.01,173 CPT,86695,"Antibody; herpes simplex, type 1 ",141.11,141.11,11.08,90.68,173 CPT,86695,HERPES SIMPLEX 1 AB IGG,141.11,141.11,8.47,119.94,14 CPT,86696,"Antibody; herpes simplex, type 2 ",96.27,96.27,16.25,133.13,173 CPT,86696,HERPES SIMPLEX 2 AB IGG,96.27,96.27,5.78,81.83,14 CPT,86698,Antibody; histoplasma ,873.04,873.04,11.58,94.84,173 CPT,86698,HISTOPLASMA AB QL,873.04,873.04,52.38,742.08,14 CPT,86701,Antibody; HIV-1 ,1255.0,1255.0,7.47,61.18,173 CPT,86701,HIV-1 AB QUAL,1255.0,1255.0,75.3,1066.75,14 CPT,86702,Antibody; HIV-2 ,1255.0,1255.0,11.36,93.03,173 CPT,86702,HIV-2 AB QUAL,1255.0,1255.0,75.3,1066.75,14 CPT,86703,"Antibody; HIV-1 and HIV-2, single result ",,,11.52,94.3,173 CPT,86704,HEP B CORE AB TOTAL,1232.0,1232.0,73.92,1047.2,14 CPT,86704,Hepatitis B core antibody (HBcAb); total ,1232.0,1232.0,10.12,82.9,173 CPT,86705,HEP B CORE AB IGM QL,1604.0,1604.0,96.24,1363.4,14 CPT,86705,Hepatitis B core antibody (HBcAb); IgM antibody ,1604.0,1604.0,9.89,81.0,173 CPT,86706,HEP B SURFACE AB QUAL,1149.0,1149.0,68.94,976.65,14 CPT,86706,Hepatitis B surface antibody (HBsAb) ,1149.0,1149.0,9.02,73.85,173 CPT,86707,HEPATITIS BE AB QL,1232.0,1232.0,73.92,1047.2,14 CPT,86707,Hepatitis Be antibody (HBeAb) ,1232.0,1232.0,9.72,79.55,173 CPT,86708,HEP A AB TOTAL,1067.0,1067.0,64.02,906.95,14 CPT,86708,Hepatitis A antibody (HAAb) ,1067.0,1067.0,10.41,85.25,173 CPT,86709,HEP A AB IGM QUAL,197.0,197.0,11.82,167.45,14 CPT,86709,"Hepatitis A antibody (HAAb), IgM antibody ",197.0,197.0,9.46,77.47,173 CPT,86710,Antibody; influenza virus ,,,11.38,93.22,173 CPT,86711,Antibody; JC (John Cunningham) virus ,,,16.55,116.2,145 CPT,86713,Antibody; Legionella ,1608.93,1608.93,12.85,105.25,173 CPT,86713,LEGIONELLA AB QUAL,1608.93,1608.93,96.54,1367.59,14 CPT,86717,Antibody; Leishmania ,,,10.29,84.26,173 CPT,86720,Antibody; Leptospira ,335.0,335.0,13.61,111.41,173 CPT,86720,LEPTOSPIRA AB QUAL,335.0,335.0,20.1,284.75,14 CPT,86723,Antibody; Listeria monocytogenes ,,,11.08,90.68,173 CPT,86727,Antibody; lymphocytic choriomeningitis ,,,10.81,88.51,173 CPT,86732,Antibody; mucormycosis ,,,12.6,103.17,173 CPT,86735,Antibody; mumps ,,,10.96,89.78,173 CPT,86735,MUMPS IGG QUAL,977.23,977.23,58.63,830.65,14 CPT,86735,MUMPS IGM QUAL,977.23,977.23,58.63,830.65,14 CPT,86738,Antibody; mycoplasma ,,,11.12,91.04,173 CPT,86738,MYCOPLASMA AB IGG QL,811.06,811.06,48.66,689.4,14 CPT,86738,MYCOPLASMA AB IGM QL,811.0,811.0,48.66,689.35,14 CPT,86741,Antibody; Neisseria meningitidis ,,,11.08,90.68,173 CPT,86744,Antibody; Nocardia ,,,13.43,109.96,173 CPT,86747,Antibody; parvovirus ,,,12.63,103.35,173 CPT,86747,PARVOVIRUS IGG,257.16,257.16,15.43,218.59,14 CPT,86747,PARVOVIRUS IGM,890.18,890.18,53.41,756.65,14 CPT,86750,Antibody; Plasmodium (malaria) ,,,11.08,90.68,173 CPT,86753,AMOEBIC AB,410.15,410.15,24.61,348.63,14 CPT,86753,"Antibody; protozoa, not elsewhere specified ",410.15,410.15,10.41,85.25,173 CPT,86756,Antibody; respiratory syncytial virus ,,,13.35,109.32,173 CPT,86757,Antibody; Rickettsia ,,,16.25,133.13,173 CPT,86757,ROCKY MTN SF AB QN IGG,2634.94,2634.94,158.1,2239.7,14 CPT,86757,ROCKY MTN SF AB QN IGM,2634.94,2634.94,158.1,2239.7,14 CPT,86757,TYPHUS FEVER AB IGG QL,425.08,425.08,25.5,361.32,14 CPT,86759,Antibody; rotavirus ,,,15.31,125.34,173 CPT,86762,Antibody; rubella ,,,12.09,99.01,173 CPT,86762,RUBELLA IGG,440.48,440.48,26.43,374.41,14 CPT,86762,RUBELLA IGM,1197.0,1197.0,71.82,1017.45,14 CPT,86765,Antibody; rubeola ,,,10.82,88.6,173 CPT,86765,RUBEOLA IGG,988.0,988.0,59.28,839.8,14 CPT,86765,RUBEOLA IGM,987.78,987.78,59.27,839.61,14 CPT,86768,Antibody; Salmonella ,,,11.08,90.68,173 CPT,86769,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,67.25,67.25,35.39,134.39,79 CPT,86769,COVID-19 AB MULTISTEP,67.25,67.25,4.04,57.16,30 CPT,86771,Antibody; Shigella ,,,20.56,168.33,173 CPT,86774,Antibody; tetanus ,,,12.43,101.81,173 CPT,86777,Antibody; Toxoplasma ,882.0,882.0,12.09,99.01,173 CPT,86777,TOXOPLASMA IGG QUAL,882.0,882.0,52.92,749.7,14 CPT,86778,"Antibody; Toxoplasma, IgM ",882.27,882.27,12.1,99.1,173 CPT,86778,TOXOPLASMA IGM QUAL,882.27,882.27,52.94,749.93,14 CPT,86780,Antibody; Treponema pallidum ,545.0,545.0,11.12,91.04,173 CPT,86780,TREPONEMA PALLIDUM AB,545.0,545.0,32.7,463.25,14 CPT,86784,Antibody; Trichinella ,,,10.55,86.43,173 CPT,86787,Antibody; varicella-zoster ,,,10.82,88.6,173 CPT,86787,VARIC ZOSTER IGG,436.52,436.52,26.19,371.04,14 CPT,86787,VARIC ZOSTER IGM,510.37,510.37,30.62,433.81,14 CPT,86788,"Antibody; West Nile virus, IgM ",,,14.15,115.93,173 CPT,86788,ENCEPH WEST NILE AB IGM,98.91,98.91,5.93,84.07,14 CPT,86788,ENCPH WST NIL AB IGM CSF,98.91,98.91,5.93,84.07,14 CPT,86789,Antibody; West Nile virus ,,,12.09,99.01,173 CPT,86789,ENCEPH WEST NILE AB IGG,98.91,98.91,5.93,84.07,14 CPT,86789,ENCPH WST NIL AB IGG CSF,98.91,98.91,5.93,84.07,14 CPT,86790,"Antibody; virus, not elsewhere specified ",,,10.82,88.6,173 CPT,86790,DENGUE VIRUS AB IGG QL,363.98,363.98,21.84,309.38,14 CPT,86790,DENGUE VIRUS AB IGM QL,763.58,763.58,45.81,649.04,14 CPT,86790,HANTAVIRUS AB QL,1113.0,1113.0,66.78,946.05,14 CPT,86790,HEPATITIS E AB QL IGG,45.0,45.0,2.7,38.25,14 CPT,86790,HEPATITIS E AB QL IGM,55.0,55.0,3.3,46.75,14 CPT,86793,Antibody; Yersinia ,,,11.08,90.68,173 CPT,86794,"Antibody; Zika virus, IgM ",,,14.15,115.93,173 CPT,86800,THYROGLOBULIN AB QUANT,948.21,948.21,56.89,805.98,14 CPT,86800,Thyroglobulin antibody ,948.21,948.21,13.36,109.41,173 CPT,86803,HEPATITIS C AB QUAL,1534.0,1534.0,92.04,1303.9,14 CPT,86803,Hepatitis C antibody; ,1534.0,1534.0,11.99,98.19,173 CPT,86804,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.01,106.52,173 CPT,86805,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,159.19,1303.47,173 CPT,86806,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,39.98,327.34,173 CPT,86807,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,66.07,540.92,173 CPT,86808,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,24.93,204.17,173 CPT,86812,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,21.68,177.56,173 CPT,86813,"HLA typing; A, B, or C, multiple antigens ",,,48.72,398.92,173 CPT,86816,"HLA typing; DR/DQ, single antigen ",,,25.34,207.52,173 CPT,86817,"HLA typing; DR/DQ, multiple antigens ",,,89.16,730.06,173 CPT,86821,"HLA typing; lymphocyte culture, mixed (MLC) ",,,30.71,251.5,173 CPT,86825,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,91.97,753.05,173 CPT,86826,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,30.69,251.23,173 CPT,86828,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,53.92,441.46,173 CPT,86829,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,53.92,441.46,173 CPT,86830,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,80.24,657.03,173 CPT,86831,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,68.78,563.18,173 CPT,86832,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,271.95,2226.75,173 CPT,86833,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,273.67,2240.87,173 CPT,86834,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,300.35,2459.34,173 CPT,86835,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,271.29,2221.32,173 CPT,86849,Unlisted immunology procedure ,,,99.55,128.28,81 CPT,86850,ANTIBODY SCREEN EA,597.41,597.41,35.84,507.8,21 CPT,86850,"Antibody screen, RBC, each serum technique ",597.41,597.41,9.57,157.81,143 CPT,86860,ANTIBODY ELUTION EA,684.0,684.0,41.04,581.4,23 CPT,86860,"Antibody elution (RBC), each elution ",684.0,684.0,126.87,457.76,98 CPT,86870,ANTIBODY ID EA,2147.0,2147.0,128.82,1824.95,23 CPT,86870,"Antibody identification, RBC antibodies, each panel for each serum technique ",2147.0,2147.0,174.24,904.08,98 CPT,86880,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.53,106.64,171 CPT,86880,DIRECT COOMBS AHG EA,513.01,513.01,30.78,436.06,15 CPT,86880,DIRECT COOMBS COMP EA,422.02,422.02,25.32,358.72,15 CPT,86880,DIRECT COOMBS IGG EA,188.59,188.59,11.32,160.3,15 CPT,86885,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",597.41,597.41,4.8,457.76,171 CPT,86885,INDIRECT COOMBS QL EA,597.41,597.41,35.84,507.8,15 CPT,86886,ANTIBODY TITER EA INDIR,497.18,497.18,29.83,422.6,15 CPT,86886,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",497.18,497.18,4.35,457.76,171 CPT,86890,"Autologous blood or component, collection processing and storage; predeposited ",,,289.87,710.24,98 CPT,86891,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,2003.96,98 CPT,86900,ABO TYPE,347.0,347.0,20.82,294.95,15 CPT,86900,"Blood typing, serologic; ABO ",347.0,347.0,2.51,347.81,171 CPT,86901,"Blood typing, serologic; Rh (D) ",257.0,257.0,2.51,106.64,171 CPT,86901,RH TYPE,257.0,257.0,15.42,218.45,15 CPT,86902,AG SC DON BLD REA SER EA,229.22,229.22,13.75,194.84,15 CPT,86902,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",229.22,229.22,5.33,904.08,171 CPT,86904,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,13.73,112.4,171 CPT,86905,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",347.0,347.0,3.22,904.08,171 CPT,86905,RBC ANTIGEN TYPING EA,347.0,347.0,20.82,294.95,15 CPT,86906,BLOOD TYPE RH PHENOTYPE,561.79,561.79,33.71,477.52,15 CPT,86906,"Blood typing, serologic; Rh phenotyping, complete ",561.79,561.79,6.51,106.64,171 CPT,86910,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,183.72,98 CPT,86911,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,24.02,159.19,98 CPT,86920,CROSSMATCH IMM SPIN,265.0,265.0,15.9,225.25,23 CPT,86920,Compatibility test each unit; immediate spin technique ,265.0,265.0,140.77,457.76,98 CPT,86921,CROSSMATCH INCUB,957.45,957.45,57.45,813.83,23 CPT,86921,Compatibility test each unit; incubation technique ,957.45,957.45,126.87,457.76,98 CPT,86922,CROSSMATCH AHG,957.45,957.45,57.45,813.83,23 CPT,86922,Compatibility test each unit; antiglobulin technique ,957.45,957.45,150.55,457.76,98 CPT,86923,Compatibility test each unit; electronic ,265.08,265.08,112.93,457.76,98 CPT,86923,ELECTRONIC XMATCH,265.08,265.08,15.9,225.32,23 CPT,86927,"Fresh frozen plasma, thawing, each unit ",,,26.2,142.09,98 CPT,86930,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,904.08,98 CPT,86931,"Frozen blood, each unit; thawing ",,,352.68,904.08,98 CPT,86932,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,67.53,710.24,98 CPT,86940,HEMOLYSIN AGGLUTIN AUTO,204.57,204.57,12.27,173.88,14 CPT,86940,"Hemolysins and agglutinins; auto, screen, each ",204.57,204.57,7.37,60.36,173 CPT,86941,Hemolysins and agglutinins; incubated ,957.45,957.45,10.17,83.26,173 CPT,86941,INCUBATED AUTO SCREEN,957.45,957.45,57.45,813.83,14 CPT,86945,IRRADIATION BLD EA,257.16,257.16,15.43,218.59,26 CPT,86945,"Irradiation of blood product, each unit ",257.16,257.16,67.53,208.15,98 CPT,86950,Leukocyte transfusion ,,,289.87,543.72,98 CPT,86960,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,457.76,98 CPT,86965,Pooling of platelets or other blood products ,,,131.03,457.76,98 CPT,86970,PRETREAT RBC'S CHEM EA,422.02,422.02,25.32,358.72,23 CPT,86970,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",422.02,422.02,67.53,208.15,98 CPT,86971,PRETREAT RBC'S ENZ EA,422.02,422.02,25.32,358.72,23 CPT,86971,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",422.02,422.02,93.4,904.08,98 CPT,86972,PRETREAT RBC'S DENS EA,422.02,422.02,25.32,358.72,23 CPT,86972,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",422.02,422.02,164.5,457.76,98 CPT,86975,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,347.81,98 CPT,86976,PRETREAT SERUM DIL EA,422.02,422.02,25.32,358.72,23 CPT,86976,Pretreatment of serum for use in RBC antibody identification; by dilution ,422.02,422.02,46.44,249.78,98 CPT,86977,PRETREAT SERUM INHIB EA,750.39,750.39,45.02,637.83,23 CPT,86977,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",750.39,750.39,140.77,457.76,98 CPT,86978,PRETREAT SERUM ABSORP EA,466.85,466.85,28.01,396.82,23 CPT,86978,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",466.85,466.85,67.53,249.78,98 CPT,86985,"Splitting of blood or blood products, each unit ",,,103.14,457.76,98 CPT,86999,Unlisted transfusion medicine procedure ,,,46.44,90.51,86 CPT,87003,"Animal inoculation, small animal, with observation and dissection ",,,14.15,115.84,173 CPT,87015,AFB CONCENTRATION,1476.0,1476.0,88.56,1254.6,14 CPT,87015,"Concentration (any type), for infectious agents ",,,5.61,45.97,173 CPT,87015,INF AGENT CONCENTRATION,146.39,146.39,8.78,124.43,14 CPT,87040,CULTURE BLOOD,1492.0,1492.0,89.52,1268.2,14 CPT,87040,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",1492.0,1492.0,8.67,70.95,173 CPT,87045,CULTURE STOOL,1298.0,1298.0,77.88,1103.3,14 CPT,87045,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",1298.0,1298.0,7.93,64.89,173 CPT,87046,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,7.93,64.89,173 CPT,87070,CULT ENVIRON EPIDEMI,1090.0,1090.0,65.4,926.5,14 CPT,87070,CULT THROAT,1039.0,1039.0,62.34,883.15,14 CPT,87070,CULTURE BODY FLUID,988.0,988.0,59.28,839.8,14 CPT,87070,CULTURE BONE MARROW,987.78,987.78,59.27,839.61,14 CPT,87070,CULTURE CATHETER TIP,833.0,833.0,49.98,708.05,14 CPT,87070,CULTURE CSF,1039.0,1039.0,62.34,883.15,14 CPT,87070,CULTURE EAR,899.0,899.0,53.94,764.15,14 CPT,87070,CULTURE EYE,1038.99,1038.99,62.34,883.14,14 CPT,87070,CULTURE GENITAL,900.0,900.0,54.0,765.0,14 CPT,87070,CULTURE RESPIRATORY,915.0,915.0,54.9,777.75,14 CPT,87070,CULTURE SPUTUM,1304.28,1304.28,78.26,1108.64,14 CPT,87070,CULTURE SURGICAL SPEC,899.0,899.0,53.94,764.15,14 CPT,87070,CULTURE WOUND,1039.0,1039.0,62.34,883.15,14 CPT,87070,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.24,59.28,173 CPT,87071,CULT QN BRONCH LAVAGE,1090.0,1090.0,65.4,926.5,14 CPT,87071,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",1090.0,1090.0,8.31,68.06,173 CPT,87073,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.11,66.43,173 CPT,87075,CULTURE ANAEROBIC,1510.02,1510.02,90.6,1283.52,14 CPT,87075,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",1510.02,1510.02,7.95,65.16,173 CPT,87076,ANAEROBIC ORG ID,1140.75,1140.75,68.44,969.64,14 CPT,87076,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",1140.75,1140.75,6.79,55.57,173 CPT,87077,AEROBIC ORG ID,1140.75,1140.75,68.44,969.64,14 CPT,87077,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",1140.75,1140.75,6.79,55.57,173 CPT,87081,CULT ECOLI 0157 H7 SCR,1039.21,1039.21,62.35,883.33,14 CPT,87081,CULT GC SCR,497.0,497.0,29.82,422.45,14 CPT,87081,CULT LEGIONELLA SCR,981.19,981.19,58.87,834.01,14 CPT,87081,CULT STREP GROUP A SCR,252.87,252.87,15.17,214.94,14 CPT,87081,CULT STREP GROUP B SCR,1020.74,1020.74,61.24,867.63,14 CPT,87081,CULT VIBRIO SCR,590.82,590.82,35.45,502.2,14 CPT,87081,CULT YERSINIA SCR,680.5,680.5,40.83,578.42,14 CPT,87081,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.57,45.61,173 CPT,87084,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,22.74,186.16,173 CPT,87086,CULT COLONY COUNT UR,1242.0,1242.0,74.52,1055.7,14 CPT,87086,"Culture, bacterial; quantitative colony count, urine ",1242.0,1242.0,6.78,55.48,173 CPT,87088,CULT W PRESUMPTIVE ID UR,1090.0,1090.0,65.4,926.5,14 CPT,87088,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",1090.0,1090.0,6.8,55.66,173 CPT,87101,CULT FUNGUS SKIN,964.04,964.04,57.84,819.43,14 CPT,87101,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",964.04,964.04,6.48,53.03,173 CPT,87102,CULT FUNGUS OTHER SRC,1208.0,1208.0,72.48,1026.8,14 CPT,87102,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",1208.0,1208.0,7.06,57.83,173 CPT,87103,CULT FUNGUS BLOOD,1208.0,1208.0,72.48,1026.8,14 CPT,87103,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",1208.0,1208.0,17.19,140.73,173 CPT,87106,"Culture, fungi, definitive identification, each organism; yeast ",1289.78,1289.78,8.67,70.95,173 CPT,87106,YEAST ID,1289.78,1289.78,77.39,1096.31,14 CPT,87107,"Culture, fungi, definitive identification, each organism; mold ",882.27,882.27,8.67,70.95,173 CPT,87107,MOLD ID,882.27,882.27,52.94,749.93,14 CPT,87109,CULT MYCOPLASMA,741.16,741.16,44.47,629.99,14 CPT,87109,"Culture, mycoplasma, any source ",741.16,741.16,12.93,105.89,173 CPT,87110,CULT CHLAMYDIA,1027.0,1027.0,61.62,872.95,14 CPT,87110,"Culture, chlamydia, any source ",1027.0,1027.0,16.46,134.85,173 CPT,87116,CULT AFB,873.0,873.0,52.38,742.05,14 CPT,87116,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",873.0,873.0,9.07,74.3,173 CPT,87118,AFB IDENTIFICATION,1208.01,1208.01,72.48,1026.81,14 CPT,87118,"Culture, mycobacterial, definitive identification, each isolate ",1208.01,1208.01,12.27,100.45,173 CPT,87140,CULT TYPING IFT,545.0,545.0,32.7,463.25,14 CPT,87140,"Culture, typing; immunofluorescent method, each antiserum ",545.0,545.0,4.68,38.28,173 CPT,87143,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.52,86.16,173 CPT,87147,CULT TYPE AGGLUT,778.09,778.09,46.69,661.38,14 CPT,87147,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",778.09,778.09,4.35,35.66,173 CPT,87149,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,16.84,137.92,173 CPT,87150,CULT TYPING AMP PROBE,862.48,862.48,51.75,733.11,14 CPT,87150,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,29.48,241.36,173 CPT,87150,MRSA AMP PR TYPING ID,791.27,791.27,47.48,672.58,14 CPT,87152,"Culture, typing; identification by pulse field gel typing ",,,6.5,53.21,173 CPT,87153,CULT TYPING SEQ EA ISO,117.3,117.3,7.04,99.7,14 CPT,87153,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",117.3,117.3,96.9,793.41,173 CPT,87154,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,183.17,1155.06,160 CPT,87158,"Culture, typing; other methods ",97.0,97.0,6.5,53.21,173 CPT,87158,ORGANISM IDENTIFICATION,97.0,97.0,5.82,82.45,14 CPT,87164,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.02,73.85,173 CPT,87166,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.49,77.74,173 CPT,87168,Macroscopic examination; arthropod ,,,3.59,29.41,173 CPT,87169,MACRO EXAM PARASITE,257.16,257.16,15.43,218.59,14 CPT,87169,Macroscopic examination; parasite ,257.16,257.16,3.62,29.68,173 CPT,87172,"Pinworm exam (eg, cellophane tape prep) ",,,3.59,29.41,173 CPT,87176,HOMOGENIZATION TISSUE,850.63,850.63,51.04,723.04,14 CPT,87176,"Homogenization, tissue, for culture ",850.63,850.63,4.94,40.45,173 CPT,87177,O&P SMEAR CONC ID,795.0,795.0,47.7,675.75,14 CPT,87177,"Ova and parasites, direct smears, concentration and identification ",795.0,795.0,7.48,61.18,173 CPT,87181,E TEST AGAR METH,675.22,675.22,40.51,573.94,14 CPT,87181,SUSC AGAR DIL EACH AGENT,253.21,253.21,15.19,215.23,14 CPT,87181,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,3.99,32.67,173 CPT,87182,SC STD CARBAPENE NZM DET,52.8,52.8,3.17,44.88,42 CPT,87182,"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, Klebsiella pneumoniae carbapenemase ºKPC», New Delhi metallo-beta-lactamase ºNDM», Verona integron-encoded metallo-beta",52.8,52.8,9.6,15.15,5 CPT,87183,SC STD CARBAPENE RES GEN,52.8,52.8,3.17,44.88,37 CPT,87183,"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP), amplified probe technique, per isolate ",52.8,52.8,34.39,111.94,49 CPT,87184,SUSC 1-12 DISKS,978.55,978.55,58.71,831.77,14 CPT,87184,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",978.55,978.55,6.28,51.4,173 CPT,87185,SUSC BETA LACTAM,669.95,669.95,40.2,569.46,14 CPT,87185,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",669.95,669.95,3.99,32.67,173 CPT,87186,FUNGAL MIC,624.0,624.0,37.44,530.4,14 CPT,87186,SUSC MIC,930.0,930.0,55.8,790.5,14 CPT,87186,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.27,59.46,173 CPT,87187,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,33.74,276.3,173 CPT,87188,SUSC MACROBROTH EA AGENT,282.87,282.87,16.97,240.44,14 CPT,87188,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",282.87,282.87,5.58,45.7,173 CPT,87190,SUSC AFB PROP EA AGENT,978.55,978.55,58.71,831.77,14 CPT,87190,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",978.55,978.55,6.14,50.32,173 CPT,87197,Serum bactericidal titer (Schlichter test) ,,,12.62,103.35,173 CPT,87205,GRAM STAIN PRIMARY SRCE,795.23,795.23,47.71,675.95,14 CPT,87205,SMEAR EOSINOPHILS STAIN,257.16,257.16,15.43,218.59,14 CPT,87205,SMEAR FUNGUS STAIN,316.51,316.51,18.99,269.03,14 CPT,87205,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.59,29.41,173 CPT,87206,SMEAR AFB,241.34,241.34,14.48,205.14,14 CPT,87206,SMEAR CALCOFLUOR WHITE,316.51,316.51,18.99,269.03,14 CPT,87206,SMEAR FUNGI FLUOR STAIN,513.0,513.0,30.78,436.05,14 CPT,87206,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.53,37.1,173 CPT,87207,SMR BLD PARASIT/INCL BDY,795.23,795.23,47.71,675.95,14 CPT,87207,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",795.23,795.23,5.03,41.18,173 CPT,87209,O&P SPECIAL STAIN,34.29,34.29,2.06,29.15,14 CPT,87209,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",34.29,34.29,15.1,123.62,173 CPT,87210,KOH PREP WET MOUNT,34.0,34.0,1.08,42.5,28 CPT,87210,SMEAR WET MOUNT,669.95,669.95,40.2,569.46,14 CPT,87210,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.89,40.0,173 CPT,87220,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.59,29.41,173 CPT,87230,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.58,135.75,173 CPT,87250,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.43,134.57,173 CPT,87252,CULT CMV,647.53,647.53,38.85,550.4,14 CPT,87252,CULT VIRUS CPE,1835.76,1835.76,110.15,1560.4,14 CPT,87252,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,21.9,179.28,173 CPT,87253,VIRUS DEFINITIVE ID,1052.78,1052.78,63.17,894.86,14 CPT,87253,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",1052.78,1052.78,16.97,138.92,173 CPT,87254,CMV RAPID CULTURE,145.07,145.07,8.7,123.31,14 CPT,87254,CULT VIRUS SHELL VIAL,145.07,145.07,8.7,123.31,14 CPT,87254,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.43,134.57,173 CPT,87255,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,28.44,232.86,173 CPT,87260,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.12,99.28,173 CPT,87265,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.06,82.36,173 CPT,87267,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.27,92.31,173 CPT,87269,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.43,93.58,173 CPT,87270,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.06,82.36,173 CPT,87271,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.27,92.31,173 CPT,87272,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.06,82.36,173 CPT,87273,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.06,82.36,173 CPT,87274,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.06,82.36,173 CPT,87275,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.29,84.26,173 CPT,87276,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.5,110.5,173 CPT,87278,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,592.0,592.0,13.1,107.33,173 CPT,87278,LEG PNEUMOPHILIA AG IFT,592.0,592.0,35.52,503.2,14 CPT,87279,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,13.8,113.03,173 CPT,87280,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.27,92.31,173 CPT,87281,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,1337.26,1337.26,10.06,82.36,173 CPT,87281,PNEUMOCYSTIS CARINII IFT,1337.26,1337.26,80.24,1136.67,14 CPT,87283,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,51.07,418.2,173 CPT,87285,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.23,83.8,173 CPT,87290,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.27,92.31,173 CPT,87299,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.52,110.77,173 CPT,87300,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.06,82.36,173 CPT,87301,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,10.06,82.36,173 CPT,87305,ASPERGILLUS AG EIA,330.53,330.53,19.83,280.95,14 CPT,87305,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",330.53,330.53,10.06,82.36,173 CPT,87320,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,12.6,103.17,173 CPT,87324,C DIFFICILE TOXIN AG EIA,1297.69,1297.69,77.86,1103.04,14 CPT,87324,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",1297.69,1297.69,10.06,82.36,173 CPT,87327,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,11.27,92.31,173 CPT,87328,CRYPTOSPORIDIUM AG EIA,700.28,700.28,42.02,595.24,14 CPT,87328,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",700.28,700.28,11.61,95.03,173 CPT,87329,GIARDIA AG EIA,700.28,700.28,42.02,595.24,14 CPT,87329,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",700.28,700.28,10.06,82.36,173 CPT,87332,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,10.06,82.36,173 CPT,87335,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,10.63,87.06,173 CPT,87336,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,13.44,110.05,173 CPT,87337,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,10.06,82.36,173 CPT,87338,H PYLORI AG EIA STOOL,254.53,254.53,15.27,216.35,14 CPT,87338,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",254.53,254.53,12.08,98.92,173 CPT,87339,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,15.68,110.05,145 CPT,87340,HEP B S AG EIA QL,1149.0,1149.0,68.94,976.65,14 CPT,87340,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",1149.0,1149.0,8.68,71.04,173 CPT,87341,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.68,71.04,173 CPT,87350,HEP BE AG EIA,70.0,70.0,4.2,59.5,14 CPT,87350,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",70.0,70.0,9.69,79.28,173 CPT,87380,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,15.42,126.25,173 CPT,87385,HISTOPLASMA CAPS AG EIA,733.0,733.0,43.98,623.05,14 CPT,87385,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",733.0,733.0,11.13,91.13,173 CPT,87389,HIV-1AG HIV-1/2AB SINGLE,123.86,123.86,7.43,105.28,14 CPT,87389,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",123.86,123.86,20.23,165.62,173 CPT,87390,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,20.21,165.52,173 CPT,87391,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,18.4,150.59,173 CPT,87400,INFLUENZA A AG IA,627.74,627.74,37.66,533.58,28 CPT,87400,INFLUENZA B AG IA,627.74,627.74,37.66,533.58,28 CPT,87400,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,11.87,97.2,173 CPT,87420,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,11.68,95.66,173 CPT,87420,RSV AG IA,958.76,958.76,57.53,814.95,28 CPT,87425,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",882.27,882.27,10.06,82.36,173 CPT,87425,ROTAVIRUS AG EIA,882.27,882.27,52.94,749.93,14 CPT,87426,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,29.68,144.28,79 CPT,87426,SARSCOV CORONAVIRU AG IA,36.93,36.93,2.22,31.39,60 CPT,87427,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",147.15,147.15,10.06,82.36,173 CPT,87427,SHIGA LIKE TOXIN EIA,147.15,147.15,8.83,125.08,14 CPT,87428,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,30.94,203.14,79 CPT,87430,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,14.12,115.66,173 CPT,87430,STREP A AG IA,795.115,795.115,47.7,675.95,28 CPT,87449,FUNGITELL B-D-GLUCAN IA,187.44,187.44,11.25,159.32,14 CPT,87449,INFECT ANTGN DETEC NOS,146.67,146.67,8.8,124.67,14 CPT,87449,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,10.06,82.36,173 CPT,87449,LEGIONELLA AG EIA,398.0,398.0,23.88,338.3,14 CPT,87451,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.83,72.31,173 CPT,87467,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.68,79.01,160 CPT,87468,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,29.48,186.82,160 CPT,87469,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,29.48,186.82,160 CPT,87471,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,29.48,241.36,173 CPT,87472,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,35.99,294.67,173 CPT,87475,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,16.84,137.92,173 CPT,87476,BORRELIA BURGDORFERI AMP,1746.0,1746.0,104.76,1484.1,14 CPT,87476,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",1746.0,1746.0,29.48,241.36,173 CPT,87478,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,29.48,186.82,160 CPT,87480,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,16.84,137.92,173 CPT,87481,CANDIDA AMP PROBE,187.48,187.48,11.25,159.36,14 CPT,87481,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",187.48,187.48,29.48,241.36,173 CPT,87482,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,46.82,383.36,173 CPT,87483,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,408.44,2866.59,145 CPT,87484,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,29.48,186.82,160 CPT,87485,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,16.84,137.92,173 CPT,87486,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,29.48,241.36,173 CPT,87487,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,35.99,294.67,173 CPT,87490,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.11,156.47,173 CPT,87491,CHLAMYDIA T AMP PROBE,145.07,145.07,8.7,123.31,14 CPT,87491,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",145.07,145.07,29.48,241.36,173 CPT,87492,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,44.91,367.79,173 CPT,87493,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.31,256.39,173 CPT,87494,CHLM TRCH&NEISR GONO MUL,51.0,51.0,3.06,43.35,37 CPT,87494,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique ",51.0,51.0,68.78,223.87,49 CPT,87495,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.23,206.52,173 CPT,87496,CMV AMP PROBE,1041.0,1041.0,62.46,884.85,14 CPT,87496,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",1041.0,1041.0,29.48,241.36,173 CPT,87497,CMV DNA QN,1124.92,1124.92,67.5,956.18,14 CPT,87497,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",1124.92,1124.92,35.99,294.67,173 CPT,87498,ENTEROVIRUS AMP/REVERS T,803.14,803.14,48.19,682.67,14 CPT,87498,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",803.14,803.14,29.48,241.36,173 CPT,87500,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,29.48,241.36,173 CPT,87501,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.1,352.95,173 CPT,87502,FLU 1ST 2 MPLEX TY SUBTY,736.18,736.18,44.17,625.75,14 CPT,87502,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",736.18,736.18,80.47,658.93,173 CPT,87503,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,24.54,201.0,173 CPT,87505,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,107.76,882.38,173 CPT,87506,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,220.91,1808.82,173 CPT,87507,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,350.1,2866.59,173 CPT,87510,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,16.84,137.92,173 CPT,87511,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,29.48,241.36,173 CPT,87512,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.08,287.25,173 CPT,87513,"Infectious agent detection by nucleic acid (DNA or RNA); Helicobacter pylori (H. pylori), clarithromycin resistance, amplified probe technique ",,,29.48,111.94,56 CPT,87516,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,29.48,241.36,173 CPT,87517,HEP B DNA QN,1808.06,1808.06,108.48,1536.85,14 CPT,87517,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",1808.06,1808.06,35.99,294.67,173 CPT,87520,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.22,214.76,173 CPT,87521,HEP C AMP PROBE AMP,1746.08,1746.08,104.76,1484.17,14 CPT,87521,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",1746.08,1746.08,29.48,241.36,173 CPT,87522,HEP C RNA QN,1163.17,1163.17,69.79,988.69,14 CPT,87522,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",1163.17,1163.17,35.99,294.67,173 CPT,87523,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,35.99,136.66,73 CPT,87525,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.03,204.98,173 CPT,87526,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,32.98,270.05,173 CPT,87527,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.08,287.25,173 CPT,87528,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,16.84,137.92,173 CPT,87529,HERPES SIMP AMP PROBE,1099.0,1099.0,65.94,934.15,14 CPT,87529,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",1099.0,1099.0,29.48,241.36,173 CPT,87530,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,35.99,294.67,173 CPT,87531,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,48.72,398.92,173 CPT,87532,HERPES 6 AMP PROBE,1392.84,1392.84,4.3,2306.9,28 CPT,87532,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,29.48,241.36,173 CPT,87533,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.08,287.25,173 CPT,87534,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.41,150.77,173 CPT,87535,HIV-1 AMP PROBE,239.2,239.2,14.35,203.32,14 CPT,87535,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",239.2,239.2,29.48,241.36,173 CPT,87536,HIV 1 RNA QN,1035.25,1035.25,62.12,879.96,14 CPT,87536,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",1035.25,1035.25,71.48,585.35,173 CPT,87537,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.41,150.77,173 CPT,87538,HIV-2 AMP PROBE,239.2,239.2,14.35,203.32,14 CPT,87538,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",239.2,239.2,29.48,241.36,173 CPT,87539,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,49.24,403.18,173 CPT,87540,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,16.84,137.92,173 CPT,87541,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,29.48,241.36,173 CPT,87542,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.08,287.25,173 CPT,87550,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,16.84,137.92,173 CPT,87551,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,40.52,331.77,173 CPT,87552,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,35.99,294.67,173 CPT,87555,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,22.58,184.89,173 CPT,87556,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",685.77,685.77,35.01,286.7,173 CPT,87556,MTB AMP PROBE,685.77,685.77,41.15,582.9,14 CPT,87557,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,35.99,294.67,173 CPT,87560,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,22.92,187.7,173 CPT,87561,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,29.48,241.36,173 CPT,87562,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,35.99,294.67,173 CPT,87563,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,29.48,241.36,172 CPT,87564,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium tuberculosis, rifampin resistance, amplified probe technique ",629.0,629.0,64.49,244.9,56 CPT,87564,MTB RIFAMPIN RST AMP,629.0,629.0,37.74,534.65,35 CPT,87580,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,16.84,137.92,173 CPT,87581,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,29.48,241.36,173 CPT,87582,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,254.2,2081.41,173 CPT,87590,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,22.58,184.89,173 CPT,87591,GC AMP PROBE,138.47,138.47,8.31,117.7,14 CPT,87591,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",138.47,138.47,29.48,241.36,173 CPT,87592,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,35.99,294.67,173 CPT,87593,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,50.28,271.24,132 CPT,87594,"Infectious agent detection by nucleic acid (DNA or RNA); Pneumocystis jirovecii, amplified probe technique ",,,29.48,111.94,56 CPT,87623,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,29.48,241.36,173 CPT,87624,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,29.48,241.36,173 CPT,87625,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.06,278.92,173 CPT,87626,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s) ",,,58.97,223.94,56 CPT,87627,"Infectious agent detection by nucleic acid (DNA or RNA); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets ",19.15,19.15,666.17,2168.47,49 CPT,87627,JT SPC PTHGN&RX RES 26+,19.15,19.15,1.15,16.28,37 CPT,87631,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,119.81,981.02,173 CPT,87632,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,183.17,1499.86,173 CPT,87633,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",3066.19,3066.19,350.1,2866.59,173 CPT,87633,RESP MPLEX RT AMP 12-25,3066.19,3066.19,183.97,2606.26,14 CPT,87634,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,58.97,482.82,173 CPT,87635,COVID-19 DNA/RNA AMP,58.03,58.03,3.48,49.33,30 CPT,87635,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",58.03,58.03,43.1,163.68,79 CPT,87636,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,119.81,454.99,79 CPT,87637,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,119.81,454.99,79 CPT,87638,Infectious agent detection by nucleic acid (DNA or RNA); rubeola (measles) virus ,614.76,614.76,,,0 CPT,87638,RUBEOLA (MEASLES) AMP PR,614.76,614.76,36.89,522.55,48 CPT,87640,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,29.48,241.36,173 CPT,87641,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,29.48,241.36,173 CPT,87650,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,16.84,137.92,173 CPT,87651,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,29.48,241.36,173 CPT,87652,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.08,287.25,173 CPT,87653,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,29.48,241.36,173 CPT,87660,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,16.84,137.92,173 CPT,87661,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",51.0,51.0,29.48,241.36,173 CPT,87661,TRICH VAGINALIS AMP PRBE,51.0,51.0,3.06,43.35,14 CPT,87662,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.1,352.95,173 CPT,87797,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.23,206.52,173 CPT,87798,BORD PERTUSSIS AMP PR,265.08,265.08,15.9,225.32,14 CPT,87798,BORDETELL PARAPERTUS AMP,224.19,224.19,13.45,190.56,14 CPT,87798,EBV AMP PROBE,1102.51,1102.51,66.15,937.13,14 CPT,87798,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,29.48,241.36,173 CPT,87798,J C VIRUS AMP PROBE,712.15,712.15,42.73,605.33,14 CPT,87798,NOROVIRUS AMP PROBE,691.61,691.61,41.5,587.87,14 CPT,87798,PARVO VIRUS AMP PROBE,617.05,617.05,37.02,524.49,14 CPT,87798,T GONDII AMP PROBE,1962.36,1962.36,117.74,1668.01,14 CPT,87798,VARICELLA ZOSTER DNA AMP,1401.0,1401.0,84.06,1190.85,14 CPT,87798,WEST NILE VIR AMP PROBE,809.74,809.74,48.58,688.28,14 CPT,87799,ADENOVIRUS AMP QN,617.05,617.05,37.02,524.49,14 CPT,87799,EB VIRUS DNA QN,2390.97,2390.97,143.46,2032.32,14 CPT,87799,HERPES (HHV) 8 AMP QN,1171.09,1171.09,70.27,995.43,14 CPT,87799,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,35.99,294.67,173 CPT,87800,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,36.68,300.37,173 CPT,87801,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,58.97,482.82,173 CPT,87802,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.69,87.51,173 CPT,87803,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.44,110.05,173 CPT,87804,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,13.9,113.85,173 CPT,87806,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,27.53,225.44,173 CPT,87807,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.0,90.14,173 CPT,87808,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,12.84,105.16,173 CPT,87809,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.28,149.69,173 CPT,87810,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,29.64,242.72,173 CPT,87811,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,34.76,141.24,79 CPT,87812,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influe",143.0,143.0,72.99,237.59,49 CPT,87812,SARSCOV2&INF TYP AB OPTI,143.0,143.0,8.58,121.55,37 CPT,87850,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,20.63,168.96,173 CPT,87880,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,13.89,113.67,173 CPT,87899,CAMPYLOBACTER AG OIA,3503.26,3503.26,210.2,2977.77,14 CPT,87899,CRYPTOCOCCAL AG IA TIT,213.11,213.11,12.79,181.14,14 CPT,87899,CRYPTOCOCCUS AG OIA,1475.73,1475.73,88.54,1254.37,14 CPT,87899,CRYPTOCOCCUS AG OIA CSF,1475.73,1475.73,88.54,1254.37,14 CPT,87899,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.5,110.5,173 CPT,87899,STREP PNEUMO AG OIA,701.6,701.6,42.1,596.36,14 CPT,87900,GENOTYPIC BIOINFORMATICS,1008.87,1008.87,60.53,857.54,14 CPT,87900,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,1008.87,1008.87,109.49,896.58,173 CPT,87901,HIV 1 GENOTYPE RT & PROT,2498.0,2498.0,149.88,2123.3,14 CPT,87901,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",2498.0,2498.0,216.26,1770.72,173 CPT,87902,HEP C GENOTYPE,1035.25,1035.25,62.12,879.96,14 CPT,87902,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,1035.25,1035.25,216.26,1770.72,173 CPT,87903,HIV 1 PHENO & 1-10 DRUGS,3961.65,3961.65,237.7,3367.4,14 CPT,87903,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",3961.65,3961.65,410.47,3360.99,173 CPT,87904,HIV 1 PHENO EA ADD DRUG,586.87,586.87,35.21,498.84,14 CPT,87904,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",586.87,586.87,21.9,179.28,173 CPT,87905,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.26,84.07,173 CPT,87906,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,108.13,885.36,173 CPT,87910,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,216.26,1770.72,173 CPT,87912,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,216.26,1770.72,173 CPT,87913,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,216.26,821.27,79 CPT,87999,Unlisted microbiology procedure ,,,99.55,128.28,81 CPT,88000,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,1498.95,98 CPT,88005,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,1748.73,98 CPT,88007,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,1831.99,98 CPT,88012,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,1498.95,98 CPT,88014,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,1446.25,98 CPT,88016,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,1915.34,98 CPT,88020,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,2581.51,98 CPT,88025,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,2498.25,98 CPT,88027,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,2664.77,98 CPT,88028,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,1791.15,98 CPT,88029,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,1791.15,98 CPT,88036,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,1483.03,98 CPT,88037,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,1204.83,98 CPT,88040,Necropsy (autopsy); forensic examination ,,,48.71,4480.16,98 CPT,88045,Necropsy (autopsy); coroner's call ,,,4.85,416.39,93 CPT,88099,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,81 CPT,88104,CYTO FWB SMEAR & INTERP,1039.0,1039.0,62.34,883.15,23 CPT,88104,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",1039.0,1039.0,67.53,288.69,98 CPT,88106,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,46.44,347.52,98 CPT,88108,CYTOLOGY CONC & INTERP,226.0,226.0,13.56,192.1,23 CPT,88108,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",226.0,226.0,67.53,303.36,98 CPT,88112,CYTO LIQUID BASE NON C/V,564.0,564.0,33.84,479.4,23 CPT,88112,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",564.0,564.0,99.93,281.36,98 CPT,88120,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,289.87,4049.78,98 CPT,88121,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,572.49,2801.61,98 CPT,88125,"Cytopathology, forensic (eg, sperm) ",,,61.05,157.81,98 CPT,88130,Sex chromatin identification; Barr bodies ,,,17.62,123.62,145 CPT,88140,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,7.83,54.93,145 CPT,88141,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,159.1,98 CPT,88142,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.02,139.37,173 CPT,88143,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.35,158.47,173 CPT,88147,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,42.47,347.79,173 CPT,88148,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.44,110.05,173 CPT,88150,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.37,109.51,173 CPT,88152,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.22,190.14,173 CPT,88153,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.19,165.25,173 CPT,88155,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.31,100.73,173 CPT,88160,"Cytopathology, smears, any other source; screening and interpretation ",,,46.44,332.77,98 CPT,88161,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,46.44,349.96,98 CPT,88162,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,99.93,538.2,98 CPT,88164,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.37,109.51,173 CPT,88165,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,35.46,290.41,173 CPT,88166,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.37,109.51,173 CPT,88167,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.37,109.51,173 CPT,88172,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",808.0,808.0,86.12,457.76,98 CPT,88172,FNA SAMPLE ADEQUACY IMM,808.0,808.0,48.48,686.8,23 CPT,88173,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",1039.0,1039.0,99.93,630.69,98 CPT,88173,FNA INTERP & REPORT,1039.0,1039.0,62.34,883.15,23 CPT,88174,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.31,174.48,173 CPT,88175,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.35,182.99,173 CPT,88177,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,14.56,51.4,98 CPT,88182,"Flow cytometry, cell cycle or DNA analysis ",,,99.93,782.55,98 CPT,88184,FC 1ST MARK,799.19,799.19,47.95,679.31,23 CPT,88184,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",799.19,799.19,308.9,904.08,98 CPT,88185,FC ADD,109.46,109.46,6.57,93.04,28 CPT,88185,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",109.46,109.46,50.24,156.75,98 CPT,88187,"Flow cytometry, interpretation; 2 to 8 markers ",,,78.62,254.03,98 CPT,88188,"Flow cytometry, interpretation; 9 to 15 markers ",,,133.22,444.17,98 CPT,88189,"Flow cytometry, interpretation; 16 or more markers ",,,178.37,596.03,98 CPT,88199,Unlisted cytopathology procedure ,,,99.93,181.85,86 CPT,88230,TISS CULT CHROM BLD NM,6819.9,6819.9,409.19,5796.91,14 CPT,88230,Tissue culture for non-neoplastic disorders; lymphocyte ,6819.9,6819.9,97.85,801.2,173 CPT,88233,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,118.21,967.9,173 CPT,88235,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,126.25,1033.78,173 CPT,88237,TISS CULT NEOPLAS BM BLD,5892.35,5892.35,353.54,5008.5,14 CPT,88237,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",5892.35,5892.35,120.75,988.71,173 CPT,88239,Tissue culture for neoplastic disorders; solid tumor ,,,123.92,1014.69,173 CPT,88240,"Cryopreservation, freezing and storage of cells, each cell line ",,,10.98,89.87,173 CPT,88241,"Thawing and expansion of frozen cells, each aliquot ",,,10.16,83.17,173 CPT,88245,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,145.46,1191.07,173 CPT,88248,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,145.46,1191.07,173 CPT,88249,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,145.46,1191.07,173 CPT,88261,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,222.05,1818.15,173 CPT,88262,CHROM & KARY 15-20 2 KAR,9625.86,9625.86,577.55,8181.98,14 CPT,88262,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",9625.86,9625.86,105.41,863.1,173 CPT,88263,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,126.24,1033.69,173 CPT,88264,CHROM ANAL 20-25 CELLS,1192.19,1192.19,71.53,1013.36,14 CPT,88264,Chromosome analysis; analyze 20-25 cells ,1192.19,1192.19,121.47,994.6,173 CPT,88267,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,158.4,1296.96,173 CPT,88269,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,145.87,1194.42,173 CPT,88271,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,17.99,147.33,173 CPT,88272,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.19,279.92,173 CPT,88273,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.24,239.46,173 CPT,88274,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,35.6,291.5,173 CPT,88275,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.0,352.05,173 CPT,88280,CHROM ADDTL KARYOTYPE,1528.47,1528.47,91.71,1299.2,14 CPT,88280,"Chromosome analysis; additional karyotypes, each study ",1528.47,1528.47,28.11,230.23,173 CPT,88283,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,57.62,471.87,173 CPT,88285,"Chromosome analysis; additional cells counted, each study ",,,22.6,185.07,173 CPT,88289,Chromosome analysis; additional high resolution study ,,,28.92,236.84,173 CPT,88291,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,33.35,236.75,100 CPT,88299,Unlisted cytogenetic study ,,,99.93,181.85,86 CPT,88300,"Level I - Surgical pathology, gross examination only ",597.0,597.0,46.44,78.1,98 CPT,88300,SURG PATH LEVEL 1,597.0,597.0,35.82,507.45,23 CPT,88302,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",1452.0,1452.0,46.44,178.47,98 CPT,88302,SURG PATH LEVEL 2,1452.0,1452.0,87.12,1234.2,23 CPT,88304,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",1452.0,1452.0,99.93,217.65,98 CPT,88304,SURG PATH LEVEL 3,1452.0,1452.0,87.12,1234.2,23 CPT,88305,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",1853.0,1853.0,99.93,244.62,98 CPT,88305,SURG PATH LEVEL 4,1853.0,1853.0,111.18,1575.05,23 CPT,88307,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",2555.0,2555.0,572.49,1473.25,98 CPT,88307,SURG PATH LEVEL 5,2555.0,2555.0,153.3,2171.75,23 CPT,88309,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",2751.0,2751.0,1229.72,2100.23,98 CPT,88309,SURG PATH LEVEL 6,2751.0,2751.0,165.06,2338.35,23 CPT,88311,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,702.0,702.0,18.2,60.91,98 CPT,88311,PATH DECALCIFICATION,702.0,702.0,42.12,596.7,28 CPT,88312,PATH STAIN GROUP 1,895.0,895.0,53.7,760.75,23 CPT,88312,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",895.0,895.0,99.93,624.27,98 CPT,88313,PATH STAIN GROUP 2,1112.0,1112.0,66.72,945.2,23 CPT,88313,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",1112.0,1112.0,67.53,496.85,98 CPT,88314,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,141.97,560.56,98 CPT,88319,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,2003.96,98 CPT,88321,Consultation and report on referred slides prepared elsewhere ,,,67.53,593.59,98 CPT,88323,Consultation and report on referred material requiring preparation of slides ,,,99.93,193.22,98 CPT,88325,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,99.93,958.49,98 CPT,88329,Pathology consultation during surgery; ,,,67.53,251.5,98 CPT,88331,PATH CONSULT FS 1 SPEC,2246.0,2246.0,134.76,1909.1,23 CPT,88331,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",2246.0,2246.0,171.16,457.76,98 CPT,88332,PATH CONSULT FS EA ADDTL,675.0,675.0,40.5,573.75,28 CPT,88332,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,675.0,675.0,44.4,173.58,98 CPT,88333,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",3242.0,3242.0,133.54,2003.96,98 CPT,88333,TOUCH PREP INITIAL SITE,3242.0,3242.0,194.52,2755.7,23 CPT,88334,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",1883.0,1883.0,34.22,137.2,98 CPT,88334,TOUCH PREP EA ADD SITE,1883.0,1883.0,112.98,1600.55,28 CPT,88341,IHC AB STAIN EA ADD,1005.0,1005.0,60.3,854.25,28 CPT,88341,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",1005.0,1005.0,130.31,435.94,98 CPT,88342,IHC AB STAIN,4109.0,4109.0,246.54,3492.65,23 CPT,88342,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",4109.0,4109.0,274.35,479.74,98 CPT,88344,IHC EA MULTIPLEX AB PROC,4335.0,4335.0,260.1,3684.75,23 CPT,88344,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",4335.0,4335.0,543.37,954.87,98 CPT,88346,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,904.08,98 CPT,88348,"Electron microscopy, diagnostic ",,,1268.96,2728.48,98 CPT,88350,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,98.27,643.82,98 CPT,88355,Morphometric analysis; skeletal muscle ,,,251.75,457.76,98 CPT,88356,Morphometric analysis; nerve ,,,99.93,848.62,98 CPT,88358,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,289.87,651.15,98 CPT,88360,M A IHC QT/SQT EA AB MAN,372.0,372.0,22.32,316.2,23 CPT,88360,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",372.0,372.0,289.87,572.77,98 CPT,88361,IHC QN/SQN EA AB COMP,1004.91,1004.91,60.29,854.17,23 CPT,88361,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",1004.91,1004.91,313.36,904.08,98 CPT,88362,Nerve teasing preparations ,,,499.29,2003.96,98 CPT,88363,EXAM SELEC RETR ARCH MOL,435.03,435.03,26.1,369.78,23 CPT,88363,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",435.03,435.03,46.44,136.84,98 CPT,88364,ISH/FISH EA ADDL PROBE,623.47,623.47,37.41,529.95,28 CPT,88364,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",623.47,623.47,198.75,749.16,98 CPT,88365,ISH/FISH INITIAL PROBE,2385.69,2385.69,143.14,2027.84,23 CPT,88365,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",2385.69,2385.69,289.87,984.01,98 CPT,88366,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,572.49,1610.99,98 CPT,88367,MORPH ANAL CMP INI PROBE,296.53,296.53,17.79,252.05,23 CPT,88367,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",296.53,296.53,337.05,904.08,98 CPT,88368,MORPH ANAL MAN INI PROBE,1021.56,1021.56,61.29,868.33,23 CPT,88368,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",1021.56,1021.56,421.79,904.08,98 CPT,88369,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,160.17,599.74,98 CPT,88371,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,18.67,152.85,171 CPT,88372,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.02,180.37,171 CPT,88373,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,96.82,315.94,98 CPT,88374,MORPH ANAL CMP MLP PROBE,623.47,623.47,37.41,529.95,23 CPT,88374,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",623.47,623.47,289.87,2042.4,98 CPT,88375,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,103.38,342.0,98 CPT,88377,MORPH ANAL MAN MLP PROBE,1735.53,1735.53,104.13,1475.2,23 CPT,88377,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",1735.53,1735.53,289.87,2463.32,98 CPT,88380,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,159.44,528.43,98 CPT,88381,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,262.8,1343.38,98 CPT,88387,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,13.84,56.02,98 CPT,88399,Unlisted surgical pathology procedure ,,,99.93,181.85,86 CPT,88720,"Bilirubin, total, transcutaneous ",,,4.22,34.57,173 CPT,88738,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,4.92,34.57,145 CPT,88740,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,9.18,64.44,145 CPT,88741,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,9.18,64.44,145 CPT,88749,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,81 CPT,89049,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,457.76,98 CPT,89050,CELL COUNT BODY FLD,420.7,420.7,25.24,357.6,14 CPT,89050,CELL COUNT CSF,420.7,420.7,25.24,357.6,14 CPT,89050,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,3.96,32.49,173 CPT,89051,CELL CT & DIFF CSF,840.07,840.07,50.4,714.06,14 CPT,89051,CELL CT&DIFF BODY FL,840.0,840.0,50.4,714.0,14 CPT,89051,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.7,38.55,173 CPT,89055,FECAL WBC COUNT QL,505.1,505.1,30.31,429.33,14 CPT,89055,"Leukocyte assessment, fecal, qualitative or semiquantitative ",505.1,505.1,3.59,29.41,173 CPT,89060,CRYSTALS BODY FL,597.0,597.0,35.82,507.45,14 CPT,89060,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",597.0,597.0,6.16,50.41,173 CPT,89125,"Fat stain, feces, urine, or respiratory secretions ",,,4.94,40.45,173 CPT,89160,"Meat fibers, feces ",,,4.07,33.39,173 CPT,89190,Nasal smear for eosinophils ,,,4.86,39.82,173 CPT,89220,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,457.76,98 CPT,89230,Sweat collection by iontophoresis ,,,10.87,157.81,98 CPT,89240,Unlisted miscellaneous pathology test ,,,99.93,181.85,86 CPT,89250,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,289.87,7499.55,98 CPT,89251,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,289.87,7800.83,98 CPT,89253,"Assisted embryo hatching, microtechniques (any method) ",,,289.87,1425.38,98 CPT,89254,Oocyte identification from follicular fluid ,,,289.87,2606.85,98 CPT,89255,Preparation of embryo for transfer (any method) ,,,99.93,2058.06,98 CPT,89257,Sperm identification from aspiration (other than seminal fluid) ,,,99.93,1829.55,98 CPT,89258,Cryopreservation; embryo(s) ,,,1268.96,3530.04,98 CPT,89259,Cryopreservation; sperm ,,,289.87,1782.67,98 CPT,89260,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,99.93,677.12,98 CPT,89261,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,99.93,658.66,98 CPT,89264,"Sperm identification from testis tissue, fresh or cryopreserved ",,,99.93,2170.82,98 CPT,89268,Insemination of oocytes ,,,289.87,2674.73,98 CPT,89272,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,1268.96,3761.54,98 CPT,89280,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,1268.96,4757.68,98 CPT,89281,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,289.87,5654.17,98 CPT,89290,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,289.87,5688.11,98 CPT,89291,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,289.87,7155.02,98 CPT,89300,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,9.64,67.69,145 CPT,89310,Semen analysis; motility and count (not including Huhner test) ,,,8.44,59.19,145 CPT,89320,"Semen analysis; volume, count, motility, and differential ",,,12.06,84.71,145 CPT,89321,"Semen analysis; sperm presence and motility of sperm, if performed ",,,11.81,82.9,145 CPT,89322,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,15.19,106.61,145 CPT,89325,Sperm antibodies ,,,10.46,73.4,145 CPT,89329,Sperm evaluation; hamster penetration test ,,,19.2,134.75,145 CPT,89330,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,10.17,71.4,145 CPT,89331,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,19.2,134.75,145 CPT,89335,"Cryopreservation, reproductive tissue, testicular ",,,99.93,962.02,98 CPT,89337,"Cryopreservation, mature oocyte(s) ",,,289.87,3745.25,98 CPT,89342,Storage (per year); embryo(s) ,,,289.87,1413.07,98 CPT,89343,Storage (per year); sperm/semen ,,,289.87,1574.43,98 CPT,89344,"Storage (per year); reproductive tissue, testicular/ovarian ",,,289.87,859.39,98 CPT,89346,Storage (per year); oocyte(s) ,,,572.49,1979.78,98 CPT,89352,Thawing of cryopreserved; embryo(s) ,,,56.68,570.33,98 CPT,89353,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,56.68,181.85,98 CPT,89354,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,56.68,570.33,98 CPT,89356,"Thawing of cryopreserved; oocytes, each aliquot ",,,40.4,570.33,98 CPT,89398,Unlisted reproductive medicine laboratory procedure ,,,99.93,181.85,86 CPT,90281,"Immune globulin (Ig), human, for intramuscular use ",,,116.56,332.25,8 CPT,90283,"Immune globulin (IgIV), human, for intravenous use ",,,26.64,259.86,8 CPT,90284,"Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each ",,,17.78,51.95,8 CPT,90287,"Botulinum antitoxin, equine, any route ",,,385.26,530.71,5 CPT,90288,"Botulism immune globulin, human, for intravenous use ",,,117866.1,151959.6,3 CPT,90291,"Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use ",,,2266.74,6139.13,8 CPT,90371,HBIG HUMAN 0.5 ML IM,1901.19,1901.19,114.07,1616.01,19 CPT,90371,HBIG HUMAN 5 ML IM,3145.0,3145.0,188.7,2673.25,19 CPT,90371,"Hepatitis B immune globulin (HBIg), human, for intramuscular use ",,,140.21,552.36,10 CPT,90375,"Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use ",,,275.18,1171.4,10 CPT,90376,"Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use ",,,743.51,1581.47,8 CPT,90377,RIG KEDRAB 150 U IMSQ,1304.97,1304.97,78.3,1109.22,19 CPT,90377,RIG KEDRAB 150 U IMSQJW,1304.97,1304.97,78.3,1109.22,19 CPT,90377,RIG KEDRAB 1500 U IMSQ,13049.83,13049.83,782.99,11092.36,19 CPT,90377,RIG KEDRAB 300 U IMSQ,2609.97,2609.97,156.6,2218.47,19 CPT,90377,"Rabies immune globulin, heat- and solvent/detergent-treated (RIg-HT S/D), human, for intramuscular and/or subcutaneous use ",,,242.18,1246.0,10 CPT,90378,"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each ",,,2661.72,6362.12,8 CPT,90380,"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use ",,,630.77,1943.35,10 CPT,90381,"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use ",,,630.77,1943.35,10 CPT,90382,"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 mL, for intramuscular use ",,,589.36,1942.89,10 CPT,90384,"Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use ",,,215.6,297.0,8 CPT,90385,"Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use ",,,56.74,104.27,8 CPT,90386,"Rho(D) immune globulin (RhIgIV), human, for intravenous use ",,,19.05,36.04,8 CPT,90389,"Tetanus immune globulin (TIg), human, for intramuscular use ",,,1038.6,2268.46,8 CPT,90396,"Varicella-zoster immune globulin, human, for intramuscular use ",,,3217.58,7969.88,8 CPT,90399,Unlisted immune globulin ,,,,,0 CPT,90460,"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine o",,,33.74,46.58,5 CPT,90461,"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid compone",,,30.35,41.89,5 CPT,90471,IMMUNIZ ADMIN SGL,337.89,337.89,19.78,294.21,273 CPT,90471,"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) ",,,141.5,195.32,5 CPT,90472,IMMUNIZ ADMIN EA ADDTL,335.515,335.515,18.06,314.54,352 CPT,90472,"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition",,,30.35,41.89,5 CPT,90473,Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid) ,,,141.5,195.32,5 CPT,90474,Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) ,,,30.35,41.89,5 CPT,90480,"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine; first or only component of each vaccine a",,,93.6,129.2,5 CPT,90481,"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine; each additional component administered (L",,,93.6,129.2,5 CPT,90482,Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes ,,,25.37,35.01,5 CPT,90483,Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minu,,,52.35,72.26,5 CPT,90484,Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes ,,,78.51,108.37,5 CPT,90581,"Anthrax vaccine, for subcutaneous or intramuscular use ",,,221.77,345.95,8 CPT,90584,"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use ",,,227.03,312.74,5 CPT,90585,"Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use ",,,212.78,617.35,8 CPT,90586,"Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use ",,,298.12,617.35,8 CPT,90587,"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use ",,,69.96,230.63,5 CPT,90589,"Chikungunya virus vaccine, live attenuated, for intramuscular use ",,,271.66,960.96,8 CPT,90593,"Chikungunya virus vaccine, recombinant, for intramuscular use ",,,630.63,960.96,8 CPT,90611,"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use ",,,289.04,943.49,5 CPT,90619,MENQUADFI VAC IM,589.64,589.64,35.38,501.19,24 CPT,90619,"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use ",589.64,589.64,166.76,600.94,10 CPT,90620,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use ",,,258.87,828.64,10 CPT,90621,"Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use ",1085.03,1085.03,229.61,724.46,10 CPT,90621,TRUMENBA VAC IM,1085.03,1085.03,65.1,922.28,24 CPT,90622,"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use ",,,0.02,0.03,3 CPT,90623,"Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use ",,,266.97,827.83,10 CPT,90624,"Meningococcal pentavalent vaccine, Men B-4C recombinant proteins and outer membrane vesicle and conjugated Men A, C, W, Y-diphtheria toxoid carrier, for intramuscular use ",,,529.16,728.95,5 CPT,90625,"Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use ",,,441.0,1018.62,8 CPT,90626,"Tick-borne encephalitis virus vaccine, inactivated; 0.25 mL dosage, for intramuscular use ",,,499.33,1061.95,8 CPT,90627,"Tick-borne encephalitis virus vaccine, inactivated; 0.5 mL dosage, for intramuscular use ",,,499.33,1061.95,8 CPT,90632,"Hepatitis A vaccine (HepA), adult dosage, for intramuscular use ",,,73.73,284.17,10 CPT,90633,"Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use ",,,42.14,135.75,10 CPT,90635,"Influenza virus vaccine, H5N1, derived from cell cultures, adjuvanted, for intramuscular use ",,,48.49,66.8,5 CPT,90636,"Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use ",,,145.23,462.76,10 CPT,90637,"Influenza virus vaccine, quadrivalent (qIRV), mRNA; 30 mcg/0.5 mL dosage, for intramuscular use ",,,36.18,49.84,5 CPT,90638,"Influenza virus vaccine, quadrivalent (qIRV), mRNA; 60 mcg/0.5 mL dosage, for intramuscular use ",,,36.18,49.84,5 CPT,90644,"Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use ",,,47.75,86.36,8 CPT,90647,"Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use ",,,32.57,106.86,10 CPT,90648,ACTHIB 4 DOSE VAC IM,63.29,63.29,3.8,53.8,24 CPT,90648,"Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use ",63.29,63.29,14.55,46.02,10 CPT,90649,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use ",,,312.42,559.7,8 CPT,90650,"Human Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for intramuscular use ",,,249.35,463.32,8 CPT,90651,GARDASIL 9 2-3 DOSE IM,1430.0,1430.0,85.8,1215.5,24 CPT,90651,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose schedule, for intramuscular use ",1430.0,1430.0,348.38,1074.9,10 CPT,90653,"Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use ",,,86.59,256.34,10 CPT,90655,"Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use ",,,31.09,43.65,8 CPT,90656,FLUZONE TRI 0.5 ML PF IM,67.8,67.8,4.07,57.63,19 CPT,90656,"Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use ",67.8,67.8,23.22,68.95,10 CPT,90657,"Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use ",,,11.03,42.82,10 CPT,90658,"Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use ",,,22.07,67.45,10 CPT,90660,"Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use ",,,29.71,88.92,5 CPT,90661,"Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use ",,,49.5,113.38,10 CPT,90662,FLUZONE HD PF IM,273.8,273.8,16.43,232.73,19 CPT,90662,"Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use ",273.8,273.8,84.53,256.34,10 CPT,90670,"Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use ",,,362.21,791.23,8 CPT,90671,"Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use ",1007.48,1007.48,269.31,800.9,10 CPT,90671,VAXNEUVANCE VAC IM,1007.48,1007.48,60.45,856.36,19 CPT,90672,"Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use ",,,44.98,85.61,8 CPT,90673,FLUBLOK TRI PF IM,267.85,267.85,16.07,227.67,19 CPT,90673,"Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use ",267.85,267.85,70.07,256.34,10 CPT,90674,"Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use ",,,41.59,105.18,8 CPT,90675,IMOVAX 1 ML VAC IM,1752.82,1752.82,105.17,1489.9,19 CPT,90675,"Rabies vaccine, for intramuscular use ",1752.82,1752.82,315.22,1518.69,10 CPT,90676,"Rabies vaccine, for intradermal use ",,,311.25,428.76,5 CPT,90677,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use ",,,312.9,959.56,10 CPT,90678,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use ",,,338.21,1072.09,10 CPT,90679,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use ",,,324.73,1070.5,10 CPT,90680,"Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use ",,,108.11,345.32,10 CPT,90681,"Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use ",,,165.14,513.74,10 CPT,90682,"Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use ",,,89.67,225.42,8 CPT,90683,"Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use ",,,307.4,1013.38,10 CPT,90684,"Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use ",,,344.25,1005.51,10 CPT,90685,"Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use ",,,36.69,66.77,8 CPT,90686,"Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use ",,,32.97,68.95,8 CPT,90687,"Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use ",,,16.29,32.23,8 CPT,90688,"Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use ",,,30.91,64.43,8 CPT,90689,"Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use ",,,16.29,22.44,5 CPT,90690,"Typhoid vaccine, live, oral ",,,81.75,409.81,8 CPT,90691,"Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use ",,,128.71,537.79,8 CPT,90694,"Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use ",,,32.97,237.56,8 CPT,90696,"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use ",,,70.09,219.52,10 CPT,90697,"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intr",,,177.4,547.28,5 CPT,90698,"Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use ",,,138.36,419.55,10 CPT,90700,DAPTACEL < 7 YRS VAC IM,123.61,123.61,7.42,105.07,24 CPT,90700,"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use ",123.61,123.61,32.97,103.4,10 CPT,90702,"Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use ",,,73.62,230.94,8 CPT,90707,MMR VAC LIVE SQ,703.13,703.13,42.19,597.66,24 CPT,90707,"Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use ",703.13,703.13,102.53,332.65,10 CPT,90710,"Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use ",,,306.52,972.0,10 CPT,90713,"Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use ",,,49.05,156.31,10 CPT,90714,TENIVAC VAC >= 7 YRS IM,1161.17,1161.17,69.67,986.99,24 CPT,90714,"Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use ",1161.17,1161.17,36.34,147.64,10 CPT,90715,ADACEL VAC >= 7 YRS IM,1138.57,1138.57,68.31,967.78,24 CPT,90715,"Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use ",1138.57,1138.57,39.48,170.35,10 CPT,90716,"Varicella virus vaccine (VAR), live, for subcutaneous use ",,,203.24,639.48,10 CPT,90717,"Yellow fever vaccine, live, for subcutaneous use ",,,220.56,821.75,8 CPT,90723,"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use ",2087.01,2087.01,117.88,362.08,10 CPT,90723,PEDIARIX VAC IM,2087.01,2087.01,125.22,1773.96,24 CPT,90732,PNEUMOVAX 23 VAC IMSQ,581.58,581.58,34.89,494.34,19 CPT,90732,"Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use ",581.58,581.58,133.47,409.13,10 CPT,90733,"Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use ",,,240.2,430.4,8 CPT,90734,"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use ",,,166.76,582.69,10 CPT,90736,"Zoster (shingles) vaccine (HZV), live, for subcutaneous injection ",,,416.83,743.15,8 CPT,90738,"Japanese encephalitis virus vaccine, inactivated, for intramuscular use ",,,487.16,1031.13,8 CPT,90739,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use ",,,177.56,544.25,10 CPT,90740,"Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use ",517.55,517.55,164.42,652.7,10 CPT,90740,RECOMBIVAX DIAL 40MCG IM,517.55,517.55,31.05,439.92,19 CPT,90743,"Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use ",,,75.15,240.46,10 CPT,90744,"Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use ",942.84,942.84,33.2,97.53,10 CPT,90744,RECOMBIVAX PED 5MCG IM,942.84,942.84,56.57,801.41,19 CPT,90746,"Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use ",1020.6,1020.6,75.15,240.46,10 CPT,90746,RECOMBIVAX ADLT 10MCG IM,1020.6,1020.6,61.24,867.51,19 CPT,90747,"Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use ",,,164.42,504.88,10 CPT,90748,"Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use ",,,82.1,146.98,8 CPT,90750,"Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted, for intramuscular use ",,,228.44,753.07,10 CPT,90756,"Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use ",,,39.44,99.65,8 CPT,90758,"Zaire ebolavirus vaccine, live, for intramuscular use ",,,319.15,439.64,5 CPT,90759,"Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramuscular use ",,,175.5,358.53,8 CPT,90867,"Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management ",,,430.09,601.0,7 CPT,90868,"Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session ",,,59.04,601.0,7 CPT,90869,Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management ,,,601.0,601.0,2 CPT,90870,Electroconvulsive therapy (includes necessary monitoring) ,,,263.11,363.18,7 CPT,90901,Biofeedback training by any modality ,,,35.47,88.43,93 CPT,90912,"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care profe",,,71.3,177.76,93 CPT,90913,"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health ca",,,28.58,81.49,93 CPT,90937,Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription ,,,77.0,77.0,2 CPT,90951,"End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counsel",,,1025.19,1025.19,2 CPT,90954,"End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of par",,,896.24,896.24,2 CPT,90955,"End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of par",,,465.81,465.81,2 CPT,90956,"End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of par",,,316.83,316.83,2 CPT,90957,"End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of pa",,,689.91,689.91,2 CPT,90958,"End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of pa",,,448.66,448.66,2 CPT,90959,"End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of pa",,,293.03,293.03,2 CPT,90960,"End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month",,,322.18,322.18,2 CPT,90961,"End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month ",,,268.45,268.45,2 CPT,90962,"End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month ",,,185.47,185.47,2 CPT,90963,"End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and",,,541.91,541.91,2 CPT,90964,"End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and developme",,,461.9,461.9,2 CPT,90965,"End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and developm",,,446.26,446.26,2 CPT,90966,"End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 20 years of age and older ",,,268.17,268.17,2 CPT,90967,"End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age ",,,15.87,15.87,2 CPT,90968,"End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age ",,,15.3,15.3,2 CPT,90969,"End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age ",,,15.02,15.02,2 CPT,90970,"End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older ",,,8.64,8.64,2 CPT,91010,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,292.64,3083.0,117 CPT,91013,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,38.8,2358.0,21 CPT,91020,Gastric motility (manometric) studies ,,,411.54,3083.0,117 CPT,91022,Duodenal motility (manometric) study ,,,224.31,3083.0,133 CPT,91030,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,215.89,2358.0,21 CPT,91034,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,332.26,2358.0,21 CPT,91035,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,952.94,2358.0,21 CPT,91037,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,270.71,2358.0,21 CPT,91038,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,921.75,2358.0,21 CPT,91040,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1020.4,2358.0,21 CPT,91065,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,155.17,2358.0,21 CPT,91110,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,783.43,2979.0,91 CPT,91111,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,809.6,2979.0,91 CPT,91112,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,809.6,3807.65,91 CPT,91113,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,831.04,3266.43,59 CPT,91117,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,333.94,1672.0,13 CPT,91120,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,16 CPT,91122,Anorectal manometry ,,,1672.0,2358.0,32 CPT,91124,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,516.2,3083.0,101 CPT,91125,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,892.1,3083.0,101 CPT,91132,"Electrogastrography, diagnostic, transcutaneous; ",,,508.53,2358.0,21 CPT,91133,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,255.13,2358.0,21 CPT,91200,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,30.41,446.87,59 CPT,91299,Unlisted diagnostic gastroenterology procedure ,,,323.74,2358.0,21 CPT,91304,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramus",,,191.92,495.14,5 CPT,91318,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use ",,,128.11,200.93,8 CPT,91319,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use ",,,94.8,269.07,10 CPT,91320,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use ",,,168.37,477.86,10 CPT,91321,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use ",,,147.06,450.78,10 CPT,91322,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use ",,,161.65,495.52,10 CPT,91323,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular use ",,,201.91,618.91,10 CPT,92002,"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient ",,,271.28,374.45,5 CPT,92004,"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits ",,,271.28,374.45,5 CPT,92012,"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient ",,,271.28,374.45,5 CPT,92014,"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits ",,,271.28,374.45,5 CPT,92015,Determination of refractive state ,,,46.38,64.02,5 CPT,92018,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,68 CPT,92019,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,68 CPT,92020,Gonioscopy (separate procedure) ,,,255.13,352.17,5 CPT,92025,"Computerized corneal topography, unilateral or bilateral, with interpretation and report ",,,128.72,177.68,5 CPT,92060,"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure) ",,,128.72,177.68,5 CPT,92065,Orthoptic training; performed by a physician or other qualified health care professional ,,,128.72,177.68,5 CPT,92066,Orthoptic training; under supervision of a physician or other qualified health care professional ,,,116.11,183.36,5 CPT,92071,Fitting of contact lens for treatment of ocular surface disease ,,,80.12,110.6,5 CPT,92072,"Fitting of contact lens for management of keratoconus, initial fitting ",,,239.5,330.59,5 CPT,92081,"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, Autoplot, arc perimeter, or single stimulus level automated test, such as Oc",,,128.72,177.68,5 CPT,92082,"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on Goldmann perimeter, or semiquantitative, automated suprathreshol",,,128.72,177.68,5 CPT,92083,"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the",,,255.13,352.17,5 CPT,92100,"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment o",,,80.96,111.76,5 CPT,92132,"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography ºOCT»), anterior segment, with interpretation and report, unilateral or bilateral ",,,128.72,177.68,5 CPT,92133,"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography ºOCT»), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve ",,,128.72,177.68,5 CPT,92134,"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography ºOCT»), posterior segment, with interpretation and report, unilateral or bilateral; retina ",,,128.72,177.68,5 CPT,92136,Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation ,,,255.13,352.17,5 CPT,92137,"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography ºOCT»), posterior segment, with interpretation and report, unilateral or bilateral; retina, including OCT angiography ",,,548.06,1205.12,5 CPT,92145,"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report ",,,78.23,107.98,5 CPT,92201,"Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral",,,128.72,177.68,5 CPT,92202,"Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral ",,,128.72,177.68,5 CPT,92227,"Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral ",,,78.23,107.98,5 CPT,92228,"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral ",,,78.23,107.98,5 CPT,92229,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,97.96,252.98,86 CPT,92230,Fluorescein angioscopy with interpretation and report ,,,1136.33,1568.52,5 CPT,92235,"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral ",,,114.68,158.3,5 CPT,92240,"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral ",,,377.82,521.52,5 CPT,92242,"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral ",,,417.43,576.2,5 CPT,92250,Fundus photography with interpretation and report ,,,255.13,352.17,5 CPT,92260,Ophthalmodynamometry ,,,78.23,107.98,5 CPT,92265,"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report ",,,128.72,177.68,5 CPT,92270,Electro-oculography with interpretation and report ,,,255.13,352.17,5 CPT,92273,"Electroretinography (ERG), with interpretation and report; full field (ie, ffERG, flash ERG, Ganzfeld ERG) ",,,229.39,316.64,5 CPT,92274,"Electroretinography (ERG), with interpretation and report; multifocal (mfERG) ",,,136.61,188.57,5 CPT,92283,"Color vision examination, extended, eg, anomaloscope or equivalent ",,,128.72,177.68,5 CPT,92284,"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report ",,,850.8,1174.4,5 CPT,92285,"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography) ",,,128.72,177.68,5 CPT,92286,Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis ,,,255.13,352.17,5 CPT,92287,Anterior segment imaging with interpretation and report; with fluorescein angiography ,,,255.13,352.17,5 CPT,92288,"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report ",,,56.3,77.71,5 CPT,92310,"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia ",,,42.41,196.74,7 CPT,92311,"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye ",,,850.8,1174.4,5 CPT,92312,"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes ",,,255.13,352.17,5 CPT,92313,"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens ",,,255.13,352.17,5 CPT,92314,"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for apha",,,24.96,116.41,7 CPT,92315,"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye ",,,255.13,352.17,5 CPT,92316,"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes ",,,128.72,177.68,5 CPT,92317,"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens ",,,78.23,107.98,5 CPT,92325,"Modification of contact lens (separate procedure), with medical supervision of adaptation ",,,255.13,352.17,5 CPT,92326,Replacement of contact lens ,,,128.72,177.68,5 CPT,92340,"Fitting of spectacles, except for aphakia; monofocal ",,,44.69,61.69,5 CPT,92341,"Fitting of spectacles, except for aphakia; bifocal ",,,57.35,79.17,5 CPT,92342,"Fitting of spectacles, except for aphakia; multifocal, other than bifocal ",,,64.94,89.63,5 CPT,92352,Fitting of spectacle prosthesis for aphakia; monofocal ,,,128.72,177.68,5 CPT,92353,Fitting of spectacle prosthesis for aphakia; multifocal ,,,128.72,177.68,5 CPT,92354,Fitting of spectacle mounted low vision aid; single element system ,,,78.23,107.98,5 CPT,92355,Fitting of spectacle mounted low vision aid; telescopic or other compound lens system ,,,78.23,107.98,5 CPT,92358,"Prosthesis service for aphakia, temporary (disposable or loan, including materials) ",,,128.72,177.68,5 CPT,92370,Repair and refitting spectacles; except for aphakia ,,,38.8,53.55,5 CPT,92371,Repair and refitting spectacles; spectacle prosthesis for aphakia ,,,128.72,177.68,5 CPT,92499,Unlisted ophthalmological service or procedure ,,,53.8,74.26,5 CPT,92502,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,52 CPT,92504,Binocular microscopy (separate diagnostic procedure) ,,,22.77,31.43,5 CPT,92507,TX SPEECH INDIVIDUAL SP,994.22,994.22,59.65,845.09,20 CPT,92507,"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual ",994.22,994.22,74.87,455.33,62 CPT,92508,"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals ",,,23.69,141.16,62 CPT,92511,Nasopharyngoscopy with endoscope (separate procedure) ,,,91.07,3083.0,101 CPT,92512,"Nasal function studies (eg, rhinomanometry) ",,,67.46,93.12,5 CPT,92516,"Facial nerve function studies (eg, electroneuronography) ",,,54.83,75.68,5 CPT,92517,"Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) ",,,91.0,143.71,5 CPT,92518,"Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; ocular (oVEMP) ",,,91.0,143.71,5 CPT,92519,"Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) and ocular (oVEMP) ",,,136.13,214.97,5 CPT,92520,"Laryngeal function studies (ie, aerodynamic testing and acoustic testing) ",,,89.02,352.17,48 CPT,92521,"Evaluation of speech fluency (eg, stuttering, cluttering) ",,,130.92,789.69,62 CPT,92522,"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); ",1164.59,1164.59,110.33,662.42,62 CPT,92522,SP/EVAL SOUND PRODUCTION,1164.59,1164.59,69.88,989.9,20 CPT,92523,"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) ",1164.59,1164.59,222.38,1348.56,62 CPT,92523,SP/EVAL SND W/ LANG EVAL,1164.59,1164.59,69.88,989.9,20 CPT,92524,Behavioral and qualitative analysis of voice and resonance ,,,107.93,652.33,62 CPT,92526,TX SWAL/ORAL FUNCTION SP,559.41,559.41,33.56,475.5,32 CPT,92526,Treatment of swallowing dysfunction and/or oral function for feeding ,559.41,559.41,82.69,284.05,50 CPT,92531,"Spontaneous nystagmus, including gaze ",,,25.3,34.92,5 CPT,92532,Positional nystagmus test ,,,33.74,46.58,5 CPT,92533,"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests) ",,,20.24,27.94,5 CPT,92534,Optokinetic nystagmus test ,,,10.11,13.95,5 CPT,92537,"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations) ",,,21.93,30.27,5 CPT,92538,"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations) ",,,12.66,17.47,5 CPT,92540,"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic ",,,59.04,81.49,5 CPT,92541,"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording ",,,255.13,352.17,5 CPT,92542,"Positional nystagmus test, minimum of 4 positions, with recording ",,,255.13,352.17,5 CPT,92544,"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording ",,,6.74,9.3,5 CPT,92545,"Oscillating tracking test, with recording ",,,6.74,9.3,5 CPT,92546,Sinusoidal vertical axis rotational testing ,,,212.52,293.35,5 CPT,92547,Use of vertical electrodes (List separately in addition to code for primary procedure) ,,,17.71,24.45,5 CPT,92548,"Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), incl",,,255.13,352.17,5 CPT,92549,"Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), incl",,,255.13,352.17,5 CPT,92550,Tympanometry and reflex threshold measurements ,,,323.74,446.87,5 CPT,92551,"Screening test, pure tone, air only ",,,13.39,38.4,7 CPT,92552,Pure tone audiometry (threshold); air only ,,,255.13,352.17,5 CPT,92553,Pure tone audiometry (threshold); air and bone ,,,323.74,446.87,5 CPT,92555,Speech audiometry threshold; ,,,78.23,107.98,5 CPT,92556,Speech audiometry threshold; with speech recognition ,,,78.23,107.98,5 CPT,92557,Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined) ,,,323.74,446.87,5 CPT,92558,"Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis ",,,15.25,15.25,2 CPT,92562,"Loudness balance test, alternate binaural or monaural ",,,323.74,446.87,5 CPT,92563,Tone decay test ,,,78.23,107.98,5 CPT,92565,"Stenger test, pure tone ",,,78.23,107.98,5 CPT,92567,Tympanometry (impedance testing) ,,,78.23,107.98,5 CPT,92568,"Acoustic reflex testing, threshold ",,,78.23,107.98,5 CPT,92570,"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing ",,,323.74,446.87,5 CPT,92571,Filtered speech test ,,,78.23,107.98,5 CPT,92572,Staggered spondaic word test ,,,323.74,446.87,5 CPT,92575,Sensorineural acuity level test ,,,78.23,107.98,5 CPT,92576,Synthetic sentence identification test ,,,78.23,107.98,5 CPT,92577,"Stenger test, speech ",,,1136.33,1568.52,5 CPT,92579,Visual reinforcement audiometry (VRA) ,,,323.74,446.87,5 CPT,92582,Conditioning play audiometry ,,,323.74,446.87,5 CPT,92583,Select picture audiometry ,,,78.23,107.98,5 CPT,92584,Electrocochleography ,,,176.25,243.28,5 CPT,92587,"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpreta",,,8.42,11.63,5 CPT,92588,"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpreta",,,10.97,15.15,5 CPT,92596,Ear protector attenuation measurements ,,,67.53,106.64,5 CPT,92597,EVAL USE/FIT VOICE PR SP,409.38,409.38,24.56,347.97,32 CPT,92597,Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech ,409.38,409.38,70.09,239.8,50 CPT,92601,"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming ",,,301.06,415.57,5 CPT,92602,"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming ",,,170.35,235.14,5 CPT,92603,"Diagnostic analysis of cochlear implant, age 7 years or older; with programming ",,,292.64,403.94,5 CPT,92604,"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming ",,,163.61,225.84,5 CPT,92605,"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour ",,,94.82,294.51,7 CPT,92606,"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification ",,,80.64,235.14,7 CPT,92607,"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour ",,,120.0,429.53,50 CPT,92608,"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (List separately in addition to code for ",,,46.82,171.13,50 CPT,92609,"Therapeutic services for the use of speech-generating device, including programming and modification ",,,100.65,358.53,50 CPT,92610,EVAL ORAL/PHARYNG SWL SP,483.13,483.13,28.99,410.66,32 CPT,92610,Evaluation of oral and pharyngeal swallowing function ,483.13,483.13,83.32,239.8,50 CPT,92611,FLUORO EVAL OF SWALW SP,1823.15,1823.15,109.39,1549.68,32 CPT,92611,Motion fluoroscopic evaluation of swallowing function by cine or video recording ,1823.15,1823.15,90.33,296.84,50 CPT,92612,Flexible endoscopic evaluation of swallowing by cine or video recording; ,,,163.61,429.14,50 CPT,92613,Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only ,,,36.35,124.55,7 CPT,92614,"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; ",,,148.93,326.74,50 CPT,92615,"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only ",,,23.25,109.43,7 CPT,92616,Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; ,,,224.43,492.37,50 CPT,92617,Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only ,,,29.34,137.37,7 CPT,92618,"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (List separately in addition to code f",,,33.68,109.43,7 CPT,92620,"Evaluation of central auditory function, with report; initial 60 minutes ",,,323.74,446.87,5 CPT,92621,"Evaluation of central auditory function, with report; each additional 15 minutes (List separately in addition to code for primary procedure) ",,,45.54,62.86,5 CPT,92622,"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes ",,,348.26,480.72,5 CPT,92623,"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (List separately in addition to code for primary procedure) ",,,41.23,56.91,5 CPT,92625,"Assessment of tinnitus (includes pitch, loudness matching, and masking) ",,,323.74,446.87,5 CPT,92626,Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour ,,,323.74,446.87,5 CPT,92627,Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (List separately in addition to cod,,,43.01,59.37,5 CPT,92628,"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, supr",,,366.12,505.37,5 CPT,92629,"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, supr",,,30.14,41.6,5 CPT,92630,Auditory rehabilitation; prelingual hearing loss ,,,353.61,353.61,2 CPT,92631,"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychos",,,301.63,416.35,5 CPT,92632,"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychos",,,30.14,41.6,5 CPT,92633,Auditory rehabilitation; postlingual hearing loss ,,,353.61,353.61,2 CPT,92634,"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, suppl",,,366.12,505.37,5 CPT,92635,"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, suppl",,,30.14,41.6,5 CPT,92636,"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg,",,,728.68,1005.82,5 CPT,92637,"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg,",,,30.14,41.6,5 CPT,92638,"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (List separately in addition to code for primary procedure) ",,,366.12,505.37,5 CPT,92639,"Hearing-aid measurement, verification with probe-microphone (List separately in addition to code for primary procedure) ",,,366.12,505.37,5 CPT,92640,"Diagnostic analysis with programming of auditory brainstem implant, per hour ",,,230.23,317.8,5 CPT,92641,"Hearing device verification, electroacoustic analysis ",,,366.12,505.37,5 CPT,92642,"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation ºFM»/digital modulation ºDM» system, remote microphone, alerting devices) ",,,366.12,505.37,5 CPT,92650,"Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis ",,,18.36,97.71,7 CPT,92651,"Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report ",,,192.18,303.5,5 CPT,92652,"Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report ",,,254.08,401.24,5 CPT,92653,"Auditory evoked potentials; neurodiagnostic, with interpretation and report ",,,187.09,295.46,5 CPT,92700,Unlisted otorhinolaryngological service or procedure ,,,53.8,74.26,5 CPT,92920,PTCA SINGLE VESSEL LC,28874.99,28874.99,3753.75,24543.74,15 CPT,92920,PTCA SINGLE VESSEL LD,28874.99,28874.99,3753.75,24543.74,15 CPT,92920,PTCA SINGLE VESSEL LM,28874.99,28874.99,3753.75,24543.74,15 CPT,92920,PTCA SINGLE VESSEL RC,28874.99,28874.99,3753.75,24543.74,15 CPT,92920,PTCA SINGLE VESSEL RI,28874.99,28874.99,3753.75,24543.74,15 CPT,92920,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,96 CPT,92920,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) with Cardiac Cath",,,7818.0,7818.0,5 CPT,92920,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) without Cardiac Cath",,,5591.0,5591.0,5 CPT,92921,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,36462.0,11 CPT,92924,COR ATH SGL ART LC,48088.31,48088.31,6251.48,40875.06,15 CPT,92924,COR ATH SGL ART LD,48978.83,48978.83,6367.25,41632.01,15 CPT,92924,COR ATH SGL ART LM,48978.83,48978.83,6367.25,41632.01,15 CPT,92924,COR ATH SGL ART RC,48978.83,48978.83,6367.25,41632.01,15 CPT,92924,COR ATH SGL ART RI,48978.83,48978.83,6367.25,41632.01,15 CPT,92924,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,96 CPT,92924,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) with Cardiac Cath",,,7818.0,7818.0,5 CPT,92924,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) without Cardiac Cath",,,5591.0,5591.0,5 CPT,92925,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,36462.0,11 CPT,92928,PTCA STNT W ANG SGL LD,49008.38,49008.38,6371.09,41657.12,15 CPT,92928,PTCA STNT W ANG SGL LC,49008.38,49008.38,6371.09,41657.12,15 CPT,92928,PTCA STNT W ANG SGL LM,49008.38,49008.38,6371.09,41657.12,15 CPT,92928,PTCA STNT W ANG SGL RC,49008.38,49008.38,6371.09,41657.12,15 CPT,92928,PTCA STNT W ANG SGL RI,49008.38,49008.38,6371.09,41657.12,15 CPT,92928,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,5591.0,43890.0,106 CPT,92929,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,36462.0,11 CPT,92930,PTCA NCOR ST WANG 2+LSLC,133308.06,133308.06,17330.05,113311.85,20 CPT,92930,PTCA NCOR ST WANG 2+LSLD,133308.06,133308.06,17330.05,113311.85,20 CPT,92930,PTCA NCOR ST WANG 2+LSLM,133308.06,133308.06,17330.05,113311.85,20 CPT,92930,PTCA NCOR ST WANG 2+LSRC,133308.06,133308.06,17330.05,113311.85,20 CPT,92930,PTCA NCOR ST WANG 2+LSRI,133308.06,133308.06,17330.05,113311.85,20 CPT,92930,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,187 CPT,92933,PTCA STN W ATH SGL LC,39184.95,39184.95,5094.04,33307.21,15 CPT,92933,PTCA STN W ATH SGL LD,39184.95,39184.95,5094.04,33307.21,15 CPT,92933,PTCA STN W ATH SGL LM,39184.95,39184.95,5094.04,33307.21,15 CPT,92933,PTCA STN W ATH SGL RC,39184.95,39184.95,5094.04,33307.21,15 CPT,92933,PTCA STN W ATH SGL RI,39184.95,39184.95,5094.04,33307.21,15 CPT,92933,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,11153.0,61050.09,96 CPT,92933,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) with Cardiac Cath",,,7818.0,7818.0,5 CPT,92933,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) without Cardiac Cath",,,5591.0,5591.0,5 CPT,92934,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,36462.0,11 CPT,92937,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,5591.0,43890.0,106 CPT,92937,RVS GFT ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,15 CPT,92937,RVS GFT ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,15 CPT,92937,RVS GFT ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,15 CPT,92937,RVS GFT ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,15 CPT,92937,RVS GFT ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,15 CPT,92938,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,36462.0,11 CPT,92941,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,106 CPT,92941,RVS AMI ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,20 CPT,92941,RVS AMI ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,20 CPT,92941,RVS AMI ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,20 CPT,92941,RVS AMI ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,20 CPT,92941,RVS AMI ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,20 CPT,92943,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,5591.0,43890.0,106 CPT,92943,RVS TCO ST/ATH/AN SGL LC,43308.5,43308.5,5630.1,36812.22,15 CPT,92943,RVS TCO ST/ATH/AN SGL LD,43308.5,43308.5,5630.1,36812.22,15 CPT,92943,RVS TCO ST/ATH/AN SGL LM,43308.5,43308.5,5630.1,36812.22,15 CPT,92943,RVS TCO ST/ATH/AN SGL RC,43308.5,43308.5,5630.1,36812.22,15 CPT,92943,RVS TCO ST/ATH/AN SGL RI,43308.5,43308.5,5630.1,36812.22,15 CPT,92944,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,36462.0,11 CPT,92945,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,144 CPT,92950,CPR,2664.71,2664.71,159.88,2265.0,26 CPT,92950,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",2664.71,2664.71,518.85,2358.0,52 CPT,92953,Temporary transcutaneous pacing ,,,1099.74,2315.0,68 CPT,92960,CARDIOVERSION EXTERNAL,3332.23,3332.23,199.93,2832.4,86 CPT,92960,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,68 CPT,92961,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,68 CPT,92970,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,60 CPT,92971,Cardioassist-method of circulatory assist; external ,,,245.4,16207.0,29 CPT,92972,PERC TRANS COR LITH LC,19783.5,19783.5,1187.01,16815.97,34 CPT,92972,PERC TRANS COR LITH LD,19783.5,19783.5,1187.01,16815.97,34 CPT,92972,PERC TRANS COR LITH LM,19783.5,19783.5,1187.01,16815.97,34 CPT,92972,PERC TRANS COR LITH RC,19783.5,19783.5,1187.01,16815.97,34 CPT,92972,PERC TRANS COR LITH RI,19783.5,19783.5,1187.01,16815.97,34 CPT,92972,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,96 CPT,92973,PERC TRANS CORON THROM,10262.63,10262.63,1334.14,8723.24,25 CPT,92973,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,10262.63,10262.63,11153.0,43890.0,28 CPT,92973,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) with Cardiac Cath,10262.63,10262.63,7818.0,7818.0,5 CPT,92973,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) without Cardiac Cath,10262.63,10262.63,5591.0,5591.0,5 CPT,92974,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,35 CPT,92974,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) with Cardiac Cath,,,7818.0,7818.0,5 CPT,92974,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) without Cardiac Cath,,,5591.0,5591.0,5 CPT,92975,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,10120.0,16207.0,11 CPT,92977,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,13036.0,11 CPT,92978,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,12100.0,12100.0,235.29,43890.0,47 CPT,92978,IVUS INITIAL VESSEL,12100.0,12100.0,1573.0,10285.0,20 CPT,92979,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,370.7,370.7,187.22,43890.0,47 CPT,92979,IVUS EA ADDL VESSEL,370.7,370.7,48.19,315.1,20 CPT,92986,PB VALVUPLSTY AORTIC VAL,27697.41,27697.41,3600.66,23542.8,15 CPT,92986,Percutaneous balloon valvuloplasty; aortic valve ,27697.41,27697.41,3673.0,43890.0,180 CPT,92986,Percutaneous balloon valvuloplasty; aortic valve with Cardiac Cath,27697.41,27697.41,7818.0,7818.0,5 CPT,92986,Percutaneous balloon valvuloplasty; aortic valve without Cardiac Cath,27697.41,27697.41,5591.0,5591.0,5 CPT,92987,PB VALVUPLSTY MITRAL VAL,57241.58,57241.58,7441.41,48655.34,15 CPT,92987,Percutaneous balloon valvuloplasty; mitral valve ,57241.58,57241.58,3673.0,43890.0,180 CPT,92987,Percutaneous balloon valvuloplasty; mitral valve with Cardiac Cath,57241.58,57241.58,7818.0,7818.0,5 CPT,92987,Percutaneous balloon valvuloplasty; mitral valve without Cardiac Cath,57241.58,57241.58,5591.0,5591.0,5 CPT,92990,PB VALVUPLSTY PULMON VAL,57241.58,57241.58,7441.41,48655.34,15 CPT,92990,Percutaneous balloon valvuloplasty; pulmonary valve ,57241.58,57241.58,3673.0,43890.0,180 CPT,92990,Percutaneous balloon valvuloplasty; pulmonary valve with Cardiac Cath,57241.58,57241.58,7818.0,7818.0,5 CPT,92990,Percutaneous balloon valvuloplasty; pulmonary valve without Cardiac Cath,57241.58,57241.58,5591.0,5591.0,5 CPT,92992,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,8 CPT,92993,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,8 CPT,92997,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,180 CPT,92997,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel with Cardiac Cath,,,7818.0,7818.0,5 CPT,92997,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel without Cardiac Cath,,,5591.0,5591.0,5 CPT,92998,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,11153.0,43890.0,44 CPT,92998,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) with Cardiac Cath,,,7818.0,7818.0,5 CPT,92998,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) without Cardiac Cath,,,5591.0,5591.0,5 CPT,93000,"Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report ",,,13.25,55.19,7 CPT,93005,EKG TRACING ONLY,1781.9,1781.9,106.91,1514.62,39 CPT,93005,"Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report ",1781.9,1781.9,128.72,177.68,5 CPT,93010,"Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only ",,,20.24,27.94,5 CPT,93015,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and re",,,169.51,233.98,5 CPT,93016,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretatio",,,53.12,73.32,5 CPT,93017,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an",12373.98,12373.98,592.25,817.51,5 CPT,93017,STRESS TEST,12373.98,12373.98,742.44,10517.88,39 CPT,93018,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only ",,,35.43,48.9,5 CPT,93024,Ergonovine provocation test ,,,850.8,1174.4,5 CPT,93025,Microvolt T-wave alternans for assessment of ventricular arrhythmias ,,,268.16,370.16,5 CPT,93040,"Rhythm ECG, 1-3 leads; with interpretation and report ",,,30.35,41.89,5 CPT,93041,RHYTHM STRIP TRACE,1205.41,1205.41,72.32,1024.6,39 CPT,93041,"Rhythm ECG, 1-3 leads; tracing only without interpretation and report ",1205.41,1205.41,128.72,177.68,5 CPT,93042,"Rhythm ECG, 1-3 leads; interpretation and report only ",,,16.87,23.29,5 CPT,93050,"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine ce",,,53.8,74.26,5 CPT,93145,"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (BAT) modulation system including telemetric iterative communication with the implantable device to monitor dev",,,307.62,424.62,5 CPT,93146,"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (BAT) modulation system including telemetric iterative communication with the implantable device to monitor dev",,,307.62,424.62,5 CPT,93150,"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming ",,,215.82,297.9,5 CPT,93151,Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system ,,,215.82,297.9,5 CPT,93152,Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography ,,,665.94,919.23,5 CPT,93153,Interrogation without programming of implanted phrenic nerve stimulator system ,,,215.82,297.9,5 CPT,93224,"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other ",,,59.98,292.19,7 CPT,93225,"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection) ",2475.69,2475.69,255.13,352.17,5 CPT,93225,HOLTER RECORD VISUAL,2475.69,2475.69,148.54,2104.34,39 CPT,93226,External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report ,2475.69,2475.69,255.13,352.17,5 CPT,93226,HOLTER SCAN VISUAL,2475.69,2475.69,148.54,2104.34,39 CPT,93227,External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional ,,,15.21,87.31,7 CPT,93228,"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with",,,21.67,86.14,7 CPT,93229,"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with",,,1682.41,2322.31,5 CPT,93241,"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation ",,,218.28,344.71,5 CPT,93242,External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording) ,,,68.36,107.95,5 CPT,93243,External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; scanning analysis with report ,,,112.43,177.56,5 CPT,93244,External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation ,,,52.42,82.78,5 CPT,93245,"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation ",,,218.28,344.71,5 CPT,93246,External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording) ,,,112.43,177.56,5 CPT,93247,External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; scanning analysis with report ,,,226.14,357.12,5 CPT,93248,External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation ,,,57.51,90.82,5 CPT,93260,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93261,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,84.82,117.09,5 CPT,93264,"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and ",,,86.02,118.73,5 CPT,93268,"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende",,,143.87,663.51,7 CPT,93270,"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende",,,84.82,117.09,5 CPT,93271,"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende",,,398.03,549.42,5 CPT,93272,"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende",,,20.45,83.82,7 CPT,93278,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,28.74,177.68,59 CPT,93279,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93280,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93281,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93282,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93283,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93284,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93285,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review an",,,84.82,117.09,5 CPT,93286,PERIPROC EVAL/PROG PM,605.0,605.0,36.3,514.25,44 CPT,93286,"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualifi",605.0,605.0,47.22,65.18,5 CPT,93287,"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualifi",,,47.22,65.18,5 CPT,93288,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,84.82,117.09,5 CPT,93289,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,84.82,117.09,5 CPT,93290,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,84.82,117.09,5 CPT,93291,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,53.8,74.26,5 CPT,93292,"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient en",,,84.82,117.09,5 CPT,93293,"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a ph",,,84.82,117.09,5 CPT,93294,"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician ",,,25.49,101.26,7 CPT,93295,"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other quali",,,31.3,146.67,7 CPT,93296,"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s),",,,84.82,117.09,5 CPT,93297,"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements fro",,,63.25,87.31,5 CPT,93298,"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physici",,,63.25,87.31,5 CPT,93303,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,220.19,563.41,59 CPT,93304,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,155.38,406.27,59 CPT,93306,ECHO2D COMP W CF DOP,3379.24,3379.24,202.75,2872.35,39 CPT,93306,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc",3379.24,3379.24,317.09,437.7,5 CPT,93307,ECHO2D COMP W/O CF DOP,1412.5,1412.5,84.75,1200.63,33 CPT,93307,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",1412.5,1412.5,136.66,313.15,59 CPT,93308,ECHO 2D W/WOM MODE LTD,1568.74,1568.74,94.12,1333.43,33 CPT,93308,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",1568.74,1568.74,98.24,238.63,59 CPT,93312,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",3379.24,3379.24,235.9,449.33,59 CPT,93312,TEE 2D W/WOM MODE COMP,3379.24,3379.24,202.75,2872.35,33 CPT,93313,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.03,38.4,59 CPT,93314,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); image acquisition, interpretation and report only ",,,347.44,479.59,5 CPT,93315,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,353.04,1606.41,59 CPT,93316,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,25.06,91.96,59 CPT,93317,"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only ",,,222.63,307.3,5 CPT,93318,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,249.26,1606.41,59 CPT,93319,3D ECHO TEE/TTE CONG CA,4808.3,4808.3,288.5,4087.05,38 CPT,93319,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",4808.3,4808.3,23.73,101.82,59 CPT,93320,"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); complete ",2733.21,2733.21,83.49,115.25,5 CPT,93320,ECHO DOPPLER COMP,2733.21,2733.21,163.99,2323.23,44 CPT,93321,"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in ",2014.65,2014.65,46.38,64.02,5 CPT,93321,ECHO DOPPLER LTD,2014.65,2014.65,120.88,1712.45,44 CPT,93325,Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) ,2014.65,2014.65,52.28,72.16,5 CPT,93325,ECHO COLOR FLOW MAPPING,2014.65,2014.65,120.88,1712.45,44 CPT,93350,ECHO STRESS,3379.24,3379.24,202.75,2872.35,33 CPT,93350,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",3379.24,3379.24,185.11,382.98,59 CPT,93351,ECHO STRESS W CONT ECG,3379.24,3379.24,202.75,2872.35,39 CPT,93351,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",3379.24,3379.24,349.97,483.08,5 CPT,93352,Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure) ,,,30.46,110.6,7 CPT,93355,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",8481.68,8481.68,219.53,764.8,59 CPT,93355,TEE GUIDANCE INTRACARD,8481.68,8481.68,508.9,7209.43,38 CPT,93356,MYOCARD STRAIN IMAGE,2216.72,2216.72,133.0,1884.21,44 CPT,93356,Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging) ,2216.72,2216.72,21.56,47.41,5 CPT,93451,CATH HRT RT W SAT/CO,16964.7,16964.7,2205.41,14420.0,15 CPT,93451,CATH HRT RT W SAT/CO 59,16964.7,16964.7,2205.41,14420.0,15 CPT,93451,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,2795.0,17384.0,101 CPT,93451,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed with Cardiac Cath",,,7818.0,7818.0,5 CPT,93452,CATH HRT LT/INJ L VENT,42697.15,42697.15,5550.63,36292.58,15 CPT,93452,CATH HRT LT/INJ L VENT59,42697.15,42697.15,5550.63,36292.58,15 CPT,93452,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,2795.0,17384.0,101 CPT,93452,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed with Cardiac Cath",,,7818.0,7818.0,5 CPT,93453,CATH HRT R&L/INJ L VENT,59549.03,59549.03,7741.37,50616.68,15 CPT,93453,CATH HRT R&L/INJ LVNT59,59549.03,59549.03,7741.37,50616.68,15 CPT,93453,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,2795.0,17384.0,101 CPT,93453,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed with Cardiac Cath",,,7818.0,7818.0,5 CPT,93454,CATH PLC/INJ CORONRY ART,28681.91,28681.91,3728.65,24379.62,15 CPT,93454,CATH PLC/INJ CRNRY ART59,28681.91,28681.91,3728.65,24379.62,15 CPT,93454,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,2795.0,17384.0,101 CPT,93454,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with Cardiac Cath",,,7818.0,7818.0,5 CPT,93455,CATH PLC/INJ BYPAS GRFTS,41797.27,41797.27,5433.65,35527.68,15 CPT,93455,CATH PLC/INJ BYPS GRFT59,41797.27,41797.27,5433.65,35527.68,15 CPT,93455,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2795.0,17384.0,106 CPT,93456,CTH PLC/INJ CR ART RHC59,45642.56,45642.56,5933.53,38796.18,15 CPT,93456,CTH PLC/INJ CR ART W RHC,45642.56,45642.56,5933.53,38796.18,15 CPT,93456,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,2795.0,17384.0,106 CPT,93457,CTH PLC/INJ GRAFT W RHC,58765.99,58765.99,7639.58,49951.09,15 CPT,93457,CTH PLC/INJ GRFT W RHC59,58765.99,58765.99,7639.58,49951.09,15 CPT,93457,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2795.0,17384.0,106 CPT,93458,CTH PLC/INJ LHC & L VENT,65833.39,65833.39,8558.34,55958.38,15 CPT,93458,CTH PLC/INJ LHC&L VENT59,65833.39,65833.39,8558.34,55958.38,15 CPT,93458,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,2795.0,17384.0,106 CPT,93459,CTH PLC/INJ LHC W GRAFT,78946.08,78946.08,10262.99,67104.17,15 CPT,93459,CTH PLC/INJ LHC W GRFT59,78946.08,78946.08,10262.99,67104.17,15 CPT,93459,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,2795.0,17384.0,106 CPT,93460,CTH PLC/INJ R&LHC/L VENT,88229.58,88229.58,11469.85,74995.14,15 CPT,93460,CTH PLC/INJ R&LHC/LVNT59,88229.58,88229.58,11469.85,74995.14,15 CPT,93460,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2795.0,17384.0,106 CPT,93461,CTH PLC/INJ R&LHC/GRAFTS,104948.49,104948.49,13643.3,89206.22,15 CPT,93461,CTH PLC/INJ R&LHC/GRFT59,104948.49,104948.49,13643.3,89206.22,15 CPT,93461,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2795.0,17384.0,106 CPT,93462,LHC TRANS SEPTAL/APICAL,66333.03,66333.03,8623.29,56383.08,25 CPT,93462,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,66333.03,66333.03,2795.0,17384.0,58 CPT,93462,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) with Cardiac Cath,66333.03,66333.03,7818.0,7818.0,5 CPT,93463,PHARMACY AGENT ADMIN,2115.39,2115.39,126.92,1798.08,44 CPT,93463,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",2115.39,2115.39,237.81,2358.0,21 CPT,93464,PHYSIO EXERCISE STUDY,8783.87,8783.87,527.03,7466.29,44 CPT,93464,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",8783.87,8783.87,382.87,2358.0,21 CPT,93503,INSERTION FLO DR CATH,4684.74,4684.74,609.02,3982.03,26 CPT,93503,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",4684.74,4684.74,2012.0,17009.0,89 CPT,93503,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath",4684.74,4684.74,7818.0,7818.0,5 CPT,93505,BIOPSY ENDOMYOCARDIAL,15637.71,15637.71,2032.9,13292.05,15 CPT,93505,Endomyocardial biopsy ,15637.71,15637.71,2795.0,17384.0,89 CPT,93505,Endomyocardial biopsy with Cardiac Cath,15637.71,15637.71,7818.0,7818.0,5 CPT,93530,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,8 CPT,93531,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,8 CPT,93532,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,8 CPT,93533,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,8 CPT,93561,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,8 CPT,93562,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,8 CPT,93563,INJ SELECT CA CONGENITAL,28814.86,28814.86,1728.89,24492.63,30 CPT,93563,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",28814.86,28814.86,2358.0,17384.0,32 CPT,93564,INJ SELECT GRFT CONGENTL,7204.38,7204.38,432.26,6123.72,30 CPT,93564,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",7204.38,7204.38,2358.0,17384.0,32 CPT,93565,INJ SELECT LT VENT/ATRIA,8282.9,8282.9,496.97,7040.47,30 CPT,93565,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",8282.9,8282.9,2358.0,17384.0,32 CPT,93566,INJ SELECT RT VENT/ATRIA,8282.9,8282.9,496.97,7040.47,30 CPT,93566,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",8282.9,8282.9,2358.0,17384.0,32 CPT,93567,INJ SUPRAVALV AORTOGRM,9001.45,9001.45,540.09,7651.23,30 CPT,93567,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",9001.45,9001.45,2358.0,17384.0,32 CPT,93568,INJ PULM ANG NON SEL,8282.9,8282.9,496.97,7040.47,30 CPT,93568,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",8282.9,8282.9,2358.0,17384.0,32 CPT,93569,INJ CATH SEL PUL ANG LT,9401.7,9401.7,564.1,7991.45,33 CPT,93569,INJ CATH SEL PUL ANG RT,9401.7,9401.7,564.1,7991.45,33 CPT,93569,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,8 CPT,93571,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",12605.0,12605.0,1672.0,2358.0,16 CPT,93571,VELOCITY BLD FLOW INT,12605.0,12605.0,756.3,10714.25,32 CPT,93572,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",7204.38,7204.38,1672.0,2358.0,16 CPT,93572,VELOCITY BLD FLOW EA ADD,7204.38,7204.38,432.26,6123.72,32 CPT,93573,INJ CATH SEL PUL ANG BI,10744.8,10744.8,644.69,9133.08,33 CPT,93573,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",10744.8,10744.8,1672.0,1672.0,8 CPT,93574,INJ CATH PUL VEN EACH VN,10744.8,10744.8,644.69,9133.08,33 CPT,93574,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",10744.8,10744.8,1672.0,1672.0,8 CPT,93575,INJ CATH PUL VEN EACH VS,13431.0,13431.0,805.86,11416.35,33 CPT,93575,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",13431.0,13431.0,1672.0,1672.0,8 CPT,93580,PER CL CON INT COM W/IMP,99081.83,99081.83,5944.91,84219.56,24 CPT,93580,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",99081.83,99081.83,3982.0,43890.0,176 CPT,93581,PER CL CON VT SP DF W/IM,99081.83,99081.83,5944.91,84219.56,24 CPT,93581,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,99081.83,99081.83,3982.0,43890.0,176 CPT,93582,PERC TRANS CLOS PDA,115356.18,115356.18,6921.37,98052.75,20 CPT,93582,Percutaneous transcatheter closure of patent ductus arteriosus ,115356.18,115356.18,3982.0,61050.09,171 CPT,93583,ABLATION SEPTAL REDUCTN,61469.41,61469.41,3688.16,52249.0,26 CPT,93583,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",61469.41,61469.41,1723.56,43890.0,163 CPT,93584,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,103.17,3083.0,101 CPT,93585,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,97.22,3083.0,101 CPT,93586,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,122.87,3083.0,101 CPT,93587,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,181.32,3083.0,101 CPT,93588,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,183.09,3083.0,101 CPT,93590,PER CLOS PARA LEAK MIT,90901.01,90901.01,5454.06,77265.86,16 CPT,93590,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",90901.01,90901.01,801.09,61050.09,85 CPT,93591,PER CLOS PARA LEAK AOR,90901.01,90901.01,5454.06,77265.86,16 CPT,93591,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",90901.01,90901.01,661.87,61050.09,85 CPT,93592,PER CLOS PARA LEAK EA A,45450.5,45450.5,2727.03,38632.93,33 CPT,93592,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,45450.5,45450.5,1672.0,36462.0,23 CPT,93593,RT CATH CHD NORMAL NAT,30348.69,30348.69,1820.92,25796.39,22 CPT,93593,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,30348.69,30348.69,3673.0,13036.0,164 CPT,93594,RT CATH CHD ABNORMAL NA,30348.69,30348.69,1820.92,25796.39,22 CPT,93594,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,30348.69,30348.69,3673.0,13036.0,164 CPT,93595,LT CATH CHD NOR ABN,30348.69,30348.69,1820.92,25796.39,22 CPT,93595,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",30348.69,30348.69,3673.0,13036.0,148 CPT,93596,RT LT CATH ANOM NNC,30348.69,30348.69,1820.92,25796.39,22 CPT,93596,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,30348.69,30348.69,3673.0,13036.0,164 CPT,93597,RT LT CATH ANOM ANC,30348.69,30348.69,1820.92,25796.39,22 CPT,93597,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,30348.69,30348.69,3673.0,13036.0,164 CPT,93598,CAR OUTPUT THER CHD,585.6,585.6,35.14,497.76,32 CPT,93598,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",585.6,585.6,1672.0,10843.0,9 CPT,93600,BUNDLE OF HIS RECORDING,10799.87,10799.87,1403.98,9179.89,19 CPT,93600,Bundle of His recording ,10799.87,10799.87,3673.0,43890.0,173 CPT,93600,Bundle of His recording with Cardiac Cath,10799.87,10799.87,7818.0,7818.0,5 CPT,93600,Bundle of His recording without Cardiac Cath,10799.87,10799.87,5591.0,5591.0,5 CPT,93602,INTRA ATRIAL RECORDING,12960.92,12960.92,1684.92,11016.78,19 CPT,93602,Intra-atrial recording ,12960.92,12960.92,12065.71,43890.0,77 CPT,93602,Intra-atrial recording with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CPT,93602,Intra-atrial recording without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CPT,93603,Right ventricular recording ,,,2024.5,43890.0,77 CPT,93603,Right ventricular recording with Cardiac Cath,,,7818.0,7818.0,5 CPT,93603,Right ventricular recording without Cardiac Cath,,,5591.0,5591.0,5 CPT,93609,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,683.09,43890.0,152 CPT,93610,IA PACING,18072.76,18072.76,2349.46,15361.85,19 CPT,93610,Intra-atrial pacing ,18072.76,18072.76,12065.71,43890.0,77 CPT,93610,Intra-atrial pacing with Cardiac Cath,18072.76,18072.76,7818.0,7818.0,5 CPT,93610,Intra-atrial pacing without Cardiac Cath,18072.76,18072.76,5591.0,5591.0,5 CPT,93612,IV PACING,12960.92,12960.92,1684.92,11016.78,19 CPT,93612,Intraventricular pacing ,12960.92,12960.92,12065.71,43890.0,77 CPT,93612,Intraventricular pacing with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CPT,93612,Intraventricular pacing without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CPT,93613,INTRACARD EP 3D MAPPING,12960.92,12960.92,1684.92,11016.78,20 CPT,93613,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,12960.92,12960.92,727.79,43890.0,46 CPT,93613,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CPT,93613,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CPT,93615,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,2310.89,43890.0,46 CPT,93615,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with Cardiac Cath,,,7818.0,7818.0,5 CPT,93615,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); without Cardiac Cath,,,5591.0,5591.0,5 CPT,93616,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,2310.89,43890.0,46 CPT,93616,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing with Cardiac Cath,,,7818.0,7818.0,5 CPT,93616,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing without Cardiac Cath,,,5591.0,5591.0,5 CPT,93618,ARRHYTHMIA INDUCE ELECT,12960.92,12960.92,1684.92,11016.78,30 CPT,93618,Induction of arrhythmia by electrical pacing ,12960.92,12960.92,2310.89,43890.0,142 CPT,93618,Induction of arrhythmia by electrical pacing with Cardiac Cath,12960.92,12960.92,7818.0,7818.0,5 CPT,93618,Induction of arrhythmia by electrical pacing without Cardiac Cath,12960.92,12960.92,5591.0,5591.0,5 CPT,93619,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",40464.92,40464.92,3673.0,43890.0,152 CPT,93619,EP W/O ARRHYTHMIA,40464.92,40464.92,5260.44,34395.18,15 CPT,93620,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,40464.92,40464.92,3673.0,43890.0,183 CPT,93620,EP W/ARRHYTHMIA,40464.92,40464.92,5260.44,34395.18,19 CPT,93621,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,38486.54,38486.54,285.88,43890.0,144 CPT,93621,EP W/LA REC W/ARRHYTHMIA,38486.54,38486.54,5003.25,32713.56,21 CPT,93622,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,46065.65,46065.65,423.35,43890.0,144 CPT,93622,EP W/LVREC W/ARRHYTHMIA,46065.65,46065.65,5988.53,39155.8,21 CPT,93623,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,12496.2,12496.2,388.77,43890.0,38 CPT,93623,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) with Cardiac Cath,12496.2,12496.2,7818.0,7818.0,5 CPT,93623,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) without Cardiac Cath,12496.2,12496.2,5591.0,5591.0,5 CPT,93623,STIM & PACE AFTER IV INF,12496.2,12496.2,1624.51,10621.77,21 CPT,93624,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,46 CPT,93624,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia with Cardiac Cath",,,7818.0,7818.0,5 CPT,93624,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia without Cardiac Cath",,,5591.0,5591.0,5 CPT,93631,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,968.97,43890.0,38 CPT,93631,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction with Cardiac Cath,,,7818.0,7818.0,5 CPT,93631,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction without Cardiac Cath,,,5591.0,5591.0,5 CPT,93640,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,438.52,43890.0,143 CPT,93641,AICD LEAD/GEN TEST INIT,18072.76,18072.76,2349.46,15361.85,20 CPT,93641,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",18072.76,18072.76,767.43,43890.0,143 CPT,93642,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2310.89,43890.0,143 CPT,93644,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,123.97,7818.0,31 CPT,93650,ABLATION AV NODE W/WO,27383.13,27383.13,3559.81,23275.66,19 CPT,93650,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",27383.13,27383.13,12065.71,43890.0,77 CPT,93650,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement with Cardiac Cath",27383.13,27383.13,7818.0,7818.0,5 CPT,93650,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement without Cardiac Cath",27383.13,27383.13,5591.0,5591.0,5 CPT,93653,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",48555.75,48555.75,5591.0,55788.29,94 CPT,93653,EP REPOS ELE SVT SGL,48555.75,48555.75,6312.25,41272.39,19 CPT,93654,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",56697.36,56697.36,3673.0,55788.29,190 CPT,93654,EP REPOS ELE VT 3D MAP,56697.36,56697.36,7370.66,48192.76,19 CPT,93655,EP INTRACARD DX TX,80130.69,80130.69,10416.99,68111.09,20 CPT,93655,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",80130.69,80130.69,1045.7,43890.0,63 CPT,93656,COM EP REPO CTH TX AFIB,44953.56,44953.56,5843.96,38210.53,19 CPT,93656,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",44953.56,44953.56,5591.0,55788.29,94 CPT,93657,ADD INTRACRD AFIB/PV ISO,58277.11,58277.11,7576.02,49535.54,20 CPT,93657,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,58277.11,58277.11,1044.01,43890.0,63 CPT,93660,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,155.17,43890.0,37 CPT,93660,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention with Cardiac C",,,7818.0,7818.0,5 CPT,93660,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention without Cardia",,,5591.0,5591.0,5 CPT,93662,INTRACARDIAC ECHO,10317.695,10317.695,625.08,13453.03,40 CPT,93662,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,343.23,43890.0,37 CPT,93662,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) with Cardiac Cath",,,7818.0,7818.0,5 CPT,93662,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) without Cardiac C",,,5591.0,5591.0,5 CPT,93668,"Peripheral arterial disease (PAD) rehabilitation, per session ",,,42.17,58.2,5 CPT,93701,Bioimpedance-derived physiologic cardiovascular analysis ,,,255.13,352.17,5 CPT,93702,"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s) ",,,301.06,415.57,5 CPT,93724,ANALYSIS ANTITACHY PCMKR,1721.83,1721.83,103.31,1463.56,39 CPT,93724,"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpret",1721.83,1721.83,79.28,109.43,5 CPT,93740,Temperature gradient studies ,,,323.74,446.87,5 CPT,93745,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,633.93,2358.0,21 CPT,93750,INTEROGT VAD INC PROGRAM,291.0,291.0,17.46,247.35,39 CPT,93750,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",291.0,291.0,111.31,2358.0,21 CPT,93770,Determination of venous pressure ,,,19.4,26.78,5 CPT,93784,"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report ",,,40.8,175.78,7 CPT,93786,"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only ",,,255.13,352.17,5 CPT,93788,"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report ",,,255.13,352.17,5 CPT,93790,"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report ",,,15.49,61.69,7 CPT,93792,"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professional, face-to-face, includin",,,124.82,172.29,5 CPT,93793,"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (INR) test result, patient instructions, dos",,,28.66,39.57,5 CPT,93797,Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session) ,,,21.08,29.1,5 CPT,93798,Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session) ,,,33.74,46.58,5 CPT,93799,UNLISTED CARDIO SERVICE,3199.26,3199.26,191.96,2719.37,39 CPT,93799,Unlisted cardiovascular service or procedure ,3199.26,3199.26,323.74,2358.0,21 CPT,93880,DUP EXTRACRANIAL BIL,5074.33,5074.33,304.45,4313.29,66 CPT,93880,Duplex scan of extracranial arteries; complete bilateral study ,,,191.46,716.98,140 CPT,93882,Duplex scan of extracranial arteries; unilateral or limited study ,,,106.88,469.33,140 CPT,93886,Transcranial Doppler study of the intracranial arteries; complete study ,,,230.13,1052.64,140 CPT,93888,Transcranial Doppler study of the intracranial arteries; limited study ,,,106.88,628.61,140 CPT,93890,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,230.13,248.54,47 CPT,93892,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,106.88,362.02,59 CPT,93893,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,106.88,362.02,59 CPT,93895,"Quantitative carotid intima media thickness and carotid atheroma evaluation, bilateral ",,,53.8,74.26,5 CPT,93896,"Vasoreactivity study performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary procedure) ",,,328.29,453.15,5 CPT,93897,"Emboli detection without intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary procedure) ",,,446.44,616.24,5 CPT,93898,"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary pro",,,456.75,630.46,5 CPT,93922,DOP ART 1-2 LEVELS BIL,1010.32,1010.32,60.62,858.77,39 CPT,93922,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",1010.32,1010.32,254.4,352.17,86 CPT,93923,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",1621.6,1621.6,128.31,499.02,140 CPT,93923,DOP ART >3 LEVELS BIL,1621.6,1621.6,97.3,1378.36,33 CPT,93924,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,157.71,624.83,140 CPT,93925,DUP LE ART BIL,3835.4049999999997,3835.4049999999997,230.12,3260.11,66 CPT,93925,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,230.13,951.18,140 CPT,93926,DUP LE ART UNI/LTD,2253.18,2253.18,135.19,1915.22,66 CPT,93926,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,106.88,563.04,140 CPT,93930,DUP UE ART BIL,2123.58,2123.58,127.41,1805.04,33 CPT,93930,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,2123.58,2123.58,196.14,740.4,140 CPT,93931,DUP UE ART UNI/LTD,1066.23,1066.23,63.97,906.3,33 CPT,93931,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,1066.23,1066.23,106.88,470.89,140 CPT,93970,DUP VEIN BIL,6121.705,6121.705,367.3,5203.51,66 CPT,93970,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,188.79,727.89,140 CPT,93971,DUP VEIN UNI RT,5543.4,5543.4,332.6,4711.89,33 CPT,93971,DUP VEIN UNI/LTD,4554.3099999999995,4554.3099999999995,213.91,4711.89,66 CPT,93971,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,106.88,459.97,140 CPT,93975,DUP AB/PEL/SC COMP,3782.02,3782.02,226.92,3214.72,33 CPT,93975,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",3782.02,3782.02,230.13,988.62,140 CPT,93976,DUP AB/PEL/SC LTD,3033.49,3033.49,182.01,2578.47,33 CPT,93976,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",3033.49,3033.49,106.88,566.14,140 CPT,93978,DUP AO/IVC/IV/BPG COMP,3376.62,3376.62,202.6,2870.13,33 CPT,93978,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",3376.62,3376.62,180.76,668.57,140 CPT,93979,DUP AO/IVC/IV/BPG LTD,2846.68,2846.68,170.8,2419.68,33 CPT,93979,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",2846.68,2846.68,106.88,441.25,140 CPT,93980,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,106.88,268.25,140 CPT,93981,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,70.16,229.21,140 CPT,93985,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,407.84,985.52,86 CPT,93986,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,232.14,581.76,86 CPT,93990,DUP A/V STUDY,1874.49,1874.49,112.47,1593.32,33 CPT,93990,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",1874.49,1874.49,106.88,577.05,140 CPT,93998,Unlisted noninvasive vascular diagnostic study ,,,53.8,74.26,5 CPT,94002,VENT MGMT INITIAL IP/OBS,2003.26,2003.26,120.2,1702.77,33 CPT,94002,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day ",2003.26,2003.26,1087.0,1500.43,5 CPT,94003,VENT MGMT IP/OBS SUB DAY,1705.72,1705.72,102.34,1449.86,33 CPT,94003,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day ",1705.72,1705.72,1087.0,1500.43,5 CPT,94004,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day ",,,118.05,162.95,5 CPT,94005,"Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other s",,,220.1,303.81,5 CPT,94010,"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation ",,,323.74,446.87,5 CPT,94011,Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age ,,,323.74,446.87,5 CPT,94012,"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age ",,,592.25,817.51,5 CPT,94013,"Measurement of lung volumes (ie, functional residual capacity ºFRC», forced vital capacity ºFVC», and expiratory reserve volume ºERV») in an infant or child through 2 years of age ",,,46.38,64.02,5 CPT,94014,"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibratio",,,850.8,1174.4,5 CPT,94015,"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration) ",,,592.25,817.51,5 CPT,94016,Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional ,,,21.3,83.82,7 CPT,94060,BRONCH EV SPIR PRE/POST,4215.55,4215.55,252.93,3583.22,39 CPT,94060,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration ",4215.55,4215.55,110.47,152.49,5 CPT,94070,"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigenºs», cold air, methacholine) ",,,73.36,101.26,5 CPT,94150,VITAL CAPACITY,503.84,503.84,30.23,428.26,39 CPT,94150,"Vital capacity, total (separate procedure) ",503.84,503.84,323.74,446.87,5 CPT,94200,"Maximum breathing capacity, maximal voluntary ventilation ",,,128.72,177.68,5 CPT,94375,Respiratory flow volume loop ,,,592.25,817.51,5 CPT,94450,Breathing response to hypoxia (hypoxia response curve) ,,,323.74,446.87,5 CPT,94452,"High altitude simulation test (HAST), with interpretation and report by a physician or other qualified health care professional; ",,,255.13,352.17,5 CPT,94453,"High altitude simulation test (HAST), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration ",,,255.13,352.17,5 CPT,94610,Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube ,,,430.47,594.19,5 CPT,94617,"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s) ",,,255.13,352.17,5 CPT,94618,"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed ",,,255.13,352.17,5 CPT,94619,"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s) ",,,112.43,177.56,5 CPT,94621,"Cardiopulmonary exercise testing, including measurements of minute ventilation, CO2 production, O2 uptake, and electrocardiographic recordings ",,,217.57,300.33,5 CPT,94625,Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session) ,,,46.38,64.02,5 CPT,94626,Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session) ,,,66.62,91.96,5 CPT,94640,INH TX AC AWY OBST,164.15,164.15,9.85,139.53,66 CPT,94640,"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, m",,,430.47,594.19,5 CPT,94640,SPUTIND,76.52,76.52,4.59,65.04,39 CPT,94642,Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis ,,,430.47,594.19,5 CPT,94644,CONT INHAL TRMT 1ST HOUR,498.89,498.89,29.93,424.06,33 CPT,94644,Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour ,498.89,498.89,255.13,352.17,5 CPT,94645,CONT IN TRMT EA ADD HOUR,355.25,355.25,21.32,301.96,38 CPT,94645,Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure) ,355.25,355.25,39.64,54.72,5 CPT,94660,CPAP VENT INT&MGMT,713.07,713.07,42.78,606.11,33 CPT,94660,"Continuous positive airway pressure ventilation (CPAP), initiation and management ",713.07,713.07,430.47,594.19,5 CPT,94664,"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device ",,,430.47,594.19,5 CPT,94667,CHEST WALL INITIAL,171.85,171.85,10.31,146.07,33 CPT,94667,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation ",171.85,171.85,255.13,352.17,5 CPT,94668,CHEST WALL SUBSEQUENT,130.81,130.81,7.85,111.19,33 CPT,94668,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent ",130.81,130.81,255.13,352.17,5 CPT,94669,"Mechanical chest wall oscillation to facilitate lung function, per session ",,,430.47,594.19,5 CPT,94680,"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple ",,,323.74,446.87,5 CPT,94681,"Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen extracted ",,,592.25,817.51,5 CPT,94690,"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure) ",,,78.23,107.98,5 CPT,94726,PLETHYSMOGRAPHY,1026.52,1026.52,61.59,872.54,39 CPT,94726,"Plethysmography for determination of lung volumes and, when performed, airway resistance ",1026.52,1026.52,592.25,817.51,5 CPT,94727,GAS DILUTION/WASHOUT,2678.13,2678.13,160.69,2276.41,39 CPT,94727,"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes ",2678.13,2678.13,323.74,446.87,5 CPT,94728,Airway resistance by oscillometry ,,,592.25,817.51,5 CPT,94729,DIFFUSING CAPACITY,2000.7,2000.7,120.04,1700.6,44 CPT,94729,"Diffusing capacity (eg, carbon monoxide, membrane) (List separately in addition to code for primary procedure) ",2000.7,2000.7,109.63,151.33,5 CPT,94760,Noninvasive ear or pulse oximetry for oxygen saturation; single determination ,343.74,343.74,5.9,8.14,5 CPT,94760,SINGLE DX PULSE OX,343.74,343.74,20.62,292.18,44 CPT,94761,"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise) ",,,10.11,13.95,5 CPT,94762,Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure) ,,,323.74,446.87,5 CPT,94772,"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant ",,,1136.33,1568.52,5 CPT,94775,"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and dis",,,323.74,446.87,5 CPT,94776,"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analys",,,323.74,446.87,5 CPT,94780,"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, ",,,78.23,107.98,5 CPT,94781,"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, ",,,20.24,27.94,5 CPT,94799,Unlisted pulmonary service or procedure ,,,323.74,446.87,5 CPT,95004,"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests ",,,2126.94,2935.91,5 CPT,95012,Nitric oxide expired gas determination ,,,78.23,107.98,5 CPT,95017,"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpret",,,53.8,74.26,5 CPT,95018,"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including ",,,78.23,107.98,5 CPT,95024,"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests ",,,128.72,177.68,5 CPT,95027,"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of te",,,53.8,74.26,5 CPT,95028,"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests ",,,78.23,107.98,5 CPT,95044,Patch or application test(s) (specify number of tests) ,,,2126.94,2935.91,5 CPT,95052,Photo patch test(s) (specify number of tests) ,,,78.23,107.98,5 CPT,95056,Photo tests ,,,255.13,352.17,5 CPT,95060,Ophthalmic mucous membrane tests ,,,255.13,352.17,5 CPT,95065,Direct nasal mucous membrane test ,,,78.23,107.98,5 CPT,95070,"Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds ",,,75.91,104.78,5 CPT,95076,"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing ",,,181.3,250.26,5 CPT,95079,"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (List separately in addition to code for primary",,,166.14,229.33,5 CPT,95115,Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection ,,,89.18,123.1,5 CPT,95117,Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections ,,,89.18,123.1,5 CPT,95120,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; singl",,,60.11,60.11,2 CPT,95125,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or ",,,85.88,85.88,2 CPT,95130,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; singl",,,68.7,68.7,2 CPT,95131,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 sti",,,100.41,100.41,2 CPT,95132,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 sti",,,114.1,114.1,2 CPT,95133,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 sti",,,176.47,176.47,2 CPT,95134,"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 sti",,,205.38,205.38,2 CPT,95144,"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials) ",,,89.18,123.1,5 CPT,95145,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom ,,,89.18,123.1,5 CPT,95146,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms ,,,89.18,123.1,5 CPT,95147,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms ,,,141.5,195.32,5 CPT,95148,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms ,,,141.5,195.32,5 CPT,95149,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms ,,,141.5,195.32,5 CPT,95165,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses) ,,,89.18,123.1,5 CPT,95170,Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses) ,,,89.18,123.1,5 CPT,95180,"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum) ",,,850.8,1174.4,5 CPT,95249,"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor",,,131.55,181.59,5 CPT,95250,Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equip,,,271.28,374.45,5 CPT,95251,"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report ",,,85.18,117.57,5 CPT,95700,"Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels ",,,592.25,817.51,5 CPT,95705,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; unmonitored ",,,592.25,817.51,5 CPT,95706,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance ",,,592.25,817.51,5 CPT,95707,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; with continuous, real-time monitoring and maintenance ",,,592.25,817.51,5 CPT,95708,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored ",,,1136.33,1568.52,5 CPT,95709,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance ",,,1136.33,1568.52,5 CPT,95710,"Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance ",,,1136.33,1568.52,5 CPT,95711,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; unmonitored ",,,592.25,817.51,5 CPT,95712,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with intermittent monitoring and maintenance ",,,592.25,817.51,5 CPT,95713,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; with continuous, real-time monitoring and maintenance ",,,1136.33,1568.52,5 CPT,95714,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored ",,,1136.33,1568.52,5 CPT,95715,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance ",,,1136.33,1568.52,5 CPT,95716,"Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance ",,,2126.94,2935.91,5 CPT,95717,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2",,,244.55,337.57,5 CPT,95718,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2",,,321.31,443.51,5 CPT,95719,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater th",,,379.5,523.84,5 CPT,95720,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater th",,,497.55,686.79,5 CPT,95721,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,499.24,689.12,5 CPT,95722,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,607.18,838.12,5 CPT,95723,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,618.16,853.27,5 CPT,95724,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,774.17,1068.61,5 CPT,95725,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,703.33,970.84,5 CPT,95726,"Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary ",,,978.24,1350.3,5 CPT,95782,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,1861.19,6810.43,23 CPT,95783,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by ",,,1974.21,7183.1,23 CPT,95800,"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time ",,,302.75,3534.0,23 CPT,95801,"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone) ",,,255.13,3534.0,23 CPT,95803,"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording) ",,,128.72,177.68,5 CPT,95805,"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness ",,,859.34,3534.0,23 CPT,95806,"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) ",,,209.99,3534.0,23 CPT,95807,"Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist ",,,876.21,3534.0,23 CPT,95808,"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist ",,,1388.09,4834.4,23 CPT,95810,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,1172.2,4060.29,23 CPT,95811,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a",,,1232.08,4245.08,23 CPT,95812,Electroencephalogram (EEG) extended monitoring; 41-60 minutes ,,,635.85,877.69,5 CPT,95813,Electroencephalogram (EEG) extended monitoring; 61-119 minutes ,,,753.92,1040.67,5 CPT,95816,EEG REC AW & DROWSY,7288.59,7288.59,437.32,6195.3,39 CPT,95816,Electroencephalogram (EEG); including recording awake and drowsy ,7288.59,7288.59,726.94,1003.43,5 CPT,95819,EEG REC AW & ASLEEP,6104.4,6104.4,366.26,5188.74,39 CPT,95819,Electroencephalogram (EEG); including recording awake and asleep ,6104.4,6104.4,879.58,1214.12,5 CPT,95822,EEG COMA OR SLEEP ONLY,5517.91,5517.91,331.07,4690.22,39 CPT,95822,Electroencephalogram (EEG); recording in coma or sleep only ,5517.91,5517.91,779.22,1075.59,5 CPT,95824,EEG CEREB DEATH,3984.5600000000004,3984.5600000000004,229.88,3517.14,78 CPT,95824,Electroencephalogram (EEG); cerebral death evaluation only ,,,95.28,131.53,5 CPT,95829,Electrocorticogram at surgery (separate procedure) ,,,3708.06,5118.39,5 CPT,95830,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,36 CPT,95836,"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days ",,,84.82,117.09,5 CPT,95851,Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine) ,,,18.56,56.07,50 CPT,95852,"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side ",,,14.34,46.03,50 CPT,95857,Cholinesterase inhibitor challenge test for myasthenia gravis ,,,71.67,98.93,5 CPT,95860,Needle electromyography; 1 extremity with or without related paraspinal areas ,,,255.13,352.17,5 CPT,95861,Needle electromyography; 2 extremities with or without related paraspinal areas ,,,255.13,352.17,5 CPT,95863,Needle electromyography; 3 extremities with or without related paraspinal areas ,,,278.3,384.14,5 CPT,95864,Needle electromyography; 4 extremities with or without related paraspinal areas ,,,339.02,467.96,5 CPT,95865,Needle electromyography; larynx ,,,255.13,352.17,5 CPT,95866,Needle electromyography; hemidiaphragm ,,,323.74,446.87,5 CPT,95867,"Needle electromyography; cranial nerve supplied muscle(s), unilateral ",,,150.95,208.37,5 CPT,95868,"Needle electromyography; cranial nerve supplied muscles, bilateral ",,,178.78,246.77,5 CPT,95869,Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12) ,,,323.74,446.87,5 CPT,95870,"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters ",,,128.72,177.68,5 CPT,95872,"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied ",,,103.73,143.19,5 CPT,95873,Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) ,,,131.55,181.59,5 CPT,95874,Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) ,,,135.77,187.4,5 CPT,95875,Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s) ,,,173.72,239.8,5 CPT,95885,"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (List separately in addition to code f",,,100.36,138.53,5 CPT,95886,"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innerv",,,114.68,158.3,5 CPT,95887,"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (List separately in addition to code for primary pro",,,105.42,145.51,5 CPT,95905,"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report ",,,255.13,352.17,5 CPT,95907,Nerve conduction studies; 1-2 studies ,,,100.36,138.53,5 CPT,95908,Nerve conduction studies; 3-4 studies ,,,134.08,185.08,5 CPT,95909,Nerve conduction studies; 5-6 studies ,,,160.22,221.16,5 CPT,95910,Nerve conduction studies; 7-8 studies ,,,205.78,284.05,5 CPT,95911,Nerve conduction studies; 9-10 studies ,,,235.29,324.78,5 CPT,95912,Nerve conduction studies; 11-12 studies ,,,242.87,335.24,5 CPT,95913,Nerve conduction studies; 13 or more studies ,,,269.01,371.32,5 CPT,95919,"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral ",,,234.54,370.39,5 CPT,95921,"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval",,,90.23,124.55,5 CPT,95922,"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuve",,,255.13,352.17,5 CPT,95923,"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, thermoregulatory sweat test, and",,,255.13,352.17,5 CPT,95924,Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt ,,,144.21,199.06,5 CPT,95925,"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs ",,,247.92,342.22,5 CPT,95926,"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs ",,,238.66,329.43,5 CPT,95927,"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head ",,,249.63,344.58,5 CPT,95928,Central motor evoked potential study (transcranial motor stimulation); upper limbs ,,,331.41,457.46,5 CPT,95929,Central motor evoked potential study (transcranial motor stimulation); lower limbs ,,,343.23,473.78,5 CPT,95930,"Visual evoked potential (VEP) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report ",,,118.05,162.95,5 CPT,95933,"Orbicularis oculi (blink) reflex, by electrodiagnostic testing ",,,128.72,177.68,5 CPT,95937,"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method ",,,126.5,174.61,5 CPT,95938,"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs ",,,714.28,985.96,5 CPT,95939,Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs ,,,938.62,1295.62,5 CPT,95940,"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary proced",,,78.44,108.27,5 CPT,95941,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (List separately ",,,433.46,598.33,5 CPT,95954,"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during EEG recording of activation phase (eg, thiopental activation test) ",,,676.33,933.57,5 CPT,95955,"Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery) ",,,371.05,512.18,5 CPT,95957,"Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis) ",,,393.82,543.61,5 CPT,95958,"Wada activation test for hemispheric function, including electroencephalographic (EEG) monitoring ",,,831.52,1147.78,5 CPT,95961,"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour",,,341.55,471.45,5 CPT,95962,"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additio",,,211.68,292.19,5 CPT,95965,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,945.16,1405.02,59 CPT,95966,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,515.27,711.25,59 CPT,95967,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,450.33,1137.95,59 CPT,95970,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,255.13,352.17,5 CPT,95971,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,98.68,136.21,5 CPT,95972,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,100.36,138.53,5 CPT,95976,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,96.13,132.69,5 CPT,95977,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,128.19,176.94,5 CPT,95981,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,223.51,297.65,36 CPT,95982,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,98.96,36 CPT,95983,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,121.45,167.64,5 CPT,95984,"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, frequency ºHz», on/off cycling, burst, magnet mode, dose locko",,,106.26,146.67,5 CPT,95990,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,220.94,2358.0,21 CPT,95991,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,96.13,2358.0,21 CPT,95992,"Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day ",,,35.44,124.55,93 CPT,95999,Unlisted neurological or neuromuscular diagnostic procedure ,,,323.74,446.87,5 CPT,96000,Comprehensive computer-based motion analysis by video-taping and 3D kinematics; ,,,229.39,316.64,5 CPT,96001,Comprehensive computer-based motion analysis by video-taping and 3D kinematics; with dynamic plantar pressure measurements during walking ,,,307.8,424.87,5 CPT,96002,"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles ",,,53.12,73.32,5 CPT,96004,"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyogra",,,108.3,380.66,7 CPT,96020,"Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie",,,393.82,543.61,5 CPT,96041,"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter ",,,122.92,169.67,5 CPT,96105,APHASIA INT&RPT/HR SP,921.75,921.75,55.3,783.49,37 CPT,96105,"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagno",921.75,921.75,96.07,210.76,45 CPT,96110,"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument ",,,23.61,32.59,5 CPT,96112,"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when ",,,323.74,446.87,5 CPT,96113,"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when ",,,139.14,192.06,5 CPT,96121,"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, ºeg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities»)",,,186.38,257.27,5 CPT,96125,COGNITIV PERFORM TEST SP,638.23,638.23,38.29,542.5,32 CPT,96125,"Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patie",638.23,638.23,101.45,363.18,50 CPT,96127,"Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder ºADHD» scale), with scoring and documentation, per standardized instrument ",,,78.23,107.98,5 CPT,96130,"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data",,,323.74,446.87,5 CPT,96131,"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data",,,199.02,274.71,5 CPT,96132,"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical",,,323.74,446.87,5 CPT,96133,"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical",,,196.49,271.22,5 CPT,96136,"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes ",,,53.8,74.26,5 CPT,96137,"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List separately",,,46.38,64.02,5 CPT,96138,"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes ",,,53.8,74.26,5 CPT,96139,"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (List separately in addition to code for primary procedure)",,,91.07,125.71,5 CPT,96146,"Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only ",,,53.8,74.26,5 CPT,96156,"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making) ",,,183.78,253.68,5 CPT,96158,"Health behavior intervention, individual, face-to-face; initial 30 minutes ",,,183.78,253.68,5 CPT,96159,"Health behavior intervention, individual, face-to-face; each additional 15 minutes (List separately in addition to code for primary service) ",,,49.75,68.67,5 CPT,96160,"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument ",,,7.58,10.47,5 CPT,96161,"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument ",,,7.58,10.47,5 CPT,96164,"Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes ",,,63.93,88.24,5 CPT,96165,"Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (List separately in addition to code for primary service) ",,,9.27,12.79,5 CPT,96167,"Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes ",,,63.93,88.24,5 CPT,96168,"Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (List separately in addition to code for primary service) ",,,54.83,75.68,5 CPT,96170,"Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes ",,,184.7,254.94,5 CPT,96171,"Health behavior intervention, family (without the patient present), face-to-face; each additional 15 minutes (List separately in addition to code for primary service) ",,,67.46,93.12,5 CPT,96202,"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualif",,,19.84,74.52,50 CPT,96203,"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualif",,,5.38,20.96,50 CPT,96360,IV HYDRAT INIT UP TO 1HR,767.22,767.22,37.48,773.29,424 CPT,96360,"Intravenous infusion, hydration; initial, 31 minutes to 1 hour ",,,90.23,124.55,5 CPT,96361,IV HYDRAT EA ADD HR,307.33,307.33,12.09,335.06,502 CPT,96361,"Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure) ",,,32.03,44.22,5 CPT,96365,IV INITIAL UP TO 1 HOUR,624.69,624.69,23.38,773.29,502 CPT,96365,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour ",,,170.35,235.14,5 CPT,96366,IV EACH ADD HOUR,394.19,394.19,12.09,365.36,424 CPT,96366,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure) ",,,51.43,71.0,5 CPT,96367,IV ADDL SEQ INF UP TO 1H,297.87,297.87,12.09,335.06,229 CPT,96367,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for ",,,74.2,102.42,5 CPT,96368,IV CONCURRENT INFUSION,266.135,266.135,8.28,335.06,303 CPT,96368,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure) ",,,49.75,68.67,5 CPT,96369,"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s) ",,,395.51,545.93,5 CPT,96370,Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure) ,,,37.11,51.23,5 CPT,96371,Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for pr,,,141.5,195.32,5 CPT,96372,INJECTION IM OR SQ,627.55,627.55,19.78,701.76,502 CPT,96372,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular ",,,141.5,195.32,5 CPT,96373,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial ",,,44.69,61.69,5 CPT,96374,IVP SINGLE/INITIAL DRUG,356.11,356.11,20.37,967.33,541 CPT,96374,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug ",,,92.76,128.04,5 CPT,96375,IVP EA ADD SEQ NEW DRUG,738.8,738.8,20.37,967.33,580 CPT,96375,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary pro",,,39.64,54.72,5 CPT,96376,IVP EA ADD SEQ SAME DRUG,738.8,738.8,20.37,967.33,655 CPT,96376,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in additi",,,55.67,76.84,5 CPT,96377,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,89.18,3083.0,101 CPT,96379,"Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion ",,,89.18,123.1,5 CPT,96380,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional ",,,25.71,129.2,7 CPT,96381,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection ",,,20.76,129.2,7 CPT,96401,"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic ",,,141.5,195.32,5 CPT,96402,"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic ",,,141.5,195.32,5 CPT,96405,"Chemotherapy administration; intralesional, up to and including 7 lesions ",,,141.5,195.32,5 CPT,96406,"Chemotherapy administration; intralesional, more than 7 lesions ",,,110.47,152.49,5 CPT,96409,"Chemotherapy administration; intravenous, push technique, single or initial substance/drug ",,,257.21,355.04,5 CPT,96411,"Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) ",,,139.14,192.06,5 CPT,96413,"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug ",,,334.81,462.15,5 CPT,96415,"Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure) ",,,72.52,100.1,5 CPT,96416,"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump ",,,335.65,463.31,5 CPT,96417,"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure) ",,,161.93,223.52,5 CPT,96420,"Chemotherapy administration, intra-arterial; push technique ",,,248.79,343.41,5 CPT,96422,"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour ",,,409.01,564.57,5 CPT,96423,"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (List separately in addition to code for primary procedure) ",,,188.91,260.76,5 CPT,96425,"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump ",,,433.46,598.33,5 CPT,96440,"Chemotherapy administration into pleural cavity, requiring and including thoracentesis ",,,301.06,415.57,5 CPT,96446,Chemotherapy administration into the peritoneal cavity via implanted port or catheter ,,,66.62,91.96,5 CPT,96450,"Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture ",,,191.44,264.25,5 CPT,96521,Refilling and maintenance of portable pump ,,,348.29,480.75,5 CPT,96522,"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial) ",,,285.04,393.45,5 CPT,96523,Irrigation of implanted venous access device for drug delivery systems ,,,128.72,177.68,5 CPT,96542,"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents ",,,100.36,138.53,5 CPT,96547,"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primar",,,66.62,91.96,5 CPT,96548,"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (List separately in addition to code ",,,66.62,91.96,5 CPT,96549,Unlisted chemotherapy procedure ,,,89.18,123.1,5 CPT,96567,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,408.87,2358.0,21 CPT,96570,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,124.82,2358.0,21 CPT,96571,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,69.99,2358.0,21 CPT,96573,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,408.87,1672.0,13 CPT,96574,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,408.87,3083.0,109 CPT,96900,Actinotherapy (ultraviolet light) ,,,78.23,107.98,5 CPT,96902,"Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality ",,,49.75,169.96,17 CPT,96904,"Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma ",,,153.48,211.86,5 CPT,96910,Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B ,,,128.72,177.68,5 CPT,96912,Photochemotherapy; psoralens and ultraviolet A (PUVA) ,,,128.72,177.68,5 CPT,96913,Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and ,,,329.73,455.14,5 CPT,96920,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,132 CPT,96921,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,132 CPT,96922,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,132 CPT,96931,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion ",,,405.64,559.92,5 CPT,96932,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion ",,,40.48,55.88,5 CPT,96933,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion ",,,111.31,153.65,5 CPT,96934,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (List separately in addition to code for pr",,,231.07,318.96,5 CPT,96935,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (List separately in addition to code for primary procedure) ",,,106.26,146.67,5 CPT,96936,"Reflectance confocal microscopy (RCM) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (List separately in addition to code for primary procedure) ",,,106.26,146.67,5 CPT,96999,Unlisted special dermatological service or procedure ,,,408.87,564.38,5 CPT,97007,"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education ",,,3394.17,4685.11,5 CPT,97008,"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period ",,,23.8,32.85,5 CPT,97009,"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (List separately in addition to code for primary procedure) ",,,15.07,20.8,5 CPT,97010,Application of a modality to 1 or more areas; hot or cold packs ,,,15.19,33.81,17 CPT,97012,"Application of a modality to 1 or more areas; traction, mechanical ",,,12.51,79.3,105 CPT,97012,TRACTION MECHANCL PTCQ,507.28,507.28,30.44,431.19,20 CPT,97012,TRACTION MECHANICAL PT,507.28,507.28,30.44,431.19,20 CPT,97014,Application of a modality to 1 or more areas; electrical stimulation (unattended) ,,,35.43,69.83,17 CPT,97016,Application of a modality to 1 or more areas; vasopneumatic devices ,,,10.49,66.02,148 CPT,97018,Application of a modality to 1 or more areas; paraffin bath ,,,6.01,31.95,62 CPT,97022,Application of a modality to 1 or more areas; whirlpool ,,,13.63,96.29,148 CPT,97024,"Application of a modality to 1 or more areas; diathermy (eg, microwave) ",,,7.3,39.47,62 CPT,97026,Application of a modality to 1 or more areas; infrared ,,,6.65,35.75,62 CPT,97028,Application of a modality to 1 or more areas; ultraviolet ,,,8.29,45.22,62 CPT,97032,"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes ",,,12.81,81.24,105 CPT,97033,"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes ",,,16.52,109.56,148 CPT,97034,"Application of a modality to 1 or more areas; contrast baths, each 15 minutes ",,,13.88,81.15,62 CPT,97035,"Application of a modality to 1 or more areas; ultrasound, each 15 minutes ",,,12.5,79.3,148 CPT,97036,"Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes ",,,34.06,190.89,62 CPT,97037,"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction ",,,89.41,123.42,5 CPT,97039,Unlisted modality (specify type and time if constant attendance) ,,,26.14,71.68,17 CPT,97110,THER EXERCIS 15 MIN PTCQ,336.92,336.92,20.22,286.38,20 CPT,97110,THER EXERCISES 15 MIN OT,358.53,358.53,21.51,304.75,20 CPT,97110,THER EXERCISES 15 MIN PT,336.92,336.92,20.22,286.38,20 CPT,97110,"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility ",,,25.19,164.26,148 CPT,97112,NEROMUSC REDUCT 15M PTCQ,282.25,282.25,16.93,239.91,20 CPT,97112,NEUROMUSC REEDUCT 15M OT,282.25,282.25,16.93,239.91,20 CPT,97112,NEUROMUSC REEDUCT 15M PT,282.25,282.25,16.93,239.91,20 CPT,97112,"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing act",,,28.36,190.81,148 CPT,97113,"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises ",,,32.06,205.94,148 CPT,97116,GAIT TRAINING 15 MIN PT,218.68,218.68,13.12,185.88,20 CPT,97116,GAIT TRAINNG 15 MN PTCQ,218.68,218.68,13.12,185.88,20 CPT,97116,"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing) ",,,25.19,164.26,105 CPT,97124,"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion) ",,,25.72,166.38,105 CPT,97129,COGSKLS DVLMNT INT15M SP,547.96,547.96,32.88,465.77,20 CPT,97129,"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage t",547.96,547.96,19.49,126.47,105 CPT,97130,COGSKLS DVLMNT EA15M SP,208.5,208.5,12.51,177.22,20 CPT,97130,"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage t",208.5,208.5,20.72,120.8,62 CPT,97139,Unlisted therapeutic procedure (specify) ,,,35.43,97.97,17 CPT,97140,MANUAL THER TECH 15M PT,395.4,395.4,23.72,336.09,20 CPT,97140,"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes ",395.4,395.4,24.04,151.07,148 CPT,97150,"Therapeutic procedure(s), group (2 or more individuals) ",,,15.68,98.23,148 CPT,97151,"Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-",,,63.93,171.96,17 CPT,97152,"Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 min",,,63.93,131.51,17 CPT,97153,"Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes ",,,63.93,132.31,17 CPT,97154,"Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 1",,,63.93,131.07,17 CPT,97155,"Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with",,,63.93,172.31,17 CPT,97156,"Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), ea",,,63.93,173.19,17 CPT,97157,"Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guar",,,63.93,172.31,17 CPT,97158,"Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes ",,,63.93,172.04,17 CPT,97161,EVAL PT LOW COMPLEX,896.955,896.955,44.47,894.79,40 CPT,97161,"Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st",,,84.58,558.88,105 CPT,97162,EVAL PT MOD COMPLEX,1055.88,1055.88,63.16,900.2,40 CPT,97162,"Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o",,,84.58,558.88,105 CPT,97163,EVAL PT HIGH COMPLEX,1214.8000000000002,1214.8000000000002,63.16,1170.37,40 CPT,97163,"Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination",,,84.58,558.88,105 CPT,97164,RE-EVALUATION PT,904.585,904.585,44.47,907.77,40 CPT,97164,"Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised",,,58.31,385.33,105 CPT,97165,EVAL OT LOW COMPLEX,797.15,797.15,47.83,677.58,20 CPT,97165,"Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or ",797.15,797.15,86.87,562.68,105 CPT,97166,EVAL OT MOD COMPLEX,1187.46,1187.46,71.25,1009.34,20 CPT,97166,"Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy r",1187.46,1187.46,86.87,562.68,105 CPT,97167,EVAL OT HIGH COMPLEX,1543.45,1543.45,92.61,1311.93,20 CPT,97167,"Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and exten",1543.45,1543.45,86.87,562.68,105 CPT,97168,RE-EVALUATION OT,741.21,741.21,44.47,630.03,20 CPT,97168,"Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the",741.21,741.21,59.16,387.19,105 CPT,97169,"Athletic training evaluation, low complexity, requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An examination of affected body a",,,120.6,293.82,17 CPT,97170,"Athletic training evaluation, moderate complexity, requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical activity; An examination of a",,,188.07,293.82,17 CPT,97171,"Athletic training evaluation, high complexity, requiring these components: A medical history and physical activity profile, with 3 or more comorbidities that affect physical activity; A comprehensive ",,,217.79,507.53,17 CPT,97172,Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient's current functional status when there is a documented change; and A revised plan of ca,,,108.9,166.47,17 CPT,97530,THER ACTIV DIR 15 MIN OT,222.49,222.49,13.35,189.12,20 CPT,97530,THER ACTIV DIR 15 MIN PT,244.1,244.1,14.65,207.49,20 CPT,97530,THER ACTV DIR 15 MN PTCQ,244.1,244.1,14.65,207.49,20 CPT,97530,"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes ",,,30.33,207.8,148 CPT,97533,SENSORY INTEGRATN 15M OT,63.57,63.57,3.81,54.03,20 CPT,97533,"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes ",63.57,63.57,52.37,360.99,105 CPT,97535,SELF/HOME ONE/ONE 15M OT,218.68,218.68,13.12,185.88,20 CPT,97535,SELF/HOME ONE/ONE 15M PT,429.72,429.72,25.78,365.26,20 CPT,97535,SELFHOME ONEONE 15M PTCQ,429.72,429.72,25.78,365.26,20 CPT,97535,"Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptiv",,,28.05,183.19,148 CPT,97537,"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive techno",,,31.57,177.53,60 CPT,97542,WHEELCHAIR MGT 15M PT,282.25,282.25,16.93,239.91,20 CPT,97542,WHELCHAR MGT 15M PTCQ,282.25,282.25,16.93,239.91,20 CPT,97542,"Wheelchair management (eg, assessment, fitting, training), each 15 minutes ",,,26.92,177.53,105 CPT,97545,Work hardening/conditioning; initial 2 hours ,,,219.26,943.68,17 CPT,97546,Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) ,,,110.47,373.03,17 CPT,97550,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living ºADLs», instrumental ADLs ºiADLs», transfers",,,51.97,174.03,50 CPT,97551,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living ºADLs», instrumental ADLs ºiADLs», transfers",,,25.62,79.91,50 CPT,97552,"Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living ºADLs», instrumental ADLs ºiADLs», tra",,,21.69,73.32,50 CPT,97597,DEBRIDE WND IN 20SQCM PT,328.02,328.02,19.68,278.82,33 CPT,97597,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",328.02,328.02,57.35,3083.0,160 CPT,97598,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,26.98,3083.0,160 CPT,97602,REM DEVITLIZD TISS NS PT,724.68,724.68,43.48,615.98,33 CPT,97602,"Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound as",724.68,724.68,408.87,564.38,5 CPT,97605,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing",,,41.35,564.38,48 CPT,97606,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing",,,49.5,1032.02,48 CPT,97607,"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical app",,,54.83,786.49,48 CPT,97608,"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical app",,,61.57,849.83,48 CPT,97610,"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day ",,,387.11,849.27,48 CPT,97750,"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes ",,,29.19,115.25,136 CPT,97755,"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with wr",,,37.16,125.71,50 CPT,97760,ORTH MGT TRAIN EA 15M PT,274.62,274.62,16.48,233.43,32 CPT,97760,ORTH MGT TRN EA 15M PTCQ,274.62,274.62,16.48,233.43,32 CPT,97760,"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minu",,,39.8,157.14,136 CPT,97761,"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes ",,,39.7,135.05,50 CPT,97763,"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes ",,,43.22,438.34,105 CPT,97802,"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes ",,,30.72,111.76,50 CPT,97803,"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes ",,,26.54,95.45,50 CPT,97804,"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes ",,,14.3,52.39,50 CPT,97810,"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient ",,,73.36,101.26,5 CPT,97811,"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to ",,,60.72,83.82,5 CPT,97813,"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient ",,,79.28,109.43,5 CPT,97814,"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (List separately in addition to cod",,,66.62,91.96,5 CPT,98000,"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When us",,,107.05,147.77,5 CPT,98001,"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total ti",,,184.77,255.04,5 CPT,98002,"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using tot",,,299.73,413.73,5 CPT,98003,"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total t",,,402.83,556.04,5 CPT,98004,"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making",,,80.1,110.56,5 CPT,98005,"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. When using",,,149.08,205.78,5 CPT,98006,"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When ",,,222.02,306.46,5 CPT,98007,"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When usin",,,299.73,413.73,5 CPT,98008,"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more th",,,102.28,141.18,5 CPT,98009,"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minute",,,177.63,245.19,5 CPT,98010,"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 m",,,279.91,386.37,5 CPT,98011,"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minut",,,367.94,507.89,5 CPT,98012,"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, an",,,75.32,103.97,5 CPT,98013,"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than ",,,137.17,189.34,5 CPT,98014,"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more ",,,202.99,280.2,5 CPT,98015,"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than",,,299.73,413.73,5 CPT,98016,"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an establi",,,35.68,49.26,5 CPT,98925,Osteopathic manipulative treatment (OMT); 1-2 body regions involved ,,,57.38,79.2,5 CPT,98926,Osteopathic manipulative treatment (OMT); 3-4 body regions involved ,,,57.38,79.2,5 CPT,98927,Osteopathic manipulative treatment (OMT); 5-6 body regions involved ,,,57.38,79.2,5 CPT,98928,Osteopathic manipulative treatment (OMT); 7-8 body regions involved ,,,57.38,79.2,5 CPT,98929,Osteopathic manipulative treatment (OMT); 9-10 body regions involved ,,,57.38,79.2,5 CPT,98940,"Chiropractic manipulative treatment (CMT); spinal, 1-2 regions ",,,57.38,79.2,5 CPT,98941,"Chiropractic manipulative treatment (CMT); spinal, 3-4 regions ",,,57.38,79.2,5 CPT,98942,"Chiropractic manipulative treatment (CMT); spinal, 5 regions ",,,57.38,79.2,5 CPT,98943,"Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions ",,,56.51,78.0,5 CPT,98960,"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) ",,,64.94,89.63,5 CPT,98961,"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) ",,,32.03,44.22,5 CPT,98962,"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) ",,,23.61,32.59,5 CPT,98966,"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and m",,,8.95,41.89,50 CPT,98967,"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and m",,,17.34,83.82,50 CPT,98968,"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and m",,,25.06,125.71,50 CPT,98970,"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes ",,,12.28,41.89,48 CPT,98971,"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes ",,,22.89,50.22,48 CPT,98972,"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes ",,,30.35,75.01,48 CPT,98975,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment ",,,21.37,391.96,48 CPT,98976,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory s",,,50.83,122.84,48 CPT,98977,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskelet",,,50.19,122.84,48 CPT,98978,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive beh",,,81.9,113.05,5 CPT,98979,"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication wit",,,26.96,37.21,5 CPT,98980,"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication wit",,,53.34,117.02,48 CPT,98981,"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication wit",,,40.98,105.94,48 CPT,98984,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory s",,,89.22,123.16,5 CPT,98985,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskelet",,,89.22,123.16,5 CPT,98986,"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive beh",,,89.22,123.16,5 CPT,99000,Handling and/or conveyance of specimen for transfer from the office to a laboratory ,,,24.75,39.08,5 CPT,99001,Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated) ,,,12.38,19.55,5 CPT,99002,"Handling, conveyance, and/or any other service in connection with the implementation of an order involving devices (eg, designing, fitting, packaging, handling, delivery or mailing) when devices such ",,,14.34,19.8,5 CPT,99026,"Hospital mandated on call service; in-hospital, each hour ",,,108.79,150.16,5 CPT,99027,"Hospital mandated on call service; out-of-hospital, each hour ",,,53.98,74.52,5 CPT,99075,Medical testimony ,,,320.46,442.35,5 CPT,99080,"Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form ",,,233.97,233.97,2 CPT,99091,"Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified ",,,136.61,188.57,5 CPT,99151,"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presenc",,,60.72,83.82,5 CPT,99152,MOD SED MD 1ST 15 >5YRS,5161.44,5161.44,309.69,4387.22,220 CPT,99152,"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presenc",,,29.51,40.73,5 CPT,99153,MOD SED MD EADD 15,2950.51,2950.51,177.03,2507.93,220 CPT,99153,"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presenc",,,25.3,34.92,5 CPT,99155,Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therape,,,214.2,295.67,5 CPT,99156,Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therape,,,188.91,260.76,5 CPT,99157,Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therape,,,153.48,211.86,5 CPT,99170,"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed ",,,208.31,287.53,5 CPT,99172,"Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may incl",,,106.49,154.81,7 CPT,99173,"Screening test of visual acuity, quantitative, bilateral ",,,2.93,9.3,7 CPT,99174,"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report ",,,5.75,18.64,7 CPT,99175,Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison ,,,61.57,84.98,5 CPT,99177,"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis ",,,4.62,15.15,7 CPT,99184,"Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophag",,,533.82,736.86,5 CPT,99188,Application of topical fluoride varnish by a physician or other qualified health care professional ,,,24.45,33.75,5 CPT,99190,Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); each hour ,,,841.63,1161.73,5 CPT,99191,Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 45 minutes ,,,625.74,863.73,5 CPT,99192,Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 30 minutes ,,,416.59,575.04,5 CPT,99195,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,36 CPT,99195,THERAPEUTIC PHLEB,1019.81,1019.81,61.19,866.84,44 CPT,99202,BASIC CARE NP,330.0,330.0,19.8,280.5,76 CPT,99202,FOLLOW UP VISIT ONLY NP,775.0,775.0,46.5,658.75,76 CPT,99202,OP VISIT LEVEL 2 NP,455.0,455.0,27.3,386.75,76 CPT,99202,"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When",,,120.6,166.47,5 CPT,99203,OP VISIT LEVEL 3 NP,525.0,525.0,31.5,446.25,76 CPT,99203,"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When us",,,181.3,250.26,5 CPT,99204,OP VISIT LEVEL 4 NP,604.0,604.0,36.24,513.4,76 CPT,99204,"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. Wh",,,306.96,423.71,5 CPT,99205,OP VISIT LEVEL 5 NP,695.0,695.0,41.7,590.75,76 CPT,99205,"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When u",,,400.58,552.94,5 CPT,99211,OP VISIT LEVEL 1 EST,330.0,330.0,19.8,280.5,76 CPT,99211,Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional ,,,21.93,30.27,5 CPT,99212,OP VISIT LEVEL 2 EST,380.0,380.0,22.8,323.0,76 CPT,99212,"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision mak",,,60.72,83.82,5 CPT,99213,OP VISIT LEVEL 3 EST,437.0,437.0,26.22,371.45,76 CPT,99213,"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making",,,121.45,167.64,5 CPT,99214,OP VISIT LEVEL 4 EST,502.0,502.0,30.12,426.7,76 CPT,99214,"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision m",,,187.22,258.43,5 CPT,99215,OP VISIT LEVEL 5 EST,580.0,580.0,34.8,493.0,76 CPT,99215,"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision makin",,,263.95,364.34,5 CPT,99221,"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low le",,,241.18,332.92,5 CPT,99222,"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical",,,325.52,449.33,5 CPT,99223,"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical dec",,,480.68,663.51,5 CPT,99231,"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low",,,93.6,129.2,5 CPT,99232,"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medi",,,172.88,238.63,5 CPT,99233,"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical ",,,247.08,341.06,5 CPT,99234,"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examina",,,316.25,436.53,5 CPT,99235,"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examina",,,402.27,555.27,5 CPT,99236,"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examina",,,516.95,713.57,5 CPT,99238,Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter ,,,173.72,239.8,5 CPT,99239,Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter ,,,254.69,351.55,5 CPT,99242,"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using tota",,,162.77,224.68,5 CPT,99243,"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total t",,,227.71,314.31,5 CPT,99244,"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using to",,,366.0,505.2,5 CPT,99245,"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total ",,,452.86,625.1,5 CPT,99252,"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total ",,,177.93,245.61,5 CPT,99253,"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total tim",,,274.08,378.33,5 CPT,99254,"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using tota",,,398.03,549.42,5 CPT,99255,"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total ti",,,479.0,661.18,5 CPT,99281,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,51.36,1716.0,105 CPT,99281,LVL 1 EMER DEPT,430.64,430.64,72.35,366.04,9 CPT,99281,LVL 1 FREE STD EMER DEPT,430.64,430.64,72.35,366.04,36 CPT,99282,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,51.36,1819.0,105 CPT,99282,LVL 2 EMER DEPT,799.45,799.45,134.31,679.53,9 CPT,99282,LVL 2 FREE STD EMER DEPT,799.45,799.45,134.31,679.53,36 CPT,99283,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,51.36,4158.0,105 CPT,99283,LVL 3 EMER DEPT,1403.04,1403.04,235.71,1192.58,9 CPT,99283,LVL 3 FREE STD EMER DEPT,1403.04,1403.04,235.71,1192.58,36 CPT,99284,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,300.0,4651.0,97 CPT,99284,LVL 4 EMER DEPT,2185.31,2185.31,305.94,1857.51,10 CPT,99284,LVL 4 FREE STD EMER DEPT,2185.31,2185.31,305.94,1857.51,40 CPT,99285,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,300.0,7960.0,97 CPT,99285,LVL 5 EMER DEPT,3138.23,3138.23,439.35,2667.5,10 CPT,99285,LVL 5 FREE STD EMER DEPT,3138.23,3138.23,439.35,2667.5,40 CPT,99288,"Physician or other qualified health care professional direction of emergency medical systems (EMS) emergency care, advanced life support ",,,366.84,506.37,5 CPT,99291,CRIT CARE 1ST 30-74 MINS,4396.96,4396.96,571.6,3737.42,15 CPT,99291,CRIT CARE 1ST 30-74M ER,4396.96,4396.96,571.6,3737.42,60 CPT,99291,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,3343.0,7960.0,68 CPT,99292,CRIT CARE EACH ADD 30MIN,1265.6,1265.6,164.53,1075.76,23 CPT,99292,CRIT CARE ECH ADD 30M ER,1265.6,1265.6,164.53,1075.76,92 CPT,99292,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service) ",,,3343.0,7960.0,53 CPT,99358,Prolonged evaluation and management service before and/or after direct patient care; first hour ,,,265.64,366.67,5 CPT,99359,Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged service) ,,,128.19,176.94,5 CPT,99360,"Standby service, requiring prolonged attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring EEG) ",,,145.9,201.39,5 CPT,99366,"Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care profe",,,100.36,138.53,5 CPT,99367,"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician ",,,135.77,187.4,5 CPT,99368,"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professiona",,,89.39,123.39,5 CPT,99374,"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, Alzheimer's facility) requiring complex and multidisciplinary care m",,,40.99,186.24,7 CPT,99375,"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, Alzheimer's facility) requiring complex and multidisciplinary care m",,,64.24,291.02,7 CPT,99377,"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of",,,134.92,186.24,5 CPT,99378,"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of",,,210.83,291.02,5 CPT,99379,"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, ",,,134.92,186.24,5 CPT,99380,"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, ",,,210.83,291.02,5 CPT,99381,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,55.36,252.59,7 CPT,99382,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,59.18,270.06,7 CPT,99383,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,63.37,286.37,7 CPT,99384,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,74.04,335.24,7 CPT,99385,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,71.48,321.29,7 CPT,99386,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,86.92,391.12,7 CPT,99387,"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reductio",,,93.02,420.22,7 CPT,99391,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,50.79,230.49,7 CPT,99392,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,55.36,252.59,7 CPT,99393,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,55.36,252.59,7 CPT,99394,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,63.37,286.37,7 CPT,99395,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,65.09,294.51,7 CPT,99396,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,70.62,318.96,7 CPT,99397,"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc",,,74.05,335.24,7 CPT,99401,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes ,,,18.01,81.49,7 CPT,99402,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes ,,,36.6,165.31,7 CPT,99403,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes ,,,53.93,246.77,7 CPT,99404,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes ,,,72.34,327.1,7 CPT,99406,"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes ",,,29.51,40.73,5 CPT,99407,"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes ",,,61.57,84.98,5 CPT,99408,"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes ",,,79.28,109.43,5 CPT,99409,"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes ",,,158.53,218.83,5 CPT,99411,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes ,,,18.56,25.61,5 CPT,99412,Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes ,,,30.35,41.89,5 CPT,99415,"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct",,,23.61,32.59,5 CPT,99416,"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct",,,10.11,13.95,5 CPT,99417,Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected u,,,22.97,108.27,7 CPT,99418,Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has b,,,97.84,135.05,5 CPT,99421,"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes ",,,31.19,43.06,5 CPT,99422,"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes ",,,64.09,88.47,5 CPT,99423,"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes ",,,102.05,140.86,5 CPT,99424,"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient ",,,183.85,253.78,5 CPT,99425,"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient ",,,128.19,176.94,5 CPT,99426,"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient ",,,123.13,169.96,5 CPT,99427,"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient ",,,86.86,119.9,5 CPT,99437,"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditi",,,127.34,175.78,5 CPT,99439,"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditi",,,68.3,94.28,5 CPT,99445,"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 da",,,89.22,123.16,5 CPT,99450,"Basic life and/or disability examination that includes: Measurement of height, weight, and blood pressure; Completion of a medical history following a life insurance pro forma; Collection of blood sam",,,419.12,578.53,5 CPT,99453,"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment ",,,271.28,374.45,5 CPT,99454,REMMON INTL DEVC EA 30 D,115.0,115.0,6.9,97.75,33 CPT,99454,"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 d",115.0,115.0,84.82,117.09,5 CPT,99455,Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commens,,,573.46,791.58,5 CPT,99456,Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examinat,,,661.17,912.64,5 CPT,99457,"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication ",,,75.91,104.78,5 CPT,99458,"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication ",,,76.75,105.94,5 CPT,99459,Pelvic examination (List separately in addition to code for primary procedure) ,,,53.91,74.42,5 CPT,99460,"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant ",,,271.28,374.45,5 CPT,99461,"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center ",,,46.13,207.2,7 CPT,99462,"Subsequent hospital care, per day, for evaluation and management of normal newborn ",,,100.36,138.53,5 CPT,99463,"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date ",,,271.28,374.45,5 CPT,99464,Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn ,,,178.78,246.77,5 CPT,99465,"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output ",,,348.29,480.75,5 CPT,99468,"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger ",,,2192.63,3026.57,5 CPT,99469,"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger ",,,947.89,1308.41,5 CPT,99470,"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication ",,,31.71,43.77,5 CPT,99471,"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age ",,,1898.3,2620.31,5 CPT,99472,"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age ",,,972.34,1342.16,5 CPT,99473,Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration ,,,53.8,74.26,5 CPT,99474,"Self-measured blood pressure using a device validated for clinical accuracy; separate self-measurements of two readings one minute apart, twice daily over a 30-day period (minimum of 12 readings), col",,,21.08,29.1,5 CPT,99475,"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age ",,,1335.81,1843.88,5 CPT,99476,"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age ",,,831.52,1147.78,5 CPT,99477,"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care servic",,,830.68,1146.62,5 CPT,99478,"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams) ",,,326.36,450.49,5 CPT,99479,"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams) ",,,296.85,409.76,5 CPT,99480,"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams) ",,,284.19,392.28,5 CPT,99483,"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the follow",,,429.25,592.51,5 CPT,99485,"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with trans",,,55.36,252.59,7 CPT,99486,"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with trans",,,48.12,218.83,7 CPT,99487,"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic",,,123.97,171.13,5 CPT,99489,"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic",,,62.41,86.14,5 CPT,99490,"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditi",,,75.91,104.78,5 CPT,99491,"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditi",,,196.49,271.22,5 CPT,99495,"Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge ",,,271.28,374.45,5 CPT,99496,"Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge ",,,271.28,374.45,5 CPT,99497,"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health ",,,86.38,253.68,48 CPT,99498,"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health ",,,77.87,244.45,48 CPT,99500,"Home visit for prenatal monitoring and assessment to include fetal heart rate, non-stress test, uterine monitoring, and gestational diabetes monitoring ",,,196.49,271.22,5 CPT,99501,Home visit for postnatal assessment and follow-up care ,,,112.16,167.09,7 CPT,99502,Home visit for newborn care and assessment ,,,112.16,167.09,7 CPT,99503,"Home visit for respiratory therapy care (eg, bronchodilator, oxygen therapy, respiratory assessment, apnea evaluation) ",,,112.16,247.86,7 CPT,99504,Home visit for mechanical ventilation care ,,,112.16,154.81,5 CPT,99505,Home visit for stoma care and maintenance including colostomy and cystostomy ,,,112.16,154.81,5 CPT,99506,Home visit for intramuscular injections ,,,112.16,161.99,7 CPT,99507,"Home visit for care and maintenance of catheter(s) (eg, urinary, drainage, and enteral) ",,,112.16,154.81,5 CPT,99509,Home visit for assistance with activities of daily living and personal care ,,,112.16,154.81,5 CPT,99510,"Home visit for individual, family, or marriage counseling ",,,112.16,154.81,5 CPT,99511,Home visit for fecal impaction management and enema administration ,,,112.16,154.81,5 CPT,99512,Home visit for hemodialysis ,,,112.16,154.81,5 CPT,99601,"Home infusion/specialty drug administration, per visit (up to 2 hours); ",,,431.79,431.79,2 CPT,99602,"Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure) ",,,285.99,285.99,2 HCPCS,A2001,"Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,266.05,409.81,5 HCPCS,A2002,"Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,18.09,5 HCPCS,A2004,"Xcellistem, 1 mg ",,,11.74,41.37,8 HCPCS,A2005,"Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1.79,2.75,5 HCPCS,A2006,"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,100.35,154.58,5 HCPCS,A2007,RESTRATA 1SQCM,1982.0,1982.0,118.92,1684.7,25 HCPCS,A2007,"Restrata, per square centimeter (add-on, list separately in addition to primary procedure) ",1982.0,1982.0,11.74,641.78,8 HCPCS,A2008,"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure) ",,,16.5,471.96,8 HCPCS,A2009,"Symphony, per square centimeter (add-on, list separately in addition to primary procedure) ",,,35.6,290.57,8 HCPCS,A2010,"Apis, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,18.09,5 HCPCS,A2011,"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,417.89,5 HCPCS,A2012,"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure) ",,,0.69,1.07,5 HCPCS,A2013,"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,4296.24,8 HCPCS,A2014,"Omeza collagen matrix or omeza complete matrix, per 100 mg ",,,1.8,407.75,8 HCPCS,A2015,"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,18.09,5 HCPCS,A2016,"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure) ",,,35.6,54.84,5 HCPCS,A2017,"Permeaderm glove, each ",,,16.5,25.42,5 HCPCS,A2018,"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure) ",,,16.5,25.42,5 HCPCS,A2019,"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure) ",,,71.06,1894.81,8 HCPCS,A2020,Ac5 advanced wound system (ac5) ,,,18.53,28.54,5 HCPCS,A2021,"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,5487.18,8 HCPCS,A2022,"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,266.05,4534.92,8 HCPCS,A2023,"Innovamatrix pd, 1 mg ",,,40.12,409.81,8 HCPCS,A2024,"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,11.74,18.09,5 HCPCS,A2025,"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure) ",,,198.77,663.0,8 HCPCS,A2026,RESTRATA MINIMATRIX 5MG,1266.0,1266.0,75.96,1076.1,44 HCPCS,A2026,"Restrata minimatrix, 5 mg ",1266.0,1266.0,9.4,14.48,5 HCPCS,A2027,MATRIDERM PER SQCM,3999.0,3999.0,239.94,3399.15,28 HCPCS,A2027,"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure) ",3999.0,3999.0,198.77,306.17,5 HCPCS,A2028,"Micromatrix flex, per mg ",,,950.44,2489.92,8 HCPCS,A2029,"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure) ",,,198.77,1326.0,8 HCPCS,A2030,"Miro3d fibers, per milligram ",,,11.33,306.17,8 HCPCS,A2031,"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,9.4,1591.2,8 HCPCS,A2032,"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,42.59,327.85,8 HCPCS,A2033,MYRIAD MORCELLS 4MG,441.5,441.5,25.26,392.7,164 HCPCS,A2033,"Myriad morcells, 4 milligrams ",,,22.89,35.26,8 HCPCS,A2034,"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure) ",,,22.89,35.26,5 HCPCS,A2035,"Corplex p or theracor p or allacor p, per milligram ",,,3801.84,5856.06,5 HCPCS,A2036,"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1.44,2.22,5 HCPCS,A2037,"G4derm plus/suprello, per milliliter ",,,9.4,14.48,5 HCPCS,A2038,"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure) ",,,71.06,109.46,5 HCPCS,A2039,"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure) ",,,9.4,14.48,5 HCPCS,A4100,"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure) ",150.0,150.0,226.42,348.77,5 HCPCS,A4100,SKIN SUB FDA DEVICE NOC,150.0,150.0,19.5,127.5,23 HCPCS,A4216,"Sterile water, saline and/or dextrose, diluent/flush, 10 ml ",,,0.53,1.16,50 HCPCS,A4217,"Sterile water/saline, 500 ml ",,,4.38,9.61,50 HCPCS,A4221,"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) ",,,25.35,55.62,50 HCPCS,A4222,"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) ",,,48.09,105.5,50 HCPCS,A4224,"Supplies for maintenance of insulin infusion catheter, per week ",,,25.35,55.62,50 HCPCS,A4225,"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each ",,,3.4,7.46,50 HCPCS,A4226,"Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week ",,,1.95,3.0,5 HCPCS,A4233,"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each ",,,0.5,1.1,50 HCPCS,A4234,"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each ",,,2.31,5.07,50 HCPCS,A4235,"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each ",,,0.98,2.15,50 HCPCS,A4236,"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each ",,,1.14,2.49,50 HCPCS,A4238,"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service ",,,175.2,603.53,50 HCPCS,A4239,"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service ",,,267.81,587.55,50 HCPCS,A4248,"Chlorhexidine containing antiseptic, 1 ml ",,,0.02,0.09,8 HCPCS,A4253,"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips ",,,8.15,17.89,50 HCPCS,A4255,"Platforms for home blood glucose monitor, 50 per box ",,,5.47,12.0,50 HCPCS,A4256,"Normal, low and high calibrator solution / chips ",,,3.31,7.27,50 HCPCS,A4257,"Replacement lens shield cartridge for use with laser skin piercing device, each ",,,17.83,39.11,50 HCPCS,A4258,"Spring-powered device for lancet, each ",,,2.08,4.56,50 HCPCS,A4259,"Lancets, per box of 100 ",,,1.39,3.05,50 HCPCS,A4264,Permanent implantable contraceptive intratubal occlusion device(s) and delivery system ,,,1373.07,1750.0,13 HCPCS,A4265,"Paraffin, per pound ",,,4.76,10.45,50 HCPCS,A4271,"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests ",,,33.42,124.63,50 HCPCS,A4280,"Adhesive skin support attachment for use with external breast prosthesis, each ",,,7.46,16.36,45 HCPCS,A4287,"Disposable collection and storage bag for breast milk, any size, any type, each ",,,0.62,0.95,5 HCPCS,A4288,"Valve for breast pump, replacement ",,,8.06,12.41,5 HCPCS,A4290,"Sacral nerve stimulation test lead, each ",,,490.36,529.59,6 HCPCS,A4295,"Intermittent urinary catheter; straight tip, hydrophilic coating, each ",,,2.53,5.55,50 HCPCS,A4296,"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each ",,,8.93,19.59,50 HCPCS,A4297,"Intermittent urinary catheter; hydrophilic coating, with insertion supplies ",,,9.77,21.44,50 HCPCS,A4310,Insertion tray without drainage bag and without catheter (accessories only) ,,,9.17,20.12,50 HCPCS,A4311,"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) ",,,17.96,39.41,50 HCPCS,A4312,"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone ",,,25.19,55.25,50 HCPCS,A4313,"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation ",,,25.87,56.76,50 HCPCS,A4314,"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) ",,,35.31,77.46,50 HCPCS,A4315,"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone ",,,35.92,78.8,50 HCPCS,A4316,"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation ",,,39.66,87.01,50 HCPCS,A4318,"Female external urinary collection cup, with or without ring attachment, per day ",,,8.9,19.52,44 HCPCS,A4320,"Irrigation tray with bulb or piston syringe, any purpose ",,,6.34,13.91,50 HCPCS,A4322,"Irrigation syringe, bulb or piston, each ",,,3.94,8.64,50 HCPCS,A4326,"Male external catheter with integral collection chamber, any type, each ",,,15.06,33.05,50 HCPCS,A4327,"Female external urinary collection device; meatal cup, each ",,,62.3,136.68,50 HCPCS,A4328,"Female external urinary collection device; pouch, each ",,,12.39,27.18,50 HCPCS,A4330,"Perianal fecal collection pouch with adhesive, each ",,,9.89,21.69,50 HCPCS,A4331,"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each ",,,4.44,9.74,50 HCPCS,A4332,"Lubricant, individual sterile packet, each ",,,0.15,0.32,50 HCPCS,A4333,"Urinary catheter anchoring device, adhesive skin attachment, each ",,,3.1,6.79,50 HCPCS,A4334,"Urinary catheter anchoring device, leg strap, each ",,,6.87,15.07,50 HCPCS,A4336,"Incontinence supply, urethral insert, any type, each ",,,2.01,4.41,50 HCPCS,A4338,"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each ",,,17.13,37.58,50 HCPCS,A4340,"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each ",,,44.34,97.29,50 HCPCS,A4341,"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each ",,,340.8,747.66,50 HCPCS,A4342,"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each ",,,860.5,1887.83,50 HCPCS,A4344,"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each ",,,19.0,41.69,50 HCPCS,A4346,"Indwelling catheter; foley type, three way for continuous irrigation, each ",,,23.25,51.0,50 HCPCS,A4349,"Male external catheter, with or without adhesive, disposable, each ",,,2.81,6.17,50 HCPCS,A4351,"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each ",,,2.53,5.55,50 HCPCS,A4352,"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each ",,,8.93,19.59,50 HCPCS,A4353,"Intermittent urinary catheter, with insertion supplies ",,,9.77,21.44,50 HCPCS,A4354,Insertion tray with drainage bag but without catheter ,,,16.49,36.18,50 HCPCS,A4355,"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each ",,,12.46,27.33,50 HCPCS,A4356,"External urethral clamp or compression device (not to be used for catheter clamp), each ",,,54.17,118.85,50 HCPCS,A4357,"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each ",,,11.52,25.28,50 HCPCS,A4358,"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each ",,,7.88,17.29,50 HCPCS,A4360,"Disposable external urethral clamp or compression device, with pad and/or pouch, each ",,,0.59,1.29,50 HCPCS,A4361,"Ostomy faceplate, each ",,,25.64,56.24,50 HCPCS,A4362,"Skin barrier; solid, 4 x 4 or equivalent; each ",,,4.47,9.8,50 HCPCS,A4363,"Ostomy clamp, any type, replacement only, each ",,,3.31,7.27,50 HCPCS,A4364,"Adhesive, liquid or equal, any type, per oz ",,,3.78,8.3,50 HCPCS,A4366,"Ostomy vent, any type, each ",,,1.8,3.96,50 HCPCS,A4367,"Ostomy belt, each ",,,9.51,20.85,50 HCPCS,A4368,"Ostomy filter, any type, each ",,,0.35,0.77,50 HCPCS,A4369,"Ostomy skin barrier, liquid (spray, brush, etc.), per oz ",,,3.39,7.44,50 HCPCS,A4371,"Ostomy skin barrier, powder, per oz ",,,5.1,11.18,50 HCPCS,A4372,"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each ",,,5.87,12.88,50 HCPCS,A4373,"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each ",,,8.76,19.22,50 HCPCS,A4375,"Ostomy pouch, drainable, with faceplate attached, plastic, each ",,,23.98,52.61,50 HCPCS,A4376,"Ostomy pouch, drainable, with faceplate attached, rubber, each ",,,66.45,145.79,50 HCPCS,A4377,"Ostomy pouch, drainable, for use on faceplate, plastic, each ",,,5.99,13.14,50 HCPCS,A4378,"Ostomy pouch, drainable, for use on faceplate, rubber, each ",,,42.94,94.21,50 HCPCS,A4379,"Ostomy pouch, urinary, with faceplate attached, plastic, each ",,,20.97,46.01,50 HCPCS,A4380,"Ostomy pouch, urinary, with faceplate attached, rubber, each ",,,52.14,114.38,50 HCPCS,A4381,"Ostomy pouch, urinary, for use on faceplate, plastic, each ",,,6.46,14.17,50 HCPCS,A4382,"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each ",,,34.39,75.44,50 HCPCS,A4383,"Ostomy pouch, urinary, for use on faceplate, rubber, each ",,,39.37,86.37,50 HCPCS,A4384,"Ostomy faceplate equivalent, silicone ring, each ",,,13.42,29.43,50 HCPCS,A4385,"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each ",,,7.11,15.61,50 HCPCS,A4387,"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each ",,,3.14,6.88,50 HCPCS,A4388,"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each ",,,6.09,13.35,50 HCPCS,A4389,"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each ",,,8.66,19.01,50 HCPCS,A4390,"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each ",,,13.41,29.41,50 HCPCS,A4391,"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each ",,,9.87,21.65,50 HCPCS,A4392,"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each ",,,11.42,25.05,50 HCPCS,A4393,"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each ",,,12.62,27.69,50 HCPCS,A4394,"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce ",,,3.62,7.93,50 HCPCS,A4395,"Ostomy deodorant for use in ostomy pouch, solid, per tablet ",,,0.05,0.11,50 HCPCS,A4396,Ostomy belt with peristomal hernia support ,,,56.54,124.03,50 HCPCS,A4398,"Ostomy irrigation supply; bag, each ",,,16.76,36.77,50 HCPCS,A4399,"Ostomy irrigation supply; cone/catheter, with or without brush ",,,14.56,31.95,50 HCPCS,A4400,Ostomy irrigation set ,,,68.26,149.75,50 HCPCS,A4402,"Lubricant, per ounce ",,,2.22,4.88,50 HCPCS,A4404,"Ostomy ring, each ",,,2.34,5.14,50 HCPCS,A4405,"Ostomy skin barrier, non-pectin based, paste, per ounce ",,,4.77,10.47,50 HCPCS,A4406,"Ostomy skin barrier, pectin-based, paste, per ounce ",,,8.0,17.54,50 HCPCS,A4407,"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each ",,,12.23,26.83,50 HCPCS,A4408,"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each ",,,13.79,30.25,50 HCPCS,A4409,"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each ",,,8.66,19.01,50 HCPCS,A4410,"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each ",,,12.62,27.69,50 HCPCS,A4411,"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each ",,,7.11,15.61,50 HCPCS,A4412,"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each ",,,3.78,8.3,50 HCPCS,A4413,"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each ",,,7.69,16.88,50 HCPCS,A4414,"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each ",,,6.87,15.07,50 HCPCS,A4415,"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each ",,,8.38,18.38,50 HCPCS,A4416,"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each ",,,3.85,8.45,50 HCPCS,A4417,"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each ",,,5.2,11.42,50 HCPCS,A4418,"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each ",,,2.53,5.55,50 HCPCS,A4419,"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each ",,,2.41,5.29,50 HCPCS,A4422,"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each ",,,0.15,0.32,50 HCPCS,A4423,"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each ",,,2.59,5.68,50 HCPCS,A4424,"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each ",,,6.64,14.58,50 HCPCS,A4425,"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each ",,,5.0,10.96,50 HCPCS,A4426,"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each ",,,3.81,8.36,50 HCPCS,A4427,"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each ",,,3.9,8.56,50 HCPCS,A4428,"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each ",,,9.1,19.97,50 HCPCS,A4429,"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each ",,,11.52,25.28,50 HCPCS,A4430,"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each ",,,11.9,26.1,50 HCPCS,A4431,"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each ",,,8.66,19.01,50 HCPCS,A4432,"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each ",,,5.01,10.99,50 HCPCS,A4433,"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each ",,,4.68,10.28,50 HCPCS,A4434,"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each ",,,5.25,11.52,50 HCPCS,A4435,"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each ",,,8.05,17.65,50 HCPCS,A4436,"Irrigation supply; sleeve, reusable, per month ",,,26.78,58.76,50 HCPCS,A4437,"Irrigation supply; sleeve, disposable, per month ",,,26.78,58.76,50 HCPCS,A4438,"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each ",,,2.57,5.63,45 HCPCS,A4450,"Tape, non-waterproof, per 18 square inches ",,,0.1,0.23,50 HCPCS,A4452,"Tape, waterproof, per 18 square inches ",,,0.49,1.07,50 HCPCS,A4453,"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each ",,,13.76,459.35,50 HCPCS,A4455,"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce ",,,1.7,3.72,50 HCPCS,A4456,"Adhesive remover, wipes, any type, each ",,,0.34,0.75,50 HCPCS,A4457,"Enema tube, with or without adapter, any type, replacement only, each ",,,1.86,2.86,5 HCPCS,A4459,"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type ",,,157.21,344.9,45 HCPCS,A4461,"Surgical dressing holder, non-reusable, each ",,,4.61,10.11,50 HCPCS,A4463,"Surgical dressing holder, reusable, each ",,,18.59,40.79,50 HCPCS,A4468,"Exsufflation belt, includes all supplies and accessories ",,,8348.18,12858.88,5 HCPCS,A4479,"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type ",,,692.25,1518.72,44 HCPCS,A4481,"Tracheostoma filter, any type, any size, each ",,,0.5,1.1,50 HCPCS,A4540,"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm ",,,300.09,462.24,5 HCPCS,A4541,Monthly supplies for use of device coded at e0733 ,,,40.25,88.3,50 HCPCS,A4542,Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist ,,,516.31,1132.73,50 HCPCS,A4543,"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month ",,,3752.86,5780.61,5 HCPCS,A4544,Electrode for external lower extremity nerve stimulator for restless legs syndrome ,,,6.21,13.63,50 HCPCS,A4545,"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month ",,,37.77,82.86,50 HCPCS,A4556,"Electrodes, (e.g., apnea monitor), per pair ",,,16.96,37.22,50 HCPCS,A4557,"Lead wires, (e.g., apnea monitor), per pair ",,,11.8,34.06,50 HCPCS,A4558,"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz ",,,6.47,14.19,50 HCPCS,A4559,"Coupling gel or paste, for use with ultrasound device, per oz ",,,0.13,0.28,50 HCPCS,A4560,"Neuromuscular electrical stimulator (nmes), disposable, replacement only ",,,611.2,941.44,5 HCPCS,A4561,"Pessary, reusable, rubber, any type ",,,28.74,63.06,45 HCPCS,A4562,"Pessary, reusable, non rubber, any type ",,,71.5,156.86,45 HCPCS,A4563,"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each ",,,87.53,3632.53,50 HCPCS,A4564,"Pessary, disposable, any type ",,,19.05,29.34,5 HCPCS,A4565,SLING ORTHO ARM,1894.0,1894.0,113.64,1609.9,38 HCPCS,A4565,Slings ,1894.0,1894.0,10.76,23.61,50 HCPCS,A4593,"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller ",,,27.37,109.63,50 HCPCS,A4594,"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each ",,,731.48,6654.51,50 HCPCS,A4595,"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) ",,,12.58,42.59,50 HCPCS,A4596,"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month ",,,40.25,1518.45,50 HCPCS,A4602,"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each ",,,5.2,11.42,50 HCPCS,A4604,Tubing with integrated heating element for use with positive airway pressure device ,,,48.53,106.47,50 HCPCS,A4605,"Tracheal suction catheter, closed system, each ",,,22.91,50.27,50 HCPCS,A4608,"Transtracheal oxygen catheter, each ",,,70.01,153.6,50 HCPCS,A4614,"Peak expiratory flow rate meter, hand held ",,,33.21,72.86,50 HCPCS,A4615,"Cannula, nasal ",,,1.02,2.24,50 HCPCS,A4616,"Tubing (oxygen), per foot ",,,0.08,0.17,50 HCPCS,A4617,Mouth piece ,,,4.33,9.5,50 HCPCS,A4618,Breathing circuits ,,,10.56,23.18,50 HCPCS,A4619,Face tent ,,,2.52,5.53,50 HCPCS,A4620,Variable concentration mask ,,,0.84,1.85,50 HCPCS,A4623,"Tracheostomy, inner cannula ",,,7.79,17.09,50 HCPCS,A4624,"Tracheal suction catheter, any type other than closed system, each ",,,3.68,8.08,50 HCPCS,A4625,Tracheostomy care kit for new tracheostomy ,,,9.67,21.22,50 HCPCS,A4626,"Tracheostomy cleaning brush, each ",,,3.78,8.3,50 HCPCS,A4628,"Oral and/or oropharyngeal suction catheter, each ",,,5.12,11.22,50 HCPCS,A4629,Tracheostomy care kit for established tracheostomy ,,,6.5,14.25,50 HCPCS,A4630,"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient ",,,8.7,19.09,50 HCPCS,A4633,"Replacement bulb/lamp for ultraviolet light therapy system, each ",,,57.32,125.75,50 HCPCS,A4635,"Underarm pad, crutch, replacement, each ",,,6.07,13.31,50 HCPCS,A4636,"Replacement, handgrip, cane, crutch, or walker, each ",,,3.89,8.54,50 HCPCS,A4637,"Replacement, tip, cane, crutch, walker, each. ",,,2.16,4.73,50 HCPCS,A4639,"Replacement pad for infrared heating pad system, each ",,,40.12,88.02,50 HCPCS,A4640,Replacement pad for use with medically necessary alternating pressure pad owned by patient ,,,60.97,133.75,50 HCPCS,A4642,"Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries ",,,3339.84,4305.91,3 HCPCS,A4648,MARKER FDCL 1.0MM 3MM,1601.0,1601.0,208.13,1360.85,28 HCPCS,A4648,MARKER FDCL 1.2MM 3MM,1512.0,1512.0,196.56,1285.2,28 HCPCS,A4725,DELFLEX 1.5%DEX 5L INJ,142.8,142.8,8.57,121.38,33 HCPCS,A4725,DELFLEX 2.5%DEXT 5L INJ,142.8,142.8,8.57,121.38,33 HCPCS,A4725,DELFLEX 4.25%DEXT 5L INJ,154.22,154.22,9.25,131.09,33 HCPCS,A4802,"Protamine sulfate, for hemodialysis, per 50 mg ",,,11.78,42.37,8 HCPCS,A5051,"Ostomy pouch, closed; with barrier attached (1 piece), each ",,,2.88,6.32,50 HCPCS,A5052,"Ostomy pouch, closed; without barrier attached (1 piece), each ",,,2.08,4.56,50 HCPCS,A5053,"Ostomy pouch, closed; for use on faceplate, each ",,,2.28,5.01,50 HCPCS,A5054,"Ostomy pouch, closed; for use on barrier with flange (2 piece), each ",,,2.51,5.5,50 HCPCS,A5055,Stoma cap ,,,1.95,4.28,50 HCPCS,A5056,"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each ",,,6.53,14.32,50 HCPCS,A5057,"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each ",,,13.41,29.41,50 HCPCS,A5061,"Ostomy pouch, drainable; with barrier attached, (1 piece), each ",,,4.94,10.84,50 HCPCS,A5062,"Ostomy pouch, drainable; without barrier attached (1 piece), each ",,,2.9,6.36,50 HCPCS,A5063,"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each ",,,3.78,8.3,50 HCPCS,A5071,"Ostomy pouch, urinary; with barrier attached (1 piece), each ",,,8.4,18.43,50 HCPCS,A5072,"Ostomy pouch, urinary; without barrier attached (1 piece), each ",,,4.81,10.56,50 HCPCS,A5073,"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each ",,,4.44,9.74,50 HCPCS,A5081,"Stoma plug or seal, any type ",,,3.93,8.62,50 HCPCS,A5082,Continent device; catheter for continent stoma ,,,16.62,36.46,50 HCPCS,A5083,"Continent device, stoma absorptive cover for continent stoma ",,,0.9,1.98,50 HCPCS,A5093,Ostomy accessory; convex insert ,,,2.72,5.98,50 HCPCS,A5102,"Bedside drainage bottle with or without tubing, rigid or expandable, each ",,,31.28,68.63,50 HCPCS,A5105,"Urinary suspensory with leg bag, with or without tube, each ",,,56.95,124.94,50 HCPCS,A5112,"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each ",,,41.11,90.19,50 HCPCS,A5113,"Leg strap; latex, replacement only, per set ",,,5.59,12.25,50 HCPCS,A5114,"Leg strap; foam or fabric, replacement only, per set ",,,12.49,27.41,50 HCPCS,A5120,"Skin barrier, wipes or swabs, each ",,,0.34,0.75,50 HCPCS,A5121,"Skin barrier; solid, 6 x 6 or equivalent, each ",,,9.97,21.87,50 HCPCS,A5122,"Skin barrier; solid, 8 x 8 or equivalent, each ",,,15.25,33.45,50 HCPCS,A5126,Adhesive or non-adhesive; disk or foam pad ,,,1.83,4.02,50 HCPCS,A5131,"Appliance cleaner, incontinence and ostomy appliances, per 16 oz. ",,,22.14,48.57,50 HCPCS,A5200,"Percutaneous catheter/tube anchoring device, adhesive skin attachment ",,,15.78,34.62,50 HCPCS,A5500,"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe ",,,88.82,194.85,50 HCPCS,A5501,"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe ",,,266.36,584.37,50 HCPCS,A5503,"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe ",,,44.06,98.45,50 HCPCS,A5504,"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe ",,,44.06,98.45,50 HCPCS,A5505,"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe ",,,44.06,98.45,50 HCPCS,A5506,"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe ",,,44.06,98.45,50 HCPCS,A5507,"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe ",,,44.06,98.45,50 HCPCS,A5512,"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer",,,36.22,79.46,50 HCPCS,A5513,"For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durom",,,54.06,118.59,50 HCPCS,A5514,"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, incl",,,54.06,118.59,50 HCPCS,A6010,"Collagen based wound filler, dry form, sterile, per gram of collagen ",,,43.26,94.9,50 HCPCS,A6011,"Collagen based wound filler, gel/paste, per gram of collagen ",,,3.19,6.99,50 HCPCS,A6021,"Collagen dressing, sterile, size 16 sq. in. or less, each ",,,29.37,64.44,50 HCPCS,A6022,"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each ",,,29.37,64.44,50 HCPCS,A6023,"Collagen dressing, sterile, size more than 48 sq. in., each ",,,265.8,583.12,50 HCPCS,A6024,"Collagen dressing wound filler, sterile, per 6 inches ",,,8.63,18.94,50 HCPCS,A6154,"Wound pouch, each ",,,19.46,42.7,50 HCPCS,A6196,"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing ",,,10.28,22.55,50 HCPCS,A6197,"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ",,,22.97,50.4,50 HCPCS,A6199,"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches ",,,7.37,16.17,50 HCPCS,A6203,"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,4.7,10.32,50 HCPCS,A6204,"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ",,,8.68,19.05,50 HCPCS,A6207,"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ",,,10.26,22.51,50 HCPCS,A6209,"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,10.44,22.9,50 HCPCS,A6210,"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,27.83,61.06,50 HCPCS,A6211,"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ",,,41.02,90.0,50 HCPCS,A6212,"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,13.56,29.76,50 HCPCS,A6214,"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing ",,,14.39,31.56,50 HCPCS,A6216,"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,0.05,0.11,50 HCPCS,A6219,"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,1.33,2.92,50 HCPCS,A6220,"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ",,,3.62,7.93,50 HCPCS,A6222,"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,2.98,6.54,50 HCPCS,A6223,"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,3.39,7.44,50 HCPCS,A6224,"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ",,,5.03,11.03,50 HCPCS,A6229,"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,5.03,11.03,50 HCPCS,A6231,"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing ",,,6.53,14.32,50 HCPCS,A6232,"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing ",,,9.58,21.03,50 HCPCS,A6233,"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing ",,,26.78,58.76,50 HCPCS,A6234,"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,9.14,20.06,50 HCPCS,A6235,"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,23.49,51.54,50 HCPCS,A6236,"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ",,,38.05,83.48,50 HCPCS,A6237,"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,11.04,24.23,50 HCPCS,A6238,"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ",,,31.85,69.88,50 HCPCS,A6240,"Hydrocolloid dressing, wound filler, paste, sterile, per ounce ",,,17.1,37.52,50 HCPCS,A6241,"Hydrocolloid dressing, wound filler, dry form, sterile, per gram ",,,3.59,7.87,50 HCPCS,A6242,"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,8.46,18.55,50 HCPCS,A6243,"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,17.21,37.75,50 HCPCS,A6244,"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ",,,54.87,120.38,50 HCPCS,A6245,"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,10.15,22.27,50 HCPCS,A6246,"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ",,,13.88,30.44,50 HCPCS,A6247,"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing ",,,33.21,72.86,50 HCPCS,A6248,"Hydrogel dressing, wound filler, gel, per fluid ounce ",,,22.69,49.77,50 HCPCS,A6251,"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,2.78,6.11,50 HCPCS,A6252,"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,4.55,9.98,50 HCPCS,A6253,"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ",,,8.85,19.41,50 HCPCS,A6254,"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ",,,1.67,3.65,50 HCPCS,A6255,"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ",,,4.25,9.33,50 HCPCS,A6257,"Transparent film, sterile, 16 sq. in. or less, each dressing ",,,2.14,4.69,50 HCPCS,A6258,"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ",,,6.02,13.2,50 HCPCS,A6259,"Transparent film, sterile, more than 48 sq. in., each dressing ",,,15.28,33.52,50 HCPCS,A6266,"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard ",,,2.67,5.85,50 HCPCS,A6402,"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,0.15,0.32,50 HCPCS,A6403,"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing ",,,0.57,1.25,50 HCPCS,A6407,"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard ",,,2.61,5.72,50 HCPCS,A6410,"Eye pad, sterile, each ",,,0.52,1.14,50 HCPCS,A6441,"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard ",,,0.95,2.09,50 HCPCS,A6442,"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard ",,,0.22,0.49,50 HCPCS,A6443,"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard ",,,0.39,0.86,50 HCPCS,A6444,"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard ",,,0.78,1.72,50 HCPCS,A6445,"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard ",,,0.44,0.97,50 HCPCS,A6446,"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard ",,,0.54,1.18,50 HCPCS,A6447,"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard ",,,0.95,2.09,50 HCPCS,A6448,"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard ",,,1.61,3.53,50 HCPCS,A6449,"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard ",,,2.45,5.38,50 HCPCS,A6450,"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard ",,,2.45,5.38,50 HCPCS,A6451,"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yar",,,2.45,5.38,50 HCPCS,A6452,"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inche",,,8.23,18.06,50 HCPCS,A6453,"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard ",,,0.88,1.94,50 HCPCS,A6454,"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard ",,,1.1,2.41,50 HCPCS,A6455,"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard ",,,1.95,4.28,50 HCPCS,A6456,"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard ",,,1.75,3.85,50 HCPCS,A6457,"Tubular dressing with or without elastic, any width, per linear yard ",,,1.59,3.48,50 HCPCS,A6460,"Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ",,,1.79,2.75,5 HCPCS,A6461,"Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ",,,2.93,4.51,5 HCPCS,A6515,"Gradient compression wrap with adjustable straps, full leg, each, custom ",,,392.88,605.16,5 HCPCS,A6516,"Gradient compression wrap with adjustable straps, foot, each, custom ",,,51.46,79.27,5 HCPCS,A6517,"Gradient compression wrap with adjustable straps, below knee, each, custom ",,,112.63,173.49,5 HCPCS,A6518,"Gradient compression wrap with adjustable straps, arm, each, custom ",,,171.52,264.19,5 HCPCS,A6519,"Gradient compression garment, not otherwise specified, for nighttime use, each ",,,3.1,4.77,5 HCPCS,A6520,"Gradient compression garment, glove, padded, for nighttime use, each ",,,123.92,271.87,50 HCPCS,A6521,"Gradient compression garment, glove, padded, for nighttime use, custom, each ",,,491.71,1078.76,50 HCPCS,A6522,"Gradient compression garment, arm, padded, for nighttime use, each ",,,301.11,660.61,50 HCPCS,A6523,"Gradient compression garment, arm, padded, for nighttime use, custom, each ",,,714.44,1567.39,50 HCPCS,A6524,"Gradient compression garment, lower leg and foot, padded, for nighttime use, each ",,,375.67,824.18,50 HCPCS,A6525,"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each ",,,758.42,1663.88,50 HCPCS,A6526,"Gradient compression garment, full leg and foot, padded, for nighttime use, each ",,,679.2,1490.08,50 HCPCS,A6527,"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each ",,,1248.96,2740.07,50 HCPCS,A6528,"Gradient compression garment, bra, for nighttime use, each ",,,653.09,1432.8,50 HCPCS,A6529,"Gradient compression garment, bra, for nighttime use, custom, each ",,,1031.98,2264.04,50 HCPCS,A6530,"Gradient compression stocking, below knee, 18-30 mmhg, each ",,,38.29,84.0,45 HCPCS,A6531,"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each ",,,60.43,132.57,50 HCPCS,A6532,"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each ",,,85.14,186.79,50 HCPCS,A6533,"Gradient compression stocking, thigh length, 18-30 mmhg, each ",,,53.76,117.95,45 HCPCS,A6534,"Gradient compression stocking, thigh length, 30-40 mmhg, each ",,,61.4,134.7,45 HCPCS,A6535,"Gradient compression stocking, thigh length, 40 mmhg or greater, each ",,,70.69,155.08,45 HCPCS,A6536,"Gradient compression stocking, full length/chap style, 18-30 mmhg, each ",,,72.47,158.99,45 HCPCS,A6537,"Gradient compression stocking, full length/chap style, 30-40 mmhg, each ",,,85.92,188.49,45 HCPCS,A6538,"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each ",,,100.6,220.7,45 HCPCS,A6539,"Gradient compression stocking, waist length, 18-30 mmhg, each ",,,95.9,210.4,45 HCPCS,A6540,"Gradient compression stocking, waist length, 30-40 mmhg, each ",,,114.35,250.86,45 HCPCS,A6541,"Gradient compression stocking, waist length, 40 mmhg or greater, each ",,,135.45,297.15,45 HCPCS,A6544,"Gradient compression stocking, garter belt ",,,38.12,83.63,44 HCPCS,A6545,"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each ",,,118.98,261.03,50 HCPCS,A6548,"Accessory to custom gradient compression garment, silicone band, any size ",,,20.44,44.85,44 HCPCS,A6550,"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories ",,,30.72,67.4,50 HCPCS,A6552,"Gradient compression stocking, below knee, 30-40 mmhg, each ",,,56.81,124.64,50 HCPCS,A6553,"Gradient compression stocking, below knee, 30-40 mmhg, custom, each ",,,221.85,486.72,50 HCPCS,A6554,"Gradient compression stocking, below knee, 40 mmhg or greater, each ",,,78.13,171.4,50 HCPCS,A6555,"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each ",,,221.85,486.72,50 HCPCS,A6556,"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each ",,,304.05,667.04,50 HCPCS,A6557,"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each ",,,304.05,667.04,50 HCPCS,A6558,"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each ",,,313.77,688.37,50 HCPCS,A6559,"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each ",,,9.3,14.32,5 HCPCS,A6560,"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each ",,,50.22,77.35,5 HCPCS,A6561,"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each ",,,98.59,151.86,5 HCPCS,A6562,"Gradient compression stocking, waist length, 18-30 mmhg, custom, each ",,,995.06,2183.05,50 HCPCS,A6563,"Gradient compression stocking, waist length, 30-40 mmhg, custom, each ",,,995.06,2183.05,50 HCPCS,A6564,"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each ",,,1071.9,2351.63,50 HCPCS,A6565,"Gradient compression gauntlet, custom, each ",,,171.94,377.22,50 HCPCS,A6566,"Gradient compression garment, neck/head, each ",,,249.66,547.71,50 HCPCS,A6567,"Gradient compression garment, neck/head, custom, each ",,,784.41,1720.9,50 HCPCS,A6568,"Gradient compression garment, torso and shoulder, each ",,,162.93,357.46,50 HCPCS,A6569,"Gradient compression garment, torso/shoulder, custom, each ",,,927.81,2035.49,50 HCPCS,A6570,"Gradient compression garment, genital region, each ",,,111.01,243.55,50 HCPCS,A6571,"Gradient compression garment, genital region, custom, each ",,,667.22,1463.81,50 HCPCS,A6572,"Gradient compression garment, toe caps, each ",,,103.01,225.99,50 HCPCS,A6573,"Gradient compression garment, toe caps, custom, each ",,,244.44,536.27,50 HCPCS,A6574,"Gradient compression arm sleeve and glove combination, custom, each ",,,311.63,683.68,50 HCPCS,A6575,"Gradient compression arm sleeve and glove combination, each ",,,100.99,221.56,50 HCPCS,A6576,"Gradient compression arm sleeve, custom, medium weight, each ",,,191.26,419.59,50 HCPCS,A6577,"Gradient compression arm sleeve, custom, heavy weight, each ",,,158.3,347.29,50 HCPCS,A6578,"Gradient compression arm sleeve, each ",,,77.96,171.03,50 HCPCS,A6579,"Gradient compression glove, custom, medium weight, each ",,,306.99,673.51,50 HCPCS,A6580,"Gradient compression glove, custom, heavy weight, each ",,,304.74,668.56,50 HCPCS,A6581,"Gradient compression glove, each ",,,71.53,156.93,50 HCPCS,A6582,"Gradient compression gauntlet, each ",,,47.71,104.66,50 HCPCS,A6583,"Gradient compression wrap with adjustable straps, below knee, each ",,,156.93,344.28,50 HCPCS,A6584,"Gradient compression wrap with adjustable straps, not otherwise specified ",,,122.71,189.01,5 HCPCS,A6585,"Gradient compression wrap with adjustable straps, above knee, each ",,,185.81,407.64,50 HCPCS,A6586,"Gradient compression wrap with adjustable straps, full leg, each ",,,547.42,1200.97,50 HCPCS,A6587,"Gradient compression wrap with adjustable straps, foot, each ",,,71.71,157.32,50 HCPCS,A6588,"Gradient compression wrap with adjustable straps, arm, each ",,,238.99,524.32,50 HCPCS,A6589,"Gradient pressure wrap with adjustable straps, bra, each ",,,94.34,206.98,50 HCPCS,A6590,"External urinary catheters; disposable, with wicking material, for use with suction pump, per month ",,,371.62,815.28,50 HCPCS,A6591,"External urinary catheter; non-disposable, for use with suction pump, per month ",,,88.83,194.88,50 HCPCS,A6594,"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each ",,,34.35,75.36,50 HCPCS,A6595,"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each ",,,33.79,74.13,50 HCPCS,A6596,"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each ",,,0.18,0.39,50 HCPCS,A6597,"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each ",,,1.52,3.33,50 HCPCS,A6598,"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each ",,,0.73,1.61,50 HCPCS,A6599,"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each ",,,1.67,3.65,50 HCPCS,A6600,"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each ",,,3.01,6.6,50 HCPCS,A6601,"Gradient compression bandaging supply, high density foam pad, any size or shape, each ",,,3.38,7.42,50 HCPCS,A6602,"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each ",,,4.93,10.81,50 HCPCS,A6603,"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each ",,,2.31,5.07,50 HCPCS,A6604,"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each ",,,1.35,2.97,50 HCPCS,A6605,"Gradient compression bandaging supply, padded foam, per linear yard, any width, each ",,,1.54,3.38,50 HCPCS,A6606,"Gradient compression bandaging supply, padded textile, per linear yard, any width, each ",,,4.58,10.04,50 HCPCS,A6607,"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each ",,,1.23,2.69,50 HCPCS,A6608,"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each ",,,5.11,11.2,50 HCPCS,A6610,"Gradient compression stocking, below knee, 18-30 mmhg, custom, each ",,,221.85,486.72,50 HCPCS,A6611,"Gradient compression wrap with adjustable straps, above knee, each, custom ",,,133.35,205.4,5 HCPCS,A7000,"Canister, disposable, used with suction pump, each ",,,10.32,22.64,50 HCPCS,A7001,"Canister, non-disposable, used with suction pump, each ",,,39.26,86.13,50 HCPCS,A7002,"Tubing, used with suction pump, each ",,,4.56,10.0,50 HCPCS,A7003,"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable ",,,1.9,4.47,50 HCPCS,A7004,"Small volume nonfiltered pneumatic nebulizer, disposable ",,,1.54,3.38,50 HCPCS,A7005,"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable ",,,13.71,41.45,50 HCPCS,A7006,"Administration set, with small volume filtered pneumatic nebulizer ",,,8.14,18.03,50 HCPCS,A7007,"Large volume nebulizer, disposable, unfilled, used with aerosol compressor ",,,3.65,8.0,50 HCPCS,A7008,"Large volume nebulizer, disposable, prefilled, used with aerosol compressor ",,,13.05,28.64,50 HCPCS,A7009,"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer ",,,54.53,119.63,50 HCPCS,A7010,"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet ",,,17.26,38.28,50 HCPCS,A7012,"Water collection device, used with large volume nebulizer ",,,3.19,6.99,50 HCPCS,A7013,"Filter, disposable, used with aerosol compressor or ultrasonic generator ",,,0.63,1.38,50 HCPCS,A7014,"Filter, nondisposable, used with aerosol compressor or ultrasonic generator ",,,3.74,8.21,50 HCPCS,A7015,"Aerosol mask, used with dme nebulizer ",,,1.5,3.4,50 HCPCS,A7016,"Dome and mouthpiece, used with small volume ultrasonic nebulizer ",,,9.12,20.02,50 HCPCS,A7017,"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen ",,,128.2,281.26,50 HCPCS,A7018,"Water, distilled, used with large volume nebulizer, 1000 ml ",,,0.37,0.82,50 HCPCS,A7020,"Interface for cough stimulating device, includes all components, replacement only ",,,19.47,42.72,50 HCPCS,A7021,"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter) ",,,132.87,291.5,50 HCPCS,A7023,"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical ",,,7.91,12.19,5 HCPCS,A7025,"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each ",,,60.75,133.28,50 HCPCS,A7026,"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each ",,,40.14,88.06,50 HCPCS,A7027,"Combination oral/nasal mask, used with continuous positive airway pressure device, each ",,,144.2,325.01,50 HCPCS,A7028,"Oral cushion for combination oral/nasal mask, replacement only, each ",,,40.04,90.34,50 HCPCS,A7029,"Nasal pillows for combination oral/nasal mask, replacement only, pair ",,,18.96,41.6,50 HCPCS,A7030,"Full face mask used with positive airway pressure device, each ",,,107.46,274.35,50 HCPCS,A7031,"Face mask interface, replacement for full face mask, each ",,,40.87,102.43,50 HCPCS,A7032,"Cushion for use on nasal mask interface, replacement only, each ",,,22.96,58.73,50 HCPCS,A7033,"Pillow for use on nasal cannula type interface, replacement only, pair ",,,18.98,43.53,50 HCPCS,A7034,"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap ",,,68.6,171.27,50 HCPCS,A7035,Headgear used with positive airway pressure device ,,,22.11,52.6,50 HCPCS,A7036,Chinstrap used with positive airway pressure device ,,,12.74,27.95,50 HCPCS,A7037,Tubing used with positive airway pressure device ,,,14.45,49.26,50 HCPCS,A7038,"Filter, disposable, used with positive airway pressure device ",,,2.58,7.12,50 HCPCS,A7039,"Filter, non disposable, used with positive airway pressure device ",,,7.53,18.85,50 HCPCS,A7040,One way chest drain valve ,,,56.8,124.61,45 HCPCS,A7041,Water seal drainage container and tubing for use with implanted chest tube ,,,106.75,234.2,45 HCPCS,A7044,"Oral interface used with positive airway pressure device, each ",,,97.65,214.23,50 HCPCS,A7045,"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only ",,,14.02,31.32,50 HCPCS,A7046,"Water chamber for humidifier, used with positive airway pressure device, replacement, each ",,,15.93,34.96,50 HCPCS,A7047,"Oral interface used with respiratory suction pump, each ",,,168.86,370.47,50 HCPCS,A7048,"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each ",,,59.41,130.33,45 HCPCS,A7049,Expiratory positive airway pressure intranasal resistance valve ,,,109.94,169.34,5 HCPCS,A7501,"Tracheostoma valve, including diaphragm, each ",,,146.67,321.77,50 HCPCS,A7502,"Replacement diaphragm/faceplate for tracheostoma valve, each ",,,69.73,152.97,50 HCPCS,A7503,"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each ",,,15.85,34.77,50 HCPCS,A7504,"Filter for use in a tracheostoma heat and moisture exchange system, each ",,,0.95,2.09,50 HCPCS,A7505,"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each ",,,6.55,14.36,50 HCPCS,A7506,"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each ",,,0.45,0.99,50 HCPCS,A7507,"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each ",,,3.49,7.65,50 HCPCS,A7508,"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each ",,,4.01,8.79,50 HCPCS,A7509,"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each ",,,1.97,4.32,50 HCPCS,A7520,"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each ",,,66.31,145.47,50 HCPCS,A7521,"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each ",,,65.7,144.14,50 HCPCS,A7522,"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each ",,,63.07,138.37,50 HCPCS,A7524,"Tracheostoma stent/stud/button, each ",,,108.12,237.21,50 HCPCS,A7525,"Tracheostomy mask, each ",,,2.88,6.32,50 HCPCS,A7526,"Tracheostomy tube collar/holder, each ",,,4.73,10.38,50 HCPCS,A7527,"Tracheostomy/laryngectomy tube plug/stop, each ",,,5.0,10.96,50 HCPCS,A8000,"Helmet, protective, soft, prefabricated, includes all components and accessories ",,,214.2,469.93,50 HCPCS,A8001,"Helmet, protective, hard, prefabricated, includes all components and accessories ",,,214.2,469.93,50 HCPCS,A9154,"Artificial saliva, 1 ml ",,,0.71,1.15,8 HCPCS,A9156,"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml ",,,4.74,7.71,8 HCPCS,A9180,"Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker ",,,2.2,4.43,8 HCPCS,A9293,"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer) ",,,42.8,65.93,5 HCPCS,A9500,TC99M SESTAMIBI DX DOSE,5135.81,5135.81,308.15,4365.44,41 HCPCS,A9500,"Technetium tc-99m sestamibi, diagnostic, per study dose ",5135.81,5135.81,240.23,367.55,8 HCPCS,A9502,"Technetium tc-99m tetrofosmin, diagnostic, per study dose ",,,190.26,271.38,8 HCPCS,A9503,TC99M MEDRONATE DX 30MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9503,"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries ",1099.56,1099.56,25.38,41.37,8 HCPCS,A9504,"Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries ",,,995.49,1283.44,3 HCPCS,A9505,TL201 THALLOUS CL DX MCI,5060.92,5060.92,303.66,4301.78,41 HCPCS,A9505,"Thallium tl-201 thallous chloride, diagnostic, per millicurie ",5060.92,5060.92,80.61,409.86,8 HCPCS,A9506,"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible ",,,612.46,843.7,5 HCPCS,A9507,"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries ",,,8581.7,13989.86,8 HCPCS,A9508,"Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie ",,,1442.91,2733.34,8 HCPCS,A9509,I123 SODIUM IOD DX 1 MCI,772.75,772.75,46.37,656.84,41 HCPCS,A9509,"Iodine i-123 sodium iodide, diagnostic, per millicurie ",772.75,772.75,347.37,4863.43,8 HCPCS,A9510,"Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries ",,,136.65,222.77,8 HCPCS,A9512,TC99M PERTECHNETA DX MCI,203.12,203.12,12.19,172.65,41 HCPCS,A9512,"Technetium tc-99m pertechnetate, diagnostic, per millicurie ",203.12,203.12,4.19,10.61,8 HCPCS,A9513,"Lutetium lu 177, dotatate, therapeutic, 1 millicurie ",,,479.22,970.73,8 HCPCS,A9513,"Lutetium lu 177, dotatate, therapeutic, 1 millicurie Chemotherapy Drugs",,,,,0 HCPCS,A9515,"Choline c-11, diagnostic, per study dose up to 20 millicuries ",,,9760.8,15912.0,8 HCPCS,A9516,I123 SOD DX 100-999 UCI,2768.75,2768.75,166.13,2353.44,41 HCPCS,A9516,"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries ",2768.75,2768.75,262.23,486.35,8 HCPCS,A9517,"Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie ",,,40.55,253.94,8 HCPCS,A9520,"Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries ",,,917.12,2105.41,8 HCPCS,A9521,TC99M EXAMETAZM DX 25MCI,5585.17,5585.17,335.11,4747.39,41 HCPCS,A9521,"Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries ",5585.17,5585.17,2842.27,5454.54,8 HCPCS,A9524,"Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries ",,,154.55,1189.44,8 HCPCS,A9526,"Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries ",,,1171.3,2097.2,8 HCPCS,A9527,"Iodine i-125, sodium iodide solution, therapeutic, per millicurie ",,,423.21,545.63,3 HCPCS,A9528,I131 SOD IOD CAP DX MCI,300.71,300.71,18.04,255.6,41 HCPCS,A9528,"Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie ",300.71,300.71,91.71,250.5,8 HCPCS,A9529,"Iodine i-131 sodium iodide solution, diagnostic, per millicurie ",,,213.64,294.3,5 HCPCS,A9530,"Iodine i-131 sodium iodide solution, therapeutic, per millicurie ",,,18.93,29.17,8 HCPCS,A9531,"Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries) ",,,8.64,25.89,8 HCPCS,A9532,"Iodine i-125 serum albumin, diagnostic, per 5 microcuries ",,,421.88,761.4,8 HCPCS,A9536,"Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries ",,,1595.07,2056.45,3 HCPCS,A9537,TC99M MEBROFEN DX 15MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9537,"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries ",1099.56,1099.56,108.0,176.03,8 HCPCS,A9538,TC99M PYROPHOS DX 25MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9538,"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries ",1099.56,1099.56,97.61,203.83,8 HCPCS,A9539,TC99M PENTETATE DX 25MCI,1338.99,1338.99,80.34,1138.14,41 HCPCS,A9539,"Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries ",1338.99,1338.99,61.17,99.72,8 HCPCS,A9540,TC99M MACRO ALB DX 10MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9540,"Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries ",1099.56,1099.56,58.56,95.47,8 HCPCS,A9541,TC99M SULFUR CO DX 20MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9541,"Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries ",1099.56,1099.56,104.39,850.86,8 HCPCS,A9542,"Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries ",,,6832.56,10558.45,8 HCPCS,A9543,"Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries ",,,106889.21,212599.11,8 HCPCS,A9546,"Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie ",,,2.66,636.74,8 HCPCS,A9547,IN111 OXYQUINO DX 0.5MCI,7955.63,7955.63,477.34,6762.29,36 HCPCS,A9547,"Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie ",7955.63,7955.63,3490.7,6698.89,8 HCPCS,A9548,IN111 PENTETAT DX 0.5MCI,3122.79,3122.79,187.37,2654.37,36 HCPCS,A9548,"Indium in-111 pentetate, diagnostic, per 0.5 millicurie ",3122.79,3122.79,806.62,2818.02,8 HCPCS,A9551,"Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries ",,,1170.16,1907.6,8 HCPCS,A9552,F18 FDG DX 45MCI,1325.37,1325.37,79.52,1126.56,44 HCPCS,A9552,"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries ",1325.37,1325.37,382.2,526.5,5 HCPCS,A9553,"Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries ",,,859.08,1516.7,8 HCPCS,A9554,"Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries ",,,68.33,119.34,8 HCPCS,A9555,"Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries ",,,509.6,1199.39,8 HCPCS,A9556,GA67 CITRATE DX 1 MCI,2582.66,2582.66,154.96,2195.26,41 HCPCS,A9556,"Gallium ga-67 citrate, diagnostic, per millicurie ",2582.66,2582.66,234.59,429.69,8 HCPCS,A9557,"Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries ",,,726.38,11667.71,8 HCPCS,A9558,XENON XE133 GAS DX 10MCI,1099.56,1099.56,65.97,934.63,41 HCPCS,A9558,"Xenon xe-133 gas, diagnostic, per 10 millicuries ",1099.56,1099.56,409.39,811.82,8 HCPCS,A9559,"Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie ",,,173.64,537.92,8 HCPCS,A9560,TC99M LABEL RBC DX 30MCI,2221.81,2221.81,133.31,1888.54,41 HCPCS,A9560,"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries ",2221.81,2221.81,182.34,297.24,8 HCPCS,A9561,"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries ",,,85.89,140.03,8 HCPCS,A9562,TC99M MERTIATID DX 15MCI,2162.8,2162.8,129.77,1838.38,41 HCPCS,A9562,"Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries ",2162.8,2162.8,1512.49,2083.54,5 HCPCS,A9563,"Sodium phosphate p-32, therapeutic, per millicurie ",,,595.17,970.23,8 HCPCS,A9564,"Chromic phosphate p-32 suspension, therapeutic, per millicurie ",,,311.43,781.11,8 HCPCS,A9567,"Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries ",,,41.91,54.04,3 HCPCS,A9568,"Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries ",,,2391.59,3334.5,8 HCPCS,A9569,TC99M AUTO WBC DX DOSE,1081.41,1081.41,64.88,919.2,36 HCPCS,A9569,"Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose ",1081.41,1081.41,2842.27,5454.54,8 HCPCS,A9570,"Indium in-111 labeled autologous white blood cells, diagnostic, per study dose ",,,6981.42,13397.78,8 HCPCS,A9571,"Indium in-111 labeled autologous platelets, diagnostic, per study dose ",,,6981.42,13397.78,8 HCPCS,A9572,IN111 PENTETREOT DX 6MCI,1116.58,1116.58,66.99,949.09,36 HCPCS,A9572,"Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries ",1116.58,1116.58,11080.47,15263.91,5 HCPCS,A9573,"Injection, gadopiclenol, 1 ml ",,,3.22,29.7,10 HCPCS,A9575,DOTAREM 15 ML INJ,394.99,394.99,23.7,335.74,24 HCPCS,A9575,DOTAREM 20 ML INJ,1041.01,1041.01,62.46,884.86,24 HCPCS,A9575,"Injection, gadoterate meglumine, 0.1 ml ",,,0.09,0.54,10 HCPCS,A9576,"Injection, gadoteridol, (prohance multipack), per ml ",,,1.39,4.43,10 HCPCS,A9577,"Injection, gadobenate dimeglumine (multihance), per ml ",,,1.79,5.83,10 HCPCS,A9577,MULTIHANCE 15 ML INJ,111.45,111.45,6.69,94.73,24 HCPCS,A9577,MULTIHANCE 20 ML INJ,148.6,148.6,8.92,126.31,24 HCPCS,A9578,"Injection, gadobenate dimeglumine (multihance multipack), per ml ",,,1.72,5.83,10 HCPCS,A9579,"Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml ",,,1.45,4.78,10 HCPCS,A9580,"Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries ",,,539.01,694.92,3 HCPCS,A9581,GADOXETATE 10 ML INJ,1139.76,1139.76,68.39,968.8,24 HCPCS,A9581,"Injection, gadoxetate disodium, 1 ml ",1139.76,1139.76,14.73,45.86,10 HCPCS,A9582,"Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries ",,,11525.9,16257.01,8 HCPCS,A9583,"Injection, gadofosveset trisodium, 1 ml ",,,34.18,47.09,5 HCPCS,A9584,I123 IOFLUPANE DX 5MCI,21984.36,21984.36,1319.06,18686.71,36 HCPCS,A9584,"Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries ",21984.36,21984.36,4817.93,8248.78,8 HCPCS,A9585,GADOBUTROL 10 ML INJ,574.64,574.64,34.48,488.44,24 HCPCS,A9585,GADOBUTROL 15 ML INJ,747.0,747.0,44.82,634.95,24 HCPCS,A9585,GADOBUTROL 7.5 ML INJ,429.49,429.49,25.77,365.07,24 HCPCS,A9585,"Injection, gadobutrol, 0.1 ml ",,,0.3,1.05,10 HCPCS,A9586,"Florbetapir f18, diagnostic, per study dose, up to 10 millicuries ",,,5578.1,9093.4,8 HCPCS,A9587,"Gallium ga-68, dotatate, diagnostic, 0.1 millicurie ",,,126.54,183.86,8 HCPCS,A9588,"Fluciclovine f-18, diagnostic, 1 millicurie ",,,781.84,1644.18,8 HCPCS,A9589,"Instillation, hexaminolevulinate hydrochloride, 100 mg ",,,1424.12,4443.91,10 HCPCS,A9590,"Iodine i-131, iobenguane, 1 millicurie ",,,589.55,1019.62,8 HCPCS,A9591,"Fluoroestradiol f 18, diagnostic, 1 millicurie ",,,1.47,2447.8,8 HCPCS,A9592,"Copper cu-64, dotatate, diagnostic, 1 millicurie ",,,1708.14,3063.06,8 HCPCS,A9593,"Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie ",,,126.54,2475.47,8 HCPCS,A9594,"Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie ",,,126.54,2423.74,8 HCPCS,A9595,"Piflufolastat f-18, diagnostic, 1 millicurie ",,,997.76,1957.36,8 HCPCS,A9596,"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie ",,,1310.73,3288.04,8 HCPCS,A9600,"Strontium sr-89 chloride, therapeutic, per millicurie ",,,3767.49,11934.0,8 HCPCS,A9601,"Flortaucipir f 18 injection, diagnostic, 1 millicurie ",,,863.94,1717.74,8 HCPCS,A9602,"Fluorodopa f-18, diagnostic, per millicurie ",,,973.87,1587.58,8 HCPCS,A9603,"Injection, pafolacianine, 0.1 mg ",,,259.29,422.67,8 HCPCS,A9604,"Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries ",,,29707.27,51818.64,8 HCPCS,A9606,"Radium ra-223 dichloride, therapeutic, per microcurie ",,,169.02,537.89,10 HCPCS,A9607,"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie ",,,414.83,790.48,8 HCPCS,A9608,"Flotufolastat f 18, diagnostic, 1 millicurie ",,,1165.2,2015.18,8 HCPCS,A9609,Fludeoxyglucose f18 up to 15 millicuries ,,,365.5,503.5,5 HCPCS,A9610,"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose ",,,2054.71,2830.46,5 HCPCS,A9611,"Flurpiridaz f 18, diagnostic, 1 millicurie ",,,103.98,167.51,8 HCPCS,A9612,"Injection, fluorescein, 1 mg ",,,0.74,1.03,5 HCPCS,A9615,"Injection, pegulicianine, 1 mg ",,,69.91,112.6,8 HCPCS,A9616,"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie ",,,2183.13,3007.37,5 HCPCS,A9697,"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose ",,,0.71,0.97,5 HCPCS,A9698,E-Z-HD POWD 334GM PO,42.88,42.88,2.57,36.45,33 HCPCS,A9698,E-Z-PAQUE 355 ML PO,36.34,36.34,2.18,30.89,33 HCPCS,A9698,ETHIODIZED OIL INJ,9602.29,9602.29,576.14,8161.95,33 HCPCS,A9698,OMNIPAQUE 12 500ML PO,52.92,52.92,3.18,44.98,33 HCPCS,A9698,OMNIPAQUE 9 500ML PO,51.78,51.78,3.11,44.01,33 HCPCS,A9698,READI-CAT 2 450ML PO,16.35,16.35,0.98,13.9,33 HCPCS,A9698,VARIBAR NECTAR 240 ML PO,71.75,71.75,4.3,60.99,33 HCPCS,A9698,VARIBAR PUDDING 230ML PO,258.65,258.65,15.52,219.85,33 HCPCS,A9698,VARIBAR THIN HON 250MLPO,281.65,281.65,16.9,239.4,33 HCPCS,A9698,VARIBAR THIN LIQ 148G PO,31.21,31.21,1.87,26.53,33 HCPCS,A9800,"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie ",,,1510.95,2151.36,8 HCPCS,B4034,"Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape ",,,3.87,3.87,2 HCPCS,B4035,"Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape ",,,6.63,6.63,2 HCPCS,B4036,"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape ",,,5.21,5.21,2 HCPCS,B4081,Nasogastric tubing with stylet ,,,18.99,18.99,2 HCPCS,B4082,Nasogastric tubing without stylet ,,,13.42,13.42,2 HCPCS,B4083,Stomach tube - levine type ,,,2.07,2.07,2 HCPCS,B4087,"Gastrostomy/jejunostomy tube, standard, any material, any type, each ",,,33.9,33.9,2 HCPCS,B4088,"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each ",,,39.8,39.8,2 HCPCS,B4105,"In-line cartridge containing digestive enzyme(s) for enteral feeding, each ",,,65.46,100.83,5 HCPCS,B4148,"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape ",,,7.06,17.44,7 HCPCS,B4149,"Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding",,,1.28,1.28,2 HCPCS,B4150,"Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calor",,,0.48,0.48,2 HCPCS,B4152,"Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fibe",,,0.39,0.39,2 HCPCS,B4153,"Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral fe",,,1.51,1.51,2 HCPCS,B4154,"Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals,",,,0.85,0.85,2 HCPCS,B4155,"Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium ch",,,0.94,0.94,2 HCPCS,B4164,"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix ",,,25.15,25.15,2 HCPCS,B4168,"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix ",,,36.68,36.68,2 HCPCS,B4176,"Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix ",,,70.96,70.96,2 HCPCS,B4178,"Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix ",,,85.16,85.16,2 HCPCS,B4180,"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix ",,,36.11,36.11,2 HCPCS,B4185,"Parenteral nutrition solution, not otherwise specified, 10 grams lipids ",,,3.61,16.62,7 HCPCS,B4187,"Omegaven, 10 grams lipids ",,,16.62,232.34,7 HCPCS,B4189,"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix ",,,263.06,263.06,2 HCPCS,B4193,"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix ",,,339.9,339.9,2 HCPCS,B4197,"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix ",,,413.83,413.83,2 HCPCS,B4199,"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix ",,,472.87,472.87,2 HCPCS,B4216,"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day ",,,11.42,11.42,2 HCPCS,B4220,"Parenteral nutrition supply kit; premix, per day ",,,11.84,11.84,2 HCPCS,B4222,"Parenteral nutrition supply kit; home mix, per day ",,,14.62,14.62,2 HCPCS,B4224,"Parenteral nutrition administration kit, per day ",,,37.0,37.0,2 HCPCS,B5000,"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-prem",,,17.6,17.6,2 HCPCS,B5100,"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix ",,,6.87,6.87,2 HCPCS,B9002,"Enteral nutrition infusion pump, any type ",,,39.47,39.47,2 HCPCS,B9004,"Parenteral nutrition infusion pump, portable ",,,295.55,295.55,2 HCPCS,B9006,"Parenteral nutrition infusion pump, stationary ",,,295.55,295.55,2 HCPCS,C1052,DEV HEMOSPRAY 10FR 220CM,70872.5,70872.5,4252.35,60241.63,44 HCPCS,C1052,"Hemostatic agent, gastrointestinal, topical ",70872.5,70872.5,14.87,22.9,5 HCPCS,C1062,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,57 HCPCS,C1601,"Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable) ",,,25.1,38.66,5 HCPCS,C1604,SYSTEM GRAFT STENT CASE,100000.0,100000.0,13000.0,85000.0,23 HCPCS,C1605,PACEMAKER DUAL CHMBR,100000.0,100000.0,13000.0,85000.0,18 HCPCS,C1605,"Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation ",100000.0,100000.0,342.64,527.77,5 HCPCS,C1606,"Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope ",,,25.1,38.66,5 HCPCS,C1607,"Neurostimulator, integrated (implantable), rechargeable with all implantable and external components including charging system ",,,8138.0,12535.14,5 HCPCS,C1713,ANCH BN RND 10X30MM,10956.0,10956.0,1424.28,9312.6,28 HCPCS,C1713,ANCHOR 2.9MM JUGGERKNOT,11745.0,11745.0,1526.85,9983.25,28 HCPCS,C1713,ANCHOR BN 1.2X6.5X14MM,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,ANCHOR BN 1.3X3.5X11MM,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,ANCHOR BN 4.75X19.1MM,25415.0,25415.0,3303.95,21602.75,28 HCPCS,C1713,ANCHOR BN NO BUTTON,22605.0,22605.0,2938.65,19214.25,28 HCPCS,C1713,ANCHOR BN SHDR 1.8,17277.0,17277.0,2246.01,14685.45,28 HCPCS,C1713,ANCHOR BN SHLD,82410.0,82410.0,10713.3,70048.5,28 HCPCS,C1713,ANCHOR BN SUTURE 5.5MM,37642.0,37642.0,4893.46,31995.7,28 HCPCS,C1713,ANCHOR BN TNDN 15 REV,16689.0,16689.0,2169.57,14185.65,28 HCPCS,C1713,ANCHOR BN W/BUTTON,24222.0,24222.0,3148.86,20588.7,28 HCPCS,C1713,ANCHOR FX BLK 4.75MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,ANCHOR KNOTLESS 4.5X20MM,11584.0,11584.0,1505.92,9846.4,28 HCPCS,C1713,ANCHOR KNTLS 4.75MM,85696.0,85696.0,11140.48,72841.6,28 HCPCS,C1713,ANCHOR SUT 1.8MM,13252.5,13252.5,1148.55,15019.5,56 HCPCS,C1713,ANCHOR SUT 2-0 1.7MM,17081.0,17081.0,2220.53,14518.85,28 HCPCS,C1713,ANCHOR SUT 2.3MM,19103.5,19103.5,2465.58,16354.85,56 HCPCS,C1713,ANCHOR SUT 2.8MM,42606.0,42606.0,5538.78,36215.1,28 HCPCS,C1713,ANCHOR SUT 24D 1.5MM,29654.0,29654.0,3855.02,25205.9,28 HCPCS,C1713,ANCHOR SUT 3.5MM,28296.0,28296.0,3678.48,24051.6,28 HCPCS,C1713,ANCHOR SUT 3.5X10.5MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,ANCHOR SUT 4.5MM,10613.0,10613.0,1379.69,9021.05,28 HCPCS,C1713,ANCHOR SUT 4.5MM 12MM,10013.0,10013.0,1301.69,8511.05,28 HCPCS,C1713,ANCHOR SUT 4.5X13.5MM,29315.0,29315.0,3810.95,24917.75,28 HCPCS,C1713,ANCHOR SUT 4.5X20MM,11584.0,11584.0,1505.92,9846.4,28 HCPCS,C1713,ANCHOR SUT 4.75MM,34376.5,34376.5,1812.2,46591.05,84 HCPCS,C1713,ANCHOR SUT 4.75MM 22MM,22701.5,22701.5,2921.75,19488.8,56 HCPCS,C1713,ANCHOR SUT 4.75X19.1MMM,93781.0,93781.0,12191.53,79713.85,28 HCPCS,C1713,ANCHOR SUT 5.5MM,37642.0,37642.0,4893.46,31995.7,28 HCPCS,C1713,ANCHOR SUT 5.5MM 16.3MM,9790.0,9790.0,1272.7,8321.5,28 HCPCS,C1713,ANCHOR SUT 5.5MM 22MM,22928.0,22928.0,2980.64,19488.8,28 HCPCS,C1713,ANCHOR SUT 5MM,7382.0,7382.0,959.66,6274.7,28 HCPCS,C1713,ANCHOR SUT 5MM 15.5MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,ANCHOR SUT BLUE 1.8MM,27285.0,27285.0,1148.55,38874.75,84 HCPCS,C1713,ANCHOR SUT KNTLSS 1.8MM,88930.0,88930.0,11560.9,75590.5,28 HCPCS,C1713,ANCHOR SUT SFT 2.6,24254.0,24254.0,3153.02,20615.9,28 HCPCS,C1713,ANCHOR SUT TENDONS,82410.0,82410.0,10713.3,70048.5,28 HCPCS,C1713,ANCHOR SUTURE #2 1.3MM,17081.0,17081.0,2220.53,14518.85,28 HCPCS,C1713,ANCHOR SUTURE 4.75MM,41231.0,41231.0,5360.03,35046.35,28 HCPCS,C1713,ANCHOR SUTURE 5.5MM,9130.0,9130.0,1186.9,7760.5,28 HCPCS,C1713,ANCHR SUT 4.5MM KNTLS,12958.0,12958.0,1684.54,11014.3,28 HCPCS,C1713,BLOCKER SPN ROD CLSR,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,BOLT BN 3.5MM 42MM,19211.0,19211.0,2497.43,16329.35,28 HCPCS,C1713,BOLT BN PLATE 3.5X40MM,19211.0,19211.0,2497.43,16329.35,28 HCPCS,C1713,BOLT BN THRD 3.5MM 36MM,17866.0,17866.0,2322.58,15186.1,28 HCPCS,C1713,BOLT FEM TI ALLOY 100MM,15550.0,15550.0,2021.5,13217.5,28 HCPCS,C1713,BOLT PLT BN 3.5MM 32MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,BOLT SPN 8.5MM 30MM,9316.0,9316.0,1211.08,7918.6,28 HCPCS,C1713,BOLT SPN FSN 8.5X25MM,9316.0,9316.0,1211.08,7918.6,28 HCPCS,C1713,BOLT SPN GRFT 8.5MM 25MM,9316.0,9316.0,1211.08,7918.6,28 HCPCS,C1713,BOLT SPN GRFT 8.5MM 35MM,9316.0,9316.0,1211.08,7918.6,28 HCPCS,C1713,BUTTON FX 15MM,9270.0,9270.0,1205.1,7879.5,28 HCPCS,C1713,CABLE FXTN 1.8MM 635CM,18183.0,18183.0,2363.79,15455.55,28 HCPCS,C1713,CABLE FXTN 1.8MM 91CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,CABLE ORTHO 1.7X750MM,16551.0,16551.0,2151.63,14068.35,28 HCPCS,C1713,CABLE SPN SGL W CRIMP,9803.0,9803.0,1274.39,8332.55,28 HCPCS,C1713,CABLE SPN TI W/ CRMP,10130.0,10130.0,1316.9,8610.5,28 HCPCS,C1713,CONN ROD SPN 35-40MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN 35-42MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN CROSS 56-66MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN CROSS LNK SZ49,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN CROSS VARI28-38,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN CROSS VARI35-45,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPEN ILIAC 20MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPEN ILIAC 30MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPN-OPN 11-14MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPN-OPN 13-16MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPN-OPN 3.5-5.5,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPN-OPN REV11MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN OPN-OPN REV15MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN RD-RD 3.5X40MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONN SPN RD-RD 3.5X45MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONNECTOR SPN 41-50MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,CONNECTOR SPN OFST 20MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,DEVICE FSTFX MNSCL,18459.0,18459.0,2399.67,15690.15,28 HCPCS,C1713,DEVICE FX FSTFX RVRS CRV,18459.0,18459.0,2399.67,15690.15,28 HCPCS,C1713,DEVICE FX PLATE BOX,18024.0,18024.0,2343.12,15320.4,28 HCPCS,C1713,DISC BN ANKL 4MM,45274.0,45274.0,5885.62,38482.9,28 HCPCS,C1713,HOOK SPN II STD BLD SM,8599.0,8599.0,1117.87,7309.15,28 HCPCS,C1713,HOOK SPN XIA SM PDCL,8599.0,8599.0,1117.87,7309.15,28 HCPCS,C1713,IMPLANT BN DEL SYS BICEP,38560.0,38560.0,5012.8,32776.0,28 HCPCS,C1713,IMPLANT BN MNDBL SML,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,IMPLANT BN PIN 2.5X16MM,41943.0,41943.0,5452.59,35651.55,28 HCPCS,C1713,KIT ANCH BN 3.5MM 4.5MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,KIT ANCH SUT 4.5X15.5MM,31579.0,31579.0,4105.27,26842.15,28 HCPCS,C1713,KIT ANCHOR SUTURE,56592.0,56592.0,7356.96,48103.2,28 HCPCS,C1713,KIT BN STAPLE 9X9MM,30848.0,30848.0,4010.24,26220.8,28 HCPCS,C1713,KIT IMP HMRTOE 0D 3X3MM,27067.0,27067.0,3518.71,23006.95,28 HCPCS,C1713,KIT IMP HMRTOE 3X3MM 10D,27067.0,27067.0,3518.71,23006.95,28 HCPCS,C1713,KIT IMPL 2.5MM,33466.0,33466.0,4350.58,28446.1,28 HCPCS,C1713,KIT IMPLANT ANKLE,80587.0,80587.0,10476.31,68498.95,28 HCPCS,C1713,KIT IMPLANT HEADLS 3MM,19437.0,19437.0,2526.81,16521.45,28 HCPCS,C1713,KIT INTERNAL BRACE W CC,52407.0,52407.0,6812.91,44545.95,28 HCPCS,C1713,KIT PLATE BN ANK FX,31724.0,31724.0,4124.12,26965.4,28 HCPCS,C1713,KIT PLATE CRNL FIXTN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,KIT SURG ORTHOGNATHICS,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,KIT SUT ANCHOR 4.75MM,49639.0,49639.0,6453.07,42193.15,28 HCPCS,C1713,LINK SPN X SZ3,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,NAIL 130D 11X180MM,37967.0,37967.0,4935.71,32271.95,28 HCPCS,C1713,NAIL BN 10MM 18CM,40150.0,40150.0,5219.5,34127.5,28 HCPCS,C1713,NAIL BN 10MM 345MM,42266.0,42266.0,5494.58,35926.1,28 HCPCS,C1713,NAIL BN 10MM 38CM,38774.0,38774.0,5040.62,32957.9,28 HCPCS,C1713,NAIL BN 11.5MM 18CM,33794.0,33794.0,4393.22,28724.9,28 HCPCS,C1713,NAIL BN 11.5MM 38CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN 130D 10MM 38CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN 130D 11.5MM 18CM,40150.0,40150.0,5219.5,34127.5,28 HCPCS,C1713,NAIL BN 130D 11MM 400MM,52808.0,52808.0,6865.04,44886.8,28 HCPCS,C1713,NAIL BN 130D 12X460MM,52808.0,52808.0,6865.04,44886.8,28 HCPCS,C1713,NAIL BN 13X18X125,40150.0,40150.0,5219.5,34127.5,28 HCPCS,C1713,NAIL BN BENT 8/7MM 16CM,38774.0,38774.0,5040.62,32957.9,28 HCPCS,C1713,NAIL BN FEM 11.5MM 32CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN FEM 11MM 440MM,42266.0,42266.0,5494.58,35926.1,28 HCPCS,C1713,NAIL BN FEM RT 11X380MM,52808.0,52808.0,6865.04,44886.8,28 HCPCS,C1713,NAIL BN LT 10MM 40CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN LT 34CM 13MM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN RT 9MM 34CM,49348.0,49348.0,6415.24,41945.8,28 HCPCS,C1713,NAIL BN TIB 9MM 330MM,42266.0,42266.0,5494.58,35926.1,28 HCPCS,C1713,NAIL BN TROCH 10MM 36CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,NAIL BN TROCH 10MM 38CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL BN TROCH 11.5M 20CM,40150.0,40150.0,5219.5,34127.5,28 HCPCS,C1713,NAIL FEM 125D 12X240MM,52808.0,52808.0,6865.04,44886.8,28 HCPCS,C1713,NAIL FEM LT 11.5MM 32CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL FEM LT 11.5MM 36CM,55518.0,55518.0,7217.34,47190.3,28 HCPCS,C1713,NAIL FEMORAL 10MM 30CM,38774.0,38774.0,5040.62,32957.9,28 HCPCS,C1713,NAIL TIB 10MM 31CM,38774.0,38774.0,5040.62,32957.9,28 HCPCS,C1713,NAIL TIB 10MMX34CM,49348.0,49348.0,6415.24,41945.8,28 HCPCS,C1713,NAIL TIB 11X200MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PACK ANCHOR SUT 4.75MM,24092.0,24092.0,3131.96,20478.2,28 HCPCS,C1713,PEG TRBCLR TI MTLBLK LNG,42687.0,42687.0,5549.31,36283.95,28 HCPCS,C1713,PIN BN 2.5X16MM,48410.0,48410.0,6293.3,41148.5,28 HCPCS,C1713,PIN BN KN CMPNTRESS,6139.0,6139.0,798.07,5218.15,28 HCPCS,C1713,PIN BN KN FIX,10960.0,10960.0,1424.8,9316.0,28 HCPCS,C1713,PIN PSTN 4.5MM,6124.0,6124.0,796.12,5205.4,28 HCPCS,C1713,PLATE ADJ BN SPNE OCT,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1713,PLATE BN 1/3 TUBLR 4H,30625.0,30625.0,3981.25,26031.25,28 HCPCS,C1713,PLATE BN 102MM SS 3.5MM,42229.0,42229.0,5489.77,35894.65,28 HCPCS,C1713,PLATE BN 105MM 2.7MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN 10HL 2.7/3.5MM,40824.0,40824.0,5307.12,34700.4,28 HCPCS,C1713,PLATE BN 10HL 232MM,45683.0,45683.0,5938.79,38830.55,28 HCPCS,C1713,PLATE BN 111MM 3.5MM,13409.0,13409.0,1743.17,11397.65,28 HCPCS,C1713,PLATE BN 11MM 81X10X2MM,27600.0,27600.0,3588.0,23460.0,28 HCPCS,C1713,PLATE BN 12HL .5MM,14534.0,14534.0,1889.42,12353.9,28 HCPCS,C1713,PLATE BN 13HL LT 128MM,57631.0,57631.0,7492.03,48986.35,28 HCPCS,C1713,PLATE BN 14HL 3.5X189MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN 16H,38783.0,38783.0,5041.79,32965.55,28 HCPCS,C1713,PLATE BN 17HL 1.5MM,38783.0,38783.0,5041.79,32965.55,28 HCPCS,C1713,PLATE BN 2.4MM,29061.0,29061.0,3777.93,24701.85,28 HCPCS,C1713,PLATE BN 2.7/3.5MM 61MM,49701.0,49701.0,6461.13,42245.85,28 HCPCS,C1713,PLATE BN 2.7/3.5MM 72MM,35827.0,35827.0,4657.51,30452.95,28 HCPCS,C1713,PLATE BN 2.7/3.5MM 81MM,27600.0,27600.0,3588.0,23460.0,28 HCPCS,C1713,PLATE BN 2.7/3.5MM 83MM,86712.0,86712.0,11272.56,73705.2,28 HCPCS,C1713,PLATE BN 2.7MM,28458.0,28458.0,3699.54,24189.3,28 HCPCS,C1713,PLATE BN 2.7MM 3.5MM,47832.5,47832.5,5254.6,46958.25,56 HCPCS,C1713,PLATE BN 2.7MM 85MM,35827.0,35827.0,4657.51,30452.95,28 HCPCS,C1713,PLATE BN 22X51MM,24771.0,24771.0,3220.23,21055.35,28 HCPCS,C1713,PLATE BN 3.5MM,27488.0,27488.0,3573.44,23364.8,28 HCPCS,C1713,PLATE BN 3.5MM 104MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN 3HL,42848.0,42848.0,5570.24,36420.8,28 HCPCS,C1713,PLATE BN 3HL73X2.7/3.5MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN 4H 31MM 3.5MM,31756.0,31756.0,4128.28,26992.6,28 HCPCS,C1713,PLATE BN 4HL 3.5X87MM,42071.0,42071.0,5469.23,35760.35,28 HCPCS,C1713,PLATE BN 4HL 89MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN 4HL LT 2.7MM,21028.0,21028.0,2733.64,17873.8,28 HCPCS,C1713,PLATE BN 5HL RT 2.7MM,20608.0,20608.0,2679.04,17516.8,28 HCPCS,C1713,PLATE BN 5MM,56592.0,56592.0,7356.96,48103.2,28 HCPCS,C1713,PLATE BN 5MM 143MM,56592.0,56592.0,7356.96,48103.2,28 HCPCS,C1713,PLATE BN 62X23X2MM,42622.0,42622.0,5540.86,36228.7,28 HCPCS,C1713,PLATE BN 69X9X1MM,5850.0,5850.0,760.5,4972.5,28 HCPCS,C1713,PLATE BN 6H 117MM 3.5MM,46793.0,46793.0,6083.09,39774.05,28 HCPCS,C1713,PLATE BN 6H 2.4MM,24302.0,24302.0,3159.26,20656.7,28 HCPCS,C1713,PLATE BN 6HL 117X3.5MM,46768.0,46768.0,6079.84,39752.8,28 HCPCS,C1713,PLATE BN 6HL 2.4MM 51MM,23427.0,23427.0,3045.51,19912.95,28 HCPCS,C1713,PLATE BN 6HL 2.4MM 66MM,26737.0,26737.0,3475.81,22726.45,28 HCPCS,C1713,PLATE BN 6HL 3.5MM 164MM,62542.0,62542.0,8130.46,53160.7,28 HCPCS,C1713,PLATE BN 6HL 3.5MM 194MM,43560.0,43560.0,5662.8,37026.0,28 HCPCS,C1713,PLATE BN 82MM 3.5MM,12480.0,12480.0,1622.4,10608.0,28 HCPCS,C1713,PLATE BN 8H 3.5MM 94MM,13020.0,13020.0,1692.6,11067.0,28 HCPCS,C1713,PLATE BN 8H 97MM,30851.0,30851.0,4010.63,26223.35,28 HCPCS,C1713,PLATE BN 8HL 246MM,23475.0,23475.0,3051.75,19953.75,28 HCPCS,C1713,PLATE BN 8HL 3.5MM 112MM,17817.0,17817.0,2316.21,15144.45,28 HCPCS,C1713,PLATE BN 8HL 3.5MM 128MM,42689.0,42689.0,5549.57,36285.65,28 HCPCS,C1713,PLATE BN ANGLED 4HL,22223.0,22223.0,2888.99,18889.55,28 HCPCS,C1713,PLATE BN CNTR 3HL,27869.0,27869.0,3622.97,23688.65,28 HCPCS,C1713,PLATE BN COMP 28X13X11MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PLATE BN CRNMXF 20H .5MM,21711.0,21711.0,2822.43,18454.35,28 HCPCS,C1713,PLATE BN CRV 10HL 3.5MM,13939.0,13939.0,1812.07,11848.15,28 HCPCS,C1713,PLATE BN FEM NK SYS 2 HL,25903.0,25903.0,3367.39,22017.55,28 HCPCS,C1713,PLATE BN FIB 8HL 137MM,19993.0,19993.0,2599.09,16994.05,28 HCPCS,C1713,PLATE BN FSN WRST,62514.0,62514.0,8126.82,53136.9,28 HCPCS,C1713,PLATE BN FULL MAXILLARY,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PLATE BN HUM LT3.5X198MM,69107.0,69107.0,8983.91,58740.95,28 HCPCS,C1713,PLATE BN L 100D 4HL,14764.0,14764.0,1919.32,12549.4,28 HCPCS,C1713,PLATE BN LAT LT SMALL,71144.0,71144.0,9248.72,60472.4,28 HCPCS,C1713,PLATE BN LCK 6HL 1.5X2.3,13508.0,13508.0,1756.04,11481.8,28 HCPCS,C1713,PLATE BN LT 10D SM,59050.0,59050.0,7676.5,50192.5,28 HCPCS,C1713,PLATE BN LT 18MM,49047.0,49047.0,6376.11,41689.95,28 HCPCS,C1713,PLATE BN LT 3HL 49MM,43107.0,43107.0,5603.91,36640.95,28 HCPCS,C1713,PLATE BN LT 4HL 57MM,53682.0,53682.0,6978.66,45629.7,28 HCPCS,C1713,PLATE BN LT 5HL 99MM,19903.0,19903.0,2587.39,16917.55,28 HCPCS,C1713,PLATE BN LT SMALL,92908.0,92908.0,12078.04,78971.8,28 HCPCS,C1713,PLATE BN MNDB 12H 1.25MM,22936.0,22936.0,2981.68,19495.6,28 HCPCS,C1713,PLATE BN MTRSL RT STNDRD,35572.0,35572.0,4624.36,30236.2,28 HCPCS,C1713,PLATE BN MXF 3X4HL 0.7MM,12198.0,12198.0,1585.74,10368.3,28 HCPCS,C1713,PLATE BN PLNTR REPR SYS,24448.0,24448.0,3178.24,20780.8,28 HCPCS,C1713,PLATE BN RT 0DEG XSML,58209.0,58209.0,7567.17,49477.65,28 HCPCS,C1713,PLATE BN RT 1.5MM,16432.0,16432.0,2136.16,13967.2,28 HCPCS,C1713,PLATE BN RT 15HL,38783.0,38783.0,5041.79,32965.55,28 HCPCS,C1713,PLATE BN RT 18MM,40326.0,40326.0,5242.38,34277.1,28 HCPCS,C1713,PLATE BN RT 3.5MM 52MM,11545.0,11545.0,1500.85,9813.25,28 HCPCS,C1713,PLATE BN RT 6H 3H 51MM,28000.0,28000.0,3640.0,23800.0,28 HCPCS,C1713,PLATE BN RT 93MM 3.5MM,41579.0,41579.0,5405.27,35342.15,28 HCPCS,C1713,PLATE BN SHRT OFST 3.5MM,53293.0,53293.0,6928.09,45299.05,28 HCPCS,C1713,PLATE BN SINUS RT SM,48507.0,48507.0,6305.91,41230.95,28 HCPCS,C1713,PLATE BN SLM 6HL,20664.0,20664.0,2686.32,17564.4,28 HCPCS,C1713,PLATE BN SMALL 4HL,23310.0,23310.0,3030.3,19813.5,28 HCPCS,C1713,PLATE BN SQ LRG 4HL,24577.0,24577.0,3195.01,20890.45,28 HCPCS,C1713,PLATE BN STAR 6HL,25224.0,25224.0,3279.12,21440.4,28 HCPCS,C1713,PLATE BN STD 0D 18MM,40326.0,40326.0,5242.38,34277.1,28 HCPCS,C1713,PLATE BN STD LT 18MM,40326.0,40326.0,5242.38,34277.1,28 HCPCS,C1713,PLATE BN STD RT,39332.0,39332.0,5113.16,33432.2,28 HCPCS,C1713,PLATE BN STD RT 18MM,49047.0,49047.0,6376.11,41689.95,28 HCPCS,C1713,PLATE BN STR 4 HL,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN STR 5HL,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,PLATE BN STR 7HL 91MM,14720.0,14720.0,1913.6,12512.0,28 HCPCS,C1713,PLATE BN STRNL 4H,17493.0,17493.0,2274.09,14869.05,28 HCPCS,C1713,PLATE BN T 3H 3.5MM 63MM,16635.0,16635.0,2162.55,14139.75,28 HCPCS,C1713,PLATE BN T 3HL 3.5X67MM,14934.0,14934.0,1941.42,12693.9,28 HCPCS,C1713,PLATE BN THOR FXTN STRL,15668.0,15668.0,2036.84,13317.8,28 HCPCS,C1713,PLATE BN TI 3HL,27869.0,27869.0,3622.97,23688.65,28 HCPCS,C1713,PLATE BN TI LOCK 4HL,14725.0,14725.0,1914.25,12516.25,28 HCPCS,C1713,PLATE BN TIB LT 6H 119MM,42134.0,42134.0,5477.42,35813.9,28 HCPCS,C1713,PLATE BN XPLATE 8H,16492.0,16492.0,2143.96,14018.2,28 HCPCS,C1713,PLATE BN XTN 10HL,77612.0,77612.0,10089.56,65970.2,28 HCPCS,C1713,PLATE BNPLNTR REPAIR SYS,24448.0,24448.0,3178.24,20780.8,28 HCPCS,C1713,PLATE CLAVICLE 8H RT,47731.0,47731.0,6205.03,40571.35,28 HCPCS,C1713,PLATE DVR MED LF,27908.0,27908.0,3628.04,23721.8,28 HCPCS,C1713,PLATE LONG RT 5D 18MM,40326.0,40326.0,5242.38,34277.1,28 HCPCS,C1713,PLATE MDFC 3D SMALL,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PLATE MED 82MM SS2.7/3.5,34734.0,34734.0,4515.42,29523.9,28 HCPCS,C1713,PLATE MNDB MDFC TI,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PLATE MNDB TRUMATCH 3D,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,PLATE NAR MINI LK DVR RT,24771.0,24771.0,3220.23,21055.35,28 HCPCS,C1713,PLATE SPN 1 LVL 10MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 1 LVL 9MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 1 SCREW SZ08,30285.0,30285.0,3937.05,25742.25,28 HCPCS,C1713,PLATE SPN 1LVL 11MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 1LVL 14MM,22538.0,22538.0,2929.94,19157.3,28 HCPCS,C1713,PLATE SPN 1LVL 20MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 32MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 36MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 38MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 42MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 44MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 2LVL 46MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 32X16X2MM 2LVL,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1713,PLATE SPN 3LVL 1.9H 50MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 3LVL 48MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 3LVL 54MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 3LVL 60MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 40MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 4LVL 72MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN 52MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN ADJT 6-18MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1713,PLATE SPN ANT 1LVL 24MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN CERV 3LVL 51MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN CRV 3LVL 63MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN FLRD LOCK 8MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1713,PLATE SPN FLRD POST 8MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1713,PLATE SPN GFT CNTN 10MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,PLATE SPN GRAFT CNTN 8MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,PLATE SPN LCK 10-18MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1713,PLATE SPN LVL3 75MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPN SM 32MM,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1713,PLATE SPN XPND 5X8-12MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,PLATE SPNL 1LVL 38MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPNL 2LVL 34MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPNL 3LVL 57MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE SPNL 66MM 3LVL,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1713,PLATE TIB 300MM 13H,47379.0,47379.0,6159.27,40272.15,28 HCPCS,C1713,PLATE TIB RT 6H 91MM,41558.0,41558.0,5402.54,35324.3,28 HCPCS,C1713,PLATE TIB SS 4H 105MM,28016.0,28016.0,3642.08,23813.6,28 HCPCS,C1713,PLT BN FEM RT316MM 13HL,57631.0,57631.0,7492.03,48986.35,28 HCPCS,C1713,POST FX DSP 5.0 X 30 MM,12369.0,12369.0,1607.97,10513.65,28 HCPCS,C1713,PUTTY DBM ALGRF 2.5CC,31579.0,31579.0,4105.27,26842.15,28 HCPCS,C1713,ROD CONN SPN 0D,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,ROD LORDOSED 3.5X70MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SAVNNH-T CRV 65MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 110MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 115D 3.5MM 125MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 200MM 3.5MM,8599.0,8599.0,1117.87,7309.15,28 HCPCS,C1713,ROD SPN 3.5-5.5MM 500MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 3.5MM 120MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 3.5MM 30MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 3.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 3.5MM 55MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 3.5MM 65MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 3.5MM 75MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 40MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5MM 100MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 110MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 120MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 130MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5MM 300MM,7023.0,7023.0,912.99,5969.55,28 HCPCS,C1713,ROD SPN 5.5MM 30MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5MM 35MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MM 400MM,22001.0,22001.0,684.45,32926.45,56 HCPCS,C1713,ROD SPN 5.5MM 40MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5MM 45MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 500MM,7792.0,7792.0,684.45,8771.15,84 HCPCS,C1713,ROD SPN 5.5MM 50MM,5265.0,5265.0,684.45,4475.25,112 HCPCS,C1713,ROD SPN 5.5MM 55MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 60MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MM 65MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MM 75MM,5265.0,5265.0,684.45,4475.25,56 HCPCS,C1713,ROD SPN 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MM 90MM,5265.0,5265.0,684.45,4475.25,84 HCPCS,C1713,ROD SPN 5.5MMM 50M,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5X45MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 5.5X7.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 50MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 6.0MM 500MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN 6MM,38737.0,38737.0,5035.81,32926.45,28 HCPCS,C1713,ROD SPN 6X40MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN CONN 12-15MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1713,ROD SPN CRVD 130MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN CRVD 55MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN HEX 5.5MM 45MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN HINGED 3.5X3.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN HXHD 5.5X40MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN LORDTC 5.5X35MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN LRDC 5.5MM 40MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN LRDTC 5.5X70MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN OC PREBENT 3.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPN STR 3.5MM 300MM,3159.0,3159.0,410.67,2685.15,28 HCPCS,C1713,ROD SPN STR 5.5MM 300MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 35 BN,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 35MM 5.5MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 5.5MM 105MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 5.5MM 120MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 5.5MM 130MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 5.5MM 70MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL 5.5MM 80MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL L80MM OD5.5MM Q,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,ROD SPNL OCC 100MM 3.5MM,8599.0,8599.0,1117.87,7309.15,28 HCPCS,C1713,SCREW BIOSURE INTRF RGNS,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,SCREW BN 1.55X1.22X10MM,3521.0,3521.0,457.73,2992.85,28 HCPCS,C1713,SCREW BN 1.55X2.65X6MM,3627.0,3627.0,471.51,3082.95,28 HCPCS,C1713,SCREW BN 1.5MM 10MM SS,1992.0,1992.0,258.96,1693.2,28 HCPCS,C1713,SCREW BN 1.5MM 14MM SS,1992.0,1992.0,258.96,1693.2,28 HCPCS,C1713,SCREW BN 1.5MM 16MM,4077.0,4077.0,530.01,3465.45,28 HCPCS,C1713,SCREW BN 1.5MM 18MM,1992.0,1992.0,258.96,1693.2,28 HCPCS,C1713,SCREW BN 1.5MM 5MM,4228.0,4228.0,549.64,3593.8,28 HCPCS,C1713,SCREW BN 1.5MM 8MM,6440.0,6440.0,837.2,5474.0,28 HCPCS,C1713,SCREW BN 1.5X7MM,2751.0,2751.0,357.63,2338.35,28 HCPCS,C1713,SCREW BN 1.5X8X1.5MM,4227.0,4227.0,549.51,3592.95,28 HCPCS,C1713,SCREW BN 1.85MM 5MM,3697.0,3697.0,480.61,3142.45,28 HCPCS,C1713,SCREW BN 1.85MM 6MM,3517.0,3517.0,457.21,2989.45,28 HCPCS,C1713,SCREW BN 1.85MM 8MM,3697.0,3697.0,480.61,3142.45,28 HCPCS,C1713,SCREW BN 1.85X265X8MM,3629.0,3629.0,471.77,3084.65,28 HCPCS,C1713,SCREW BN 1.85X5MM,4227.0,4227.0,549.51,3592.95,28 HCPCS,C1713,SCREW BN 10.5MM 100MM,15436.5,15436.5,1955.07,13458.9,56 HCPCS,C1713,SCREW BN 10.5MM 115MM,15039.0,15039.0,1955.07,12783.15,28 HCPCS,C1713,SCREW BN 10.5MM 90MM,15039.0,15039.0,1955.07,12783.15,28 HCPCS,C1713,SCREW BN 10.5MM 95MM,15039.0,15039.0,1955.07,12783.15,28 HCPCS,C1713,SCREW BN 100MM,10484.0,10484.0,1362.92,8911.4,28 HCPCS,C1713,SCREW BN 100MM 4.5MM,20050.0,20050.0,2606.5,17042.5,28 HCPCS,C1713,SCREW BN 105MM 4.5MM,20050.0,20050.0,2606.5,17042.5,28 HCPCS,C1713,SCREW BN 10MM 28MM,10367.0,10367.0,1347.71,8811.95,28 HCPCS,C1713,SCREW BN 11MM 25MM,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,SCREW BN 12MM 2.4MM,4058.0,4058.0,527.54,3449.3,28 HCPCS,C1713,SCREW BN 14MM 3.5X34MM,17866.0,17866.0,2322.58,15186.1,28 HCPCS,C1713,SCREW BN 14MM 5MM,3120.0,3120.0,405.6,2652.0,28 HCPCS,C1713,SCREW BN 2.0MM 10MM,2609.5,2609.5,132.21,3571.7,56 HCPCS,C1713,SCREW BN 2.0MM 11MM,10449.0,10449.0,1358.37,8881.65,28 HCPCS,C1713,SCREW BN 2.0MM 12MM,7600.5,7600.5,445.12,16688.05,112 HCPCS,C1713,SCREW BN 2.0MM 14MM,2981.0,2981.0,330.33,2907.85,56 HCPCS,C1713,SCREW BN 2.0MM 16MM,4202.0,4202.0,546.26,3571.7,28 HCPCS,C1713,SCREW BN 2.0MM 20MM,1017.0,1017.0,132.21,864.45,28 HCPCS,C1713,SCREW BN 2.0MM 5MM,2943.0,2943.0,382.59,2501.55,28 HCPCS,C1713,SCREW BN 2.0MM 8MM,2545.0,2545.0,330.85,2163.25,28 HCPCS,C1713,SCREW BN 2.2MM 12MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,SCREW BN 2.2MM 12MM IBS,16374.0,16374.0,2128.62,13917.9,28 HCPCS,C1713,SCREW BN 2.3MM 22MM,3131.0,3131.0,407.03,2661.35,28 HCPCS,C1713,SCREW BN 2.3MM 7MM,5791.0,5791.0,752.83,4922.35,28 HCPCS,C1713,SCREW BN 2.3X7MM,2968.0,2968.0,385.84,2522.8,28 HCPCS,C1713,SCREW BN 2.4MM 10MM,3299.5,3299.5,330.33,3449.3,56 HCPCS,C1713,SCREW BN 2.4MM 12MM,2860.5,2860.5,330.33,2703.0,56 HCPCS,C1713,SCREW BN 2.4MM 14MM,3180.0,3180.0,413.4,2703.0,28 HCPCS,C1713,SCREW BN 2.4MM 16MM,5994.5,5994.5,563.16,6508.45,56 HCPCS,C1713,SCREW BN 2.4MM 18MM,4072.0,4072.0,330.33,10673.45,112 HCPCS,C1713,SCREW BN 2.4MM 20MM,11377.0,11377.0,446.55,16421.15,56 HCPCS,C1713,SCREW BN 2.4MM 20MM SS,4709.0,4709.0,612.17,4002.65,28 HCPCS,C1713,SCREW BN 2.4MM 22MM,4960.0,4960.0,644.8,4216.0,28 HCPCS,C1713,SCREW BN 2.4MM 26MM SS,4332.0,4332.0,563.16,3682.2,28 HCPCS,C1713,SCREW BN 2.4MM 4MM 14MM,2366.0,2366.0,307.58,2011.1,28 HCPCS,C1713,SCREW BN 2.4MM 4MM 16MM,2366.0,2366.0,307.58,2011.1,28 HCPCS,C1713,SCREW BN 2.4MM 4MM 22MM,2366.0,2366.0,307.58,2011.1,28 HCPCS,C1713,SCREW BN 2.4MM 5MM,4058.0,4058.0,527.54,3449.3,28 HCPCS,C1713,SCREW BN 2.4MM 6MM,5007.0,5007.0,650.91,4255.95,28 HCPCS,C1713,SCREW BN 2.4MM 8MM,5007.0,5007.0,650.91,4255.95,28 HCPCS,C1713,SCREW BN 2.4X3.5X22X5MM,6519.0,6519.0,847.47,5541.15,28 HCPCS,C1713,SCREW BN 2.4X3.5X26X6MM,6519.0,6519.0,847.47,5541.15,28 HCPCS,C1713,SCREW BN 2.4X30MM,7225.0,7225.0,939.25,6141.25,28 HCPCS,C1713,SCREW BN 2.5MM 12MM,4243.0,4243.0,492.18,8845.1,84 HCPCS,C1713,SCREW BN 2.5MM 14MM,6198.0,6198.0,492.18,13117.2,84 HCPCS,C1713,SCREW BN 2.5MM 15MM,3786.0,3786.0,492.18,3218.1,28 HCPCS,C1713,SCREW BN 2.5MM 16MM,6198.0,6198.0,492.18,8845.1,84 HCPCS,C1713,SCREW BN 2.5MM 18MM,11152.0,11152.0,893.36,13117.2,56 HCPCS,C1713,SCREW BN 2.5MM 20MM,6535.0,6535.0,805.74,5841.2,56 HCPCS,C1713,SCREW BN 2.5MM 22MM,6240.0,6240.0,805.74,8845.1,84 HCPCS,C1713,SCREW BN 2.5MM 24MM,6198.0,6198.0,805.74,5268.3,28 HCPCS,C1713,SCREW BN 2.5MM 26MM,6872.0,6872.0,893.36,5841.2,28 HCPCS,C1713,SCREW BN 2.5X26MM,3580.0,3580.0,465.4,3043.0,28 HCPCS,C1713,SCREW BN 2.7 4.5MM 22MM,1493.0,1493.0,194.09,1269.05,28 HCPCS,C1713,SCREW BN 2.7MM,35314.0,35314.0,4590.82,30016.9,28 HCPCS,C1713,SCREW BN 2.7MM 10MM,5466.5,5466.5,351.52,6926.65,112 HCPCS,C1713,SCREW BN 2.7MM 11MM,7147.0,7147.0,929.11,6074.95,28 HCPCS,C1713,SCREW BN 2.7MM 12MM,4349.5,4349.5,277.55,9055.05,168 HCPCS,C1713,SCREW BN 2.7MM 13MM,2145.0,2145.0,240.5,2074.0,56 HCPCS,C1713,SCREW BN 2.7MM 14MM,3121.0,3121.0,277.55,9117.1,112 HCPCS,C1713,SCREW BN 2.7MM 14MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 15MM,2440.0,2440.0,317.2,2074.0,28 HCPCS,C1713,SCREW BN 2.7MM 16MM,5249.5,5249.5,240.5,9055.05,224 HCPCS,C1713,SCREW BN 2.7MM 18MM,3802.0,3802.0,132.21,9055.05,140 HCPCS,C1713,SCREW BN 2.7MM 18MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 20MM,3069.5,3069.5,132.21,3218.1,112 HCPCS,C1713,SCREW BN 2.7MM 20MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 22MM,3387.5,3387.5,132.21,3945.7,112 HCPCS,C1713,SCREW BN 2.7MM 24MM,3435.0,3435.0,351.52,3945.7,84 HCPCS,C1713,SCREW BN 2.7MM 24MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 26MM,3786.0,3786.0,492.18,3218.1,28 HCPCS,C1713,SCREW BN 2.7MM 26MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 28MM,2704.0,2704.0,351.52,2298.4,28 HCPCS,C1713,SCREW BN 2.7MM 2MM 10MM,4909.0,4909.0,638.17,4172.65,28 HCPCS,C1713,SCREW BN 2.7MM 2MM 14MM,4909.0,4909.0,638.17,4172.65,28 HCPCS,C1713,SCREW BN 2.7MM 30MM SS,5225.0,5225.0,679.25,4441.25,28 HCPCS,C1713,SCREW BN 2.7MM 32MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 34MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2.7MM 36MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 38MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 40MM SS,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 42MM,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 44MM,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN 2.7MM 55MM,1850.0,1850.0,240.5,1572.5,28 HCPCS,C1713,SCREW BN 2.7MM 5MM 12MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2.7MM 5MM 16MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2.7MM 5MM 18MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2.7MM 6MM,4416.0,4416.0,574.08,3753.6,28 HCPCS,C1713,SCREW BN 2.7MM 8MM,3786.0,3786.0,351.52,3753.6,84 HCPCS,C1713,SCREW BN 2.7MM 9MM,8149.0,8149.0,1059.37,6926.65,28 HCPCS,C1713,SCREW BN 2.7X4.3X46MM,4707.0,4707.0,611.91,4000.95,28 HCPCS,C1713,SCREW BN 2.7X4.5X20MM,4707.0,4707.0,611.91,4000.95,28 HCPCS,C1713,SCREW BN 2.7X4.5X46MM,1850.0,1850.0,240.5,1572.5,28 HCPCS,C1713,SCREW BN 2.7X52MM,5533.0,5533.0,719.29,4703.05,28 HCPCS,C1713,SCREW BN 2.7X5MM 14MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2.8MM 12MM,6198.0,6198.0,805.74,5268.3,28 HCPCS,C1713,SCREW BN 2.8MM 14MM,4992.0,4992.0,492.18,5268.3,56 HCPCS,C1713,SCREW BN 2.8MM 16MM,6198.0,6198.0,805.74,5268.3,28 HCPCS,C1713,SCREW BN 2.8MM 18MM,6198.0,6198.0,805.74,5268.3,28 HCPCS,C1713,SCREW BN 2.8MM 20MM,4992.0,4992.0,492.18,5268.3,56 HCPCS,C1713,SCREW BN 20MM 10MM,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,SCREW BN 2MM 10MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN 2MM 12MM,1926.5,1926.5,132.21,2410.6,56 HCPCS,C1713,SCREW BN 2MM 13MM,10449.0,10449.0,1358.37,8881.65,28 HCPCS,C1713,SCREW BN 2MM 14MM,16335.0,16335.0,2123.55,13884.75,28 HCPCS,C1713,SCREW BN 2MM 18MM IBS 1.,16374.0,16374.0,2128.62,13917.9,28 HCPCS,C1713,SCREW BN 2MM 6MM,3228.5,3228.5,368.68,3077.85,56 HCPCS,C1713,SCREW BN 2MM 8MM,3498.0,3498.0,454.74,2973.3,28 HCPCS,C1713,SCREW BN 2X11MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 2X12MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 2X13MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 2X14MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 2X5MM,2630.0,2630.0,341.9,2235.5,28 HCPCS,C1713,SCREW BN 2X7MM,2630.0,2630.0,341.9,2235.5,28 HCPCS,C1713,SCREW BN 3-2.5X100X30MM,4942.0,4942.0,642.46,4200.7,28 HCPCS,C1713,SCREW BN 3.0MM 14MM,12123.0,12123.0,1365.26,11682.4,56 HCPCS,C1713,SCREW BN 3.0MM 16MM,14910.5,14910.5,1365.26,16421.15,56 HCPCS,C1713,SCREW BN 3.0MM 18MM,6951.0,6951.0,903.63,5908.35,28 HCPCS,C1713,SCREW BN 3.0MM 22MM,6951.0,6951.0,903.63,5908.35,28 HCPCS,C1713,SCREW BN 3.0MM 32MM,10406.0,10406.0,1352.78,8845.1,28 HCPCS,C1713,SCREW BN 3.0MM 32MM 14MM,6597.0,6597.0,857.61,5607.45,28 HCPCS,C1713,SCREW BN 3.0X16MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 3.0X20MM,10406.0,10406.0,1352.78,8845.1,28 HCPCS,C1713,SCREW BN 3.3MM 42MM,29008.0,29008.0,3771.04,24656.8,28 HCPCS,C1713,SCREW BN 3.3MM 50MM,29008.0,29008.0,3771.04,24656.8,28 HCPCS,C1713,SCREW BN 3.5MM 10MM,3018.5,3018.5,244.53,3532.6,56 HCPCS,C1713,SCREW BN 3.5MM 12MM,4950.0,4950.0,231.14,10847.7,196 HCPCS,C1713,SCREW BN 3.5MM 14MM,5301.0,5301.0,244.53,10673.45,196 HCPCS,C1713,SCREW BN 3.5MM 16MM,3534.0,3534.0,167.96,9179.15,224 HCPCS,C1713,SCREW BN 3.5MM 18MM,3897.0,3897.0,167.96,11682.4,140 HCPCS,C1713,SCREW BN 3.5MM 20MM,1881.0,1881.0,116.61,6508.45,140 HCPCS,C1713,SCREW BN 3.5MM 22MM,1650.5,1650.5,132.21,3800.35,112 HCPCS,C1713,SCREW BN 3.5MM 24MM,3810.0,3810.0,244.53,20615.9,84 HCPCS,C1713,SCREW BN 3.5MM 24MM SS,1292.0,1292.0,167.96,1098.2,28 HCPCS,C1713,SCREW BN 3.5MM 26MM,4538.5,4538.5,184.6,6508.45,56 HCPCS,C1713,SCREW BN 3.5MM 26MM SS,1292.0,1292.0,167.96,1098.2,28 HCPCS,C1713,SCREW BN 3.5MM 28MM,3810.0,3810.0,184.6,4435.3,84 HCPCS,C1713,SCREW BN 3.5MM 28MM SS,1292.0,1292.0,167.96,1098.2,28 HCPCS,C1713,SCREW BN 3.5MM 30MM,4514.0,4514.0,184.6,33397.35,112 HCPCS,C1713,SCREW BN 3.5MM 30MM SS,1292.0,1292.0,167.96,1098.2,28 HCPCS,C1713,SCREW BN 3.5MM 32MM,5853.0,5853.0,760.89,4975.05,28 HCPCS,C1713,SCREW BN 3.5MM 34MM,3810.0,3810.0,495.3,3238.5,28 HCPCS,C1713,SCREW BN 3.5MM 36MM,3316.5,3316.5,132.21,4773.6,56 HCPCS,C1713,SCREW BN 3.5MM 40MM,2615.0,2615.0,184.6,3238.5,56 HCPCS,C1713,SCREW BN 3.5MM 44MM,15302.0,15302.0,678.34,21578.1,56 HCPCS,C1713,SCREW BN 3.5MM 45MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 46MM,1420.0,1420.0,184.6,1207.0,28 HCPCS,C1713,SCREW BN 3.5MM 48MM,5420.0,5420.0,704.6,4607.0,28 HCPCS,C1713,SCREW BN 3.5MM 50MM,3810.0,3810.0,116.61,5304.0,84 HCPCS,C1713,SCREW BN 3.5MM 54MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN 3.5MM 55MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN 3.5MM 60MM,6437.5,6437.5,678.34,6508.45,56 HCPCS,C1713,SCREW BN 3.5MM 65MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 14MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 18MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 22MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 24MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 26MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 30MM,924.0,924.0,120.12,785.4,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 32MM,924.0,924.0,120.12,785.4,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 36MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 40MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 6MM 60MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN 3.5MM 70MM,5084.0,5084.0,643.5,4435.3,56 HCPCS,C1713,SCREW BN 3.5MM 75MM,3273.0,3273.0,207.48,4207.5,56 HCPCS,C1713,SCREW BN 3.5MM 80MM,4950.0,4950.0,617.5,4435.3,84 HCPCS,C1713,SCREW BN 3.5MM 85MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN 3.5MMX26MM,1881.0,1881.0,244.53,1598.85,28 HCPCS,C1713,SCREW BN 3.5X12MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW BN 3.5X14MM,6951.0,6951.0,903.63,5908.35,28 HCPCS,C1713,SCREW BN 3.5X16MM,4713.0,4713.0,612.69,4006.05,28 HCPCS,C1713,SCREW BN 3.5X18MM,4742.5,4742.5,557.05,4420.0,56 HCPCS,C1713,SCREW BN 3.5X2.9X55MM,4247.0,4247.0,552.11,3609.95,28 HCPCS,C1713,SCREW BN 3.5X2.9X85MM,4750.0,4750.0,617.5,4037.5,28 HCPCS,C1713,SCREW BN 3.5X22MM,2715.0,2715.0,167.96,3517.3,56 HCPCS,C1713,SCREW BN 3.5X23 AND 26MM,18770.0,18770.0,2440.1,15954.5,28 HCPCS,C1713,SCREW BN 3.5X26MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN 3.5X28MM,1017.0,1017.0,132.21,864.45,28 HCPCS,C1713,SCREW BN 3.5X32MM,1456.0,1456.0,184.6,1268.2,56 HCPCS,C1713,SCREW BN 3.5X34MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN 3.5X36MM,7026.5,7026.5,678.34,7509.75,56 HCPCS,C1713,SCREW BN 3.5X38MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN 3.5X40MM,5924.0,5924.0,770.12,5035.4,28 HCPCS,C1713,SCREW BN 3.5X42MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN 3.5X50MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN 3.5X75MM,4750.0,4750.0,617.5,4037.5,28 HCPCS,C1713,SCREW BN 3.7MM 28MM,27164.0,27164.0,3531.32,23089.4,28 HCPCS,C1713,SCREW BN 3.7MM 36MM,27164.0,27164.0,3531.32,23089.4,56 HCPCS,C1713,SCREW BN 3.8MM 18MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 30MM 4.5MM,2829.0,2829.0,367.77,2404.65,28 HCPCS,C1713,SCREW BN 34MM 4.5MM,4160.0,4160.0,540.8,3536.0,28 HCPCS,C1713,SCREW BN 35MM 32MM,39291.0,39291.0,5107.83,33397.35,28 HCPCS,C1713,SCREW BN 3MM 12MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,SCREW BN 3MM 13MM,8560.5,8560.5,1102.66,7343.15,56 HCPCS,C1713,SCREW BN 3MM 13MM(4/4EA),27940.0,27940.0,3632.2,23749.0,28 HCPCS,C1713,SCREW BN 3MM 16MM,5616.0,5616.0,684.45,8845.1,84 HCPCS,C1713,SCREW BN 3MM 18MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN 3MM 20MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN 3MM 30MM,15143.0,15143.0,1968.59,12871.55,28 HCPCS,C1713,SCREW BN 3X4X1.2X36X16MM,6597.0,6597.0,857.61,5607.45,28 HCPCS,C1713,SCREW BN 3X4X1.2X38X18MM,6597.0,6597.0,857.61,5607.45,28 HCPCS,C1713,SCREW BN 4.0MM 14MM,698.0,698.0,90.74,593.3,28 HCPCS,C1713,SCREW BN 4.0MM 38MM,10406.0,10406.0,1352.78,8845.1,28 HCPCS,C1713,SCREW BN 4.0MM 40MM,11127.0,11127.0,1446.51,9457.95,28 HCPCS,C1713,SCREW BN 4.0MM 46MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,SCREW BN 4.0MM 48MM,25386.0,25386.0,3300.18,21578.1,28 HCPCS,C1713,SCREW BN 4.5MM 20MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 22MM,4160.0,4160.0,161.72,5674.6,84 HCPCS,C1713,SCREW BN 4.5MM 26MM,4160.0,4160.0,277.55,5674.6,84 HCPCS,C1713,SCREW BN 4.5MM 28M,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN 4.5MM 28MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 30MM,4160.0,4160.0,405.6,23089.4,84 HCPCS,C1713,SCREW BN 4.5MM 32M,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN 4.5MM 32MM,5188.5,5188.5,405.6,6168.45,56 HCPCS,C1713,SCREW BN 4.5MM 34MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 36MM,4227.5,4227.5,231.27,5674.6,56 HCPCS,C1713,SCREW BN 4.5MM 38MM,5418.0,5418.0,540.8,5674.6,56 HCPCS,C1713,SCREW BN 4.5MM 40MM,1779.0,1779.0,231.27,1512.15,28 HCPCS,C1713,SCREW BN 4.5MM 42MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 44MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 46MM,4160.0,4160.0,540.8,3536.0,28 HCPCS,C1713,SCREW BN 4.5MM 48MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 50MM,7367.0,7367.0,957.71,6261.95,28 HCPCS,C1713,SCREW BN 4.5MM 54MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 56MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 60MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 64MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5MM 68MM,7898.0,7898.0,1026.74,6713.3,28 HCPCS,C1713,SCREW BN 4.5MM 72MM,9043.0,9043.0,1175.59,7686.55,28 HCPCS,C1713,SCREW BN 4.5MM 8MM 24MM,922.0,922.0,119.86,783.7,28 HCPCS,C1713,SCREW BN 4.5MM 8MM 30MM,922.0,922.0,119.86,783.7,28 HCPCS,C1713,SCREW BN 4.5MM 8MM 32MM,922.0,922.0,119.86,783.7,28 HCPCS,C1713,SCREW BN 4.5MM 8MM 38MM,922.0,922.0,119.86,783.7,28 HCPCS,C1713,SCREW BN 4.5X38MM,6668.0,6668.0,866.84,5667.8,28 HCPCS,C1713,SCREW BN 4.5X52MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.5X6.5X1.75MM,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1713,SCREW BN 4.75MM 45MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN 4.7MM 14MM,3074.0,3074.0,399.62,2612.9,28 HCPCS,C1713,SCREW BN 4.7MM 18MM,7328.0,7328.0,952.64,6228.8,28 HCPCS,C1713,SCREW BN 4MM 1.35MM 32MM,6558.0,6558.0,852.54,5574.3,28 HCPCS,C1713,SCREW BN 4MM 1.35MM 36MM,6558.0,6558.0,852.54,5574.3,28 HCPCS,C1713,SCREW BN 4MM 1.35MM 40MM,6558.0,6558.0,852.54,5574.3,28 HCPCS,C1713,SCREW BN 4MM 1.35MM 42MM,6558.0,6558.0,852.54,5574.3,28 HCPCS,C1713,SCREW BN 4MM 12MM,698.0,698.0,90.74,593.3,28 HCPCS,C1713,SCREW BN 4MM 14MM,10799.0,10799.0,1403.87,9179.15,28 HCPCS,C1713,SCREW BN 4MM 24MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 4MM 3.4MM 14MM,4953.0,4953.0,643.89,4210.05,28 HCPCS,C1713,SCREW BN 4MM 38MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 4MM 42MM,5075.0,5075.0,659.75,4313.75,28 HCPCS,C1713,SCREW BN 4MM 42MM 14MM,5699.0,5699.0,740.87,4844.15,28 HCPCS,C1713,SCREW BN 4MM 44MM,6532.0,6532.0,849.16,5552.2,28 HCPCS,C1713,SCREW BN 4MM 44MM 15MM,5990.0,5990.0,778.7,5091.5,28 HCPCS,C1713,SCREW BN 4MM 48MM,5990.0,5990.0,778.7,5091.5,28 HCPCS,C1713,SCREW BN 4MM 50MM 17MM,5990.0,5990.0,778.7,5091.5,28 HCPCS,C1713,SCREW BN 4MM 60MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 4MM 6MM 45MM,706.0,706.0,91.78,600.1,28 HCPCS,C1713,SCREW BN 4MM 6MM 55MM,747.0,747.0,97.11,634.95,28 HCPCS,C1713,SCREW BN 4MM 70MM 23.5MM,6181.0,6181.0,803.53,5253.85,28 HCPCS,C1713,SCREW BN 5.0MM 14MM,3079.0,3079.0,400.27,2617.15,28 HCPCS,C1713,SCREW BN 5.0MM 30MM,39049.0,39049.0,5076.37,33191.65,28 HCPCS,C1713,SCREW BN 5.0MM 55M,39049.0,39049.0,5076.37,33191.65,28 HCPCS,C1713,SCREW BN 5.0MM 65MM,6985.0,6985.0,908.05,5937.25,28 HCPCS,C1713,SCREW BN 5.0MM 75MM,7158.0,7158.0,930.54,6084.3,28 HCPCS,C1713,SCREW BN 5.0X35MM,39051.0,39051.0,5076.63,33193.35,28 HCPCS,C1713,SCREW BN 5MM 10MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN 5MM 15MM,15511.0,15511.0,2016.43,13184.35,28 HCPCS,C1713,SCREW BN 5MM 22MM,2953.5,2953.5,362.31,2652.0,56 HCPCS,C1713,SCREW BN 5MM 26MM,3120.0,3120.0,362.31,5985.7,84 HCPCS,C1713,SCREW BN 5MM 30MM,4264.0,4264.0,405.6,4596.8,56 HCPCS,C1713,SCREW BN 5MM 32MM,10212.0,10212.0,648.96,13117.2,56 HCPCS,C1713,SCREW BN 5MM 35MM,14609.0,14609.0,1899.17,12417.65,28 HCPCS,C1713,SCREW BN 5MM 37.5MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN 5MM 40MM,6420.0,6420.0,648.96,5985.7,84 HCPCS,C1713,SCREW BN 5MM 42MM,5443.5,5443.5,405.6,14574.95,112 HCPCS,C1713,SCREW BN 5MM 45MM,39049.0,39049.0,5076.37,33191.65,28 HCPCS,C1713,SCREW BN 5MM 47.5MM,11069.5,11069.5,648.96,14574.95,56 HCPCS,C1713,SCREW BN 5MM 50MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN 5MM 57MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN 5MM 60MM,39049.0,39049.0,5076.37,33191.65,28 HCPCS,C1713,SCREW BN 5MM 65MM,7158.0,7158.0,930.54,6084.3,28 HCPCS,C1713,SCREW BN 5MM 75MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN 5MM 85MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN 5MN 30MM,3079.0,3079.0,400.27,2617.15,28 HCPCS,C1713,SCREW BN 5X37MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN 5X46MM,3120.0,3120.0,405.6,2652.0,28 HCPCS,C1713,SCREW BN 6.0MM,3629.0,3629.0,471.77,3084.65,28 HCPCS,C1713,SCREW BN 6.5MM 100MM,6479.0,6479.0,842.27,5507.15,28 HCPCS,C1713,SCREW BN 6.5MM 20MM,2541.0,2541.0,250.38,2404.65,112 HCPCS,C1713,SCREW BN 6.5MM 25MM,4305.5,4305.5,330.33,8344.45,196 HCPCS,C1713,SCREW BN 6.5MM 30MM,2541.0,2541.0,330.33,2159.85,84 HCPCS,C1713,SCREW BN 6.5MM 35MM,2541.0,2541.0,250.38,10013.0,140 HCPCS,C1713,SCREW BN 6.5MM 40MM,2541.0,2541.0,231.27,10963.3,112 HCPCS,C1713,SCREW BN 6.5MM 45MM,7639.0,7639.0,330.33,10963.3,112 HCPCS,C1713,SCREW BN 6.5MM 50MM,10105.5,10105.5,330.33,15019.5,84 HCPCS,C1713,SCREW BN 6.5MM 70MM,3180.0,3180.0,413.4,2703.0,28 HCPCS,C1713,SCREW BN 6.5MM 80MM,40617.0,40617.0,5280.21,34524.45,28 HCPCS,C1713,SCREW BN 6.5X100X32MM,11675.0,11675.0,1517.75,9923.75,28 HCPCS,C1713,SCREW BN 6.5X15MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN 6.5X2.9MM 85MM,9511.0,9511.0,1236.43,8084.35,28 HCPCS,C1713,SCREW BN 6.5X2.9MM 90MM,9355.0,9355.0,1216.15,7951.75,28 HCPCS,C1713,SCREW BN 6.5X25MM,2233.5,2233.5,250.38,2159.85,56 HCPCS,C1713,SCREW BN 6.5X30MM,2233.5,2233.5,250.38,2159.85,56 HCPCS,C1713,SCREW BN 6.5X30MM XIA 3,17670.0,17670.0,2297.1,15019.5,28 HCPCS,C1713,SCREW BN 6.5X35MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN 6.5X50MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN 7MM 20MM,10210.0,10210.0,1327.3,8678.5,28 HCPCS,C1713,SCREW BN 80MM 75MM,20050.0,20050.0,2606.5,17042.5,28 HCPCS,C1713,SCREW BN 8MM 20MM,12557.0,12557.0,1632.41,10673.45,28 HCPCS,C1713,SCREW BN 95MM 90MM,20050.0,20050.0,2606.5,17042.5,28 HCPCS,C1713,SCREW BN 9MM 20MM,19319.0,19319.0,2511.47,16421.15,28 HCPCS,C1713,SCREW BN ACTB 25MM,2591.0,2591.0,336.83,2202.35,28 HCPCS,C1713,SCREW BN ANCH 4.0MM 20MM,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1713,SCREW BN ANCH 4.0MM 30MM,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1713,SCREW BN ANKL 3.5X18MM,6115.0,6115.0,794.95,5197.75,28 HCPCS,C1713,SCREW BN CANC 5MM 44MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN CANC 5MM 46MM,5895.0,5895.0,766.35,5010.75,28 HCPCS,C1713,SCREW BN CANN 2.5MM 20MM,10406.0,10406.0,1352.78,8845.1,28 HCPCS,C1713,SCREW BN CANN 2.5MM 24MM,10406.0,10406.0,1352.78,8845.1,28 HCPCS,C1713,SCREW BN CANN 3.5X16MM,13744.0,13744.0,1786.72,11682.4,28 HCPCS,C1713,SCREW BN CANN 3MM 30MM,6597.0,6597.0,857.61,5607.45,28 HCPCS,C1713,SCREW BN CANN 4.5X30MM,7367.0,7367.0,957.71,6261.95,28 HCPCS,C1713,SCREW BN CANN 4MM 40MM,5990.0,5990.0,778.7,5091.5,28 HCPCS,C1713,SCREW BN CANN 4X44MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN CMPR 4.5MM 35MM,3120.0,3120.0,405.6,2652.0,28 HCPCS,C1713,SCREW BN COMP 6MM 15MM,12094.0,12094.0,1572.22,10279.9,28 HCPCS,C1713,SCREW BN COMP 6MM 20MM,12094.0,12094.0,1572.22,10279.9,28 HCPCS,C1713,SCREW BN CORT 2MM 8MM,1619.0,1619.0,210.47,1376.15,28 HCPCS,C1713,SCREW BN CORT 3.5MM 38MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN CORT 3.5X14MM,3946.5,3946.5,231.14,5197.75,56 HCPCS,C1713,SCREW BN CORT 30MMX4.5MM,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN CORT 4.5X20MM,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN CORT 4.5X40MM,922.0,922.0,119.86,783.7,28 HCPCS,C1713,SCREW BN CORT 6.5X15MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN CRTX ST2.7X20MM,1850.0,1850.0,240.5,1572.5,28 HCPCS,C1713,SCREW BN GLND 5.0X34MM,3120.0,3120.0,405.6,2652.0,28 HCPCS,C1713,SCREW BN GLND 6.5X40MM,11780.0,11780.0,1531.4,10013.0,28 HCPCS,C1713,SCREW BN GLND PLATE LT,4160.0,4160.0,540.8,3536.0,28 HCPCS,C1713,SCREW BN HAND 2.5MM 12MM,3786.0,3786.0,492.18,3218.1,28 HCPCS,C1713,SCREW BN HD 4MM 30MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN HD 4MM 40MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN HDLS 2.5X10MM,13744.0,13744.0,1786.72,11682.4,28 HCPCS,C1713,SCREW BN HDLSS 2.3X40MM,27488.0,27488.0,3573.44,23364.8,28 HCPCS,C1713,SCREW BN HIP 6.5MM 20MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN HIP 6.5MM 60MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN L13 2.7MM,70627.0,70627.0,9181.51,60032.95,28 HCPCS,C1713,SCREW BN L8 2.7MM,7147.0,7147.0,929.11,6074.95,28 HCPCS,C1713,SCREW BN L9 2.7MM,7147.0,7147.0,929.11,6074.95,28 HCPCS,C1713,SCREW BN LAG 1.4X4X48MM,6911.0,6911.0,898.43,5874.35,28 HCPCS,C1713,SCREW BN LAG 85/80MM,20050.0,20050.0,2606.5,17042.5,28 HCPCS,C1713,SCREW BN LCK 2.4X14MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN LCK 2.5MM 14MM,6872.0,6872.0,893.36,5841.2,28 HCPCS,C1713,SCREW BN LCK 2.5X22MM,6872.0,6872.0,893.36,5841.2,28 HCPCS,C1713,SCREW BN LCK 2.7MM 12MM,3578.0,3578.0,465.14,3041.3,28 HCPCS,C1713,SCREW BN LCK 2.7MM 16MM,4707.0,4707.0,611.91,4000.95,28 HCPCS,C1713,SCREW BN LCK 2.7MM 8MM,3578.0,3578.0,465.14,3041.3,28 HCPCS,C1713,SCREW BN LCK 2.7X24MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN LCK 20MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN LCK 2X12MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN LCK 3.5MM 14MM,3574.0,3574.0,464.62,3037.9,28 HCPCS,C1713,SCREW BN LCK 3.5MM 26MM,12409.0,12409.0,1613.17,10547.65,28 HCPCS,C1713,SCREW BN LCK 3.5MM 28MM,12409.0,12409.0,1613.17,10547.65,28 HCPCS,C1713,SCREW BN LCK 3.5MM 32MM,12409.0,12409.0,1613.17,10547.65,28 HCPCS,C1713,SCREW BN LCK 3.5MM 34MM,12409.0,12409.0,1613.17,10547.65,28 HCPCS,C1713,SCREW BN LCK 3.5MM 38MM,12409.0,12409.0,1613.17,10547.65,28 HCPCS,C1713,SCREW BN LCK 3.5MM 75MM,5218.0,5218.0,678.34,4435.3,28 HCPCS,C1713,SCREW BN LCK 3.5MN 12MM,3574.0,3574.0,464.62,3037.9,28 HCPCS,C1713,SCREW BN LCK 3.5X16.0MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN LCK 3.5X36MM,3810.0,3810.0,495.3,3238.5,28 HCPCS,C1713,SCREW BN LCK 3.5X38MM,3897.0,3897.0,506.61,3312.45,28 HCPCS,C1713,SCREW BN LCK 30MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN LCK 3MM 22MM,6106.0,6106.0,793.78,5190.1,28 HCPCS,C1713,SCREW BN LCK 3X14MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,SCREW BN LCK 4.5MM 15MM,3162.0,3162.0,411.06,2687.7,28 HCPCS,C1713,SCREW BN LCK 5MM 40MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN LCK 5MM 47MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN LCK 5MM 60MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN LCK 5X40,5341.0,5341.0,694.33,4539.85,28 HCPCS,C1713,SCREW BN LCK 5X57.5MM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C1713,SCREW BN LCK F-T6.5X95MM,6479.0,6479.0,842.27,5507.15,28 HCPCS,C1713,SCREW BN LCK SD 2.7X11MM,8149.0,8149.0,1059.37,6926.65,28 HCPCS,C1713,SCREW BN LCK THRD 3.5X12,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN LCKG 3.5X40MM,7657.0,7657.0,995.41,6508.45,28 HCPCS,C1713,SCREW BN LOPRO 3.5X20MM,4960.0,4960.0,644.8,4216.0,28 HCPCS,C1713,SCREW BN NLCK 2.5X14MM,4243.0,4243.0,551.59,3606.55,28 HCPCS,C1713,SCREW BN NLCK 2.5X16MM,4243.0,4243.0,551.59,3606.55,28 HCPCS,C1713,SCREW BN NLCK 2.7X16MM,4285.0,4285.0,557.05,3642.25,28 HCPCS,C1713,SCREW BN NLCK 2.7X18MM,4071.0,4071.0,529.23,3460.35,28 HCPCS,C1713,SCREW BN NLCK 3.5MM 16MM,5658.0,5658.0,735.54,4809.3,28 HCPCS,C1713,SCREW BN NLCK 3.5MM 28MM,3827.0,3827.0,497.51,3252.95,28 HCPCS,C1713,SCREW BN NLCK 3.5MM 30MM,3827.0,3827.0,497.51,3252.95,28 HCPCS,C1713,SCREW BN NLCK 3.5MM 34MM,3827.0,3827.0,497.51,3252.95,28 HCPCS,C1713,SCREW BN NLCK 3.5X34MM,10799.0,10799.0,1403.87,9179.15,28 HCPCS,C1713,SCREW BN NLCK 3.5X38MM,10799.0,10799.0,1403.87,9179.15,28 HCPCS,C1713,SCREW BN NLCK 3X12MM,5727.0,5727.0,744.51,4867.95,28 HCPCS,C1713,SCREW BN NLCKG 2.7X18MM,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN NON 2.7MM 20MM,1017.0,1017.0,132.21,864.45,28 HCPCS,C1713,SCREW BN NONLCK 2X16MM,1017.0,1017.0,132.21,864.45,28 HCPCS,C1713,SCREW BN NONLCK 3.5X12MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN NONLCK 3.5X24MM,1017.0,1017.0,132.21,864.45,28 HCPCS,C1713,SCREW BN NONLCK 3.5X40MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN P-AX 3.5X18MM,5745.0,5745.0,746.85,4883.25,28 HCPCS,C1713,SCREW BN P-AX 5MM 30MM,1881.0,1881.0,244.53,1598.85,28 HCPCS,C1713,SCREW BN P-AX LCK 3X16MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW BN PLT NLCK 3X14MM,5616.0,5616.0,730.08,4773.6,28 HCPCS,C1713,SCREW BN RELINE MAS SPNE,6449.0,6449.0,838.37,5481.65,28 HCPCS,C1713,SCREW BN S/T 2MM 10MM,2836.0,2836.0,368.68,2410.6,28 HCPCS,C1713,SCREW BN S/T 3.5MM 16MM,897.0,897.0,116.61,762.45,28 HCPCS,C1713,SCREW BN S/T 3.5X14MM,1327.0,1327.0,172.51,1127.95,28 HCPCS,C1713,SCREW BN S/T LCK2.7X16MM,4913.0,4913.0,638.69,4176.05,28 HCPCS,C1713,SCREW BN SHLDR 30MM,23446.0,23446.0,3047.98,19929.1,28 HCPCS,C1713,SCREW BN SLFDRL 2.7X8MM,8067.0,8067.0,1048.71,6856.95,28 HCPCS,C1713,SCREW BN SLFTP 5X38MM,8458.0,8458.0,1099.54,7189.3,28 HCPCS,C1713,SCREW BN SPN 4.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW BN SPN 4.5MM 12MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW BN SPN 4MM 34MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW BN SPN 6.5MM 45MM,16904.0,16904.0,2197.52,14368.4,28 HCPCS,C1713,SCREW BN SPN 6.5MM 50MM,16904.0,16904.0,2197.52,14368.4,28 HCPCS,C1713,SCREW BN SPN 6.5X40MM,16904.0,16904.0,2197.52,14368.4,28 HCPCS,C1713,SCREW BN SPN 6.5X50MM,16904.0,16904.0,2197.52,14368.4,28 HCPCS,C1713,SCREW BN SPN CERV 4X16MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW BN SPRCL 6.5X30MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SCREW BN STERNAL 3X8MM,2777.0,2777.0,361.01,2360.45,28 HCPCS,C1713,SCREW BN T10 3.5X18MM,3574.0,3574.0,464.62,3037.9,28 HCPCS,C1713,SCREW BN T10 3.5X20MM,3667.5,3667.5,277.55,4420.0,56 HCPCS,C1713,SCREW BN T8 2.7/L16MM,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1713,SCREW BN T8 2.7X50MM,1850.0,1850.0,240.5,1572.5,28 HCPCS,C1713,SCREW BN THRD 2.7 14MM,5200.0,5200.0,676.0,4420.0,28 HCPCS,C1713,SCREW BN TI 2.4X26MM,19319.0,19319.0,2511.47,16421.15,28 HCPCS,C1713,SCREW BN TI 2.4X28MM,19319.0,19319.0,2511.47,16421.15,28 HCPCS,C1713,SCREW BN TI 2.4X30MM,19319.0,19319.0,2511.47,16421.15,28 HCPCS,C1713,SCREW BN TI CORT 4X22MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW BN TI SLF DRL 4MM,3629.0,3629.0,471.77,3084.65,28 HCPCS,C1713,SCREW BN TIB KN 5X60MM,6420.0,6420.0,834.6,5457.0,28 HCPCS,C1713,SCREW CORT 2.0X10,1361.0,1361.0,176.93,1156.85,28 HCPCS,C1713,SCREW CORT BN 4.5MM 30MM,1779.0,1779.0,231.27,1512.15,28 HCPCS,C1713,SCREW FT ANKL 2.5X12MM,6240.0,6240.0,811.2,5304.0,28 HCPCS,C1713,SCREW LOCKING 4.5X20MM,3162.0,3162.0,411.06,2687.7,28 HCPCS,C1713,SCREW SD LCK 2.3X12MM,4335.0,4335.0,563.55,3684.75,28 HCPCS,C1713,SCREW SET FOR TIB INSERT,4160.0,4160.0,540.8,3536.0,28 HCPCS,C1713,SCREW SET SPN,2201.0,2201.0,286.13,1870.85,56 HCPCS,C1713,SCREW SET SPN 5.5MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SET SPN UNIV,10319.0,10319.0,1341.47,8771.15,28 HCPCS,C1713,SCREW SHLDR RVRS,14136.0,14136.0,1837.68,12015.6,28 HCPCS,C1713,SCREW SPN 04.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 10.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 10.5MM 60MM,49301.0,49301.0,6409.13,41905.85,56 HCPCS,C1713,SCREW SPN 10.5MM 70MM,49301.0,49301.0,6409.13,41905.85,28 HCPCS,C1713,SCREW SPN 2MM 4MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN 2MM 6MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN 2MM 8MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN 3.5MM 10MM,7765.5,7765.5,342.29,10963.3,84 HCPCS,C1713,SCREW SPN 3.5MM 12MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 3.5MM 14MM,7765.5,7765.5,342.29,10963.3,84 HCPCS,C1713,SCREW SPN 3.5MM 18MM,12898.0,12898.0,1676.74,10963.3,56 HCPCS,C1713,SCREW SPN 3.5MM 22MM,12898.0,12898.0,1676.74,10963.3,56 HCPCS,C1713,SCREW SPN 3.5MM 28MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 3.5MM 30MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 3.5MM 8MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 3.5X12MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 4.0MM 12MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 4.0MM 14MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.0MM 16MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.0MM 18MM,7765.5,7765.5,342.29,10963.3,56 HCPCS,C1713,SCREW SPN 4.0MM 24MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.0MM 35MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.5MM 10MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 4.5MM 12MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 4.5MM 14MM,7765.5,7765.5,342.29,10963.3,56 HCPCS,C1713,SCREW SPN 4.5MM 18MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.5MM 24MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.5MM 26MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.5MM 28MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 4.5MM 35MM,14196.5,14196.5,1676.74,13170.75,84 HCPCS,C1713,SCREW SPN 4.5MM 40MM,12898.0,12898.0,1676.74,10963.3,84 HCPCS,C1713,SCREW SPN 4.5MM 6MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 4.5MM 8MM,2633.0,2633.0,342.29,2238.05,56 HCPCS,C1713,SCREW SPN 4MM 12MM,2633.0,2633.0,342.29,2238.05,84 HCPCS,C1713,SCREW SPN 4MM 14MM,2633.0,2633.0,342.29,2238.05,84 HCPCS,C1713,SCREW SPN 4MM 16MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 5.0MM 25MM,9316.0,9316.0,1211.08,7918.6,56 HCPCS,C1713,SCREW SPN 5.0MM 28MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 5.0MM 30MM,11107.0,11107.0,1211.08,10963.3,56 HCPCS,C1713,SCREW SPN 5.0MM 35MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 5.5/6MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN 5.5MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN 5.5MM 24MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 5.5MM 25MM,7765.5,7765.5,342.29,10963.3,84 HCPCS,C1713,SCREW SPN 5.5MM 30MM,12898.0,12898.0,342.29,13170.75,196 HCPCS,C1713,SCREW SPN 5.5MM 35MM,15495.0,15495.0,1676.74,24389.9,168 HCPCS,C1713,SCREW SPN 5.5MM 40MM,14196.5,14196.5,1676.74,13170.75,140 HCPCS,C1713,SCREW SPN 5.5MM 45MM,14331.0,14331.0,1676.74,13170.75,168 HCPCS,C1713,SCREW SPN 50MM 7.5MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 5MM 12MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN 5MM 30MM,9316.0,9316.0,1211.08,7918.6,28 HCPCS,C1713,SCREW SPN 6.5MM 25MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 6.5MM 35MM,14196.5,14196.5,684.45,13303.35,224 HCPCS,C1713,SCREW SPN 6.5MM 40MM,15651.0,15651.0,1676.74,16403.3,112 HCPCS,C1713,SCREW SPN 6.5MM 45MM,14331.0,14331.0,1676.74,13303.35,224 HCPCS,C1713,SCREW SPN 6.5MM 50MM,13614.5,13614.5,1024.79,13303.35,112 HCPCS,C1713,SCREW SPN 6.5MM 55MM,14196.5,14196.5,1676.74,13170.75,56 HCPCS,C1713,SCREW SPN 6.5X45MM,12393.5,12393.5,1024.79,14368.4,56 HCPCS,C1713,SCREW SPN 7.5MM 40MM,14196.5,14196.5,1676.74,13170.75,84 HCPCS,C1713,SCREW SPN 7.5MM 45MM,14331.0,14331.0,1676.74,13170.75,168 HCPCS,C1713,SCREW SPN 7.5MM 50MM,13614.5,13614.5,1024.79,13170.75,140 HCPCS,C1713,SCREW SPN 7.5MM 55MM,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1713,SCREW SPN 7.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 7.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 7.5X45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 8.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 8.5MM 45MM,14331.0,14331.0,1676.74,13170.75,84 HCPCS,C1713,SCREW SPN 8.5MM 50MM,12898.0,12898.0,1211.08,13170.75,84 HCPCS,C1713,SCREW SPN 8.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 8.5MM 70MM,12898.0,12898.0,1676.74,10963.3,56 HCPCS,C1713,SCREW SPN 8.5MM 80MM,13614.5,13614.5,1676.74,12181.35,56 HCPCS,C1713,SCREW SPN 9.0MM 60MM,49301.0,49301.0,6409.13,41905.85,28 HCPCS,C1713,SCREW SPN 9.0MM 70MM,49301.0,49301.0,6409.13,41905.85,28 HCPCS,C1713,SCREW SPN 9.0MM 80MM,49301.0,49301.0,6409.13,41905.85,28 HCPCS,C1713,SCREW SPN 9.5MM 35MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 9.5MM 40MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 9.5MM 45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 9.5MM 60MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 9.5MM 70MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN 9.5MM 80MM,49301.0,49301.0,6409.13,41905.85,28 HCPCS,C1713,SCREW SPN CLOSURE TOP,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN DSTRCT 14MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN LOCKING,4423.0,4423.0,574.99,3759.55,28 HCPCS,C1713,SCREW SPN P-AX 05.5X40MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN P-AX 05.5X45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN P-AX 4X22MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1713,SCREW SPN PAX LCK 3X10MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1713,SCREW SPN SET,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN SET GRY,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,SCREW SPN SHNK 6.5MM45MM,7883.0,7883.0,1024.79,6700.55,28 HCPCS,C1713,SCREW SPN SHNK 8.5MM45MM,7883.0,7883.0,1024.79,6700.55,28 HCPCS,C1713,SCREW SPN SLFDRL 4X14MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN SLFDRL3.5X19MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPN XIA 4823-16535,19298.0,19298.0,2508.74,16403.3,28 HCPCS,C1713,SCREW SPNL 4MM 10MM,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPNL 4X16MM FXANG,2633.0,2633.0,342.29,2238.05,28 HCPCS,C1713,SCREW SPNL 6.5MM 45MM,19298.0,19298.0,2508.74,16403.3,28 HCPCS,C1713,SCREW SPNL LCK 2.4X12MM,5590.0,5590.0,726.7,4751.5,28 HCPCS,C1713,SCREW SPNL LCK 2.7X14MM,881.0,881.0,114.53,748.85,28 HCPCS,C1713,SCREW TT LCK SELFDRILL 5,7100.0,7100.0,915.46,6084.3,84 HCPCS,C1713,SCREW VAR ANG 4.5X15MM,2829.0,2829.0,367.77,2404.65,28 HCPCS,C1713,SET PLANTAR PLATE IMPLAN,42687.0,42687.0,5549.31,36283.95,28 HCPCS,C1713,SET SCREW BN 2.0X12MM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1713,SET SCREW SPN,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1713,STAPLE BN 14X14X18MM,39970.0,39970.0,5196.1,33974.5,28 HCPCS,C1713,STAPLE BN 14X18X18MM,44530.0,44530.0,5788.9,37850.5,28 HCPCS,C1713,STAPLE BN 16MM 18MM,78840.0,78840.0,10249.2,67014.0,28 HCPCS,C1713,STAPLE BN 18MM 18MM 18MM,39970.0,39970.0,5196.1,33974.5,28 HCPCS,C1713,STAPLE BN 18X14X14MM,44530.0,44530.0,5788.9,37850.5,28 HCPCS,C1713,STAPLE BN 18X18X18MM,38891.0,38891.0,5055.83,33057.35,28 HCPCS,C1713,STAPLE BN 26MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,STAPLE BN 8X8MM,54975.0,54975.0,7146.75,46728.75,28 HCPCS,C1713,STAPLE BN NITL 30MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,SUTURE ANCH 14.5X1.3MM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1713,SUTURE ANCHOR 4.75MM,20373.0,20373.0,2648.49,17317.05,28 HCPCS,C1713,SUTURE FIB #2 48IN,4035.0,4035.0,524.55,3429.75,28 HCPCS,C1713,SYS IMPLANT BN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,SYSTEM CBL HIP 23X121MM,88962.0,88962.0,11565.06,75617.7,28 HCPCS,C1713,SYSTEM CBL HIP 23X53MM,55686.0,55686.0,7239.18,47333.1,28 HCPCS,C1713,SYSTEM FX ANCHOR 37CM,33236.0,33236.0,4320.68,28250.6,28 HCPCS,C1713,SYSTEM IMPL ACL 11MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,SYSTEM IMPL SYNDSMS FX,43560.0,43560.0,5662.8,37026.0,28 HCPCS,C1713,SYSTEM IMPLNT ACH MID SB,34178.0,34178.0,4443.14,29051.3,28 HCPCS,C1713,SYSTEM IMPLNT TNPDSIS,36381.0,36381.0,4729.53,30923.85,28 HCPCS,C1713,SYSTEM KNOTLES AC REPAIR,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1713,SYSTEM MENISCAL REPAIR,18063.0,18063.0,2348.19,15353.55,28 HCPCS,C1713,SYSTM FX 30 TISS ANCHORS,27446.0,27446.0,3567.98,23329.1,28 HCPCS,C1713,TULIP SPN EXTNDED P-AX,6449.0,6449.0,838.37,5481.65,28 HCPCS,C1713,WASHER BN 13.0MM,1196.0,1196.0,155.48,1016.6,28 HCPCS,C1714,CATH ATHR 112CM 2.5MM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1714,CATH ATHRCM 2.5MM 112CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1716,"Brachytherapy source, non-stranded, gold-198, per source ",,,213.12,349.38,5 HCPCS,C1717,"Brachytherapy source, non-stranded, high dose rate iridium-192, per source ",,,589.3,966.06,5 HCPCS,C1719,"Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source ",,,115.24,188.91,5 HCPCS,C1721,DEFIB ICD 69X51X12MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD CRD 5.37X7.68CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD DC DR-T DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD DEFB DLCHMBR MRI IS1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD DEFIB 68X51X13MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD DR MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1721,ICD VVED 36.5MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,CRT-D HF-T DF1 360D,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD 12MM 36J ANG 51X68MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD CHAMBER 1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD CRD 5.3X7.79X0.99CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD DEFIB CARD 7.36CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1722,ICD DEFIB CARD DEVICE,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD XT MRI DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1722,ICD-S 12.7MM 83.1X69.1MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1724,BURR CATH ARTHRM 1.25MM,59317.0,59317.0,3559.02,50419.45,49 HCPCS,C1724,BURR CATH ARTHRM 1.50MM,59317.0,59317.0,3559.02,50419.45,49 HCPCS,C1724,CATH .038 65CM 4FR,1453.0,1453.0,87.18,1235.05,49 HCPCS,C1724,CATH ARTHCTMY 5F 146CM,50535.0,50535.0,3032.1,42954.75,49 HCPCS,C1724,CATH ATHRCM 0.9MM 150CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1724,CATH ATHRCM 1.4MM 150CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1724,CATH ATHRCM 1.50MM 145CM,96863.0,96863.0,5811.78,82333.55,49 HCPCS,C1724,CATH ATHRCM 1.7MM 150CM,78576.0,78576.0,4714.56,66789.6,98 HCPCS,C1724,CATH ATHRCM 145CM 1.25MM,96863.0,96863.0,5811.78,82333.55,98 HCPCS,C1724,CATH ATHRCM 200CM 1.50MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1724,CATH ATHRCM 2MM 145CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1724,CATH ATHRCM 6FR 130CM,69177.5,69177.5,4150.65,58800.88,98 HCPCS,C1724,CATH ATHRCM 7FR 135CM,69177.5,69177.5,4150.65,58800.88,49 HCPCS,C1724,CATH ATHRCM STRL 1.75MM,3917.0,3917.0,235.02,3329.45,49 HCPCS,C1724,CATH SET 6F 135MM,79654.5,79654.5,4779.27,67706.32,49 HCPCS,C1724,CATH SET 6FR 110CM,89361.0,89361.0,5361.66,75956.85,49 HCPCS,C1724,CATH SET 8F 85CM,82740.0,82740.0,4964.4,70329.0,49 HCPCS,C1724,CATH SET 8FR 110CM,79654.5,79654.5,4779.27,67706.32,49 HCPCS,C1724,SYSTEM CATH ARTHRCM 1.5M,96863.0,96863.0,5811.78,82333.55,49 HCPCS,C1724,SYSTEM CATH ARTHRCM 135C,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1724,SYSTEM CATH ARTHRCM 2MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,BALLOON PTCA 2.5MM 10MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 2.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 2MM 10MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 2MM 15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 3.5MM 10MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 3.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 3MM 10MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 3MM 15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,BALLOON PTCA 4MM 10MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH ANGIO 16MM 4CM 80CM,9226.5,9226.5,553.59,7842.52,49 HCPCS,C1725,CATH ANGIO 5F 100CM,615.5,615.5,36.93,523.17,49 HCPCS,C1725,CATH ANGIO 6FR 80CM,4140.5,4140.5,248.43,3519.43,49 HCPCS,C1725,CATH ANGIO DIL 5.50X15MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH ANGIO DIL 6X15MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH ANGIO PGTL 5F 100CM,3446.5,3446.5,206.79,2929.53,49 HCPCS,C1725,CATH BALLOON PTCA 4X15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH BALLOON2.5X120MM,46221.0,46221.0,2773.26,39287.85,49 HCPCS,C1725,CATH BLDL 2X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLDL 2X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLDL 2X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN .014 2.5X120MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 1.2X12MM 145CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLN 1.5X120MM 150CM,7187.0,7187.0,376.38,6885.85,98 HCPCS,C1725,CATH BLN 1.5X20MM 145CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLN 1.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2.0X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLN 2.0X20MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLN 2.25MM 15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 2.25MMX10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 2.5MMX12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 2.5X100MM 150CM,6482.0,6482.0,376.38,5687.35,98 HCPCS,C1725,CATH BLN 2.5X120MM 150CM,6691.0,6691.0,363.84,8231.4,147 HCPCS,C1725,CATH BLN 2.5X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLN 2.5X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLN 2.5X20MM 150CM,6482.0,6482.0,376.38,5687.35,147 HCPCS,C1725,CATH BLN 2.5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 2.5X40MM 150CM,6482.0,6482.0,363.84,8081.8,196 HCPCS,C1725,CATH BLN 2.5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2.5X60MM 150CM,6691.0,6691.0,376.38,6097.48,147 HCPCS,C1725,CATH BLN 2.5X80MM 150CM,6273.0,6273.0,363.84,5687.35,147 HCPCS,C1725,CATH BLN 20MM 80CM,10164.5,10164.5,609.87,8639.83,49 HCPCS,C1725,CATH BLN 22X4.5X110MM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLN 2MM 150CM 40MM,8101.0,8101.0,486.06,6885.85,49 HCPCS,C1725,CATH BLN 2X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2X120MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 2X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2X20MM 150CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 2X210MM 150CM,10036.0,10036.0,602.16,8530.6,98 HCPCS,C1725,CATH BLN 2X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 2X40MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 2X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 2X80MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 3.0X120MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLN 3.0X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 HCPCS,C1725,CATH BLN 3.0X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3.5X100MM 150CM,6273.0,6273.0,363.84,5687.35,147 HCPCS,C1725,CATH BLN 3.5X120MM 150CM,6482.0,6482.0,376.38,5687.35,98 HCPCS,C1725,CATH BLN 3.5X20MM 150CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 3.5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 3.5X40MM 150CM,6273.0,6273.0,363.84,5687.35,147 HCPCS,C1725,CATH BLN 3.5X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3.5X60MM 150CM,6482.0,6482.0,376.38,5687.35,98 HCPCS,C1725,CATH BLN 3.5X80MM 150CM,6273.0,6273.0,363.84,5687.35,147 HCPCS,C1725,CATH BLN 3X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 3X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3X120MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 3X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3X20MM 150CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 3X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 3X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 3X40MM 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 3X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 3X80MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 3X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4.0X135MM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 4.0X210MM 150CM,10036.0,10036.0,602.16,8530.6,49 HCPCS,C1725,CATH BLN 4.0X80MM 135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 40MM 80CM,10164.5,10164.5,609.87,8639.83,49 HCPCS,C1725,CATH BLN 4MM 100CM,13997.0,13997.0,839.82,11897.45,49 HCPCS,C1725,CATH BLN 4X100MM 150CM,6273.0,6273.0,363.84,5687.35,196 HCPCS,C1725,CATH BLN 4X100MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X150 135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 4X150MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 4X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 4X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X40MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 4X40MM 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 4X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 4X80MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 4X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5.0X150MM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 5.5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X100MM 135CM,16975.25,16975.25,188.19,26191.9,98 HCPCS,C1725,CATH BLN 5X100MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 5X100MM 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 5X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 5X150MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 5X150MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X240MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 5X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 5X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 5X40MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 5X40MM 200CM,6273.0,6273.0,376.38,5332.05,147 HCPCS,C1725,CATH BLN 5X60MM 135CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 5X80MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 5X80MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 5X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 5X80MMX135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 6.0X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 6.0X40MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 6X100MM 135CM,16975.25,16975.25,188.19,26191.9,98 HCPCS,C1725,CATH BLN 6X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 6X100MM 200CM,6273.0,6273.0,376.38,5332.05,147 HCPCS,C1725,CATH BLN 6X120MM 150CM,46221.0,46221.0,2773.26,39287.85,49 HCPCS,C1725,CATH BLN 6X150MM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 6X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 6X150MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 6X150MM 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 6X20MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 6X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 6X240MM 135CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 6X240MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 6X240MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 6X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 6X40MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 6X40MM 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLN 6X60MM 135CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLN 6X80MM 135CM,16859.75,16859.75,174.33,26191.9,98 HCPCS,C1725,CATH BLN 6X80MM 150CM,6168.5,6168.5,363.84,5332.05,98 HCPCS,C1725,CATH BLN 6X80MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 7FR 14MM 80CM,9508.0,9508.0,570.48,8081.8,49 HCPCS,C1725,CATH BLN 7X100MM 135CM,16859.75,16859.75,174.33,26191.9,98 HCPCS,C1725,CATH BLN 7X100MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 7X150MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 7X20MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 7X40MM 135CM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C1725,CATH BLN 7X40MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLN 7X60MM 135CM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLN 7X60MM 200CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN 7X80MM 135CM,16859.75,16859.75,174.33,26191.9,98 HCPCS,C1725,CATH BLN 8F 12MM 4X75CM,9152.0,9152.0,549.12,7779.2,49 HCPCS,C1725,CATH BLN ANGIO 2.50X08MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLN ANGIO 2.50X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLN ANGIO 3.0X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLN ANGIO 40MM 80CM,9226.5,9226.5,553.59,7842.52,49 HCPCS,C1725,CATH BLN BIB 28.0MM 5.0C,50385.0,50385.0,3023.1,42827.25,49 HCPCS,C1725,CATH BLN BIB 30MM 110CM,50385.0,50385.0,3023.1,42827.25,49 HCPCS,C1725,CATH BLN PRPF 80MM 150CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH BLN PTA 3X100MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLN PTCA 1.5MM 15MM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH BLN PTCA 1.75X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.0X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.0X15MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.25MM,20029.5,20029.5,1201.77,17025.08,49 HCPCS,C1725,CATH BLN PTCA 2.25X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.5X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.5X15MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 2.75X10MM,23110.5,23110.5,1386.63,19643.92,49 HCPCS,C1725,CATH BLN PTCA 2.75X15MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 3.0X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 3.5X10MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 3.5X15MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 3X15MM,21398.5,21398.5,1283.91,18188.72,49 HCPCS,C1725,CATH BLN PTCA 4.0X10MM,21570.0,21570.0,1294.2,18334.5,49 HCPCS,C1725,CATH BLN PTCA 4.0X15MM,20029.5,20029.5,1201.77,17025.08,49 HCPCS,C1725,CATH BLNDIL 1.25MM 10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 1.25MM 5MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 1.2MM 12MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 1.2MM 15MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 1.2MM 8MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 1.2MM0MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 1.2X12MM,14086.0,14086.0,845.16,11973.1,49 HCPCS,C1725,CATH BLNDIL 1.50X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 1.50X6MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 1.5MM 10MM,19941.25,19941.25,174.33,31430.45,98 HCPCS,C1725,CATH BLNDIL 1.5MM 12MM,3765.0,3765.0,225.9,3200.25,49 HCPCS,C1725,CATH BLNDIL 1.5MM 15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 1.5MM 20MM,12721.5,12721.5,763.29,10813.27,49 HCPCS,C1725,CATH BLNDIL 1.5MM 40MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 1.5MM 8MM,3854.0,3854.0,199.02,3732.35,98 HCPCS,C1725,CATH BLNDIL 1.5X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 1.75X10M,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 10MM 2.5MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 10MM 20MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 10MM 40MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 10MM 60MM,5478.5,5478.5,328.71,4656.73,98 HCPCS,C1725,CATH BLNDIL 10MM 80MM,5478.5,5478.5,328.71,4656.73,98 HCPCS,C1725,CATH BLNDIL 10X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 10X40MM 75CM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 10X40MM 80CM,4348.0,4348.0,260.88,3695.8,49 HCPCS,C1725,CATH BLNDIL 10X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 10X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 10X80MM 80CM,4739.0,4739.0,284.34,4028.15,49 HCPCS,C1725,CATH BLNDIL 12MM 20MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 12MM 40MM,5478.5,5478.5,328.71,4656.73,98 HCPCS,C1725,CATH BLNDIL 12MM 60MM,5477.5,5477.5,328.59,4656.73,98 HCPCS,C1725,CATH BLNDIL 12MM 80MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 144CM 20MM,10212.5,10212.5,612.75,8680.63,49 HCPCS,C1725,CATH BLNDIL 144CM 40MM,6452.0,6452.0,387.12,5484.2,49 HCPCS,C1725,CATH BLNDIL 145CM 40MM,6710.25,6710.25,378.21,8680.63,343 HCPCS,C1725,CATH BLNDIL 14MM 40MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 15MM 1.50MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 15MM 4.00MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 18MM 6X100CM,17712.0,17712.0,920.7,17067.15,98 HCPCS,C1725,CATH BLNDIL 18X4.5X110,21308.0,21308.0,1278.48,18111.8,49 HCPCS,C1725,CATH BLNDIL 1MM 10MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 1MM 15MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 1MM 5MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 2.0X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.0X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.0X8MM,5719.0,5719.0,343.14,4861.15,49 HCPCS,C1725,CATH BLNDIL 2.25MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 2.25MM 12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.25MM 15MM,4182.75,4182.75,225.9,3910.43,98 HCPCS,C1725,CATH BLNDIL 2.25MM 20MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 2.25MM 6MM,12828.75,12828.75,199.02,18989.42,98 HCPCS,C1725,CATH BLNDIL 2.25MM 8MM,3958.75,3958.75,199.02,3910.43,98 HCPCS,C1725,CATH BLNDIL 2.25X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.50X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.50X20MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 2.50X25MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.50X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2.5MM 100MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 2.5MM 10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.5MM 120MM,9144.75,9144.75,379.17,10174.5,98 HCPCS,C1725,CATH BLNDIL 2.5MM 12MM,3958.75,3958.75,199.02,3910.43,98 HCPCS,C1725,CATH BLNDIL 2.5MM 150CM,8101.0,8101.0,486.06,6885.85,49 HCPCS,C1725,CATH BLNDIL 2.5MM 150MM,6636.0,6636.0,378.21,5923.23,98 HCPCS,C1725,CATH BLNDIL 2.5MM 15MM,3317.0,3317.0,174.33,3200.25,147 HCPCS,C1725,CATH BLNDIL 2.5MM 18MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.5MM 20MM,6968.5,6968.5,418.11,5923.23,49 HCPCS,C1725,CATH BLNDIL 2.5MM 220MM,6970.5,6970.5,418.11,5926.63,98 HCPCS,C1725,CATH BLNDIL 2.5MM 60MM,6319.5,6319.5,379.17,5371.57,49 HCPCS,C1725,CATH BLNDIL 2.5MM 6MM,12828.75,12828.75,199.02,18989.42,98 HCPCS,C1725,CATH BLNDIL 2.5MM 80MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 2.5MM 8MM,3317.0,3317.0,199.02,2819.45,98 HCPCS,C1725,CATH BLNDIL 2.5MM0MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 2.5X8MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.75MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 2.75MM 15MM,3765.0,3765.0,225.9,3200.25,49 HCPCS,C1725,CATH BLNDIL 2.75MM 20MM,4495.75,4495.75,263.46,3910.43,98 HCPCS,C1725,CATH BLNDIL 2.75MM 6MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 2.75MM 8MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 2.75X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.75X12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.75X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2.75X8MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 20MM 1.5MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 20MM 5X100CM,15345.0,15345.0,920.7,13043.25,49 HCPCS,C1725,CATH BLNDIL 20X4.5X110,21308.0,21308.0,1278.48,18111.8,49 HCPCS,C1725,CATH BLNDIL 26X4.5X110,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDIL 28X4.5X110,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDIL 2MM 100MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 2MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 2MM 120MM,11075.0,11075.0,378.21,13469.52,98 HCPCS,C1725,CATH BLNDIL 2MM 12MM,3958.75,3958.75,199.02,3910.43,98 HCPCS,C1725,CATH BLNDIL 2MM 150MM,6636.0,6636.0,378.21,5923.23,98 HCPCS,C1725,CATH BLNDIL 2MM 15MM,3765.0,3765.0,199.02,3910.43,147 HCPCS,C1725,CATH BLNDIL 2MM 1MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 2MM 20MM,5108.5,5108.5,225.9,5484.2,98 HCPCS,C1725,CATH BLNDIL 2MM 220MM,6972.5,6972.5,418.35,5926.63,98 HCPCS,C1725,CATH BLNDIL 2MM 60MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 2MM 6MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 2MM 80MM,6311.5,6311.5,378.21,5371.57,98 HCPCS,C1725,CATH BLNDIL 2MM 8MM,4209.5,4209.5,199.02,4336.7,98 HCPCS,C1725,CATH BLNDIL 2MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 2MM0MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 2X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 2X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 2X20MM 145CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDIL 3.25MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 3.25MM 12MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3.25MM 15MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3.25MM 20MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3.25MM 8MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3.5MM 100MM,6319.5,6319.5,379.17,5371.57,49 HCPCS,C1725,CATH BLNDIL 3.5MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 3.5MM 120MM,11083.0,11083.0,379.17,13469.52,98 HCPCS,C1725,CATH BLNDIL 3.5MM 12MM,4066.0,4066.0,225.9,3910.43,147 HCPCS,C1725,CATH BLNDIL 3.5MM 135CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1725,CATH BLNDIL 3.5MM 150MM,15846.5,15846.5,950.79,13469.52,98 HCPCS,C1725,CATH BLNDIL 3.5MM 15MM,3958.75,3958.75,199.02,3910.43,147 HCPCS,C1725,CATH BLNDIL 3.5MM 20MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 3.5MM 220MM,11409.5,11409.5,418.35,13469.52,98 HCPCS,C1725,CATH BLNDIL 3.5MM 60MM,6319.5,6319.5,379.17,5371.57,49 HCPCS,C1725,CATH BLNDIL 3.5MM 80MM,6311.5,6311.5,378.21,5371.57,98 HCPCS,C1725,CATH BLNDIL 3.5MM 8MM,4282.0,4282.0,199.02,4459.95,147 HCPCS,C1725,CATH BLNDIL 3.5MM0MM,3765.0,3765.0,225.9,3200.25,49 HCPCS,C1725,CATH BLNDIL 3.5X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 3.5X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 3.75MM 12MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3.75MM 15MM,3136.5,3136.5,188.19,2666.03,49 HCPCS,C1725,CATH BLNDIL 3.75MM 20MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 3.75MM 8MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3MM 100MM,5891.0,5891.0,328.71,5357.98,98 HCPCS,C1725,CATH BLNDIL 3MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 3MM 120MM,6311.5,6311.5,378.21,5371.57,98 HCPCS,C1725,CATH BLNDIL 3MM 12MM,4066.0,4066.0,188.19,3910.43,147 HCPCS,C1725,CATH BLNDIL 3MM 135CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1725,CATH BLNDIL 3MM 150MM,6303.5,6303.5,376.38,10174.5,147 HCPCS,C1725,CATH BLNDIL 3MM 15MM,3958.75,3958.75,199.02,3910.43,147 HCPCS,C1725,CATH BLNDIL 3MM 200MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 3MM 20MM,5478.5,5478.5,225.9,5923.23,147 HCPCS,C1725,CATH BLNDIL 3MM 220MM,11409.5,11409.5,418.35,13469.52,98 HCPCS,C1725,CATH BLNDIL 3MM 60MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 3MM 80MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 3MM 8MM,4333.25,4333.25,243.96,3910.43,98 HCPCS,C1725,CATH BLNDIL 3MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 3MM0MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 3X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 3X12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 3X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 3X30X80CM,8559.5,8559.5,513.57,7275.57,49 HCPCS,C1725,CATH BLNDIL 3X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 3X60MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 3X6MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL 3X80MM 150CM,9684.0,9684.0,581.04,8231.4,49 HCPCS,C1725,CATH BLNDIL 4.0X25MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 4.0X35MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 4.5MM 12MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 4.5MM 135CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1725,CATH BLNDIL 4.5MM 15MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 4.5MM 20MM,4066.0,4066.0,243.96,3456.1,49 HCPCS,C1725,CATH BLNDIL 4MM 100MM,6273.0,6273.0,328.71,5357.98,196 HCPCS,C1725,CATH BLNDIL 4MM 10MM,22340.5,22340.5,1340.43,18989.42,49 HCPCS,C1725,CATH BLNDIL 4MM 120MM,6676.25,6676.25,378.21,5991.65,98 HCPCS,C1725,CATH BLNDIL 4MM 12MM,4282.0,4282.0,199.02,4459.95,147 HCPCS,C1725,CATH BLNDIL 4MM 135CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1725,CATH BLNDIL 4MM 150MM,6303.5,6303.5,328.71,5484.2,196 HCPCS,C1725,CATH BLNDIL 4MM 15MM,3958.75,3958.75,199.02,3910.43,98 HCPCS,C1725,CATH BLNDIL 4MM 200MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 4MM 20MM,5478.5,5478.5,225.9,5332.05,147 HCPCS,C1725,CATH BLNDIL 4MM 220MM,6972.5,6972.5,378.21,10174.5,147 HCPCS,C1725,CATH BLNDIL 4MM 40MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 4MM 60MM,5875.75,5875.75,328.71,5332.05,98 HCPCS,C1725,CATH BLNDIL 4MM 80MM,6311.5,6311.5,378.21,5371.57,98 HCPCS,C1725,CATH BLNDIL 4MM 8MM,4267.5,4267.5,225.9,4054.5,98 HCPCS,C1725,CATH BLNDIL 4MM 8MM LUM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 4MM0MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 4X100MM 80CM,4348.0,4348.0,260.88,3695.8,98 HCPCS,C1725,CATH BLNDIL 4X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDIL 4X120MM 80CM,5078.25,5078.25,260.88,4937.23,98 HCPCS,C1725,CATH BLNDIL 4X20MM 80CM,3952.0,3952.0,237.12,3359.2,98 HCPCS,C1725,CATH BLNDIL 4X20X80,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 4X40MM 135CM,4725.75,4725.75,238.38,4656.73,98 HCPCS,C1725,CATH BLNDIL 4X40MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 4X40MM 80CM,3914.5,3914.5,232.62,3359.2,98 HCPCS,C1725,CATH BLNDIL 4X60MM 150CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLNDIL 4X60MM 80CM,3962.5,3962.5,237.12,3377.05,98 HCPCS,C1725,CATH BLNDIL 4X80MM 135CM,4739.0,4739.0,284.34,4028.15,49 HCPCS,C1725,CATH BLNDIL 4X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 4X80MM 80CM,4348.0,4348.0,260.88,3695.8,49 HCPCS,C1725,CATH BLNDIL 5.0X25MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 5.0X35MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 5.5MM 12MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 5.5MM 20MM,4391.0,4391.0,263.46,3732.35,49 HCPCS,C1725,CATH BLNDIL 5.5X20X80,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 5MM 100MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 5MM 120MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 5MM 12MM,3765.0,3765.0,225.9,3200.25,49 HCPCS,C1725,CATH BLNDIL 5MM 150MM,6273.0,6273.0,348.51,5371.57,147 HCPCS,C1725,CATH BLNDIL 5MM 15MM,4282.0,4282.0,199.02,4459.95,98 HCPCS,C1725,CATH BLNDIL 5MM 200MM,6288.25,6288.25,376.38,5357.98,147 HCPCS,C1725,CATH BLNDIL 5MM 20MM,5666.75,5666.75,243.96,5332.05,245 HCPCS,C1725,CATH BLNDIL 5MM 220MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 5MM 40MM,5875.75,5875.75,328.71,5332.05,98 HCPCS,C1725,CATH BLNDIL 5MM 60MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 5X12MM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1725,CATH BLNDIL 5X20X80,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 5X40MM 135CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 5X80MM 135CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 5X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 6.0MM 35MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 6.0X25MM,11938.0,11938.0,716.28,10147.3,49 HCPCS,C1725,CATH BLNDIL 6MM 100MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 6MM 120MM,7049.0,7049.0,422.94,5991.65,49 HCPCS,C1725,CATH BLNDIL 6MM 12MM,3317.0,3317.0,199.02,2819.45,49 HCPCS,C1725,CATH BLNDIL 6MM 150MM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1725,CATH BLNDIL 6MM 200MM,6288.25,6288.25,376.38,5357.98,147 HCPCS,C1725,CATH BLNDIL 6MM 20MM,5478.5,5478.5,263.46,5332.05,245 HCPCS,C1725,CATH BLNDIL 6MM 220MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 6MM 40MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 6MM 60MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 6MM 75X4CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 6MM 80MM,5598.75,5598.75,328.71,4861.15,98 HCPCS,C1725,CATH BLNDIL 6X100MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 6X120MM 80CM,4348.0,4348.0,260.88,3695.8,49 HCPCS,C1725,CATH BLNDIL 6X20MM 135CM,3962.5,3962.5,237.12,3377.05,98 HCPCS,C1725,CATH BLNDIL 6X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 6X20X80,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 6X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 6X40MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 6X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 6X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 7F 12X80X4,9226.5,9226.5,553.59,7842.52,49 HCPCS,C1725,CATH BLNDIL 7F 40 75X9X8,6684.5,6684.5,401.07,5681.82,49 HCPCS,C1725,CATH BLNDIL 7MM 100MM,5478.5,5478.5,328.59,5332.05,147 HCPCS,C1725,CATH BLNDIL 7MM 120MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 7MM 150MM,8054.75,8054.75,376.38,8361.02,98 HCPCS,C1725,CATH BLNDIL 7MM 200MM,6288.25,6288.25,376.38,5357.98,147 HCPCS,C1725,CATH BLNDIL 7MM 20MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 7MM 220MM,6303.5,6303.5,378.21,5357.98,49 HCPCS,C1725,CATH BLNDIL 7MM 40MM,5478.5,5478.5,328.59,5332.05,147 HCPCS,C1725,CATH BLNDIL 7MM 60MM,5875.75,5875.75,328.71,5332.05,147 HCPCS,C1725,CATH BLNDIL 7MM 80MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 7X100MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 7X120MM 80CM,4348.0,4348.0,260.88,3695.8,49 HCPCS,C1725,CATH BLNDIL 7X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 7X40MM 135CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 7X40MM 80CM,3877.0,3877.0,232.62,3295.45,49 HCPCS,C1725,CATH BLNDIL 7X60MM 80CM,4739.0,4739.0,284.34,4028.15,49 HCPCS,C1725,CATH BLNDIL 7X80MM 135CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 8MM 100MM,5476.5,5476.5,328.59,4655.02,49 HCPCS,C1725,CATH BLNDIL 8MM 150MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 8MM 200MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 8MM 40MM,7710.75,7710.75,328.71,8451.55,98 HCPCS,C1725,CATH BLNDIL 8MM 60MM,6596.25,6596.25,328.71,6556.9,147 HCPCS,C1725,CATH BLNDIL 8MM 80MM,6596.25,6596.25,328.71,6556.9,98 HCPCS,C1725,CATH BLNDIL 8X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 8X60MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 8X80MM 135CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 8X80MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDIL 8X80MM 80CM,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATH BLNDIL 9MM 20MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 9MM 60MM,5598.75,5598.75,328.71,4861.15,98 HCPCS,C1725,CATH BLNDIL 9MM 80MM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 9X20MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 9X40MM 75CM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH BLNDIL 9X40MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 9X60MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL 9X80MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDIL1.50X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL1.50X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH BLNDIL2X120MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDIL2X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDIL2X40M 150CM,7747.5,7747.5,464.85,6585.38,49 HCPCS,C1725,CATH BLNDIL2X60MM 150CM,7173.5,7173.5,430.41,6097.48,49 HCPCS,C1725,CATH BLNDIL2X80MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDL 10X40MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 14X40MM 80CM,9508.0,9508.0,570.48,8081.8,49 HCPCS,C1725,CATH BLNDL 1MM 8MM PERC,5440.0,5440.0,326.4,4624.0,49 HCPCS,C1725,CATH BLNDL 2.5X8MM 150CM,9684.0,9684.0,581.04,8231.4,49 HCPCS,C1725,CATH BLNDL 2.75MM 10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATH BLNDL 21MM 110CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDL 23MM 110CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDL 24MM 110CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDL 25MM 110CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH BLNDL 2X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 2X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 2X40XMM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 2X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 2X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 3X100MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 3X120MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDL 3X150MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 3X200MM 150CM,8275.5,8275.5,496.53,7034.18,49 HCPCS,C1725,CATH BLNDL 3X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 3X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 3X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 4X120MM 135CM,5808.5,5808.5,348.51,4937.23,49 HCPCS,C1725,CATH BLNDL 4X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 4X200MM 150CM,7182.0,7182.0,430.92,6104.7,49 HCPCS,C1725,CATH BLNDL 4X250MM 135CM,6642.0,6642.0,398.52,5645.7,49 HCPCS,C1725,CATH BLNDL 4X40MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 4X60MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 4X80MM 150CM,6691.0,6691.0,401.46,5687.35,49 HCPCS,C1725,CATH BLNDL 5X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 5X120MM 135CM,4739.0,4739.0,284.34,4028.15,49 HCPCS,C1725,CATH BLNDL 5X120MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 5X200MM 150MM,7182.0,7182.0,430.92,6104.7,49 HCPCS,C1725,CATH BLNDL 5X220MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 5X250MM 135CM,5852.0,5852.0,351.12,4974.2,49 HCPCS,C1725,CATH BLNDL 5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 5X80MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 6FR 7MM 75CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 6X100MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 6X120MM 135CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDL 6X150MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 6X2/80MM 80CM,3877.0,3877.0,232.62,3295.45,49 HCPCS,C1725,CATH BLNDL 6X200MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 6X250MM 135CM,5852.0,5852.0,351.12,4974.2,49 HCPCS,C1725,CATH BLNDL 7MM 150CM,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1725,CATH BLNDL 7X120MM 135CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNDL 7X200MM 135CM,7747.5,7747.5,464.85,6585.38,49 HCPCS,C1725,CATH BLNDL 7X80MM 80CM,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATH BLNDL 8MM 75X4CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNL 1.5X40MM 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1725,CATH BLNOCC 26-42MM,20276.0,20276.0,1216.56,17234.6,49 HCPCS,C1725,CATH DIL 12MMX4CM 100CM,15846.5,15846.5,950.79,13469.52,49 HCPCS,C1725,CATH DIL 14MMX4CM 100CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH DIL 16MMX6CM 100CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH DIL 20MMX4CM 100CM,21508.5,21508.5,1290.51,18282.22,49 HCPCS,C1725,CATH DIL 22MMX4CM 100CM,16551.0,16551.0,993.06,14068.35,49 HCPCS,C1725,CATH DIL VASC 1.5X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 1.5X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.25X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.25X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.25X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.5X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.5X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.5X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.5X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.75X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.75X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2.75X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 2X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.00X6MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.25X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.25X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.25X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.50X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.50X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.50X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.50X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.75X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.75X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3.75X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 3X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.00X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.00X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.00X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.50X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.50X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.50X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 4.5X20MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 5.00X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 5.00X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 5.00X8MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 5.50X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 5.50X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 6.00X12MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH DIL VASC 6.00X15MM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1725,CATH INTVN .014IN 135CM,26500.5,26500.5,1590.03,22525.42,49 HCPCS,C1725,CATH IVL 2.5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH IVL 3.5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH IVL 4MM 80MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH IVL 5MM 80MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH IVL 60MM 80MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH MUST 5MM 40MM 135CM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH MUST 8MM 40MM 75CM,5478.5,5478.5,328.71,4656.73,49 HCPCS,C1725,CATH PRF20MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH PRF22MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH PRF24MMX3.5CM 110CM,36977.0,36977.0,2218.62,31430.45,49 HCPCS,C1725,CATH RINGER PTCA 4X20MM,80116.5,80116.5,4806.99,68099.02,49 HCPCS,C1725,CATH RNGR PTCA 2.5X20MM,80116.5,80116.5,4806.99,68099.02,49 HCPCS,C1725,CATH RNGR PTCA 3.5X20MM,80116.5,80116.5,4806.99,68099.02,49 HCPCS,C1725,CATH RNGR PTCA 3X20MM,80116.5,80116.5,4806.99,68099.02,49 HCPCS,C1725,CATH RNGR PTCA 4.5X20MM,80116.5,80116.5,4806.99,68099.02,49 HCPCS,C1725,CATH ULTSNC 10.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSNC 12.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND 2.5MM 40MM,84738.5,84738.5,5084.31,72027.73,49 HCPCS,C1725,CATH ULTSND 3.5MM 40MM,84738.5,84738.5,5084.31,72027.73,49 HCPCS,C1725,CATH ULTSND IVL 3.5X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 4.0X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 5.5X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 5X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 6.5X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 6X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 7X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH ULTSND IVL 8X60MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1725,CATH VASC 19F 1CM 23CM,11549.0,11549.0,692.94,9816.65,49 HCPCS,C1725,CATH VASC 21F 135CM,13857.5,13857.5,831.45,11778.88,49 HCPCS,C1725,CATH VASC 25F20CM 55CM,15778.0,15778.0,946.68,13411.3,49 HCPCS,C1725,CATH VASC 6FR 110CM,9332.0,9332.0,559.92,7932.2,98 HCPCS,C1725,CATHETER BLNDIL 1.25X8MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 1.5X12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 12X80X40,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATHETER BLNDIL 12X80X60,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATHETER BLNDIL 12X80X80,4348.0,4348.0,260.88,3695.8,49 HCPCS,C1725,CATHETER BLNDIL 14X80X40,3973.0,3973.0,238.38,3377.05,49 HCPCS,C1725,CATHETER BLNDIL 14X80X60,3952.0,3952.0,237.12,3359.2,49 HCPCS,C1725,CATHETER BLNDIL 14X80X80,4739.0,4739.0,284.34,4028.15,49 HCPCS,C1725,CATHETER BLNDIL 2.5X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2.5X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2.5X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2.5X30MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2X12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 2X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3.5X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3.5X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3.5X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3X12MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 3X30MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 4X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 4X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDIL 4X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDL 2.25X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDL 2.75X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDL 3.25X10MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDL 3.25X15MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER BLNDL 3.25X20MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1725,CATHETER PTCA 5F 145CM,5102.0,5102.0,306.12,4336.7,49 HCPCS,C1725,DEVICE CATH 2FR 97-112CM,9684.0,9684.0,581.04,8231.4,49 HCPCS,C1725,MICROCATH VASC2.9F 135CM,17718.5,17718.5,1063.11,15060.73,49 HCPCS,C1725,MICROCATH VASC2.9F 150CM,18488.5,18488.5,1109.31,15715.23,49 HCPCS,C1726,BLNDIL ENDO 7.5FR 240CM,6286.5,6286.5,377.19,5343.52,294 HCPCS,C1726,CATH BLN ANGIO 4.0X120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 4.0X150MM,47762.0,47762.0,2865.72,40597.7,49 HCPCS,C1726,CATH BLN ANGIO 4.0X40MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 4.0X60MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 4.0X80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 5.0X120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 5.0X150MM,47762.0,47762.0,2865.72,40597.7,49 HCPCS,C1726,CATH BLN ANGIO 5.0X40MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 5.0X60MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 5.0X80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 6.0X120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 6.0X150MM,47762.0,47762.0,2865.72,40597.7,49 HCPCS,C1726,CATH BLN ANGIO 6.0X40MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 6.0X60MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 6.0X80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 7.0X40MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 7.0X80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN ANGIO 7X60MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C1726,CATH BLN SINUS 6MM 16MM,60087.5,60087.5,3605.25,51074.38,49 HCPCS,C1726,CATH BLN URTH RX 18F 5CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1726,CATH BLN URTH RX 24F 5CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1726,CATH BLN W/INFL DEV 30FR,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1726,CATH BLNDIL 10MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 HCPCS,C1726,CATH BLNDIL 30FR 12CM,7003.5,7003.5,420.21,5952.98,49 HCPCS,C1726,CATH BLNDIL 5.5CM 240CM,6654.25,6654.25,377.19,5968.7,98 HCPCS,C1726,CATH BLNDIL 6MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 HCPCS,C1726,CATH BLNDIL 8MM 4X180CM,7943.5,7943.5,476.61,6751.98,49 HCPCS,C1726,CATH URN 5.8FR 75CM,6783.0,6783.0,406.98,5765.55,49 HCPCS,C1726,CATHETER BIL ULTSND BLN,1203.0,1203.0,72.18,1022.55,49 HCPCS,C1726,DILATOR BLN 30MM 90CM,18757.5,18757.5,1125.45,15943.88,49 HCPCS,C1726,DILATOR BLN 35MM 90CM,18757.5,18757.5,1125.45,15943.88,49 HCPCS,C1726,DILATOR BLN 40MM 90CM,18757.5,18757.5,1125.45,15943.88,49 HCPCS,C1726,DILATOR BLN 5.5X240CM,6286.5,6286.5,377.19,5343.52,49 HCPCS,C1726,DILATOR BLN 8-9-10MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1726,DILATOR BLN 8X180CM,5909.75,5909.75,332.79,5332.05,245 HCPCS,C1726,DILATOR ENDO 6-7-8MM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1726,KIT CATH BLND 30FR 12CM,7479.5,7479.5,448.77,6357.57,49 HCPCS,C1726,KIT CATH BLNDIL 18FR 6CM,7478.5,7478.5,448.71,6356.73,49 HCPCS,C1729,CATH DRAIN 15FR 11.5CM,13596.5,13596.5,815.79,11557.02,49 HCPCS,C1729,CATH DRN 10.2FR 25CM,4183.75,4183.75,174.33,4642.7,98 HCPCS,C1729,CATH DRN 10FR 25CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1729,CATH DRN 11FR,13596.5,13596.5,815.79,11557.02,49 HCPCS,C1729,CATH DRN 12FR 25CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1729,CATH DRN 13FR,13596.5,13596.5,815.79,11557.02,49 HCPCS,C1729,CATH DRN 14FR 25CM MCLC,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1729,CATH DRN 15FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 16FR 25CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1729,CATH DRN 17FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 18FR 25CM,3721.5,3721.5,223.29,3163.28,49 HCPCS,C1729,CATH DRN 19FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 21FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 21FR 38CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 25FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 27FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 29FR,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATH DRN 8.5FR 25CM,4406.25,4406.25,174.33,5020.95,98 HCPCS,C1729,CATH DRN 8FR 2.7MM 25CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1729,CATH DRN 9FR,13596.5,13596.5,815.79,11557.02,49 HCPCS,C1729,CATH DRN BIL 10.2FR 40CM,2927.0,2927.0,175.62,2487.95,49 HCPCS,C1729,CATH DRN BIL 12FR 40CM,2927.0,2927.0,175.62,2487.95,49 HCPCS,C1729,CATH DRN BIL 8.5F 40,2927.0,2927.0,175.62,2487.95,49 HCPCS,C1729,CATH DRN THOR 32FR 23IN,1033.0,1033.0,18.78,1490.05,98 HCPCS,C1729,CATH DRN THOR 36FR 23IN,352.5,352.5,18.78,333.2,98 HCPCS,C1729,CATH DRN XTRN 80CM,6409.0,6409.0,384.54,5447.65,49 HCPCS,C1729,CATH NPHSTM 16FR,539.5,539.5,32.37,458.57,49 HCPCS,C1729,CATH THOR 20FR FRM,755.5,755.5,45.33,642.17,49 HCPCS,C1729,CATH THOR RT ANG 28FR,392.0,392.0,23.52,333.2,49 HCPCS,C1729,CATH THOR STR 24FR 22IN,336.5,336.5,20.19,286.02,49 HCPCS,C1729,CATH THOR STR 40FR,337.0,337.0,20.22,286.45,49 HCPCS,C1729,CATH XTRN DRN .7X1.5MM,8029.0,8029.0,481.74,6824.65,49 HCPCS,C1729,CATHETER DRN 23FR 61CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1729,CATHETER DRN 32FR,611.5,611.5,36.69,519.77,49 HCPCS,C1729,CATHETER DRN 32FR 5 EYLT,363.0,363.0,21.78,308.55,49 HCPCS,C1729,CATHETER DRN 36FR,623.0,623.0,37.38,529.55,49 HCPCS,C1729,CATHETER DRN 5FR 10CM,803.5,803.5,48.21,682.98,49 HCPCS,C1729,CATHETER DRN 5FR 7CM,803.5,803.5,48.21,682.98,49 HCPCS,C1729,KIT CATH PERI 8.3FR,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1729,KIT CATH PLR STRT 1000ML,29043.5,29043.5,1742.61,24686.97,49 HCPCS,C1729,KIT DCMPRS 14FR 175CM,5436.5,5436.5,326.19,4621.02,49 HCPCS,C1729,KIT PRCRDCNTS PGT 8F40CM,4413.5,4413.5,264.81,3751.47,49 HCPCS,C1729,SHUNT CSF DRAIN EXT VENT,4061.5,4061.5,243.69,3452.28,49 HCPCS,C1729,SYS DRN BAL WET SEAL SGL,56852.0,56852.0,3411.12,48324.2,49 HCPCS,C1729,SYS DRN PLS THRX 1 CHMBR,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1729,T-TUBE DEAVER 10FR,420.5,420.5,25.23,357.43,49 HCPCS,C1729,TRAY CATH DRN 8FR,1418.5,1418.5,85.11,1205.72,49 HCPCS,C1729,TRAY PRCNTS 5FR 7CM,1758.5,1758.5,105.51,1494.72,49 HCPCS,C1730,CATH ABL 7FR 115CM,4112.0,4112.0,246.72,3495.2,49 HCPCS,C1730,CATH ABL QDPL 5MM REPR,955.0,955.0,57.3,811.75,49 HCPCS,C1730,CATH EP 2FR 1.3MM 130CM,45297.0,45297.0,2717.82,38502.45,49 HCPCS,C1730,CATH EP 5FR 110CM,6711.5,6711.5,224.34,8231.4,147 HCPCS,C1730,CATH EP 5FR 115CM,6605.25,6605.25,376.38,5896.88,98 HCPCS,C1730,CATH EP 6FR 110CM,10564.5,10564.5,633.87,8979.83,49 HCPCS,C1730,CATH EP 6FR 110CM PSH,5535.0,5535.0,332.1,4704.75,49 HCPCS,C1730,CATH EP 6FR 120CM,3119.0,3119.0,187.14,2651.15,49 HCPCS,C1730,CATH EP 6FR 95CM,23881.0,23881.0,1432.86,20298.85,49 HCPCS,C1730,CATH EP J 2-5-2X120 6FR,3119.0,3119.0,187.14,2651.15,49 HCPCS,C1730,CATHETER EP 5F 120CM 5MM,955.0,955.0,57.3,811.75,49 HCPCS,C1731,CATH EP 7FR 95CM,23573.0,23573.0,1414.38,20037.05,49 HCPCS,C1732,CATH 3D MAP 1.5CM CRV D,74466.0,74466.0,4467.96,63296.1,49 HCPCS,C1732,CATH ABL 25-35MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1732,CATH ABL 7FR 115CM,20136.5,20136.5,695.1,24384.8,98 HCPCS,C1732,CATH ABL 8FR 115CM D CRV,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1732,CATH ABL 8FR 115CM F CRV,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1732,CATH ABL MAP 8FR 4MM,84738.5,84738.5,5084.31,72027.73,98 HCPCS,C1732,CATH ELECTR MAP D-F/36P,70718.5,70718.5,4243.11,60110.72,49 HCPCS,C1732,CATH EP 6FR 105CM,4856.5,4856.5,291.39,4128.02,49 HCPCS,C1732,CATH EP 7FR 115CM,61085.0,61085.0,3665.1,51922.25,49 HCPCS,C1732,CATH EP 8FR 115CM,75125.0,75125.0,4507.5,63856.25,49 HCPCS,C1732,CATH EP ABL DF 8FR 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1732,CATH EP MAP D-F,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1732,CATH MAP 13X13MM 105CM,59528.0,59528.0,3571.68,50598.8,49 HCPCS,C1732,CATH MAPPING 1.5CM,74684.0,74684.0,4481.04,63481.4,49 HCPCS,C1732,CATH MAPPING 3.0CM,74684.0,74684.0,4481.04,63481.4,49 HCPCS,C1732,KIT BUNDLE EP CABL 2F 6F,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1733,CATH EP ABL NAV PFA 31MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1733,CATH EP ABL NAV PFA 35MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1733,CATH EP ABL PFA 31MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1733,CATH EP ABL PFA 35MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1733,CATH EP PFA 2.7MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1734,GRAFT BN ALGRF INJ 3.0CC,81935.0,81935.0,10651.55,69644.75,28 HCPCS,C1735,CATHETER RENAL 6FR,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C1738,"Powered, single-use (i.e. disposable) endoscopic ultrasound-guided biopsy device ",,,25.1,38.66,5 HCPCS,C1740,"Leadless electrode, transmitter, battery (all implantable), for sequential left ventricular pacing ",,,412.08,634.73,5 HCPCS,C1741,"Anchor/screw for bone fixation, absorbable, metallic (implantable) ",,,412.08,634.73,5 HCPCS,C1742,"Pressure monitoring system, compartmental intramuscular (implantable), continuous, including all components (e.g., introducer, sensor), excludes mobile (wireless) software application ",,,412.08,634.73,5 HCPCS,C1743,SYSTEM SCFLD 2.5MM 38MM,82344.0,82344.0,10704.72,69992.4,28 HCPCS,C1743,SYSTEM SCFLD 3.5MM 28MM,88930.0,88930.0,11560.9,75590.5,28 HCPCS,C1743,SYSTEM SCFLD 3.5MM 38MM,82344.0,82344.0,10704.72,69992.4,28 HCPCS,C1743,SYSTEM SCFLD 3.75MM 38MM,82344.0,82344.0,10704.72,69992.4,28 HCPCS,C1743,SYSTEM SCFLD 3MM 38MM,82344.0,82344.0,10704.72,69992.4,28 HCPCS,C1747,"Endoscope, single-use (i.e. disposable), urinary tract, imaging/illumination device (insertable) ",,,25.1,38.66,5 HCPCS,C1748,"Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable) ",,,25.1,38.66,5 HCPCS,C1750,CATH DLYS 15FR 62CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1750,CATH DLYS 2.5MM 2 CUFF,4475.0,4475.0,268.5,3803.75,49 HCPCS,C1750,CATH HEMO 14.5F 23CM,9684.0,9684.0,581.04,8231.4,49 HCPCS,C1750,CATH HEMO 28FR 45CM,7871.5,7871.5,472.29,6690.77,49 HCPCS,C1750,CATH HMDIAL 14.5FR 47CM,12339.0,12339.0,740.34,10488.15,49 HCPCS,C1750,CATH HMDIAL 14.5FR 72CM,7871.5,7871.5,472.29,6690.77,49 HCPCS,C1750,CATH HMDIAL 33CM 14.5FR,7931.0,7931.0,475.86,6741.35,49 HCPCS,C1750,GRAFT HMDIAL 7.4MM 50CM,48216.0,48216.0,6268.08,40983.6,28 HCPCS,C1750,GRAFT HMDL 19F 5MM 40CM,90547.0,90547.0,11771.11,76964.95,28 HCPCS,C1750,KIT CATH 14.5FR 36CM,11374.5,11374.5,682.47,9668.33,49 HCPCS,C1750,KIT CATH 16CM 13.5FR,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1750,KIT CATH PRTNL 57CM,2945.5,2945.5,176.73,2503.68,49 HCPCS,C1750,KIT CATH PRTNL CRL 62CM,2945.5,2945.5,176.73,2503.68,49 HCPCS,C1750,KIT HMDIAL 12FR 24CM,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1750,KIT HMDIAL 15.5FR 36CM,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1750,KIT HMDIAL 40FR 23CM,7871.5,7871.5,472.29,6690.77,49 HCPCS,C1751,CATH CV 5FR 55CM,8962.5,8962.5,537.75,7618.13,49 HCPCS,C1751,CATH CV 7FR 6IN,602.0,602.0,36.12,511.7,49 HCPCS,C1751,CATH CV PED 9FR 2LUM,5093.0,5093.0,305.58,4329.05,49 HCPCS,C1751,CATH DLV 5.4/7FR 43CM,12325.0,12325.0,739.5,10476.25,49 HCPCS,C1751,CATH INFS 5FR 100CM,3471.0,3471.0,208.26,2950.35,49 HCPCS,C1751,CATH INFS 5FR 135CM,4495.75,4495.75,215.79,4585.75,98 HCPCS,C1751,CATH INFS 5FR 65CM,3471.0,3471.0,208.26,2950.35,49 HCPCS,C1751,CATH PERI 16GA 1.75IN,1076.0,1076.0,64.56,914.6,49 HCPCS,C1751,CATH PERI 18GA 1.75IN,778.0,778.0,46.68,661.3,49 HCPCS,C1751,CATH PICC PWR 5FR DL,3647.5,3647.5,218.85,3100.38,49 HCPCS,C1751,CATHETER DUAL LUMEN 28FR,69832.5,69832.5,4189.95,59357.63,49 HCPCS,C1751,CATHETER DUAL LUMEN 30FR,75494.5,75494.5,4529.67,64170.32,49 HCPCS,C1751,CTHGD INFS CRMC 5X50X135,5395.0,5395.0,323.7,4585.75,49 HCPCS,C1751,KIT CATH 12FR 16CM,4851.0,4851.0,291.06,4123.35,49 HCPCS,C1751,KIT CATH 18GA 10CM PWGLD,4631.5,4631.5,277.89,3936.78,49 HCPCS,C1751,KIT CATH 9.6FR 56CM,4738.5,4738.5,284.31,4027.72,49 HCPCS,C1751,KIT CATH CV 6.0FR 20CM,7946.5,7946.5,476.79,6754.52,49 HCPCS,C1751,KIT CATH CV 8FR 16CM,5846.5,5846.5,350.79,4969.52,49 HCPCS,C1751,KIT CATH MIDLINE 3FR,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1751,KIT CATH PICC 5FR 55CM,10351.5,10351.5,595.2,9165.55,98 HCPCS,C1751,KIT CATH VASC 4FR 20CM,7355.0,7355.0,441.3,6251.75,49 HCPCS,C1751,TRAY CATH 20GA 10CM,4736.0,4736.0,284.16,4025.6,49 HCPCS,C1751,TRAY CATH 3FR P PICC,8857.5,8857.5,531.45,7528.88,49 HCPCS,C1751,TRAY CATH 4FR P PICC PRO,8343.0,8343.0,500.58,7091.55,49 HCPCS,C1751,TRAY CATH 5FR 3LUM,7430.5,7430.5,445.83,6315.93,49 HCPCS,C1751,TRAY CATH BASIC 18G 10CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1751,TRAY CATH CV 3FR 20CM,6274.5,6274.5,376.47,5333.32,49 HCPCS,C1751,TRAY CATH CV 3FR 55CM,9789.5,9789.5,587.37,8321.08,49 HCPCS,C1751,TRAY CATH CV 4FR 55CM,10070.5,10070.5,604.23,8559.92,49 HCPCS,C1751,TRAY CATH CV 5FR 55CM,9025.0,9025.0,541.5,7671.25,49 HCPCS,C1751,TRAY CATH PICC 3FR 1LUM,8098.5,8098.5,485.91,6883.73,49 HCPCS,C1751,TRAY CATH PICC 3FR 55CM,9083.75,9083.75,527.31,7972.15,98 HCPCS,C1751,TRAY CATH PICC 4FR 55CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1751,TRAY CATH PICC 5FR 55CM,6409.0,6409.0,384.54,5447.65,49 HCPCS,C1751,TRAY CATH PICC 6FR 50CM,8130.5,8130.5,487.83,6910.93,49 HCPCS,C1751,TRAY CATH PICC PRVN 4FR,9217.5,9217.5,553.05,7834.88,49 HCPCS,C1752,CATH DYLS PED 62CM 3MM,4140.5,4140.5,248.43,3519.43,49 HCPCS,C1752,CATH HMDIAL 13.5F 30CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1752,CATH HMDIAL 13.5FR 24CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1752,CATH HMDL GRN 30CM 12.5F,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1752,KIT HMDIAL CATH 24CM,4893.0,4893.0,293.58,4159.05,49 HCPCS,C1752,KIT LAPSCP DLYS DIL GD,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1753,BLN ULTR ENDOSC BFUC160F,1322.0,1322.0,79.32,1123.7,49 HCPCS,C1753,CATH ULTSNC 9.0MM 30MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1753,CATH ULTSND 3.4FR 135CM,20029.5,20029.5,1201.77,17025.08,49 HCPCS,C1753,CATH ULTSND 3.5FR 150CM,9032.0,9032.0,541.92,7677.2,49 HCPCS,C1753,CATH ULTSND 4.0MM 40MM,84738.5,84738.5,5084.31,72027.73,49 HCPCS,C1753,CATH ULTSND 4MM 40MM,84738.5,84738.5,5084.31,72027.73,49 HCPCS,C1753,CATH ULTSND 5FR 150CM,22186.25,22186.25,1321.92,18989.42,98 HCPCS,C1753,CATH ULTSND 6FR 120CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1753,CATH ULTSND 8.5FR 90CM,29273.5,29273.5,1756.41,24882.47,49 HCPCS,C1753,CATH UTLSND 14IN 150CM,22032.0,22032.0,1321.92,18727.2,49 HCPCS,C1753,CATH VASC US 3FR 135CM,21601.0,21601.0,1296.06,18360.85,49 HCPCS,C1753,CATHETER ULTSND 8FR 90CM,18343.0,18343.0,1100.58,15591.55,49 HCPCS,C1753,CATHSND 3.6FR 135CM,21601.0,21601.0,1296.06,18360.85,49 HCPCS,C1753,CATHSND 3FR 1MM,21601.0,21601.0,1296.06,18360.85,49 HCPCS,C1755,CATH INTHCL 4FR 140CM,29105.0,29105.0,3783.65,24739.25,28 HCPCS,C1757,CATH RTVR THRMB 12F 80CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH RTVR THRMB 80CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH SYS THRMB 107CM,31584.5,31584.5,1895.07,26846.83,49 HCPCS,C1757,CATH SYS THRMB 154CM,31584.5,31584.5,1895.07,26846.83,49 HCPCS,C1757,CATH SYS THRMB 16F 82CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH SYS THRMB 177CM,31584.5,31584.5,1895.07,26846.83,49 HCPCS,C1757,CATH SYS THRMB 67CM,31584.5,31584.5,1895.07,26846.83,49 HCPCS,C1757,CATH THMB 2F 0.67MM 60CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1757,CATH THRM 6-16MM 80CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 100CM 135CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 10FR 100CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 115CM 135CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 12FR 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 140CM .044IN,56534.5,56534.5,3392.07,48054.32,49 HCPCS,C1757,CATH THRMB 16F 117CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 16MM 105CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 16MM 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 24F 85CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 2F 135CM,14966.0,14966.0,897.96,12721.1,49 HCPCS,C1757,CATH THRMB 3F 80CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1757,CATH THRMB 4F 80CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1757,CATH THRMB 5F 80CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1757,CATH THRMB 5FR 160CM,68561.5,68561.5,4113.69,58277.28,49 HCPCS,C1757,CATH THRMB 6FR 137CM,68561.5,68561.5,4113.69,58277.28,49 HCPCS,C1757,CATH THRMB 6FR 140CM,14262.0,14262.0,855.72,12122.7,49 HCPCS,C1757,CATH THRMB 6FR 65CM,15846.5,15846.5,950.79,13469.52,49 HCPCS,C1757,CATH THRMB 7F 80CM,1975.5,1975.5,118.53,1679.17,49 HCPCS,C1757,CATH THRMB 7FR 130CM,100000.0,100000.0,6000.0,85000.0,98 HCPCS,C1757,CATH THRMB 8FR 50CM,83198.0,83198.0,4991.88,70718.3,49 HCPCS,C1757,CATH THRMB 8FR 65CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATH THRMB 8FR 90CM,83198.0,83198.0,4991.88,70718.3,49 HCPCS,C1757,CATH THRMB SCTN 7FR,100000.0,100000.0,6000.0,85000.0,147 HCPCS,C1757,CATH THRMBCTM 6FR 120CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,CATHETER EMB 5.5FR 40CM,3230.5,3230.5,193.83,2745.93,49 HCPCS,C1757,CATHETER THRMB 2FR 60CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1757,CATHETER THRMB 3FR 80CM,1975.5,1975.5,118.53,1679.17,49 HCPCS,C1757,CATHETER THRMB 4FR 80CM,4675.0,4675.0,280.5,3973.75,49 HCPCS,C1757,CATHETER THRMB 5FR 80CM,1975.5,1975.5,118.53,1679.17,49 HCPCS,C1757,CATHETER THRMB 6FR 50CM,11788.0,11788.0,707.28,10019.8,49 HCPCS,C1757,KIT CATH 12F 100CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH 12F 100CM W/TB,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH 12F 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH 7D + 7F 50CM,80425.0,80425.0,4825.5,68361.25,49 HCPCS,C1757,KIT CATH ASP TB 6F 132CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH CANN 18F 105CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH CANN PRFSN,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,KIT CATH THRMB 8FR 50CM,80425.0,80425.0,4825.5,68361.25,49 HCPCS,C1757,KIT THRMB MED DELIVERY,3296.0,3296.0,197.76,2801.6,49 HCPCS,C1757,PACK CATH GD VASC 100CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,PACK CATH GD VASC 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,SEPARATOR THRMB 190CM,50997.5,50997.5,3059.85,43347.88,49 HCPCS,C1757,SHEATH CATH 8FR 65CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,SHEATH CATH 8FR 90CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,SYSTEM MECH THRMB,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1757,SYSTEM THRMB 18FR 115CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1758,CATH URET 2LUM 10FR,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1758,CATH URET 5FR 70CM,486.25,486.25,28.44,423.73,98 HCPCS,C1758,CATH URET 6FR 70CM,483.5,483.5,29.01,410.98,49 HCPCS,C1758,CTH URET AXXCESS 6F OE,3734.5,3734.5,224.07,3174.32,49 HCPCS,C1759,CATH DX US INTRCAR 10F,98605.0,98605.0,5916.3,83814.25,49 HCPCS,C1759,CATH ULTSND 8FR 90CM,86258.25,86258.25,4797.06,78680.68,98 HCPCS,C1759,CATH ULTSND 9FR 90CM,94322.0,94322.0,5659.32,80173.7,49 HCPCS,C1760,DEVICE CLOSURE 14FR,29794.0,29794.0,3873.22,25324.9,28 HCPCS,C1760,DEVICE CLSR 5FR,7854.0,7854.0,1021.02,6675.9,28 HCPCS,C1760,DEVICE CLSR 6FR .035IN,9817.0,9817.0,1276.21,8344.45,28 HCPCS,C1760,DEVICE CLSR 6FR-7FR,7854.0,7854.0,1021.02,6675.9,28 HCPCS,C1760,DEVICE CLSR 8.5-10FR,12762.0,12762.0,1659.06,10847.7,28 HCPCS,C1760,DEVICE CLSR 8FR .038IN,9817.0,9817.0,1276.21,8344.45,28 HCPCS,C1760,DEVICE CLSR FEM 5FR,7854.0,7854.0,1021.02,6675.9,28 HCPCS,C1760,DEVICE CLSR FEM 6FR,6291.0,6291.0,817.83,5347.35,28 HCPCS,C1760,DEVICE CLSR FEM 7FR,6291.0,6291.0,817.83,5347.35,28 HCPCS,C1760,DEVICE CLSR FEM ART 14F,3274.0,3274.0,425.62,2782.9,28 HCPCS,C1760,DEVICE CLSR FEM ART 8F,2541.0,2541.0,330.33,2159.85,28 HCPCS,C1760,DEVICE CLSR VASC 18FR,29794.0,29794.0,3873.22,25324.9,28 HCPCS,C1760,DEVICE CLSR VASC 26-29FR,67910.0,67910.0,8828.3,57723.5,28 HCPCS,C1760,DEVICE CLSR VASC 5FR,7249.0,7249.0,838.24,6842.5,56 HCPCS,C1760,DEVICE CLSR VASC 6/12FR,8639.0,8639.0,1123.07,7343.15,28 HCPCS,C1760,DEVICE CLSR VASC 6/7FR,8050.0,8050.0,1046.5,6842.5,56 HCPCS,C1760,DEVICE CLSR VASC 6FR,67910.0,67910.0,8828.3,57723.5,28 HCPCS,C1761,CATH CORN 2.5MM 12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH CORN 3.0MM 12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH CORN 3.5MM 12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 2.5X12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 2.5X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 3.0X12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 3.5X12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 3.5X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 3X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 4.0X12MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1761,CATH IVL 4X12MM 138CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1762,GRAFT ST TIS 7X4CM,69633.0,69633.0,9052.29,59188.05,28 HCPCS,C1763,SUB BNGF CAPHS 10CC,74684.0,74684.0,9708.92,63481.4,28 HCPCS,C1763,SUB BNGF FOAM 10CC,36845.0,36845.0,4789.85,31318.25,28 HCPCS,C1763,SUB BNGF FOAM 2.5CC,8666.0,8666.0,1126.58,7366.1,28 HCPCS,C1763,SUB BNGF FOAM 5CC,19959.0,19959.0,2594.67,16965.15,28 HCPCS,C1764,DEVICE ICM 46.5X9.4X3.1,64679.0,64679.0,8408.27,54977.15,28 HCPCS,C1764,DEVICE ICM 49X9.4X4.4,67522.0,67522.0,8777.86,57393.7,28 HCPCS,C1764,ICM 45.1X8.0X4.2MM,69895.0,69895.0,9086.35,59410.75,28 HCPCS,C1764,MONITOR CARDIAC INSERT,70839.0,70839.0,9209.07,60213.15,28 HCPCS,C1765,BARRIER ADH 5IN 6IN,13528.5,13528.5,811.71,11499.23,49 HCPCS,C1765,BARRIER ADH ABS 3X4IN,7857.0,7857.0,471.42,6678.45,49 HCPCS,C1766,INTR0 SHTH 8.5FR 71CM,27292.0,27292.0,1637.52,23198.2,49 HCPCS,C1766,INTRO DR 8.5F 22.4MM,27292.0,27292.0,1637.52,23198.2,49 HCPCS,C1766,INTRO SHTH 6FR 45CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1766,INTRO SHTH 8.5FR 40CM,32509.0,32509.0,1950.54,27632.65,49 HCPCS,C1766,INTRO SHTH STRBL SZ LG,67637.0,67637.0,4058.22,57491.45,49 HCPCS,C1766,INTRO SHTH STRBL SZ MED,67637.0,67637.0,4058.22,57491.45,49 HCPCS,C1766,INTRO SHTH STRBL SZ SM,67637.0,67637.0,4058.22,57491.45,49 HCPCS,C1766,INTRODCR SHTH 8.5F 91X71,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,INTRODUCER INTRA 11.5FR,22555.0,22555.0,1353.3,19171.75,49 HCPCS,C1766,SHEATH 12F 20MM,33094.5,33094.5,1985.67,28130.33,49 HCPCS,C1766,SHEATH CATH 6.5FR 45CM,14438.0,14438.0,866.28,12272.3,49 HCPCS,C1766,SHEATH CATH 6.5FR 55CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,SHEATH CATH 6.5FR 70CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,SHEATH CATH 7FR 45CM,17718.5,17718.5,1063.11,15060.73,49 HCPCS,C1766,SHEATH CATH 7FR 55CM,17718.5,17718.5,1063.11,15060.73,49 HCPCS,C1766,SHEATH CATH 8.5FR 45CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,SHEATH CATH 8.5FR 55CM,17607.0,17607.0,1056.42,14965.95,98 HCPCS,C1766,SHEATH CATH 8.5FR 90CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,SHEATH DLVRY 14FR 75CM,22648.5,22648.5,1358.91,19251.22,49 HCPCS,C1766,SHEATH ENDO 5FR 2.2MM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1766,SHEATH INTRO 15FR 65CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C1766,SHEATH STRBL 13FR 91CM,40058.5,40058.5,2403.51,34049.72,49 HCPCS,C1766,SHEATH STRBL 5.7MM 4.2MM,46221.0,46221.0,2773.26,39287.85,49 HCPCS,C1767,DEVICE IPG SLEEP 51MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,DEVICE IPG SLEEP APENA,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,IPG NRSTM 44MM 51MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,IPG NRSTM RECHGFRE 1.1CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,NEUROSTIM RECHARGEABLE,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,NRSTM IMP 44MM 51MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1767,NRSTM NON RECHARGEABLE,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GFT CV HMSH MCVL18X9X40,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GFT VASC 20-80CM 3-6MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GFT VSC STRCH 6X70X80,49332.0,49332.0,6413.16,41932.2,28 HCPCS,C1768,GFT VSC STRCH 8X70X80,51805.0,51805.0,6734.65,44034.25,28 HCPCS,C1768,GFT VSC SWL STRCH 4-7X45,21699.0,21699.0,2820.87,18444.15,28 HCPCS,C1768,GRAFT AOR ART 4/6-11CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT CV 10MM 30CM,12829.0,12829.0,1667.77,10904.65,28 HCPCS,C1768,GRAFT CV 10X20MM 50CM,29394.0,29394.0,3821.22,24984.9,28 HCPCS,C1768,GRAFT CV 10X22MM 50CM,30863.0,30863.0,4012.19,26233.55,28 HCPCS,C1768,GRAFT CV 10X24MM 50CM,30863.0,30863.0,4012.19,26233.55,28 HCPCS,C1768,GRAFT CV 10X26MM 50CM,30863.0,30863.0,4012.19,26233.55,28 HCPCS,C1768,GRAFT CV 10X28MM 50CM,30863.0,30863.0,4012.19,26233.55,28 HCPCS,C1768,GRAFT CV 10X30MM 50CM,31789.0,31789.0,4132.57,27020.65,28 HCPCS,C1768,GRAFT CV 10X32MM 50CM,31789.0,31789.0,4132.57,27020.65,28 HCPCS,C1768,GRAFT CV 10X34MM 50CM,30863.0,30863.0,4012.19,26233.55,28 HCPCS,C1768,GRAFT CV 12MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 12X6MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 14MM 20CM,57116.0,57116.0,7425.08,48548.6,28 HCPCS,C1768,GRAFT CV 14MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 14X7MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 15.2CM 5.1CM,6969.0,6969.0,905.97,5923.65,28 HCPCS,C1768,GRAFT CV 15.2X15.2CM,10137.0,10137.0,1317.81,8616.45,28 HCPCS,C1768,GRAFT CV 15CM 24X32X24MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 15CM 26X34X26MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 15CM 28X36X28MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 15CM 30X38X30MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 15CM 32X40X32MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 15CM 34X42X34MM,56262.0,56262.0,7314.06,47822.7,28 HCPCS,C1768,GRAFT CV 16MM 30CM,12433.0,12433.0,1616.29,10568.05,28 HCPCS,C1768,GRAFT CV 16X8MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 18MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 20MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 20X10MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 20X11MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 22MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 24MM 30CM,13055.0,13055.0,1697.15,11096.75,28 HCPCS,C1768,GRAFT CV 24MM 47CM,87358.0,87358.0,11356.54,74254.3,28 HCPCS,C1768,GRAFT CV 24MM 50MM,36087.0,36087.0,4691.31,30673.95,28 HCPCS,C1768,GRAFT CV 24X12MM 40CM,17229.0,17229.0,2239.77,14644.65,28 HCPCS,C1768,GRAFT CV 26MM 30CM,13909.0,13909.0,1808.17,11822.65,28 HCPCS,C1768,GRAFT CV 26MM 47CM,47011.0,47011.0,6111.43,39959.35,28 HCPCS,C1768,GRAFT CV 26MM 50CM,83797.0,83797.0,10893.61,71227.45,28 HCPCS,C1768,GRAFT CV 26MM 50MM,34368.0,34368.0,4467.84,29212.8,28 HCPCS,C1768,GRAFT CV 28MM 20CM,32298.0,32298.0,4198.74,27453.3,28 HCPCS,C1768,GRAFT CV 28MM 30CM,13909.0,13909.0,1808.17,11822.65,28 HCPCS,C1768,GRAFT CV 28MM 47CM,47011.0,47011.0,6111.43,39959.35,28 HCPCS,C1768,GRAFT CV 28MM 50CM,69568.5,69568.5,6547.97,75452.8,56 HCPCS,C1768,GRAFT CV 28MM 50MM,36087.0,36087.0,4691.31,30673.95,28 HCPCS,C1768,GRAFT CV 30MM 20CM,32298.0,32298.0,4198.74,27453.3,28 HCPCS,C1768,GRAFT CV 30MM 30CM,13909.0,13909.0,1808.17,11822.65,28 HCPCS,C1768,GRAFT CV 30MM 38MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT CV 30MM 47CM,47011.0,47011.0,6111.43,39959.35,28 HCPCS,C1768,GRAFT CV 30MM 50CM,71617.0,71617.0,7726.81,71227.45,56 HCPCS,C1768,GRAFT CV 30MM 50MM,36087.0,36087.0,4691.31,30673.95,28 HCPCS,C1768,GRAFT CV 32MM 20CM,32298.0,32298.0,4198.74,27453.3,28 HCPCS,C1768,GRAFT CV 32MM 30CM,13909.0,13909.0,1808.17,11822.65,28 HCPCS,C1768,GRAFT CV 32MM 50CM,83797.0,83797.0,10893.61,71227.45,28 HCPCS,C1768,GRAFT CV 4MM 35CM,79645.0,79645.0,10353.85,67698.25,28 HCPCS,C1768,GRAFT CV 4MM 40CM,82430.0,82430.0,10715.9,70065.5,28 HCPCS,C1768,GRAFT CV 55X85CM 8MM,36919.5,36919.5,4728.62,31845.25,56 HCPCS,C1768,GRAFT CV 6MM 30CM,31702.5,31702.5,1619.15,43307.5,56 HCPCS,C1768,GRAFT CV 6MM 40CM,78730.0,78730.0,10234.9,66920.5,28 HCPCS,C1768,GRAFT CV 6MM 45CM,92467.0,92467.0,12020.71,78596.95,28 HCPCS,C1768,GRAFT CV 7.6CM 5.1CM,4014.0,4014.0,521.82,3411.9,28 HCPCS,C1768,GRAFT CV 7MM 45CM,81477.0,81477.0,10592.01,69255.45,28 HCPCS,C1768,GRAFT CV 7MM 50CM,85446.0,85446.0,11107.98,72629.1,28 HCPCS,C1768,GRAFT CV 8MM 30CM,12829.0,12829.0,1667.77,10904.65,28 HCPCS,C1768,GRAFT PTCH CV 8X6CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1768,GRAFT STNT VASC 28X150MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT STNT VASC 30X150MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT VASC 10X14MM 30CM,30476.0,30476.0,3961.88,25904.6,28 HCPCS,C1768,GRAFT VASC 12X30X30MM,34435.0,34435.0,4476.55,29269.75,28 HCPCS,C1768,GRAFT VASC 20CM 20MM,25368.0,25368.0,3297.84,21562.8,28 HCPCS,C1768,GRAFT VASC 20FR 10X45MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT VASC 20FR 10X61MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT VASC 30CM 16MM,34435.0,34435.0,4476.55,29269.75,28 HCPCS,C1768,GRAFT VASC 45CM 4-6MM,47592.0,47592.0,6186.96,40453.2,28 HCPCS,C1768,GRAFT VASC 45CM 4-7MM,47592.0,47592.0,6186.96,40453.2,28 HCPCS,C1768,GRAFT VASC 8X12MM 30CM,30476.0,30476.0,3961.88,25904.6,28 HCPCS,C1768,GRAFT VASC 90CM 8MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAFT VASC STD 60CM 6MM,69877.0,69877.0,9084.01,59395.45,28 HCPCS,C1768,GRAFT VASC STD 60CM 8MM,69877.0,69877.0,9084.01,59395.45,28 HCPCS,C1768,GRAFT VASC STD 80CM 6MM,93108.0,93108.0,12104.04,79141.8,28 HCPCS,C1768,GRAFT VASC THIN 40CM 6MM,41846.0,41846.0,5439.98,35569.1,28 HCPCS,C1768,GRAFT VASC THIN 40CM 8MM,41846.0,41846.0,5439.98,35569.1,28 HCPCS,C1768,GRAFT VASC THIN 80CM 6MM,86230.0,86230.0,10329.15,79054.25,56 HCPCS,C1768,GRAFT VASC THIN 80CM 8MM,75005.0,75005.0,9750.65,63754.25,28 HCPCS,C1768,GRAFT VASC THIN 90CM 6MM,98725.0,98725.0,12834.25,83916.25,28 HCPCS,C1768,GRAFT VASC THIN 90CM 8MM,93779.0,93779.0,12191.27,79712.15,28 HCPCS,C1768,GRAFT VASC. STR 14MM 30C,34435.0,34435.0,4476.55,29269.75,28 HCPCS,C1768,GRAFT VSC 26X28MM 100MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,GRAVT CV 26MM 10MM 20CM,35579.0,35579.0,4625.27,30242.15,28 HCPCS,C1768,PATCH CV 10X5CM ENCAP,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1768,PATCH VASC 1CM X 6CM,5440.0,5440.0,707.2,4624.0,28 HCPCS,C1768,PATCH VASC 9X2CM,10565.0,10565.0,1373.45,8980.25,28 HCPCS,C1768,STENT GRAFT 30X36 100MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,STENT GRFT 30X34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,STENT ILIAC 12X45X41MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,STENT ILIAC 20FR 12X58MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1768,STENT VASC 30X150MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1769,EXTENSION GW VASC 165CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GDWIRE ORTH 1.4X620MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GDWIRE VASC .014IN 300CM,5928.0,5928.0,355.68,5038.8,49 HCPCS,C1769,GDWIRE VASC .035IN 300CM,12433.0,12433.0,745.98,10568.05,49 HCPCS,C1769,GDWIRE VASC 185CM,19875.5,19875.5,1192.53,16894.17,49 HCPCS,C1769,GDWIRE VASC W/FLX TP.014,6358.0,6358.0,381.48,5404.3,49 HCPCS,C1769,GDWRE VASC .014IN 190CM,3931.0,3931.0,235.86,3341.35,49 HCPCS,C1769,GUIDEWIRE .36/.27 190/15,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1769,GUIDEWIRE ENDO 200CM,4600.5,4600.5,276.03,3910.43,49 HCPCS,C1769,GUIDEWIRE ORTH 1.4X150MM,4558.5,4558.5,273.51,3874.72,49 HCPCS,C1769,GUIDEWIRE PRESSURE,20383.5,20383.5,1223.01,17325.97,49 HCPCS,C1769,GUIDEWIRE VASC .035IN 30,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GUIDEWIRE VASC 180CM,7008.5,7008.5,376.38,8999.8,147 HCPCS,C1769,GUIDEWIRE VASC 190CM,5018.5,5018.5,301.11,4265.73,98 HCPCS,C1769,GUIDEWIRE VASC 230CM,7395.0,7395.0,443.7,6285.75,49 HCPCS,C1769,GUIDEWIRE VASC 260CM,1921.0,1921.0,115.26,1632.85,49 HCPCS,C1769,GW NWTN TFE 035 145 10,784.0,784.0,47.04,666.4,49 HCPCS,C1769,GW STRQ 035 180 ANG,2758.0,2758.0,165.48,2344.3,49 HCPCS,C1769,GW VASC 3MMJSTR .035X150,433.0,433.0,25.98,368.05,49 HCPCS,C1769,GW VASC HDRPHSPC.035X180,1865.0,1865.0,111.9,1585.25,49 HCPCS,C1769,GW VSC AGL 014 350,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1769,GWIRE .46MM 3CM 150CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE 0.014IN 190CM,3241.0,3241.0,188.19,2843.68,98 HCPCS,C1769,GWIRE 0.018IN 320CM,23110.5,23110.5,1386.63,19643.92,49 HCPCS,C1769,GWIRE 2.4MM,2441.0,2441.0,146.46,2074.85,49 HCPCS,C1769,GWIRE 3.2MM 350MM,8064.0,8064.0,483.84,6854.4,49 HCPCS,C1769,GWIRE 3.2MM 400MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE 450CM 45 ANGLE,4511.0,4511.0,270.66,3834.35,49 HCPCS,C1769,GWIRE BEAD TIP STRL,14667.0,14667.0,880.02,12466.95,49 HCPCS,C1769,GWIRE CATH .027IN 130CM,19320.5,19320.5,1159.23,16422.42,49 HCPCS,C1769,GWIRE CROSSING 190CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1769,GWIRE DBL 0.9X150MM,1453.0,1453.0,87.18,1235.05,49 HCPCS,C1769,GWIRE ENDO .025IN 450CM,4284.0,4284.0,257.04,3641.4,49 HCPCS,C1769,GWIRE ENDO .035IN 260CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1769,GWIRE ENDO .035IN 450CM,5278.5,5278.5,257.04,5332.05,98 HCPCS,C1769,GWIRE EXTN STRETCH 150CM,3165.5,3165.5,189.93,2690.68,49 HCPCS,C1769,GWIRE FLPY 330X2.2CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE IAB .018IN 260CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1769,GWIRE ORT 1000MM,9843.0,9843.0,590.58,8366.55,49 HCPCS,C1769,GWIRE ORTH .8MM 100MM,688.0,688.0,41.28,584.8,49 HCPCS,C1769,GWIRE ORTH 0.8MM 70MM,627.0,627.0,37.62,532.95,49 HCPCS,C1769,GWIRE ORTH 0.9X150MM,2195.0,2195.0,131.7,1865.75,49 HCPCS,C1769,GWIRE ORTH 1.1MM 150MM,1367.25,1367.25,76.89,1235.05,98 HCPCS,C1769,GWIRE ORTH 1.25MM 150MM,1281.5,1281.5,76.89,1089.28,49 HCPCS,C1769,GWIRE ORTH 1.35X150MM,1947.0,1947.0,116.82,1654.95,49 HCPCS,C1769,GWIRE ORTH 1.4MM 150MM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE ORTH 150MM .053IN,1260.0,1260.0,75.6,1071.0,49 HCPCS,C1769,GWIRE ORTH 150MM 1.6MM,1520.5,1520.5,89.88,1311.55,98 HCPCS,C1769,GWIRE ORTH 150X1.4MM,1756.0,1756.0,105.36,1492.6,49 HCPCS,C1769,GWIRE ORTH 2.8MM 300MM,2324.5,2324.5,139.47,1975.83,49 HCPCS,C1769,GWIRE ORTH 3MM 100CM,6279.5,6279.5,376.38,5343.1,98 HCPCS,C1769,GWIRE ORTH 3MM 800MM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1769,GWIRE ORTH NSE 3MM 80CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE ORTH S2 3X1000MM,5687.5,5687.5,341.25,4834.38,49 HCPCS,C1769,GWIRE ORTH T2 3X800MM,5888.5,5888.5,353.31,5005.23,49 HCPCS,C1769,GWIRE ORTH TI 100X1.6MM,1395.0,1395.0,83.7,1185.75,49 HCPCS,C1769,GWIRE ORTHO .062IN 6IN,1685.5,1685.5,101.13,1432.67,49 HCPCS,C1769,GWIRE PRESSR 3.2CM 280CM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1769,GWIRE SNSR ENDO .035X150,2076.5,2076.5,124.59,1765.03,49 HCPCS,C1769,GWIRE STRAIGHT 190CM,3098.0,3098.0,185.88,2633.3,49 HCPCS,C1769,GWIRE STRAIT 190CM,3053.0,3053.0,183.18,2595.05,49 HCPCS,C1769,GWIRE STRL NITINOL,8310.5,8310.5,498.63,7063.93,49 HCPCS,C1769,GWIRE STRT 300CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE TIP TROCAR 310MM,1453.0,1453.0,87.18,1235.05,49 HCPCS,C1769,GWIRE TROCAR 18IN,1453.0,1453.0,87.18,1235.05,49 HCPCS,C1769,GWIRE URO .035IN 150CM,4110.25,4110.25,108.06,5456.57,147 HCPCS,C1769,GWIRE URO ANGLD .035X150,2119.0,2119.0,127.14,1801.15,49 HCPCS,C1769,GWIRE VASC .014 335CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE VASC .014IN 180CM,4056.5,4056.5,243.39,3448.03,49 HCPCS,C1769,GWIRE VASC .014IN 182CM,3073.25,3073.25,174.33,2754.85,196 HCPCS,C1769,GWIRE VASC .014IN 185CM,8803.5,8803.5,528.21,7482.98,49 HCPCS,C1769,GWIRE VASC .014IN 190CM,4851.25,4851.25,213.3,5225.38,98 HCPCS,C1769,GWIRE VASC .014IN 200CM,9613.5,9613.5,576.81,8171.48,49 HCPCS,C1769,GWIRE VASC .014IN 300CM,3555.0,3555.0,174.33,3448.03,294 HCPCS,C1769,GWIRE VASC .014IN 475CM,5808.5,5808.5,348.51,4937.23,49 HCPCS,C1769,GWIRE VASC .016IN 180CM,9525.5,9525.5,521.88,8800.05,98 HCPCS,C1769,GWIRE VASC .017X.014 PGW,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE VASC .018IN 180CM,6273.0,6273.0,174.33,8839.58,147 HCPCS,C1769,GWIRE VASC .018IN 260CM,2943.0,2943.0,176.58,2501.55,49 HCPCS,C1769,GWIRE VASC .018IN 300CM,7206.5,7206.5,183.18,9448.17,147 HCPCS,C1769,GWIRE VASC .018IN 9.75IN,4659.0,4659.0,279.54,3960.15,49 HCPCS,C1769,GWIRE VASC .032IN 260CM,1162.0,1162.0,69.72,987.7,49 HCPCS,C1769,GWIRE VASC .035IN 145CM,2079.5,2079.5,75.21,2469.68,98 HCPCS,C1769,GWIRE VASC .035IN 150CM,718.5,718.5,43.11,610.73,49 HCPCS,C1769,GWIRE VASC .035IN 175CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE VASC .035IN 180CM,1641.0,1641.0,41.85,2469.68,294 HCPCS,C1769,GWIRE VASC .035IN 200CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1769,GWIRE VASC .035IN 260CM,1843.0,1843.0,41.85,7366.52,686 HCPCS,C1769,GWIRE VASC .035IN 300CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1769,GWIRE VASC .035IN 80CM,929.5,929.5,55.77,790.08,49 HCPCS,C1769,GWIRE VASC .035X185X15,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE VASC 0.014IN 300CM,5928.0,5928.0,355.68,5038.8,49 HCPCS,C1769,GWIRE VASC 0.018IN 80CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE VASC 145CM .014IN,3178.5,3178.5,190.71,2701.72,49 HCPCS,C1769,GWIRE VASC 175CM .014IN,18488.5,18488.5,1109.31,15715.23,49 HCPCS,C1769,GWIRE VASC 180CM .009IN,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1769,GWIRE VASC 180CM .014IN,3554.75,3554.75,175.65,5332.05,196 HCPCS,C1769,GWIRE VASC 180CM .035IN,439.0,439.0,26.34,373.15,49 HCPCS,C1769,GWIRE VASC 180X4.5CM,726.5,726.5,43.59,617.52,49 HCPCS,C1769,GWIRE VASC 185CM .014IN,19875.5,19875.5,1192.53,16894.17,49 HCPCS,C1769,GWIRE VASC 18F 90CM,70811.0,70811.0,4248.66,60189.35,49 HCPCS,C1769,GWIRE VASC 190CM .014IN,3721.25,3721.25,174.33,4278.9,784 HCPCS,C1769,GWIRE VASC 200CM BANDIT,4809.5,4809.5,288.57,4088.07,49 HCPCS,C1769,GWIRE VASC 260CM,987.5,987.5,59.25,839.38,49 HCPCS,C1769,GWIRE VASC 260CM .035IN,2195.0,2195.0,131.7,1865.75,49 HCPCS,C1769,GWIRE VASC 260CM 3MM,1162.0,1162.0,69.72,987.7,49 HCPCS,C1769,GWIRE VASC 275X2.9X3.2CM,35004.0,35004.0,2100.24,29753.4,49 HCPCS,C1769,GWIRE VASC 275X4.2X4.2CM,25723.0,25723.0,1543.38,21864.55,49 HCPCS,C1769,GWIRE VASC 300CM .014IN,3678.5,3678.5,174.33,5332.05,784 HCPCS,C1769,GWIRE VASC 300CM .018IN,14549.0,14549.0,376.38,19401.25,147 HCPCS,C1769,GWIRE VASC 300CM .035IN,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE VASC 300CM WARRIOR,5436.5,5436.5,326.19,4621.02,49 HCPCS,C1769,GWIRE VASC 335CM .014IN,5808.5,5808.5,348.51,4937.23,49 HCPCS,C1769,GWIRE VASC 40CM 4FR,1275.5,1275.5,76.53,1084.17,49 HCPCS,C1769,GWIRE VASC 95CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE VASC ANG .035X180,1641.0,1641.0,98.46,1394.85,49 HCPCS,C1769,GWIRE VASC ANG .035X260,3032.0,3032.0,181.92,2577.2,49 HCPCS,C1769,GWIRE VASC CTIP 10X260CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1769,GWIRE VASC FLX 260CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1769,GWIRE VASC MIC.014 300CM,6147.5,6147.5,368.85,5225.38,49 HCPCS,C1769,GWIRE VASC ORBT 360,6358.0,6358.0,381.48,5404.3,49 HCPCS,C1769,GWIRE VASC STRT .035X180,1641.0,1641.0,98.46,1394.85,49 HCPCS,C1769,GWIRE VASC.035 145X10CM,814.0,814.0,48.84,691.9,49 HCPCS,C1769,KIT INTRO CATH 5F 40CM,1101.5,1101.5,66.09,936.27,49 HCPCS,C1769,SPHNTM CANN 20MM 260CM,10371.5,10371.5,622.29,8815.77,49 HCPCS,C1769,SPHNTM GW 20MM 260CM,13527.5,13527.5,811.65,11498.38,49 HCPCS,C1769,SPHNTM GWIRE 4.4FR 20MM,13527.5,13527.5,811.65,11498.38,49 HCPCS,C1769,WIRE GUIDE ESOPHAGE 250M,5227.5,5227.5,313.65,4443.38,49 HCPCS,C1769,WRE STRQ .035 180 MJ,2758.0,2758.0,165.48,2344.3,49 HCPCS,C1769,WRE STRQ .035 300,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1771,OBTURATOR SLING 12CM,35718.0,35718.0,4643.34,30360.3,28 HCPCS,C1771,SLING GYNECARE TVT EXACT,39747.0,39747.0,5167.11,33784.95,28 HCPCS,C1771,SLING MALE ADVANCE XP,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1771,SLING SURG MESH MALE,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1771,SYSTEM URTH MESH 9CM,38332.0,38332.0,4983.16,32582.2,28 HCPCS,C1771,SYSTEM URTH SUPP 2.7MM,31274.0,31274.0,4065.62,26582.9,28 HCPCS,C1771,SYSTEM URTH SUPP 9CM,38332.0,38332.0,4983.16,32582.2,28 HCPCS,C1771,SYSTEM URTH SUPP BLU,29010.0,29010.0,3771.3,24658.5,28 HCPCS,C1772,PUMP PAIN INFN 20ML,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1773,DEVICE LEAD LCK 65CM SS,18591.0,18591.0,1115.46,15802.35,49 HCPCS,C1773,DILATOR SHT 9FR 6.1X15.5,54387.0,54387.0,3263.22,46228.95,49 HCPCS,C1773,FORCEPS RTRVL 3FR 120CM,14966.0,14966.0,897.96,12721.1,49 HCPCS,C1773,KIT LD LCK 65CM,18591.0,18591.0,1115.46,15802.35,98 HCPCS,C1773,KIT LD LCK 85CM,18591.0,18591.0,1115.46,15802.35,49 HCPCS,C1773,KIT SNARE RTRVL 20MM,22016.0,22016.0,1320.96,18713.6,49 HCPCS,C1773,RETRIEVER VASC 6FR 90CM,19212.5,19212.5,1152.75,16330.63,49 HCPCS,C1773,SET SHTH DIL 11FR 13.6CM,56062.5,56062.5,3363.75,47653.13,49 HCPCS,C1773,SET SHTH DIL 11FR 40.6CM,69486.0,69486.0,4169.16,59063.1,49 HCPCS,C1773,SET SHTH DIL 13FR 40.6CM,69486.0,69486.0,4169.16,59063.1,49 HCPCS,C1773,SET SHTH DIL 9FR 13.6CM,56062.5,56062.5,3363.75,47653.13,49 HCPCS,C1773,SET SHTH DIL 9FR 40.6CM,46067.0,46067.0,2764.02,39156.95,49 HCPCS,C1773,SHEATH DIL 0.145IN,70410.0,70410.0,4224.6,59848.5,49 HCPCS,C1773,SHEATH DIL 11FR,57160.0,57160.0,3429.6,48586.0,49 HCPCS,C1773,SHEATH DIL 13FR,57160.0,57160.0,3429.6,48586.0,49 HCPCS,C1773,SHEATH DIL 9FR,57160.0,57160.0,3429.6,48586.0,49 HCPCS,C1773,SHEATH DIL 9FR 47.5CM,70410.0,70410.0,4224.6,59848.5,49 HCPCS,C1773,SHEATH DIL ROT SZ13FR,70410.0,70410.0,4224.6,59848.5,49 HCPCS,C1773,SHEATH VASC DIL 15.5CM,54387.0,54387.0,3263.22,46228.95,49 HCPCS,C1773,SNARE ESCPC 18-30X120 7F,11103.5,11103.5,666.21,9437.98,49 HCPCS,C1773,SNARE VASC 120CM 6-10MM,11103.5,11103.5,666.21,9437.98,49 HCPCS,C1773,SNARE VASC 12F 13MM 94CM,59410.5,59410.5,3564.63,50498.93,49 HCPCS,C1773,SNARE VASC 16F 20MM 94CM,59410.5,59410.5,3564.63,50498.93,49 HCPCS,C1773,SNARE VASC 9-15MM 120CM,11103.5,11103.5,666.21,9437.98,49 HCPCS,C1773,STYLET LD WIRE CRD 140CM,20953.5,20953.5,1257.21,17810.47,49 HCPCS,C1773,SYSTEM EMBL PRTC 75CM .0,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1776,AUG ACTB HIP 15MM45MM,44802.0,44802.0,5824.26,38081.7,28 HCPCS,C1776,AUGMENT FEM KN RM/LL SZE,79977.0,79977.0,10397.01,67980.45,28 HCPCS,C1776,AXLE FEM KN GMRS SM,19129.0,19129.0,2486.77,16259.65,28 HCPCS,C1776,BASE ANCHOR SHLDR 38MM,76065.0,76065.0,9888.45,64655.25,28 HCPCS,C1776,BASEPLATE AUG +2MM 27MM,42118.0,42118.0,5475.34,35800.3,28 HCPCS,C1776,BASEPLATE GLENOID SML RT,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1776,BASEPLATE GLENOID STD,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1776,BASEPLATE GLND +3MM 24MM,59162.0,59162.0,7691.06,50287.7,28 HCPCS,C1776,BASEPLATE GLND SHLDR SM,40850.0,40850.0,5310.5,34722.5,28 HCPCS,C1776,BASEPLATE HUM SHLDR 30MM,38737.0,38737.0,5035.81,32926.45,28 HCPCS,C1776,BASEPLATE KN SZ SM-2,56359.0,56359.0,7326.67,47905.15,28 HCPCS,C1776,BASEPLATE KN SZ4,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLATE KN TIB LT SZ7,50945.0,50945.0,6622.85,43303.25,28 HCPCS,C1776,BASEPLATE KN TIB RT SZ6,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLATE KN TIB TI SZ5,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,BASEPLATE LAT SHLDR 25MM,39441.0,39441.0,5127.33,33524.85,28 HCPCS,C1776,BASEPLATE S-R 10D 27MM,42118.0,42118.0,5475.34,35800.3,28 HCPCS,C1776,BASEPLATE SHLDR RT SM,42118.0,42118.0,5475.34,35800.3,28 HCPCS,C1776,BASEPLATE STD SHLDR SHRT,8828.0,8828.0,1147.64,7503.8,28 HCPCS,C1776,BASEPLATE TIB KN LFT SZ3,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLATE TIB KN RT SZ2,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,BASEPLATE TIB KN RT SZ3,25720.0,25720.0,3296.15,22172.25,56 HCPCS,C1776,BASEPLATE TIB KN RT SZ7,48397.0,48397.0,6291.61,41137.45,28 HCPCS,C1776,BASEPLATE TIB KN SZ3,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,BASEPLATE TIB KN SZ4,28172.0,28172.0,3131.44,31130.4,112 HCPCS,C1776,BASEPLATE TIB KN SZ5,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,BASEPLATE TIB KN SZ6,33102.5,33102.5,3845.53,31130.4,56 HCPCS,C1776,BASEPLATE TIB KN SZ8,29581.0,29581.0,3845.53,25143.85,28 HCPCS,C1776,BASEPLATE TIB KN UNV SZ2,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,BASEPLATE TIB STD 75MM,66767.0,66767.0,8679.71,56751.95,28 HCPCS,C1776,BASEPLATE TIB UNV SZ6,32398.0,32398.0,4211.74,27538.3,28 HCPCS,C1776,BASEPLT GLND 0D 10MM 24M,51865.0,51865.0,6742.45,44085.25,28 HCPCS,C1776,BASEPLT KN LT SZ5,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLT KN RT SZ4,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLT TIB KN LT SZ2,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,BASEPLT TIB KN RM/LL SZ3,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,BASPLATE SHLDR 4.5X20MM,2387.0,2387.0,310.31,2028.95,28 HCPCS,C1776,BDY HUM SMR RVRVS TI LCK,68177.0,68177.0,8863.01,57950.45,28 HCPCS,C1776,BEARING HUM +3A 0D 33MM,31638.0,31638.0,4112.94,26892.3,28 HCPCS,C1776,BEARING HUM STD 44X41MM,20425.0,20425.0,2655.25,17361.25,28 HCPCS,C1776,BODY CONE HIP SZD 60MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,BODY HUM SHLDR FIN RVRS,68177.0,68177.0,8863.01,57950.45,28 HCPCS,C1776,BODY HUM SMR TI LCK SCR,44625.0,44625.0,5801.25,37931.25,28 HCPCS,C1776,BSPLT GLND SHLDR15D 25MM,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,BSPLTE GLND SHLDR 25MM,39441.0,39441.0,5127.33,33524.85,28 HCPCS,C1776,BUSHNG KN FEM SM,5876.0,5876.0,763.88,4994.6,28 HCPCS,C1776,CMPNT FEM HIP 13MM,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1776,CMPNT FEM HIP 15MM 165MM,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,CMPNT FEM HIP SZ 5,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,CMPNT FEM HIP SZ 7,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,CMPNT FEM HIP SZ15,52170.0,52170.0,6782.1,44344.5,28 HCPCS,C1776,CMPNT FEM HIP SZ6,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,CMPNT FEM KN COCR CMNT,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,CMPNT FEM KN LT SZ3,38596.0,38596.0,5017.48,32806.6,28 HCPCS,C1776,CMPNT FEM KN LT SZ4,42258.0,42258.0,5493.54,35919.3,56 HCPCS,C1776,CMPNT FEM KN LT SZC,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CMPNT FEM KN NAR RT SZ5,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,CMPNT FEM KN POST RT SZ8,40146.0,40146.0,5218.98,34124.1,28 HCPCS,C1776,CMPNT FEM KN RM/LL SZ4,38596.0,38596.0,5017.48,32806.6,28 HCPCS,C1776,CMPNT FEM KN RM/LL SZ5,38596.0,38596.0,5017.48,32806.6,28 HCPCS,C1776,CMPNT FEM KN RT SZ6,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,CMPNT FEM KN RT SZ7,39723.0,39723.0,4211.74,39990.8,56 HCPCS,C1776,CMPNT FEM KN STR12.5X150,36289.0,36289.0,4717.57,30845.65,28 HCPCS,C1776,CMPNT FEM KN SZ2,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,CMPNT FEM KN SZ8,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,CMPNT FEM KN TWN PEG LG,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,CMPNT FEM NAR KN RT SZ5,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,CMPNT GLND SHLDR SZSM-R,7567.0,7567.0,983.71,6431.95,28 HCPCS,C1776,CMPNT HIP FEM 9MM 137MM,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,CMPNT HUM SHLDR +0MM,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,CMPNT JNT FNGR SZ 40P,39441.0,39441.0,5127.33,33524.85,28 HCPCS,C1776,CMPNT KN DPHSL SEG 3CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CMPNT KN FEM BSHNG STD,4899.0,4899.0,636.87,4164.15,28 HCPCS,C1776,CMPNT KN FEM ELP LT 7CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CMPNT KN FEM LT ELP 7CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CMPNT KN FEM PROX LT 7CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CMPNT KN FEM STR14.5X150,36289.0,36289.0,4717.57,30845.65,28 HCPCS,C1776,CMPNT KN HINGED ROTATE,5717.0,5717.0,743.21,4859.45,28 HCPCS,C1776,CMPNT KN PLTR 38MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT KN RT SZ4,38596.0,38596.0,5017.48,32806.6,28 HCPCS,C1776,CMPNT KN RT SZ6,38596.0,38596.0,5017.48,32806.6,28 HCPCS,C1776,CMPNT KN SZ4,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,CMPNT KN TIB AXLE,8673.0,8673.0,1127.49,7372.05,28 HCPCS,C1776,CMPNT KN TIB SZ2,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,CMPNT KN YOKE REINFC,19937.0,19937.0,2591.81,16946.45,28 HCPCS,C1776,CMPNT KNEE FEM RT SZ5,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,CMPNT PATELLAR OVAL 35MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT PTLA 3PEG STD31X8,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT PTLA KN 34MM 9MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT PTLA KN DOME 38MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,CMPNT PTLR KN 10MM 32MM,12325.0,12325.0,1602.25,10476.25,28 HCPCS,C1776,CMPNT PTLR KN 10X35MM,9513.0,9513.0,1236.69,8086.05,28 HCPCS,C1776,CMPNT PTLR KN 8MM 28MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT PTLR KN 9MM 29MM,12325.0,12325.0,1602.25,10476.25,28 HCPCS,C1776,CMPNT PTLR KN 9MM 32MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,CMPNT TIB BLCK 10 79/83,21085.0,21085.0,2741.05,17922.25,28 HCPCS,C1776,CMPNT TIB KN 14MM SZ3,22538.0,22538.0,2929.94,19157.3,28 HCPCS,C1776,CMPNT TIB KN 63MM,66767.0,66767.0,8679.71,56751.95,28 HCPCS,C1776,CMPNT TIB KN RS 160X10,65549.0,65549.0,8521.37,55716.65,28 HCPCS,C1776,CMPNT TIB KN SZ7,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,COMP BN SHLDR 38MM 6MM,17242.0,17242.0,2241.46,14655.7,28 HCPCS,C1776,COMP FEM KN LT SIZE C,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMP FEM KN LT SZ7,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMP GLENSP 33MM +3MM,60429.0,60429.0,7855.77,51364.65,28 HCPCS,C1776,COMP GLENSPHR SHLDR MED,8828.0,8828.0,1147.64,7503.8,28 HCPCS,C1776,COMP PTLR KN 8.5MM 29MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,COMP TIB KN ARTC 11MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,COMP TIB KN RT 0D SZC,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1776,COMPNT BRNG KN LT TIB F5,59162.0,59162.0,7691.06,50287.7,28 HCPCS,C1776,COMPNT FEM KN LT SZ5,45668.0,45668.0,5757.44,39990.8,56 HCPCS,C1776,COMPNT FEM KN LT SZ7,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMPNT FEM KN RT 65MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,COMPNT FEM KN RT SZ5,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMPNT FEM KN RT SZ6,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMPNT FEM KN RT SZ7,32398.0,32398.0,4211.74,27538.3,28 HCPCS,C1776,COMPNT FEM KN RT SZ8,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,COMPNT FEM LT KN SZ4,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,COMPNT FEM RT KN SZ5,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,COMPNT FEM W CBLT SZ3 3D,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,COMPNT HUM SHLDR SMR,68177.0,68177.0,8863.01,57950.45,28 HCPCS,C1776,COMPNT PTLA DOME 32MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,COMPNT PTLR KN 10X35MM,12325.0,12325.0,1602.25,10476.25,28 HCPCS,C1776,COMPNT PTLR KN 9MM 29MM,10892.0,10892.0,1415.96,9258.2,28 HCPCS,C1776,COMPNT PTLR KN 9X32MM,6808.0,6808.0,885.04,5786.8,28 HCPCS,C1776,COMPNT TIB LT KN XS-XL,54696.0,54696.0,7110.48,46491.6,28 HCPCS,C1776,COMPONENT FEM KN 3CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,COMPONENT FEM KN LT 3,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,COMPONENT FEM KN LT CR 6,47048.0,47048.0,6116.24,39990.8,28 HCPCS,C1776,COMPONENT SHLDR REV 40MM,55492.0,55492.0,7213.96,47168.2,28 HCPCS,C1776,CONE FEM HIP 50MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,CUP ACTB HIP 28MM 46MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1776,CUP HUMERAL 36 +9,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,DOME PTELA 38 OVL 3PEG,6535.0,6535.0,849.55,5554.75,28 HCPCS,C1776,DOME TALAR 36X37 SZ4 RT,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,FLEX HUM SHLDR +6MM 0MM,16904.0,16904.0,2197.52,14368.4,28 HCPCS,C1776,GLENOID 3-4PEG CMNT SZXS,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,GLENOID HUM PEG E SZ54,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,GLENOID PEG SM STD LONG,37187.0,37187.0,4834.31,31608.95,28 HCPCS,C1776,GLENOSPHERE SHLDR 36MM,36624.0,36624.0,4761.12,31130.4,28 HCPCS,C1776,GLENOSPHERE SMR ECC 36MM,50790.0,50790.0,6602.7,43171.5,28 HCPCS,C1776,GLNSPHR HEAD SHLDR 36MM,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,HEAD ACTB HIP 44MM 28MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,HEAD FEM 12/14 36MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM 28MM +8.5MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP +0X32MM,17397.0,17397.0,2261.61,14787.45,28 HCPCS,C1776,HEAD FEM HIP +3MM 36MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD FEM HIP +4MM SZ36,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP +7MM 36MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP -3.5/36MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP -3MM 32MM,29299.0,29299.0,3808.87,24904.15,28 HCPCS,C1776,HEAD FEM HIP -3MM 36MM,17420.5,17420.5,1304.16,21087.65,56 HCPCS,C1776,HEAD FEM HIP -6MM 36MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD FEM HIP 0MM 28MM,19721.0,19721.0,2563.73,16762.85,28 HCPCS,C1776,HEAD FEM HIP 12/14 +8 28,17397.0,17397.0,2261.61,14787.45,28 HCPCS,C1776,HEAD FEM HIP 12/14 28MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP 12/14 36MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP 12/14MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP 28MM +1.5MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP 28MM 45MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1776,HEAD FEM HIP 36MM,22265.0,22265.0,2563.73,21087.65,56 HCPCS,C1776,HEAD FEM HIP 40MM +5MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP BIP 28X46MM,11465.0,11465.0,1490.45,9745.25,28 HCPCS,C1776,HEAD FEM HIP STD 36MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD FEM HIP SZ12/14,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD FEM HIP SZ36/0.0MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD GLND SHLDR STD 39MM,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,HEAD HIP -4MM 32MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD HIP 45MM 28MM,11465.0,11465.0,1490.45,9745.25,28 HCPCS,C1776,HEAD HIP CTAP 36MM,19721.0,19721.0,2563.73,16762.85,28 HCPCS,C1776,HEAD HIP TPR NK+6X28MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD HIP TPR NK-6X28MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD HIP TPR STD NK 28MM,10032.0,10032.0,1304.16,8527.2,28 HCPCS,C1776,HEAD HUM SHLDR -4MM 36MM,19721.0,19721.0,2563.73,16762.85,28 HCPCS,C1776,HEAD HUM SHLDR 18MM 50MM,35215.0,35215.0,4577.95,29932.75,28 HCPCS,C1776,HEAD HUM SHLDR 20X48MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HEAD HUM SHLDR 36MM,19721.0,19721.0,2563.73,16762.85,28 HCPCS,C1776,HEAD HUM SHLDR 45MM SMR,22313.0,22313.0,2900.69,18966.05,28 HCPCS,C1776,HEAD HUM SHLDR MED SMR,27065.0,27065.0,3518.45,23005.25,28 HCPCS,C1776,HEAD HUMRL SHLDR IMP42MM,22313.0,22313.0,2900.69,18966.05,28 HCPCS,C1776,HEAD SHLDR HUM 13X42MM,26031.0,26031.0,3384.03,22126.35,28 HCPCS,C1776,HEAD SHLDR HUM 15MM 46MM,22313.0,22313.0,2900.69,18966.05,28 HCPCS,C1776,HEAD SHOULDER 36MM,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,HIP HEAD FEM +0 12/14 22,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,HUM REV BDYEXT SHLDR SMR,44963.0,44963.0,5845.19,38218.55,28 HCPCS,C1776,IMPLANT ACTB HIP CUST,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,IMPLANT TIB ALKL RT SZ3X,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,IMPLANT TOE JOINT 20MM,84376.0,84376.0,10968.88,71719.6,28 HCPCS,C1776,INS TIB 3X15 STAB+,14332.0,14332.0,1863.16,12182.2,28 HCPCS,C1776,INSERT ACTB HIP 10D 32MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT ACTB HIP SZE 36MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT ART KN LT 3-4 9MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT ARTC 5-6 9MM DSH,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT ARTC KN 7-8 13MM,35182.0,35182.0,4573.66,29904.7,28 HCPCS,C1776,INSERT HIP 0D E 36MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT HIP 28X44MM,14720.0,14720.0,1913.6,12512.0,28 HCPCS,C1776,INSERT HUM SHLDR +4 36MM,19017.0,19017.0,2472.21,16164.45,28 HCPCS,C1776,INSERT HUM SHLDR 32MM,20932.0,20932.0,2721.16,17792.2,28 HCPCS,C1776,INSERT KN ARTC 3-4 11MM,35182.0,35182.0,4573.66,29904.7,28 HCPCS,C1776,INSERT KN BMPR 3DEG,11666.0,11666.0,1516.58,9916.1,28 HCPCS,C1776,INSERT KN BRNG SZ2 10MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT KN TIB STD 12MM,21346.0,21346.0,2774.98,18144.1,28 HCPCS,C1776,INSERT KN TIB STD 20MM,21346.0,21346.0,2774.98,18144.1,28 HCPCS,C1776,INSERT SCKT SHLDR 36MM,19017.0,19017.0,2472.21,16164.45,28 HCPCS,C1776,INSERT SHD +0 1/2 39MM,47329.0,47329.0,6152.77,40229.65,28 HCPCS,C1776,INSERT SHLDR +0MM 19MM,5265.0,5265.0,684.45,4475.25,28 HCPCS,C1776,INSERT SHLDR +6MM 36MM,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1776,INSERT SHLDR SZ3 36MM,55781.0,55781.0,7251.53,47413.85,28 HCPCS,C1776,INSERT SHLDR SZ3/4 36MM,55781.0,55781.0,7251.53,47413.85,28 HCPCS,C1776,INSERT TIB 3-8MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB CR LAT A,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB CR LAT B,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB KN 11MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN 20MM,35639.5,35639.5,2768.74,42483.85,56 HCPCS,C1776,INSERT TIB KN 3-4 11MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT TIB KN ARTC 15MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,INSERT TIB KN BRNG 9MM,26764.0,26764.0,3479.32,22749.4,56 HCPCS,C1776,INSERT TIB KN CR LAT C,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB KN LT 1-2 9MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT TIB KN ONLAY SZ2,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1776,INSERT TIB KN ONLAY SZ4,14331.0,14331.0,1863.03,12181.35,28 HCPCS,C1776,INSERT TIB KN RT SZ7 5MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT TIB KN STAB 7 5MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT TIB KN STD 14MM,21346.0,21346.0,2774.98,18144.1,28 HCPCS,C1776,INSERT TIB KN SZ1 9MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ1-2 9MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSERT TIB KN SZ2 12MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,INSERT TIB KN SZ2 9MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ3 10MM,21129.5,21129.5,2014.35,22749.4,56 HCPCS,C1776,INSERT TIB KN SZ3 12MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ3 9MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ3-4 18MM,17397.0,17397.0,2261.61,14787.45,28 HCPCS,C1776,INSERT TIB KN SZ3-4 9MM,18382.5,18382.5,2380.56,15685.05,56 HCPCS,C1776,INSERT TIB KN SZ4 10MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ4 9MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ4/5 13MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT TIB KN SZ5 11MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,INSERT TIB KN SZ5 12MM,28694.0,28694.0,3730.22,24389.9,28 HCPCS,C1776,INSERT TIB KN SZ5 8MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,INSERT TIB KN SZ7-8 9MM,37034.0,37034.0,4814.42,31478.9,28 HCPCS,C1776,INSERT TIB MDL 6MM,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB MDL 7MM,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB MDL 8MM,4686.0,4686.0,609.18,3983.1,28 HCPCS,C1776,INSERT TIB PLY SZ4 16MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,INSERT TIB POLY SZ2 14MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,INSERT TIB RT SZ3 11MM,70674.0,70674.0,9187.62,60072.9,28 HCPCS,C1776,INSERT TIB SZ2 16MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,INSERT XLPE KN SZ5-6 9MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,INSRT TIB HNG SM 23MM,89651.0,89651.0,11654.63,76203.35,28 HCPCS,C1776,JOINT FNGR 1PC SZ 00,27778.0,27778.0,3611.14,23611.3,28 HCPCS,C1776,JOINT FNGR 20 DIST PROX,50287.0,50287.0,6537.31,42743.95,28 HCPCS,C1776,JOINT FNGR 30P,55187.0,55187.0,7174.31,46908.95,28 HCPCS,C1776,JOINT FNGR COMPONENT 30D,50287.0,50287.0,6537.31,42743.95,28 HCPCS,C1776,JOINT TOE 20MM MED HEMI,41554.0,41554.0,5402.02,35320.9,28 HCPCS,C1776,LINER ACTB 10D 11.2X36MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB 20D 36MM 62MM,14720.0,14720.0,1913.6,12512.0,28 HCPCS,C1776,LINER ACTB HIP 10D SZ36,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER ACTB HIP 28MM 56MM,38737.0,38737.0,5035.81,32926.45,28 HCPCS,C1776,LINER ACTB HIP 28X40MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB HIP 32MM 50MM,14720.0,14720.0,1913.6,12512.0,28 HCPCS,C1776,LINER ACTB HIP 36MM 56MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER ACTB HIP 36MM SZG,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB HIP 36X50MM,14720.0,14720.0,1913.6,12512.0,28 HCPCS,C1776,LINER ACTB HIP 42MM 28MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER ACTB HIP 42MM 52MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1776,LINER ACTB HIP 44/58MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,LINER ACTB HIP 46/60MM,26764.0,26764.0,3479.32,22749.4,28 HCPCS,C1776,LINER ACTB HIP 50MM 28MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1776,LINER ACTB HIP 52MM 40MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER ACTB HIP 54MM 44MM,30990.0,30990.0,4028.7,26341.5,28 HCPCS,C1776,LINER ACTB HIP MF/36MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER ACTB HIP SZ24 36MM,33807.0,33807.0,4394.91,28735.95,28 HCPCS,C1776,LINER ACTB HIP SZB 32MM,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,LINER ACTB HIP SZD 36MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB HIP SZE 36MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB HIP SZF 40MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER ACTB HIP52MM 40MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER FEM HIP D 36MM,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,LINER HIP 20D 52MM 36MM,15495.0,15495.0,2014.35,13170.75,28 HCPCS,C1776,LINER HIP ACTB F 36MM,21129.0,21129.0,2746.77,17959.65,28 HCPCS,C1776,LINER HUM +3MM 36MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER HUM 0MM 36MM,22538.0,22538.0,2929.94,19157.3,28 HCPCS,C1776,LINER HUM 36MMSMR+3MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER HUM RVRS SMR 36MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER HUM SHLDR +0 36MM,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,LINER HUM SHLDR 36MM,23453.5,23453.5,2801.76,21551.75,56 HCPCS,C1776,LINER HUM SMR STD UHMWPE,10594.0,10594.0,1377.22,9004.9,28 HCPCS,C1776,LINER REV SHO +0MM 40MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER REV SHO 6X40MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER REVERSE +6MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINER SHLDR HUM 36MM,21552.0,21552.0,2801.76,18319.2,28 HCPCS,C1776,LINR ACTB HIP R3 58MM,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,LNR ACTB COC HIP G7D40MM,18312.0,18312.0,2380.56,15565.2,28 HCPCS,C1776,PATELLA KN POLY SZ4 7MM,7166.0,7166.0,931.58,6091.1,28 HCPCS,C1776,PEG BN GLND SZS-R MED,37187.0,37187.0,4834.31,31608.95,28 HCPCS,C1776,PEG SHLDR RT XLONG SM,37187.0,37187.0,4834.31,31608.95,28 HCPCS,C1776,PEG TRBCLR TITNM MTB SRT,37187.0,37187.0,4834.31,31608.95,28 HCPCS,C1776,PIN FX KN XS/SM,6912.0,6912.0,898.56,5875.2,28 HCPCS,C1776,PLATE TIB KN SZ2 62X41MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,SHELL ACTB 58MM HIP MLH,83743.0,83743.0,10886.59,71181.55,28 HCPCS,C1776,SHELL ACTB HIP 13H 64MM,59901.0,59901.0,7787.13,50915.85,28 HCPCS,C1776,SHELL ACTB HIP 3 H 50MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP 3H 52MM,26763.5,26763.5,3296.15,23946.2,56 HCPCS,C1776,SHELL ACTB HIP 3H 62MM,24088.0,24088.0,3131.44,20474.8,28 HCPCS,C1776,SHELL ACTB HIP 3HL 50MM,24088.0,24088.0,3131.44,20474.8,28 HCPCS,C1776,SHELL ACTB HIP 46MM,83743.0,83743.0,10886.59,71181.55,28 HCPCS,C1776,SHELL ACTB HIP 4HL 60MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP 5 SCR56MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP 50MM,53140.5,53140.5,2929.94,71181.55,56 HCPCS,C1776,SHELL ACTB HIP 52MM,42258.0,42258.0,5493.54,35919.3,28 HCPCS,C1776,SHELL ACTB HIP 54MM,42258.0,42258.0,2929.94,71181.55,84 HCPCS,C1776,SHELL ACTB HIP 56MM,60700.0,60700.0,3662.36,61063.15,84 HCPCS,C1776,SHELL ACTB HIP 5H 54MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP MLH 56MM,40166.0,40166.0,5221.58,34141.1,28 HCPCS,C1776,SHELL ACTB HIP MOD 58MM,62964.0,62964.0,8185.32,53519.4,28 HCPCS,C1776,SHELL ACTB HIP MOD 60MM,62964.0,62964.0,8185.32,53519.4,28 HCPCS,C1776,SHELL ACTB HIP RT 68MM,57623.0,57623.0,7490.99,48979.55,28 HCPCS,C1776,SHELL ACTB HIP SZE 52MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP SZF 54MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL ACTB HIP SZG 58MM,28172.0,28172.0,3662.36,23946.2,28 HCPCS,C1776,SHELL BIP HIP 50MM 28MM,12898.0,12898.0,1676.74,10963.3,28 HCPCS,C1776,SHELL HIP ACTB SZ24MM,2534.0,2534.0,329.42,2153.9,28 HCPCS,C1776,SHELL HIP CMNTLSS 52MM,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,SHELL HIP R3 POR 56MM,25355.0,25355.0,3296.15,21551.75,28 HCPCS,C1776,SLEEVE FEM HIP V40,2201.0,2201.0,286.13,1870.85,28 HCPCS,C1776,SLEEVE KN TIBTRY ROT HNG,9760.0,9760.0,1268.8,8296.0,28 HCPCS,C1776,SPACER FEM KN RT SZ4,40146.0,40146.0,5218.98,34124.1,28 HCPCS,C1776,SPACER SHLDR HUM 9X30MM,69388.0,69388.0,9020.44,58979.8,28 HCPCS,C1776,SPHERE GLND SHLDR 36MM,33807.0,33807.0,4394.91,28735.95,28 HCPCS,C1776,STEM FEM 15X250MM,60285.0,60285.0,7837.05,51242.25,28 HCPCS,C1776,STEM FEM BW 150X11MM,34045.0,34045.0,4425.85,28938.25,28 HCPCS,C1776,STEM FEM BW 225X14.5MM,37976.0,37976.0,4936.88,32279.6,28 HCPCS,C1776,STEM FEM HIP 11MM 142MM,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,STEM FEM HIP 128D SZ12,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM FEM HIP 12MM 144MM,47945.0,47945.0,6232.85,40753.25,28 HCPCS,C1776,STEM FEM HIP 12MM 250MM,60285.0,60285.0,7837.05,51242.25,28 HCPCS,C1776,STEM FEM HIP 132D 111MM,54429.0,54429.0,7075.77,46264.65,28 HCPCS,C1776,STEM FEM HIP 13MM 146MM,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,STEM FEM HIP 140MM 10MM,70430.0,70430.0,9155.9,59865.5,28 HCPCS,C1776,STEM FEM HIP 155X13MM,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM FEM HIP 19MM 250MM,60285.0,60285.0,7837.05,51242.25,28 HCPCS,C1776,STEM FEM HIP 6MM 132MM,56344.0,56344.0,7324.72,47892.4,28 HCPCS,C1776,STEM FEM HIP 8MM 136MM,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,STEM FEM HIP ACT SZ6,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM FEM HIP LNG SZ 20,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM FEM HIP LT 3 150MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM FEM HIP OFST 170X16,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM FEM HIP SZ14,50851.0,50851.0,6610.63,43223.35,28 HCPCS,C1776,STEM FEM HIP SZ18,50851.0,50851.0,6610.63,43223.35,28 HCPCS,C1776,STEM FEM KN 120MM 10MM,23545.0,23545.0,3060.85,20013.25,28 HCPCS,C1776,STEM FEM KN 120MM 12MM,23341.0,23341.0,3034.33,19839.85,28 HCPCS,C1776,STEM FEM KN 15MM 100MM,20113.0,20113.0,2614.69,17096.05,28 HCPCS,C1776,STEM FEM KN 225X12.5MM,37976.0,37976.0,4936.88,32279.6,28 HCPCS,C1776,STEM FEM KN PRSFT 100X13,22442.0,22442.0,2917.46,19075.7,28 HCPCS,C1776,STEM FEM REV135D18X190MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM FEM SZ8 12/14 139MM,39441.0,39441.0,5127.33,33524.85,28 HCPCS,C1776,STEM FIN SHLDR DIA 16MM,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HIP 132D SZ2 124MM,39441.0,39441.0,5127.33,33524.85,28 HCPCS,C1776,STEM HIP FEM STD 10X130,49208.0,49208.0,6397.04,41826.8,28 HCPCS,C1776,STEM HIP SZ4 103X32.5MM,54429.0,54429.0,7075.77,46264.65,28 HCPCS,C1776,STEM HIP SZ5 38.5X105MM,52823.0,52823.0,6866.99,44899.55,28 HCPCS,C1776,STEM HIP SZ6 107MM 35MM,54429.0,54429.0,7075.77,46264.65,28 HCPCS,C1776,STEM HUM 24X80MM FN,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HUM 60X11MM CMNTLS,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HUM 80X18MM CMNTLS,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HUM 80X18MM FN CMNT,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HUM PRSFT 14MM,52119.0,52119.0,6775.47,44301.15,28 HCPCS,C1776,STEM HUM PRSFT 9MM,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM HUM SHLDR 10MM 48MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM HUM SHLDR 10MM 95MM,71839.0,71839.0,9339.07,61063.15,28 HCPCS,C1776,STEM HUM SHLDR 10X108MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM HUM SHLDR 11MM,53527.0,53527.0,6958.51,45497.95,28 HCPCS,C1776,STEM HUM SHLDR 120MM,76065.0,76065.0,9888.45,64655.25,28 HCPCS,C1776,STEM HUM SHLDR 15MM,52119.0,52119.0,6775.47,44301.15,28 HCPCS,C1776,STEM HUM SHLDR 80MM 15MM,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM HUM SHLDR 9MM 90MM,84516.0,84516.0,10987.08,71838.6,28 HCPCS,C1776,STEM HUM SHLDR SZ12 48MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM HUM SHLDR SZ2+,76065.0,76065.0,9888.45,64655.25,28 HCPCS,C1776,STEM HUM SHLDR SZ3,92968.0,92968.0,12085.84,79022.8,28 HCPCS,C1776,STEM HUM SHLDRSZ13 130MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM KN FEM 11X150MM,32984.0,32984.0,4287.92,28036.4,28 HCPCS,C1776,STEM NECK HIP 132D SZ9,54429.0,54429.0,7075.77,46264.65,28 HCPCS,C1776,STEM SHLDR 80MM 14MM,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM SHLDR 9MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1776,STEM SHLDR CMNTLS 17MM,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STEM SHLDR FIN 20MM SMR,23552.0,23552.0,3061.76,20019.2,28 HCPCS,C1776,STM FEM HIP 150MM 16MM,91475.0,91475.0,11891.75,77753.75,28 HCPCS,C1776,TAPR ADPT SHLDR 2MM SMR,4633.0,4633.0,602.29,3938.05,28 HCPCS,C1776,TOTAL JOINT KN FEM SZ6,50710.0,50710.0,6592.3,43103.5,28 HCPCS,C1776,TRAY HUM SHLDR +5MM,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,TRAY RVRS HUM +0,47893.0,47893.0,6226.09,40709.05,28 HCPCS,C1776,TRAY TIBIAL KN CR CMNT,33779.0,33779.0,4391.27,28712.15,28 HCPCS,C1776,WEDGE AUG KN SZ7-8 10MM,26075.0,26075.0,3389.75,22163.75,28 HCPCS,C1776,WEDGE TIB 10MM,25469.0,25469.0,3310.97,21648.65,28 HCPCS,C1776,WEDGE TIB KN 10MM,15264.0,15264.0,1984.32,12974.4,28 HCPCS,C1776,WEDGE TIB KN CONE SZSM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1777,LEAD CRT PCNG 62CM,66165.0,66165.0,8601.45,56240.25,28 HCPCS,C1777,LEAD CRT PCNG 8.6FR 72CM,48627.0,48627.0,6321.51,41332.95,28 HCPCS,C1777,LEAD DEFIB 60CM,67522.0,67522.0,8777.86,57393.7,28 HCPCS,C1777,LEAD ENDOCARDIAC 60CM,46682.0,46682.0,6068.66,39679.7,28 HCPCS,C1777,LEAD ICD ENDO 65CM,46682.0,46682.0,6068.66,39679.7,28 HCPCS,C1777,LEAD ICD PCNG 8.6FR 65CM,53004.0,53004.0,6890.52,45053.4,28 HCPCS,C1777,LEAD ICD SC DF4 59CM,59127.0,59127.0,7686.51,50257.95,28 HCPCS,C1777,LEAD ICD SC DF4 64CM,59127.0,59127.0,7686.51,50257.95,28 HCPCS,C1777,LEAD PCNG 58CM,68600.0,68600.0,8918.0,58310.0,28 HCPCS,C1777,LEAD PCNG 65CM,67522.0,67522.0,8777.86,57393.7,28 HCPCS,C1778,KIT NRSTM LD LF45 30.5CM,3495.0,3495.0,454.35,2970.75,28 HCPCS,C1778,KIT NRSTM LD PNE 30.5CM,2135.0,2135.0,277.55,1814.75,28 HCPCS,C1778,LEAD NRSTM 0.170IN 28CM,97960.0,97960.0,12734.8,83266.0,28 HCPCS,C1778,LEAD NRSTM 2.8MM 65CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1778,LEAD NRSTM 5MM 60CM,70966.0,70966.0,9225.58,60321.1,28 HCPCS,C1778,LEAD SENSING RESP,53130.0,53130.0,6906.9,45160.5,28 HCPCS,C1778,LEAD SPN CLMN STIMU 50CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1778,LEAD STIM SLEEP APNEA,63060.0,63060.0,8197.8,53601.0,28 HCPCS,C1778,LEAD TINED 30CM 1.3MM,92390.0,92390.0,12010.7,78531.5,28 HCPCS,C1779,LEAD PCNG 45CM,8309.0,8309.0,1080.17,7062.65,28 HCPCS,C1781,GFT SFT TISS SYN 10X7CM,13712.0,13712.0,1782.56,11655.2,28 HCPCS,C1781,GRAFT MESH 20X15CM,47796.0,47796.0,6213.48,40626.6,28 HCPCS,C1781,GRAFT PRCN 3.9X2.4IN,55441.0,55441.0,7207.33,47124.85,28 HCPCS,C1781,GRAFT PRCN 3.9X3.9IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,GRAFT PRCN 5.9X3.9IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,GRAFT PRCN 7.9X5.9IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,GRAFT PRCN 7.9X7.9IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,GRAFT ST TIS 35.4CM,36293.0,36293.0,4718.09,30849.05,28 HCPCS,C1781,KIT REPAIR DEV AND MESH,24513.0,24513.0,3186.69,20836.05,28 HCPCS,C1781,MESH ABDOMINAL 2-4 X6 EL,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH CIR LRG WSTRP 3.2IN,20386.0,20386.0,2650.18,17328.1,28 HCPCS,C1781,MESH FULL INGUINAL 15 X,5988.0,5988.0,778.44,5089.8,28 HCPCS,C1781,MESH FULL INGUINAL 6X4IN,5988.0,5988.0,778.44,5089.8,28 HCPCS,C1781,MESH GRAFT KNIT 12CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1781,MESH HERNIA 8X10IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HERNIA PP 20X10CM,51741.0,51741.0,6726.33,43979.85,28 HCPCS,C1781,MESH HRN 10CM 15CM,98001.0,98001.0,12740.13,83300.85,28 HCPCS,C1781,MESH HRN 9X9CM,33325.0,33325.0,4332.25,28326.25,28 HCPCS,C1781,MESH HRN GRN 10X14IN,6676.0,6676.0,867.88,5674.6,28 HCPCS,C1781,MESH HRN GRN 2X4IN,1992.0,1992.0,258.96,1693.2,28 HCPCS,C1781,MESH HRN LG 10X16CM,12464.5,12464.5,1503.45,11359.4,56 HCPCS,C1781,MESH HRN LT 5.3X3.1IN,7064.0,7064.0,918.32,6004.4,28 HCPCS,C1781,MESH HRN LT 6.2X4.1IN,7936.0,7936.0,1031.68,6745.6,28 HCPCS,C1781,MESH HRN MED LT 8X14CM,9067.0,9067.0,1178.71,7706.95,28 HCPCS,C1781,MESH HRN MED RT 3X5IN,9067.0,9067.0,1178.71,7706.95,28 HCPCS,C1781,MESH HRN OPEN PSTN 6X8,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN PLGLY 10X6CM,29687.0,29687.0,3859.31,25233.95,28 HCPCS,C1781,MESH HRN PLGLY 12X10CM,59373.0,59373.0,7718.49,50467.05,28 HCPCS,C1781,MESH HRN PLGLY 20X16CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN PLGLY 20X20IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN PP 12CM 18CM,88885.0,88885.0,11555.05,75552.25,28 HCPCS,C1781,MESH HRN PP 12X10IN,31045.0,31045.0,4035.85,26388.25,28 HCPCS,C1781,MESH HRN PP 17CM 10CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1781,MESH HRN PP 20X20IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN PP 25X30IN S,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN RSRB 20X20CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH HRN RT 6.2X4.1IN,8902.0,8902.0,1157.26,7566.7,28 HCPCS,C1781,MESH HRN SFT 12X12IN,23892.0,23892.0,3105.96,20308.2,28 HCPCS,C1781,MESH PERM CIRC 12X12CM,59257.0,59257.0,7703.41,50368.45,28 HCPCS,C1781,MESH PRFX XL 1.6IN 2IN,12017.0,12017.0,1562.21,10214.45,28 HCPCS,C1781,MESH SURG 10CM 17CM,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1781,MESH SURG 12CM 10CM,31045.0,31045.0,4035.85,26388.25,28 HCPCS,C1781,MESH SURG 15X10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH SURG 1X4IN,1367.0,1367.0,177.71,1161.95,28 HCPCS,C1781,MESH SURG 20CM 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH SURG 2X12IN,2231.0,2231.0,290.03,1896.35,28 HCPCS,C1781,MESH SURG 34CM 6CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1781,MESH SURG 3IN 5IN,7853.5,7853.5,870.87,7656.8,56 HCPCS,C1781,MESH SURG 4.5IN,42026.0,42026.0,5463.38,35722.1,28 HCPCS,C1781,MESH SURG 4IN 6IN,6240.0,6240.0,811.2,5304.0,56 HCPCS,C1781,MESH SURG 4X6IN,14631.0,14631.0,1902.03,12436.35,28 HCPCS,C1781,MESH SURG 5IN 7IN,8798.0,8798.0,1021.02,8280.7,56 HCPCS,C1781,MESH SURG 6IN,46940.0,46940.0,6102.2,39899.0,28 HCPCS,C1781,MESH SURG 6X4IN,89130.0,89130.0,11586.9,75760.5,28 HCPCS,C1781,MESH SURG 7.5CM 15CM,2384.0,2384.0,309.92,2026.4,28 HCPCS,C1781,MESH SURG 8X6IN,59480.0,59480.0,7732.4,50558.0,28 HCPCS,C1781,MESH SURG FEM SUI 3MM,29654.0,29654.0,3855.02,25205.9,28 HCPCS,C1781,MESH SURG GYN 10IN 8IN,57679.0,57679.0,7498.27,49027.15,28 HCPCS,C1781,MESH SURG HERNIA 10X15CM,19633.0,19633.0,2552.29,16688.05,56 HCPCS,C1781,MESH SURG HRN 4IN 6IN,34909.0,34909.0,4538.17,29672.65,28 HCPCS,C1781,MESH SURG PLG 1.9X1.6IN,10422.0,10422.0,1354.86,8858.7,28 HCPCS,C1781,PATCH CARD 8X14CM,18882.0,18882.0,2454.66,16049.7,28 HCPCS,C1781,PATCH CV PRCRD .08X8CM,6283.0,6283.0,816.79,5340.55,28 HCPCS,C1781,PATCH HERN 4.3CM,16437.0,16437.0,2136.81,13971.45,28 HCPCS,C1781,PATCH SURG MFL 6.4CM,23799.0,23799.0,3093.87,20229.15,28 HCPCS,C1781,PLUG SURG 1.55X1.3IN,10326.0,10326.0,1342.38,8777.1,28 HCPCS,C1781,PLUG SURG HRN 1.35X1IN,10233.0,10233.0,1330.29,8698.05,28 HCPCS,C1782,BLADE SHAVER DENSE MINI,26087.5,26087.5,1565.25,22174.38,49 HCPCS,C1782,BLADE SHAVER DENSE PLUS,21819.5,21819.5,1309.17,18546.58,49 HCPCS,C1782,BLADE SHAVER SOFT MINI,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1782,BLADE SHAVER SOFT PLUS,14688.0,14688.0,881.28,12484.8,49 HCPCS,C1785,PCMKR 2CH W HOME MNTR,36784.0,36784.0,4781.92,31266.4,28 HCPCS,C1785,PCMKR 4.45X5.88X0.75CM,42819.0,42819.0,5566.47,36396.15,28 HCPCS,C1785,PCMKR 46.6X50.8X7.4MM,84428.0,84428.0,10975.64,71763.8,28 HCPCS,C1785,PCMKR CRD 4.45X4.81X0.75,42819.0,42819.0,5566.47,36396.15,28 HCPCS,C1785,PCMKR CRD 4.45X5.88X0.75,42819.0,42819.0,5566.47,36396.15,28 HCPCS,C1785,PCMKR CRD 47X50X6MM,46215.0,46215.0,6007.95,39282.75,28 HCPCS,C1785,PCMKR DR 4.45X5.02X.75CM,42819.0,42819.0,5566.47,36396.15,28 HCPCS,C1785,PCMKR DR 50.3X47.9X7.5MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1786,PACEMAKER 23F 105CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1786,PACEMAKER LDLS VR 38.0MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1786,PACEMAKR LDLS DR 32.2MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1786,PCMKR CRD 4.45X4.81X0.75,42819.0,42819.0,5566.47,36396.15,28 HCPCS,C1786,PCMKR CRD 47X50X6MM,45489.0,45489.0,5913.57,38665.65,28 HCPCS,C1786,PCMKR SC MRI SR-T,36784.0,36784.0,4781.92,31266.4,28 HCPCS,C1786,PCMKR SNGL 7.4 50.8X42.6,76500.0,76500.0,9945.0,65025.0,28 HCPCS,C1786,SYSTEM PCNG LEADLESS,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1787,CONTROL REMOTE PT NRSTM,21693.5,21693.5,1301.61,18439.47,49 HCPCS,C1787,CONTROLLER NRSTM EXTN,27579.0,27579.0,1654.74,23442.15,49 HCPCS,C1787,KIT NRSTM PT PROGRAMMER,47238.0,47238.0,2834.28,40152.3,49 HCPCS,C1787,KIT PATIENT PRGRMR,40397.5,40397.5,2423.85,34337.88,49 HCPCS,C1787,PROGRAMMER NRSTM VRF 4,9133.0,9133.0,547.98,7763.05,49 HCPCS,C1787,PROGRAMMER PATIENT,43140.0,43140.0,2588.4,36669.0,49 HCPCS,C1787,SYSTEM PROGRAMR CHARGING,27579.0,27579.0,1654.74,23442.15,49 HCPCS,C1788,PORT IMPL INFSN 6FR,11073.5,11073.5,1245.53,10681.1,56 HCPCS,C1788,PORT IMPL INFSN 8FR,10277.5,10277.5,1245.53,9327.9,56 HCPCS,C1788,PORT IMPL INFSN 9.6FR,20212.0,20212.0,2627.56,17180.2,28 HCPCS,C1789,IMPLANT BREAST 150CC,32338.0,32338.0,4203.94,27487.3,56 HCPCS,C1789,IMPLANT BREAST 175CC,26647.0,26647.0,3464.11,22649.95,28 HCPCS,C1789,IMPLANT BREAST 180CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 190CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 200CC,29023.5,29023.5,3342.17,27487.3,56 HCPCS,C1789,IMPLANT BREAST 215CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 220CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 225CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 235CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 240CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 250CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 255CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 260CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 265CC,33874.5,33874.5,3342.17,35734.0,56 HCPCS,C1789,IMPLANT BREAST 270CC,37189.0,37189.0,4834.57,31610.65,28 HCPCS,C1789,IMPLANT BREAST 275CC,25985.5,25985.5,2552.29,27487.3,112 HCPCS,C1789,IMPLANT BREAST 290CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 295CC,31449.0,31449.0,3342.17,31610.65,56 HCPCS,C1789,IMPLANT BREAST 300CC,25985.5,25985.5,2552.29,27487.3,84 HCPCS,C1789,IMPLANT BREAST 310CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 320CC,37189.0,37189.0,4203.94,35734.0,56 HCPCS,C1789,IMPLANT BREAST 325CC,29023.5,29023.5,2552.29,31610.65,112 HCPCS,C1789,IMPLANT BREAST 330CC,33874.5,33874.5,3342.17,35734.0,56 HCPCS,C1789,IMPLANT BREAST 335CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 340CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 340ML,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 345CC,25709.0,25709.0,3342.17,21852.65,56 HCPCS,C1789,IMPLANT BREAST 350CC,32338.0,32338.0,2552.29,31610.65,112 HCPCS,C1789,IMPLANT BREAST 360CC,29023.5,29023.5,3342.17,27487.3,56 HCPCS,C1789,IMPLANT BREAST 365CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 370CC,39614.5,39614.5,4834.57,35734.0,56 HCPCS,C1789,IMPLANT BREAST 375CC,37189.0,37189.0,4203.94,35734.0,84 HCPCS,C1789,IMPLANT BREAST 385CC,29023.5,29023.5,3342.17,27487.3,56 HCPCS,C1789,IMPLANT BREAST 390CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 400CC,34763.5,34763.5,3464.11,35734.0,112 HCPCS,C1789,IMPLANT BREAST 405CC,33147.0,33147.0,4203.94,35734.0,84 HCPCS,C1789,IMPLANT BREAST 415CC,31449.0,31449.0,3342.17,31610.65,56 HCPCS,C1789,IMPLANT BREAST 425CC,32338.0,32338.0,4203.94,27487.3,84 HCPCS,C1789,IMPLANT BREAST 430CC,39614.5,39614.5,4834.57,35734.0,56 HCPCS,C1789,IMPLANT BREAST 435CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 440CC,37593.5,37593.5,4309.11,35734.0,56 HCPCS,C1789,IMPLANT BREAST 445CC,32338.0,32338.0,4203.94,27487.3,28 HCPCS,C1789,IMPLANT BREAST 450CC,34763.5,34763.5,3342.17,35734.0,140 HCPCS,C1789,IMPLANT BREAST 454CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 465CC,35168.0,35168.0,4309.11,31610.65,56 HCPCS,C1789,IMPLANT BREAST 470CC,37189.0,37189.0,4203.94,35734.0,84 HCPCS,C1789,IMPLANT BREAST 475CC,26647.0,26647.0,3464.11,22649.95,28 HCPCS,C1789,IMPLANT BREAST 480CC,42040.0,42040.0,5465.2,35734.0,56 HCPCS,C1789,IMPLANT BREAST 485CC,25709.0,25709.0,3342.17,21852.65,28 HCPCS,C1789,IMPLANT BREAST 490CC,37189.0,37189.0,4834.57,31610.65,28 HCPCS,C1789,IMPLANT BREAST 500CC,34763.5,34763.5,3464.11,35734.0,112 HCPCS,C1789,IMPLANT BREAST 520CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 530CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 535CC,37189.0,37189.0,4834.57,31610.65,28 HCPCS,C1789,IMPLANT BREAST 545CC,39614.5,39614.5,4834.57,35734.0,84 HCPCS,C1789,IMPLANT BREAST 560CC,34925.5,34925.5,4246.06,31610.65,56 HCPCS,C1789,IMPLANT BREAST 580CC,39614.5,39614.5,4834.57,35734.0,56 HCPCS,C1789,IMPLANT BREAST 585CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 590CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 595CC,37189.0,37189.0,4834.57,31610.65,28 HCPCS,C1789,IMPLANT BREAST 600CC,26647.0,26647.0,3464.11,22649.95,28 HCPCS,C1789,IMPLANT BREAST 630CC,33147.0,33147.0,4246.06,35734.0,84 HCPCS,C1789,IMPLANT BREAST 635CC,42040.0,42040.0,5465.2,35734.0,56 HCPCS,C1789,IMPLANT BREAST 650CC,29897.0,29897.0,3464.11,28174.95,56 HCPCS,C1789,IMPLANT BREAST 675CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 685CC,37351.0,37351.0,4246.06,35734.0,56 HCPCS,C1789,IMPLANT BREAST 700CC,33147.0,33147.0,3464.11,35734.0,112 HCPCS,C1789,IMPLANT BREAST 730CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 740CC,42040.0,42040.0,5465.2,35734.0,28 HCPCS,C1789,IMPLANT BREAST 755CC,33147.0,33147.0,4309.11,28174.95,28 HCPCS,C1789,IMPLANT BREAST 775CC,37593.5,37593.5,4309.11,35734.0,84 HCPCS,C1789,IMPLANT BREAST 800CC,19633.0,19633.0,2552.29,16688.05,28 HCPCS,C1813,KIT PROSTH PENL ACC,36381.0,36381.0,4729.53,30923.85,28 HCPCS,C1813,PROS PENILE PUMP INFL,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROS PENL 16CM-25CM 11MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROS PNL NRW 0 ANG 16CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSPENL PUMP 6FR 45CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL 18CM 12.5MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL 28CM LCK-OUT,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL LCK-OUT 16CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL OD PMP 22CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PS 10CM 18CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTH PENL PS 12CM 21CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PS 14CM 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PL 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PL 21CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PL 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PS 12CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTH PENL PUMP PS 14CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PS 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PS 16CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTH PENL PUMP PS 18CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTH PENL PUMP PS 21CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH PENL PUMP PS 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTH RESRVOIR 125ML,76221.0,76221.0,9908.73,64787.85,28 HCPCS,C1813,PROSTHES PENL INFL 18CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENILE TITAN,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTHESIS PENL 13MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENL INF 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENL TTN 11CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENL TTN 18CM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1813,PROSTHESIS PENL TTN 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENL TTN 26CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PENL TTN PMP,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PNL 75ML,76221.0,76221.0,9908.73,64787.85,28 HCPCS,C1813,PROSTHESIS PNLE 20CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,PROSTHESIS PNLE 24CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1813,RESERVOIR PENL 100MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1815,CUFF URTH SPHNC AB 3.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1815,CUFF URTH SPHNCR AB 4.5C,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1815,CUFF URTH SPHNCR AB 4CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1815,CUFF URTH SPHNCR AB 5.5C,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1815,CUFF URTH SPHNCR AB 5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUD CV 7MM 16MM MSC,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUD CV 7MM 18MM MSCL,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 10X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 11FR 37MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 12FR 44MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 25MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 3X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 3X6MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 4X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 4X6MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 5X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 5X6MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCLUDER CV 6X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 15X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 16X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 17X4MM,109000.0,109000.0,14170.0,92650.0,28 HCPCS,C1817,OCCULDER CV 18X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 19X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 20X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 22X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 230X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 24X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 26X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 28X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 32X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 34X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 36X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 38X4MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 5X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 6X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 7X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 8X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1817,OCCULDER CV 9X3MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1820,IPG NRSTM 61X4.95X1.34CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1820,IPG NRSTM MRI 1.5T,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1822,IMPLANT PULSE 8.5X15.5IN,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1824,GEN PLS CARD MOD SYS,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1824,GEN PLS CARD SMART MINI,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1826,"Generator, neurostimulator (implantable), includes closed feedback loop leads and all implantable components, with rechargeable battery and charging system ",,,7672.04,11817.42,5 HCPCS,C1827,"Generator, neurostimulator (implantable), non-rechargeable, with implantable stimulation lead and external paired stimulation controller ",,,7672.04,11817.42,5 HCPCS,C1830,TRAY BX NDL 6X10CM,13034.0,13034.0,782.04,11078.9,49 HCPCS,C1830,TRAY NDL 10/12GA 10/14CM,13034.0,13034.0,782.04,11078.9,49 HCPCS,C1832,"Autograft suspension, including cell processing and application, and all system components ",,,3.96,6.09,5 HCPCS,C1833,"Monitor, cardiac, including intracardiac lead and all system components (implantable) ",,,651.0,1002.75,5 HCPCS,C1874,GRAFT AAA 20-24 105MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 26-27 155MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 28-29 155MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 31-32 113MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 31-32 161MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 31-32 209MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 33-34 167MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 33-34 178MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 35-36 167MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT AAA 40-42 125MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT CV SYN 38X154MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EV 20FR 30MM 125MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 109MM 28MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 113MM 30MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 11MM 107MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 11MM 39MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 11X11X122MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 127MM 36-12MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 12FR 76MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 13MM 74MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 13MMX107MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 13X13X56MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 14FR 11X56MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 14FR 13X122MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 155X32X28-29,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 161MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 161MM 30-34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 161X34X30MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 16F 56X20X6MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 16FR 24X39MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 16FR 24X74MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 179MM 42-46MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 18FR 39X26MM,80393.0,80393.0,10451.09,68334.05,28 HCPCS,C1874,GRAFT EVAS 201X32X28-29,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 20F 50X36MM,75891.0,75891.0,9865.83,64507.35,28 HCPCS,C1874,GRAFT EVAS 20FR 26X109MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 20MM 90MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 217X36-40X35,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 22MM 85MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 22MM 96MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 24MM 56MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 26MM 96MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 28MM 111MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 28MM 155MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 28MM 39MM,80393.0,80393.0,10451.09,68334.05,28 HCPCS,C1874,GRAFT EVAS 30MM 96MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 30X34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 32MM 96MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 36MM 113MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 36MM 95MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 38MM 217MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 56MM 14F 16MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 74MM 16MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 79MM 24MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 79MM 34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 79MM 38MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 82MM 28MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 82MM 32MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 90MM 16MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT EVAS 9MM 74MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT STENT 14-25X103MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT STNT 10FR 14X100MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT STNT 13FR 14X120MM,91581.0,91581.0,11905.53,77843.85,28 HCPCS,C1874,GRAFT STNT 14FR 22X45MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRAFT STNT 22MM 13X40MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 113X34X30MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 117X38X33-34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 125X46X40-42MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 167X37X33-34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 18FR 82MM 24MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 20F 34MM 137MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,GRFT EVAS 20FR 122X34MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT 5X19MM 6FR 135CM,83853.0,83853.0,10900.89,71275.05,28 HCPCS,C1874,STENT AAA 13MMX90MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT AAA 16MMX39MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ART 6F 5X29MM135CM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT BIL 10MM 60MM,77450.0,77450.0,10068.5,65832.5,28 HCPCS,C1874,STENT BIL 10MM 80MM,77450.0,77450.0,10068.5,65832.5,28 HCPCS,C1874,STENT BIL 8.5FR 10X60MM,76447.0,76447.0,9938.11,64979.95,28 HCPCS,C1874,STENT BIL 8.5FR 10X80MM,77612.0,77612.0,10089.56,65970.2,28 HCPCS,C1874,STENT BLN ENDO 6FR 135CM,92487.0,92487.0,12023.31,78613.95,28 HCPCS,C1874,STENT COR 15X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 15X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 2.00MM X22 MM,16652.0,16652.0,2164.76,14154.2,28 HCPCS,C1874,STENT COR 2.00MMX08MM,14860.0,14860.0,1931.8,12631.0,28 HCPCS,C1874,STENT COR 2.00MMX12MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 2.00MMX18MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 2.00MMX26MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 2.00MMX30MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 2.0MMX15MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 2.25MM 15MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.25MM 18MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 2.25MM 23MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.25MM 28MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.25MM 33MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 2.25MM 38MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.25MM 8MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.25MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX26MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25MMX38MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25X32MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.25X34MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.25X8MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.50 X 48MM,8650.0,8650.0,1124.5,7352.5,28 HCPCS,C1874,STENT COR 2.50MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX26MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX34MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50MMX38MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.50X20MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.50X24MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.50X32MM,20121.0,20121.0,2615.73,17102.85,28 HCPCS,C1874,STENT COR 2.50X48MM,15223.0,15223.0,1978.99,12939.55,28 HCPCS,C1874,STENT COR 2.50X8MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.5MM 12MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.5MM 15MM,18795.5,18795.5,2361.32,16512.95,56 HCPCS,C1874,STENT COR 2.5MM 18MM,18795.5,18795.5,2361.32,16512.95,56 HCPCS,C1874,STENT COR 2.5MM 22MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 2.5MM 23MM,22121.5,22121.5,2525.51,21093.6,56 HCPCS,C1874,STENT COR 2.5MM 26MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 2.5MM 28MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.5MM 33MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.5MM 35MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 2.5MM 38MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.5MM 8MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.5MM 9MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 2.5X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 2.5X20MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 2.75MM 12MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 2.75MM 15MM,18620.0,18620.0,2361.32,16214.6,56 HCPCS,C1874,STENT COR 2.75MM 18MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.75MM 23MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.75MM 28MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 2.75MM 33MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 2.75MM 38MM,16362.5,16362.5,1728.74,16512.95,56 HCPCS,C1874,STENT COR 2.75MM 8MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 2.75MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX26MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75MMX34MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 2.75X20MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.75X28MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 2.75X8MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 22X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 22X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 26X2.75 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 26X3MM 140CM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.00MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX26MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX34MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00MMX38MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.00X16MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.00X32MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.00X38MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.00X48MM,15223.0,15223.0,1978.99,12939.55,28 HCPCS,C1874,STENT COR 3.00X8MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.0X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 3.0X26MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 3.25MM 12MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.25MM 15MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.25MM 18MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.25MM 23MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3.25MM 33MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.25MM 38MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.25MM 8MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3.50 X 12MM,20184.0,20184.0,2623.92,17156.4,28 HCPCS,C1874,STENT COR 3.50 X 16MM,19820.0,19820.0,2576.6,16847.0,28 HCPCS,C1874,STENT COR 3.50 X 20MM,20184.0,20184.0,2623.92,17156.4,28 HCPCS,C1874,STENT COR 3.50 X 24MM,19820.0,19820.0,2576.6,16847.0,28 HCPCS,C1874,STENT COR 3.50 X 28MM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1874,STENT COR 3.50 X 8MM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1874,STENT COR 3.50MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX26MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50MMX34MM,13542.0,13542.0,1760.46,11510.7,28 HCPCS,C1874,STENT COR 3.50MMX38MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 3.50X12MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X16MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X24MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X28MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X32MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X38MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.50X48MM,11936.5,11936.5,1124.5,12939.55,56 HCPCS,C1874,STENT COR 3.50X8MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 3.5MM 15MM,18795.5,18795.5,2361.32,16512.95,56 HCPCS,C1874,STENT COR 3.5MM 18MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3.5MM 22MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.5MM 26MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.5MM 30MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.5MM 35MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.5MM 38MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3.5MM 40MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3.5MM 8MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3.5X15MM 140CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 3.5X26MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 3MM 12MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3MM 15MM,18795.5,18795.5,2361.32,16512.95,56 HCPCS,C1874,STENT COR 3MM 18MM,18061.0,18061.0,2170.35,16512.95,56 HCPCS,C1874,STENT COR 3MM 28MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3MM 30MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3MM 33MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3MM 35MM,18334.5,18334.5,2383.49,15584.33,28 HCPCS,C1874,STENT COR 3MM 38MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 3MM 40MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 3MM 8MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 3X48MM,8650.0,8650.0,1124.5,7352.5,28 HCPCS,C1874,STENT COR 4.00 X 12MM,19820.0,19820.0,2576.6,16847.0,28 HCPCS,C1874,STENT COR 4.00 X 16MM,19820.0,19820.0,2576.6,16847.0,28 HCPCS,C1874,STENT COR 4.00 X 28MM,22202.0,22202.0,2886.26,18871.7,28 HCPCS,C1874,STENT COR 4.00 X 8MM,20184.0,20184.0,2623.92,17156.4,28 HCPCS,C1874,STENT COR 4.00MMX08MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX12MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX15MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX18MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX22MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX26MM,13542.0,13542.0,1760.46,11510.7,28 HCPCS,C1874,STENT COR 4.00MMX30MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00MMX38MM,13298.0,13298.0,1728.74,11303.3,28 HCPCS,C1874,STENT COR 4.00X20MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 4.00X28MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 4.00X48MM,22297.0,22297.0,2898.61,18952.45,28 HCPCS,C1874,STENT COR 4.0X26MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT COR 4.50 X 12MM,20184.0,20184.0,2623.92,17156.4,28 HCPCS,C1874,STENT COR 4.50 X 24MM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1874,STENT COR 4.50 X 8MM,22202.0,22202.0,2886.26,18871.7,28 HCPCS,C1874,STENT COR 4.50MMX12MM,14592.0,14592.0,1896.96,12403.2,28 HCPCS,C1874,STENT COR 4.50MMX15MM,17981.0,17981.0,2337.53,15283.85,28 HCPCS,C1874,STENT COR 4.50MMX18MM,14860.0,14860.0,1931.8,12631.0,28 HCPCS,C1874,STENT COR 4.50MMX22MM,17981.0,17981.0,2337.53,15283.85,28 HCPCS,C1874,STENT COR 4.50MMX26MM,16346.0,16346.0,2124.98,13894.1,28 HCPCS,C1874,STENT COR 4.50MMX30MM,14860.0,14860.0,1931.8,12631.0,28 HCPCS,C1874,STENT COR 4.50X12MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 4.50X16MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 4.50X20MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 4MM 12MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 4MM 15MM,18795.5,18795.5,2361.32,16512.95,56 HCPCS,C1874,STENT COR 4MM 18MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 4MM 22MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 4MM 23MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 4MM 28MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 4MM 33MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR 4MM 38MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 4MM 40MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR 4MM 8MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR 4X48MM,8650.0,8650.0,1124.5,7352.5,28 HCPCS,C1874,STENT COR 5.00 X 12MM,20184.0,20184.0,2623.92,17156.4,28 HCPCS,C1874,STENT COR 5.00 X 32MM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1874,STENT COR 5.00 X 8MM,19820.0,19820.0,2576.6,16847.0,28 HCPCS,C1874,STENT COR 5.00MMX12MM,16346.0,16346.0,2124.98,13894.1,28 HCPCS,C1874,STENT COR 5.00MMX15MM,16346.0,16346.0,2124.98,13894.1,28 HCPCS,C1874,STENT COR 5.00MMX18MM,16346.0,16346.0,2124.98,13894.1,28 HCPCS,C1874,STENT COR 5.00MMX22MM,17981.0,17981.0,2337.53,15283.85,28 HCPCS,C1874,STENT COR 5.00MMX26MM,17981.0,17981.0,2337.53,15283.85,28 HCPCS,C1874,STENT COR 5.00MMX30MM,17981.0,17981.0,2337.53,15283.85,28 HCPCS,C1874,STENT COR 5.00X12MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 5.00X16MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 5.00X20MM,7863.0,7863.0,1022.19,6683.55,28 HCPCS,C1874,STENT COR 5X12MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR 5X15MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR 5X18MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR 5X23MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR 5X28MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR 5X33MM,3083.0,3083.0,400.79,2620.55,28 HCPCS,C1874,STENT COR DES 2.25X9MM,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT COR RX 2.25X12MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR RX 3.25X28MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR RX 3.5X12MM,19076.0,19076.0,2479.88,16214.6,28 HCPCS,C1874,STENT COR RX 3.5X23MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR RX 3.5X28MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR RX 3.5X33MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COR RX 3X23MM,19427.0,19427.0,2525.51,16512.95,28 HCPCS,C1874,STENT COVRD 7MM 60MM,82423.0,82423.0,10714.99,70059.55,28 HCPCS,C1874,STENT COVRD 8MM 80MM,85476.0,85476.0,11111.88,72654.6,28 HCPCS,C1874,STENT ENDO 5X39MM 135CM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT ENDO 5X59MM 135CM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT ENDO 5X79MM 135CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ENDO 6FR 135CM,94815.0,94815.0,12325.95,80592.75,84 HCPCS,C1874,STENT ENDO 6FR 6X135CM,92487.0,92487.0,12023.31,78613.95,28 HCPCS,C1874,STENT ENDO 6FR 7X135CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ENDO 6X15MM 135CM,83853.0,83853.0,10900.89,71275.05,28 HCPCS,C1874,STENT ENDO 6X19MM 135CM,85955.0,85955.0,11174.15,73061.75,28 HCPCS,C1874,STENT ENDO 6X29MM 135CM,94815.0,94815.0,12325.95,80592.75,28 HCPCS,C1874,STENT ENDO 7FR 135CM,93651.0,93651.0,12023.31,80592.75,84 HCPCS,C1874,STENT ENDO 7FR 8X135CM,89506.0,89506.0,11635.78,76080.1,56 HCPCS,C1874,STENT ENDO 7X19MM 135CM,85955.0,85955.0,11174.15,73061.75,28 HCPCS,C1874,STENT ENDO 8FR 8X135CM,97407.5,97407.5,12325.95,85000.0,56 HCPCS,C1874,STENT ENDO 9X79MM 135CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10CM 10MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10CM 11MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10CM 13MM,98373.0,98373.0,12788.49,83617.05,28 HCPCS,C1874,STENT EPRSTH 10MM 120CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10MM 4CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10MM 5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10MM 8CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 10X13X39MM,87308.0,87308.0,11350.04,74211.8,28 HCPCS,C1874,STENT EPRSTH 11X16X29MM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT EPRSTH 11X16X39MM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT EPRSTH 11X16X59MM,89506.0,89506.0,11635.78,76080.1,28 HCPCS,C1874,STENT EPRSTH 14FR 3.9CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 14FR 4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 5CM 10MM,90635.0,90635.0,11782.55,77039.75,28 HCPCS,C1874,STENT EPRSTH 5CM 11MM,88865.0,88865.0,11552.45,75535.25,28 HCPCS,C1874,STENT EPRSTH 5CM 13MM,88865.0,88865.0,11552.45,75535.25,28 HCPCS,C1874,STENT EPRSTH 5MM 10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 5MM 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 5MM 2.5CM,95062.0,95062.0,12358.06,80802.7,28 HCPCS,C1874,STENT EPRSTH 5MM 25CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 5MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 HCPCS,C1874,STENT EPRSTH 6CM 8-10MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 6MM 10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 6MM 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 6MM 2.5CM,95062.0,95062.0,12358.06,80802.7,28 HCPCS,C1874,STENT EPRSTH 6MM 5CM,97531.0,97531.0,12358.06,85000.0,56 HCPCS,C1874,STENT EPRSTH 6MM 7.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 6X8X29MM,87308.0,87308.0,11350.04,74211.8,28 HCPCS,C1874,STENT EPRSTH 7.5CM 9MM,99671.0,99671.0,12957.23,84720.35,28 HCPCS,C1874,STENT EPRSTH 7.5MM 5.0CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 7CM 8-10MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 7MM 10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 7MM 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 7MM 2.5CM,97531.0,97531.0,12358.06,85000.0,56 HCPCS,C1874,STENT EPRSTH 7MM 25CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 7MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 HCPCS,C1874,STENT EPRSTH 7X11X29MM,87308.0,87308.0,11350.04,74211.8,28 HCPCS,C1874,STENT EPRSTH 8MM 10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 8MM 15CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 8MM 25CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 8MM 5.0CM,95062.0,95062.0,12358.06,80802.7,28 HCPCS,C1874,STENT EPRSTH 8MM 7.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 8X16X39MM,87308.0,87308.0,11350.04,74211.8,28 HCPCS,C1874,STENT EPRSTH 8X16X59MM,87308.0,87308.0,11350.04,74211.8,28 HCPCS,C1874,STENT EPRSTH 8X16X79MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 9MM 10CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT EPRSTH 9MM 5CM,90635.0,90635.0,11782.55,77039.75,28 HCPCS,C1874,STENT ESPH 18.5FR 23MM,70610.5,70610.5,8795.28,60919.5,140 HCPCS,C1874,STENT ESPH 18X119MM,88529.0,88529.0,11508.77,75249.65,56 HCPCS,C1874,STENT ESPH 18X149MM,91155.0,91155.0,11508.77,79713.85,56 HCPCS,C1874,STENT ESPH 18X59MM,88529.0,88529.0,11508.77,75249.65,28 HCPCS,C1874,STENT ESPH 22X150X70MM,45791.0,45791.0,5952.83,38922.35,28 HCPCS,C1874,STENT ESPH 23MM 120MM,93781.0,93781.0,12191.53,79713.85,28 HCPCS,C1874,STENT ESPH FLCVR 18X97MM,88529.0,88529.0,11508.77,75249.65,28 HCPCS,C1874,STENT GFT 18F 70MM 23MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRAFT 16X10X124MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRAFT 16X10X93MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRFT 23MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRFT 26MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRFT 32MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT GRFT 36MMX4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ILIAC 20FR 10X58MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ILIAC 20FR 12X58MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT ILIAC 20FR 12X61MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT PANC 21MM 146MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT PANC 24MM 146MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT PANC 29MM 146MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT RX ELT 2.25X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.25X15X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.25X18X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.25X22X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.25X26X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.25X30X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.75X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.75X30X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.75X35X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELT 2.75X40X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 2.5X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 2.5X30X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 2.5X40X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 2.75X9X140,18334.5,18334.5,2383.49,15584.33,28 HCPCS,C1874,STENT RX ELUT 3.5X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 3.5X18X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 3.5X9X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 3X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 3X9X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X13X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X18X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X26X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X30X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X35X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT RX ELUT 4X9X140,18164.0,18164.0,2361.32,15439.4,28 HCPCS,C1874,STENT VASC 10X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 10X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 12X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 12X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 36MM 120MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 36MM 180MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 46MM 120MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 46MM 180MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 46MM 80MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 5X100MM 125CM,54796.0,54796.0,7123.48,46576.6,28 HCPCS,C1874,STENT VASC 5X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 HCPCS,C1874,STENT VASC 5X140MM 125CM,73112.0,73112.0,9504.56,62145.2,28 HCPCS,C1874,STENT VASC 5X26MM 135CM,65634.0,65634.0,8532.42,55788.9,28 HCPCS,C1874,STENT VASC 5X37MM 135CM,65634.0,65634.0,8532.42,55788.9,28 HCPCS,C1874,STENT VASC 5X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 HCPCS,C1874,STENT VASC 5X60MM 125CM,45638.0,45638.0,5932.94,38792.3,28 HCPCS,C1874,STENT VASC 5X80MM 125CM,54796.0,54796.0,7123.48,46576.6,28 HCPCS,C1874,STENT VASC 6MM 100MM,79218.0,79218.0,10298.34,67335.3,56 HCPCS,C1874,STENT VASC 6MM 120MM,88376.0,88376.0,11488.88,75119.6,28 HCPCS,C1874,STENT VASC 6MM 40MM,60902.0,60902.0,7917.26,51766.7,28 HCPCS,C1874,STENT VASC 6MM 60MM,70060.0,70060.0,9107.8,59551.0,28 HCPCS,C1874,STENT VASC 6MM 80MM,79218.0,79218.0,10298.34,67335.3,28 HCPCS,C1874,STENT VASC 6X100MM 123CM,54796.0,54796.0,7123.48,46576.6,28 HCPCS,C1874,STENT VASC 6X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 HCPCS,C1874,STENT VASC 6X140MM 125CM,73112.0,73112.0,9504.56,62145.2,28 HCPCS,C1874,STENT VASC 6X150MM 130CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 6X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 6X26MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 6X37MM 135CM,65634.0,65634.0,8532.42,55788.9,28 HCPCS,C1874,STENT VASC 6X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 HCPCS,C1874,STENT VASC 6X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 6X80MM 125CM,54796.0,54796.0,7123.48,46576.6,28 HCPCS,C1874,STENT VASC 7MM 120MM,88376.0,88376.0,11488.88,75119.6,28 HCPCS,C1874,STENT VASC 7MM 150MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,STENT VASC 7MM 40MM,60902.0,60902.0,7917.26,51766.7,28 HCPCS,C1874,STENT VASC 7MM 60MM,70060.0,70060.0,9107.8,59551.0,28 HCPCS,C1874,STENT VASC 7MM 80MM,79218.0,79218.0,10298.34,67335.3,28 HCPCS,C1874,STENT VASC 7X120MM 125CM,60902.0,60902.0,7917.26,51766.7,28 HCPCS,C1874,STENT VASC 7X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 7X26MM 135CM,82423.0,82423.0,10714.99,70059.55,28 HCPCS,C1874,STENT VASC 7X37MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 7X40MM 125CM,35870.0,35870.0,4663.1,30489.5,28 HCPCS,C1874,STENT VASC 7X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 8X100MM 125CM,54796.0,54796.0,7123.48,46576.6,28 HCPCS,C1874,STENT VASC 8X16MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 8X26MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 8X37MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 8X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 9X38MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STENT VASC 9X58MM 135CM,73265.0,73265.0,9524.45,62275.25,28 HCPCS,C1874,STNT ENDO 14FR 9MM 90MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,SYSTEM SCFLD 3MM 28MM,88930.0,88930.0,11560.9,75590.5,28 HCPCS,C1874,SYSTEM STENT,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1874,VALVE AOR TRNS CATH 23MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1876,STENT APS 14X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT BIL 10MM 40MM,49614.0,49614.0,6449.82,42171.9,28 HCPCS,C1876,STENT BIL 10X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 10X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 10X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 10X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 12X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 12X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 12X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 12X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 14X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 14X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 4MM 15MM,28296.0,28296.0,3678.48,24051.6,28 HCPCS,C1876,STENT BIL 4MM 18MM,28296.0,28296.0,3678.48,24051.6,28 HCPCS,C1876,STENT BIL 5.0MM 15MM,28296.0,28296.0,3678.48,24051.6,28 HCPCS,C1876,STENT BIL 5.0MM 18MM,29094.0,29094.0,3782.22,24729.9,28 HCPCS,C1876,STENT BIL 6.0MM 15MM,39075.0,39075.0,5079.75,33213.75,28 HCPCS,C1876,STENT BIL 6.0MM 18MM,28296.0,28296.0,3678.48,24051.6,28 HCPCS,C1876,STENT BIL 6FR 10MM 37MM,22025.0,22025.0,2863.25,18721.25,28 HCPCS,C1876,STENT BIL 6FR 10MM 57MM,44478.0,44478.0,5782.14,37806.3,28 HCPCS,C1876,STENT BIL 6FR 4MM 15MM,41503.0,41503.0,5395.39,35277.55,28 HCPCS,C1876,STENT BIL 6FR 4MM 19MM,26949.0,26949.0,3503.37,22906.65,28 HCPCS,C1876,STENT BIL 6FR 5MM 15MM,34174.0,34174.0,4442.62,29047.9,28 HCPCS,C1876,STENT BIL 6FR 5MM 19MM,36231.0,36231.0,4710.03,30796.35,28 HCPCS,C1876,STENT BIL 6FR 6MM 14MM,41503.0,41503.0,5395.39,35277.55,28 HCPCS,C1876,STENT BIL 6FR 6MM 18MM,34174.0,34174.0,4442.62,29047.9,28 HCPCS,C1876,STENT BIL 6FR 7MM 15MM,41503.0,41503.0,5395.39,35277.55,28 HCPCS,C1876,STENT BIL 6FR 7MM 17MM,21020.0,21020.0,2732.6,17867.0,28 HCPCS,C1876,STENT BIL 6FR 7MM 27MM,21020.0,21020.0,2732.6,17867.0,28 HCPCS,C1876,STENT BIL 6FR 7MM 37MM,21020.0,21020.0,2732.6,17867.0,56 HCPCS,C1876,STENT BIL 6FR 7MM 57MM,38846.0,38846.0,5049.98,33019.1,28 HCPCS,C1876,STENT BIL 6FR 8MM 17MM,21020.0,21020.0,2732.6,17867.0,28 HCPCS,C1876,STENT BIL 6FR 8MM 27MM,30893.0,30893.0,4016.09,26259.05,28 HCPCS,C1876,STENT BIL 6FR 8MM 37MM,24007.0,24007.0,3120.91,20405.95,28 HCPCS,C1876,STENT BIL 6FR 8MM 57MM,38846.0,38846.0,5049.98,33019.1,28 HCPCS,C1876,STENT BIL 7FR 10MM 25MM,21020.0,21020.0,2732.6,17867.0,28 HCPCS,C1876,STENT BIL 7FR 10MM 37MM,27488.0,27488.0,3573.44,23364.8,28 HCPCS,C1876,STENT BIL 7FR 7MM 19MM,38429.0,38429.0,4995.77,32664.65,28 HCPCS,C1876,STENT BIL 7FR 9MM 25MM,21020.0,21020.0,2732.6,17867.0,28 HCPCS,C1876,STENT BIL 8FR 10X100MM,50370.0,50370.0,6548.1,42814.5,28 HCPCS,C1876,STENT BIL 8FR 10X60MM,49614.0,49614.0,6449.82,42171.9,28 HCPCS,C1876,STENT BIL 8FR 10X80MM,50370.0,50370.0,6548.1,42814.5,28 HCPCS,C1876,STENT BIL 8FR 8X100MM,49614.0,49614.0,6449.82,42171.9,28 HCPCS,C1876,STENT BIL 8X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 8X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 8X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 8X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 9X100MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 9X20MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 9X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT BIL 9X80MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT CAROTID SYS 8X40MM,74792.0,74792.0,9722.96,63573.2,28 HCPCS,C1876,STENT CAROTID SYS 9X40MM,74792.0,74792.0,9722.96,63573.2,28 HCPCS,C1876,STENT CARTID SYS 10X30MM,74792.0,74792.0,9722.96,63573.2,28 HCPCS,C1876,STENT CARTID SYS 10X40MM,74792.0,74792.0,9722.96,63573.2,28 HCPCS,C1876,STENT CIL 14X40MM 80CM,14940.0,14940.0,1942.2,12699.0,28 HCPCS,C1876,STENT COL 27/22MM 12CM,79474.0,79474.0,10331.62,67552.9,28 HCPCS,C1876,STENT COL 27X22MM 9CM,79474.0,79474.0,10331.62,67552.9,28 HCPCS,C1876,STENT DUODENAL 22MM 90MM,79474.0,79474.0,10331.62,67552.9,28 HCPCS,C1876,STENT DUODENAL 22X120MM,79474.0,79474.0,10331.62,67552.9,28 HCPCS,C1876,STENT GRAFT 15X13X100MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1876,STENT GRAFT 15X20X140MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1876,STENT ILAC 10X 80MM 75CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 10X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 10X40MM 120CM,20439.0,20439.0,2657.07,17373.15,28 HCPCS,C1876,STENT ILAC 10X60MM 120CM,20814.0,20814.0,2705.82,17691.9,28 HCPCS,C1876,STENT ILAC 10X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 12X40MM 120CM,20439.0,20439.0,2657.07,17373.15,28 HCPCS,C1876,STENT ILAC 12X60MM 120CM,21377.0,21377.0,2779.01,18170.45,28 HCPCS,C1876,STENT ILAC 6X120MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 6X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 6X40MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 6X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 8X20MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 8X40MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT ILAC 8X80MM 120CM,19843.0,19843.0,2579.59,16866.55,28 HCPCS,C1876,STENT SLFEXP 12X40X135CM,27488.0,27488.0,3573.44,23364.8,28 HCPCS,C1876,STENT SLFEXP 14X40X75CM,25185.0,25185.0,3274.05,21407.25,28 HCPCS,C1876,STENT SLFEXP 18X40X75CM,25948.0,25948.0,3373.24,22055.8,28 HCPCS,C1876,STENT SLFEXP 20X40X75CM,25948.0,25948.0,3373.24,22055.8,28 HCPCS,C1876,STENT VASC 10X100X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 10X19MM 80CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 10X29MM 80CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 10X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 10X40X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 10X59MM 80CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 10X60X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 10X80X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 5.5MM 150MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5.5MM 40MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5.5MM 80MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5.5X100M,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5.5X120MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5FR 5X10MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5FR 5X120MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5FR 5X40MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5FR 5X60MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5FR 6X10MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5FR 6X120MM,18317.0,18317.0,2381.21,15569.45,28 HCPCS,C1876,STENT VASC 5X100MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5X120MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5X40MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 5X60MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 6.0X120MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 6FR 100X5MM,20606.0,20606.0,2678.78,17515.1,28 HCPCS,C1876,STENT VASC 6FR 100X8MM,24007.0,24007.0,3120.91,20405.95,28 HCPCS,C1876,STENT VASC 6FR 120X5MM,22729.0,22729.0,2954.77,19319.65,28 HCPCS,C1876,STENT VASC 6FR 120X6MM,22729.0,22729.0,2954.77,19319.65,28 HCPCS,C1876,STENT VASC 6FR 150X5MM,25002.0,25002.0,3250.26,21251.7,28 HCPCS,C1876,STENT VASC 6FR 40X5MM,20606.0,20606.0,2678.78,17515.1,28 HCPCS,C1876,STENT VASC 6FR 60X5MM,20606.0,20606.0,2678.78,17515.1,28 HCPCS,C1876,STENT VASC 6FR 60X7MM,21058.0,21058.0,2737.54,17899.3,28 HCPCS,C1876,STENT VASC 6FR 80X5MM,20606.0,20606.0,2678.78,17515.1,28 HCPCS,C1876,STENT VASC 6MM 150MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 6X100MM,42738.0,42738.0,5555.94,36327.3,28 HCPCS,C1876,STENT VASC 6X100X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 6X10MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X120MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X12MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 6X150MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X16MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 6X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 6X19MM 80CM,24040.0,24040.0,3125.2,20434.0,28 HCPCS,C1876,STENT VASC 6X29MM 135CM,24977.0,24977.0,3247.01,21230.45,28 HCPCS,C1876,STENT VASC 6X29MM 80CM,24977.0,24977.0,3247.01,21230.45,28 HCPCS,C1876,STENT VASC 6X39MM 80CM,24040.0,24040.0,3125.2,20434.0,28 HCPCS,C1876,STENT VASC 6X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X40X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 6X40X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 6X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 6X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 6X60MM 200XM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X60X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 6X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 6X80X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 6X80X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 7MM 30MM,79229.0,79229.0,10299.77,67344.65,28 HCPCS,C1876,STENT VASC 7X100MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X100X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 7X100X80,21895.0,21895.0,2846.35,18610.75,28 HCPCS,C1876,STENT VASC 7X120MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X12MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X150MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X16MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X29MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 7X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X39MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X40X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 7X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 7X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 7X60MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 7X80X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X100MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 8X100X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 8X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 8X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 8X39MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 8X39MM 80CM,24040.0,24040.0,3125.2,20434.0,28 HCPCS,C1876,STENT VASC 8X40MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 8X40X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X40X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X59MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VASC 8X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 8X60MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 8X60X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X80MM 200CM,27765.0,27765.0,3609.45,23600.25,28 HCPCS,C1876,STENT VASC 8X80X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 8X80X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 9X19MM 135CM,24977.0,24977.0,3247.01,21230.45,28 HCPCS,C1876,STENT VASC 9X19MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X29MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X29MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X39MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X40X135,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 9X40X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VASC 9X59MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X59MM 80CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VASC 9X80X80,19080.0,19080.0,2480.4,16218.0,28 HCPCS,C1876,STENT VNS 10X100MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 10X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 14X40MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 14X80MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 16X100MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 16X60MM 80CM,39686.0,39686.0,5159.18,33733.1,28 HCPCS,C1876,STENT VNS 16X80MM 80CM,47317.0,47317.0,6151.21,40219.45,28 HCPCS,C1876,STENT VNS 18X60MM 80CM,45791.0,45791.0,5952.83,38922.35,28 HCPCS,C1876,STENT VNS 18X80MM 80CM,45791.0,45791.0,5952.83,38922.35,28 HCPCS,C1876,STENT VNS 20X60MM 80CM,45791.0,45791.0,5952.83,38922.35,28 HCPCS,C1876,STENT VNS 20X80MM 80CM,45791.0,45791.0,5952.83,38922.35,28 HCPCS,C1876,STENT VSC 10X19MM 135CM,24422.0,24422.0,3174.86,20758.7,28 HCPCS,C1876,STENT VSC 10X29MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VSC 10X39MM 135CM,27475.0,27475.0,3571.75,23353.75,28 HCPCS,C1876,STENT VSC 10X59MM 135CM,24977.0,24977.0,3247.01,21230.45,28 HCPCS,C1876,STENTCAROTID SYS 7X40MM,74792.0,74792.0,9722.96,63573.2,28 HCPCS,C1877,STENT BIL 10X40MM,29764.0,29764.0,3869.32,25299.4,28 HCPCS,C1880,FILTER EMBL NAVALIGN DLV,30074.0,30074.0,3909.62,25562.9,28 HCPCS,C1880,KIT DLV FILTER EMBL FEM,57400.0,57400.0,7462.0,48790.0,28 HCPCS,C1880,KIT DLV FILTER EMBL JUG,57400.0,57400.0,7462.0,48790.0,28 HCPCS,C1882,CRT DEFIB CARD 51X73MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT DEFIB CARD 51X74MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT DEFIB CARD 71X51X12,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT DEFIB CARD DF1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT- DEBIFB CARD DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT-D 5.37X8.18X0.99CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT-D CRD 5.37X8.08X0.99,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT-D CRD 5.37X8.18CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT-D HF-T DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRT-D VOLUME 36MM,100000.0,100000.0,13000.0,85000.0,56 HCPCS,C1882,CRTD HF MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD HF MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD HF QUAD MRI IS4 DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD XT MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD XT MRI IS1 DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD XT MRI QUAD DF4,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,CRTD XT QUAD MRI DF1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1882,ICD MRI IS1 DF1,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1883,"Adapter/extension, pacing lead or neurostimulator lead (implantable) ",,,733.9,792.61,6 HCPCS,C1883,EXTENSION NRSTM 40CM,19633.0,19633.0,2748.62,16688.05,24 HCPCS,C1883,LEAD XTN SPN CLMN 25CM,16904.0,16904.0,2366.56,14368.4,24 HCPCS,C1884,FILTER EMBL 3MM 320CM,29304.5,29304.5,1758.27,24908.83,49 HCPCS,C1884,FILTER EMBL 4MM 320CM,29304.5,29304.5,1758.27,24908.83,49 HCPCS,C1884,FILTER EMBL 5MM 320CM,29304.5,29304.5,1758.27,24908.83,49 HCPCS,C1884,FILTER EMBL 6MM 320CM,29304.5,29304.5,1758.27,24908.83,49 HCPCS,C1884,FILTER EMBL 7MM 320CM,29304.5,29304.5,1758.27,24908.83,49 HCPCS,C1884,GWIRE FILTER 5.5MM 190CM,43621.0,43621.0,2617.26,37077.85,49 HCPCS,C1885,CATH ARTHRCM 2.5X.035IN,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1885,CATH ATHRCM 1.4MM 150CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1885,CATH ATHRCM 150CM 2MM,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1885,CATH LASR 4F 0.9MM 150CM,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C1887,CATH ANGIO 5FR .035IN,1151.0,1151.0,69.06,978.35,49 HCPCS,C1887,CATH ANGIO ALW CRV 65CM,2899.0,2899.0,173.94,2464.15,49 HCPCS,C1887,CATH ANGIO C2 5FR 65CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1887,CATH ANGIO CRV 5F 100CM,1151.0,1151.0,69.06,978.35,49 HCPCS,C1887,CATH CLS4 GD 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH DEL 6.5FR 8FR 40CM,15529.5,15529.5,931.77,13200.08,49 HCPCS,C1887,CATH DLV SYS 135CM,18180.5,18180.5,1090.83,15453.42,49 HCPCS,C1887,CATH GD .018IN 150CM,5227.5,5227.5,313.65,4443.38,49 HCPCS,C1887,CATH GD .035IN 135CM,5227.5,5227.5,313.65,4443.38,49 HCPCS,C1887,CATH GD .035IN 150CM,5227.5,5227.5,313.65,4443.38,49 HCPCS,C1887,CATH GD .035IN 200CM,6521.0,6521.0,391.26,5542.85,49 HCPCS,C1887,CATH GD 1.5FR 135CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH GD 1.5FR 150CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH GD 1.8FR 135CM,9492.25,9492.25,301.11,11871.1,98 HCPCS,C1887,CATH GD 10.06FR 47CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1887,CATH GD 100CM 6FR JL5,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 100CM 6FR JL6,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 130D 7.1FR 5.7FR,7677.0,7677.0,460.62,6525.45,49 HCPCS,C1887,CATH GD 2.3FR 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD 2.3FR 90CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD 2.6FR 150CM,6338.5,6338.5,380.31,5387.73,98 HCPCS,C1887,CATH GD 2.9FR 135CM,18951.0,18951.0,1137.06,16108.35,49 HCPCS,C1887,CATH GD 3.1FR 135CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH GD 3.1FR 150CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH GD 40CM 2.4MM,7254.5,7254.5,435.27,6166.32,49 HCPCS,C1887,CATH GD 4FR 135CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD 4FR 90CM,6273.0,6273.0,376.38,5332.05,98 HCPCS,C1887,CATH GD 5.1FR 150CM,20799.5,20799.5,1247.97,17679.58,49 HCPCS,C1887,CATH GD 5.4-7.0F 30CM,7254.5,7254.5,435.27,6166.32,49 HCPCS,C1887,CATH GD 5.5FR 0.051IN,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GD 5.5FR 150CM,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GD 5.7FR 150CM,20799.5,20799.5,1247.97,17679.58,49 HCPCS,C1887,CATH GD 5F 100CM,2150.5,2150.5,129.03,1827.92,98 HCPCS,C1887,CATH GD 5FR 100CM,2274.5,2274.5,129.03,2701.72,147 HCPCS,C1887,CATH GD 6.0FR 0.056IN,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GD 6.8MM 105MM,51200.5,51200.5,3072.03,43520.43,49 HCPCS,C1887,CATH GD 6F JL3 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD 6F JR3.5 100CM,1611.0,1611.0,96.66,1369.35,49 HCPCS,C1887,CATH GD 6F JR4 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD 6F MPA1 125CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD 6F XB3 100CM,1611.0,1611.0,96.66,1369.35,49 HCPCS,C1887,CATH GD 6F XB3.25 100CM,1501.0,1501.0,90.06,1275.85,49 HCPCS,C1887,CATH GD 6F XBRCA 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD 6FR,3872.5,3872.5,232.35,3291.63,49 HCPCS,C1887,CATH GD 6FR 100CM,2371.0,2371.0,129.03,2074.85,882 HCPCS,C1887,CATH GD 6FR 100CM AL1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 100CM AL2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 100CM AL3,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 100CM IM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 110CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 125CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 150CM,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GD 6FR 55CM,2905.5,2905.5,174.33,2469.68,98 HCPCS,C1887,CATH GD 6FR 85CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 6FR 90CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD 7FR 100CM,2274.5,2274.5,136.47,1933.33,49 HCPCS,C1887,CATH GD 7FR 25CM,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GD 7FR 3DRC 100CM,2690.5,2690.5,161.43,2286.93,49 HCPCS,C1887,CATH GD 7FR 42CM,15529.5,15529.5,931.77,13200.08,49 HCPCS,C1887,CATH GD 7FR 43CM,10566.5,10566.5,633.99,8981.52,49 HCPCS,C1887,CATH GD 7FR 69CM,15529.5,15529.5,931.77,13200.08,49 HCPCS,C1887,CATH GD 8.4FR 45CM,10952.0,10952.0,657.12,9309.2,49 HCPCS,C1887,CATH GD 8F 2.46MM 59CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD 8FR 65CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD 90D 7.1FR,7677.0,7677.0,460.62,6525.45,49 HCPCS,C1887,CATH GD 9FR 45CM,8698.0,8698.0,521.88,7393.3,49 HCPCS,C1887,CATH GD 9FR 50CM,14625.5,14625.5,521.88,17470.05,98 HCPCS,C1887,CATH GD ADROIT 5F 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD ADRT 3D 5F 100CM,2208.5,2208.5,132.51,1877.22,49 HCPCS,C1887,CATH GD AL1 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD AL2 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD ALI 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD AR1 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD CLS4 100CM 6FR,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD CRV 6FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD IMA 6FR 55CM,2685.0,2685.0,161.1,2282.25,49 HCPCS,C1887,CATH GD JL4 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD JR3.5 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD JR4 5FR 100CM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD KR3S 6FR 2.1MM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD LCB 5FR 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD LG .75 CRV 6FR,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CATH GD LG 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1887,CATH GD LG XLNG 9FR 65CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1887,CATH GD MD 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1887,CATH GD MP1 6FR 100CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1887,CATH GD RT IR1.0 100CM,3178.5,3178.5,190.71,2701.72,49 HCPCS,C1887,CATH GD SM 9FR 58CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1887,CATH GD VASC 135CM,19875.5,19875.5,1192.53,16894.17,49 HCPCS,C1887,CATH GD VASC 200CM,12149.0,12149.0,728.94,10326.65,49 HCPCS,C1887,CATH GD VASC 45CM,10130.5,10130.5,607.83,8610.92,49 HCPCS,C1887,CATH GD VASC 59CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH GD VASC 9FR 45CM,8698.0,8698.0,521.88,7393.3,49 HCPCS,C1887,CATH GD VSC 115D 7F 42CM,7501.0,7501.0,450.06,6375.85,49 HCPCS,C1887,CATH GD VSC 130D 7F 42CM,7501.0,7501.0,450.06,6375.85,49 HCPCS,C1887,CATH GD XB3 6FR 100CM,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATH GD XB3.5 6FR 100CM,4511.25,4511.25,142.26,5653.77,98 HCPCS,C1887,CATH GDLINER 6F 2.24X135,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATH GLIDE ANGLED 120CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1887,CATH GUIDE 100CM 5FR,2289.75,2289.75,132.51,2015.35,294 HCPCS,C1887,CATH INFS 90D 130CM,16903.0,16903.0,1014.18,14367.55,49 HCPCS,C1887,CATH INTVN 2.9FR 135CM,18642.5,18642.5,1118.55,15846.13,49 HCPCS,C1887,CATH INTVN 6.5FR 150CM,20799.5,20799.5,1247.97,17679.58,49 HCPCS,C1887,CATH MICRO SYS 165CM,27917.5,27917.5,1675.05,23729.88,49 HCPCS,C1887,CATH PERI .014IN 130CM,16903.0,16903.0,1014.18,14367.55,49 HCPCS,C1887,CATH SUP ANG 2.3FR 135CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH SUPP 2.3FR 150CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1887,CATH SUPP ANG 2.6F 90CM,6338.5,6338.5,380.31,5387.73,49 HCPCS,C1887,CATH SUPP GD 90CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH SUPP STR 2.6F 90CM,6338.5,6338.5,380.31,5387.73,49 HCPCS,C1887,CATH VASC 7FR 55CM,7958.5,7958.5,477.51,6764.73,49 HCPCS,C1887,CATH VASC GD 1.8FR 90CM,5018.5,5018.5,301.11,4265.73,49 HCPCS,C1887,CATH VASC GD 17F 65CM,27733.0,27733.0,1663.98,23573.05,49 HCPCS,C1887,CATH VASC GD 17FR 13CM,27733.0,27733.0,1663.98,23573.05,49 HCPCS,C1887,CATH VESSEL 5FR,3446.5,3446.5,206.79,2929.53,49 HCPCS,C1887,CATHETER ANGIO .038IN 4F,1511.0,1511.0,90.66,1284.35,49 HCPCS,C1887,CATHETER GD 100CM 5FR,2289.75,2289.75,132.51,2015.35,147 HCPCS,C1887,CATHETER GD 5FR 59CM,6945.0,6945.0,416.7,5903.25,49 HCPCS,C1887,CATHETER GD 6FR 150CM,13205.5,13205.5,792.33,11224.67,49 HCPCS,C1887,CATHETER GD 9FR 57.5CM,8698.0,8698.0,521.88,7393.3,49 HCPCS,C1887,CATHETER GD BLU YLW 100C,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CATHETER SUP 2.6FR 135CM,6338.5,6338.5,380.31,5387.73,49 HCPCS,C1887,CATHGD VBT 6X070HSTK 100,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CTHGD 6F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 100CM M1 JL3.5,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 100CM M1 JL4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 100CM M1 JR4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 90CM M1 KR3H,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 90CM M1 KR4H,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 6F 90CM M1 KR4S,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 AI.75,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 AL2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 AR1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 AR2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 HS,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 IM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 JR4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 7F 100CM M1 MP1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 AL.75,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 AL2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 AR1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 AR2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 CLS3,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 CLS3.5,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 CLS4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 IM,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 JL3.5,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 JL4,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 100CM M1 MP1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 90CM M1 AL1,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD 8F 90CM M1 HS,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD CLS3.5 7FR 0.081IN,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,CTHGD VBT 6F 070 IM 100,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CTHGD VBT 6F 070 LCB 100,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CTHGD VBT 6F 070 RCB 100,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CTHGD VBT 6X070 3DRC,2371.0,2371.0,142.26,2015.35,49 HCPCS,C1887,CTHGD VBT 7F 078 XB3 100,2274.5,2274.5,136.47,1933.33,49 HCPCS,C1887,CTHGD VBT 7F 078 XB4 100,2274.5,2274.5,136.47,1933.33,49 HCPCS,C1887,DEVICE CATH GD 18X106CM,83044.0,83044.0,4982.64,70587.4,49 HCPCS,C1887,GCATH 5F CONVEY LTBU3.75,2441.0,2441.0,146.46,2074.85,49 HCPCS,C1887,GDCATH LIVER 41CM 10FR,18704.0,18704.0,1122.24,15898.4,49 HCPCS,C1887,KIT CATH VASC 8.5F 40CM,32509.0,32509.0,1950.54,27632.65,49 HCPCS,C1887,KIT MCTH INFS 20CM 135CM,14790.0,14790.0,887.4,12571.5,49 HCPCS,C1887,MCTH INFS 20CM 150CM,10063.0,10063.0,603.78,8553.55,49 HCPCS,C1887,MCTH INFS 3-2.4FR 130CM,10423.5,10423.5,625.41,8859.98,49 HCPCS,C1887,MCTH INFS 3-2.4FR 150CM,11326.75,11326.75,625.41,10395.5,98 HCPCS,C1887,MICROCATH COX 2.4FR 130C,19320.5,19320.5,1159.23,16422.42,49 HCPCS,C1887,MODEL-5F CONVEY AL.75,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,MODEL-5F CONVEY AR2,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,MODEL-5F CONVEY JR3.5,2150.5,2150.5,129.03,1827.92,49 HCPCS,C1887,SET BX NDL ACC 18G 100,19875.0,19875.0,1192.5,16893.75,49 HCPCS,C1887,SHEATH GD 149CM 6FR,9613.5,9613.5,576.81,8171.48,49 HCPCS,C1887,SHEATH GD 6FR 119CM,9613.5,9613.5,576.81,8171.48,49 HCPCS,C1887,SHEATH GD 6FR 90CM,5269.5,5269.5,316.17,4479.07,49 HCPCS,C1887,SYSTEM DLV CATH 1 CLIP,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1887,SYSTEM PRO LEAD DELIVERY,31276.5,31276.5,1876.59,26585.03,49 HCPCS,C1892,INTRO LD 49CM 9FR SFSH,16656.5,16656.5,999.39,14158.02,49 HCPCS,C1892,INTRO LD 50CM 9FR 18GA,10564.5,10564.5,633.87,8979.83,49 HCPCS,C1892,INTRO OC R 9FR 47CM,13368.5,13368.5,802.11,11363.23,49 HCPCS,C1892,INTRO OC-135 9FR 47CM,14438.0,14438.0,866.28,12272.3,49 HCPCS,C1892,INTRO PLWY 12F 30,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1892,INTRO SHTH 10FR 13CM,2020.0,2020.0,121.2,1717.0,49 HCPCS,C1892,INTRO SHTH 6FR 13CM,2020.0,2020.0,121.2,1717.0,49 HCPCS,C1892,INTRO SHTH 7FR 13CM,2020.0,2020.0,121.2,1717.0,49 HCPCS,C1892,INTRO SHTH 7FR 25CM,2534.0,2534.0,152.04,2153.9,49 HCPCS,C1892,INTRO SHTH 8FR 10CM MRKR,10564.5,10564.5,633.87,8979.83,49 HCPCS,C1892,INTRODCR SPLTBL 8FR 13CM,2020.0,2020.0,121.2,1717.0,49 HCPCS,C1892,KIT INTRO SHEATH,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1892,KIT SHTH 6FR 13CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1892,SHEATH GD 8FR 65CM,4558.5,4558.5,273.51,3874.72,49 HCPCS,C1892,SHEATH INTR TER 10CM 4F,1743.5,1743.5,104.61,1481.97,49 HCPCS,C1892,SHEATH INTRO 5F 10CM,1743.5,1743.5,104.61,1481.97,49 HCPCS,C1892,SHEATH INTRO 8.5FR 13CM,1940.0,1940.0,116.4,1649.0,49 HCPCS,C1892,SHEATH INTRO 8FR 25CM,2563.0,2563.0,153.78,2178.55,49 HCPCS,C1892,SHEATH INTRO 9FR 25CM,2471.0,2471.0,148.26,2100.35,49 HCPCS,C1892,SHTH INTRO SPLT 9FR 13CM,2690.5,2690.5,161.43,2286.93,49 HCPCS,C1892,SYS INTRO 23CM 11FR 18GA,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1892,SYSTEM INTRO 9FR 19.5CM,6974.0,6974.0,418.44,5927.9,49 HCPCS,C1893,CATH GD 8.7FR 45CM,6945.0,6945.0,416.7,5903.25,49 HCPCS,C1893,CATH GD CRV 7.3FR 55CM,6796.5,6796.5,407.79,5777.02,49 HCPCS,C1893,INTO SHTH 10.06FR 47CM,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1893,INTRO SHTH 10.06FR,13037.5,13037.5,782.25,11081.88,49 HCPCS,C1893,INTRO SHTH 10.6FR,13037.5,13037.5,782.25,11081.88,98 HCPCS,C1893,INTRO SHTH 8.5FR 67CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1893,INTRO SHTH GD 8.5FR 63CM,4751.0,4751.0,285.06,4038.35,49 HCPCS,C1893,INTRODUCR SHTH 10F 25CM,2696.5,2696.5,161.79,2292.03,49 HCPCS,C1893,KIT CARDIAC CATHETER,4893.0,4893.0,293.58,4159.05,49 HCPCS,C1893,KIT GD SHEATH DISP,5035.0,5035.0,302.1,4279.75,49 HCPCS,C1893,SET INTRO 16FR 27IN,23120.0,23120.0,1387.2,19652.0,49 HCPCS,C1893,SHEATH WIRE 45D 63CM,29890.0,29890.0,1793.4,25406.5,49 HCPCS,C1893,SHEATH WIRE 45F 230CM,29890.0,29890.0,1793.4,25406.5,49 HCPCS,C1894,CATH GD 6.5MM 105MM,51200.5,51200.5,3072.03,43520.43,49 HCPCS,C1894,DILATOR VASC 230CM,30660.0,30660.0,1839.6,26061.0,98 HCPCS,C1894,GD WIRE 22GA 7FR 18CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,GRAFT AAA 40-42 179MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C1894,INRO SHTH ACCESS 180P,30660.0,30660.0,1839.6,26061.0,49 HCPCS,C1894,INTRCR SHTH 23FR 55.7CM,18488.5,18488.5,1109.31,15715.23,49 HCPCS,C1894,INTRO 10CM 6FR GLDESHTH,3199.5,3199.5,191.97,2719.57,49 HCPCS,C1894,INTRO CATH 12FR 13CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRO CATH 12FR 30CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRO CATH 14FR 30CM,4119.0,4119.0,247.14,3501.15,49 HCPCS,C1894,INTRO CATH CKFL 20F 25CM,15705.5,15705.5,942.33,13349.67,49 HCPCS,C1894,INTRO CATH UNIV MIC 6FR,1739.5,1739.5,104.37,1478.58,49 HCPCS,C1894,INTRO SHEATH 10FR 33CM,17887.25,17887.25,887.4,17836.83,147 HCPCS,C1894,INTRO SHEATH 12FR 11CM,916.0,916.0,54.96,778.6,49 HCPCS,C1894,INTRO SHEATH 14FR 33CM,14790.0,14790.0,887.4,12571.5,49 HCPCS,C1894,INTRO SHEATH 14FR 65CM,23912.0,23912.0,1434.72,20325.2,49 HCPCS,C1894,INTRO SHEATH 16FR 33CM,14790.0,14790.0,887.4,12571.5,49 HCPCS,C1894,INTRO SHEATH 18FR 33CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1894,INTRO SHEATH 18FR 65CM,23912.0,23912.0,1434.72,20325.2,49 HCPCS,C1894,INTRO SHEATH 20FR 33CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1894,INTRO SHEATH 22FR 33CM,17607.0,17607.0,1056.42,14965.95,98 HCPCS,C1894,INTRO SHEATH 22FR 65CM,23912.0,23912.0,1434.72,20325.2,49 HCPCS,C1894,INTRO SHEATH 24FR 33CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1894,INTRO SHEATH 24FR 65CM,23912.0,23912.0,1434.72,20325.2,49 HCPCS,C1894,INTRO SHEATH 26FR 33CM,14700.0,14700.0,882.0,12495.0,49 HCPCS,C1894,INTRO SHEATH 26FR 65CM,24405.0,24405.0,1464.3,20744.25,49 HCPCS,C1894,INTRO SHEATH NTNL 6FR,2034.0,2034.0,122.04,1728.9,49 HCPCS,C1894,INTRO SHTH 10FR 10CM,639.5,639.5,38.37,543.58,49 HCPCS,C1894,INTRO SHTH 11 10FR,577.0,577.0,34.62,490.45,49 HCPCS,C1894,INTRO SHTH 11FR 10CM,639.5,639.5,38.37,543.58,49 HCPCS,C1894,INTRO SHTH 12F 45CM,2969.0,2969.0,178.14,2523.65,49 HCPCS,C1894,INTRO SHTH 12FR 12CM,848.5,848.5,50.91,721.23,49 HCPCS,C1894,INTRO SHTH 14FR 11CM,832.0,832.0,49.92,707.2,49 HCPCS,C1894,INTRO SHTH 16FR 42CM,4119.0,4119.0,247.14,3501.15,49 HCPCS,C1894,INTRO SHTH 17FR 45CM,11445.0,11445.0,686.7,9728.25,49 HCPCS,C1894,INTRO SHTH 18FR 30CM,4119.0,4119.0,247.14,3501.15,49 HCPCS,C1894,INTRO SHTH 5FR 11CM,492.5,492.5,29.55,418.63,49 HCPCS,C1894,INTRO SHTH 5FR 25CM,1424.0,1424.0,85.44,1210.4,49 HCPCS,C1894,INTRO SHTH 6F 110CM,4244.5,4244.5,254.67,3607.82,49 HCPCS,C1894,INTRO SHTH 7FR 6CM,1090.0,1090.0,65.4,926.5,49 HCPCS,C1894,INTRO SHTH 7FR 75CM,2990.0,2990.0,179.4,2541.5,49 HCPCS,C1894,INTRO SHTH 7FR 85CM MLN,2990.0,2990.0,179.4,2541.5,49 HCPCS,C1894,INTRO SHTH 9.5FR,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRO SHTH 9FR 10CM,1743.5,1743.5,104.61,1481.97,49 HCPCS,C1894,INTRO SHTH ANSL 6FR 55CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRO SHTH PNCL R/O,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1894,INTRO SHTH VASC 6F 45CM,3131.5,3131.5,187.89,2661.78,49 HCPCS,C1894,INTRO SHTH VASC 6F 90CM,4001.5,4001.5,240.09,3401.28,98 HCPCS,C1894,INTRODUCER 10FR 45CM,2969.0,2969.0,178.14,2523.65,49 HCPCS,C1894,INTRODUCER CATH 45CM 5FR,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRODUCER CATH 6FR 45CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRODUCER SHTH 6FR 90CM,5269.5,5269.5,316.17,4479.07,49 HCPCS,C1894,INTRODUCER SHTH 7FR 55CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRODUCER SHTH 7FR 70CM,3512.5,3512.5,210.75,2985.63,49 HCPCS,C1894,INTRODUCER SHTH 7FR 90CM,5269.5,5269.5,316.17,4479.07,49 HCPCS,C1894,INTRODUCER SHTH 8FR 45CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRODUCER SHTH 8FR 63CM,2990.0,2990.0,179.4,2541.5,49 HCPCS,C1894,INTRODUCER SHTH 8FR 70CM,3512.5,3512.5,210.75,2985.63,49 HCPCS,C1894,INTRODUCER SHTH 8FR 90CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,INTRODUCER VASC 14F 45CM,5206.5,5206.5,312.39,4425.52,49 HCPCS,C1894,INTRODUCR SHTH 7CM 4FR,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT ACC INTRO 6FR 15CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT CAROTID EMBLC PRTCT,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1894,KIT CATH 9FR 11.5CM,5783.5,5783.5,309.9,5441.7,98 HCPCS,C1894,KIT DEVICE CATH CUFF,755.5,755.5,45.33,642.17,49 HCPCS,C1894,KIT INTRO 21GA 5FR 10CM,1684.0,1684.0,101.04,1431.4,49 HCPCS,C1894,KIT INTRO 25FR 50CM,14628.0,14628.0,877.68,12433.8,49 HCPCS,C1894,KIT INTRO 5FR 21GA 10CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT INTRO 8.5FR 10CM,5553.0,5553.0,333.18,4720.05,49 HCPCS,C1894,KIT INTRO SHTH 7FR 10CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT INTRO SHTH 9.5F 13CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT INTRO SHTH 9FR 13CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,KIT INTVN TRANSCAROTID,100000.0,100000.0,6000.0,85000.0,49 HCPCS,C1894,KIT MCR INTRO 5FR 41CM,1275.5,1275.5,76.53,1084.17,49 HCPCS,C1894,KIT MINTRDCR 40CM 5FR,1159.5,1159.5,69.57,985.58,49 HCPCS,C1894,KIT MINTRDCR 5FR 35CM UN,1703.0,1703.0,102.18,1447.55,49 HCPCS,C1894,KIT MINTRDCR 7CM 21GA ND,6064.0,6064.0,363.84,5154.4,49 HCPCS,C1894,KIT MNTRDCR 5FR 21G 40CM,1043.5,1043.5,62.61,886.98,49 HCPCS,C1894,KT INTRO SHTH 6FR 10CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,SET DILATION SHEATH 6FR,1898.5,1898.5,113.91,1613.72,49 HCPCS,C1894,SET DILATOR SHTH 24-30FR,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1894,SET INTRO 14FR 13CM,2556.5,2556.5,153.39,2173.03,49 HCPCS,C1894,SET INTRO 8-14FR 14CM,6106.0,6106.0,366.36,5190.1,49 HCPCS,C1894,SET SHTH INTRO 24FR 33CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C1894,SET SHTH INTRO 24FR 65CM,24405.0,24405.0,1464.3,20744.25,49 HCPCS,C1894,SET SHTH URT 11-13F 36CM,4274.5,4274.5,256.47,3633.32,49 HCPCS,C1894,SET SHTH URT 11-14F 28CM,4274.5,4274.5,256.47,3633.32,49 HCPCS,C1894,SHEATH CATH GW 7FR 55CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,SHEATH DLV TUN 16GA 12IN,1575.0,1575.0,94.5,1338.75,49 HCPCS,C1894,SHEATH GD 14FR 63CM,4119.0,4119.0,247.14,3501.15,49 HCPCS,C1894,SHEATH GD 4FR 45CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,SHEATH GD 5FR 110CM,4244.5,4244.5,254.67,3607.82,49 HCPCS,C1894,SHEATH GD 5FR 45CM,4349.5,4349.5,260.97,3697.07,49 HCPCS,C1894,SHEATH GD 5FR 55CM,2969.0,2969.0,178.14,2523.65,49 HCPCS,C1894,SHEATH GD 5FR 70CM,3512.5,3512.5,210.75,2985.63,49 HCPCS,C1894,SHEATH GD 5FR 90CM,4244.5,4244.5,254.67,3607.82,49 HCPCS,C1894,SHEATH GD 6FR 45CM,4349.5,4349.5,260.97,3697.07,49 HCPCS,C1894,SHEATH GD 6FR 70CM,3512.5,3512.5,210.75,2985.63,49 HCPCS,C1894,SHEATH GD 7FR 45CM,4349.5,4349.5,260.97,3697.07,49 HCPCS,C1894,SHEATH GD 8FR 90CM,5269.5,5269.5,316.17,4479.07,49 HCPCS,C1894,SHEATH GD 90CM 6FR.087IN,4244.5,4244.5,254.67,3607.82,49 HCPCS,C1894,SHEATH GD RDC 6FR 45CM,4349.5,4349.5,260.97,3697.07,49 HCPCS,C1894,SHEATH GUIDE 8F 45CM,3131.5,3131.5,187.89,2661.78,49 HCPCS,C1894,SHEATH INTR 5FR 25CM,1336.5,1336.5,80.19,1136.03,49 HCPCS,C1894,SHEATH INTRO 10F 25CM,1395.0,1395.0,83.7,1185.75,49 HCPCS,C1894,SHEATH INTRO 10FR 11CM,1017.0,1017.0,61.02,864.45,49 HCPCS,C1894,SHEATH INTRO 11GA 8IN,2644.0,2644.0,158.64,2247.4,49 HCPCS,C1894,SHEATH INTRO 12F 28CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C1894,SHEATH INTRO 14F 28CM,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1894,SHEATH INTRO 14FR 25CM,1092.5,1092.5,65.55,928.63,49 HCPCS,C1894,SHEATH INTRO 16FR 28CM,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1894,SHEATH INTRO 20FR 28CM,8803.5,8803.5,528.21,7482.98,49 HCPCS,C1894,SHEATH INTRO 20FR 65CM,24405.0,24405.0,1464.3,20744.25,49 HCPCS,C1894,SHEATH INTRO 21G 5F 10CM,2789.5,2789.5,167.37,2371.07,49 HCPCS,C1894,SHEATH INTRO 21G 5F 16CM,2789.5,2789.5,167.37,2371.07,49 HCPCS,C1894,SHEATH INTRO 21G 6F 10CM,2789.5,2789.5,167.37,2371.07,49 HCPCS,C1894,SHEATH INTRO 21G 6F 16CM,2789.5,2789.5,167.37,2371.07,49 HCPCS,C1894,SHEATH INTRO 22FR 28CM,8803.5,8803.5,528.21,7482.98,49 HCPCS,C1894,SHEATH INTRO 24F 28CM,8803.5,8803.5,528.21,7482.98,49 HCPCS,C1894,SHEATH INTRO 6FR 15.5CM,2905.5,2905.5,174.33,2469.68,49 HCPCS,C1894,SHEATH INTRO 6FR 25CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1894,SHEATH INTRO 6FR 65CM,5102.0,5102.0,306.12,4336.7,49 HCPCS,C1894,SHEATH INTRO 7FR 10CM,1244.0,1244.0,74.64,1057.4,49 HCPCS,C1894,SHEATH INTRO 7FR 25CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1894,SHEATH INTRO 7FR 65CM,5102.0,5102.0,306.12,4336.7,49 HCPCS,C1894,SHEATH INTRO 8FR 25CM,1918.0,1918.0,115.08,1630.3,49 HCPCS,C1894,SHEATH INTRO GW 6F 11CM,492.5,492.5,29.55,418.63,49 HCPCS,C1894,SHEATH INTRO GW 7F 11CM,492.5,492.5,29.55,418.63,49 HCPCS,C1894,SHEATH INTRO GW 8F 11CM,492.5,492.5,29.55,418.63,49 HCPCS,C1894,SHEATH INTRO GW 9F 11CM,492.5,492.5,29.55,418.63,49 HCPCS,C1894,SHEATH INTRO M00115727B1,916.0,916.0,54.96,778.6,49 HCPCS,C1894,SHEATH NVGRT 12/14F 36CM,4081.0,4081.0,244.86,3468.85,49 HCPCS,C1894,SHEATH NVGRT 12/14F 46CM,4164.5,4164.5,249.87,3539.82,49 HCPCS,C1894,SHEATH TEFLON 30FR./20CM,1799.5,1799.5,107.97,1529.58,49 HCPCS,C1894,SHEATH TPR 13FR 11FR 2,4164.5,4164.5,249.87,3539.82,49 HCPCS,C1894,SHEATH URET 11/13FR 40CM,11445.0,11445.0,686.7,9728.25,49 HCPCS,C1894,SHEATH URET 11/13FR 46CM,11445.0,11445.0,686.7,9728.25,49 HCPCS,C1894,SHEATH URET 12-14FR 46CM,11445.0,11445.0,686.7,9728.25,49 HCPCS,C1894,SHEATH URET 12/14FR 40CM,11445.0,11445.0,686.7,9728.25,49 HCPCS,C1894,SHEATH VASC 18FR 28CM,7043.0,7043.0,422.58,5986.55,49 HCPCS,C1894,SHEATH VASC 6F 45CM,3131.5,3131.5,187.89,2661.78,49 HCPCS,C1894,SHEATH VASC 6FR 65CM,3262.0,3262.0,195.72,2772.7,49 HCPCS,C1894,SHEATH VASC 8FR 65CM,3262.0,3262.0,195.72,2772.7,49 HCPCS,C1894,SHTH 7FX63 RCFW,2990.0,2990.0,179.4,2541.5,49 HCPCS,C1894,SHTH DLV 80CM 14FR 5.5IN,22648.5,22648.5,1358.91,19251.22,49 HCPCS,C1894,SHTH DSTN 7F 45 C-C RDC,4349.5,4349.5,260.97,3697.07,49 HCPCS,C1894,TUNNLER SHTH 11GA 8IN,1604.0,1604.0,96.24,1363.4,49 HCPCS,C1894,TUNNLER SHTH 17GA 10IN,1616.0,1616.0,96.96,1373.6,49 HCPCS,C1895,LEAD DEFIB 58CM,67522.0,67522.0,8777.86,57393.7,28 HCPCS,C1895,LEAD DEFIB 65CM,74775.0,74775.0,9720.75,63558.75,28 HCPCS,C1895,LEAD ICD 52CM,84850.0,84850.0,11030.5,72122.5,28 HCPCS,C1895,LEAD ICD 62CM,51382.0,51382.0,6679.66,43674.7,28 HCPCS,C1895,LEAD ICD 63CM,84850.0,84850.0,11030.5,72122.5,28 HCPCS,C1895,LEAD ICD DEFIB 58CM,67522.0,67522.0,8777.86,57393.7,28 HCPCS,C1896,ICD ELECTRODE DEFIB 45CM,62968.0,62968.0,8185.84,53522.8,28 HCPCS,C1896,LEAD CRT PCNG 55CM,66165.0,66165.0,8601.45,56240.25,28 HCPCS,C1897,KIT LEAD TRIAL STM BILAT,13744.0,13744.0,1924.16,11682.4,24 HCPCS,C1897,KIT PNE LEAD IMPLANT,1589.0,1589.0,222.46,1350.65,24 HCPCS,C1897,LEAD NRSTM 60CM,27035.0,27035.0,3784.9,22979.75,24 HCPCS,C1897,LEAD TRIAL STIM IMPLANT,885.0,885.0,123.9,752.25,24 HCPCS,C1897,"Lead, neurostimulator test kit (implantable) ",,,1336.6,1443.53,6 HCPCS,C1897,TRIAL LEAD NRSTM 50CM,19633.0,19633.0,2748.62,16688.05,24 HCPCS,C1898,LEAD PACEMAKER 46CM,6180.0,6180.0,803.4,5253.0,28 HCPCS,C1898,LEAD PACEMAKER 65CM,6180.0,6180.0,803.4,5253.0,28 HCPCS,C1898,LEAD PACING 59CM,5971.0,5971.0,776.23,5075.35,28 HCPCS,C1898,LEAD PACING 6FR 58CM,6180.0,6180.0,803.4,5253.0,28 HCPCS,C1898,LEAD PACNG 52CM,5971.0,5971.0,776.23,5075.35,28 HCPCS,C1898,LEAD PCNG 4.1FR 59CM,6040.0,6040.0,785.2,5134.0,28 HCPCS,C1898,LEAD PCNG 4.1FR 69CM,9393.0,9393.0,1221.09,7984.05,28 HCPCS,C1898,LEAD PCNG 45CM,7140.0,7140.0,776.23,7062.65,56 HCPCS,C1898,LEAD PCNG 46CM,6229.0,6229.0,803.4,5336.3,56 HCPCS,C1898,LEAD PCNG 52CM,6278.0,6278.0,785.2,5817.4,112 HCPCS,C1898,LEAD PCNG 53CM,4802.0,4802.0,490.49,4956.35,56 HCPCS,C1898,LEAD PCNG 54MM,8007.0,8007.0,1040.91,6805.95,28 HCPCS,C1898,LEAD PCNG 58CM,6124.5,6124.5,776.23,5336.3,56 HCPCS,C1898,LEAD PCNG 6.2FR 52CM,7623.0,7623.0,990.99,6479.55,28 HCPCS,C1898,LEAD PCNG 6.6FR 35CM,6040.0,6040.0,785.2,5134.0,28 HCPCS,C1898,LEAD PCNG 60CM,5831.0,5831.0,758.03,4956.35,28 HCPCS,C1898,LEAD PCNG 65CM,6040.0,6040.0,785.2,5134.0,28 HCPCS,C1898,LEAD PCNG 6FR 58CM,6110.0,6110.0,785.2,5253.0,56 HCPCS,C1898,LEAD PCNG 6FR 65CM,6792.0,6792.0,882.96,5773.2,28 HCPCS,C1898,LEAD PCNG MYO 6.6FR 53CM,6040.0,6040.0,785.2,5134.0,28 HCPCS,C1898,LEAD PCNG RT VNTRC 52CM,5587.0,5587.0,726.31,4748.95,28 HCPCS,C1900,LEAD CRT PACING 88CM,26589.0,26589.0,3456.57,22600.65,28 HCPCS,C1900,LEAD CRT PCNG 5.3FR 78CM,20827.0,20827.0,2707.51,17702.95,28 HCPCS,C1900,LEAD CRT PCNG 5.3FR 88CM,20827.0,20827.0,2707.51,17702.95,28 HCPCS,C1900,LEAD CRT PCNG 78CM,25754.0,25754.0,3348.02,21890.9,28 HCPCS,C1900,LEAD CRT PCNG 88CM,23080.0,23080.0,2953.6,19924.0,56 HCPCS,C1900,LEAD CRT PCNG VNS 78CM,20827.0,20827.0,2707.51,17702.95,28 HCPCS,C1900,LEAD CRT-D 1.6MM 87CM,16065.0,16065.0,2088.45,13655.25,28 HCPCS,C1900,LEAD PCNG 3.9-5.2FR 86CM,22228.0,22228.0,2889.64,18893.8,28 HCPCS,C1900,LEAD PCNG 4.7FR 86CM,24946.5,24946.5,3217.37,21372.4,56 HCPCS,C1900,LEAD PCNG 86CM,25979.0,25979.0,2889.64,23295.95,84 HCPCS,C1900,LEAD PCNG 90CM,21221.0,21221.0,2758.73,18037.85,28 HCPCS,C1900,LEAD PCNG VNS 78CM,23629.0,23629.0,3071.77,20084.65,28 HCPCS,C2615,SEALANT PLR PROGL 4ML,38840.5,38840.5,2330.43,33014.43,49 HCPCS,C2616,BRACHYTX NS YTTRIUM 90,100000.0,100000.0,13000.0,85000.0,18 HCPCS,C2616,"Brachytherapy source, non-stranded, yttrium-90, per source ",100000.0,100000.0,17480.0,51274.71,7 HCPCS,C2617,SET STENT URTH 7.2F 75CM,4513.0,4513.0,586.69,3836.05,28 HCPCS,C2617,STENT BIL DB 7FR 5CM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C2617,STENT BIL PGTL 10FR 3CM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C2617,STENT BIL PGTL 10FR 5CM,1975.0,1975.0,256.75,1678.75,28 HCPCS,C2617,STENT BIL PGTL 7FR 3CM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C2617,STENT BIL PGTL 7FR 7CM,2541.0,2541.0,330.33,2159.85,28 HCPCS,C2617,STENT PANC 5FR 3CM,3097.0,3097.0,399.62,2652.0,56 HCPCS,C2617,STENT PANC 5FR 5CM,3120.0,3120.0,405.6,2652.0,28 HCPCS,C2617,STENT PANC 5FR 7CM,2897.0,2897.0,353.6,2612.9,56 HCPCS,C2617,STENT PANC 7FR 5CM,4237.5,4237.5,452.79,4243.2,56 HCPCS,C2617,STENT PANC 7FR 7CM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C2617,STENT PANC 7FR 9CM,4992.0,4992.0,648.96,4243.2,28 HCPCS,C2617,STENT URET 4.8FR 26CM,6072.0,6072.0,789.36,5161.2,28 HCPCS,C2617,STENT URET 4.8FR 28CM,3804.0,3804.0,494.52,3233.4,28 HCPCS,C2617,STENT URET 5FR 26CM,4367.0,4367.0,567.71,3711.95,28 HCPCS,C2617,STENT URET 6FR 22-30CM,4837.0,4837.0,628.81,4111.45,28 HCPCS,C2617,STENT URET 6FR 22CM,4908.0,4908.0,494.52,5161.2,84 HCPCS,C2617,STENT URET 6FR 24CM,5619.0,5619.0,494.52,6313.8,112 HCPCS,C2617,STENT URET 6FR 26CM,5490.0,5490.0,494.52,5706.9,112 HCPCS,C2617,STENT URET 6FR 28CM,5490.0,5490.0,638.04,5161.2,56 HCPCS,C2617,STENT URET 6FR 80CM,6349.0,6349.0,825.37,5396.65,28 HCPCS,C2617,STENT URET 7FR 22-30CM,4837.0,4837.0,628.81,4111.45,28 HCPCS,C2617,STENT URET 7FR 22CM,5490.0,5490.0,638.04,5161.2,56 HCPCS,C2617,STENT URET 7FR 24CM,5009.0,5009.0,651.17,4257.65,28 HCPCS,C2617,STENT URET 7FR 26CM,5540.5,5540.5,651.17,5161.2,56 HCPCS,C2617,STENT URET 7FR 28CM,6168.0,6168.0,638.04,6313.8,56 HCPCS,C2617,STENT URET 8FR 20CM,7580.0,7580.0,985.4,6443.0,28 HCPCS,C2617,STENT URET 8FR 22CM,7428.0,7428.0,965.64,6313.8,28 HCPCS,C2617,STENT URET 8FR 24CM,6244.0,6244.0,638.04,6443.0,56 HCPCS,C2618,PROBE CRYO 11IN,86279.5,86279.5,5176.77,73337.57,49 HCPCS,C2618,PROBE CRYO 17IN,89361.0,89361.0,5361.66,75956.85,49 HCPCS,C2618,PROBE CRYO TIP 11IN 8MM,75494.5,75494.5,4529.67,64170.32,49 HCPCS,C2618,PROBE CRYO-ABLTN 10CM,23367.5,23367.5,1402.05,19862.38,49 HCPCS,C2618,PROBE CRYOSPHERE 18IN 8M,78576.0,78576.0,4714.56,66789.6,49 HCPCS,C2621,CRT-P 11X19.9X46.5,83291.0,83291.0,10827.83,70797.35,28 HCPCS,C2621,CRT-P 4.45X6.13X0.75CM,88722.0,88722.0,11533.86,75413.7,28 HCPCS,C2621,CRT-P 59X59X6MM,93749.0,93749.0,12187.37,79686.65,28 HCPCS,C2621,CRT-P CRD 11X46.5X59MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C2621,CRT-P CRD 59X46.5X11MM,89002.0,89002.0,11570.26,75651.7,28 HCPCS,C2621,CRT-P MR 15MM,93749.0,93749.0,12187.37,79686.65,28 HCPCS,C2622,PROSTHESIS PENILE 9.5MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C2622,PROSTHESIS PENL 27 13MM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C2623,BALLN LTNX 6X60MM 130CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,BALLN LUTNX OTW4X100X130,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLN 10X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 12X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 4X100MM,30814.0,30814.0,1848.84,26191.9,49 HCPCS,C2623,CATH BLN 5F 4X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 5F 4X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 5F 4X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 5F 4X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 5F 5X40MM 130CM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C2623,CATH BLN 5FR 4X130X150MM,48532.5,48532.5,2911.95,41252.63,49 HCPCS,C2623,CATH BLN 5FR 4X130X40MM,33895.5,33895.5,2033.73,28811.17,49 HCPCS,C2623,CATH BLN 5FR 5X130X100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLN 5FR 5X130X60MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLN 5FR 6X130X40MM,35107.0,35107.0,2106.42,29840.95,49 HCPCS,C2623,CATH BLN 5FR 6X130X60MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLN 5X200MM 200CM,83044.0,83044.0,4982.64,70587.4,49 HCPCS,C2623,CATH BLN 6F 5X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 5X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 5X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 5X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 6X120MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 6X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 6X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6F 80CM 6X40MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 6FR 4X130X100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLN 7F 7X40MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 7F 7X60MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 7F 7X80MM 80CM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLN 7F 8X40X80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 7F 8X60X80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 7F 8X80MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 7F 9X40MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 7F 9X60MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLN 9F 9X80MM 80CM,50381.0,50381.0,3022.86,42823.85,49 HCPCS,C2623,CATH BLNDIL 130CM 6X80MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 4MM 100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 4MM 120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 4MM 150MM,46221.25,46221.25,2680.83,40597.7,98 HCPCS,C2623,CATH BLNDIL 4MM 200MM,56852.0,56852.0,3411.12,48324.2,49 HCPCS,C2623,CATH BLNDIL 4MM 220MM,57776.5,57776.5,3466.59,49110.03,49 HCPCS,C2623,CATH BLNDIL 4MM 250MM,62552.5,62552.5,3753.15,53169.63,49 HCPCS,C2623,CATH BLNDIL 4MM 300MM,76881.0,76881.0,4612.86,65348.85,49 HCPCS,C2623,CATH BLNDIL 4MM 40MM,36977.0,36977.0,2126.19,32739.88,98 HCPCS,C2623,CATH BLNDIL 4MM 60MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 4MM 80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 4X120MM,38209.5,38209.5,2292.57,32478.08,49 HCPCS,C2623,CATH BLNDIL 5MM 100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 5MM 120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 5MM 150MM,46221.25,46221.25,2680.83,40597.7,98 HCPCS,C2623,CATH BLNDIL 5MM 200MM,56852.0,56852.0,3411.12,48324.2,49 HCPCS,C2623,CATH BLNDIL 5MM 220MM,57776.5,57776.5,3466.59,49110.03,49 HCPCS,C2623,CATH BLNDIL 5MM 250MM,62552.5,62552.5,3753.15,53169.63,49 HCPCS,C2623,CATH BLNDIL 5MM 300MM,76881.0,76881.0,4612.86,65348.85,49 HCPCS,C2623,CATH BLNDIL 5MM 40MM,36812.25,36812.25,2106.42,32739.88,98 HCPCS,C2623,CATH BLNDIL 5MM 60MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 5MM 80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 5X150MM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLNDIL 5X200MM,56698.0,56698.0,3401.88,48193.3,49 HCPCS,C2623,CATH BLNDIL 6MM 100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 6MM 120MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 6MM 150MM,46666.75,46666.75,2734.29,40597.7,98 HCPCS,C2623,CATH BLNDIL 6MM 200MM,56852.0,56852.0,3411.12,48324.2,49 HCPCS,C2623,CATH BLNDIL 6MM 220MM,57776.5,57776.5,3466.59,49110.03,49 HCPCS,C2623,CATH BLNDIL 6MM 250MM,62552.5,62552.5,3753.15,53169.63,49 HCPCS,C2623,CATH BLNDIL 6MM 300MM,76881.0,76881.0,4612.86,65348.85,49 HCPCS,C2623,CATH BLNDIL 6MM 40MM,36977.0,36977.0,2126.19,32739.88,98 HCPCS,C2623,CATH BLNDIL 6MM 60MM,36977.0,36977.0,2126.19,32739.88,98 HCPCS,C2623,CATH BLNDIL 7MM 100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDIL 7MM 150MM,45571.5,45571.5,2734.29,38735.78,49 HCPCS,C2623,CATH BLNDIL 7MM 220MM,57776.5,57776.5,3466.59,49110.03,49 HCPCS,C2623,CATH BLNDIL 7MM 40MM,36977.0,36977.0,2126.19,32739.88,98 HCPCS,C2623,CATH BLNDIL 7MM 60MM,36977.0,36977.0,2126.19,32739.88,98 HCPCS,C2623,CATH BLNDIL 7MM 80MM,38517.5,38517.5,2311.05,32739.88,49 HCPCS,C2623,CATH BLNDIL 9X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLNDL 75CM 12X60MM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLNDL 7MM 75CM 80MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDL 8MM 75CM 80MM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLNDL 9MM 75CM 80MM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH BLNDL7MM 75CM 100MM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH BLNDL8MM 75CM 100MM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH DBC 5X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH DBC 6X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH DBC 7X60MM 75CM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH DBC 8X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH DCB 10X60MM 75CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATH DCB 7X60MM 130CM,35436.5,35436.5,2126.19,30121.03,49 HCPCS,C2623,CATH PTA 8X100MM-100CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,CATHETER BLNDIL 8MM 80M,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2623,LUTONIC 6X80MMX130CM,44680.5,44680.5,2680.83,37978.43,49 HCPCS,C2624,SYSTEM MNTR 2X15MM 4.5CM,100000.0,100000.0,13000.0,85000.0,28 HCPCS,C2625,KIT STENT 5FR 7CM,6460.0,6460.0,839.8,5491.0,28 HCPCS,C2625,KIT STENT PANC 5FR 3CM,6460.0,6460.0,839.8,5491.0,28 HCPCS,C2625,KIT STENT PANC 5FR 5CM,6460.0,6460.0,839.8,5491.0,28 HCPCS,C2625,SET STENT 8.5FR 22CM,4617.0,4617.0,600.21,3924.45,28 HCPCS,C2625,STENT BIL 10FR 12CM,4608.0,4608.0,599.04,3916.8,28 HCPCS,C2625,STENT BIL 10FR 5CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 10FR 7CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 10FR 9CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 7FR 7CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 7FR 9CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 8.5FR 12CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 8.5FR 7CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL 8.5FR 9CM,5286.0,5286.0,687.18,4493.1,28 HCPCS,C2625,STENT BIL PANC GNN 5X5,4992.0,4992.0,648.96,4243.2,28 HCPCS,C2625,STENT NPHURSTM 22CM,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STENT NPHURSTM 24CM,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STENT NPHURSTM 28CM,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STENT URE 8.5FR 24CM,4617.0,4617.0,600.21,3924.45,28 HCPCS,C2625,STENT URET 10.2FR 28CM,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STENT URET 8.5F 22CM.038,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STENT URET 8.5FR 26CM,4617.0,4617.0,600.21,3924.45,28 HCPCS,C2625,STENT URO 8.5FR 24CM,3765.0,3765.0,489.45,3200.25,28 HCPCS,C2625,STNT URE APMTZ 8.5X20,4617.0,4617.0,600.21,3924.45,28 HCPCS,C2627,KIT SUPRAPUBIC 12FR,4391.0,4391.0,263.46,3732.35,49 HCPCS,C2628,BLN 10-37MMX4.0CMX90CM,17255.0,17255.0,1035.3,14666.75,49 HCPCS,C2628,CATH BLN BRDG OCL 90CM,28657.0,28657.0,1719.42,24358.45,49 HCPCS,C2628,CATH BLNOCC 12FR 1.5CM,17572.0,17572.0,1054.32,14936.2,49 HCPCS,C2628,CATH BLNOCC 12FR 24CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C2628,CATH BLNOCC 6FR 80CM,6273.0,6273.0,376.38,5332.05,49 HCPCS,C2628,CATH BLNOCC 9FR 120CM,17607.0,17607.0,1056.42,14965.95,49 HCPCS,C2628,CATH BLNOCC 9FR 23CM,13698.5,13698.5,758.52,12541.75,98 HCPCS,C2628,CATH OCC 10FR 46MM 140CM,17279.0,17279.0,1036.74,14687.15,49 HCPCS,C2628,CATH OCL L40 OD3FR,2215.0,2215.0,132.9,1882.75,49 HCPCS,C2629,DILATOR SHTH 33CM 16FR,8980.0,8980.0,538.8,7633.0,49 HCPCS,C2629,DILATOR SHTH 43CM 16FR,9508.0,9508.0,570.48,8081.8,49 HCPCS,C2629,SHEATH DIL 12FR 33CM,8980.0,8980.0,538.8,7633.0,49 HCPCS,C2629,SHEATH DIL 12FR 43CM,9508.0,9508.0,570.48,8081.8,98 HCPCS,C2629,SHEATH DIL 5MM,8980.0,8980.0,538.8,7633.0,49 HCPCS,C2634,"Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source ",,,332.9,545.73,5 HCPCS,C2635,"Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source ",,,103.18,169.14,5 HCPCS,C2636,"Brachytherapy linear source, non-stranded, palladium-103, per 1 mm ",,,65.93,108.09,5 HCPCS,C2638,"Brachytherapy source, stranded, iodine-125, per source ",,,63.23,103.65,5 HCPCS,C2639,"Brachytherapy source, non-stranded, iodine-125, per source ",,,65.22,106.92,5 HCPCS,C2640,"Brachytherapy source, stranded, palladium-103, per source ",,,152.99,250.8,5 HCPCS,C2641,"Brachytherapy source, non-stranded, palladium-103, per source ",,,126.98,208.17,5 HCPCS,C2642,"Brachytherapy source, stranded, cesium-131, per source ",,,140.38,230.13,5 HCPCS,C2643,"Brachytherapy source, non-stranded, cesium-131, per source ",,,175.17,287.16,5 HCPCS,C2645,"Brachytherapy planar source, palladium-103, per square millimeter ",,,8.58,14.07,5 HCPCS,C2698,"Brachytherapy source, stranded, not otherwise specified, per source ",,,63.23,103.65,5 HCPCS,C2699,"Brachytherapy source, non-stranded, not otherwise specified, per source ",,,65.22,106.92,5 HCPCS,C5271,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,133 HCPCS,C5272,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,112 HCPCS,C5273,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,149 HCPCS,C5274,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,112 HCPCS,C5275,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,133 HCPCS,C5276,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,112 HCPCS,C5277,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,149 HCPCS,C5278,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3083.0,112 HCPCS,C7500,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,161 HCPCS,C7501,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,161 HCPCS,C7502,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,161 HCPCS,C7503,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,161 HCPCS,C7504,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,161 HCPCS,C7505,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,161 HCPCS,C7506,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,161 HCPCS,C7507,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,161 HCPCS,C7508,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,161 HCPCS,C7509,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,161 HCPCS,C7510,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,161 HCPCS,C7511,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,161 HCPCS,C7512,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,161 HCPCS,C7513,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,165 HCPCS,C7514,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,165 HCPCS,C7515,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,165 HCPCS,C7516,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,13036.0,147 HCPCS,C7517,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,13036.0,147 HCPCS,C7518,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,13036.0,147 HCPCS,C7519,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,13036.0,147 HCPCS,C7520,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,13036.0,147 HCPCS,C7521,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,13036.0,147 HCPCS,C7522,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,13036.0,147 HCPCS,C7523,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,13036.0,147 HCPCS,C7524,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,13036.0,147 HCPCS,C7525,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,13036.0,147 HCPCS,C7526,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,13036.0,147 HCPCS,C7527,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,13036.0,147 HCPCS,C7528,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,13036.0,147 HCPCS,C7529,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,13036.0,147 HCPCS,C7530,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,13835.0,165 HCPCS,C7531,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,36462.0,147 HCPCS,C7532,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,36462.0,147 HCPCS,C7533,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,36462.0,51 HCPCS,C7534,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,36462.0,147 HCPCS,C7535,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,36462.0,147 HCPCS,C7537,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,165 HCPCS,C7538,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,165 HCPCS,C7539,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,165 HCPCS,C7540,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,165 HCPCS,C7541,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,161 HCPCS,C7542,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,161 HCPCS,C7543,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,161 HCPCS,C7544,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,161 HCPCS,C7545,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,161 HCPCS,C7546,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,161 HCPCS,C7547,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,165 HCPCS,C7548,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,165 HCPCS,C7549,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,161 HCPCS,C7550,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,161 HCPCS,C7551,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,161 HCPCS,C7552,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,13036.0,147 HCPCS,C7553,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,13036.0,147 HCPCS,C7554,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,161 HCPCS,C7555,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,161 HCPCS,C7556,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,153 HCPCS,C7557,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,13036.0,139 HCPCS,C7558,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right and left heart cat",,,10120.0,13036.0,3 HCPCS,C7560,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,153 HCPCS,C7562,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,3982.0,10071.44,136 HCPCS,C7563,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,136 HCPCS,C7564,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,136 HCPCS,C7565,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,132 HCPCS,C7566,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,132 HCPCS,C7567,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,132 HCPCS,C7568,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,136 HCPCS,C7569,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,136 HCPCS,C7570,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,136 HCPCS,C7571,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,132 HCPCS,C7903,"Group psychotherapy service for diagnosis, evaluation, or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provide mental health services ",,,63.98,88.31,5 HCPCS,C8001,"3d anatomical segmentation imaging for preoperative planning, data preparation and transmission, obtained from previous diagnostic computed tomographic or magnetic resonance examination of the same an",,,154.97,340.75,5 HCPCS,C8002,"Preparation of skin cell suspension autograft, automated, including all enzymatic processing and device components (do not report with manual suspension preparation) ",,,7750.62,11938.45,5 HCPCS,C8003,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,132 HCPCS,C8004,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,40 HCPCS,C8005,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,132 HCPCS,C8006,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,132 HCPCS,C8007,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,96 HCPCS,C8008,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,96 HCPCS,C8009,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,96 HCPCS,C8010,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,96 HCPCS,C8011,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,96 HCPCS,C8012,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,96 HCPCS,C8013,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,96 HCPCS,C8014,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,96 HCPCS,C8900,"Magnetic resonance angiography with contrast, abdomen ",,,672.06,2739.0,29 HCPCS,C8901,"Magnetic resonance angiography without contrast, abdomen ",,,410.15,2739.0,29 HCPCS,C8902,MRA W/O FOL W/CONT ABD,28516.08,28516.08,1710.96,24238.67,32 HCPCS,C8902,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",28516.08,28516.08,672.06,2739.0,29 HCPCS,C8903,"Magnetic resonance imaging with contrast, breast; unilateral ",,,320.71,2739.0,29 HCPCS,C8905,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,672.06,2739.0,29 HCPCS,C8906,"Magnetic resonance imaging with contrast, breast; bilateral ",,,672.06,2739.0,29 HCPCS,C8908,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,672.06,2739.0,29 HCPCS,C8909,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,672.06,2739.0,29 HCPCS,C8910,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,410.15,2739.0,29 HCPCS,C8911,MRA W/O FOL W/CONT CHEST,26264.47,26264.47,1575.87,22324.8,32 HCPCS,C8911,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",26264.47,26264.47,672.06,2739.0,29 HCPCS,C8912,"Magnetic resonance angiography with contrast, lower extremity ",,,672.06,2739.0,29 HCPCS,C8913,"Magnetic resonance angiography without contrast, lower extremity ",,,410.15,2739.0,29 HCPCS,C8914,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,672.06,2739.0,29 HCPCS,C8918,"Magnetic resonance angiography with contrast, pelvis ",,,672.06,2739.0,29 HCPCS,C8919,"Magnetic resonance angiography without contrast, pelvis ",,,410.15,2739.0,29 HCPCS,C8920,MRA WO FOL W CONT PELVIS,26401.51,26401.51,1584.09,22441.28,32 HCPCS,C8920,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",26401.51,26401.51,672.06,2739.0,29 HCPCS,C8921,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete ",,,1593.12,2199.05,5 HCPCS,C8922,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study ",,,1593.12,2199.05,5 HCPCS,C8923,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spect",,,1593.12,2199.05,5 HCPCS,C8924,TTE2D W OR W&WO LIMITED,4440.7,4440.7,266.44,3774.59,39 HCPCS,C8924,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited st",4440.7,4440.7,893.53,1233.38,5 HCPCS,C8925,"Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placeme",,,1593.12,2199.05,5 HCPCS,C8926,"Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and ",,,1593.12,2199.05,5 HCPCS,C8927,"Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and i",,,1593.12,2199.05,5 HCPCS,C8928,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiov",,,1593.12,2199.05,5 HCPCS,C8929,TTE2D W OR W/WO CN W DOP,4974.84,4974.84,298.49,4228.61,39 HCPCS,C8929,"Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral",4974.84,4974.84,1593.12,2199.05,5 HCPCS,C8930,TTE W W/WO STRS CONT ECG,4974.84,4974.84,298.49,4228.61,39 HCPCS,C8930,"Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardio",4974.84,4974.84,1593.12,2199.05,5 HCPCS,C8931,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,672.06,2739.0,29 HCPCS,C8932,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,410.15,2739.0,29 HCPCS,C8933,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,672.06,2739.0,29 HCPCS,C8934,"Magnetic resonance angiography with contrast, upper extremity ",,,672.06,2739.0,29 HCPCS,C8935,"Magnetic resonance angiography without contrast, upper extremity ",,,410.15,2739.0,29 HCPCS,C8936,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,672.06,2739.0,29 HCPCS,C8937,"Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretati",,,32.98,72.52,5 HCPCS,C8957,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,36 HCPCS,C9038,"Injection, mogamulizumab-kpkc, 1 mg ",,,,,0 HCPCS,C9038,"Injection, mogamulizumab-kpkc, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,C9046,"Cocaine hydrochloride nasal solution (goprelto), 1 mg ",2306.88,2306.88,2.37,5.37,8 HCPCS,C9046,GOPRELTO 160 MG NASAL,2306.88,2306.88,138.41,1960.85,25 HCPCS,C9047,"Injection, caplacizumab-yhdp, 1 mg ",,,1351.2,2479.87,8 HCPCS,C9067,"Gallium ga-68, dotatoc, diagnostic, 0.01 mci ",,,16.93,24.12,8 HCPCS,C9088,"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg ",,,1.86,2.4,3 HCPCS,C9089,"Bupivacaine, collagen-matrix implant, 1 mg ",,,2.06,2.65,3 HCPCS,C9101,"Injection, oliceridine, 0.1 mg ",,,0.76,4.12,8 HCPCS,C9143,"Cocaine hydrochloride nasal solution (numbrino), 1 mg ",1684.4,1684.4,2.37,7.14,8 HCPCS,C9143,NUMBRINO 160 MG NASAL,1684.4,1684.4,101.06,1431.74,25 HCPCS,C9144,"Injection, bupivacaine (posimir), 1 mg ",,,1.19,2.65,8 HCPCS,C9145,"Injection, aprepitant, (aponvie), 1 mg ",,,3.67,5.93,8 HCPCS,C9174,"Injection, datopotamab deruxtecan-dlnk, 1 mg ",,,120.73,155.66,3 HCPCS,C9175,"Injection, treosulfan, 50 mg ",,,75.29,97.06,3 HCPCS,C9176,"Tc-99m from domestically produced non-heu mo-99, ºminimum 50 percent», full cost recovery add-on, per study dose ",,,19.6,27.0,5 HCPCS,C9248,"Injection, clevidipine butyrate, 1 mg ",,,8.71,11.23,3 HCPCS,C9250,"Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml ",,,453.92,585.22,3 HCPCS,C9254,"Injection, lacosamide, 1 mg ",1064.8,1064.8,0.48,0.62,3 HCPCS,C9254,LACOSAMIDE 200 MG INJ,1064.8,1064.8,63.89,905.08,30 HCPCS,C9257,"Injection, bevacizumab, 0.25 mg ",,,4.91,6.33,3 HCPCS,C9285,"Lidocaine 70 mg/tetracaine 70 mg, per patch ",,,41.84,53.94,3 HCPCS,C9293,"Injection, glucarpidase, 10 units ",,,1016.35,1310.34,3 HCPCS,C9307,"Injection, linvoseltamab-gcpt, 1 mg ",,,189.77,261.41,5 HCPCS,C9308,"Injection, carboplatin (avyxa), 1 mg ",,,10.09,13.91,5 HCPCS,C9352,"Microporous collagen implantable tube (neuragen nerve guide), per centimeter length ",,,2562.2,3303.33,3 HCPCS,C9353,"Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length ",,,2732.83,3523.32,3 HCPCS,C9354,"Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter ",,,46.9,60.47,3 HCPCS,C9355,"Collagen nerve cuff (neuromatrix), per 0.5 centimeter length ",,,441.02,568.59,3 HCPCS,C9356,"Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter ",,,271.16,349.6,3 HCPCS,C9359,"Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc ",,,150.09,162.1,6 HCPCS,C9360,"Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters ",,,19.03,20.55,6 HCPCS,C9361,"Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length ",,,223.28,553.05,9 HCPCS,C9362,"Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc ",,,150.09,162.1,6 HCPCS,C9363,INTEGRA MESHED 1SQCM,2276.0,2276.0,103.62,4541.55,90 HCPCS,C9363,"Skin substitute, integra meshed bilayer wound matrix, per square centimeter ",,,166.52,214.69,3 HCPCS,C9364,"Porcine implant, permacol, per square centimeter ",,,44.5,57.38,3 HCPCS,C9399,BRIDION 200 MG INJ,633.37,633.37,38.0,538.36,30 HCPCS,C9399,BRIDION 500 MG INJ,1160.04,1160.04,69.6,986.03,30 HCPCS,C9399,GIAPREZA 2.5 MG INJ,8922.96,8922.96,535.38,7584.52,30 HCPCS,C9399,OLUMIANT 1 MG PO,565.12,565.12,33.91,480.35,30 HCPCS,C9399,OLUMIANT 2 MG PO,565.12,565.12,33.91,480.35,30 HCPCS,C9399,PAXLOVID 150/100 MG PO,462.3,462.3,27.74,392.95,30 HCPCS,C9399,PAXLOVID 300/100 MG PO,239.8,239.8,14.39,203.83,30 HCPCS,C9399,PRAXBIND 2.5 G INJ,13873.42,13873.42,832.41,11792.41,30 HCPCS,C9399,Unclassified drugs or biologicals ,,,,,0 HCPCS,C9399,XACDURO 1 G/1 G INJ,2694.6,2694.6,161.68,2290.41,30 HCPCS,C9408,"Iodine i-131 iobenguane, therapeutic, 1 millicurie ",,,,,0 HCPCS,C9408,"Iodine i-131 iobenguane, therapeutic, 1 millicurie Chemotherapy Drugs",,,,,0 HCPCS,C9460,CANGRELOR 1 MG INJ,141.58,141.58,8.49,120.34,25 HCPCS,C9460,CANGRELOR 1 MG INJJW,141.58,141.58,8.49,120.34,25 HCPCS,C9460,CANGRELOR 50 MG INJ,7050.33,7050.33,423.02,5992.78,25 HCPCS,C9460,"Injection, cangrelor, 1 mg ",,,49.44,63.74,3 HCPCS,C9462,"Injection, delafloxacin, 1 mg ",,,0.96,1.5,8 HCPCS,C9482,"Injection, sotalol hydrochloride, 1 mg ",,,19.58,76.85,8 HCPCS,C9488,"Injection, conivaptan hydrochloride, 1 mg ",,,61.37,141.84,8 HCPCS,C9507,"Plasma, high titer covid-19 convalescent, each unit ",,,750.5,2424.11,11 HCPCS,C9600,PERC DRUG EL COR STNT LC,39184.95,39184.95,5094.04,33307.21,15 HCPCS,C9600,PERC DRUG EL COR STNT LD,39184.95,39184.95,5094.04,33307.21,15 HCPCS,C9600,PERC DRUG EL COR STNT LM,39184.95,39184.95,5094.04,33307.21,15 HCPCS,C9600,PERC DRUG EL COR STNT RC,39184.95,39184.95,5094.04,33307.21,15 HCPCS,C9600,PERC DRUG EL COR STNT RI,39184.95,39184.95,5094.04,33307.21,15 HCPCS,C9600,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,11153.0,54054.0,96 HCPCS,C9600,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch with Cardiac Cath",,,7818.0,7818.0,5 HCPCS,C9600,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch without Cardiac Cath",,,5591.0,5591.0,5 HCPCS,C9601,PERC D-EL COR STN AD LC,36416.81,36416.81,4734.19,30954.29,25 HCPCS,C9601,PERC D-EL COR STN AD LD,36416.81,36416.81,4734.19,30954.29,25 HCPCS,C9601,PERC D-EL COR STN AD RC,36416.81,36416.81,4734.19,30954.29,25 HCPCS,C9601,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,5591.0,54054.0,66 HCPCS,C9602,PRC D-EL COR STNT ATH LC,120046.28,120046.28,15606.02,102039.34,15 HCPCS,C9602,PRC D-EL COR STNT ATH LD,120046.28,120046.28,15606.02,102039.34,15 HCPCS,C9602,PRC D-EL COR STNT ATH LM,120046.28,120046.28,15606.02,102039.34,15 HCPCS,C9602,PRC D-EL COR STNT ATH RC,120046.28,120046.28,15606.02,102039.34,15 HCPCS,C9602,PRC D-EL COR STNT ATH RI,120046.28,120046.28,15606.02,102039.34,15 HCPCS,C9602,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,11153.0,61050.09,96 HCPCS,C9602,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch with Cardiac Cath",,,7818.0,7818.0,5 HCPCS,C9602,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch without Cardiac Cath",,,5591.0,5591.0,5 HCPCS,C9603,P D-EL COR STN ATH AD LC,43308.5,43308.5,5630.1,36812.22,25 HCPCS,C9603,P D-EL COR STN ATH AD LD,43308.5,43308.5,5630.1,36812.22,25 HCPCS,C9603,P D-EL COR STN ATH AD RC,43308.5,43308.5,5630.1,36812.22,25 HCPCS,C9603,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,5591.0,54054.0,66 HCPCS,C9604,PRC D-EL COR RVSC CABGLC,37087.02,37087.02,4821.31,31523.97,15 HCPCS,C9604,PRC D-EL COR RVSC CABGLD,37087.02,37087.02,4821.31,31523.97,15 HCPCS,C9604,PRC D-EL COR RVSC CABGLM,37087.02,37087.02,4821.31,31523.97,15 HCPCS,C9604,PRC D-EL COR RVSC CABGRC,37087.02,37087.02,4821.31,31523.97,15 HCPCS,C9604,PRC D-EL COR RVSC CABGRI,37087.02,37087.02,4821.31,31523.97,15 HCPCS,C9604,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,5591.0,54054.0,106 HCPCS,C9605,P D-EL COR RVS CABG A LC,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9605,P D-EL COR RVS CABG A LD,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9605,P D-EL COR RVS CABG A RC,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9605,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,5591.0,54054.0,66 HCPCS,C9606,PRC D-E COR REVSC AMI LC,39184.95,39184.95,5094.04,33307.21,24 HCPCS,C9606,PRC D-E COR REVSC AMI LD,39184.95,39184.95,5094.04,33307.21,24 HCPCS,C9606,PRC D-E COR REVSC AMI LM,39184.95,39184.95,5094.04,33307.21,24 HCPCS,C9606,PRC D-E COR REVSC AMI RC,39184.95,39184.95,5094.04,33307.21,24 HCPCS,C9606,PRC D-E COR REVSC AMI RI,39184.95,39184.95,5094.04,33307.21,24 HCPCS,C9606,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,5591.0,54054.0,102 HCPCS,C9607,PRC D-E COR REVSC CHRNLC,42917.41,42917.41,5579.26,36479.8,15 HCPCS,C9607,PRC D-E COR REVSC CHRNLD,42917.41,42917.41,5579.26,36479.8,15 HCPCS,C9607,PRC D-E COR REVSC CHRNLM,42917.41,42917.41,5579.26,36479.8,15 HCPCS,C9607,PRC D-E COR REVSC CHRNRC,42917.41,42917.41,5579.26,36479.8,15 HCPCS,C9607,PRC D-E COR REVSC CHRNRI,42917.41,42917.41,5579.26,36479.8,15 HCPCS,C9607,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,5591.0,61050.09,106 HCPCS,C9608,PRC D-E COR REVSC COT LC,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9608,PRC D-E COR REVSC COT LD,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9608,PRC D-E COR REVSC COT RC,43705.82,43705.82,5681.76,37149.95,25 HCPCS,C9608,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,5591.0,54054.0,66 HCPCS,C9610,CATH BLNDIL 2.25MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.25MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.25MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.25MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.50MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.50MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.50MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.75MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.75MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.75MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2.75MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 2MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3.50MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3.50MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3.50MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3.50MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 3MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 4MM 12MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 4MM 15MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 4MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH BLNDIL 4MM 30MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH DCB 2.5MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9610,CATH DCB 3MM 20MM,100000.0,100000.0,6000.0,85000.0,44 HCPCS,C9725,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,68 HCPCS,C9726,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,16 HCPCS,C9727,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,68 HCPCS,C9728,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,36 HCPCS,C9733,Non-ophthalmic fluorescent vascular angiography ,,,672.06,1477.76,5 HCPCS,C9734,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,89 HCPCS,C9738,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,104 HCPCS,C9739,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2780.78,15059.0,207 HCPCS,C9740,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,207 HCPCS,C9741,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,17009.0,36 HCPCS,C9742,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,24 HCPCS,C9743,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,16 HCPCS,C9751,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,125 HCPCS,C9756,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,135.66,3083.0,158 HCPCS,C9757,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,143 HCPCS,C9758,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,10120.0,34126.36,39 HCPCS,C9759,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1078.12,2370.65,13 HCPCS,C9760,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,10120.0,48376.94,8 HCPCS,C9761,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,161 HCPCS,C9762,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,418.0,2739.0,83 HCPCS,C9763,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,418.0,2739.0,83 HCPCS,C9764,REVSC LOW EXT IVL ANG BI,42771.6,42771.6,2566.3,36355.86,23 HCPCS,C9764,REVSC LOW EXT IVL ANG LT,28514.4,28514.4,1710.86,24237.24,23 HCPCS,C9764,REVSC LOW EXT IVL ANG RT,28514.4,28514.4,1710.86,24237.24,23 HCPCS,C9764,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,161 HCPCS,C9765,RVSC LOW EXT IVL/STNT BI,53074.04,53074.04,3184.44,45112.93,23 HCPCS,C9765,RVSC LOW EXT IVL/STNT LT,35382.69,35382.69,2122.96,30075.29,23 HCPCS,C9765,RVSC LOW EXT IVL/STNT RT,35382.69,35382.69,2122.96,30075.29,23 HCPCS,C9765,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,161 HCPCS,C9766,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,161 HCPCS,C9767,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,161 HCPCS,C9768,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,410.15,3083.0,101 HCPCS,C9769,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,125 HCPCS,C9770,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,8 HCPCS,C9771,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,8 HCPCS,C9772,REVSC TIB/PER IVL ANG BI,35382.0,35382.0,2122.92,30074.7,17 HCPCS,C9772,REVSC TIB/PER IVL ANG LT,23588.0,23588.0,1415.28,20049.8,17 HCPCS,C9772,REVSC TIB/PER IVL ANG RT,23588.0,23588.0,1415.28,20049.8,17 HCPCS,C9772,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,183 HCPCS,C9773,RVSC TIB/PER IVL/STNT BI,56185.5,56185.5,3371.13,47757.68,17 HCPCS,C9773,RVSC TIB/PER IVL/STNT LT,37457.0,37457.0,2247.42,31838.45,17 HCPCS,C9773,RVSC TIB/PER IVL/STNT RT,37457.0,37457.0,2247.42,31838.45,17 HCPCS,C9773,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,183 HCPCS,C9774,REVSC TIB/PER IVL/ATH,37457.0,37457.0,2247.42,31838.45,17 HCPCS,C9774,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",37457.0,37457.0,2996.0,43854.72,183 HCPCS,C9775,RVSC TIB/PR IVL ST/AT BI,56185.5,56185.5,3371.13,47757.68,17 HCPCS,C9775,RVSC TIB/PR IVL ST/AT LT,37457.0,37457.0,2247.42,31838.45,17 HCPCS,C9775,RVSC TIB/PR IVL ST/AT RT,37457.0,37457.0,2247.42,31838.45,17 HCPCS,C9775,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,183 HCPCS,C9776,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,135.33,169.57,54 HCPCS,C9777,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,270.71,15059.0,130 HCPCS,C9778,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,161 HCPCS,C9779,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,161 HCPCS,C9780,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,161 HCPCS,C9781,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,161 HCPCS,C9782,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,10120.0,26618.87,39 HCPCS,C9783,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,143 HCPCS,C9784,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,125 HCPCS,C9785,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,161 HCPCS,C9789,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,161 HCPCS,C9790,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,117 HCPCS,C9791,"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent, chest, including preparation and administration of agent ",,,2450.98,3376.35,5 HCPCS,C9792,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,147 HCPCS,C9793,"3d predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography and/or magnetic resonance imaging with report ",,,1753.28,3855.22,5 HCPCS,C9796,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,153 HCPCS,C9797,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,157 HCPCS,C9800,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,24 HCPCS,C9808,"Nerve cryoablation probe (e.g., cryoice, cryosphere, cryosphere max, cryoice cryosphere, cryoice cryo2), including probe and all disposable system components, non-opioid medical device (must be a qual",,,1.22,1.87,5 HCPCS,C9809,"Cryoablation needle (e.g., iovera system), including needle/tip and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgic",,,1.22,1.87,5 HCPCS,C9810,"Water circulating motorized cold therapy device (e.g., iceman) including all system components (e.g. pads, console, disposable parts), non-opioid medical device (must be a qualifying medicare non-opio",,,321.69,495.51,5 HCPCS,C9811,"Electronic ambulatory infusion pump (e.g. sapphire pump), including all pump components, including disposable components , non-opioid medical device (must be a qualifying medicare non-opioid medical d",,,2380.69,3286.17,5 HCPCS,C9812,"Echogenic nerve block needles (e.g. sonoplex, sonoblock, sonotap), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with s",,,0.95,1.47,5 HCPCS,C9813,"Perforated continuous infusion catheter set (e.g. infiltralong), including all components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain rel",,,38.37,59.1,5 HCPCS,C9814,"Continuous anesthesia echogenic conduction catheter set (e.g. sonolong), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance ",,,14624.85,22526.98,5 HCPCS,C9815,"Linear peristaltic pain management infusion pump (e.g. cadd-solis ambulatory infusion pump), and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid m",,,2380.69,3286.17,5 HCPCS,C9817,"Electronic cryo-pneumatic compression, pain management system (e.g. game ready grpro 2.1 system), including control unit, anatomically correct wrap(s), and other system component(s), non-opioid medica",,,666.23,1026.2,5 HCPCS,C9901,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,132 HCPCS,D0416,Viral culture ,,,271.28,366.43,12 HCPCS,D0431,Diag tst detect mucos abnorm ,,,148.54,200.64,12 HCPCS,D0475,Decalcification procedure ,,,356.44,481.46,12 HCPCS,D0476,Spec stains for microorganis ,,,560.39,756.94,12 HCPCS,D0477,Spec stains not for microorg ,,,580.22,783.73,12 HCPCS,D0478,Immunohistochemical stains ,,,301.03,406.62,12 HCPCS,D0479,Tissue in-situ hybridization ,,,453.46,612.5,12 HCPCS,D0481,Electron microscopy diagnost ,,,479.25,647.35,12 HCPCS,D0482,Direct immunofluorescence ,,,203.95,275.48,12 HCPCS,D0483,Indirect immunofluorescence ,,,247.57,334.4,12 HCPCS,D3471,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,8 HCPCS,D3472,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,8 HCPCS,D3473,Surgical repair of root resorption - molar ,,,12018.0,12018.0,8 HCPCS,D3501,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,8 HCPCS,D3502,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,8 HCPCS,D3503,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,8 HCPCS,D3921,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,8 HCPCS,D4286,Removal of non-resorbable barrier ,,,12018.0,12018.0,8 HCPCS,D5995,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,8 HCPCS,D5996,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,8 HCPCS,D6105,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,8 HCPCS,D6106,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,8 HCPCS,D6107,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,8 HCPCS,D6191,Semi-precision abutment - placement ,,,12018.0,12018.0,8 HCPCS,D6192,Semi-precision attachment - placement ,,,12018.0,12018.0,8 HCPCS,D6197,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,8 HCPCS,D6198,Remove interim implant component ,,,12018.0,12018.0,8 HCPCS,D7298,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,8 HCPCS,D7299,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,8 HCPCS,D7300,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,8 HCPCS,D7509,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,8 HCPCS,D7956,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,8 HCPCS,D7957,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,8 HCPCS,D7961,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,8 HCPCS,D7962,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,8 HCPCS,D7993,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,8 HCPCS,D7994,Surgical placement zygomatic implant ,,,12018.0,12018.0,8 HCPCS,D9949,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,8 HCPCS,E0100,"Cane, includes canes of all materials, adjustable or fixed, with tip ",,,27.37,60.05,50 HCPCS,E0105,"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips ",,,66.65,146.22,50 HCPCS,E0110,"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips ",,,99.69,218.7,50 HCPCS,E0111,"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips ",,,63.21,138.67,50 HCPCS,E0112,"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips ",,,51.69,113.39,50 HCPCS,E0113,"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip ",,,25.57,56.09,50 HCPCS,E0114,"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips ",,,57.51,126.16,50 HCPCS,E0116,"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each ",,,32.95,72.28,50 HCPCS,E0117,"Crutch, underarm, articulating, spring assisted, each ",,,26.9,59.02,50 HCPCS,E0130,"Walker, rigid (pickup), adjustable or fixed height ",,,52.43,115.02,50 HCPCS,E0135,"Walker, folding (pickup), adjustable or fixed height ",,,52.43,127.3,50 HCPCS,E0140,"Walker, with trunk support, adjustable or fixed height, any type ",,,31.49,69.08,50 HCPCS,E0141,"Walker, rigid, wheeled, adjustable or fixed height ",,,58.52,150.62,50 HCPCS,E0143,"Walker, folding, wheeled, adjustable or fixed height ",,,58.52,159.85,50 HCPCS,E0144,"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat ",,,33.67,73.87,50 HCPCS,E0147,"Walker, heavy duty, multiple braking system, variable wheel resistance ",,,489.84,1074.66,50 HCPCS,E0148,"Walker, heavy duty, without wheels, rigid or folding, any type, each ",,,95.33,209.15,50 HCPCS,E0149,"Walker, heavy duty, wheeled, rigid or folding, any type ",,,13.58,33.48,50 HCPCS,E0152,"Walker, battery powered, wheeled, folding, adjustable or fixed height ",,,68.99,106.27,5 HCPCS,E0153,"Platform attachment, forearm crutch, each ",,,96.92,212.63,50 HCPCS,E0154,"Platform attachment, walker, each ",,,55.6,121.97,50 HCPCS,E0155,"Wheel attachment, rigid pick-up walker, per pair ",,,23.97,52.59,50 HCPCS,E0156,"Seat attachment, walker ",,,18.22,39.97,50 HCPCS,E0157,"Crutch attachment, walker, each ",,,61.77,135.51,50 HCPCS,E0158,"Leg extensions for walker, per set of four (4) ",,,24.59,53.94,50 HCPCS,E0159,"Brake attachment for wheeled walker, replacement, each ",,,17.11,37.54,50 HCPCS,E0160,"Sitz type bath or equipment, portable, used with or without commode ",,,33.21,72.86,50 HCPCS,E0161,"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s ",,,27.98,61.38,50 HCPCS,E0162,Sitz bath chair ,,,172.97,379.47,50 HCPCS,E0163,"Commode chair, mobile or stationary, with fixed arms ",,,64.17,176.98,50 HCPCS,E0165,"Commode chair, mobile or stationary, with detachable arms ",,,14.45,33.29,50 HCPCS,E0167,"Pail or pan for use with commode chair, replacement only ",,,12.95,28.4,50 HCPCS,E0168,"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each ",,,136.49,299.45,50 HCPCS,E0170,"Commode chair with integrated seat lift mechanism, electric, any type ",,,195.79,429.55,50 HCPCS,E0171,"Commode chair with integrated seat lift mechanism, non-electric, any type ",,,36.86,80.86,50 HCPCS,E0175,"Foot rest, for use with commode chair, each ",,,92.5,202.94,50 HCPCS,E0181,"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty ",,,19.44,45.0,50 HCPCS,E0182,"Pump for alternating pressure pad, for replacement only ",,,25.23,55.36,50 HCPCS,E0183,"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty ",,,15.88,42.66,50 HCPCS,E0184,Dry pressure mattress ,,,186.27,408.65,50 HCPCS,E0185,"Gel or gel-like pressure pad for mattress, standard mattress length and width ",,,211.43,530.27,50 HCPCS,E0186,Air pressure mattress ,,,22.49,49.34,50 HCPCS,E0187,Water pressure mattress ,,,26.34,57.79,50 HCPCS,E0188,Synthetic sheepskin pad ,,,27.92,61.25,50 HCPCS,E0189,"Lambswool sheepskin pad, any size ",,,62.59,137.32,50 HCPCS,E0191,"Heel or elbow protector, each ",,,13.07,28.68,50 HCPCS,E0193,Powered air flotation bed (low air loss therapy) ,,,845.06,1853.97,50 HCPCS,E0194,Air fluidized bed ,,,4142.05,9087.15,50 HCPCS,E0196,Gel pressure mattress ,,,38.32,84.06,50 HCPCS,E0197,"Air pressure pad for mattress, standard mattress length and width ",,,21.15,47.62,50 HCPCS,E0198,"Water pressure pad for mattress, standard mattress length and width ",,,26.31,57.73,50 HCPCS,E0199,"Dry pressure pad for mattress, standard mattress length and width ",,,37.55,82.39,50 HCPCS,E0200,"Heat lamp, without stand (table model), includes bulb, or infrared element ",,,110.73,242.93,50 HCPCS,E0201,"Penile contracture device, manual, greater than 3 lbs traction force ",,,143.59,315.02,50 HCPCS,E0202,Phototherapy (bilirubin) light with photometer ,,,87.47,191.89,50 HCPCS,E0205,"Heat lamp, with stand, includes bulb, or infrared element ",,,271.03,594.6,50 HCPCS,E0210,"Electric heat pad, standard ",,,38.77,85.05,50 HCPCS,E0215,"Electric heat pad, moist ",,,98.94,217.06,50 HCPCS,E0217,Water circulating heat pad with pump ,,,693.38,1521.19,50 HCPCS,E0225,"Hydrocollator unit, includes pads ",,,542.8,1190.84,50 HCPCS,E0235,"Paraffin bath unit, portable (see medical supply code a4265 for paraffin) ",,,24.09,52.85,50 HCPCS,E0236,Pump for water circulating pad ,,,61.8,135.58,50 HCPCS,E0239,"Hydrocollator unit, portable ",,,628.25,1378.3,50 HCPCS,E0249,"Pad for water circulating heat unit, for replacement only ",,,139.1,305.17,50 HCPCS,E0250,"Hospital bed, fixed height, with any type side rails, with mattress ",,,75.67,166.0,50 HCPCS,E0251,"Hospital bed, fixed height, with any type side rails, without mattress ",,,70.89,155.53,50 HCPCS,E0255,"Hospital bed, variable height, hi-lo, with any type side rails, with mattress ",,,75.95,175.74,50 HCPCS,E0256,"Hospital bed, variable height, hi-lo, with any type side rails, without mattress ",,,74.28,162.97,50 HCPCS,E0260,"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress ",,,75.95,197.78,50 HCPCS,E0261,"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress ",,,75.95,194.34,50 HCPCS,E0265,"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress ",,,180.33,395.62,50 HCPCS,E0266,"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress ",,,156.91,344.24,50 HCPCS,E0271,"Mattress, innerspring ",,,146.24,324.85,50 HCPCS,E0272,"Mattress, foam rubber ",,,164.46,360.81,50 HCPCS,E0275,"Bed pan, standard, metal or plastic ",,,17.12,37.56,50 HCPCS,E0276,"Bed pan, fracture, metal or plastic ",,,14.91,32.7,50 HCPCS,E0277,Powered pressure-reducing air mattress ,,,251.5,871.99,50 HCPCS,E0280,"Bed cradle, any type ",,,38.13,83.66,50 HCPCS,E0290,"Hospital bed, fixed height, without side rails, with mattress ",,,71.31,156.46,50 HCPCS,E0291,"Hospital bed, fixed height, without side rails, without mattress ",,,55.19,121.09,50 HCPCS,E0292,"Hospital bed, variable height, hi-lo, without side rails, with mattress ",,,75.76,166.22,50 HCPCS,E0293,"Hospital bed, variable height, hi-lo, without side rails, without mattress ",,,71.41,156.67,50 HCPCS,E0294,"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress ",,,75.95,188.36,50 HCPCS,E0295,"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress ",,,75.95,185.16,50 HCPCS,E0296,"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress ",,,140.7,308.68,50 HCPCS,E0297,"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress ",,,124.16,272.38,50 HCPCS,E0300,"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure ",,,313.51,687.81,50 HCPCS,E0301,"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress ",,,199.0,436.58,50 HCPCS,E0302,"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress ",,,577.2,1266.31,50 HCPCS,E0303,"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress ",,,202.52,459.55,50 HCPCS,E0304,"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress ",,,584.05,1281.34,50 HCPCS,E0305,"Bed side rails, half length ",,,13.21,28.98,50 HCPCS,E0310,"Bed side rails, full length ",,,134.39,294.83,50 HCPCS,E0316,"Safety enclosure frame/canopy for use with hospital bed, any type ",,,232.29,509.61,50 HCPCS,E0325,"Urinal; male, jug-type, any material ",,,11.52,25.26,50 HCPCS,E0326,"Urinal; female, jug-type, any material ",,,11.89,26.08,50 HCPCS,E0371,"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width ",,,251.5,624.11,50 HCPCS,E0372,"Powered air overlay for mattress, standard mattress length and width ",,,251.5,715.03,50 HCPCS,E0373,Nonpowered advanced pressure reducing mattress ,,,251.5,786.88,50 HCPCS,E0424,"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ",,,96.2,261.23,50 HCPCS,E0431,"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing ",,,21.67,130.62,50 HCPCS,E0433,"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with o",,,46.23,130.62,50 HCPCS,E0434,"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing ",,,46.23,130.62,50 HCPCS,E0439,"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing ",,,96.2,261.23,50 HCPCS,E0441,"Stationary oxygen contents, gaseous, 1 month's supply = 1 unit ",,,66.47,145.83,50 HCPCS,E0442,"Stationary oxygen contents, liquid, 1 month's supply = 1 unit ",,,66.47,145.83,50 HCPCS,E0443,"Portable oxygen contents, gaseous, 1 month's supply = 1 unit ",,,60.24,132.16,50 HCPCS,E0444,"Portable oxygen contents, liquid, 1 month's supply = 1 unit ",,,60.24,132.16,50 HCPCS,E0447,"Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm) ",,,90.36,198.23,50 HCPCS,E0462,Rocking bed with or without side rails ,,,406.99,892.89,50 HCPCS,E0465,"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) ",,,1333.12,2924.71,50 HCPCS,E0466,"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) ",,,1333.12,2924.71,50 HCPCS,E0467,"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all acc",,,1540.83,3380.4,50 HCPCS,E0468,"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions ",,,1433.22,3144.31,50 HCPCS,E0469,"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device ",,,1536.03,3369.87,50 HCPCS,E0470,"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive a",,,130.72,358.3,50 HCPCS,E0471,"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive air",,,317.86,802.49,50 HCPCS,E0472,"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pre",,,483.96,1061.76,50 HCPCS,E0480,"Percussor, electric or pneumatic, home model ",,,61.39,134.68,50 HCPCS,E0482,"Cough stimulating device, alternating positive and negative airway pressure ",,,600.6,1317.65,50 HCPCS,E0483,"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each ",,,1484.82,3257.51,50 HCPCS,E0484,"Oscillatory positive expiratory pressure device, non-electric, any type, each ",,,51.59,113.18,50 HCPCS,E0490,"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote ",,,125.03,274.3,50 HCPCS,E0491,"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day suppl",,,103.26,226.55,50 HCPCS,E0492,"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application ",,,907.43,1397.74,5 HCPCS,E0493,"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day sup",,,907.43,1397.74,5 HCPCS,E0500,"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source ",,,153.3,336.32,50 HCPCS,E0530,"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type ",,,36.38,79.81,50 HCPCS,E0550,"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery ",,,70.02,153.62,50 HCPCS,E0560,"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery ",,,206.45,452.92,50 HCPCS,E0561,"Humidifier, non-heated, used with positive airway pressure device ",,,84.06,184.43,50 HCPCS,E0562,"Humidifier, heated, used with positive airway pressure device ",,,166.41,432.48,50 HCPCS,E0565,"Compressor, air power source for equipment which is not self-contained or cylinder driven ",,,51.53,113.05,50 HCPCS,E0570,"Nebulizer, with compressor ",,,7.01,23.86,50 HCPCS,E0572,"Aerosol compressor, adjustable pressure, light duty for intermittent use ",,,28.58,72.14,50 HCPCS,E0574,Ultrasonic/electronic aerosol generator with small volume nebulizer ,,,56.21,123.32,50 HCPCS,E0575,"Nebulizer, ultrasonic, large volume ",,,143.55,314.93,50 HCPCS,E0580,"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter ",,,161.36,354.0,50 HCPCS,E0585,"Nebulizer, with compressor and heater ",,,31.53,69.17,50 HCPCS,E0600,"Respiratory suction pump, home model, portable or stationary, electric ",,,63.95,140.29,50 HCPCS,E0601,Continuous positive airway pressure (cpap) device ,,,49.89,141.32,50 HCPCS,E0602,"Breast pump, manual, any type ",,,41.22,90.43,50 HCPCS,E0605,"Vaporizer, room type ",,,36.89,80.93,50 HCPCS,E0606,Postural drainage board ,,,28.13,61.7,50 HCPCS,E0607,Home blood glucose monitor ,,,93.33,204.74,50 HCPCS,E0610,"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems) ",,,332.19,728.79,50 HCPCS,E0615,"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems ",,,668.69,1467.03,50 HCPCS,E0616,"Implantable cardiac event recorder with memory, activator and programmer ",,,2180.91,2355.38,6 HCPCS,E0617,External defibrillator with integrated electrocardiogram analysis ,,,424.63,931.6,50 HCPCS,E0618,"Apnea monitor, without recording feature ",,,332.83,730.18,50 HCPCS,E0620,"Skin piercing device for collection of capillary blood, laser, each ",,,122.1,267.87,50 HCPCS,E0621,"Sling or seat, patient lift, canvas or nylon ",,,103.85,227.84,50 HCPCS,E0627,"Seat lift mechanism, electric, any type ",,,311.94,684.37,50 HCPCS,E0629,"Seat lift mechanism, non-electric, any type ",,,306.18,671.72,50 HCPCS,E0630,"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) ",,,71.36,173.91,50 HCPCS,E0635,"Patient lift, electric with seat or sling ",,,154.1,338.09,50 HCPCS,E0636,"Multipositional patient support system, with integrated lift, patient accessible controls ",,,1215.3,2666.21,50 HCPCS,E0639,"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories ",,,155.8,341.81,50 HCPCS,E0640,"Patient lift, fixed system, includes all components/accessories ",,,155.8,341.81,50 HCPCS,E0650,"Pneumatic compressor, non-segmental home model ",,,976.2,2141.66,50 HCPCS,E0651,"Pneumatic compressor, segmental home model without calibrated gradient pressure ",,,1282.67,2814.03,50 HCPCS,E0652,"Pneumatic compressor, segmental home model with calibrated gradient pressure ",,,7404.2,16243.92,50 HCPCS,E0655,"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm ",,,146.02,320.35,50 HCPCS,E0656,"Segmental pneumatic appliance for use with pneumatic compressor, trunk ",,,80.7,177.05,50 HCPCS,E0657,"Segmental pneumatic appliance for use with pneumatic compressor, chest ",,,75.82,166.35,50 HCPCS,E0658,"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest ",,,175.57,385.17,50 HCPCS,E0659,"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest ",,,175.57,385.17,50 HCPCS,E0660,"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg ",,,223.11,489.47,50 HCPCS,E0665,"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm ",,,191.34,419.79,50 HCPCS,E0666,"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg ",,,192.86,423.12,50 HCPCS,E0667,"Segmental pneumatic appliance for use with pneumatic compressor, full leg ",,,452.18,992.03,50 HCPCS,E0668,"Segmental pneumatic appliance for use with pneumatic compressor, full arm ",,,617.15,1353.94,50 HCPCS,E0669,"Segmental pneumatic appliance for use with pneumatic compressor, half leg ",,,243.1,533.33,50 HCPCS,E0670,"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk ",,,1755.64,3851.66,50 HCPCS,E0671,"Segmental gradient pressure pneumatic appliance, full leg ",,,580.1,1272.67,50 HCPCS,E0672,"Segmental gradient pressure pneumatic appliance, full arm ",,,450.72,988.83,50 HCPCS,E0673,"Segmental gradient pressure pneumatic appliance, half leg ",,,374.52,821.64,50 HCPCS,E0675,"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) ",,,537.07,1178.26,50 HCPCS,E0677,"Non-pneumatic sequential compression garment, trunk ",,,80.7,177.05,50 HCPCS,E0678,"Non-pneumatic sequential compression garment, full leg ",,,45.22,99.2,50 HCPCS,E0679,"Non-pneumatic sequential compression garment, half leg ",,,24.31,53.34,50 HCPCS,E0680,Non-pneumatic compression controller with sequential calibrated gradient pressure ,,,740.42,1624.39,50 HCPCS,E0681,Non-pneumatic compression controller without calibrated gradient pressure ,,,128.27,281.41,50 HCPCS,E0682,"Non-pneumatic sequential compression garment, full arm ",,,61.71,135.39,50 HCPCS,E0683,"Non-pneumatic, non-sequential, peristaltic wave compression pump ",,,79.9,175.29,50 HCPCS,E0691,"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less ",,,1255.0,2753.31,50 HCPCS,E0692,"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel ",,,1575.94,3457.41,50 HCPCS,E0693,"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel ",,,1942.68,4262.01,50 HCPCS,E0694,"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection ",,,6183.39,13565.6,50 HCPCS,E0705,"Transfer device, any type, each ",,,55.18,121.07,50 HCPCS,E0711,"Upper extremity medical tubing/lines enclosure or covering device, restricts elbow range of motion ",,,9.3,14.32,5 HCPCS,E0715,Intravaginal device intended to strengthen pelvic floor muscles during kegel exercises ,,,499.73,769.75,5 HCPCS,E0716,Supplies and accessories for intravaginal device intended to strengthen pelvic floor muscles during kegel exercises ,,,499.73,769.75,5 HCPCS,E0720,"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation ",,,69.42,457.29,50 HCPCS,E0721,Transcutaneous electrical nerve stimulator for nerves in the auricular region ,,,355.01,546.83,5 HCPCS,E0730,"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation ",,,68.96,466.88,50 HCPCS,E0731,Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) ,,,88.44,423.1,50 HCPCS,E0732,"Cranial electrotherapy stimulation (ces) system, any type ",,,48.84,107.16,50 HCPCS,E0733,Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve ,,,48.84,107.16,50 HCPCS,E0734,External upper limb tremor stimulator of the peripheral nerves of the wrist ,,,439.36,963.91,50 HCPCS,E0735,Non-invasive vagus nerve stimulator ,,,48.84,107.16,50 HCPCS,E0736,Transcutaneous tibial nerve stimulator ,,,48.84,769.75,50 HCPCS,E0737,"Transcutaneous tibial nerve stimulator, controlled by phone application ",,,499.73,769.75,5 HCPCS,E0738,"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories ",,,1998.85,98928.45,50 HCPCS,E0739,"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors ",,,1565.71,98928.45,50 HCPCS,E0740,"Non-implanted pelvic floor electrical stimulator, complete system ",,,73.03,160.22,50 HCPCS,E0743,"External lower extremity nerve stimulator for restless legs syndrome, each ",,,237.36,520.73,50 HCPCS,E0744,Neuromuscular stimulator for scoliosis ,,,108.71,238.5,50 HCPCS,E0745,"Neuromuscular stimulator, electronic shock unit ",,,125.03,274.3,50 HCPCS,E0747,"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications ",,,5469.32,11999.02,50 HCPCS,E0748,"Osteogenesis stimulator, electrical, non-invasive, spinal applications ",,,5433.9,11921.32,50 HCPCS,E0749,"Osteogenesis stimulator, electrical, surgically implanted ",,,397.15,3009.78,56 HCPCS,E0760,"Osteogenesis stimulator, low intensity ultrasound, non-invasive ",,,4515.47,9906.38,50 HCPCS,E0762,"Transcutaneous electrical joint stimulation device system, includes all accessories ",,,130.54,286.38,50 HCPCS,E0764,"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completi",,,1545.6,3390.85,50 HCPCS,E0765,"Fda approved nerve stimulator, for treatment of nausea and vomiting ",,,121.2,186.68,5 HCPCS,E0766,"Electrical stimulation device used for cancer treatment, includes all accessories, any type ",,,16057.01,35227.11,50 HCPCS,E0767,"Intrabuccal, systemic delivery of amplitude-modulated, radiofrequency electromagnetic field device, for cancer treatment, includes all accessories ",,,94790.81,146008.42,5 HCPCS,E0776,Iv pole ,,,62.06,372.85,52 HCPCS,E0779,"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater ",,,23.35,51.23,50 HCPCS,E0780,"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours ",,,14.48,31.78,50 HCPCS,E0781,"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient ",,,303.14,665.06,50 HCPCS,E0782,"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) ",,,3753.51,11735.65,56 HCPCS,E0783,"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) ",,,7480.4,24913.34,56 HCPCS,E0784,"External ambulatory infusion pump, insulin ",,,546.6,1199.16,50 HCPCS,E0785,"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement ",,,659.92,1447.79,50 HCPCS,E0786,"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) ",,,10750.8,23585.93,50 HCPCS,E0787,"External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing ",,,5689.99,8764.42,5 HCPCS,E0791,"Parenteral infusion pump, stationary, single or multi-channel ",,,360.13,790.08,50 HCPCS,E0840,"Traction frame, attached to headboard, cervical traction ",,,86.98,190.83,50 HCPCS,E0849,"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible ",,,71.98,157.92,50 HCPCS,E0850,"Traction stand, free standing, cervical traction ",,,146.72,321.88,50 HCPCS,E0855,Cervical traction equipment not requiring additional stand or frame ,,,69.03,151.45,50 HCPCS,E0856,"Cervical traction device, with inflatable air bladder(s) ",,,21.49,47.15,50 HCPCS,E0860,"Traction equipment, overdoor, cervical ",,,45.75,100.36,50 HCPCS,E0870,"Traction frame, attached to footboard, extremity traction, (e.g., buck's) ",,,162.45,356.41,50 HCPCS,E0880,"Traction stand, free standing, extremity traction ",,,155.4,340.93,50 HCPCS,E0890,"Traction frame, attached to footboard, pelvic traction ",,,168.15,368.9,50 HCPCS,E0900,"Traction stand, free standing, pelvic traction, (e.g., buck's) ",,,164.71,361.35,50 HCPCS,E0910,"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar ",,,13.29,30.6,50 HCPCS,E0911,"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar ",,,50.67,111.16,50 HCPCS,E0912,"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar ",,,100.14,219.69,50 HCPCS,E0920,"Fracture frame, attached to bed, includes weights ",,,64.46,141.43,50 HCPCS,E0930,"Fracture frame, free standing, includes weights ",,,63.8,139.96,50 HCPCS,E0935,Continuous passive motion exercise device for use on knee only ,,,31.77,69.7,50 HCPCS,E0940,"Trapeze bar, free standing, complete with grab bar ",,,25.14,55.15,50 HCPCS,E0941,"Gravity assisted traction device, any type ",,,60.61,132.98,50 HCPCS,E0942,Cervical head harness/halter ,,,27.71,60.8,50 HCPCS,E0944,Pelvic belt/harness/boot ,,,54.45,119.45,50 HCPCS,E0945,Extremity belt/harness ,,,52.62,115.43,50 HCPCS,E0946,"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster) ",,,70.24,154.09,50 HCPCS,E0947,"Fracture frame, attachments for complex pelvic traction ",,,719.96,1579.5,50 HCPCS,E0948,"Fracture frame, attachments for complex cervical traction ",,,696.35,1527.7,50 HCPCS,E0950,"Wheelchair accessory, tray, each ",,,91.13,199.93,50 HCPCS,E0951,"Heel loop/holder, any type, with or without ankle strap, each ",,,14.81,32.49,50 HCPCS,E0952,"Toe loop/holder, any type, each ",,,20.29,44.5,50 HCPCS,E0953,"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each ",,,91.77,201.33,50 HCPCS,E0954,"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot ",,,63.99,140.39,50 HCPCS,E0955,"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each ",,,17.16,38.68,50 HCPCS,E0956,"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each ",,,91.77,201.33,50 HCPCS,E0957,"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each ",,,147.33,323.23,50 HCPCS,E0958,"Manual wheelchair accessory, one-arm drive attachment, each ",,,49.77,109.2,50 HCPCS,E0959,"Manual wheelchair accessory, adapter for amputee, each ",,,53.13,116.55,50 HCPCS,E0960,"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware ",,,87.43,191.8,50 HCPCS,E0961,"Manual wheelchair accessory, wheel lock brake extension (handle), each ",,,23.69,62.55,50 HCPCS,E0966,"Manual wheelchair accessory, headrest extension, each ",,,86.69,190.19,50 HCPCS,E0967,"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each ",,,85.89,188.43,50 HCPCS,E0968,"Commode seat, wheelchair ",,,25.03,54.91,50 HCPCS,E0969,"Narrowing device, wheelchair ",,,199.06,436.71,50 HCPCS,E0971,"Manual wheelchair accessory, anti-tipping device, each ",,,34.3,96.26,50 HCPCS,E0973,"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each ",,,60.99,186.91,50 HCPCS,E0974,"Manual wheelchair accessory, anti-rollback device, each ",,,90.24,197.97,50 HCPCS,E0978,"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each ",,,27.17,79.27,50 HCPCS,E0980,"Safety vest, wheelchair ",,,43.25,94.88,50 HCPCS,E0981,"Wheelchair accessory, seat upholstery, replacement only, each ",,,48.25,105.84,50 HCPCS,E0982,"Wheelchair accessory, back upholstery, replacement only, each ",,,56.4,123.73,50 HCPCS,E0983,"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control ",,,349.06,765.79,50 HCPCS,E0984,"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control ",,,266.82,585.38,50 HCPCS,E0985,"Wheelchair accessory, seat lift mechanism ",,,25.65,56.27,50 HCPCS,E0986,"Manual wheelchair accessory, power assist system ",,,679.38,1490.47,50 HCPCS,E0988,"Manual wheelchair accessory, lever-activated, wheel drive, pair ",,,402.0,881.93,50 HCPCS,E0990,"Wheelchair accessory, elevating leg rest, complete assembly, each ",,,79.6,214.68,50 HCPCS,E0992,"Manual wheelchair accessory, solid seat insert ",,,94.32,206.92,50 HCPCS,E0994,"Arm rest, each ",,,20.93,45.92,50 HCPCS,E0995,"Wheelchair accessory, calf rest/pad, replacement only, each ",,,31.11,68.24,50 HCPCS,E1002,"Wheelchair accessory, power seating system, tilt only ",,,454.17,996.4,50 HCPCS,E1003,"Wheelchair accessory, power seating system, recline only, without shear reduction ",,,528.61,1159.71,50 HCPCS,E1004,"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction ",,,584.3,1281.87,50 HCPCS,E1005,"Wheelchair accessory, power seating system, recline only, with power shear reduction ",,,634.41,1391.82,50 HCPCS,E1006,"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction ",,,777.09,1704.84,50 HCPCS,E1007,"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction ",,,978.25,2146.15,50 HCPCS,E1008,"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction ",,,1003.41,2201.36,50 HCPCS,E1010,"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair ",,,136.36,299.15,50 HCPCS,E1012,"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each ",,,136.36,299.15,50 HCPCS,E1014,"Reclining back, addition to pediatric size wheelchair ",,,51.02,111.93,50 HCPCS,E1015,"Shock absorber for manual wheelchair, each ",,,141.41,310.25,50 HCPCS,E1016,"Shock absorber for power wheelchair, each ",,,133.98,293.93,50 HCPCS,E1020,"Residual limb support system for wheelchair, any type ",,,21.7,47.6,50 HCPCS,E1028,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other ",,,15.38,39.48,50 HCPCS,E1029,"Wheelchair accessory, ventilator tray, fixed ",,,44.47,97.57,50 HCPCS,E1030,"Wheelchair accessory, ventilator tray, gimbaled ",,,140.28,307.75,50 HCPCS,E1031,"Rollabout chair, any and all types with casters 5 or greater ",,,51.4,112.77,50 HCPCS,E1032,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface ",,,15.38,47.48,50 HCPCS,E1033,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type ",,,15.38,47.48,50 HCPCS,E1034,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type ",,,15.38,47.48,50 HCPCS,E1035,"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs ",,,703.95,1544.39,50 HCPCS,E1036,"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs ",,,991.87,2176.04,50 HCPCS,E1037,"Transport chair, pediatric size ",,,123.18,270.23,50 HCPCS,E1038,"Transport chair, adult size, patient weight capacity up to and including 300 pounds ",,,17.63,38.68,50 HCPCS,E1039,"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds ",,,38.31,84.04,50 HCPCS,E1050,"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests ",,,139.71,306.5,50 HCPCS,E1060,"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests ",,,176.06,386.25,50 HCPCS,E1070,"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest ",,,149.67,328.35,50 HCPCS,E1083,"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest ",,,93.47,205.07,50 HCPCS,E1084,"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests ",,,137.0,300.57,50 HCPCS,E1087,"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests ",,,176.72,387.71,50 HCPCS,E1088,"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests ",,,210.57,461.97,50 HCPCS,E1092,"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests ",,,179.49,393.77,50 HCPCS,E1093,"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests ",,,154.36,338.65,50 HCPCS,E1100,"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests ",,,144.97,318.05,50 HCPCS,E1110,"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest ",,,141.96,311.45,50 HCPCS,E1150,"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests ",,,113.92,249.94,50 HCPCS,E1160,"Wheelchair, fixed full length arms, swing away detachable elevating legrests ",,,87.31,191.54,50 HCPCS,E1161,"Manual adult size wheelchair, includes tilt in space ",,,330.45,724.96,50 HCPCS,E1170,"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests ",,,124.76,273.72,50 HCPCS,E1171,"Amputee wheelchair, fixed full length arms, without footrests or legrest ",,,111.94,245.57,50 HCPCS,E1172,"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest ",,,136.85,300.23,50 HCPCS,E1180,"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests ",,,141.53,310.5,50 HCPCS,E1190,"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests ",,,163.5,358.71,50 HCPCS,E1195,"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests ",,,175.44,384.89,50 HCPCS,E1200,"Amputee wheelchair, fixed full length arms, swing away detachable footrest ",,,121.52,266.6,50 HCPCS,E1221,"Wheelchair with fixed arm, footrests ",,,66.37,145.6,50 HCPCS,E1222,"Wheelchair with fixed arm, elevating legrests ",,,90.5,198.55,50 HCPCS,E1223,"Wheelchair with detachable arms, footrests ",,,103.37,226.78,50 HCPCS,E1224,"Wheelchair with detachable arms, elevating legrests ",,,113.35,248.67,50 HCPCS,E1225,"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each ",,,43.96,96.45,50 HCPCS,E1226,"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each ",,,439.21,1029.15,50 HCPCS,E1227,Special height arms for wheelchair ,,,329.44,722.74,50 HCPCS,E1228,Special back height for wheelchair ,,,39.14,85.87,50 HCPCS,E1230,Power operated vehicle (three or four wheel nonhighway) specify brand name and model number ,,,2916.23,6397.84,50 HCPCS,E1232,"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system ",,,298.68,655.28,50 HCPCS,E1233,"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system ",,,309.44,678.88,50 HCPCS,E1234,"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system ",,,269.41,591.06,50 HCPCS,E1235,"Wheelchair, pediatric size, rigid, adjustable, with seating system ",,,259.43,569.15,50 HCPCS,E1236,"Wheelchair, pediatric size, folding, adjustable, with seating system ",,,228.88,502.13,50 HCPCS,E1237,"Wheelchair, pediatric size, rigid, adjustable, without seating system ",,,230.86,506.48,50 HCPCS,E1238,"Wheelchair, pediatric size, folding, adjustable, without seating system ",,,228.88,502.13,50 HCPCS,E1240,"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest ",,,143.89,315.68,50 HCPCS,E1270,"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests ",,,110.26,241.9,50 HCPCS,E1280,"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests ",,,183.32,402.18,50 HCPCS,E1295,"Heavy duty wheelchair, fixed full length arms, elevating legrest ",,,169.64,372.16,50 HCPCS,E1296,Special wheelchair seat height from floor ,,,583.66,1280.48,50 HCPCS,E1297,"Special wheelchair seat depth, by upholstery ",,,124.19,272.45,50 HCPCS,E1298,"Special wheelchair seat depth and/or width, by construction ",,,502.94,1103.38,50 HCPCS,E1301,"Whirlpool tub, walk-in, portable ",,,248.0,382.0,5 HCPCS,E1310,"Whirlpool, non-portable (built-in type) ",,,2999.15,6579.77,50 HCPCS,E1353,Regulator ,,,39.55,86.77,50 HCPCS,E1355,Stand/rack ,,,29.81,65.4,50 HCPCS,E1372,Immersion external heater for nebulizer ,,,133.88,308.9,50 HCPCS,E1390,"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate ",,,96.2,261.23,50 HCPCS,E1391,"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each ",,,96.2,261.23,50 HCPCS,E1392,"Portable oxygen concentrator, rental ",,,46.23,130.62,50 HCPCS,E1405,Oxygen and water vapor enriching system with heated delivery ,,,127.72,330.11,50 HCPCS,E1406,Oxygen and water vapor enriching system without heated delivery ,,,103.2,285.58,50 HCPCS,E1629,Tablo hemodialysis system for the billable dialysis service ,,,35.24,54.28,5 HCPCS,E1700,Jaw motion rehabilitation system ,,,40.94,89.83,50 HCPCS,E1701,"Replacement cushions for jaw motion rehabilitation system, pkg. of 6 ",,,14.12,30.98,50 HCPCS,E1702,"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200 ",,,26.78,58.76,50 HCPCS,E1800,"Dynamic adjustable elbow extension and flexion device, includes soft interface material ",,,148.38,325.53,50 HCPCS,E1801,"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ",,,180.18,395.3,50 HCPCS,E1802,"Dynamic adjustable forearm pronation/supination device, includes soft interface material ",,,456.44,1001.36,50 HCPCS,E1803,"Dynamic adjustable elbow extension only device, includes soft interface material ",,,148.38,325.53,50 HCPCS,E1804,"Dynamic adjustable elbow flexion only device, includes soft interface material ",,,148.38,325.53,50 HCPCS,E1805,"Dynamic adjustable wrist extension and flexion device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1806,"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories ",,,147.95,324.59,50 HCPCS,E1807,"Dynamic adjustable wrist extension only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1808,"Dynamic adjustable wrist flexion only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1810,"Dynamic adjustable knee extension and flexion device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1811,"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ",,,187.31,410.93,50 HCPCS,E1812,"Dynamic knee, extension/flexion device with active resistance control ",,,120.1,263.48,50 HCPCS,E1813,"Dynamic adjustable knee extension only device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1814,"Dynamic adjustable knee flexion only device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1815,"Dynamic adjustable ankle extension and flexion device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1816,"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories ",,,190.29,417.47,50 HCPCS,E1818,"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories ",,,194.25,426.15,50 HCPCS,E1820,"Replacement soft interface material, dynamic adjustable extension/flexion device ",,,114.17,250.47,50 HCPCS,E1821,Replacement soft interface material/cuffs for bi-directional static progressive stretch device ,,,146.98,322.46,50 HCPCS,E1822,"Dynamic adjustable ankle extension only device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1823,"Dynamic adjustable ankle flexion only device, includes soft interface material ",,,150.43,330.02,50 HCPCS,E1825,"Dynamic adjustable finger extension and flexion device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1826,"Dynamic adjustable finger extension only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1827,"Dynamic adjustable finger flexion only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1828,"Dynamic adjustable toe extension only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1829,"Dynamic adjustable toe flexion only device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1830,"Dynamic adjustable toe extension and flexion device, includes soft interface material ",,,150.0,329.08,50 HCPCS,E1831,"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ",,,88.75,194.7,50 HCPCS,E1832,"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ",,,88.75,194.7,50 HCPCS,E1840,"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material ",,,534.51,1172.65,50 HCPCS,E1841,"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories ",,,632.66,1387.98,50 HCPCS,E1905,"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software ",,,661.27,1450.76,45 HCPCS,E2000,"Gastric suction pump, home model, portable or stationary, electric ",,,72.39,158.82,50 HCPCS,E2001,"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system ",,,63.95,140.29,50 HCPCS,E2100,Blood glucose monitor with integrated voice synthesizer ,,,763.54,1675.11,50 HCPCS,E2101,Blood glucose monitor with integrated lancing/blood sample ,,,263.34,577.73,50 HCPCS,E2102,"Adjunctive, non-implanted continuous glucose monitor or receiver ",,,234.44,661.26,50 HCPCS,E2103,"Non-adjunctive, non-implanted continuous glucose monitor or receiver ",,,295.24,647.73,50 HCPCS,E2104,Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge ,,,53.43,117.22,50 HCPCS,E2120,Pulse generator system for tympanic treatment of inner ear endolymphatic fluid ,,,395.97,868.71,50 HCPCS,E2201,"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches ",,,364.63,827.91,50 HCPCS,E2202,"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches ",,,520.36,1141.61,50 HCPCS,E2203,"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches ",,,497.36,1091.15,50 HCPCS,E2204,"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches ",,,854.78,1875.27,50 HCPCS,E2205,"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each ",,,40.87,89.66,50 HCPCS,E2206,"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each ",,,44.56,97.76,50 HCPCS,E2207,"Wheelchair accessory, crutch and cane holder, each ",,,53.75,117.93,50 HCPCS,E2208,"Wheelchair accessory, cylinder tank carrier, each ",,,89.5,227.18,50 HCPCS,E2209,"Accessory, arm trough, with or without hand support, each ",,,97.1,213.02,50 HCPCS,E2210,"Wheelchair accessory, bearings, any type, replacement only, each ",,,6.24,13.7,50 HCPCS,E2211,"Manual wheelchair accessory, pneumatic propulsion tire, any size, each ",,,39.66,87.01,50 HCPCS,E2212,"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each ",,,7.3,16.02,50 HCPCS,E2213,"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each ",,,34.8,76.35,50 HCPCS,E2214,"Manual wheelchair accessory, pneumatic caster tire, any size, each ",,,37.5,82.28,50 HCPCS,E2215,"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each ",,,11.88,26.06,50 HCPCS,E2216,"Manual wheelchair accessory, foam filled propulsion tire, any size, each ",,,51.46,112.9,50 HCPCS,E2217,"Manual wheelchair accessory, foam filled caster tire, any size, each ",,,45.54,99.91,50 HCPCS,E2218,"Manual wheelchair accessory, foam propulsion tire, any size, each ",,,51.46,112.9,50 HCPCS,E2219,"Manual wheelchair accessory, foam caster tire, any size, each ",,,45.54,99.91,50 HCPCS,E2220,"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each ",,,33.06,72.52,50 HCPCS,E2221,"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each ",,,30.96,67.92,50 HCPCS,E2222,"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each ",,,26.48,58.09,50 HCPCS,E2224,"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each ",,,107.34,235.49,50 HCPCS,E2225,"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each ",,,22.12,48.53,50 HCPCS,E2226,"Manual wheelchair accessory, caster fork, any size, replacement only, each ",,,46.06,101.05,50 HCPCS,E2227,"Manual wheelchair accessory, gear reduction drive wheel, each ",,,251.2,551.11,50 HCPCS,E2228,"Manual wheelchair accessory, wheel braking system and lock, complete, each ",,,110.3,241.98,50 HCPCS,E2231,"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware ",,,163.94,359.67,50 HCPCS,E2298,"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type ",,,206.13,452.23,50 HCPCS,E2310,"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection ",,,132.99,291.75,50 HCPCS,E2311,"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function s",,,268.36,588.76,50 HCPCS,E2312,"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware ",,,270.84,594.2,50 HCPCS,E2313,"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each ",,,43.04,94.43,50 HCPCS,E2321,"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware ",,,180.69,495.09,50 HCPCS,E2322,"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware ",,,169.76,524.26,50 HCPCS,E2323,"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated ",,,83.21,182.56,50 HCPCS,E2324,"Power wheelchair accessory, chin cup for chin control interface ",,,52.74,115.71,50 HCPCS,E2325,"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware ",,,162.14,355.72,50 HCPCS,E2326,"Power wheelchair accessory, breath tube kit for sip and puff interface ",,,41.8,91.7,50 HCPCS,E2327,"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware ",,,314.45,759.03,50 HCPCS,E2328,"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware ",,,596.49,1308.62,50 HCPCS,E2329,"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array",,,212.6,466.42,50 HCPCS,E2330,"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head arr",,,411.92,903.71,50 HCPCS,E2340,"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches ",,,500.48,1097.98,50 HCPCS,E2341,"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches ",,,750.8,1647.16,50 HCPCS,E2342,"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches ",,,625.68,1372.67,50 HCPCS,E2343,"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches ",,,1001.09,2196.27,50 HCPCS,E2351,"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface ",,,841.28,1845.67,50 HCPCS,E2359,"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) ",,,197.48,433.25,50 HCPCS,E2360,"Power wheelchair accessory, 22nf non-sealed lead acid battery, each ",,,149.63,328.26,50 HCPCS,E2361,"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) ",,,133.03,291.84,50 HCPCS,E2362,"Power wheelchair accessory, group 24 non-sealed lead acid battery, each ",,,128.47,281.84,50 HCPCS,E2363,"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) ",,,163.59,358.9,50 HCPCS,E2364,"Power wheelchair accessory, u-1 non-sealed lead acid battery, each ",,,150.8,330.84,50 HCPCS,E2365,"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) ",,,85.63,214.51,50 HCPCS,E2366,"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each ",,,176.39,504.16,50 HCPCS,E2367,"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each ",,,458.55,1006.01,50 HCPCS,E2368,"Power wheelchair component, drive wheel motor, replacement only ",,,47.76,104.77,50 HCPCS,E2369,"Power wheelchair component, drive wheel gear box, replacement only ",,,44.29,97.16,50 HCPCS,E2370,"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only ",,,62.2,153.56,50 HCPCS,E2371,"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each ",,,163.94,359.67,50 HCPCS,E2373,"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware ",,,94.42,231.45,50 HCPCS,E2374,"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacemen",,,61.28,134.44,50 HCPCS,E2375,"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only ",,,78.72,172.71,50 HCPCS,E2376,"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only ",,,152.24,334.0,50 HCPCS,E2377,"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue ",,,56.4,123.73,50 HCPCS,E2378,"Power wheelchair component, actuator, replacement only ",,,65.55,143.81,50 HCPCS,E2381,"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each ",,,70.45,154.56,50 HCPCS,E2382,"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each ",,,22.33,49.0,50 HCPCS,E2383,"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each ",,,151.01,331.29,50 HCPCS,E2384,"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each ",,,71.12,156.03,50 HCPCS,E2385,"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each ",,,53.6,117.58,50 HCPCS,E2386,"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each ",,,121.28,287.82,50 HCPCS,E2387,"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each ",,,57.24,125.58,50 HCPCS,E2388,"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each ",,,58.33,127.97,50 HCPCS,E2389,"Power wheelchair accessory, foam caster tire, any size, replacement only, each ",,,32.6,71.53,50 HCPCS,E2390,"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each ",,,50.48,110.75,50 HCPCS,E2391,"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each ",,,20.56,45.11,50 HCPCS,E2392,"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each ",,,48.27,105.91,50 HCPCS,E2394,"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each ",,,68.79,150.91,50 HCPCS,E2395,"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each ",,,51.68,113.37,50 HCPCS,E2396,"Power wheelchair accessory, caster fork, any size, replacement only, each ",,,59.91,131.43,50 HCPCS,E2397,"Power wheelchair accessory, lithium-based battery, each ",,,521.8,1144.77,50 HCPCS,E2398,"Wheelchair accessory, dynamic positioning hardware for back ",,,160.22,376.17,50 HCPCS,E2402,"Negative pressure wound therapy electrical pump, stationary or portable ",,,782.06,2323.63,50 HCPCS,E2500,"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time ",,,546.15,1198.19,50 HCPCS,E2502,"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time ",,,1670.09,3663.97,50 HCPCS,E2504,"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time ",,,2203.09,4833.31,50 HCPCS,E2506,"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time ",,,3230.34,7086.98,50 HCPCS,E2508,"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device ",,,4995.21,10958.87,50 HCPCS,E2510,"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access ",,,9452.78,20738.23,50 HCPCS,E2513,"Accessory for speech generating device, electromyographic sensor ",,,4401.18,9655.65,50 HCPCS,E2601,"General use wheelchair seat cushion, width less than 22 inches, any depth ",,,44.51,116.97,50 HCPCS,E2602,"General use wheelchair seat cushion, width 22 inches or greater, any depth ",,,96.24,228.34,50 HCPCS,E2603,"Skin protection wheelchair seat cushion, width less than 22 inches, any depth ",,,121.27,289.88,50 HCPCS,E2604,"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth ",,,176.77,387.82,50 HCPCS,E2605,"Positioning wheelchair seat cushion, width less than 22 inches, any depth ",,,248.68,545.58,50 HCPCS,E2606,"Positioning wheelchair seat cushion, width 22 inches or greater, any depth ",,,401.29,880.38,50 HCPCS,E2607,"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth ",,,241.38,554.34,50 HCPCS,E2608,"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth ",,,308.47,676.76,50 HCPCS,E2611,"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware ",,,181.22,597.37,50 HCPCS,E2612,"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware ",,,357.85,808.1,50 HCPCS,E2613,"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware ",,,363.64,797.78,50 HCPCS,E2614,"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware ",,,535.98,1175.88,50 HCPCS,E2615,"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware ",,,415.69,911.97,50 HCPCS,E2616,"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware ",,,559.73,1227.97,50 HCPCS,E2619,"Replacement cover for wheelchair seat cushion or back cushion, each ",,,60.05,131.75,50 HCPCS,E2620,"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware ",,,454.11,1047.44,50 HCPCS,E2621,"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware ",,,534.4,1172.42,50 HCPCS,E2622,"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth ",,,380.97,835.81,50 HCPCS,E2623,"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth ",,,481.77,1056.94,50 HCPCS,E2624,"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth ",,,387.13,849.31,50 HCPCS,E2625,"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth ",,,479.11,1051.11,50 HCPCS,E2626,"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable ",,,740.97,1625.59,50 HCPCS,E2627,"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type ",,,1191.76,2614.57,50 HCPCS,E2628,"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining ",,,885.42,1942.5,50 HCPCS,E2629,"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints) ",,,1151.97,2527.28,50 HCPCS,E2630,"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support ",,,798.52,1751.86,50 HCPCS,E2631,"Wheelchair accessory, addition to mobile arm support, elevating proximal arm ",,,322.13,706.7,50 HCPCS,E2632,"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control ",,,203.6,446.68,50 HCPCS,E2633,"Wheelchair accessory, addition to mobile arm support, supinator ",,,169.5,371.86,50 HCPCS,E3000,"Speech volume modulation system, any type, including all components and accessories ",,,239.94,526.41,50 HCPCS,E3200,"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only ",,,1155.09,2686.41,50 HCPCS,G0008,ADMIN INFLUENZA VACCINE,279.41,279.41,16.76,237.5,39 HCPCS,G0008,Administration of influenza virus vaccine ,279.41,279.41,55.67,76.84,5 HCPCS,G0009,ADMIN PNEUMOCOCCAL VAC,279.41,279.41,16.76,237.5,78 HCPCS,G0009,Administration of pneumococcal vaccine ,,,112.16,154.81,5 HCPCS,G0010,Administration of hepatitis b vaccine ,,,121.45,167.64,5 HCPCS,G0011,"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial ",,,18.95,73.32,7 HCPCS,G0012,"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle ",,,13.15,122.2,7 HCPCS,G0013,"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv ",,,198.74,274.32,5 HCPCS,G0017,"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); ",,,147.73,610.76,7 HCPCS,G0018,"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); ",,,71.49,306.46,7 HCPCS,G0019,"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes p",,,198.74,274.32,5 HCPCS,G0022,"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019) ",,,82.46,113.83,5 HCPCS,G0023,"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month",,,198.74,274.32,5 HCPCS,G0024,"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023) ",,,82.46,113.83,5 HCPCS,G0027,Semen analysis; presence and/or motility of sperm excluding huhner ,,,6.37,44.71,145 HCPCS,G0068,"Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy ",,,42.59,58.79,5 HCPCS,G0069,Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home,,,98.89,136.5,5 HCPCS,G0070,Professional services for the administration of intravenous chemotherapy or other intravenous highly complex drug or biological infusion for each infusion drug administration calendar day in the indiv,,,83.7,115.54,5 HCPCS,G0088,"Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excludi",,,42.59,58.79,5 HCPCS,G0089,"Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the i",,,98.89,136.5,5 HCPCS,G0090,"Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the i",,,83.7,115.54,5 HCPCS,G0101,Cervical or vaginal cancer screening; pelvic and clinical breast examination ,,,65.78,90.8,5 HCPCS,G0102,Prostate cancer screening; digital rectal examination ,,,21.08,29.1,5 HCPCS,G0103,PROS SPEC AG (PSA) SCR,1273.95,1273.95,76.44,1082.86,21 HCPCS,G0103,Prostate cancer screening; prostate specific antigen test (psa) ,1273.95,1273.95,18.92,132.85,145 HCPCS,G0104,Colorectal cancer screening; flexible sigmoidoscopy ,,,130.67,3083.0,186 HCPCS,G0105,Colorectal cancer screening; colonoscopy on individual at high risk ,,,328.5,3755.0,207 HCPCS,G0108,"Diabetes outpatient self-management training services, individual, per 30 minutes ",,,55.22,181.59,50 HCPCS,G0109,"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes ",,,15.85,50.06,50 HCPCS,G0117,Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist ,,,133.24,183.92,5 HCPCS,G0118,Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist ,,,99.52,137.37,5 HCPCS,G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,328.5,3755.0,207 HCPCS,G0123,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,19.85,139.37,145 HCPCS,G0124,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician ",,,65.53,115.12,17 HCPCS,G0127,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,73 HCPCS,G0128,"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes ",,,18.56,25.61,5 HCPCS,G0130,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,35.75,93.46,59 HCPCS,G0136,"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months ",,,63.98,88.31,5 HCPCS,G0137,"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental hea",,,234.51,323.71,5 HCPCS,G0138,"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alf",,,1522.17,2101.11,5 HCPCS,G0140,"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per ",,,198.74,274.32,5 HCPCS,G0141,"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician ",,,65.53,115.12,17 HCPCS,G0143,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,26.51,186.07,145 HCPCS,G0144,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,43.09,302.45,145 HCPCS,G0145,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,25.96,182.18,145 HCPCS,G0146,"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140) ",,,82.46,113.83,5 HCPCS,G0147,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,18.17,109.51,145 HCPCS,G0148,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,31.3,219.64,145 HCPCS,G0166,"External counterpulsation, per treatment session ",,,255.13,3128.0,26 HCPCS,G0168,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,52 HCPCS,G0175,Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present ,,,823.19,1136.28,5 HCPCS,G0179,"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and revi",,,97.84,135.05,5 HCPCS,G0180,"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review ",,,126.5,174.61,5 HCPCS,G0181,Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplin,,,256.37,353.88,5 HCPCS,G0182,Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revisi,,,256.37,353.88,5 HCPCS,G0183,"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast) ",,,154.97,340.75,5 HCPCS,G0186,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,208.33,3667.92,207 HCPCS,G0219,Pet imaging whole body; melanoma for non-covered indications ,,,3727.08,8195.34,5 HCPCS,G0219,Pet imaging whole body; melanoma for non-covered indications PET Scan,,,2268.0,5672.0,12 HCPCS,G0235,"Pet imaging, any site, not otherwise specified PET Scan",,,2268.0,5672.0,12 HCPCS,G0237,"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) ",,,22.77,31.43,5 HCPCS,G0238,"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) ",,,23.61,32.59,5 HCPCS,G0239,"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) ",,,29.51,40.73,5 HCPCS,G0245,"Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2)",,,271.28,374.45,5 HCPCS,G0246,Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient,,,271.28,374.45,5 HCPCS,G0247,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,57 HCPCS,G0248,"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteri",,,271.28,374.45,5 HCPCS,G0249,"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage c",,,271.28,374.45,5 HCPCS,G0250,"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicar",,,7.8,29.89,7 HCPCS,G0252,"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) ",,,134.46,295.67,5 HCPCS,G0252,"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) PET Scan",,,2268.0,5672.0,12 HCPCS,G0257,EMERGENT DIALYSIS ESRD,3316.59,3316.59,383.87,3932.95,198 HCPCS,G0257,Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility ,,,1497.67,2067.3,5 HCPCS,G0259,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,112 HCPCS,G0260,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,185 HCPCS,G0268,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,16 HCPCS,G0269,OCCLUSIVE DEVICE VEN/ART,2420.0,2420.0,145.2,2057.0,32 HCPCS,G0269,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",2420.0,2420.0,1672.0,2358.0,16 HCPCS,G0270,"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hour",,,26.54,95.45,48 HCPCS,G0271,"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hou",,,14.3,52.39,48 HCPCS,G0276,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,89 HCPCS,G0278,ILC/FEM ART ANG AT CCATH,11680.91,11680.91,700.85,9928.77,34 HCPCS,G0279,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,12.35,665.0,110 HCPCS,G0281,"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable ",,,10.2,46.58,136 HCPCS,G0282,"Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281 ",,,50.52,50.52,2 HCPCS,G0283,EL ST UN IND NOT WC PT,326.74,326.74,19.6,277.73,32 HCPCS,G0283,"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care ",326.74,326.74,11.06,46.58,136 HCPCS,G0288,"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery ",,,64.06,140.87,5 HCPCS,G0289,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,7026.0,28 HCPCS,G0293,"Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day ",,,78.23,107.98,5 HCPCS,G0294,"Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day ",,,78.23,107.98,5 HCPCS,G0295,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,36 HCPCS,G0296,Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) ,,,63.25,87.31,5 HCPCS,G0297,Low dose ct scan (ldct) for lung cancer screening ,,,1635.0,2106.0,12 HCPCS,G0302,"Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services ",,,1136.33,1568.52,5 HCPCS,G0303,"Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services ",,,323.74,446.87,5 HCPCS,G0304,"Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services ",,,1136.33,1568.52,5 HCPCS,G0305,"Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services ",,,1136.33,1568.52,5 HCPCS,G0306,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.53,53.49,173 HCPCS,G0307,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.43,44.53,173 HCPCS,G0310,"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicai",,,59.04,81.49,5 HCPCS,G0311,"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid",,,59.04,81.49,5 HCPCS,G0312,"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code i",,,59.04,81.49,5 HCPCS,G0313,"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is",,,59.04,81.49,5 HCPCS,G0314,"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagno",,,59.04,81.49,5 HCPCS,G0315,"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnos",,,59.04,81.49,5 HCPCS,G0316,Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date o,,,75.91,104.78,5 HCPCS,G0317,Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service),,,75.91,104.78,5 HCPCS,G0318,Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service,,,74.2,102.42,5 HCPCS,G0320,Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system ,,,21.93,30.27,5 HCPCS,G0321,Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system ,,,21.93,30.27,5 HCPCS,G0322,"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring) ",,,136.61,188.57,5 HCPCS,G0328,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.16,124.17,173 HCPCS,G0329,"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healin",,,10.55,36.08,50 HCPCS,G0330,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,1377.94,13835.0,72 HCPCS,G0337,"Hospice evaluation and counseling services, pre-election ",,,172.88,238.63,5 HCPCS,G0339,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,58 HCPCS,G0340,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,58 HCPCS,G0341,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,57 HCPCS,G0342,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,5202.0,13835.0,69 HCPCS,G0343,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,57 HCPCS,G0364,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,8 HCPCS,G0372,Physician service required to establish and document the need for a power mobility device ,,,6.66,29.1,7 HCPCS,G0378,OBS PER HOUR,242.41,242.41,14.05,412.1,150 HCPCS,G0379,DIRECT REFERRAL TO OBS,606.02,606.02,30.85,1030.24,80 HCPCS,G0379,Direct admission of patient for hospital observation care ,,,297.69,410.92,5 HCPCS,G0380,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,51.36,1716.0,58 HCPCS,G0381,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,51.36,1819.0,58 HCPCS,G0382,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,51.36,4158.0,58 HCPCS,G0383,Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,1160.0,4651.0,41 HCPCS,G0384,Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,3343.0,7960.0,41 HCPCS,G0390,Trauma response team associated with hospital critical care service ,,,2085.29,2878.41,5 HCPCS,G0396,"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes ",,,79.28,109.43,5 HCPCS,G0397,"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes ",,,154.32,213.02,5 HCPCS,G0398,"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation ",,,279.47,441.34,5 HCPCS,G0399,"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation ",,,279.47,611.45,17 HCPCS,G0400,"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels ",,,279.47,605.87,17 HCPCS,G0402,"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment ",,,271.28,374.45,5 HCPCS,G0403,"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report ",,,34.95,55.19,5 HCPCS,G0404,"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination ",,,20.24,27.94,5 HCPCS,G0405,"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination ",,,20.24,27.94,5 HCPCS,G0406,"Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth ",,,91.92,126.87,5 HCPCS,G0407,"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth ",,,171.19,236.31,5 HCPCS,G0408,"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth ",,,246.24,339.89,5 HCPCS,G0412,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,177 HCPCS,G0413,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,185 HCPCS,G0414,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,177 HCPCS,G0415,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,177 HCPCS,G0416,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,572.49,997.31,98 HCPCS,G0420,"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour ",,,98.17,363.18,50 HCPCS,G0421,"Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour ",,,23.66,84.98,50 HCPCS,G0422,"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session ",,,276.61,381.82,5 HCPCS,G0423,"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session ",,,276.61,381.82,5 HCPCS,G0425,"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth ",,,236.97,327.1,5 HCPCS,G0426,"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth ",,,322.15,444.67,5 HCPCS,G0427,"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth ",,,478.16,660.02,5 HCPCS,G0428,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,60 HCPCS,G0432,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,19.18,134.57,145 HCPCS,G0433,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.36,125.8,173 HCPCS,G0435,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,11.74,82.36,145 HCPCS,G0438,"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit ",,,150.12,379.71,45 HCPCS,G0439,"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit ",,,118.38,299.43,45 HCPCS,G0448,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,17009.0,93 HCPCS,G0451,"Development testing, with interpretation and report, per standardized instrument form ",,,183.78,253.68,5 HCPCS,G0452,Molecular pathology procedure; physician interpretation and report ,,,11.66,59.78,98 HCPCS,G0453,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,67.71,2358.0,21 HCPCS,G0455,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,132 HCPCS,G0460,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,36 HCPCS,G0463,Hospital outpatient clinic visit for assessment and management of a patient ,,,271.28,4060.0,6 HCPCS,G0465,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,36 HCPCS,G0471,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,10.1,55.69,133 HCPCS,G0472,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,45.42,318.83,145 HCPCS,G0475,"Hiv antigen/antibody, combination assay, screening ",,,23.6,165.62,145 HCPCS,G0476,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,34.39,241.36,145 HCPCS,G0480,DRUG TEST DEF 1-7 CLASS,3111.02,3111.02,186.66,2644.37,15 HCPCS,G0480,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",3111.02,3111.02,96.12,787.08,173 HCPCS,G0481,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,131.54,1077.04,173 HCPCS,G0482,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,166.94,1366.91,173 HCPCS,G0483,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,207.41,1698.32,173 HCPCS,G0498,"Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community s",,,724.46,1000.01,5 HCPCS,G0499,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,23.75,149.1,161 HCPCS,G0500,"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of",,,13.5,18.64,5 HCPCS,G0506,Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) ,,,108.79,150.16,5 HCPCS,G0508,"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth ",,,497.55,686.79,5 HCPCS,G0509,"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth ",,,469.73,648.39,5 HCPCS,G0513,"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 3",,,145.9,201.39,5 HCPCS,G0514,"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each ad",,,145.9,201.39,5 HCPCS,G0516,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,161 HCPCS,G0517,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,161 HCPCS,G0518,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,161 HCPCS,G0532,"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in ad",,,153.55,211.52,5 HCPCS,G0533,"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group thera",,,1495.54,2064.36,5 HCPCS,G0534,"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery supp",,,82.46,113.83,5 HCPCS,G0535,"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-adv",,,82.46,113.83,5 HCPCS,G0536,"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatme",,,198.74,274.32,5 HCPCS,G0537,"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months ",,,69.71,96.22,5 HCPCS,G0538,Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month ,,,216.45,298.77,5 HCPCS,G0539,"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (w",,,34.08,151.03,7 HCPCS,G0540,"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified healt",,,17.99,81.01,7 HCPCS,G0541,"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to ",,,34.08,151.03,7 HCPCS,G0542,"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to ",,,17.99,81.01,7 HCPCS,G0543,"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniqu",,,8.1,35.01,7 HCPCS,G0544,"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month ",,,216.45,298.77,5 HCPCS,G0545,"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission ris",,,105.46,145.58,5 HCPCS,G0546,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services fo,,,14.11,58.01,7 HCPCS,G0547,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,28.12,117.12,7 HCPCS,G0548,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,41.74,177.33,7 HCPCS,G0549,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,55.46,237.53,7 HCPCS,G0550,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,26.22,109.46,7 HCPCS,G0551,Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to service,,,27.06,114.92,7 HCPCS,G0552,"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan ",,,53.85,82.95,5 HCPCS,G0553,First 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan,,,301.56,416.25,5 HCPCS,G0554,Each additional 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral th,,,69.78,96.32,5 HCPCS,G0556,"Advanced primary care management services for a patient with one chronic condition ºexpected to last at least 12 months, or until the death of the patient, which place the patient at significant risk ",,,69.71,96.22,5 HCPCS,G0557,"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient a",,,69.71,96.22,5 HCPCS,G0558,"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death ",,,216.45,298.77,5 HCPCS,G0559,"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the ",,,21.41,29.55,5 HCPCS,G0560,"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safet",,,33.84,139.02,7 HCPCS,G0561,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,96 HCPCS,G0562,"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., mo",,,3432.88,7548.44,5 HCPCS,G0563,"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, e",,,6863.41,11251.5,5 HCPCS,G0566,"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy ",,,275.37,605.5,5 HCPCS,G0567,"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique ",,,34.39,101.41,51 HCPCS,G0571,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,96 HCPCS,G0659,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,52.2,328.72,159 HCPCS,G0681,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,2195.0,3249.0,96 HCPCS,G0682,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3083.0,96 HCPCS,G0683,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,2195.0,3249.0,96 HCPCS,G0684,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3083.0,96 HCPCS,G1028,Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary pr,,,0.05,0.06,5 HCPCS,G2000,"Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), perfo",,,1136.33,1568.52,5 HCPCS,G2010,"Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not ",,,21.93,30.27,5 HCPCS,G2011,"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes ",,,39.64,54.72,5 HCPCS,G2025,Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only ,,,84.02,84.02,2 HCPCS,G2078,Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure ,,,0.04,0.05,5 HCPCS,G2079,Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary pro,,,19.87,27.38,5 HCPCS,G2082,Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of u,,,59.88,82.66,5 HCPCS,G2083,Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of ,,,59.88,82.66,5 HCPCS,G2211,Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care servi,,,41.32,57.04,5 HCPCS,G2212,Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary ,,,78.44,108.27,5 HCPCS,G2213,"Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list",,,159.38,220.0,5 HCPCS,G2214,"Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed b",,,94.44,130.36,5 HCPCS,G2215,Take-home supply of nasal naloxone; 2-pack of 4mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary pr,,,0.04,0.05,5 HCPCS,G2216,Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure ,,,19.87,27.38,5 HCPCS,G2250,"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not ",,,6.95,31.43,50 HCPCS,G2251,"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, n",,,9.24,44.22,50 HCPCS,G2252,"Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an establ",,,19.54,84.98,7 HCPCS,G3002,"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revisio",,,182.99,252.59,5 HCPCS,G3003,"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when",,,63.25,87.31,5 HCPCS,G9143,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,118.31,830.34,143 HCPCS,G9157,"Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes ",,,232.76,321.29,5 HCPCS,G9481,"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a proble",,,44.69,61.69,5 HCPCS,G9482,"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expan",,,85.18,117.57,5 HCPCS,G9483,"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detail",,,132.4,182.75,5 HCPCS,G9484,"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a compre",,,223.47,308.46,5 HCPCS,G9485,"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a compre",,,291.8,402.78,5 HCPCS,G9486,"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the follo",,,43.85,60.53,5 HCPCS,G9487,"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the follo",,,87.7,121.06,5 HCPCS,G9488,"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the follo",,,134.92,186.24,5 HCPCS,G9489,"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the foll",,,190.59,263.08,5 HCPCS,G9490,"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of ",,,104.57,144.35,5 HCPCS,G9886,"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes ",,,37.95,52.39,5 HCPCS,G9887,"Behavioral counseling for diabetes prevention, distance learning, 60 minutes ",,,37.95,52.39,5 HCPCS,H0003,Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs ,,,0.07,0.09,12 HCPCS,H0047,"Alcohol and/or other drug abuse services, not otherwise specified ",,,266.07,266.07,2 HCPCS,H0049,Alcohol and/or drug screening ,,,0.07,0.09,12 HCPCS,H0052,Missing and murdered indigenous persons (mmip) mental health and clinical care ,,,255.34,352.46,5 HCPCS,H0053,Historical trauma (ht) mental health and clinical care for indigenous persons ,,,255.34,352.46,5 HCPCS,H2019,"Therapeutic behavioral services, per 15 minutes ",,,34.54,34.54,2 HCPCS,J0013,"Esketamine, nasal spray, 1 mg ",,,29.44,40.55,5 HCPCS,J0120,"Injection, tetracycline, up to 250 mg ",,,,,0 HCPCS,J0121,"Injection, omadacycline, 1 mg ",,,4.13,12.76,10 HCPCS,J0122,ERAVACYCLINE 1 MG INJ,7.57,7.57,0.45,6.43,24 HCPCS,J0122,ERAVACYCLINE 1 MG INJ JW,7.57,7.57,0.45,6.43,24 HCPCS,J0122,ERAVACYCLINE 100 MG INJ,700.0,700.0,42.0,595.0,24 HCPCS,J0122,ERAVACYCLINE 50 MG INJ,378.33,378.33,22.7,321.58,24 HCPCS,J0122,"Injection, eravacycline, 1 mg ",,,1.29,4.09,10 HCPCS,J0129,"Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",,,44.72,138.81,10 HCPCS,J0129,"Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) Chemotherapy Drugs",,,,,0 HCPCS,J0130,"Injection abciximab, 10 mg ",,,2642.43,4458.7,8 HCPCS,J0131,ACETAMINO NOS 1000MG INJ,35.15,35.15,2.11,29.88,24 HCPCS,J0131,"Injection, acetaminophen, not otherwise specified,10 mg ",35.15,35.15,0.05,0.81,10 HCPCS,J0132,ACETYLCYSTEIN 6000MG INJ,4089.1,4089.1,245.35,3475.74,24 HCPCS,J0132,"Injection, acetylcysteine, 100 mg ",4089.1,4089.1,0.51,5.86,10 HCPCS,J0133,ACYCLOVIR 5 MG/ML INJ,46.4,46.4,2.78,39.44,24 HCPCS,J0133,ACYCLOVIR 500 MG INJ,1961.86,1961.86,117.71,1667.58,24 HCPCS,J0133,"Injection, acyclovir, 5 mg ",,,0.02,0.32,10 HCPCS,J0134,505FK ACETAMIN 1000MGINJ,32.78,32.78,1.97,27.86,24 HCPCS,J0134,"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg ",32.78,32.78,0.05,0.41,10 HCPCS,J0136,505BB ACETAMIN 1000MGINJ,33.31,33.31,2.0,28.31,24 HCPCS,J0136,"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg ",33.31,33.31,0.05,0.16,10 HCPCS,J0137,"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg ",,,0.06,0.22,10 HCPCS,J0138,"Injection, acetaminophen 10 mg and ibuprofen 3 mg ",,,0.09,0.69,10 HCPCS,J0139,"Injection, adalimumab, 1 mg ",,,4920.11,6777.7,5 HCPCS,J0153,ADENOSINE 6 MG INJ,4247.33,4247.33,254.84,3610.23,24 HCPCS,J0153,ADENOSINE 90 MG INJ,6272.25,6272.25,376.33,5331.41,24 HCPCS,J0153,"Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) ",,,0.48,3.4,10 HCPCS,J0162,"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg ",,,0.43,1.38,7 HCPCS,J0163,505EN EPI NACL 5MG INJ,300.0,300.0,18.0,255.0,27 HCPCS,J0163,"Injection, epinephrine in sodium chloride (endo), 0.1 mg ",300.0,300.0,0.3,2.94,7 HCPCS,J0164,"Injection, epinephrine in sodium chloride (baxter), 0.1 mg ",,,0.92,2.48,7 HCPCS,J0165,EPI NOS 1 MG INJ,65.06,65.06,3.36,63.07,48 HCPCS,J0165,EPI NOS 10 MG MDV,248.02,248.02,14.88,210.82,24 HCPCS,J0165,EPI NOS 30 MG MDV,555.5,555.5,33.33,472.18,24 HCPCS,J0165,EPI NOS 40MCG/ML INJ,19.05,19.05,1.14,16.19,24 HCPCS,J0165,"Injection, epinephrine, not otherwise specified, 0.1 mg ",,,0.31,2.13,10 HCPCS,J0166,"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg ",,,0.84,7.11,10 HCPCS,J0167,"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg ",,,1.08,2.31,10 HCPCS,J0168,"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg ",,,2.88,6.8,10 HCPCS,J0169,ADRENALIN 1 MG INJ,49.2,49.2,2.95,41.82,24 HCPCS,J0169,"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg ",49.2,49.2,0.87,6.83,10 HCPCS,J0172,"Injection, aducanumab-avwa, 2 mg ",,,14.47,18.66,3 HCPCS,J0174,"Lecanemab-irmb, for intravenous injection, 1 mg ",,,1.34,4.15,10 HCPCS,J0175,"Injection, donanemab-azbt, 2 mg ",,,4.14,12.92,10 HCPCS,J0177,"Injection, aflibercept hd, 1 mg ",,,301.18,1027.16,10 HCPCS,J0178,"Injection, aflibercept, 1 mg ",,,731.89,2497.5,10 HCPCS,J0179,"Injection, brolucizumab-dbll, 1 mg ",,,353.07,1080.11,10 HCPCS,J0180,"Injection, agalsidase beta, 1 mg ",,,227.58,718.41,10 HCPCS,J0184,"Injection, amisulpride, 1 mg ",,,17.56,30.36,8 HCPCS,J0185,"Injection, aprepitant, 1 mg ",,,1.69,7.29,10 HCPCS,J0185,"Injection, aprepitant, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0200,"Injection, alatrofloxacin mesylate, 100 mg ",,,41.12,53.01,3 HCPCS,J0202,"Injection, alemtuzumab, 1 mg ",,,2440.42,7614.98,10 HCPCS,J0205,"Injection, alglucerase, per 10 units ",,,101.71,131.13,3 HCPCS,J0206,"Injection, allopurinol sodium, 1 mg ",,,3.81,17.47,10 HCPCS,J0207,"Injection, amifostine, 500 mg ",,,2162.96,3409.66,8 HCPCS,J0208,"Injection, sodium thiosulfate (pedmark), 100 mg ",,,178.3,290.66,8 HCPCS,J0209,505HP NA THIOS 100MG JW,4.28,4.28,0.26,3.64,25 HCPCS,J0209,505HP NA THIOS 100MGINJ,4.28,4.28,0.26,3.64,25 HCPCS,J0209,505HP NA THIOS 12.5GINJ,534.28,534.28,32.06,454.14,25 HCPCS,J0209,"Injection, sodium thiosulfate (hope), 100 mg ",,,1.53,2.56,8 HCPCS,J0210,"Injection, methyldopate hcl, up to 250 mg ",,,78.4,132.29,8 HCPCS,J0211,"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote) ",1046.52,1046.52,3.76,6.24,8 HCPCS,J0211,NITHIODOT 300MG/12.5GINJ,1046.52,1046.52,62.79,889.54,20 HCPCS,J0215,"Injection, alefacept, 0.5 mg ",,,100.77,129.92,3 HCPCS,J0216,"Injection, alfentanil hydrochloride, 500 micrograms ",,,5.61,8.02,8 HCPCS,J0217,"Injection, velmanase alfa-tycv, 1 mg ",,,465.23,1450.96,10 HCPCS,J0218,"Injection, olipudase alfa-rpcp, 1 mg ",,,395.6,1228.72,10 HCPCS,J0219,"Injection, avalglucosidase alfa-ngpt, 4 mg ",,,81.2,251.94,10 HCPCS,J0220,"Injection, alglucosidase alfa, 10 mg, not otherwise specified ",,,144.67,644.9,8 HCPCS,J0221,"Injection, alglucosidase alfa, (lumizyme), 10 mg ",,,207.51,644.65,10 HCPCS,J0222,"Injection, patisiran, 0.1 mg ",,,100.9,311.44,10 HCPCS,J0223,"Injection, givosiran, 0.5 mg ",,,120.98,365.63,10 HCPCS,J0224,"Injection, lumasiran, 0.5 mg ",,,327.72,1026.79,10 HCPCS,J0225,"Injection, vutrisiran, 1 mg ",,,5019.27,15549.64,10 HCPCS,J0248,"Injection, remdesivir, 1 mg ",3708.39,3708.39,6.9,21.0,10 HCPCS,J0248,REMDESIVIR 100 MG INJ,3708.39,3708.39,222.5,3152.13,19 HCPCS,J0256,"Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg ",,,5.14,16.19,10 HCPCS,J0257,"Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg ",,,5.66,17.82,10 HCPCS,J0270,ALPROSTADIL 500 MCG INJ,1988.03,1988.03,119.28,1689.83,41 HCPCS,J0270,"Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",1988.03,1988.03,0.37,32.7,8 HCPCS,J0275,"Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",,,62.24,167.45,8 HCPCS,J0278,AMIKACIN 10 MG/ML INJ,82.09,82.09,4.93,69.78,24 HCPCS,J0278,AMIKACIN SULFATE 500 MG,185.6,185.6,11.14,157.76,24 HCPCS,J0278,"Injection, amikacin sulfate, 100 mg ",,,0.61,2.94,10 HCPCS,J0280,AMINOPHYLLIN 250 MG INJ,92.34,92.34,5.54,78.49,24 HCPCS,J0280,AMINOPHYLLIN 500 MG INJ,71.39,71.39,4.28,60.68,24 HCPCS,J0280,"Injection, aminophyllin, up to 250 mg ",,,1.33,25.9,10 HCPCS,J0281,AMINOCAPROIC 5 G INJ,49.79,49.79,2.99,42.32,24 HCPCS,J0281,"Injection, aminocaproic acid, 1 gram ",49.79,49.79,1.57,4.68,10 HCPCS,J0282,AMIODARONE 1.8 MG/ML INJ,10.7,10.7,0.64,9.09,24 HCPCS,J0282,AMIODARONE 150 MG INJ,142.77,142.77,8.57,121.35,24 HCPCS,J0282,AMIODARONE 450 MG INJ,28.56,28.56,1.71,24.28,24 HCPCS,J0282,"Injection, amiodarone hydrochloride, 30 mg ",,,0.39,1.59,10 HCPCS,J0283,"Injection, amiodarone hydrochloride (nexterone), 30 mg ",109.27,109.27,2.49,10.34,10 HCPCS,J0283,NEXTERONE AMIO 150MG INJ,109.27,109.27,6.56,92.88,24 HCPCS,J0285,AMPHOTERICN B 50 MG INJ,302.19,302.19,18.13,256.86,24 HCPCS,J0285,"Injection, amphotericin b, 50 mg ",302.19,302.19,44.33,106.45,10 HCPCS,J0287,"Injection, amphotericin b lipid complex, 10 mg ",,,19.6,32.14,8 HCPCS,J0288,"Injection, amphotericin b cholesteryl sulfate complex, 10 mg ",,,33.88,43.68,3 HCPCS,J0289,AMPHOT B LIPOSOME 10 MG,124.92,124.92,7.5,106.18,19 HCPCS,J0289,AMPHOT B LIPOSOME 10MGJW,124.92,124.92,7.5,106.18,19 HCPCS,J0289,AMPHOT B LIPOSOME 50 MG,625.8,625.8,37.55,531.93,19 HCPCS,J0289,"Injection, amphotericin b liposome, 10 mg ",,,22.81,133.46,10 HCPCS,J0290,AMPICILLIN 1 G INJ,393.8,393.8,23.63,334.73,24 HCPCS,J0290,AMPICILLIN 100 MG/ML INJ,69.0,69.0,4.14,58.65,24 HCPCS,J0290,AMPICILLIN 2 G INJ,765.0,765.0,45.9,650.25,24 HCPCS,J0290,AMPICILLIN 250 MG/ML INJ,98.74,98.74,5.92,83.93,24 HCPCS,J0290,AMPICILLIN 500 MG INJ,159.42,159.42,9.57,135.51,24 HCPCS,J0290,"Injection, ampicillin sodium, 500 mg ",,,0.64,6.48,10 HCPCS,J0291,"Injection, plazomicin, 5 mg ",,,3.51,11.14,10 HCPCS,J0295,AMPICIL/SULBAC 1.5 G INJ,429.49,429.49,25.77,365.07,24 HCPCS,J0295,AMPICIL/SULBAC 3 G INJ,659.11,659.11,39.55,560.24,24 HCPCS,J0295,"Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm ",,,1.35,8.48,10 HCPCS,J0300,"Injection, amobarbital, up to 125 mg ",,,359.19,583.22,8 HCPCS,J0330,"Injection, succinylcholine chloride, up to 20 mg ",17.28,17.28,2.03,3.59,8 HCPCS,J0330,SUCCINYLCHOL 200 MG MDV,17.28,17.28,1.04,14.69,25 HCPCS,J0348,ANIDULAFUNGIN 100 MG INJ,775.42,775.42,46.53,659.11,24 HCPCS,J0348,"Injection, anidulafungin, 1 mg ",775.42,775.42,0.49,4.86,10 HCPCS,J0349,"Injection, rezafungin, 1 mg ",,,10.79,33.13,10 HCPCS,J0349,REZAFUNGIN 1 MG INJ,53.71,53.71,3.22,45.65,19 HCPCS,J0349,REZAFUNGIN 200 MG INJ,10740.6,10740.6,644.44,9129.51,19 HCPCS,J0360,HYDRALAZINE 20 MG INJ,726.93,726.93,43.62,617.89,24 HCPCS,J0360,"Injection, hydralazine hcl, up to 20 mg ",726.93,726.93,4.29,17.5,10 HCPCS,J0364,"Injection, apomorphine hydrochloride, 1 mg ",,,71.87,110.48,8 HCPCS,J0365,"Injection, aprotonin, 10,000 kiu ",,,6.41,8.27,3 HCPCS,J0380,"Injection, metaraminol bitartrate, per 10 mg ",,,2.76,3.56,3 HCPCS,J0391,"Injection, artesunate, 1 mg ",,,88.38,155.59,8 HCPCS,J0395,"Injection, arbutamine hcl, 1 mg ",,,387.2,499.2,3 HCPCS,J0400,"Injection, aripiprazole, intramuscular, 0.25 mg ",,,1.39,2.34,8 HCPCS,J0401,"Injection, aripiprazole (abilify maintena), 1 mg ",,,7.27,22.59,10 HCPCS,J0402,"Injection, aripiprazole (abilify asimtufii), 1 mg ",,,6.02,18.81,10 HCPCS,J0456,AZITHROMYCIN 2 MG/ML INJ,69.0,69.0,4.14,58.65,24 HCPCS,J0456,AZITHROMYCIN 500 MG INJ,214.15,214.15,12.85,182.03,24 HCPCS,J0456,"Injection, azithromycin, 500 mg ",,,1.94,11.21,10 HCPCS,J0457,AZTREONAM 1 G INJ,148.54,148.54,8.91,126.26,24 HCPCS,J0457,AZTREONAM 100 MG INJ,14.85,14.85,0.89,12.62,24 HCPCS,J0457,AZTREONAM 100 MG INJ JW,14.85,14.85,0.89,12.62,24 HCPCS,J0457,AZTREONAM 2 G INJ,297.13,297.13,17.83,252.56,24 HCPCS,J0457,AZTREONAM 20 MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J0457,"Injection, aztreonam, 100 mg ",,,2.29,8.33,10 HCPCS,J0458,"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg) ",,,1.68,4.46,7 HCPCS,J0461,ATROPINE 0.5MG / 5ML INJ,310.33,310.33,18.62,263.78,24 HCPCS,J0461,ATROPINE 1 MG/1 ML INJ,38.12,38.12,2.29,32.4,24 HCPCS,J0461,ATROPINE 1 MG/10 ML INJ,253.41,253.41,15.2,215.4,24 HCPCS,J0461,"Injection, atropine sulfate, 0.01 mg ",,,0.1,0.22,10 HCPCS,J0462,ATROPINE NTE 1MG INJ,38.12,38.12,2.29,32.4,27 HCPCS,J0462,"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg ",38.12,38.12,0.1,0.41,7 HCPCS,J0463,"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg ",,,0.01,0.01,2 HCPCS,J0470,"Injection, dimercaprol, per 100 mg ",,,110.58,170.2,8 HCPCS,J0475,"Injection, baclofen, 10 mg ",,,178.05,548.56,10 HCPCS,J0476,"Injection, baclofen, 50 mcg for intrathecal trial ",,,54.34,209.66,10 HCPCS,J0480,"Injection, basiliximab, 20 mg ",,,4812.31,14578.11,10 HCPCS,J0485,"Injection, belatacept, 1 mg ",,,3.89,12.14,10 HCPCS,J0490,"Injection, belimumab, 10 mg ",,,57.19,174.75,10 HCPCS,J0491,"Injection, anifrolumab-fnia, 1 mg ",,,18.31,56.47,10 HCPCS,J0500,DICYCLOMINE 20 MG INJ,694.8,694.8,41.69,590.58,24 HCPCS,J0500,"Injection, dicyclomine hcl, up to 20 mg ",694.8,694.8,9.37,75.82,10 HCPCS,J0515,BENZTROPINE 2 MG INJ,2397.3,2397.3,143.84,2037.71,24 HCPCS,J0515,"Injection, benztropine mesylate, per 1 mg ",2397.3,2397.3,13.52,53.88,10 HCPCS,J0517,"Injection, benralizumab, 1 mg ",,,163.36,524.57,10 HCPCS,J0517,"Injection, benralizumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0520,"Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg ",,,10.87,14.01,3 HCPCS,J0525,"Injection, cefotetan disodium, 10 mg ",,,0.47,0.65,5 HCPCS,J0558,"Injection, penicillin g benzathine and penicillin g procaine, 100,000 units ",,,9.02,54.19,10 HCPCS,J0561,"Injection, penicillin g benzathine, 100,000 units ",,,24.7,91.42,10 HCPCS,J0561,PEN G BEN 1200000 U INJ,1621.6,1621.6,97.3,1378.36,19 HCPCS,J0561,PEN G BEN 2400000 U INJ,2265.25,2265.25,135.91,1925.46,19 HCPCS,J0561,PEN G BEN 600000 U INJ,983.9,983.9,59.03,836.32,19 HCPCS,J0565,"Injection, bezlotoxumab, 10 mg ",,,39.83,124.27,10 HCPCS,J0567,"Injection, cerliponase alfa, 1 mg ",,,174.64,373.09,8 HCPCS,J0567,"Injection, cerliponase alfa, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0570,"Buprenorphine implant, 74.2 mg ",,,2444.9,3367.98,5 HCPCS,J0571,BUPRENORPHINE 2 MG PO,9.51,9.51,0.57,8.08,25 HCPCS,J0571,BUPRENORPHINE 8 MG PO,17.84,17.84,1.07,15.16,25 HCPCS,J0571,"Buprenorphine, oral, 1 mg ",,,0.65,2.97,8 HCPCS,J0572,"Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine ",,,5.55,7.64,5 HCPCS,J0573,"Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine ",,,9.94,13.69,5 HCPCS,J0574,"Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine ",,,9.94,13.69,5 HCPCS,J0575,"Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine ",,,19.87,27.38,5 HCPCS,J0577,"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy ",,,417.21,1319.23,10 HCPCS,J0578,"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy ",,,1668.84,5276.89,10 HCPCS,J0582,"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg ",,,0.13,0.41,7 HCPCS,J0583,BIVALIRUDIN 250 MG INJ,11551.06,11551.06,693.06,9818.4,24 HCPCS,J0583,"Injection, bivalirudin, 1 mg ",11551.06,11551.06,0.12,3.73,10 HCPCS,J0584,"Injection, burosumab-twza 1 mg ",,,498.72,1502.5,10 HCPCS,J0584,"Injection, burosumab-twza 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0585,"Injection, onabotulinumtoxina, 1 unit ",11096.59,11096.59,6.51,19.53,10 HCPCS,J0585,ONABOTULINUMTOXA 100 U,11096.59,11096.59,665.8,9432.1,19 HCPCS,J0586,"Injection, abobotulinumtoxina, 5 units ",,,8.9,28.61,10 HCPCS,J0587,"Injection, rimabotulinumtoxinb, 100 units ",,,13.28,41.62,10 HCPCS,J0588,"Injection, incobotulinumtoxin a, 1 unit ",,,5.29,16.57,10 HCPCS,J0589,"Injection, daxibotulinumtoxina-lanm, 1 unit ",,,3.09,11.42,10 HCPCS,J0591,"Injection, deoxycholic acid, 1 mg ",,,29.28,47.74,8 HCPCS,J0592,"Injection, buprenorphine hydrochloride, 0.1 mg ",,,4.17,12.89,10 HCPCS,J0593,"Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered) ",,,86.85,271.25,10 HCPCS,J0594,"injection, busulfan, 1 mg ",,,0.68,22.71,10 HCPCS,J0594,"injection, busulfan, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0595,BUTORPHANOL 2 MG INJ,61.86,61.86,3.71,52.58,24 HCPCS,J0595,"Injection, butorphanol tartrate, 1 mg ",61.86,61.86,1.78,15.76,10 HCPCS,J0596,"Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units ",,,36.68,114.63,10 HCPCS,J0597,"Injection, c-1 esterase inhibitor (human), berinert, 10 units ",,,76.05,236.68,10 HCPCS,J0598,"Injection, c-1 esterase inhibitor (human), cinryze, 10 units ",,,65.5,205.08,10 HCPCS,J0599,"Injection, c-1 esterase inhibitor (human), (haegarda), 10 units ",,,18.17,38.5,8 HCPCS,J0599,"Injection, c-1 esterase inhibitor (human), (haegarda), 10 units Chemotherapy Drugs",,,,,0 HCPCS,J0600,"Injection, edetate calcium disodium, up to 1000 mg ",,,6102.87,20138.26,10 HCPCS,J0601,"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis) ",,,0.02,0.03,8 HCPCS,J0602,"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis) ",,,0.1,0.16,8 HCPCS,J0603,"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis) ",,,0.22,0.32,8 HCPCS,J0604,"Cinacalcet, oral, 1 mg, (for esrd on dialysis) ",,,0.05,1.59,8 HCPCS,J0605,"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis) ",,,0.35,0.56,8 HCPCS,J0606,"Injection, etelcalcetide, 0.1 mg ",,,6.41,13.14,8 HCPCS,J0607,"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis) ",,,0.08,0.12,8 HCPCS,J0608,"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis) ",,,0.12,0.19,8 HCPCS,J0609,"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis) ",,,0.22,0.34,8 HCPCS,J0612,CA GLUC NOS 1 G INJ,52.23,52.23,3.13,44.4,24 HCPCS,J0612,CA GLUC NOS 2 G INJ,215.82,215.82,12.95,183.45,24 HCPCS,J0612,CA GLUC NOS 20MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J0612,"Injection, calcium gluconate, not otherwise specified, 10 mg ",,,0.03,0.14,10 HCPCS,J0613,505WG CAGLUC 2G/100MLINJ,98.57,98.57,5.91,83.78,24 HCPCS,J0613,505WGCAGL1G/NACL 50MLINJ,46.75,46.75,2.81,39.74,24 HCPCS,J0613,"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg ",,,0.07,0.25,10 HCPCS,J0614,"Injection, treosulfan, 50 mg ",,,31.61,97.17,7 HCPCS,J0615,"Calcium acetate, oral, 23 mg (for esrd on dialysis) ",,,0.04,0.06,8 HCPCS,J0616,"Injection, metoprolol tartrate, 1 mg ",17.44,17.44,0.13,0.41,10 HCPCS,J0616,METOPROLOL 5 MG INJ,17.44,17.44,1.05,14.82,24 HCPCS,J0618,CALCIUM CHL 1 G INJ,64.98,64.98,2.97,68.43,50 HCPCS,J0618,"Injection, calcium chloride, 2 mg ",,,0.06,0.09,8 HCPCS,J0620,"Injection, calcium glycerophosphate and calcium lactate, per 10 ml ",,,21.66,34.51,8 HCPCS,J0630,CALCITONIN SALMON 400 U,24370.38,24370.38,1462.22,20714.82,41 HCPCS,J0630,"Injection, calcitonin salmon, up to 400 units ",24370.38,24370.38,1974.72,7298.29,8 HCPCS,J0636,"Injection, calcitriol, 0.1 mcg ",,,1.47,3.15,8 HCPCS,J0637,"Injection, caspofungin acetate, 5 mg ",,,3.58,31.02,10 HCPCS,J0638,"Injection, canakinumab, 1 mg ",,,149.57,439.92,10 HCPCS,J0640,"Injection, leucovorin calcium, per 50 mg ",42.83,42.83,3.59,12.32,10 HCPCS,J0640,LEUCOVORIN CA 50 MG INJ,42.83,42.83,2.57,36.41,24 HCPCS,J0641,"Injection, levoleucovorin, not otherwise specified, 0.5 mg ",,,0.05,0.65,10 HCPCS,J0642,"Injection, levoleucovorin (khapzory), 0.5 mg ",,,1.29,6.13,10 HCPCS,J0650,"Injection, levothyroxine sodium, not otherwise specified, 10 mcg ",,,7.41,28.73,10 HCPCS,J0650,LEVOTHY NOS 100 MCG INJ,546.5,546.5,32.79,464.52,24 HCPCS,J0650,LEVOTHY NOS 10MCG/MLINJ,17.63,17.63,1.06,14.99,24 HCPCS,J0651,505FK LEVOTH100MCG/MLINJ,532.15,532.15,31.93,452.33,19 HCPCS,J0651,505FK LEVOTHY 100MCGINJ,532.15,532.15,31.93,452.33,19 HCPCS,J0651,"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg ",,,6.96,24.14,10 HCPCS,J0652,"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg ",,,6.32,20.39,10 HCPCS,J0654,"Injection, liothyronine, 1 mcg ",,,87.06,119.93,5 HCPCS,J0665,BUPIVACAINE 15 MG INJ,197.82,197.82,11.87,168.15,24 HCPCS,J0665,BUPIVACAINE 150 MG INJ,23.03,23.03,1.38,19.58,24 HCPCS,J0665,BUPIVACAINE 25 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J0665,BUPIVACAINE 50 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J0665,BUPIVACAINE 75 MG INJ,13.299999999999999,13.299999999999999,0.45,16.18,48 HCPCS,J0665,"Injection, bupivicaine, not otherwise specified, 0.5 mg ",,,0.01,0.05,10 HCPCS,J0666,BUPIVAC LIPO 133MG INJ,1468.12,1468.12,88.09,1247.9,19 HCPCS,J0666,BUPIVAC LIPO 266MG INJ,2392.1,2392.1,143.53,2033.29,19 HCPCS,J0666,"Injection, bupivacaine liposome, 1 mg ",,,1.41,4.65,10 HCPCS,J0668,"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg ",,,1.49,2.05,5 HCPCS,J0670,"Injection, mepivacaine hydrochloride, per 10 ml ",41.64,41.64,2.59,11.92,10 HCPCS,J0670,MEPIVACAIN 1% 30 ML INJ,41.64,41.64,2.5,35.39,24 HCPCS,J0675,CARBOPROST 0.25MG INJ,398.51,398.51,23.91,338.73,23 HCPCS,J0675,"Injection, carboprost tromethamine, 0.1 mg ",398.51,398.51,98.78,136.08,5 HCPCS,J0681,"Injection, ceftobiprole medocaril sodium, 3 mg ",,,2.1,2.89,5 HCPCS,J0687,505WG CEFAZOL 2 G INJ,25.23,25.23,1.51,21.45,24 HCPCS,J0687,505WG CEFAZOL 3 G INJ,26.55,26.55,1.59,22.57,24 HCPCS,J0687,"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg ",,,0.74,3.24,10 HCPCS,J0688,505HK CEFAZOLIN 3 G INJ,26.03,26.03,1.56,22.13,24 HCPCS,J0688,"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg ",26.03,26.03,0.85,3.13,10 HCPCS,J0689,505BXCEFAZ 1G/D5W50MLINJ,40.58,40.58,2.43,34.49,24 HCPCS,J0689,"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg ",40.58,40.58,1.24,4.15,10 HCPCS,J0690,CEFAZOLIN 1 G INJ,155.75,155.75,1.06,249.79,48 HCPCS,J0690,CEFAZOLIN 2 G INJ,105.21,105.21,1.42,158.77,48 HCPCS,J0690,CEFAZOLIN 20 MG/ML INJ,38.07,38.07,2.28,32.36,24 HCPCS,J0690,CEFAZOLIN 330MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J0690,"Injection, cefazolin sodium, 500 mg ",,,0.74,2.62,10 HCPCS,J0691,"Injection, lefamulin, 1 mg ",,,1.57,2.18,8 HCPCS,J0692,CEFEPIME 280 MG/ML INJ,241.51,241.51,14.49,205.28,24 HCPCS,J0692,CEFEPIME 40 MG/ML INJ,33.31,33.31,2.0,28.31,24 HCPCS,J0692,CEFEPIME HCL 1 G INJ,315.27,315.27,18.92,267.98,24 HCPCS,J0692,CEFEPIME HCL 2 G INJ,1806.01,1806.01,108.36,1535.11,24 HCPCS,J0692,"Injection, cefepime hydrochloride, 500 mg ",,,1.27,4.64,10 HCPCS,J0694,CEFOXITIN 1 G INJ,535.38,535.38,32.12,455.07,24 HCPCS,J0694,CEFOXITIN 2 G INJ,924.42,924.42,55.47,785.76,24 HCPCS,J0694,CEFOXITIN 40 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J0694,"Injection, cefoxitin sodium, 1 gm ",,,3.56,16.01,10 HCPCS,J0695,CEFTOLOZ TAZOBACT 1.5 G,1597.81,1597.81,95.87,1358.14,19 HCPCS,J0695,"Injection, ceftolozane 50 mg and tazobactam 25 mg ",1597.81,1597.81,8.84,28.49,10 HCPCS,J0696,CEFTRIAXONE 1 G INJ,553.22,553.22,33.19,470.24,24 HCPCS,J0696,CEFTRIAXONE 2 G INJ,360.48,360.48,21.63,306.41,24 HCPCS,J0696,CEFTRIAXONE 250 MG INJ,17.63,17.63,1.06,14.99,24 HCPCS,J0696,CEFTRIAXONE 350MG/ML INJ,14.28,14.28,0.86,12.14,24 HCPCS,J0696,CEFTRIAXONE 40 MG/ML INJ,28.56,28.56,1.71,24.28,24 HCPCS,J0696,CEFTRIAXONE 500MG INJ,530.61,530.61,31.84,451.02,24 HCPCS,J0696,"Injection, ceftriaxone sodium, per 250 mg ",,,0.43,6.83,10 HCPCS,J0697,CEFUROXIME 1.5 G INJ,69.0,69.0,4.14,58.65,24 HCPCS,J0697,CEFUROXIME 750 MG INJ,69.0,69.0,4.14,58.65,24 HCPCS,J0697,"Injection, sterile cefuroxime sodium, per 750 mg ",,,1.99,7.14,10 HCPCS,J0698,CEFOTAXIME 300 MG/ML INJ,207.01,207.01,12.42,175.96,25 HCPCS,J0698,"Injection, cefotaxime sodium, per gm ",207.01,207.01,4.06,31.2,8 HCPCS,J0699,CEFIDEROCOL 1 G INJ,1137.38,1137.38,68.24,966.77,19 HCPCS,J0699,CEFIDEROCOL 10 MG INJ,11.9,11.9,0.71,10.12,19 HCPCS,J0699,CEFIDEROCOL 10 MG INJJW,11.9,11.9,0.71,10.12,19 HCPCS,J0699,"Injection, cefiderocol, 10 mg ",,,2.42,7.49,10 HCPCS,J0701,505BX CEFEP 1 G INJ,246.22,246.22,14.77,209.29,24 HCPCS,J0701,505BX CEFEP 2G/100ML INJ,246.22,246.22,14.77,209.29,24 HCPCS,J0701,"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg ",,,5.91,18.31,10 HCPCS,J0702,BETAMETHSN 6 MG INJ,97.56,97.56,5.85,82.93,24 HCPCS,J0702,"Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg ",97.56,97.56,6.97,21.5,10 HCPCS,J0703,505BB CEFEPI 2G/50ML INJ,155.21,155.21,9.31,131.93,24 HCPCS,J0703,"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg ",155.21,155.21,4.89,15.82,10 HCPCS,J0706,"Injection, caffeine citrate, 5 mg ",,,2.7,3.84,8 HCPCS,J0710,"Injection, cephapirin sodium, up to 1 gm ",,,3.36,4.34,3 HCPCS,J0712,CEFTAROLINE 400 MG INJ,1469.32,1469.32,88.16,1248.92,19 HCPCS,J0712,CEFTAROLINE 600 MG INJ,1469.32,1469.32,88.16,1248.92,19 HCPCS,J0712,"Injection, ceftaroline fosamil, 10 mg ",,,4.25,13.23,10 HCPCS,J0713,CEFTAZIDIME 1 G INJ,326.41,326.41,19.58,277.45,24 HCPCS,J0713,CEFTAZIDIME 2 G INJ,845.9,845.9,50.75,719.01,24 HCPCS,J0713,CEFTAZIDIME 40 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J0713,CEFTAZIDME 280 MG/ML INJ,55.92,55.92,3.36,47.53,24 HCPCS,J0713,"Injection, ceftazidime, per 500 mg ",,,1.41,5.12,10 HCPCS,J0714,CEFTA/AVI 0.5/0.125G INJ,1130.24,1130.24,67.81,960.7,19 HCPCS,J0714,CEFTA/AVI 0.5/0.125G JW,1130.24,1130.24,67.81,960.7,19 HCPCS,J0714,CEFTAZ/AVIBACT 2.5 G INJ,4523.34,4523.34,271.4,3844.84,19 HCPCS,J0714,"Injection, ceftazidime and avibactam, 0.5 g/0.125 g ",,,104.75,327.44,10 HCPCS,J0715,"Injection, ceftizoxime sodium, per 500 mg ",,,12.68,16.35,3 HCPCS,J0716,"Injection, centruroides immune f(ab)2, up to 120 milligrams ",,,9098.93,16695.18,8 HCPCS,J0717,"Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",,,3.79,25.6,10 HCPCS,J0720,"Injection, chloramphenicol sodium succinate, up to 1 gm ",,,52.72,154.81,8 HCPCS,J0725,"Injection, chorionic gonadotropin, per 1,000 usp units ",,,15.17,58.27,10 HCPCS,J0735,CLONIDINE HCL 1 MG INJ,195.36,195.36,11.72,166.06,24 HCPCS,J0735,"Injection, clonidine hydrochloride, 1 mg ",195.36,195.36,17.92,55.13,10 HCPCS,J0736,CLINDAMY/D5W 600MG/50ML,90.13,90.13,5.41,76.61,24 HCPCS,J0736,CLINDAMYCIN 12 MG/ML INJ,33.31,33.31,2.0,28.31,24 HCPCS,J0736,CLINDAMYCIN 600 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J0736,CLINDAMYCIN 900 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J0736,"Injection, clindamycin phosphate, 300 mg ",,,1.86,5.21,10 HCPCS,J0737,505BX CLINDA 300MG NS 50,31.1,31.1,1.87,26.43,24 HCPCS,J0737,505BX CLINDA 600MG NS 50,43.17,43.17,2.59,36.69,24 HCPCS,J0737,505BX CLINDA 900MG NS 50,53.97,53.97,3.24,45.87,24 HCPCS,J0737,"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg ",,,2.32,11.69,10 HCPCS,J0738,"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) ",,,16.1,48.49,7 HCPCS,J0739,"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) ",,,7.15,21.93,10 HCPCS,J0740,CIDOFOVIR 375 MG INJ,6965.86,6965.86,417.95,5920.98,19 HCPCS,J0740,"Injection, cidofovir, 375 mg ",6965.86,6965.86,560.79,1651.67,10 HCPCS,J0741,"Injection, cabotegravir and rilpivirine, 2mg/3mg ",,,24.18,73.73,10 HCPCS,J0742,IMIPEN/CILAS/RELEB 1.25G,35918.27,35918.27,2155.1,30530.53,24 HCPCS,J0742,IMIPEN4/CILA4/REL2 INJJW,287.3,287.3,17.24,244.21,24 HCPCS,J0742,IMIPEN4/CILAS4/RELE2 INJ,287.3,287.3,17.24,244.21,24 HCPCS,J0742,"Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg ",,,2.6,8.14,10 HCPCS,J0743,CILASTATN/IMIPINM 500 MG,53.92,53.92,3.24,45.83,24 HCPCS,J0743,"Injection, cilastatin sodium; imipenem, per 250 mg ",53.92,53.92,6.32,21.75,10 HCPCS,J0744,CIPRO/D5W 200MG/100ML IV,630.56,630.56,37.83,535.98,24 HCPCS,J0744,CIPRO/D5W 400MG/200ML IV,950.59,950.59,57.04,808.0,24 HCPCS,J0744,"Injection, ciprofloxacin for intravenous infusion, 200 mg ",,,0.76,7.24,10 HCPCS,J0745,"Injection, codeine phosphate, per 30 mg ",,,2.47,3.4,5 HCPCS,J0750,"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) ",,,0.49,5.43,10 HCPCS,J0751,"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv) ",,,71.44,222.36,10 HCPCS,J0752,"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) ",,,621.96,1349.62,7 HCPCS,J0759,"Injection, clevidipine butyrate, 1 mg ",,,2.84,9.59,7 HCPCS,J0770,COLISTIMETHATE 150MG INJ,2416.34,2416.34,144.98,2053.89,24 HCPCS,J0770,"Injection, colistimethate sodium, up to 150 mg ",2416.34,2416.34,14.27,43.55,10 HCPCS,J0775,"Injection, collagenase, clostridium histolyticum, 0.01 mg ",,,78.35,228.26,10 HCPCS,J0780,"Injection, prochlorperazine, up to 10 mg ",372.38,372.38,3.33,33.59,10 HCPCS,J0780,PROCHLORPERAZ 10 MG INJ,372.38,372.38,22.34,316.52,24 HCPCS,J0791,"Injection, crizanlizumab-tmca, 5 mg ",,,129.94,404.29,10 HCPCS,J0795,"Injection, corticorelin ovine triflutate, 1 microgram ",,,22.53,29.05,3 HCPCS,J0799,"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified ",,,0.57,0.78,5 HCPCS,J0801,"Injection, corticotropin (acthar gel), up to 40 units ",,,4094.26,13064.78,10 HCPCS,J0802,"Injection, corticotropin (ani), up to 40 units ",,,3571.35,11067.64,10 HCPCS,J0834,COSYNTROPIN 0.25 MG INJ,2048.72,2048.72,122.92,1741.41,24 HCPCS,J0834,"Injection, cosyntropin, 0.25 mg ",2048.72,2048.72,16.26,164.57,10 HCPCS,J0840,ANTIVENIN CROFAB 1 G INJ,33776.37,33776.37,2026.58,28709.91,19 HCPCS,J0840,"Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram ",33776.37,33776.37,1841.02,8634.6,10 HCPCS,J0841,"Injection, crotalidae immune f(ab')2 (equine), 120 mg ",,,2391.2,3294.0,8 HCPCS,J0841,"Injection, crotalidae immune f(ab')2 (equine), 120 mg Chemotherapy Drugs",,,,,0 HCPCS,J0850,"Injection, cytomegalovirus immune globulin intravenous (human), per vial ",,,1808.61,5645.45,10 HCPCS,J0870,"Injection, imetelstat, 1 mg ",,,58.17,177.9,10 HCPCS,J0872,"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg ",,,0.05,1.0,10 HCPCS,J0873,"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg ",,,0.03,0.16,10 HCPCS,J0874,"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg ",,,0.06,0.22,10 HCPCS,J0875,DALBAVANCIN 500 MG INJ,8519.96,8519.96,511.2,7241.97,19 HCPCS,J0875,"Injection, dalbavancin, 5 mg ",8519.96,8519.96,15.0,48.52,10 HCPCS,J0877,505HS DAPTOMY 350 MG INJ,169.42,169.42,10.17,144.01,24 HCPCS,J0877,"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg ",169.42,169.42,0.05,0.19,10 HCPCS,J0878,DAPTOMYCIN 350MG INJ,390.0,390.0,23.4,331.5,24 HCPCS,J0878,DAPTOMYCIN 500 MG INJ,6955.15,6955.15,417.31,5911.88,24 HCPCS,J0878,"Injection, daptomycin, 1 mg ",,,0.03,1.51,10 HCPCS,J0879,"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis) ",,,0.35,0.75,8 HCPCS,J0881,"Injection, darbepoetin alfa, 1 microgram (non-esrd use) ",,,3.07,9.08,10 HCPCS,J0881,"Injection, darbepoetin alfa, 1 microgram (non-esrd use) Chemotherapy Drugs",,,,,0 HCPCS,J0882,"Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) ",,,3.07,9.36,10 HCPCS,J0883,ARGATROB 250MG NESRD INJ,2584.33,2584.33,155.06,2196.68,19 HCPCS,J0883,ARGATROB 50MG NESRD INJ,357.1,357.1,21.43,303.54,19 HCPCS,J0883,"Injection, argatroban, 1 mg (for non-esrd use) ",,,1.01,3.73,10 HCPCS,J0884,ARGATROB 250MG ESRD INJ,2584.33,2584.33,155.06,2196.68,24 HCPCS,J0884,ARGATROB 50MG ESRD INJ,357.1,357.1,21.43,303.54,24 HCPCS,J0884,"Injection, argatroban, 1 mg (for esrd on dialysis) ",,,1.01,3.73,10 HCPCS,J0885,"Injection, epoetin alfa, (for non-esrd use), 1000 units ",,,7.31,43.09,10 HCPCS,J0885,"Injection, epoetin alfa, (for non-esrd use), 1000 units Chemotherapy Drugs",,,,,0 HCPCS,J0887,"Injection, epoetin beta, 1 microgram, (for esrd on dialysis) ",,,1.03,4.86,10 HCPCS,J0888,"Injection, epoetin beta, 1 microgram, (for non esrd use) ",,,1.03,4.86,10 HCPCS,J0889,"Daprodustat, oral, 1 mg, (for esrd on dialysis) ",,,9.66,12.45,3 HCPCS,J0890,"Injection, peginesatide, 0.1 mg (for esrd on dialysis) ",,,19.84,29.08,8 HCPCS,J0891,505AC ARGAT 1MG NESRDINJ,21.62,21.62,1.3,18.38,20 HCPCS,J0891,505AC ARGAT 50MG NESRD,1081.88,1081.88,64.91,919.6,20 HCPCS,J0891,505ACARGAT1MG NESRDINJJW,21.62,21.62,1.3,18.38,20 HCPCS,J0891,"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use) ",,,1.23,12.6,8 HCPCS,J0892,505AC ARGAT 1MG ESRD INJ,21.62,21.62,1.3,18.38,25 HCPCS,J0892,505AC ARGAT 1MGESRDINJJW,21.62,21.62,1.3,18.38,25 HCPCS,J0892,505AC ARGAT 50MG ESRDINJ,1081.88,1081.88,64.91,919.6,25 HCPCS,J0892,"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis) ",,,1.23,12.6,8 HCPCS,J0893,505SP DECITABIN 50MG INJ,272.57,272.57,16.35,231.68,25 HCPCS,J0893,"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg ",272.57,272.57,1.89,4.75,8 HCPCS,J0894,"Injection, decitabine, 1 mg ",,,1.0,21.38,10 HCPCS,J0894,"Injection, decitabine, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J0895,DEFEROX MESY 500 MG INJ,110.65,110.65,6.64,94.05,24 HCPCS,J0895,"Injection, deferoxamine mesylate, 500 mg ",110.65,110.65,8.58,28.14,10 HCPCS,J0896,"Injection, luspatercept-aamt, 0.25 mg ",,,42.75,130.92,10 HCPCS,J0897,"Injection, denosumab, 1 mg ",,,29.51,91.23,10 HCPCS,J0898,505AU ARGAT 1MG NESRDINJ,21.31,21.31,1.28,18.11,24 HCPCS,J0898,505AU ARGAT 50MG NESRD,1065.45,1065.45,63.93,905.63,24 HCPCS,J0898,505AU ARGAT1MGNESRDINJJW,21.31,21.31,1.28,18.11,24 HCPCS,J0898,"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use) ",,,1.38,6.56,10 HCPCS,J0899,505AU ARGAT 1MG ESRD INJ,21.31,21.31,1.28,18.11,24 HCPCS,J0899,505AU ARGAT 50MG ESRD,1065.45,1065.45,63.93,905.63,24 HCPCS,J0899,"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis) ",,,1.38,6.56,10 HCPCS,J0901,"Vadadustat, oral, 1 mg (for esrd on dialysis) ",,,0.14,0.44,10 HCPCS,J0911,"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis) ",,,16.46,26.52,8 HCPCS,J0945,"Injection, brompheniramine maleate, per 10 mg ",,,1.94,2.5,3 HCPCS,J1000,"Injection, depo-estradiol cypionate, up to 5 mg ",,,25.97,146.36,10 HCPCS,J1010,"Injection, methylprednisolone acetate, 1 mg ",,,0.11,0.41,10 HCPCS,J1010,METHYLPRED ACE 40 MG INJ,361.68,361.68,21.7,307.43,24 HCPCS,J1010,METHYLPRED ACE 80 MG INJ,631.75,631.75,37.91,536.99,24 HCPCS,J1050,"Injection, medroxyprogesterone acetate, 1 mg ",1186.16,1186.16,0.41,1.78,8 HCPCS,J1050,MEDRXYPRGTRN 150MG INJ,1186.16,1186.16,71.17,1008.24,25 HCPCS,J1071,"Injection, testosterone cypionate, 1 mg ",111.83,111.83,0.02,0.09,10 HCPCS,J1071,TESTOSTERNE CY 200MG INJ,111.83,111.83,6.71,95.06,24 HCPCS,J1072,"Injection, testosterone cypionate (azmiro), 1 mg ",,,0.14,4.15,10 HCPCS,J1073,"Testosterone pellet, implant, 75 mg ",,,207.7,286.12,5 HCPCS,J1095,"Injection, dexamethasone 9 percent, intraocular, 1 microgram ",,,2.33,3.65,8 HCPCS,J1096,"Dexamethasone, lacrimal ophthalmic insert, 0.1 mg ",,,92.55,363.72,10 HCPCS,J1097,"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml ",,,227.85,375.52,8 HCPCS,J1100,DEXAMETH NA PHOS 10 MG,117.78,117.78,7.07,100.11,24 HCPCS,J1100,DEXAMTH NAP 4MG/ML INJ,43.425,43.425,2.0,45.51,48 HCPCS,J1100,"Injection, dexamethasone sodium phosphate, 1 mg ",,,0.04,0.37,10 HCPCS,J1105,"Dexmedetomidine, oral, 1 mcg ",,,1.16,1.59,5 HCPCS,J1110,DIHYDROERGOT 1 MG INJ,3138.5,3138.5,188.31,2667.72,24 HCPCS,J1110,"Injection, dihydroergotamine mesylate, per 1 mg ",3138.5,3138.5,54.89,524.12,10 HCPCS,J1120,ACETAZOLAMIDE 500 MG INJ,1273.01,1273.01,76.38,1082.06,24 HCPCS,J1120,"Injection, acetazolamide sodium, up to 500 mg ",1273.01,1273.01,24.36,67.96,10 HCPCS,J1130,"Injection, diclofenac sodium, 0.5 mg ",,,0.41,0.66,8 HCPCS,J1160,DIGOXIN 0.5 MG INJ,92.79,92.79,5.57,78.87,24 HCPCS,J1160,"Injection, digoxin, up to 0.5 mg ",92.79,92.79,7.45,12.48,10 HCPCS,J1162,DIG IMMUNE FAB 40 MG INJ,14493.27,14493.27,869.6,12319.28,19 HCPCS,J1162,"Injection, digoxin immune fab (ovine), per vial ",14493.27,14493.27,5166.99,15501.97,10 HCPCS,J1163,DILTIAZEM 125 MG INJ,74.36,74.36,4.46,63.21,24 HCPCS,J1163,DILTIAZEM 25 MG INJ,24.62,24.62,1.48,20.93,24 HCPCS,J1163,"Injection, diltiazem hydrochloride, 0.5 mg ",,,0.04,0.12,10 HCPCS,J1164,"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg ",,,0.18,0.18,2 HCPCS,J1165,"Injection, phenytoin sodium, per 50 mg ",,,0.42,2.06,10 HCPCS,J1165,PHENYTOIN 100 MG INJ,67.81,67.81,4.07,57.64,24 HCPCS,J1165,PHENYTOIN 250 MG INJ,139.2,139.2,8.35,118.32,24 HCPCS,J1171,HYDROMORPH 0.2 MG INJ,16.0,16.0,0.96,13.6,24 HCPCS,J1171,HYDROMORPH 0.5 MG INJ,27.99,27.99,1.68,23.79,24 HCPCS,J1171,HYDROMORPH 1 MG INJ,54.82,54.82,3.29,46.6,24 HCPCS,J1171,HYDROMORPH 10 MG INJ,51.025000000000006,51.025000000000006,2.06,57.5,48 HCPCS,J1171,HYDROMORPH 2 MG INJ,51.32,51.32,3.08,43.62,24 HCPCS,J1171,HYDROMORPH 50 MG INJ,34.4,34.4,2.06,29.24,24 HCPCS,J1171,"Injection, hydromorphone, 0.1 mg ",,,0.1,0.28,10 HCPCS,J1190,"Injection, dexrazoxane hydrochloride, per 250 mg ",,,49.74,511.81,10 HCPCS,J1190,"Injection, dexrazoxane hydrochloride, per 250 mg Chemotherapy Drugs",,,,,0 HCPCS,J1200,DIPHENHYDRAMNE 50 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J1200,"Injection, diphenhydramine hcl, up to 50 mg ",51.16,51.16,0.69,2.81,10 HCPCS,J1201,"Injection, cetirizine hydrochloride, 0.5 mg ",,,16.92,51.17,10 HCPCS,J1202,"Miglustat, oral, 65 mg ",,,64.21,106.67,8 HCPCS,J1203,"Injection, cipaglucosidase alfa-atga, 5 mg ",,,92.4,280.18,10 HCPCS,J1205,CHLOROTHIAZIDE 500MG INJ,9836.67,9836.67,590.2,8361.17,24 HCPCS,J1205,"Injection, chlorothiazide sodium, per 500 mg ",9836.67,9836.67,46.92,388.02,10 HCPCS,J1212,DMSO 50% 50 ML INJ,3679.67,3679.67,220.78,3127.72,19 HCPCS,J1212,"Injection, dmso, dimethyl sulfoxide, 50%, 50 ml ",3679.67,3679.67,748.98,2317.85,10 HCPCS,J1230,"Injection, methadone hcl, up to 10 mg ",,,14.71,71.48,10 HCPCS,J1240,"Injection, dimenhydrinate, up to 50 mg ",,,7.72,27.08,10 HCPCS,J1245,"Injection, dipyridamole, per 10 mg ",,,5.37,12.04,10 HCPCS,J1250,DOBUTAM 250 MG 20 ML INJ,140.39,140.39,8.42,119.33,24 HCPCS,J1250,DOBUTAM 250MG/250ML INJ,74.95,74.95,4.5,63.71,24 HCPCS,J1250,DOBUTAM 500MG/250ML INJ,580.59,580.59,34.84,493.5,24 HCPCS,J1250,DOBUTAMINE 1000 MG INJ,77.98,77.98,4.68,66.28,24 HCPCS,J1250,DOBUTAMNE 2000MCG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J1250,"Injection, dobutamine hydrochloride, per 250 mg ",,,5.59,24.9,10 HCPCS,J1260,"Injection, dolasetron mesylate, 10 mg ",,,11.45,19.25,8 HCPCS,J1265,DOPA 800MG/D5W 250ML INJ,46.4,46.4,2.78,39.44,20 HCPCS,J1265,DOPAM 400MG/D5W250ML INJ,731.68,731.68,43.9,621.93,20 HCPCS,J1265,DOPAMINE 1600 MCG/ML INJ,17.28,17.28,1.04,14.69,20 HCPCS,J1265,DOPAMINE 3200 MCG/ML INJ,11.9,11.9,0.71,10.12,20 HCPCS,J1265,DOPAMINE 400 MG INJ,102.315,102.315,2.78,134.5,40 HCPCS,J1265,"Injection, dopamine hcl, 40 mg ",,,0.49,2.06,16 HCPCS,J1267,"Injection, doripenem, 10 mg ",,,2.13,2.75,3 HCPCS,J1270,"Injection, doxercalciferol, 1 mcg ",,,0.31,1.86,10 HCPCS,J1271,DOXYCYCL HYCL 100 MG INJ,133.38,133.38,8.0,113.37,24 HCPCS,J1271,"Injection, doxycycline hyclate, 1 mg ",133.38,133.38,0.09,0.37,10 HCPCS,J1290,"Injection, ecallantide, 1 mg ",,,578.75,1809.57,10 HCPCS,J1299,"Injection, eculizumab, 2 mg ",,,44.7,139.68,10 HCPCS,J1301,"Injection, edaravone, 1 mg ",,,15.18,58.78,10 HCPCS,J1301,"Injection, edaravone, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J1302,"Injection, sutimlimab-jome, 10 mg ",,,19.64,56.5,10 HCPCS,J1303,"Injection, ravulizumab-cwvz, 10 mg ",,,223.68,702.59,10 HCPCS,J1304,"Injection, tofersen, 1 mg ",,,160.01,484.66,10 HCPCS,J1305,"Injection, evinacumab-dgnb, 5mg ",,,197.63,592.02,10 HCPCS,J1306,"Injection, inclisiran, 1 mg ",,,12.61,38.53,10 HCPCS,J1307,"Injection, crovalimab-akkz, 10 mg ",,,551.51,1655.78,10 HCPCS,J1308,FAMOTIDINE 2 MG/ML INJ,16.0,16.0,0.96,13.6,24 HCPCS,J1308,FAMOTIDINE 20 MG INJ,17.28,17.28,1.04,14.69,24 HCPCS,J1308,"Injection, famotidine, 0.25 mg ",,,0.01,0.03,10 HCPCS,J1320,"Injection, amitriptyline hcl, up to 20 mg ",,,5.42,6.99,3 HCPCS,J1322,"Injection, elosulfase alfa, 1 mg ",,,311.95,957.22,10 HCPCS,J1323,"Injection, elranatamab-bcmm, 1 mg ",,,186.79,578.17,10 HCPCS,J1324,"Injection, enfuvirtide, 1 mg ",,,1.29,2.12,8 HCPCS,J1325,EPOPROSTENOL 0.5 MG INJ,138.95,138.95,8.34,118.11,24 HCPCS,J1325,EPOPROSTENOL 1.5 MG INJ,310.81,310.81,18.65,264.19,24 HCPCS,J1325,"Injection, epoprostenol, 0.5 mg ",,,14.88,50.54,10 HCPCS,J1326,"Injection, zolbetuximab-clzb, 2 mg ",,,33.65,104.71,10 HCPCS,J1327,EPTIFIBATIDE 20 MG INJ,3214.64,3214.64,192.88,2732.44,25 HCPCS,J1327,EPTIFIBATIDE 5 MG INJ,683.95,683.95,41.04,581.36,25 HCPCS,J1327,EPTIFIBATIDE 5 MG INJ JW,683.95,683.95,41.04,581.36,25 HCPCS,J1327,EPTIFIBATIDE 75 MG INJ,10099.6,10099.6,605.98,8584.66,25 HCPCS,J1327,"Injection, eptifibatide, 5 mg ",,,26.23,41.04,8 HCPCS,J1330,"Injection, ergonovine maleate, up to 0.2 mg ",,,11.79,15.19,3 HCPCS,J1335,ERTAPENEM SOD 1 G INJ,2170.07,2170.07,130.2,1844.56,24 HCPCS,J1335,"Injection, ertapenem sodium, 500 mg ",2170.07,2170.07,7.22,91.04,10 HCPCS,J1364,ERYTHRO LACTO 500 MG INJ,418.78,418.78,25.13,355.96,24 HCPCS,J1364,"Injection, erythromycin lactobionate, per 500 mg ",418.78,418.78,91.23,234.16,10 HCPCS,J1370,"Injection, esomeprazole sodium, 1 mg ",,,1.06,1.46,5 HCPCS,J1380,"Injection, estradiol valerate, up to 10 mg ",,,7.19,24.06,10 HCPCS,J1410,ESTROGEN CONJ 25 MG INJ,2525.8,2525.8,151.55,2146.93,19 HCPCS,J1410,"Injection, estrogen conjugated, per 25 mg ",2525.8,2525.8,391.72,1219.11,10 HCPCS,J1412,"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10°13 vector genomes ",,,22114.31,30463.59,5 HCPCS,J1426,"Injection, casimersen, 10 mg ",,,312.35,509.18,8 HCPCS,J1427,"Injection, viltolarsen, 10 mg ",,,110.09,179.49,8 HCPCS,J1428,"Injection, eteplirsen, 10 mg ",,,313.6,509.18,8 HCPCS,J1429,"Injection, golodirsen, 10 mg ",,,312.35,509.18,8 HCPCS,J1430,"Injection, ethanolamine oleate, 100 mg ",,,518.63,1620.9,10 HCPCS,J1434,"Injection, fosaprepitant (focinvez), 1 mg ",,,2.55,8.95,10 HCPCS,J1435,"Injection, estrone, per 1 mg ",,,0.58,0.75,3 HCPCS,J1437,"Injection, ferric derisomaltose, 10 mg ",,,2.72,59.12,10 HCPCS,J1438,"Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",,,1067.34,3245.08,8 HCPCS,J1439,"Injection, ferric carboxymaltose, 1 mg ",,,1.1,3.75,10 HCPCS,J1440,"Fecal microbiota, live - jslm, 1 ml ",,,64.32,199.77,10 HCPCS,J1442,FILGRASTIM 1 MCG INJ,10.7,10.7,0.64,9.09,19 HCPCS,J1442,"Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram ",10.7,10.7,1.02,3.09,10 HCPCS,J1443,"Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron ",,,0.07,0.09,3 HCPCS,J1444,"Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron ",,,0.07,0.09,3 HCPCS,J1445,"Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron ",,,0.44,0.56,3 HCPCS,J1447,"Injection, tbo-filgrastim, 1 microgram ",,,0.25,2.21,10 HCPCS,J1447,"Injection, tbo-filgrastim, 1 microgram Chemotherapy Drugs",,,,,0 HCPCS,J1447,TBO-FILGRASTIM 1 MCG INJ,5.95,5.95,0.36,5.06,19 HCPCS,J1447,TBO-FILGRASTIM 1MCGINJJW,5.95,5.95,0.36,5.06,19 HCPCS,J1447,TBO-FILGRASTM 300MCG INJ,1944.01,1944.01,116.64,1652.41,19 HCPCS,J1447,TBO-FILGRASTM 480MCG INJ,3111.13,3111.13,186.67,2644.46,19 HCPCS,J1448,"Injection, trilaciclib, 1mg ",,,5.49,16.82,10 HCPCS,J1449,"Injection, eflapegrastim-xnst, 0.1 mg ",,,38.96,91.69,10 HCPCS,J1450,FLUCO 200MG/NACL100MLINJ,3504.93,3504.93,210.3,2979.19,24 HCPCS,J1450,FLUCO 400MG/NACL200MLINJ,5125.35,5125.35,307.52,4356.55,24 HCPCS,J1450,FLUCON 100MG/NACL50MLINJ,46.4,46.4,2.78,39.44,24 HCPCS,J1450,FLUCONAZOLE 2 MG/ML INJ,14.28,14.28,0.86,12.14,24 HCPCS,J1450,"Injection fluconazole, 200 mg ",,,3.87,17.04,10 HCPCS,J1451,FOMEPIZOLE 15 MG INJ,74.95,74.95,4.5,63.71,20 HCPCS,J1451,FOMEPIZOLE 15 MG INJJW,74.95,74.95,4.5,63.71,20 HCPCS,J1451,FOMEPIZOLE 1500 MG INJ,10552.89,10552.89,633.17,8969.96,20 HCPCS,J1451,"Injection, fomepizole, 15 mg ",,,20.33,40.22,8 HCPCS,J1452,"Injection, fomivirsen sodium, intraocular, 1.65 mg ",,,513.04,661.44,3 HCPCS,J1453,"Injection, fosaprepitant, 1 mg ",,,0.11,3.89,10 HCPCS,J1454,"Injection, fosnetupitant 235 mg and palonosetron 0.25 mg ",,,524.18,1891.81,10 HCPCS,J1454,"Injection, fosnetupitant 235 mg and palonosetron 0.25 mg Chemotherapy Drugs",,,,,0 HCPCS,J1455,FOSCARNET 1000 MG INJ,816.16,816.16,48.97,693.74,24 HCPCS,J1455,FOSCARNET 1000 MG INJJW,816.16,816.16,48.97,693.74,24 HCPCS,J1455,FOSCARNET 6000 MG INJ,4895.73,4895.73,293.74,4161.37,24 HCPCS,J1455,"Injection, foscarnet sodium, per 1000 mg ",,,8.36,209.55,10 HCPCS,J1456,"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg ",,,0.04,5.4,10 HCPCS,J1457,"Injection, gallium nitrate, 1 mg ",,,5.03,6.49,3 HCPCS,J1458,"Injection, galsulfase, 1 mg ",,,513.6,1577.19,10 HCPCS,J1459,IVIG PRIVIGEN 10G,10556.4,10556.4,633.38,8972.94,19 HCPCS,J1459,IVIG PRIVIGEN 20G,21112.8,21112.8,1266.77,17945.88,19 HCPCS,J1459,IVIG PRIVIGEN 40G,8445.12,8445.12,506.71,7178.35,19 HCPCS,J1459,IVIG PRIVIGEN 500 MGJW,817.34,817.34,49.04,694.74,19 HCPCS,J1459,IVIG PRIVIGEN 500MG,817.34,817.34,49.04,694.74,19 HCPCS,J1459,IVIG PRIVIGEN 5G,5278.2,5278.2,316.69,4486.47,19 HCPCS,J1459,"Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg ",,,49.53,157.34,10 HCPCS,J1460,IG GAMMA GLOBULIN 10MLIM,2339.28,2339.28,140.36,1988.39,19 HCPCS,J1460,"Injection, gamma globulin, intramuscular, 1 cc ",2339.28,2339.28,48.95,151.07,10 HCPCS,J1551,"Injection, immune globulin (cutaquig), 100 mg ",,,13.93,44.34,10 HCPCS,J1552,"Injection, immune globulin (alyglo), 500 mg ",,,123.13,441.48,10 HCPCS,J1553,"Injection, immune globulin (yimmugo), 100 mg ",,,24.32,24.32,2 HCPCS,J1554,"Injection, immune globulin (asceniv), 500 mg ",,,500.93,1549.11,10 HCPCS,J1555,"Injection, immune globulin (cuvitru), 100 mg ",,,17.58,54.88,10 HCPCS,J1556,"Injection, immune globulin (bivigam), 500 mg ",,,79.44,241.08,10 HCPCS,J1557,"Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg ",,,64.65,194.91,10 HCPCS,J1558,"Injection, immune globulin (xembify), 100 mg ",,,15.37,50.63,10 HCPCS,J1559,"Injection, immune globulin (hizentra), 100 mg ",,,14.52,44.05,10 HCPCS,J1560,"Injection, gamma globulin, intramuscular, over 10 cc ",,,160.29,802.79,10 HCPCS,J1561,IVIG GAMUNEX-C 10G,3629.44,3629.44,217.77,3085.02,19 HCPCS,J1561,IVIG GAMUNEX-C 20G,7258.94,7258.94,435.54,6170.1,19 HCPCS,J1561,IVIG GAMUNEX-C 40G,14517.88,14517.88,871.07,12340.2,19 HCPCS,J1561,IVIG GAMUNEX-C 5G,1814.72,1814.72,108.88,1542.51,19 HCPCS,J1561,"Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg ",,,49.73,149.85,10 HCPCS,J1566,"Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg ",,,57.55,254.9,10 HCPCS,J1568,"Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg ",,,47.04,176.44,10 HCPCS,J1569,"Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg ",,,49.08,149.14,10 HCPCS,J1570,GANCICLOVIR 5 MG/ML INJ,114.21,114.21,6.85,97.08,24 HCPCS,J1570,GANCICLOVIR 500 MG INJ,1885.72,1885.72,113.14,1602.86,24 HCPCS,J1570,"Injection, ganciclovir sodium, 500 mg ",,,34.05,123.61,10 HCPCS,J1571,"Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml ",,,70.23,229.07,10 HCPCS,J1572,"Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg ",,,130.68,168.48,3 HCPCS,J1573,"Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml ",,,70.23,229.07,10 HCPCS,J1574,"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg ",,,97.61,159.12,8 HCPCS,J1575,"Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin ",,,18.8,57.38,10 HCPCS,J1576,"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg ",,,73.83,232.32,10 HCPCS,J1580,GENTAMI 100MG/NS 50MLINJ,17.63,17.63,1.06,14.99,24 HCPCS,J1580,GENTAMI 100MG/NS100MLINJ,51.84,51.84,3.11,44.06,24 HCPCS,J1580,GENTAMI 120MG/NS100MLINJ,51.84,51.84,3.11,44.06,24 HCPCS,J1580,GENTAMI 80MG/NS 100MLINJ,185.6,185.6,11.14,157.76,24 HCPCS,J1580,GENTAMICIN 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J1580,GENTAMICIN 20 MG INJ,192.74,192.74,11.56,163.83,24 HCPCS,J1580,GENTAMICIN 80 MG INJ,99.93,99.93,6.0,84.94,24 HCPCS,J1580,GENTAMICIN 800 MG MDV,123.77,123.77,7.43,105.2,24 HCPCS,J1580,"Injection, garamycin, gentamicin, up to 80 mg ",,,1.93,8.17,10 HCPCS,J1595,"Injection, glatiramer acetate, 20 mg ",,,154.28,252.42,8 HCPCS,J1596,GLYCOPYRROL 0.2 MG INJ,69.9,69.9,4.19,59.42,24 HCPCS,J1596,GLYCOPYRROL 0.4 MG INJ,117.98,117.98,7.08,100.28,24 HCPCS,J1596,"Injection, glycopyrrolate, 0.1 mg ",,,0.37,1.84,10 HCPCS,J1597,"Injection, glycopyrrolate (glyrx-pf), 0.1 mg ",,,1.35,5.09,10 HCPCS,J1598,"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg ",,,1.34,6.91,10 HCPCS,J1599,"Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg ",,,162.03,474.18,8 HCPCS,J1600,"Injection, gold sodium thiomalate, up to 50 mg ",,,28.48,94.07,8 HCPCS,J1602,"Injection, golimumab, 1 mg, for intravenous use ",,,11.29,95.45,10 HCPCS,J1610,GLUCAGON 1 MG INJ,2519.85,2519.85,151.19,2141.87,19 HCPCS,J1610,"Injection, glucagon hydrochloride, per 1 mg ",2519.85,2519.85,146.33,610.86,10 HCPCS,J1611,505FK GLUCAGON 1 MG INJ,1174.74,1174.74,70.48,998.53,19 HCPCS,J1611,"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg ",1174.74,1174.74,135.0,486.94,10 HCPCS,J1612,"Injection, glucagon (gvoke), 0.01 mg ",,,2.37,6.86,7 HCPCS,J1626,"Injection, granisetron hydrochloride, 100 mcg ",,,0.16,1.43,10 HCPCS,J1627,"Injection, granisetron, extended-release, 0.1 mg ",,,3.88,16.69,10 HCPCS,J1628,"Injection, guselkumab, 1 mg ",,,67.81,293.19,10 HCPCS,J1628,"Injection, guselkumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J1630,HALOPERIDOL LACT 5MG INJ,296.24,296.24,17.77,251.8,24 HCPCS,J1630,"Injection, haloperidol, up to 5 mg ",296.24,296.24,0.79,10.72,10 HCPCS,J1631,"Injection, haloperidol decanoate, per 50 mg ",,,6.07,32.51,10 HCPCS,J1632,"Injection, brexanolone, 1 mg ",,,145.43,237.09,8 HCPCS,J1640,"Injection, hemin, 1 mg ",,,35.31,106.61,10 HCPCS,J1642,"Injection, heparin sodium, (heparin lock flush), per 10 units ",,,0.02,0.08,10 HCPCS,J1643,505PF HEPARIN 1000 U INJ,19.04,19.04,1.14,16.18,24 HCPCS,J1643,"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units ",19.04,19.04,0.65,9.39,10 HCPCS,J1644,HEPAR 10000U/10ML MDV,28.56,28.56,1.71,24.28,24 HCPCS,J1644,HEPAR 1000U/NS 500ML INJ,83.28,83.28,5.0,70.79,24 HCPCS,J1644,HEPAR 25000U/D5W250MLINJ,53.6,53.6,3.22,45.56,24 HCPCS,J1644,HEPAR 30000U/30ML MDV,26.99,26.99,1.62,22.94,24 HCPCS,J1644,HEPARIN 10000U / 1ML INJ,51.16,51.16,3.07,43.49,24 HCPCS,J1644,HEPARIN 1000U / 1 ML INJ,28.56,28.56,1.71,24.28,24 HCPCS,J1644,HEPARIN 2000 U/NS 1L INJ,245.08,245.08,14.7,208.32,24 HCPCS,J1644,HEPARIN 5000U / 1ML INJ,113.02,113.02,6.78,96.07,24 HCPCS,J1644,"Injection, heparin sodium, per 1000 units ",,,0.22,0.69,10 HCPCS,J1645,"Injection, dalteparin sodium, per 2500 iu ",,,15.86,56.28,10 HCPCS,J1650,ENOXAPARIN 100 MG INJ,2750.65,2750.65,165.04,2338.05,24 HCPCS,J1650,ENOXAPARIN 120 MG INJ,2430.62,2430.62,145.84,2066.03,24 HCPCS,J1650,ENOXAPARIN 150 MG INJ,187.97,187.97,11.28,159.77,24 HCPCS,J1650,ENOXAPARIN 30 MG INJ,1039.82,1039.82,62.39,883.85,24 HCPCS,J1650,ENOXAPARIN 40 MG INJ,1391.98,1391.98,83.52,1183.18,24 HCPCS,J1650,ENOXAPARIN 60 MG INJ,2594.8,2594.8,155.69,2205.58,24 HCPCS,J1650,ENOXAPARIN 80 MG INJ,2750.65,2750.65,165.04,2338.05,24 HCPCS,J1650,"Injection, enoxaparin sodium, 10 mg ",,,0.54,3.29,10 HCPCS,J1652,FONDAPARINUX 10 MG INJ,120.55,120.55,7.23,102.47,24 HCPCS,J1652,FONDAPARINUX 2.5 MG INJ,1913.08,1913.08,114.78,1626.12,24 HCPCS,J1652,FONDAPARINUX 5 MG INJ,3711.95,3711.95,222.72,3155.16,24 HCPCS,J1652,FONDAPARINUX 7.5 MG INJ,3711.95,3711.95,222.72,3155.16,24 HCPCS,J1652,"Injection, fondaparinux sodium, 0.5 mg ",,,0.8,6.29,10 HCPCS,J1655,"Injection, tinzaparin sodium, 1000 iu ",,,8.45,10.89,3 HCPCS,J1670,"Injection, tetanus immune globulin, human, up to 250 units ",8031.85,8031.85,558.12,1800.4,10 HCPCS,J1670,TETANUS IG HUM 250 U INJ,8031.85,8031.85,481.91,6827.07,19 HCPCS,J1675,"Injection, histrelin acetate, 10 micrograms ",,,1.98,2.56,3 HCPCS,J1700,"Injection, hydrocortisone acetate, up to 25 mg ",,,1.57,2.03,3 HCPCS,J1710,"Injection, hydrocortisone sodium phosphate, up to 50 mg ",,,11.33,14.6,3 HCPCS,J1720,HYDROCORT SUCC 100MG INJ,139.86,139.86,5.72,156.75,48 HCPCS,J1720,HYDROCORT SUCC 250MG INJ,449.71,449.71,26.98,382.25,24 HCPCS,J1720,HYDROCORTISN 1 MG/ML INJ,15.47,15.47,0.93,13.15,24 HCPCS,J1720,"Injection, hydrocortisone sodium succinate, up to 100 mg ",,,19.48,66.14,10 HCPCS,J1726,"Injection, hydroxyprogesterone caproate, (makena), 10 mg ",,,,,0 HCPCS,J1729,"Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg ",,,33.66,43.4,3 HCPCS,J1736,"Injection, meloxicam (delova), 1 mg ",,,1.98,2.73,5 HCPCS,J1737,"Injection, meloxicam (azurity), 1 mg ",,,1.98,2.73,5 HCPCS,J1738,"Injection, meloxicam, 1 mg ",,,6.12,9.98,8 HCPCS,J1740,"Injection, ibandronate sodium, 1 mg ",,,9.06,96.1,10 HCPCS,J1741,"Injection, ibuprofen, 100 mg ",,,3.18,9.48,10 HCPCS,J1742,IBUTILIDE FUM 1 MG INJ,9220.39,9220.39,553.22,7837.33,20 HCPCS,J1742,"Injection, ibutilide fumarate, 1 mg ",9220.39,9220.39,751.68,1159.81,8 HCPCS,J1743,"Injection, idursulfase, 1 mg ",,,558.22,1742.71,10 HCPCS,J1744,"Injection, icatibant, 1 mg ",,,172.62,494.1,8 HCPCS,J1745,INFLIXIMAB 10 MG INJJW,736.44,736.44,44.19,625.97,19 HCPCS,J1745,INFLIXIMAB 100 MG INJ,12448.12,12448.12,746.89,10580.9,19 HCPCS,J1745,"Injection, infliximab, excludes biosimilar, 10 mg ",,,31.04,293.25,10 HCPCS,J1746,"Injection, ibalizumab-uiyk, 10 mg ",,,77.68,247.7,10 HCPCS,J1746,"Injection, ibalizumab-uiyk, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J1747,"Injection, spesolimab-sbzo, 1 mg ",,,65.73,205.08,10 HCPCS,J1748,"Injection, infliximab-dyyb (zymfentra), 10 mg ",,,508.82,852.42,8 HCPCS,J1749,"Injection, iloprost, 0.1 mcg ",,,5.71,396.6,10 HCPCS,J1750,"Injection, iron dextran, 50 mg ",,,18.11,56.25,10 HCPCS,J1756,IRON SUCROSE 100 MG INJ,471.13,471.13,28.27,400.46,24 HCPCS,J1756,"Injection, iron sucrose, 1 mg ",471.13,471.13,0.22,0.94,10 HCPCS,J1786,"Injection, imiglucerase, 10 units ",,,42.83,135.06,10 HCPCS,J1790,DROPERIDOL 2.5 MG INJ,24.52,24.52,1.47,20.84,24 HCPCS,J1790,DROPERIDOL 5 MG INJ,42.83,42.83,2.57,36.41,24 HCPCS,J1790,"Injection, droperidol, up to 5 mg ",,,3.27,16.72,10 HCPCS,J1800,"Injection, propranolol hcl, up to 1 mg ",,,13.64,31.01,8 HCPCS,J1800,PROPRANOL 0.2 MG/ML INJ,16.07,16.07,0.96,13.66,25 HCPCS,J1800,PROPRANOLOL 1 MG INJ,297.43,297.43,17.85,252.82,25 HCPCS,J1805,ESMOLO 2.5G/NACL250MLINJ,503.87,503.87,30.23,428.29,24 HCPCS,J1805,ESMOLOL 100 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J1805,ESMOLOL 2G/NACL100ML INJ,304.9,304.9,18.29,259.16,24 HCPCS,J1805,"Injection, esmolol hydrochloride, 10 mg ",,,0.24,0.87,10 HCPCS,J1806,"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg ",,,0.2,1.46,10 HCPCS,J1807,"Injection, ethacrynate sodium, 1 mg ",,,75.07,103.41,5 HCPCS,J1808,FOLIC ACID 1 MG INJ,16.0,16.0,0.96,13.6,24 HCPCS,J1808,FOLIC ACID 50 MG MDV,117.21,117.21,7.03,99.63,24 HCPCS,J1808,"Injection, folic acid, 0.1 mg ",,,0.05,0.19,10 HCPCS,J1809,"Injection, fosdenopterin, 0.1 mg ",,,17.59,51.0,7 HCPCS,J1811,"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units ",,,8.76,24.21,10 HCPCS,J1812,"Insulin (fiasp), per 5 units ",,,2.82,4.62,8 HCPCS,J1813,"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units ",,,15.1,47.64,10 HCPCS,J1814,"Insulin (lyumjev), per 5 units ",,,2.69,4.37,8 HCPCS,J1815,ADMELOG 20 U INJ,17.28,17.28,1.04,14.69,41 HCPCS,J1815,HUMALOG 75/25 20 U INJ,38.07,38.07,2.28,32.36,41 HCPCS,J1815,HUMULIN 70/30 20 U INJ,24.98,24.98,1.5,21.23,41 HCPCS,J1815,HUMULIN N 20 U INJ,38.07,38.07,2.28,32.36,41 HCPCS,J1815,HUMULIN R 20 U INJ,24.98,24.98,1.5,21.23,41 HCPCS,J1815,"Injection, insulin, per 5 units ",,,0.27,0.72,8 HCPCS,J1815,MYXREDLIN 100U/100ML INJ,70.29,70.29,4.22,59.75,41 HCPCS,J1815,NOVOLIN R 5 U INJ,16.65,16.65,1.0,14.15,41 HCPCS,J1815,SEMGLEE 20 U INJ,82.09,82.09,4.93,69.78,41 HCPCS,J1817,"Insulin for administration through dme (i.e., insulin pump) per 50 units ",,,3.13,12.83,10 HCPCS,J1823,"Injection, inebilizumab-cdon, 1 mg ",,,495.55,1542.62,10 HCPCS,J1826,"Injection, interferon beta-1a, 30 mcg ",,,3393.62,6872.24,8 HCPCS,J1830,"Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",,,870.61,2261.28,8 HCPCS,J1833,"Injection, isavuconazonium, 1 mg ",,,1.67,3.37,8 HCPCS,J1834,ISONIAZID 1000MG MDV,551.43,551.43,33.09,468.72,23 HCPCS,J1834,"Injection, isoniazid, 1 mg ",551.43,551.43,0.57,0.78,5 HCPCS,J1836,"Injection, metronidazole, 10 mg ",,,0.03,0.09,10 HCPCS,J1836,METRON500MG/NACL100MLINJ,57.11,57.11,3.43,48.54,24 HCPCS,J1836,METRONIDAZOL 5 MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J1836,METRONIDAZOLE 250 MG INJ,48.0,48.0,2.88,40.8,24 HCPCS,J1837,"Injection, posaconazole, 1 mg ",,,0.35,1.05,7 HCPCS,J1837,POSACONAZOLE 1MG INJ,5.0,5.0,0.3,4.25,27 HCPCS,J1837,POSACONAZOLE 1MG INJ JW,5.0,5.0,0.3,4.25,27 HCPCS,J1837,POSACONAZOLE 300MG INJ,1500.71,1500.71,90.04,1275.6,27 HCPCS,J1885,"Injection, ketorolac tromethamine, per 15 mg ",,,0.34,1.09,10 HCPCS,J1885,KETOROLAC 15 MG INJ,28.56,28.56,1.71,24.28,19 HCPCS,J1885,KETOROLAC 30 MG INJ,65.44,65.44,3.93,55.62,19 HCPCS,J1885,KETOROLAC 60 MG INJ,255.93,255.93,15.36,217.54,19 HCPCS,J1920,"Injection, labetalol hydrochloride, 5 mg ",,,0.26,1.22,10 HCPCS,J1920,LABETALOL 100 MG MDV,17.63,17.63,1.06,14.99,24 HCPCS,J1920,LABETALOL 20 MG INJ,19.21,19.21,1.15,16.33,24 HCPCS,J1921,"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg ",,,0.9,4.31,10 HCPCS,J1930,"Injection, lanreotide, 1 mg ",,,35.72,177.79,10 HCPCS,J1931,"Injection, laronidase, 0.1 mg ",,,39.95,124.43,10 HCPCS,J1932,"Injection, lanreotide, (cipla), 1 mg ",,,32.19,183.01,10 HCPCS,J1938,FUROSEMIDE 10 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J1938,FUROSEMIDE 100 MG INJ,89.23,89.23,5.35,75.85,24 HCPCS,J1938,FUROSEMIDE 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J1938,FUROSEMIDE 20 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J1938,FUROSEMIDE 40 MG INJ,53.54,53.54,3.21,45.51,24 HCPCS,J1938,"Injection, furosemide, 1 mg ",,,0.02,0.06,10 HCPCS,J1939,BUMETANIDE 0.5 MG INJ,72.58,72.58,4.35,61.69,24 HCPCS,J1939,BUMETANIDE 1 MG INJ,17.63,17.63,1.06,14.99,24 HCPCS,J1939,BUMETANIDE 2.5 MG MDV,17.63,17.63,1.06,14.99,24 HCPCS,J1939,"Injection, bumetanide, 0.5 mg ",,,0.47,2.0,10 HCPCS,J1941,"Injection, furosemide (furoscix), 20 mg ",,,401.17,753.79,8 HCPCS,J1943,"Injection, aripiprazole lauroxil, (aristada initio), 1 mg ",,,3.25,10.17,10 HCPCS,J1944,"Injection, aripiprazole lauroxil, (aristada), 1 mg ",,,3.32,10.39,10 HCPCS,J1945,"Injection, lepirudin, 50 mg ",,,1380.71,1780.08,3 HCPCS,J1950,"Injection, leuprolide acetate (for depot suspension), per 3.75 mg ",,,1489.82,5419.75,10 HCPCS,J1951,"Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg ",,,140.71,438.14,10 HCPCS,J1952,"Leuprolide injectable, camcevi, 1 mg ",,,39.95,160.4,10 HCPCS,J1953,"Injection, levetiracetam, 10 mg ",,,0.03,0.3,10 HCPCS,J1953,LEVETIRAC 500MG/5ML INJ,1771.5,1771.5,106.29,1505.78,24 HCPCS,J1953,LEVETIRACTM 15 MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J1954,"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg ",,,534.19,1214.68,10 HCPCS,J1955,"Injection, levocarnitine, per 1 gm ",284.34,284.34,23.09,89.42,10 HCPCS,J1955,LEVOCARNITINE 1 G INJ,284.34,284.34,17.06,241.69,24 HCPCS,J1956,"Injection, levofloxacin, 250 mg ",,,2.16,6.12,10 HCPCS,J1956,LEVOF 250MG/D5W 50ML INJ,883.97,883.97,53.04,751.37,24 HCPCS,J1956,LEVOF 500MG/D5W100ML INJ,1384.84,1384.84,83.09,1177.11,24 HCPCS,J1956,LEVOF 750MG/D5W150ML INJ,1513.34,1513.34,90.8,1286.34,24 HCPCS,J1956,LEVOFLOXACIN 5 MG/ML INJ,33.31,33.31,2.0,28.31,24 HCPCS,J1961,"Injection, lenacapavir (only for use as hiv treatment), 1 mg ",,,22.3,68.7,10 HCPCS,J1980,"Injection, hyoscyamine sulfate, up to 0.25 mg ",,,58.43,171.85,8 HCPCS,J1990,"Injection, chlordiazepoxide hcl, up to 100 mg ",,,50.94,65.68,3 HCPCS,J2002,"Injection, lidocaine hcl in 5% dextrose, 1 mg ",32.39,32.39,0.01,0.03,10 HCPCS,J2002,LIDO D5W 2G/500 ML INJ,32.39,32.39,1.94,27.53,24 HCPCS,J2003,"Injection, lidocaine hydrochloride, 1 mg ",,,0.02,0.03,8 HCPCS,J2003,LIDO 0.5% 250MG/50ML INJ,46.98,46.98,2.82,39.93,25 HCPCS,J2003,LIDO 1 MG INJ,17.28,17.28,1.04,14.69,25 HCPCS,J2003,LIDO 1% 200MG/20ML MDV,18.32,18.32,1.1,15.57,25 HCPCS,J2003,LIDO 1% 20MG/2ML INJ,17.31,17.31,1.04,14.71,25 HCPCS,J2003,LIDO 1% 300MG/30ML INJ,32.14,32.14,1.93,27.32,25 HCPCS,J2003,LIDO 1% 500MG/50ML MDV,23.49,23.49,1.41,19.97,25 HCPCS,J2003,LIDO 1% 50MG/5ML INJ,29.68,29.68,1.78,25.23,25 HCPCS,J2003,LIDO 2% 100MG/5ML INJ,272.005,272.005,1.93,435.09,50 HCPCS,J2003,LIDO 2% 200MG/10ML INJ,33.38,33.38,2.0,28.37,25 HCPCS,J2003,LIDO 2% 400MG/20ML MDV,29.68,29.68,1.78,25.23,25 HCPCS,J2003,LIDO 2% 40MG/2ML INJ,29.68,29.68,1.78,25.23,25 HCPCS,J2003,LIDO 4% 200MG/5ML INJ,35.86,35.86,2.15,30.48,25 HCPCS,J2003,LIDO 8000 MCG/ML INJ,4.76,4.76,0.29,4.05,25 HCPCS,J2004,"Injection, lidocaine hcl with epinephrine, 1 mg ",,,0.02,0.03,8 HCPCS,J2004,LIDO 1G/EPI 0.5MG MDV,42.2,42.2,2.53,35.87,25 HCPCS,J2004,LIDO 200MG/EPI 0.2MG MDV,17.63,17.63,1.06,14.99,25 HCPCS,J2004,LIDO 200MG/EPI0.05MG INJ,25.91,25.91,1.55,22.02,25 HCPCS,J2004,LIDO 300MG/EPI 0.3MG MDV,25.96,25.96,1.56,22.07,25 HCPCS,J2004,LIDO 300MG/EPI0.15MG INJ,46.98,46.98,2.82,39.93,25 HCPCS,J2004,LIDO 400MG/EPI 0.1MG INJ,38.33,38.33,2.3,32.58,25 HCPCS,J2004,LIDO 400MG/EPI 0.2MG MDV,158.25,158.25,9.49,134.51,25 HCPCS,J2004,LIDO 500MG/EPI 0.5MG MDV,29.68,29.68,1.78,25.23,25 HCPCS,J2004,LIDO 600MG/EPI 0.3MG MDV,30.91,30.91,1.85,26.27,25 HCPCS,J2004,LIDO/EPI 1 MG INJ,17.28,17.28,1.04,14.69,25 HCPCS,J2010,"Injection, lincomycin hcl, up to 300 mg ",,,4.72,20.6,10 HCPCS,J2020,"Injection, linezolid, 200 mg ",,,2.48,38.88,10 HCPCS,J2020,LINEZ/D5W 600MG/300MLINJ,3120.66,3120.66,187.24,2652.56,24 HCPCS,J2020,LINEZOLID 2 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J2021,"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg ",,,15.34,49.38,10 HCPCS,J2060,"Injection, lorazepam, 2 mg ",,,0.73,4.12,10 HCPCS,J2060,LORAZEPAM 2 MG INJ,115.41,115.41,6.92,98.1,24 HCPCS,J2060,LORAZEPAM 20 MG MDV,55.03,55.03,3.3,46.78,24 HCPCS,J2062,"Loxapine for inhalation, 1 mg ",,,29.4,47.74,8 HCPCS,J2062,"Loxapine for inhalation, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J2150,"Injection, mannitol, 25% in 50 ml ",185.6,185.6,5.42,6.99,3 HCPCS,J2150,MANNITOL 25% 50 ML INJ,185.6,185.6,11.14,157.76,30 HCPCS,J2151,"Injection, mannitol, 250 mg ",,,0.05,0.19,7 HCPCS,J2151,MANNITOL 100G INJ,809.83,809.83,48.59,688.36,27 HCPCS,J2151,MANNITOL 12.5G INJ,185.6,185.6,11.14,157.76,27 HCPCS,J2170,"Injection, mecasermin, 1 mg ",,,218.74,1169.94,8 HCPCS,J2175,"Injection, meperidine hydrochloride, per 100 mg ",,,3.57,48.95,10 HCPCS,J2175,MEPERIDINE 25 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2175,MEPERIDINE 50 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2180,"Injection, meperidine and promethazine hcl, up to 50 mg ",,,9.17,11.82,3 HCPCS,J2182,"Injection, mepolizumab, 1 mg ",,,31.82,97.75,10 HCPCS,J2183,505WG MEROPEN 2 G INJ,136.35,136.35,8.18,115.9,24 HCPCS,J2183,"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg ",136.35,136.35,1.48,5.05,10 HCPCS,J2184,505BB MEROPEN 1 G INJ,159.25,159.25,9.55,135.36,24 HCPCS,J2184,"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg ",159.25,159.25,1.97,6.49,10 HCPCS,J2185,"Injection, meropenem, 100 mg ",,,0.37,5.97,10 HCPCS,J2185,MEROPENEM 1 G INJ,2516.27,2516.27,150.98,2138.83,24 HCPCS,J2185,MEROPENEM 50 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J2185,MEROPENEM 500 MG INJ,1516.9,1516.9,91.01,1289.37,24 HCPCS,J2186,"Injection, meropenem and vaborbactam, 10mg/10mg (20mg) ",,,3.23,7.08,8 HCPCS,J2186,MEROPNM/VABORB 20MG INJ,92.79,92.79,5.57,78.87,20 HCPCS,J2186,MEROPNM/VABORB 20MGINJJW,92.79,92.79,5.57,78.87,20 HCPCS,J2186,MEROPNM/VABORB 2G INJ,1845.27,1845.27,110.72,1568.48,20 HCPCS,J2210,"Injection, methylergonovine maleate, up to 0.2 mg ",296.73,296.73,21.61,68.83,10 HCPCS,J2210,METHYLERGONOV 0.2 MG INJ,296.73,296.73,17.8,252.22,24 HCPCS,J2212,"Injection, methylnaltrexone, 0.1 mg ",1151.66,1151.66,1.88,4.52,8 HCPCS,J2212,METHYLNLTRXONE 12 MG INJ,1151.66,1151.66,69.1,978.91,41 HCPCS,J2246,"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg ",,,0.37,2.24,10 HCPCS,J2247,505PP MICAFUN 50 MG INJ,408.67,408.67,24.52,347.37,24 HCPCS,J2247,"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg ",408.67,408.67,0.22,1.12,10 HCPCS,J2248,"Injection, micafungin sodium, 1 mg ",,,0.26,5.05,10 HCPCS,J2248,MICAFUNGIN 1 MG INJ,15.47,15.47,0.93,13.15,24 HCPCS,J2248,MICAFUNGIN 100 MG INJ,1600.18,1600.18,96.01,1360.15,24 HCPCS,J2248,MICAFUNGIN 50 MG INJ,800.69,800.69,48.04,680.59,24 HCPCS,J2249,"Injection, remimazolam, 1 mg ",,,4.04,6.99,8 HCPCS,J2250,"Injection, midazolam hydrochloride, per 1 mg ",,,0.16,0.5,10 HCPCS,J2250,MIDAZOLAM 1 MG/ML INJ,33.31,33.31,2.0,28.31,24 HCPCS,J2250,MIDAZOLAM 10 MG INJ,17.28,17.28,1.04,14.69,24 HCPCS,J2250,MIDAZOLAM 2 MG INJ,28.56,28.56,1.71,24.28,24 HCPCS,J2250,MIDAZOLAM 5 MG/1 ML INJ,52.35,52.35,3.14,44.5,24 HCPCS,J2250,MIDAZOLAM 5 MG/5 ML INJ,65.44,65.44,3.93,55.62,24 HCPCS,J2250,MIDAZOLAM 50 MG MDV,55.2,55.2,3.31,46.92,24 HCPCS,J2251,"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg ",,,0.16,0.92,10 HCPCS,J2251,MIDAZOL/0.9NS 100 MG IV,152.95,152.95,9.18,130.01,24 HCPCS,J2251,MIDAZOL/0.9NS 50 MG IV,117.19,117.19,7.03,99.61,24 HCPCS,J2252,"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg ",,,0.14,0.22,8 HCPCS,J2253,"Injection, midazolam (seizalam), 1 mg ",,,0.18,0.24,5 HCPCS,J2260,"Injection, milrinone lactate, 5 mg ",,,1.18,4.75,10 HCPCS,J2260,MILRIN 20MG/D5W100ML INJ,3670.53,3670.53,220.23,3119.95,24 HCPCS,J2260,MILRINONE 200 MCG/ML INJ,4.76,4.76,0.29,4.05,24 HCPCS,J2260,MILRINONE LAC 20 MG INJ,22.78,22.78,1.37,19.36,24 HCPCS,J2265,"Injection, minocycline hydrochloride, 1 mg ",1688.22,1688.22,3.18,8.24,8 HCPCS,J2265,MINOCYCLINE HCL 100 MG,1688.22,1688.22,101.29,1434.99,20 HCPCS,J2267,"Injection, mirikizumab-mrkz, 1 mg ",,,42.09,150.6,10 HCPCS,J2270,"Injection, morphine sulfate, up to 10 mg ",,,0.14,14.2,10 HCPCS,J2270,MORPHINE 1MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J2270,MORPHINE SULF 10MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2270,MORPHINE SULF 2MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2270,MORPHINE SULF 4MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2272,505FK MORPH 2 MG/ML INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2272,505FK MORPHINE 10 MG INJ,18.3,18.3,1.1,15.55,24 HCPCS,J2272,505FK MORPHINE 2 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2272,505FK MORPHINE 4 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2272,505FK MORPHINE 5 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J2272,"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg ",,,8.34,25.37,10 HCPCS,J2274,"Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg ",,,9.13,33.66,10 HCPCS,J2274,MORPHINE EPD/IT PF 10 MG,51.16,51.16,3.07,43.49,24 HCPCS,J2274,MORPHINE EPD/IT PF 5 MG,187.65,187.65,11.26,159.5,24 HCPCS,J2277,"Injection, motixafortide, 0.25 mg ",,,26.48,78.69,10 HCPCS,J2278,"Injection, ziconotide, 1 microgram ",,,10.46,31.61,10 HCPCS,J2280,"Injection, moxifloxacin, 100 mg ",1328.93,1328.93,8.74,29.75,10 HCPCS,J2280,MOXIFLOXACIN 400 MG INJ,1328.93,1328.93,79.74,1129.59,24 HCPCS,J2281,"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg ",,,6.64,29.24,10 HCPCS,J2290,"Injection, nafcillin sodium, 20 mg ",,,0.05,0.59,10 HCPCS,J2290,NAFCILLIN 1 G INJ,18.9,18.9,1.13,16.06,24 HCPCS,J2290,NAFCILLIN 2 G INJ,29.43,29.43,1.77,25.02,24 HCPCS,J2290,NAFCILLIN 20 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J2291,"Injection, nafcillin sodium (baxter), 20 mg ",,,0.15,0.46,7 HCPCS,J2300,"Injection, nalbuphine hydrochloride, per 10 mg ",,,3.42,10.95,10 HCPCS,J2300,NALBUPHINE 10 MG INJ,60.67,60.67,3.64,51.57,24 HCPCS,J2300,NALBUPHINE 20 MG INJ,67.08,67.08,4.02,57.02,24 HCPCS,J2305,"Injection, nitroglycerin, 5 mg ",,,1.67,4.43,10 HCPCS,J2305,NITROG 50MG/D5W 250MLINJ,36.23,36.23,2.17,30.8,24 HCPCS,J2305,NITROGLYCERIN 50 MG INJ,65.73,65.73,3.94,55.87,24 HCPCS,J2312,"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg ",,,0.07,0.22,10 HCPCS,J2312,NALOX NOS 0.4MG INJ,102.55,102.55,6.15,87.17,24 HCPCS,J2312,NALOX NOS 2 MG INJ,213.84,213.84,12.83,181.76,24 HCPCS,J2312,NALOX NOS 4 MG MDV,198.34,198.34,11.9,168.59,24 HCPCS,J2313,"Injection, naloxone hydrochloride (zimhi), 0.01 mg ",,,0.02,0.06,8 HCPCS,J2315,"Injection, naltrexone, depot form, 1 mg ",,,4.25,13.23,10 HCPCS,J2320,"Injection, nandrolone decanoate, up to 50 mg ",,,9.07,11.7,3 HCPCS,J2323,"Injection, natalizumab, 1 mg ",,,24.32,75.29,10 HCPCS,J2325,"Injection, nesiritide, 0.1 mg ",,,138.38,190.62,8 HCPCS,J2326,"Injection, nusinersen, 0.1 mg ",,,2043.3,3879.84,8 HCPCS,J2327,"Injection, risankizumab-rzaa, intravenous, 1 mg ",52654.54,52654.54,14.6,47.49,10 HCPCS,J2327,RISANKIZU-RZAA 600MG INJ,52654.54,52654.54,3159.27,44756.36,19 HCPCS,J2329,"Injection, ublituximab-xiiy, 1mg ",,,68.75,224.33,10 HCPCS,J2350,"Injection, ocrelizumab, 1 mg ",,,59.6,186.26,10 HCPCS,J2351,"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq ",,,46.79,147.39,10 HCPCS,J2353,"Injection, octreotide, depot form for intramuscular injection, 1 mg ",,,188.35,662.06,10 HCPCS,J2354,"Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg ",,,0.62,1.9,10 HCPCS,J2354,OCTREOT 100MCG ND SQIV,311.71,311.71,18.7,264.95,40 HCPCS,J2354,OCTREOT 25MCG ND SQIV,25.73,25.73,1.54,21.87,40 HCPCS,J2354,OCTREOT 500MCG ND SQIV,152.28,152.28,9.14,129.44,40 HCPCS,J2354,OCTREOT 50MCG ND SQIV,171.32,171.32,10.28,145.62,40 HCPCS,J2354,OCTREOTID ND 1000MCG MDV,1029.11,1029.11,61.75,874.74,40 HCPCS,J2355,"Injection, oprelvekin, 5 mg ",,,860.44,1331.99,8 HCPCS,J2356,"Injection, tezepelumab-ekko, 1 mg ",,,17.58,57.1,10 HCPCS,J2357,"Injection, omalizumab, 5 mg ",,,41.82,126.55,10 HCPCS,J2357,OMALIZUMAB 150 MG INJ,6807.63,6807.63,408.46,5786.49,19 HCPCS,J2357,OMALIZUMAB 5 MG INJ,227.24,227.24,13.63,193.15,19 HCPCS,J2357,OMALIZUMAB 75 MG INJ,3403.81,3403.81,204.23,2893.24,19 HCPCS,J2358,"Injection, olanzapine, long-acting, 1 mg ",,,3.19,9.11,10 HCPCS,J2359,"Injection, olanzapine, 0.5 mg ",,,0.71,2.84,10 HCPCS,J2360,"Injection, orphenadrine citrate, up to 60 mg ",795.93,795.93,8.22,29.48,10 HCPCS,J2360,ORPHENADRINE 60 MG INJ,795.93,795.93,47.76,676.54,24 HCPCS,J2371,"Injection, phenylephrine hydrochloride, 20 micrograms ",,,0.01,0.03,10 HCPCS,J2371,PHENYLEPHN 20 MCG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J2371,PHENYLEPHRINE 10 MG INJ,23.25,23.25,1.4,19.76,24 HCPCS,J2371,PHENYLEPHRINE 100 MG MDV,47.14,47.14,2.83,40.07,24 HCPCS,J2371,PHENYLEPHRINE 50 MG MDV,98.27,98.27,5.9,83.53,24 HCPCS,J2371,PHENYLEPHRINE 500MCG INJ,22.01,22.01,1.32,18.71,24 HCPCS,J2372,BIORPHEN 20 MCG INJ,0.86,0.86,0.05,0.73,24 HCPCS,J2372,BIORPHEN 20 MCG INJJW,0.86,0.86,0.05,0.73,24 HCPCS,J2372,BIORPHEN 500 MCG INJ,30.0,30.0,1.8,25.5,24 HCPCS,J2372,"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms ",,,0.15,0.57,10 HCPCS,J2373,IMMPHENTIV 500 MCG INJ,30.0,30.0,1.8,25.5,24 HCPCS,J2373,"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms ",30.0,30.0,0.13,0.65,10 HCPCS,J2401,"Injection, chloroprocaine hydrochloride, per 1 mg ",,,0.04,0.12,10 HCPCS,J2402,"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg ",,,0.59,0.97,8 HCPCS,J2403,"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg ",,,0.59,60.97,10 HCPCS,J2404,"Injection, nicardipine, 0.1 mg ",,,0.07,0.28,10 HCPCS,J2404,NICARDIP 40MG/200ML INJ,305.25,305.25,18.32,259.46,24 HCPCS,J2404,NICARDIPIN 25MG/10ML INJ,50.89,50.89,3.05,43.26,24 HCPCS,J2404,NICARDIPINE 0.2MG/ML INJ,17.63,17.63,1.06,14.99,24 HCPCS,J2405,"Injection, ondansetron hydrochloride, per 1 mg ",71.39,71.39,0.09,2.59,10 HCPCS,J2405,ONDANSETRON 4 MG INJ,71.39,71.39,4.28,60.68,24 HCPCS,J2406,"Injection, oritavancin (kimyrsa), 10 mg ",,,43.72,129.17,10 HCPCS,J2407,"Injection, oritavancin (orbactiv), 10 mg ",,,28.57,88.98,10 HCPCS,J2410,"Injection, oxymorphone hcl, up to 1 mg ",,,6.1,8.89,8 HCPCS,J2425,"Injection, palifermin, 50 micrograms ",,,36.72,112.04,10 HCPCS,J2426,"Injection, paliperidone palmitate extended release (invega sustenna), 1 mg ",,,15.08,47.05,10 HCPCS,J2427,"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg ",,,12.95,40.44,10 HCPCS,J2428,"Injection, paliperidone palmitate extended release (erzofri), 1 mg ",,,14.49,52.98,10 HCPCS,J2430,"Injection, pamidronate disodium, per 30 mg ",,,12.42,34.82,10 HCPCS,J2430,"Injection, pamidronate disodium, per 30 mg Chemotherapy Drugs",,,,,0 HCPCS,J2430,PAMIDRONATE 30 MG INJ,3927.29,3927.29,235.64,3338.2,24 HCPCS,J2430,PAMIDRONATE 90 MG INJ,584.16,584.16,35.05,496.54,24 HCPCS,J2440,"Injection, papaverine hcl, up to 60 mg ",,,48.47,119.34,8 HCPCS,J2460,"Injection, oxytetracycline hcl, up to 50 mg ",,,2.27,2.93,3 HCPCS,J2468,"Injection, palonosetron hydrochloride (posfrea), 25 micrograms ",,,2.14,183.58,10 HCPCS,J2469,"Injection, palonosetron hcl, 25 mcg ",,,0.65,18.66,10 HCPCS,J2470,"Injection, pantoprazole sodium, 40 mg ",,,4.67,12.39,8 HCPCS,J2470,PANTOPRAZ 0.4 MG/ML INJ,17.63,17.63,1.06,14.99,25 HCPCS,J2470,PANTOPRAZOLE 40 MG INJ,17.63,17.63,1.06,14.99,25 HCPCS,J2471,"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg ",,,12.84,20.69,8 HCPCS,J2472,"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg ",,,17.42,28.05,8 HCPCS,J2501,"Injection, paricalcitol, 1 mcg ",274.83,274.83,1.02,3.92,10 HCPCS,J2501,PARICALCITOL 2 MCG INJ,274.83,274.83,16.49,233.61,24 HCPCS,J2502,"Injection, pasireotide long acting, 1 mg ",,,413.32,1759.02,10 HCPCS,J2503,"Injection, pegaptanib sodium, 0.3 mg ",,,1900.91,2450.76,3 HCPCS,J2504,"Injection, pegademase bovine, 25 iu ",,,890.46,1148.04,3 HCPCS,J2506,"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg ",,,127.38,547.13,10 HCPCS,J2507,"Injection, pegloticase, 1 mg ",,,3824.52,11353.24,10 HCPCS,J2508,"Injection, pegunigalsidase alfa-iwxj, 1 mg ",,,223.4,718.47,10 HCPCS,J2510,"Injection, penicillin g procaine, aqueous, up to 600,000 units ",,,41.22,146.23,8 HCPCS,J2513,"Injection, pentastarch, 10% solution, 100 ml ",,,30.78,39.69,3 HCPCS,J2515,"Injection, pentobarbital sodium, per 50 mg ",,,71.56,168.07,8 HCPCS,J2516,"Injection, pentamidine isethionate, 1 mg ",1727.48,1727.48,0.16,0.7,7 HCPCS,J2516,PENTAMIDINE 300MG INJ,1727.48,1727.48,103.65,1468.36,27 HCPCS,J2540,"Injection, penicillin g potassium, up to 600,000 units ",118.97,118.97,0.68,4.0,10 HCPCS,J2540,PCNG K 5 MILLION U INJ,118.97,118.97,7.14,101.12,24 HCPCS,J2543,"Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) ",,,1.09,6.24,10 HCPCS,J2543,PIP SOD/TAZ 2.25 G INJ,615.09,615.09,36.91,522.83,24 HCPCS,J2543,PIP SOD/TAZ 3.375 G INJ,381.91,381.91,2.28,616.88,48 HCPCS,J2543,PIP SOD/TAZ 4.5 G INJ,916.09,916.09,54.97,778.68,24 HCPCS,J2543,PIP/TAZ60MG/7.5MG PER ML,26.18,26.18,1.57,22.25,24 HCPCS,J2545,"Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg ",,,73.57,405.54,10 HCPCS,J2547,"Injection, peramivir, 1 mg ",,,3.1,5.05,8 HCPCS,J2550,"Injection, promethazine hcl, up to 50 mg ",51.16,51.16,0.59,8.95,10 HCPCS,J2550,PROMETHAZINE 25 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J2560,"Injection, phenobarbital sodium, up to 120 mg ",,,23.65,85.36,10 HCPCS,J2561,"Injection, phenobarbital sodium (sezaby), 1 mg ",,,2.61,4.24,8 HCPCS,J2562,"Injection, plerixafor, 1 mg ",,,32.74,870.18,10 HCPCS,J2590,"Injection, oxytocin, up to 10 units ",185.6,185.6,1.06,4.46,8 HCPCS,J2590,OXYTOCIN 10 U INJ,185.6,185.6,11.14,157.76,25 HCPCS,J2596,"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit ",,,1.18,5.37,7 HCPCS,J2597,DESMOPRESSIN 1 MCG INJ,113.02,113.02,6.78,96.07,24 HCPCS,J2597,DESMOPRESSIN 1 MCG INJJW,140.39,140.39,8.42,119.33,24 HCPCS,J2597,DESMOPRESSIN 4 MCG INJ,560.36,560.36,33.62,476.31,24 HCPCS,J2597,"Injection, desmopressin acetate, per 1 mcg ",,,3.41,12.14,10 HCPCS,J2598,"Injection, vasopressin, 1 unit ",127.47,127.47,0.53,8.78,10 HCPCS,J2598,VASOPRESSIN 20 UNIT INJ,127.47,127.47,7.65,108.35,24 HCPCS,J2599,"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit ",,,0.84,6.32,10 HCPCS,J2601,"Injection, vasopressin (baxter), 1 unit ",,,1.53,10.21,10 HCPCS,J2650,"Injection, prednisolone acetate, up to 1 ml ",,,1.26,1.62,3 HCPCS,J2670,"Injection, tolazoline hcl, up to 25 mg ",,,8.32,10.73,3 HCPCS,J2675,"Injection, progesterone, per 50 mg ",,,0.66,6.35,10 HCPCS,J2679,"Injection, fluphenazine hcl, 1.25 mg ",,,7.35,23.18,10 HCPCS,J2680,"Injection, fluphenazine decanoate, up to 25 mg ",,,5.59,53.14,10 HCPCS,J2690,"Injection, procainamide hcl, up to 1 gm ",,,190.18,606.28,10 HCPCS,J2690,PROCAINAMIDE 1 G MDV,312.9,312.9,18.77,265.96,19 HCPCS,J2690,PROCAINAMIDE 4 MG/ML INJ,1054.1,1054.1,63.25,895.98,19 HCPCS,J2690,PROCAINAMIDE 8 MG/ML INJ,22.5,22.5,1.35,19.13,19 HCPCS,J2700,"Injection, oxacillin sodium, up to 250 mg ",,,0.85,5.37,10 HCPCS,J2704,"Injection, propofol, 10 mg ",,,0.09,0.46,10 HCPCS,J2704,PROPOFOL 10 MG/ML INJ,16.65,16.65,1.0,14.15,24 HCPCS,J2704,PROPOFOL 1000 MG INJ,375.96,375.96,22.56,319.57,24 HCPCS,J2704,PROPOFOL 200 MG INJ,297.43,297.43,17.85,252.82,24 HCPCS,J2710,"Injection, neostigmine methylsulfate, up to 0.5 mg ",,,1.76,2.56,8 HCPCS,J2710,NEOSTIG METH 0.5 MG INJ,6.2,6.2,0.37,5.27,25 HCPCS,J2710,NEOSTIGMINE 10 MG MDV,123.93,123.93,7.44,105.34,25 HCPCS,J2711,"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg ",,,1.39,1.92,5 HCPCS,J2720,"Injection, protamine sulfate, per 10 mg ",,,1.67,5.12,10 HCPCS,J2720,PROTAMINE 250 MG INJ,315.27,315.27,18.92,267.98,24 HCPCS,J2720,PROTAMINE 50 MG INJ,350.97,350.97,21.06,298.32,24 HCPCS,J2724,"Injection, protein c concentrate, intravenous, human, 10 iu ",,,15.05,46.89,10 HCPCS,J2725,"Injection, protirelin, per 250 mcg ",,,52.71,67.95,3 HCPCS,J2730,"Injection, pralidoxime chloride, up to 1 gm ",741.2,741.2,169.93,275.9,8 HCPCS,J2730,PRALIDOXIME 1 G INJ,741.2,741.2,44.47,630.02,25 HCPCS,J2760,"Injection, phentolamine mesylate, up to 5 mg ",1621.6,1621.6,257.45,1361.91,10 HCPCS,J2760,PHENTOLAMINE MES 5MG INJ,1621.6,1621.6,97.3,1378.36,35 HCPCS,J2765,"Injection, metoclopramide hcl, up to 10 mg ",,,0.95,4.1,10 HCPCS,J2765,METOCLOPRAMIDE 10 MG INJ,90.42,90.42,5.43,76.86,24 HCPCS,J2765,METOCLOPRM 0.2 MG/ML INJ,14.28,14.28,0.86,12.14,24 HCPCS,J2770,"Injection, quinupristin/dalfopristin, 500 mg (150/350) ",,,795.13,1483.03,8 HCPCS,J2777,"Injection, faricimab-svoa, 0.1 mg ",,,32.87,114.4,10 HCPCS,J2778,"Injection, ranibizumab, 0.1 mg ",,,67.85,1010.88,10 HCPCS,J2779,"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg ",,,76.2,250.16,10 HCPCS,J2781,"Injection, pegcetacoplan, intravitreal, 1 mg ",,,147.81,461.43,10 HCPCS,J2782,"Injection, avacincaptad pegol, 0.1 mg ",,,103.4,330.41,10 HCPCS,J2783,"Injection, rasburicase, 0.5 mg ",,,382.19,1174.62,10 HCPCS,J2783,RASBURICASE 0.5 MG INJJW,6605.37,6605.37,396.32,5614.56,19 HCPCS,J2783,RASBURICASE 1.5 MG INJ,5918.4,5918.4,355.1,5030.64,19 HCPCS,J2785,"Injection, regadenoson, 0.1 mg ",346.15,346.15,2.9,164.0,10 HCPCS,J2785,REGADENOSON 0.4 MG INJ,346.15,346.15,20.77,294.23,24 HCPCS,J2786,"Injection, reslizumab, 1 mg ",,,11.53,33.01,10 HCPCS,J2787,"Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml ",,,2793.0,7255.87,8 HCPCS,J2788,"Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) ",,,27.52,86.92,10 HCPCS,J2790,"Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) ",2336.62,2336.62,78.9,257.15,10 HCPCS,J2790,RHIG HMN FULLDOSE 300MCG,2336.62,2336.62,140.2,1986.13,24 HCPCS,J2791,IG RHOPHYLAC 1500 IU,423.54,423.54,25.41,360.01,24 HCPCS,J2791,"Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu ",423.54,423.54,4.85,26.24,10 HCPCS,J2792,"Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu ",,,34.26,96.0,10 HCPCS,J2793,"Injection, rilonacept, 1 mg ",,,44.1,86.24,8 HCPCS,J2794,"Injection, risperidone (risperdal consta), 0.5 mg ",,,10.8,34.13,10 HCPCS,J2795,"Injection, ropivacaine hydrochloride, 1 mg ",,,0.05,0.19,10 HCPCS,J2795,ROPIVACA 200MG/100ML INJ,347.4,347.4,20.84,295.29,24 HCPCS,J2795,ROPIVACAINE 150 MG INJ,230.81,230.81,13.85,196.19,24 HCPCS,J2797,"Injection, rolapitant, 0.5 mg ",,,1.74,2.81,8 HCPCS,J2797,"Injection, rolapitant, 0.5 mg Chemotherapy Drugs",,,,,0 HCPCS,J2798,"Injection, risperidone, (perseris), 0.5 mg ",,,12.17,37.88,10 HCPCS,J2799,"Injection, risperidone (uzedy), 1 mg ",,,25.16,78.25,10 HCPCS,J2800,"Injection, methocarbamol, up to 10 ml ",528.24,528.24,4.2,33.99,10 HCPCS,J2800,METHOCARBAM 1G/10ML INJ,528.24,528.24,31.69,449.0,24 HCPCS,J2801,"Injection, risperidone (rykindo), 0.5 mg ",,,24.28,39.12,8 HCPCS,J2802,"Injection, romiplostim, 1 microgram ",,,11.11,34.32,10 HCPCS,J2802,ROMIPLOSTIM 125 MCG INJ,7093.75,7093.75,425.63,6029.69,19 HCPCS,J2802,ROMIPLOSTIM 250 MCG INJ,14187.33,14187.33,851.24,12059.23,19 HCPCS,J2804,"Injection, rifampin, 1 mg ",369.36,369.36,0.17,0.5,10 HCPCS,J2804,RIFAMPIN 600 MG INJ,369.36,369.36,22.16,313.96,24 HCPCS,J2805,"Injection, sincalide, 5 micrograms ",952.97,952.97,108.2,424.23,10 HCPCS,J2805,SINCALIDE 5 MCG INJ,952.97,952.97,57.18,810.02,24 HCPCS,J2810,"Injection, theophylline, per 40 mg ",,,0.76,1.28,8 HCPCS,J2820,"Injection, sargramostim (gm-csf), 50 mcg ",,,61.89,175.0,10 HCPCS,J2820,SARGRAMOSTIM 250 MCG INJ,2038.77,2038.77,122.33,1732.95,19 HCPCS,J2820,SARGRAMOSTIM 50 MCGJW,573.45,573.45,34.41,487.43,19 HCPCS,J2840,"Injection, sebelipase alfa, 1 mg ",,,996.58,1624.62,8 HCPCS,J2850,"Injection, secretin, synthetic, human, 1 microgram ",,,64.31,131.48,8 HCPCS,J2860,"Injection, siltuximab, 10 mg ",,,174.08,505.32,10 HCPCS,J2865,"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg ",,,0.04,0.16,10 HCPCS,J2865,SMX/TMP 2400/480MG MDV,49.63,49.63,2.98,42.19,24 HCPCS,J2865,SMX/TMP 3.2/0.64 MG/ML,17.28,17.28,1.04,14.69,24 HCPCS,J2865,SMX/TMP 800/160MG MDV,69.45,69.45,4.17,59.03,24 HCPCS,J2910,"Injection, aurothioglucose, up to 50 mg ",,,59.29,76.44,3 HCPCS,J2916,"Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg ",1201.63,1201.63,2.39,6.8,10 HCPCS,J2916,NA FERRIC GLUCON 62.5 MG,1201.63,1201.63,72.1,1021.39,24 HCPCS,J2919,"Injection, methylprednisolone sodium succinate, 5 mg ",,,0.24,0.83,10 HCPCS,J2919,METHYLPRED SS 1 G MDV,1049.34,1049.34,62.96,891.94,24 HCPCS,J2919,METHYLPRED SS 125 MGINJ,75.225,75.225,1.96,100.07,48 HCPCS,J2919,METHYLPRED SS 2.5MG/ML,17.63,17.63,1.06,14.99,24 HCPCS,J2919,METHYLPRED SS 40 MG INJ,83.485,83.485,1.24,124.39,48 HCPCS,J2919,METHYLPRED SS 500 MG MDV,521.1,521.1,31.27,442.94,24 HCPCS,J2940,"Injection, somatrem, 1 mg ",,,102.34,131.94,3 HCPCS,J2941,"Injection, somatropin, 1 mg ",,,107.06,494.71,8 HCPCS,J2993,"Injection, reteplase, 18.1 mg ",,,4871.4,9614.12,8 HCPCS,J2995,"Injection, streptokinase, per 250,000 iu ",,,192.39,248.04,3 HCPCS,J2997,ALTEPLASE RECOM 1MG INJ,849.46,849.46,50.97,722.04,19 HCPCS,J2997,ALTEPLASE RECOMB 1 MGJW,740.02,740.02,44.4,629.02,19 HCPCS,J2997,ALTEPLASE RECOMB 100 MG,101105.46,101105.46,6066.33,85939.64,19 HCPCS,J2997,ALTEPLASE RECOMB 2 MG,2462.73,2462.73,147.76,2093.32,19 HCPCS,J2997,ALTEPLASE RECOMB 50 MG,37026.72,37026.72,2221.6,31472.71,19 HCPCS,J2997,"Injection, alteplase recombinant, 1 mg ",,,73.79,293.75,10 HCPCS,J2998,"Injection, plasminogen, human-tvmh, 1 mg ",,,58.56,115.44,8 HCPCS,J3000,"Injection, streptomycin, up to 1 gm ",,,40.26,202.5,10 HCPCS,J3010,FENTANYL 10 MCG/ML INJ,33.31,33.31,2.0,28.31,24 HCPCS,J3010,FENTANYL 50 MCG/ML INJ,69.0,69.0,4.14,58.65,24 HCPCS,J3010,FENTANYL CIT 0.05 MG INJ,17.28,17.28,1.04,14.69,24 HCPCS,J3010,FENTANYL CIT 0.1 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J3010,FENTANYL CIT 0.25 MG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J3010,FENTANYL CIT 1 MG INJ,66.63,66.63,4.0,56.64,24 HCPCS,J3010,"Injection, fentanyl citrate, 0.1 mg ",,,0.76,3.0,10 HCPCS,J3030,"Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) ",2172.32,2172.32,47.41,117.75,8 HCPCS,J3030,SUMATRIPTAN SUCC 6MG INJ,2172.32,2172.32,130.34,1846.47,41 HCPCS,J3031,"Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered) ",,,5.04,10.7,8 HCPCS,J3032,"Injection, eptinezumab-jjmr, 1 mg ",,,20.55,61.93,10 HCPCS,J3055,"Injection, talquetamab-tgvs, 0.25 mg ",,,74.88,225.89,10 HCPCS,J3060,"Injection, taliglucerase alfa, 10 units ",,,40.66,128.11,10 HCPCS,J3070,"Injection, pentazocine, 30 mg ",,,236.49,338.18,8 HCPCS,J3090,"Injection, tedizolid phosphate, 1 mg ",,,1.96,5.96,10 HCPCS,J3095,"Injection, telavancin, 10 mg ",,,7.03,23.31,10 HCPCS,J3101,"Injection, tenecteplase, 1 mg ",,,197.44,536.45,10 HCPCS,J3101,TENECTEPLASE 1 MG INJ,986.29,986.29,59.18,838.35,19 HCPCS,J3101,TENECTEPLASE 1 MG INJJW,986.29,986.29,59.18,838.35,19 HCPCS,J3101,TENECTEPLASE 25 MG INJ,41186.1,41186.1,2471.17,35008.18,19 HCPCS,J3101,TENECTEPLASE 50 MG INJ,59160.41,59160.41,3549.62,50286.35,19 HCPCS,J3105,"Injection, terbutaline sulfate, up to 1 mg ",,,2.96,8.55,10 HCPCS,J3105,TERBUTALINE 1 MG INJ,192.74,192.74,11.56,163.83,24 HCPCS,J3105,TERBUTALINE 1 MG/ML INJ,1024.36,1024.36,61.46,870.71,24 HCPCS,J3110,"Injection, teriparatide, 10 mcg ",,,111.94,154.2,8 HCPCS,J3111,"Injection, romosozumab-aqqg, 1 mg ",,,12.19,37.44,10 HCPCS,J3121,"Injection, testosterone enanthate, 1 mg ",,,0.05,0.19,10 HCPCS,J3145,"Injection, testosterone undecanoate, 1 mg ",,,2.13,6.21,10 HCPCS,J3230,CHLORPROMAZINE 50 MG INJ,358.11,358.11,21.49,304.39,24 HCPCS,J3230,"Injection, chlorpromazine hcl, up to 50 mg ",358.11,358.11,20.96,84.46,10 HCPCS,J3240,"Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial ",,,2125.34,6593.31,10 HCPCS,J3241,"Injection, teprotumumab-trbw, 10 mg ",,,367.91,1120.36,10 HCPCS,J3243,"Injection, tigecycline, 1 mg ",1399.12,1399.12,0.57,5.05,10 HCPCS,J3243,TIGECYCLINE 50 MG INJ,1399.12,1399.12,83.95,1189.25,24 HCPCS,J3244,"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg ",,,4.88,7.96,8 HCPCS,J3245,"Injection, tildrakizumab, 1 mg ",,,118.2,393.87,10 HCPCS,J3245,"Injection, tildrakizumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J3246,"Injection, tirofiban hcl, 0.25 mg ",,,3.19,27.97,10 HCPCS,J3247,"Injection, secukinumab, intravenous, 1 mg ",,,18.04,55.66,10 HCPCS,J3250,"Injection, trimethobenzamide hcl, up to 200 mg ",,,57.22,166.61,10 HCPCS,J3260,"Injection, tobramycin sulfate, up to 80 mg ",,,0.88,7.68,10 HCPCS,J3260,TOBRAMYCIN 1200 MG MDV,300.53,300.53,18.03,255.45,24 HCPCS,J3260,TOBRAMYCIN 2 MG/ML INJ,14.28,14.28,0.86,12.14,24 HCPCS,J3260,TOBRAMYCIN 80 MG INJ,97.56,97.56,5.85,82.93,24 HCPCS,J3262,"Injection, tocilizumab, 1 mg ",,,5.53,18.06,10 HCPCS,J3262,TOCILIZUMAB 1 MG INJ,54.72,54.72,3.28,46.51,19 HCPCS,J3262,TOCILIZUMAB 1 MG INJJW,54.72,54.72,3.28,46.51,19 HCPCS,J3262,TOCILIZUMAB 200MG INJ,9867.6,9867.6,592.06,8387.46,19 HCPCS,J3262,TOCILIZUMAB 400MG INJ,21708.97,21708.97,1302.54,18452.62,19 HCPCS,J3263,"Injection, toripalimab-tpzi, 1 mg ",,,39.99,123.24,10 HCPCS,J3265,"Injection, torsemide, 10 mg/ml ",,,4.04,6.83,8 HCPCS,J3280,"Injection, thiethylperazine maleate, up to 10 mg ",,,11.52,14.85,3 HCPCS,J3285,"Injection, treprostinil, 1 mg ",,,55.19,173.1,10 HCPCS,J3290,"Injection, tranexamic acid, 5 mg ",208.95,208.95,0.06,0.08,5 HCPCS,J3290,TRANEXAMIC 1000MG INJ,208.95,208.95,12.54,177.61,28 HCPCS,J3291,"Injection, tranexamic acid in sodium chloride, 5 mg ",208.95,208.95,0.2,0.27,5 HCPCS,J3291,TRANEX NACL 1000MG INJ,208.95,208.95,12.54,177.61,28 HCPCS,J3299,"Injection, triamcinolone acetonide (xipere), 1 mg ",,,47.78,149.76,10 HCPCS,J3300,"Injection, triamcinolone acetonide, preservative free, 1 mg ",,,7.37,76.47,10 HCPCS,J3301,"Injection, triamcinolone acetonide, not otherwise specified, 10 mg ",,,0.9,3.43,10 HCPCS,J3301,TRIAMCINOLN ACE 40MG INJ,359.29,359.29,21.56,305.4,24 HCPCS,J3301,TRIAMCINOLN ACE NOS 10MG,62.19,62.19,3.73,52.86,24 HCPCS,J3302,"Injection, triamcinolone diacetate, per 5 mg ",,,0.68,0.87,3 HCPCS,J3303,"Injection, triamcinolone hexacetonide, per 5 mg ",,,6.94,25.86,8 HCPCS,J3304,"Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg ",,,18.64,56.82,10 HCPCS,J3304,"Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J3310,"Injection, perphenazine, up to 5 mg ",,,15.44,19.91,3 HCPCS,J3315,"Injection, triptorelin pamoate, 3.75 mg ",,,469.38,1680.88,10 HCPCS,J3316,"Injection, triptorelin, extended-release, 3.75 mg ",,,3723.76,11771.29,10 HCPCS,J3316,"Injection, triptorelin, extended-release, 3.75 mg Chemotherapy Drugs",,,,,0 HCPCS,J3320,"Injection, spectinomycin dihydrochloride, up to 2 gm ",,,72.79,93.85,3 HCPCS,J3350,"Injection, urea, up to 40 gm ",,,182.83,235.72,3 HCPCS,J3355,"Injection, urofollitropin, 75 iu ",,,153.5,197.9,3 HCPCS,J3357,"Ustekinumab, for subcutaneous injection, 1 mg ",,,465.32,901.96,8 HCPCS,J3358,"Ustekinumab, for intravenous injection, 1 mg ",,,11.62,41.46,10 HCPCS,J3360,DIAZEPAM 10 MG INJ,172.51,172.51,10.35,146.63,24 HCPCS,J3360,"Injection, diazepam, up to 5 mg ",172.51,172.51,8.51,19.25,10 HCPCS,J3364,"Injection, urokinase, 5000 iu vial ",,,22.17,28.58,3 HCPCS,J3365,"Injection, iv, urokinase, 250,000 i.u. vial ",,,1107.71,1428.12,3 HCPCS,J3371,505MY VANCOMY 1.25 G INJ,68.35,68.35,4.1,58.1,33 HCPCS,J3373,"Injection, vancomycin hydrochloride, 10 mg ",,,0.03,0.11,10 HCPCS,J3373,VANCO 1 G INJ,81.38,81.38,4.88,69.17,24 HCPCS,J3373,VANCO 1.25 G INJ,73.82,73.82,4.43,62.75,24 HCPCS,J3373,VANCO 1.5 G INJ,73.82,73.82,4.43,62.75,24 HCPCS,J3373,VANCO 125 MG INJ,13.56,13.56,0.81,11.53,24 HCPCS,J3373,VANCO 5 G MDV,541.55,541.55,32.49,460.32,24 HCPCS,J3373,VANCO 5 MG/ML INJ,17.28,17.28,1.04,14.69,24 HCPCS,J3373,VANCO 500 MG INJ,30.270000000000003,30.270000000000003,1.19,34.65,48 HCPCS,J3373,VANCO 750 MG INJ,48.11,48.11,2.89,40.89,24 HCPCS,J3374,505MY VANCO 1.25 G INJ,120.6,120.6,7.24,102.51,24 HCPCS,J3374,505MY VANCO 1.5 G INJ,144.7,144.7,8.68,122.99,24 HCPCS,J3374,505MY VANCO 750 MG INJ,62.75,62.75,3.77,53.34,24 HCPCS,J3374,"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg ",,,0.1,0.37,10 HCPCS,J3375,"Injection, vancomycin hydrochloride (xellia), not therapeutically equivalent to j3373, 10 mg ",,,0.16,0.41,10 HCPCS,J3376,"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg ",,,0.01,0.05,7 HCPCS,J3379,"Injection, valproate sodium, 5 mg ",,,0.04,0.14,7 HCPCS,J3379,VALPROATE 30MG/ML INJ,17.28,17.28,1.04,14.69,27 HCPCS,J3379,VALPROATE 500MG INJ,164.44,164.44,9.87,139.77,27 HCPCS,J3380,"Injection, vedolizumab, intravenous, 1 mg ",,,20.98,68.83,10 HCPCS,J3385,"Injection, velaglucerase alfa, 100 units ",,,388.16,1186.16,10 HCPCS,J3396,"Injection, verteporfin, 0.1 mg ",,,11.57,36.04,10 HCPCS,J3397,"Injection, vestronidase alfa-vjbk, 1 mg ",,,414.54,864.33,8 HCPCS,J3397,"Injection, vestronidase alfa-vjbk, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J3398,"Injection, voretigene neparvovec-rzyl, 1 billion vector genomes ",,,4398.24,6058.8,5 HCPCS,J3398,"Injection, voretigene neparvovec-rzyl, 1 billion vector genomes Chemotherapy Drugs",,,,,0 HCPCS,J3399,"Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10°15 vector genomes ",,,,,0 HCPCS,J3400,"Injection, triflupromazine hcl, up to 20 mg ",,,26.74,34.48,3 HCPCS,J3401,"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10°9 pfu/ml vector genomes, per 0.1 ml ",,,1004.58,3148.7,10 HCPCS,J3402,"Injection, remestemcel-l-rknd, per therapeutic dose ",,,202714.0,618084.0,7 HCPCS,J3403,"Revakinagene taroretcel-lwey, per implant ",,,493920.0,680400.0,5 HCPCS,J3410,HYDROXYZIN HCL 50 MG INJ,159.42,159.42,9.57,135.51,24 HCPCS,J3410,"Injection, hydroxyzine hcl, up to 25 mg ",159.42,159.42,1.33,52.82,10 HCPCS,J3411,"Injection, thiamine hcl, 100 mg ",52.35,52.35,1.55,8.29,10 HCPCS,J3411,THIAMINE 100 MG INJ,52.35,52.35,3.14,44.5,24 HCPCS,J3415,"Injection, pyridoxine hcl, 100 mg ",42.07,42.07,14.9,39.94,10 HCPCS,J3415,PYRIDOXINE 100 MG INJ,42.07,42.07,2.52,35.76,24 HCPCS,J3420,CYANOCOBAL 1000 MCG INJ,51.16,51.16,3.07,43.49,24 HCPCS,J3420,"Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg ",51.16,51.16,0.67,9.32,10 HCPCS,J3424,HYDROXOCOBALAM 5 G IV,4984.47,4984.47,299.07,4236.8,20 HCPCS,J3424,"Injection, hydroxocobalamin, intravenous, 25 mg ",4984.47,4984.47,9.56,15.88,8 HCPCS,J3425,"Injection, hydroxocobalamin, intramuscular, 10 mcg ",,,0.01,0.03,10 HCPCS,J3430,"Injection, phytonadione (vitamin k), per 1 mg ",,,3.16,8.86,10 HCPCS,J3430,VIT K PHYTON 1 MG/ML INJ,140.39,140.39,8.42,119.33,24 HCPCS,J3430,VIT K PHYTONAD 1 MG INJ,271.25,271.25,16.27,230.56,24 HCPCS,J3430,VIT K PHYTONAD 10 MG INJ,557.98,557.98,33.48,474.28,24 HCPCS,J3465,"Injection, voriconazole, 10 mg ",3722.66,3722.66,0.65,11.85,10 HCPCS,J3465,VORICONAZOLE 200 MG INJ,3722.66,3722.66,223.36,3164.26,24 HCPCS,J3470,"Injection, hyaluronidase, up to 150 units ",,,31.55,150.66,10 HCPCS,J3471,"Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) ",,,0.8,1.56,8 HCPCS,J3472,"Injection, hyaluronidase, ovine, preservative free, per 1000 usp units ",,,333.48,429.94,3 HCPCS,J3473,HYALURONIDASE RECB 150 U,282.44,282.44,16.95,240.07,24 HCPCS,J3473,"Injection, hyaluronidase, recombinant, 1 usp unit ",282.44,282.44,0.36,1.12,10 HCPCS,J3475,"Injection, magnesium sulfate, per 500 mg ",,,0.14,1.56,10 HCPCS,J3475,MAG SUL 1G/D5W 100ML INJ,222.48,222.48,13.35,189.11,24 HCPCS,J3475,MAG SUL 20G/WFI 500MLINJ,245.08,245.08,14.7,208.32,24 HCPCS,J3475,MAG SUL 4G/WFI 100ML INJ,883.97,883.97,53.04,751.37,24 HCPCS,J3475,MAG SULF 2G/WFI 50ML INJ,479.46,479.46,28.77,407.54,24 HCPCS,J3475,MAG SULFATE 1G INJ,53.17,53.17,3.19,45.19,24 HCPCS,J3475,MAG SULFATE 40 MG/ML INJ,16.65,16.65,1.0,14.15,24 HCPCS,J3475,MAG SULFATE 5G/10ML INJ,28.56,28.56,1.71,24.28,24 HCPCS,J3480,"Injection, potassium chloride, per 2 meq ",,,0.13,0.53,10 HCPCS,J3480,K10/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K10/WFI 100 ML INJ,185.6,185.6,11.14,157.76,24 HCPCS,J3480,K20 / WFI 100 ML INJ,185.6,185.6,11.14,157.76,24 HCPCS,J3480,K20/D5 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K20/D5/0.2NACL 1L INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K20/D5LR 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K20/D5NS 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K20/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K20/NS 1000 ML INJ,57.11,57.11,3.43,48.54,24 HCPCS,J3480,K20/NS0.45 1000 ML INJ,479.46,479.46,28.77,407.54,24 HCPCS,J3480,K30/D5NS0.45 1000 ML INJ,64.29,64.29,3.86,54.65,24 HCPCS,J3480,K40 / WFI 100 ML INJ,48.0,48.0,2.88,40.8,24 HCPCS,J3480,K40/D5NS 1000 ML INJ,374.35,374.35,22.46,318.2,24 HCPCS,J3480,K40/D5NS0.45 1000 ML INJ,404.3,404.3,24.26,343.65,24 HCPCS,J3480,K40/NS 1000 ML INJ,361.68,361.68,21.7,307.43,24 HCPCS,J3480,POTASS CL 0.08MEQ/ML INJ,16.65,16.65,1.0,14.15,24 HCPCS,J3480,POTASS CL 0.1 MEQ/ML INJ,16.0,16.0,0.96,13.6,24 HCPCS,J3480,POTASS CL 20 MEQ INJ,69.0,69.0,4.14,58.65,24 HCPCS,J3480,POTASS CL 40 MEQ INJ,53.17,53.17,3.19,45.19,24 HCPCS,J3485,"Injection, zidovudine, 10 mg ",,,1.51,4.71,10 HCPCS,J3485,ZIDOVUDINE 10 MG INJ,11.66,11.66,0.7,9.91,24 HCPCS,J3485,ZIDOVUDINE 10 MG INJ JW,11.66,11.66,0.7,9.91,24 HCPCS,J3485,ZIDOVUDINE 200 MG INJ,233.18,233.18,13.99,198.2,24 HCPCS,J3485,ZIDOVUDINE 4 MG/ML INJ,16.65,16.65,1.0,14.15,24 HCPCS,J3486,"Injection, ziprasidone mesylate, 10 mg ",816.16,816.16,5.87,67.07,10 HCPCS,J3486,ZIPRASIDONE 20 MG INJ,816.16,816.16,48.97,693.74,24 HCPCS,J3489,"Injection, zoledronic acid, 1 mg ",70.19,70.19,12.58,30.88,10 HCPCS,J3489,ZOLEDRONIC ACID 4MG INJ,70.19,70.19,4.21,59.66,24 HCPCS,J3490,ACD A/ANTICO-CIT-DEX1000,108.8,108.8,6.53,92.48,46 HCPCS,J3490,BUPIV125MG/EPI0.25MG MDV,82.84,82.84,4.97,70.41,30 HCPCS,J3490,BUPIV2.5/EPI0.005MG 10ML,46.98,46.98,2.82,39.93,46 HCPCS,J3490,BUPIV2.5/EPI0.005MG 30ML,74.19,74.19,4.45,63.06,46 HCPCS,J3490,BUPIV5MG/EPI0.005MG 10ML,48.22,48.22,2.89,40.99,46 HCPCS,J3490,BUPIV5MG/EPI0.005MG 1ML,2.57,2.57,0.15,2.18,46 HCPCS,J3490,BUPIV5MG/EPI0.005MG 30ML,80.36,80.36,4.82,68.31,46 HCPCS,J3490,BUPIV7.5/EPI0.005MG 30ML,100.15,100.15,6.01,85.13,46 HCPCS,J3490,CARBOPROST 250 MCG IM,398.51,398.51,23.91,338.73,30 HCPCS,J3490,CISATRACURIUM 10 MG INJ,123.64,123.64,7.42,105.09,46 HCPCS,J3490,CISATRACURIUM 200 MG INJ,2556.73,2556.73,153.4,2173.22,30 HCPCS,J3490,CLINIMIX 4.25/5 1L INJ,356.08,356.08,21.36,302.67,30 HCPCS,J3490,CLINIMIX 4.25/5 2L INJ,913.69,913.69,54.82,776.64,30 HCPCS,J3490,CLINIMIX 5/15 1L INJ,158.2,158.2,9.49,134.47,30 HCPCS,J3490,CLINIMIX 5/15 2L INJ,289.57,289.57,17.37,246.13,30 HCPCS,J3490,CLINIMIX 5/20 1L INJ,422.84,422.84,25.37,359.41,30 HCPCS,J3490,CLINIMIX 5/20 2L INJ,766.56,766.56,45.99,651.58,30 HCPCS,J3490,CLINIMIX E 4.25/10 1LINJ,565.02,565.02,33.9,480.27,30 HCPCS,J3490,CLINIMIX E 4.25/10 2LINJ,363.5,363.5,21.81,308.98,30 HCPCS,J3490,CLINIMIX E 4.25/5 1L INJ,272.01,272.01,16.32,231.21,30 HCPCS,J3490,CLINIMIX E 4.25/5 2L INJ,361.02,361.02,21.66,306.87,30 HCPCS,J3490,CLINIMIX E 5/15 1L INJ,422.84,422.84,25.37,359.41,30 HCPCS,J3490,CLINIMIX E 5/15 2L INJ,448.8,448.8,26.93,381.48,30 HCPCS,J3490,CLINIMIX E 5/20 1L INJ,425.31,425.31,25.52,361.51,30 HCPCS,J3490,CLINIMIX E 5/20 2L INJ,817.25,817.25,49.03,694.66,30 HCPCS,J3490,DANTROLENE 20 MG INJ,667.44,667.44,40.05,567.32,30 HCPCS,J3490,DEXMED 400MCG/NS100MLINJ,79.28,79.28,4.76,67.39,46 HCPCS,J3490,DEXMEDETOMID 200 MCG INJ,2061.05,2061.05,123.66,1751.89,46 HCPCS,J3490,ENALAPRILAT 25MCG/ML INJ,15.47,15.47,0.93,13.15,30 HCPCS,J3490,EPHEDRINE 50 MG INJ,258.4,258.4,15.5,219.64,46 HCPCS,J3490,FLUMAZENIL 0.1 MG INJ,48.06,48.06,2.88,40.85,30 HCPCS,J3490,INDOMETHACIN 50 MG SUPP,1759.61,1759.61,105.58,1495.67,30 HCPCS,J3490,ISOPROTERENOL 0.2MG INJ,14198.63,14198.63,851.92,12068.84,30 HCPCS,J3490,ISOPROTERENOL 1MG INJ,10186.45,10186.45,611.19,8658.48,30 HCPCS,J3490,KETAMINE 100 MG INJ,11.12,11.12,0.67,9.45,46 HCPCS,J3490,KETAMINE 2 MG/ML INJ,17.28,17.28,1.04,14.69,30 HCPCS,J3490,KETAMINE 200 MG MDV,97.79,97.79,5.87,83.12,30 HCPCS,J3490,KETAMINE 50 MG INJ,27.21,27.21,1.63,23.13,46 HCPCS,J3490,KETAMINE 500 MG MDV,272.1,272.1,16.33,231.29,30 HCPCS,J3490,LIPID EMUL 20% 250ML INJ,305.32,305.32,18.32,259.52,46 HCPCS,J3490,LIPID EMUL 20% 500ML INJ,105.56,105.56,6.33,89.73,46 HCPCS,J3490,NA BICARB 0.5 MEQ/ML INJ,17.31,17.31,1.04,14.71,30 HCPCS,J3490,NITROPRUSSIDE 50 MG INJ,85.67,85.67,5.14,72.82,30 HCPCS,J3490,NOREPI 16MCG/ML INJ,69.0,69.0,4.14,58.65,30 HCPCS,J3490,PHOXILLUM B22K 4/0,194.45,194.45,11.67,165.28,30 HCPCS,J3490,PLASMA-LYTE A 1L INJ,404.3,404.3,24.26,343.65,46 HCPCS,J3490,POSACONAZOLE 300 MG INJ,1500.71,1500.71,90.04,1275.6,30 HCPCS,J3490,POT PHOS 0.05MMOL/ML INJ,16.65,16.65,1.0,14.15,30 HCPCS,J3490,PRISMASOL BGK 2/3.5,231.99,231.99,13.92,197.19,30 HCPCS,J3490,PRISMASOL BGK 4/2.5,195.0,195.0,11.7,165.75,46 HCPCS,J3490,ROCURONIUM 10 MG/ML INJ,17.63,17.63,1.06,14.99,30 HCPCS,J3490,ROCURONIUM 100 MG MDV,35.26,35.26,2.12,29.97,30 HCPCS,J3490,ROCURONIUM 50 MG MDV,17.63,17.63,1.06,14.99,30 HCPCS,J3490,SOD PHOS 0.12MMOL/ML INJ,53.54,53.54,3.21,45.51,30 HCPCS,J3490,SOD TETRADECYL 1%2ML MDV,619.1,619.1,37.15,526.24,30 HCPCS,J3490,Unclassified drugs ,,,,,0 HCPCS,J3490,VALPROIC ACD 30MG/ML INJ,17.28,17.28,1.04,14.69,30 HCPCS,J3520,"Edetate disodium, per 150 mg ",,,2.43,3.96,8 HCPCS,J3535,ALBUTEROL 90MCG 6.7G INH,166.56,166.56,9.99,141.58,33 HCPCS,J3535,ALBUTEROL 90MCG 8G INH,113.45,113.45,6.81,96.43,33 HCPCS,J3535,FLUTI/SAL250/50MCG 60INH,1174.7,1174.7,70.48,998.5,33 HCPCS,J3535,FLUTIC/SAL 250/50 PUFF,2245.4,2245.4,134.72,1908.59,49 HCPCS,J3535,MOMET/FOR 100/5MCG 60INH,841.14,841.14,50.47,714.97,33 HCPCS,J3535,MOMET/FOR 200/5MCG 60INH,841.14,841.14,50.47,714.97,33 HCPCS,J3535,MOMETASONE 110MCG 30INH,747.14,747.14,44.83,635.07,33 HCPCS,J3535,MOMETASONE 220MCG PUFF,1639.44,1639.44,98.37,1393.52,49 HCPCS,J3535,TIOTROPIUM 18 MCG 1CAP,97.56,97.56,5.85,82.93,49 HCPCS,J3535,TIOTROPIUM 18 MCG 5CAP,453.75,453.75,27.23,385.69,33 HCPCS,J3535,TIOTROPIUM 2.5MCG 10INH,189.16,189.16,11.35,160.79,33 HCPCS,J3535,TIOTROPIUM 2.5MCG 60INH,791.1,791.1,47.47,672.43,33 HCPCS,J3570,"Laetrile, amygdalin, vitamin b17 ",,,,,0 HCPCS,J3590,THROMBIN 5000 U TOPICAL,2123.67,2123.67,127.42,1805.12,30 HCPCS,J3590,Unclassified biologics ,2123.67,2123.67,,,0 HCPCS,J7030,"Infusion, normal saline solution , 1000 cc ",441.39,441.39,2.19,40.23,10 HCPCS,J7030,NS 1000 ML,441.39,441.39,26.48,375.18,24 HCPCS,J7040,"Infusion, normal saline solution, sterile (500 ml = 1 unit) ",200.3,200.3,1.36,20.12,10 HCPCS,J7040,NS 500 ML,200.3,200.3,12.02,170.25,24 HCPCS,J7042,5% dextrose/normal saline (500 ml = 1 unit) ,,,1.29,4.54,10 HCPCS,J7042,D5NS 1000 ML,55.31,55.31,3.32,47.01,24 HCPCS,J7042,D5NS 500 ML,83.28,83.28,5.0,70.79,24 HCPCS,J7050,"Infusion, normal saline solution, 250 cc ",,,0.7,10.04,10 HCPCS,J7050,NS 100 ML,195.825,195.825,3.17,287.95,48 HCPCS,J7050,NS 250 ML,208.2,208.2,12.49,176.97,24 HCPCS,J7050,NS 50 ML,195.305,195.305,3.11,287.95,48 HCPCS,J7060,5% dextrose/water (500 ml = 1 unit) ,,,1.87,20.47,10 HCPCS,J7060,D5W 100 ML INJ,192.88,192.88,11.57,163.95,24 HCPCS,J7060,D5W 150 ML INJ,48.0,48.0,2.88,40.8,24 HCPCS,J7060,D5W 250 ML INJ,237.385,237.385,11.57,239.61,48 HCPCS,J7060,D5W 50 ML INJ,125.59,125.59,3.5,163.95,48 HCPCS,J7060,D5W 500 ML INJ,302.19,302.19,18.13,256.86,24 HCPCS,J7070,D5W 1000ML,404.3,404.3,24.26,343.65,24 HCPCS,J7070,"Infusion, d5w, 1000 cc ",404.3,404.3,3.07,40.93,10 HCPCS,J7100,"Infusion, dextran 40, 500 ml ",,,52.0,211.82,8 HCPCS,J7110,"Infusion, dextran 75, 500 ml ",,,35.14,45.3,3 HCPCS,J7120,LACTATED RINGERS 1000 ML,441.39,441.39,26.48,375.18,24 HCPCS,J7120,LACTATED RINGERS 500 ML,320.22,320.22,19.21,272.19,24 HCPCS,J7120,"Ringers lactate infusion, up to 1000 cc ",,,2.6,16.04,10 HCPCS,J7121,"5% dextrose in lactated ringers infusion, up to 1000 cc ",389.04,389.04,9.7,25.4,8 HCPCS,J7121,D5 LR 1000 ML,389.04,389.04,23.34,330.68,25 HCPCS,J7131,23.4% NACL 30 ML INJ,38.72,38.72,2.32,32.91,25 HCPCS,J7131,3% NACL 500 ML INJ,290.55,290.55,17.43,246.97,25 HCPCS,J7131,"Hypertonic saline solution, 1 ml ",,,0.1,0.53,8 HCPCS,J7165,BALFAXAR 1 U IX INJ,7.38,7.38,0.44,6.27,20 HCPCS,J7165,BALFAXAR 1280 U IX INJ,9447.32,9447.32,566.84,8030.22,20 HCPCS,J7165,BALFAXAR 640 U IX INJ,5018.89,5018.89,301.13,4266.06,20 HCPCS,J7165,"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity ",,,6.23,10.02,8 HCPCS,J7168,"Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity ",,,5.12,9.48,8 HCPCS,J7169,"Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg ",,,308.55,739.53,8 HCPCS,J7170,"Injection, emicizumab-kxwh, 0.5 mg ",,,55.64,179.18,10 HCPCS,J7170,"Injection, emicizumab-kxwh, 0.5 mg Chemotherapy Drugs",,,,,0 HCPCS,J7171,"Injection, adamts13, recombinant-krhn, 10 iu ",,,35.58,111.04,10 HCPCS,J7172,"Injection, marstacimab-hncq, 0.5 mg ",,,50.19,158.22,10 HCPCS,J7173,"Injection, concizumab-mtci, 0.5 mg ",,,83.47,259.69,7 HCPCS,J7174,"Injection, fitusiran, 0.04 mg ",,,132.63,351.41,7 HCPCS,J7175,"Injection, factor x, (human), 1 i.u. ",,,9.95,30.92,10 HCPCS,J7177,FIBRYGA 1000 MG INJ,4847.04,4847.04,290.82,4119.98,19 HCPCS,J7177,"Injection, human fibrinogen concentrate (fibryga), 1 mg ",4847.04,4847.04,1.24,3.78,10 HCPCS,J7177,"Injection, human fibrinogen concentrate (fibryga), 1 mg Chemotherapy Drugs",4847.04,4847.04,,,0 HCPCS,J7178,"Injection, human fibrinogen concentrate, not otherwise specified, 1 mg ",,,1.52,4.74,10 HCPCS,J7179,"Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco ",,,1.83,5.77,10 HCPCS,J7180,"Injection, factor xiii (antihemophilic factor, human), 1 i.u. ",,,10.78,33.63,10 HCPCS,J7181,"Injection, factor xiii a-subunit, (recombinant), per iu ",,,18.33,57.06,10 HCPCS,J7182,"Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu ",4847.04,4847.04,1.41,4.74,10 HCPCS,J7182,NOVOEIGHT 1000 U INJ,4847.04,4847.04,290.82,4119.98,19 HCPCS,J7183,"Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco ",,,1.32,3.96,10 HCPCS,J7185,"Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u. ",,,1.49,4.8,10 HCPCS,J7186,"Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u. ",,,1.25,3.84,10 HCPCS,J7187,HUMATE-P 1200 U VWF:RCO,7138.37,7138.37,428.3,6067.61,19 HCPCS,J7187,"Injection, von willebrand factor complex (humate-p), per iu vwf:rco ",7138.37,7138.37,1.49,4.65,10 HCPCS,J7188,"Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u. ",,,3.24,10.08,10 HCPCS,J7189,"Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram ",,,2.64,8.27,10 HCPCS,J7189,NOVOSEVEN RT 1 MCGJW,17.84,17.84,1.07,15.16,19 HCPCS,J7189,NOVOSEVEN RT 1 MG INJ,19331.89,19331.89,1159.91,16432.11,19 HCPCS,J7189,NOVOSEVEN RT 1 MICROGRAM,17.84,17.84,1.07,15.16,19 HCPCS,J7189,NOVOSEVEN RT 2 MG INJ,38662.6,38662.6,2319.76,32863.21,19 HCPCS,J7190,"Factor viii (antihemophilic factor, human) per i.u. ",4075.92,4075.92,1.39,3.53,10 HCPCS,J7190,KOATE 1000 U INJ,4075.92,4075.92,244.56,3464.53,19 HCPCS,J7192,"Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified ",,,1.57,4.8,10 HCPCS,J7193,"Factor ix (antihemophilic factor, purified, non-recombinant) per i.u. ",,,1.37,4.18,10 HCPCS,J7194,"Factor ix, complex, per i.u. ",,,1.7,5.3,10 HCPCS,J7194,PROFILNINE 1 U INJ,9.35,9.35,0.56,7.95,19 HCPCS,J7194,PROFILNINE 1000 U INJ,9350.0,9350.0,561.0,7947.5,19 HCPCS,J7194,PROFILNINE 500 U INJ,4675.0,4675.0,280.5,3973.75,19 HCPCS,J7195,BENEFIX 1000 U INJ,5508.0,5508.0,330.48,4681.8,19 HCPCS,J7195,BENEFIX 2000 U INJ,11016.0,11016.0,660.96,9363.6,19 HCPCS,J7195,BENEFIX 3000 U INJ,16524.0,16524.0,991.44,14045.4,19 HCPCS,J7195,"Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified ",,,1.84,5.87,10 HCPCS,J7196,"Injection, antithrombin recombinant, 50 i.u. ",,,275.38,447.13,8 HCPCS,J7197,"Antithrombin iii (human), per i.u. ",,,4.1,12.76,10 HCPCS,J7197,THROMBATE III 1 U INJ,18.89,18.89,1.13,16.06,19 HCPCS,J7197,THROMBATE III 500 U INJ,9446.22,9446.22,566.77,8029.29,19 HCPCS,J7198,"Anti-inhibitor, per i.u. ",,,2.42,7.64,10 HCPCS,J7199,"Hemophilia clotting factor, not otherwise classified ",,,,,0 HCPCS,J7200,"Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu ",,,1.74,4.9,10 HCPCS,J7201,"Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u. ",,,3.58,11.33,10 HCPCS,J7202,"Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u. ",,,5.32,16.66,10 HCPCS,J7203,"Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu ",,,4.5,14.29,10 HCPCS,J7203,"Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu Chemotherapy Drugs",,,,,0 HCPCS,J7204,"Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu ",,,2.23,7.05,10 HCPCS,J7205,"Injection, factor viii fc fusion protein (recombinant), per iu ",,,2.46,7.55,10 HCPCS,J7207,"Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. ",,,2.14,6.71,10 HCPCS,J7208,"Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u. ",,,2.66,8.27,10 HCPCS,J7209,"Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u. ",,,1.18,3.68,10 HCPCS,J7210,"Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u. ",,,1.57,4.93,10 HCPCS,J7211,"Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u. ",,,1.56,4.93,10 HCPCS,J7212,"Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram ",,,2.2,7.49,10 HCPCS,J7213,"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u. ",,,1.97,5.96,10 HCPCS,J7214,"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u. ",,,4.49,14.57,10 HCPCS,J7294,"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each ",,,4080.01,7703.16,8 HCPCS,J7295,"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each ",,,274.3,390.53,8 HCPCS,J7296,"Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg ",,,1838.97,3865.46,8 HCPCS,J7297,"Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg ",,,1468.82,2965.15,8 HCPCS,J7298,"Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg ",,,1781.58,3865.46,8 HCPCS,J7299,Intrauterine copper contraceptive (miudella) ,,,2250.3,3099.9,5 HCPCS,J7300,Intrauterine copper contraceptive (paragard) ,,,1733.62,3622.63,8 HCPCS,J7301,"Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg ",,,1531.27,3218.62,8 HCPCS,J7304,"Contraceptive supply, hormone containing patch, each ",,,79.81,109.94,5 HCPCS,J7306,"Levonorgestrel (contraceptive) implant system, including implants and supplies ",,,773.24,996.9,3 HCPCS,J7307,"Etonogestrel (contraceptive) implant system, including implant and supplies ",,,1832.25,3865.46,8 HCPCS,J7308,"Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) ",,,390.02,1228.87,10 HCPCS,J7309,"Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram ",,,202.53,261.11,3 HCPCS,J7310,"Ganciclovir, 4.5 mg, long-acting implant ",,,41043.2,52915.2,3 HCPCS,J7311,"Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg ",,,338.79,1060.05,10 HCPCS,J7312,"Injection, dexamethasone, intravitreal implant, 0.1 mg ",,,194.23,640.47,23 HCPCS,J7313,"Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg ",,,509.81,1553.14,10 HCPCS,J7314,"Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg ",,,529.89,1661.65,10 HCPCS,J7315,"Mitomycin, ophthalmic, 0.2 mg ",,,703.64,1368.43,8 HCPCS,J7316,"Injection, ocriplasmin, 0.125 mg ",,,1935.83,3266.42,8 HCPCS,J7318,"Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg ",,,6.73,21.06,10 HCPCS,J7318,"Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J7320,"Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg ",,,3.68,20.68,10 HCPCS,J7321,"Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose ",,,74.43,228.98,10 HCPCS,J7322,"Hyaluronan or derivative, hymovis or hymovis one, for intra-articular injection, 1 mg ",,,18.13,54.41,10 HCPCS,J7323,"Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose ",,,105.58,461.94,10 HCPCS,J7324,"Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose ",,,109.09,401.79,10 HCPCS,J7325,"Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg ",,,6.96,32.0,10 HCPCS,J7326,"Hyaluronan or derivative, gel-one, for intra-articular injection, per dose ",,,526.79,1634.94,10 HCPCS,J7327,"Hyaluronan or derivative, monovisc, for intra-articular injection, per dose ",,,655.34,2156.09,10 HCPCS,J7328,"Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg ",,,0.68,2.67,10 HCPCS,J7329,"Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg ",,,3.27,17.0,10 HCPCS,J7329,"Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J7330,"Autologous cultured chondrocytes, implant ",,,74830.84,209471.93,8 HCPCS,J7331,"Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg ",,,3.12,17.5,10 HCPCS,J7332,"Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg ",,,10.55,66.02,10 HCPCS,J7336,"Capsaicin 8% patch, per square centimeter ",,,3.42,10.55,10 HCPCS,J7340,"Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml ",,,244.04,758.63,10 HCPCS,J7342,"Instillation, ciprofloxacin otic suspension, 6 mg ",,,55.51,90.11,8 HCPCS,J7345,"Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg ",,,1.77,5.65,10 HCPCS,J7345,"Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J7351,"Injection, bimatoprost, intracameral implant, 1 microgram ",,,214.02,662.56,10 HCPCS,J7352,"Afamelanotide implant, 1 mg ",,,6309.04,10026.4,8 HCPCS,J7353,"Anacaulase-bcdb, 8.8% gel, 1 gram ",,,111.82,182.27,8 HCPCS,J7354,"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg) ",,,667.07,2089.12,10 HCPCS,J7355,"Injection, travoprost, intracameral implant, 1 microgram ",,,196.88,506.22,7 HCPCS,J7356,"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg ",,,0.7,2.18,10 HCPCS,J7402,"Mometasone furoate sinus implant, (sinuva), 10 micrograms ",,,11.35,35.41,10 HCPCS,J7500,AZATHIOPRINE 50 MG PO,57.11,57.11,3.43,48.54,24 HCPCS,J7500,"Azathioprine, oral, 50 mg ",57.11,57.11,0.18,6.68,10 HCPCS,J7501,"Azathioprine, parenteral, 100 mg ",,,229.32,795.6,8 HCPCS,J7502,CYCLOSP 100 MG/ML LIQ PO,8.28,8.28,0.5,7.04,24 HCPCS,J7502,CYCLOSPORINE 100 MG PO,311.71,311.71,18.7,264.95,24 HCPCS,J7502,"Cyclosporine, oral, 100 mg ",,,1.43,8.56,10 HCPCS,J7503,"Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg ",,,1.86,5.71,10 HCPCS,J7504,"Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg ",,,3907.91,15640.9,10 HCPCS,J7507,TACROLIMUS IMM 0.5 MG PO,98.74,98.74,5.92,83.93,24 HCPCS,J7507,TACROLIMUS IMM 1 MG PO,151.065,151.065,2.42,222.48,48 HCPCS,J7507,TACROLIMUS IMM 5 MG PO,50.68,50.68,3.04,43.08,24 HCPCS,J7507,"Tacrolimus, immediate release, oral, 1 mg ",,,0.23,9.8,10 HCPCS,J7508,"Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg ",,,0.59,1.84,10 HCPCS,J7509,METHYLPRED 4 MG PO,53.54,53.54,3.21,45.51,24 HCPCS,J7509,"Methylprednisolone oral, per 4 mg ",53.54,53.54,0.14,1.0,10 HCPCS,J7510,PREDNISOLONE 15MG PO,117.78,117.78,7.07,100.11,24 HCPCS,J7510,"Prednisolone oral, per 5 mg ",117.78,117.78,0.37,0.84,10 HCPCS,J7511,"Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg ",,,1023.12,3108.74,10 HCPCS,J7512,PREDNISONE 10 MG PO,11.12,11.12,0.67,9.45,24 HCPCS,J7512,PREDNISONE 1MG/1ML LIQPO,9.51,9.51,0.57,8.08,24 HCPCS,J7512,PREDNISONE 20 MG PO,11.12,11.12,0.67,9.45,24 HCPCS,J7512,PREDNISONE 5 MG PO,11.9,11.9,0.71,10.12,24 HCPCS,J7512,PREDNISONE 50 MG PO,4.59,4.59,0.28,3.9,24 HCPCS,J7512,PREDNISONE IR/DR 1 MG PO,10.7,10.7,0.64,9.09,24 HCPCS,J7512,"Prednisone, immediate release or delayed release, oral, 1 mg ",,,0.01,0.03,10 HCPCS,J7514,"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg ",,,2.25,6.96,10 HCPCS,J7515,CYCLOSPORINE 25 MG PO,75.545,75.545,3.64,76.86,48 HCPCS,J7515,"Cyclosporine, oral, 25 mg ",,,0.63,2.4,10 HCPCS,J7516,"Injection, cyclosporine, 250 mg ",,,52.98,226.79,10 HCPCS,J7517,MYCOPHE 200MG/1ML LIQ PO,25.27,25.27,1.52,21.48,40 HCPCS,J7517,MYCOPHENOLATE 250 MG PO,78.53,78.53,4.71,66.75,24 HCPCS,J7517,MYCOPHENOLATE 500 MG PO,187.97,187.97,11.28,159.77,24 HCPCS,J7517,"Mycophenolate mofetil, oral, 250 mg ",,,0.14,1.54,10 HCPCS,J7518,"Mycophenolic acid, oral, 180 mg ",,,0.32,5.32,10 HCPCS,J7519,"Injection, mycophenolate mofetil, 10 mg ",,,0.4,3.89,10 HCPCS,J7520,SIROLIMUS 0.5 MG PO,69.0,69.0,4.14,58.65,24 HCPCS,J7520,SIROLIMUS 1 MG PO,121.35,121.35,7.28,103.15,24 HCPCS,J7520,SIROLIMUS 1 MG/ML LIQ PO,46.95,46.95,2.82,39.91,24 HCPCS,J7520,"Sirolimus, oral, 1 mg ",,,1.27,24.49,10 HCPCS,J7521,TACROLIMUS 0.2MG GRAN PO,27.05,27.05,1.62,22.99,40 HCPCS,J7521,"Tacrolimus, granules, oral suspension, 0.1 mg ",27.05,27.05,1.28,4.02,10 HCPCS,J7525,"Tacrolimus, parenteral, 5 mg ",,,259.96,818.16,10 HCPCS,J7527,"Everolimus, oral, 0.25 mg ",,,1.24,23.73,10 HCPCS,J7528,"Mycophenolate mofetil, for suspension, oral, 100 mg ",,,0.31,0.73,7 HCPCS,J7599,"Immunosuppressive drug, not otherwise classified ",,,,,0 HCPCS,J7601,"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg ",,,52.12,162.61,10 HCPCS,J7605,"Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms ",,,0.73,46.33,10 HCPCS,J7606,FORMOTEROL 20 MCG INH,14.09,14.09,0.85,11.98,24 HCPCS,J7606,"Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms ",14.09,14.09,1.78,45.93,10 HCPCS,J7608,ACETYLCYSTN 10% 4 ML INH,204.64,204.64,12.28,173.94,24 HCPCS,J7608,ACETYLCYSTN 20% 4 ML INH,296.24,296.24,17.77,251.8,24 HCPCS,J7608,"Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram ",,,3.0,27.74,10 HCPCS,J7609,"Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg ",,,0.2,1.59,8 HCPCS,J7610,"Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg ",,,2.98,3.84,3 HCPCS,J7611,"Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg ",,,0.2,0.5,10 HCPCS,J7612,"Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg ",,,0.32,4.16,10 HCPCS,J7613,ALBUTERL NC UD 2.5MG INH,46.4,46.4,2.78,39.44,24 HCPCS,J7613,ALBUTERLNC UD 1.25MG INH,5.4,5.4,0.32,4.59,24 HCPCS,J7613,"Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg ",,,0.08,0.25,10 HCPCS,J7614,LEVALBU NCUD 0.63 MG INH,149.9,149.9,8.99,127.42,24 HCPCS,J7614,LEVALBU NCUD 1.25 MG INH,72.58,72.58,4.35,61.69,24 HCPCS,J7614,"Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg ",,,0.09,3.13,10 HCPCS,J7615,"Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg ",,,3.48,4.49,3 HCPCS,J7620,ALBUT/IPRA 2.5/0.5MG INH,69.24,69.24,4.15,58.85,24 HCPCS,J7620,"Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme ",69.24,69.24,0.21,0.65,10 HCPCS,J7626,BUDESON NC UD 0.25MG INH,186.79,186.79,11.21,158.77,24 HCPCS,J7626,BUDESONIDE NC 0.5 MG INH,19.87,19.87,1.19,16.89,24 HCPCS,J7626,BUDESONIDE NC 1 MG INH,16.69,16.69,1.0,14.19,24 HCPCS,J7626,"Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg ",,,1.1,15.23,10 HCPCS,J7627,"Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg ",,,0.04,0.97,8 HCPCS,J7628,"Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram ",,,0.43,0.69,8 HCPCS,J7631,"Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams ",,,0.7,16.88,10 HCPCS,J7632,"Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams ",,,0.65,0.84,3 HCPCS,J7633,"Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram ",,,11.66,15.04,3 HCPCS,J7639,DORNASEALFA UD 2.5MG INH,720.92,720.92,43.26,612.78,24 HCPCS,J7639,"Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram ",720.92,720.92,55.17,172.1,10 HCPCS,J7640,"Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms ",,,4.19,5.4,3 HCPCS,J7641,"Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram ",,,20.62,26.58,3 HCPCS,J7643,"Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram ",,,1.45,2.37,8 HCPCS,J7644,IPRATROPIUM NC 0.5MG INH,55.92,55.92,3.36,47.53,24 HCPCS,J7644,"Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram ",55.92,55.92,0.44,1.38,10 HCPCS,J7645,"Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram ",,,0.12,0.16,3 HCPCS,J7650,"Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram ",,,,,0 HCPCS,J7650,"Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram Chemotherapy Drugs",,,,,0 HCPCS,J7665,"Mannitol, administered through an inhaler, 5 mg ",,,12.9,20.94,8 HCPCS,J7669,"Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams ",,,1.04,1.34,3 HCPCS,J7674,METHACHOLINE 100 MG INH,778.09,778.09,46.69,661.38,25 HCPCS,J7674,"Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg ",778.09,778.09,1.47,5.4,8 HCPCS,J7677,"Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram ",,,0.2,0.59,10 HCPCS,J7680,"Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram ",,,25.94,33.45,3 HCPCS,J7681,"Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram ",,,25.94,33.45,3 HCPCS,J7682,TOBRAMYCIN NC 300 MG INH,107.07,107.07,6.42,91.01,24 HCPCS,J7682,"Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams ",107.07,107.07,7.77,150.2,10 HCPCS,J7683,"Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram ",,,9.32,12.01,3 HCPCS,J7685,"Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams ",,,119.11,153.57,3 HCPCS,J7686,"Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg ",,,789.18,2496.47,10 HCPCS,J7999,CMPD ACYCLOV 500MG/100ML,17.63,17.63,1.06,14.99,30 HCPCS,J7999,CMPD CARDIOPLEGIA,411.65,411.65,19.99,416.64,60 HCPCS,J7999,CMPD DILTZM 125MG 125B,46.76,46.76,2.81,39.75,30 HCPCS,J7999,CMPD EPI 5 MG 250B,186.75,186.75,11.21,158.74,30 HCPCS,J7999,CMPD EPI 5MG 255ML,99.04,99.04,5.94,84.18,30 HCPCS,J7999,CMPD FENTPF 1000MCG 100B,1092.17,1092.17,65.53,928.34,30 HCPCS,J7999,CMPD FTBP5MCG-0.0625250B,186.75,186.75,11.21,158.74,30 HCPCS,J7999,CMPD HEP 30000U 1000ML,99.93,99.93,6.0,84.94,30 HCPCS,J7999,CMPD HYMOR 10MG 50B,47.58,47.58,2.85,40.44,30 HCPCS,J7999,CMPD HYMOR 10MG 50ML,47.58,47.58,2.85,40.44,30 HCPCS,J7999,CMPD HYMOR 25MG 50B,204.64,204.64,12.28,173.94,30 HCPCS,J7999,CMPD HYMOR 25MG 50ML,204.64,204.64,12.28,173.94,30 HCPCS,J7999,CMPD INDOMET 100MG SUPP,1200.0,1200.0,72.0,1020.0,46 HCPCS,J7999,CMPD KETAMIN 1000MG 100B,61.86,61.86,3.71,52.58,30 HCPCS,J7999,CMPD KETAMIN 2500MG 250B,61.86,61.86,3.71,52.58,30 HCPCS,J7999,CMPD KETAMIN 500MG 260ML,40.0,40.0,2.4,34.0,30 HCPCS,J7999,CMPD KPHOS 15MM 250B,59.99,59.99,3.6,50.99,30 HCPCS,J7999,CMPD LACTULOSE ENEMA,113.4,113.4,6.8,96.39,46 HCPCS,J7999,CMPD LANSOPRAZ 3MG/ML PO,13.09,13.09,0.79,11.13,46 HCPCS,J7999,CMPD LORAZPM 50MG 50B,43.2,43.2,2.59,36.72,30 HCPCS,J7999,CMPD MIDZLM 100MG 100B,780.46,780.46,46.83,663.39,30 HCPCS,J7999,CMPD MIDZLM 50MG 50B,43.2,43.2,2.59,36.72,30 HCPCS,J7999,CMPD MORPH 100MG 100B,198.69,198.69,11.92,168.89,30 HCPCS,J7999,CMPD MORPH 30MG 30B,82.73,82.73,4.96,70.32,30 HCPCS,J7999,CMPD NITROGL1000MCG 10ML,52.35,52.35,3.14,44.5,30 HCPCS,J7999,CMPD NOREPI 16MG 250B,148.72,148.72,8.92,126.41,30 HCPCS,J7999,CMPD NOREPI 16MG 266ML,148.72,148.72,8.92,126.41,30 HCPCS,J7999,CMPD OXYTOCIN 30U 500B,43.2,43.2,2.59,36.72,30 HCPCS,J7999,CMPD PHENYLEPN 0.5MG 5S,30.0,30.0,1.8,25.5,30 HCPCS,J7999,CMPD PHENYLEPN 1MG 10S,178.46,178.46,10.71,151.69,30 HCPCS,J7999,CMPD ROP/CLON/EPI/KETOR,131.49,131.49,7.89,111.77,30 HCPCS,J7999,CMPD SOD PHOS 15MMOL250B,312.6,312.6,18.76,265.71,30 HCPCS,J7999,CMPD TACROL 0.5MG/ML PO,16.65,16.65,1.0,14.15,46 HCPCS,J7999,CMPD VANCO 1.25G 250B,282.02,282.02,16.92,239.72,30 HCPCS,J7999,CMPD VANCO 1.75G 500B,217.79,217.79,13.07,185.12,30 HCPCS,J7999,CMPD VANCO 2G 500B,170.49,170.49,10.23,144.92,30 HCPCS,J7999,CMPD VIT K 5MG/5ML PO,425.31,425.31,25.52,361.51,46 HCPCS,J7999,"Compounded drug, not otherwise classified ",,,,,0 HCPCS,J8498,"Antiemetic drug, rectal/suppository, not otherwise specified ",,,,,0 HCPCS,J8499,BIKTARVY 50/200/25 MG PO,712.65,712.65,42.76,605.75,30 HCPCS,J8499,BUPROPION IR 100 MG PO,144.66,144.66,8.68,122.96,30 HCPCS,J8499,BUPROPION IR 75 MG PO,106.33,106.33,6.38,90.38,30 HCPCS,J8499,BUPROPION XL 150 MG PO,30.93,30.93,1.86,26.29,30 HCPCS,J8499,BUPROPION XL 300 MG PO,45.21,45.21,2.71,38.43,30 HCPCS,J8499,DAPAGLIFLOZIN 10 MG PO,89.23,89.23,5.35,75.85,30 HCPCS,J8499,DAPAGLIFLOZIN 5 MG PO,98.74,98.74,5.92,83.93,30 HCPCS,J8499,FIDAXOMICIN 200 MG PO,1825.04,1825.04,109.5,1551.28,30 HCPCS,J8499,FLUCYTOSINE 500 MG PO,1244.45,1244.45,74.67,1057.78,30 HCPCS,J8499,HYDROXYCHLOROQN 200MG PO,81.6,81.6,4.9,69.36,30 HCPCS,J8499,IVERMECTIN 3 MG PO,24.85,24.85,1.49,21.12,30 HCPCS,J8499,LACOSAM 100MG/10ML LIQPO,111.5,111.5,6.69,94.78,30 HCPCS,J8499,LINEZOLID 600 MG PO,2277.42,2277.42,136.65,1935.81,30 HCPCS,J8499,NALOXEGOL 25 MG PO,73.76,73.76,4.43,62.7,30 HCPCS,J8499,NITAZOXANIDE 500 MG PO,604.68,604.68,36.28,513.98,30 HCPCS,J8499,POSACONAZOLE ER 100MG PO,8.25,8.25,0.49,7.01,30 HCPCS,J8499,PYRIMETHAMINE 25 MG PO,7767.74,7767.74,466.06,6602.58,30 HCPCS,J8499,"Prescription drug, oral, non chemotherapeutic, nos ",,,,,0 HCPCS,J8499,RITONAVIR 100 MG PO,72.58,72.58,4.35,61.69,30 HCPCS,J8499,TERBUTALINE 5 MG PO,49.45,49.45,2.97,42.03,30 HCPCS,J8499,TOLVAPTAN 15 MG PO,5885.19,5885.19,353.11,5002.41,30 HCPCS,J8499,TOLVAPTAN 30 MG PO,594.1,594.1,35.65,504.99,30 HCPCS,J8501,"Aprepitant, oral, 5 mg ",,,2.39,19.66,10 HCPCS,J8502,"Injection, aprepitant (aponvie), 1 mg ",,,1.95,1.95,2 HCPCS,J8510,BUSULFAN 2 MG PO,185.6,185.6,11.14,157.76,20 HCPCS,J8510,"Busulfan; oral, 2 mg ",185.6,185.6,47.29,437.14,8 HCPCS,J8515,"Cabergoline, oral, 0.25 mg ",,,0.15,21.38,10 HCPCS,J8521,"Capecitabine, oral, 500 mg ",,,,,0 HCPCS,J8521,"Capecitabine, oral, 500 mg Chemotherapy Drugs",,,,,0 HCPCS,J8522,"Capecitabine, oral, 50 mg ",,,0.03,0.19,10 HCPCS,J8530,CYCLOPHOSPHAMIDE 25MG PO,59.49,59.49,3.57,50.57,24 HCPCS,J8530,CYCLOPHOSPHAMIDE 50MG PO,102.32,102.32,6.14,86.97,24 HCPCS,J8530,"Cyclophosphamide; oral, 25 mg ",,,1.65,13.1,10 HCPCS,J8530,"Cyclophosphamide; oral, 25 mg Chemotherapy Drugs",,,,,0 HCPCS,J8540,DEXAMETH 0.5MG/5ML LIQPO,52.35,52.35,3.14,44.5,24 HCPCS,J8540,DEXAMETHASONE 0.5 MG PO,9.51,9.51,0.57,8.08,24 HCPCS,J8540,DEXAMETHASONE 0.75 MG PO,9.51,9.51,0.57,8.08,24 HCPCS,J8540,DEXAMETHASONE 1 MG PO,10.7,10.7,0.64,9.09,24 HCPCS,J8540,DEXAMETHASONE 2 MG PO,5.4,5.4,0.32,4.59,24 HCPCS,J8540,DEXAMETHASONE 4 MG PO,27.37,27.37,1.64,23.26,24 HCPCS,J8540,DEXAMETHASONE 6 MG PO,6.05,6.05,0.36,5.14,24 HCPCS,J8540,"Dexamethasone, oral, 0.25 mg ",,,0.02,0.06,10 HCPCS,J8540,"Dexamethasone, oral, 0.25 mg Chemotherapy Drugs",,,,,0 HCPCS,J8541,"Dexamethasone (hemady), oral, 0.25 mg ",,,0.67,1.15,8 HCPCS,J8560,ETOPOSIDE 50 MG PO,600.81,600.81,36.05,510.69,24 HCPCS,J8560,"Etoposide; oral, 50 mg ",600.81,600.81,86.84,236.37,10 HCPCS,J8560,"Etoposide; oral, 50 mg Chemotherapy Drugs",600.81,600.81,,,0 HCPCS,J8565,"Gefitinib, oral, 250 mg ",,,346.08,722.03,8 HCPCS,J8565,"Gefitinib, oral, 250 mg Chemotherapy Drugs",,,,,0 HCPCS,J8597,"Antiemetic drug, oral, not otherwise specified ",,,,,0 HCPCS,J8597,"Antiemetic drug, oral, not otherwise specified Chemotherapy Drugs",,,,,0 HCPCS,J8600,"Melphalan; oral, 2 mg ",,,13.78,29.14,8 HCPCS,J8600,"Melphalan; oral, 2 mg Chemotherapy Drugs",,,,,0 HCPCS,J8610,METHOTREXATE 2.5 MG PO,185.6,185.6,11.14,157.76,24 HCPCS,J8610,"Methotrexate; oral, 2.5 mg ",185.6,185.6,0.14,5.54,10 HCPCS,J8610,"Methotrexate; oral, 2.5 mg Chemotherapy Drugs",185.6,185.6,,,0 HCPCS,J8611,"Methotrexate (jylamvo), oral, 2.5 mg ",,,18.71,57.81,10 HCPCS,J8612,"Methotrexate (xatmep), oral, 2.5 mg ",,,22.3,70.7,10 HCPCS,J8650,"Nabilone, oral, 1 mg ",,,96.75,124.74,3 HCPCS,J8655,"Netupitant 300 mg and palonosetron 0.5 mg, oral ",,,397.79,1619.54,10 HCPCS,J8670,"Rolapitant, oral, 1 mg ",,,3.78,9.45,8 HCPCS,J8700,"Temozolomide, oral, 5 mg ",,,0.4,11.1,10 HCPCS,J8700,"Temozolomide, oral, 5 mg Chemotherapy Drugs",,,,,0 HCPCS,J8705,"Topotecan, oral, 0.25 mg ",,,125.22,389.69,10 HCPCS,J8999,"Prescription drug, oral, chemotherapeutic, nos ",,,,,0 HCPCS,J8999,"Prescription drug, oral, chemotherapeutic, nos Chemotherapy Drugs",,,,,0 HCPCS,J9000,DOXORUBICIN 50 MG INJ,1038.64,1038.64,62.32,882.84,24 HCPCS,J9000,"Injection, doxorubicin hydrochloride, 10 mg ",1038.64,1038.64,2.73,9.42,10 HCPCS,J9000,"Injection, doxorubicin hydrochloride, 10 mg Chemotherapy Drugs",1038.64,1038.64,,,0 HCPCS,J9011,"Injection, datopotamab deruxtecan-dlnk, 1 mg ",,,51.52,154.98,7 HCPCS,J9015,"Injection, aldesleukin, per single use vial ",,,9115.59,19285.34,8 HCPCS,J9015,"Injection, aldesleukin, per single use vial Chemotherapy Drugs",,,,,0 HCPCS,J9017,"Injection, arsenic trioxide, 1 mg ",,,6.45,110.86,10 HCPCS,J9017,"Injection, arsenic trioxide, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9019,"Injection, asparaginase (erwinaze), 1,000 iu ",,,994.98,1282.79,3 HCPCS,J9019,"Injection, asparaginase (erwinaze), 1,000 iu Chemotherapy Drugs",,,,,0 HCPCS,J9020,"Injection, asparaginase, not otherwise specified, 10,000 units ",,,,,0 HCPCS,J9020,"Injection, asparaginase, not otherwise specified, 10,000 units Chemotherapy Drugs",,,,,0 HCPCS,J9021,"Injection, asparaginase, recombinant, (rylaze), 0.1 mg ",,,56.29,172.54,10 HCPCS,J9022,"Injection, atezolizumab, 10 mg ",,,94.0,283.98,10 HCPCS,J9023,"Injection, avelumab, 10 mg ",,,105.55,312.94,10 HCPCS,J9024,"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs ",,,31.95,98.72,10 HCPCS,J9025,"Injection, azacitidine, 1 mg ",,,0.41,2.81,10 HCPCS,J9025,"Injection, azacitidine, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9026,"Injection, tarlatamab-dlle, 1 mg ",,,1567.72,4890.57,10 HCPCS,J9027,"Injection, clofarabine, 1 mg ",,,10.94,216.65,10 HCPCS,J9027,"Injection, clofarabine, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9028,"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram ",,,94.6,293.65,10 HCPCS,J9029,"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose ",,,64282.3,432000.0,10 HCPCS,J9030,"Bcg live intravesical instillation, 1 mg ",,,3.39,9.73,10 HCPCS,J9031,Bcg (intravesical) per instillation ,,,,,0 HCPCS,J9031,Bcg (intravesical) per instillation Chemotherapy Drugs,,,,,0 HCPCS,J9032,"Injection, belinostat, 10 mg ",,,53.11,162.36,10 HCPCS,J9032,"Injection, belinostat, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9033,"Injection, bendamustine hydrochloride, 1 mg ",,,2.16,82.65,10 HCPCS,J9034,"Injection, bendamustine hcl (bendeka), 1 mg ",,,12.9,48.47,10 HCPCS,J9034,"Injection, bendamustine hcl (bendeka), 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9035,"Injection, bevacizumab, 10 mg ",,,74.36,227.92,10 HCPCS,J9035,"Injection, bevacizumab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9036,"Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg ",,,13.94,48.47,10 HCPCS,J9038,"Injection, axatilimab-csfr, 0.1 mg ",,,55.65,167.08,10 HCPCS,J9039,"Injection, blinatumomab, 1 microgram ",,,163.96,509.22,10 HCPCS,J9039,"Injection, blinatumomab, 1 microgram Chemotherapy Drugs",,,,,0 HCPCS,J9040,BLEOMYCIN SULF 15 U INJ,299.81,299.81,17.99,254.84,24 HCPCS,J9040,"Injection, bleomycin sulfate, 15 units ",299.81,299.81,16.6,86.08,10 HCPCS,J9040,"Injection, bleomycin sulfate, 15 units Chemotherapy Drugs",299.81,299.81,,,0 HCPCS,J9041,BORTEZOMIB 0.1 MG INJ,395.59,395.59,23.74,336.25,24 HCPCS,J9041,BORTEZOMIB 0.1 MG INJJW,395.59,395.59,23.74,336.25,24 HCPCS,J9041,BORTEZOMIB 3.5 MG INJ,13845.79,13845.79,830.75,11768.92,24 HCPCS,J9041,"Injection, bortezomib, 0.1 mg ",,,2.25,121.72,10 HCPCS,J9041,"Injection, bortezomib, 0.1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9042,"Injection, brentuximab vedotin, 1 mg ",,,268.73,806.58,10 HCPCS,J9042,"Injection, brentuximab vedotin, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9043,"Injection, cabazitaxel, 1 mg ",,,231.05,708.55,10 HCPCS,J9044,"Injection, bortezomib, not otherwise specified, 0.1 mg ",,,,,0 HCPCS,J9044,"Injection, bortezomib, not otherwise specified, 0.1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9045,CARBOPLATIN 50 MG INJ,36.88,36.88,2.21,31.35,24 HCPCS,J9045,"Injection, carboplatin, 50 mg ",36.88,36.88,2.94,7.24,10 HCPCS,J9045,"Injection, carboplatin, 50 mg Chemotherapy Drugs",36.88,36.88,,,0 HCPCS,J9046,"Injection, bortezomib (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg ",,,23.91,145.77,8 HCPCS,J9047,"Injection, carfilzomib, 1 mg ",,,56.24,171.88,10 HCPCS,J9047,"Injection, carfilzomib, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9048,"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg ",,,5.86,145.77,8 HCPCS,J9049,"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg ",,,1.26,21.44,10 HCPCS,J9050,"Injection, carmustine, 100 mg ",,,241.8,6969.0,10 HCPCS,J9050,"Injection, carmustine, 100 mg Chemotherapy Drugs",,,,,0 HCPCS,J9051,"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg ",,,6.68,10.89,8 HCPCS,J9052,"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg ",,,40.14,779.69,8 HCPCS,J9054,"Injection, bortezomib (boruzu), 0.1 mg ",,,25.41,81.15,10 HCPCS,J9055,"Injection, cetuximab, 10 mg ",,,80.46,244.83,10 HCPCS,J9055,"Injection, cetuximab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9056,"Injection, bendamustine hydrochloride (vivimusta), 1 mg ",,,31.74,100.17,10 HCPCS,J9057,"Injection, copanlisib, 1 mg ",,,157.29,278.65,8 HCPCS,J9057,"Injection, copanlisib, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9060,CISPLATIN 100MG MDV,186.61,186.61,11.2,158.62,24 HCPCS,J9060,CISPLATIN 50MG MDV,106.41,106.41,6.38,90.45,24 HCPCS,J9060,"Injection, cisplatin, powder or solution, 10 mg ",,,2.17,6.62,10 HCPCS,J9060,"Injection, cisplatin, powder or solution, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9061,"Injection, amivantamab-vmjw, 2 mg ",,,22.63,69.3,10 HCPCS,J9063,"Injection, mirvetuximab soravtansine-gynx, 1 mg ",,,71.13,216.9,10 HCPCS,J9064,"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg ",,,436.79,601.7,5 HCPCS,J9065,"Injection, cladribine, per 1 mg ",,,8.73,65.31,10 HCPCS,J9065,"Injection, cladribine, per 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9070,"Cyclophosphamide, 100 mg ",,,,,0 HCPCS,J9070,"Cyclophosphamide, 100 mg Chemotherapy Drugs",,,,,0 HCPCS,J9071,"Injection, cyclophosphamide (auromedics), 5 mg ",,,0.52,9.86,10 HCPCS,J9072,"Injection, cyclophosphamide (frindovyx), 5 mg ",,,7.13,28.08,10 HCPCS,J9073,"Injection, cyclophosphamide (dr. reddy's), 5 mg ",,,0.5,3.62,10 HCPCS,J9074,"Injection, cyclophosphamide (sandoz), 5 mg ",,,3.65,13.14,10 HCPCS,J9075,CYCLOPHOS NOS 500 MGINJ,1517.4,1517.4,91.04,1289.79,19 HCPCS,J9075,"Injection, cyclophosphamide, not otherwise specified, 5 mg ",1517.4,1517.4,0.77,2.77,10 HCPCS,J9076,"Injection, cyclophosphamide (baxter), 5 mg ",,,3.72,15.69,10 HCPCS,J9098,"Injection, cytarabine liposome, 10 mg ",,,1520.66,1960.51,3 HCPCS,J9100,CYTARABINE 100 MG INJ,58.3,58.3,3.5,49.55,24 HCPCS,J9100,"Injection, cytarabine, 100 mg ",58.3,58.3,0.8,2.53,10 HCPCS,J9100,"Injection, cytarabine, 100 mg Chemotherapy Drugs",58.3,58.3,,,0 HCPCS,J9118,"Injection, calaspargase pegol-mknl, 10 units ",,,82.08,255.56,10 HCPCS,J9119,"Injection, cemiplimab-rwlc, 1 mg ",,,29.76,89.54,10 HCPCS,J9120,"Injection, dactinomycin, 0.5 mg ",,,337.67,2834.49,10 HCPCS,J9120,"Injection, dactinomycin, 0.5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9130,DACARBAZINE 200 MG INJ,154.67,154.67,9.28,131.47,24 HCPCS,J9130,"Dacarbazine, 100 mg ",154.67,154.67,3.85,15.31,10 HCPCS,J9130,"Dacarbazine, 100 mg Chemotherapy Drugs",154.67,154.67,,,0 HCPCS,J9144,"Injection, daratumumab, 10 mg and hyaluronidase-fihj ",,,55.03,170.57,10 HCPCS,J9145,"Injection, daratumumab, 10 mg ",,,70.77,217.9,10 HCPCS,J9145,"Injection, daratumumab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9150,"Injection, daunorubicin, 10 mg ",,,24.75,125.17,10 HCPCS,J9150,"Injection, daunorubicin, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9151,"Injection, daunorubicin citrate, liposomal formulation, 10 mg ",,,139.54,179.9,3 HCPCS,J9151,"Injection, daunorubicin citrate, liposomal formulation, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9153,"Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine ",,,261.2,795.88,10 HCPCS,J9153,"Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine Chemotherapy Drugs",,,,,0 HCPCS,J9155,"Injection, degarelix, 1 mg ",,,4.46,16.01,10 HCPCS,J9160,"Injection, denileukin diftitox, 300 micrograms ",,,,,0 HCPCS,J9160,"Injection, denileukin diftitox, 300 micrograms Chemotherapy Drugs",,,,,0 HCPCS,J9161,"Injection, denileukin diftitox-cxdl, 1 mcg ",,,3031.71,4176.33,5 HCPCS,J9165,"Injection, diethylstilbestrol diphosphate, 250 mg ",,,,,0 HCPCS,J9165,"Injection, diethylstilbestrol diphosphate, 250 mg Chemotherapy Drugs",,,,,0 HCPCS,J9171,"Injection, docetaxel, 1 mg ",,,0.56,6.53,10 HCPCS,J9172,"Injection, docetaxel (docivyx), 1 mg ",,,2.18,153.13,10 HCPCS,J9173,"Injection, durvalumab, 10 mg ",,,86.15,265.98,10 HCPCS,J9173,"Injection, durvalumab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9174,"Injection, docetaxel (beizray), 1 mg ",,,97.8,157.53,8 HCPCS,J9175,"Injection, elliotts' b solution, 1 ml ",,,17.62,32.45,8 HCPCS,J9175,"Injection, elliotts' b solution, 1 ml Chemotherapy Drugs",,,,,0 HCPCS,J9176,"Injection, elotuzumab, 1 mg ",,,8.04,24.59,10 HCPCS,J9176,"Injection, elotuzumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9177,"Injection, enfortumab vedotin-ejfv, 0.25 mg ",,,36.71,114.38,10 HCPCS,J9178,"Injection, epirubicin hcl, 2 mg ",,,1.77,4.96,10 HCPCS,J9178,"Injection, epirubicin hcl, 2 mg Chemotherapy Drugs",,,,,0 HCPCS,J9179,"Injection, eribulin mesylate, 0.1 mg ",,,76.76,326.29,10 HCPCS,J9181,ETOPOSIDE 100 MG MDV,80.9,80.9,4.85,68.77,24 HCPCS,J9181,"Injection, etoposide, 10 mg ",80.9,80.9,0.9,4.06,10 HCPCS,J9181,"Injection, etoposide, 10 mg Chemotherapy Drugs",80.9,80.9,,,0 HCPCS,J9183,"Gemcitabine intravesical system, 225 mg ",,,73088.3,73088.3,2 HCPCS,J9184,"Injection, gemcitabine hydrochloride (avyxa), 200 mg ",,,410.44,1061.42,7 HCPCS,J9185,"Injection, fludarabine phosphate, 50 mg ",,,128.03,223.55,10 HCPCS,J9185,"Injection, fludarabine phosphate, 50 mg Chemotherapy Drugs",,,,,0 HCPCS,J9190,FLUOROURACIL 500 MG INJ,69.0,69.0,4.14,58.65,24 HCPCS,J9190,"Injection, fluorouracil, 500 mg ",69.0,69.0,2.06,5.83,10 HCPCS,J9190,"Injection, fluorouracil, 500 mg Chemotherapy Drugs",69.0,69.0,,,0 HCPCS,J9196,"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg ",,,5.29,16.5,10 HCPCS,J9198,"Injection, gemcitabine hydrochloride, (infugem), 100 mg ",,,74.19,120.93,8 HCPCS,J9200,"Injection, floxuridine, 500 mg ",,,161.21,12871.72,10 HCPCS,J9200,"Injection, floxuridine, 500 mg Chemotherapy Drugs",,,,,0 HCPCS,J9201,GEMCITABINE NOS 2 G INJ,144.83,144.83,8.69,123.11,24 HCPCS,J9201,"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg ",144.83,144.83,3.24,13.77,10 HCPCS,J9201,"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg Chemotherapy Drugs",144.83,144.83,,,0 HCPCS,J9202,"Goserelin acetate implant, per 3.6 mg ",,,1145.37,2290.55,8 HCPCS,J9202,"Goserelin acetate implant, per 3.6 mg Chemotherapy Drugs",,,,,0 HCPCS,J9203,"Injection, gemtuzumab ozogamicin, 0.1 mg ",,,240.17,738.25,10 HCPCS,J9204,"Injection, mogamulizumab-kpkc, 1 mg ",,,253.47,775.32,10 HCPCS,J9205,"Injection, irinotecan liposome, 1 mg ",,,66.37,203.61,10 HCPCS,J9205,"Injection, irinotecan liposome, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9206,IRINOTECAN 100 MG INJ,2221.23,2221.23,133.27,1888.05,24 HCPCS,J9206,"Injection, irinotecan, 20 mg ",2221.23,2221.23,1.53,7.72,10 HCPCS,J9206,"Injection, irinotecan, 20 mg Chemotherapy Drugs",2221.23,2221.23,,,0 HCPCS,J9207,"Injection, ixabepilone, 1 mg ",,,139.75,432.65,10 HCPCS,J9208,"Injection, ifosfamide, 1 gram ",,,24.68,73.32,10 HCPCS,J9208,"Injection, ifosfamide, 1 gram Chemotherapy Drugs",,,,,0 HCPCS,J9209,"Injection, mesna, 200 mg ",129.28,129.28,1.33,19.12,10 HCPCS,J9209,"Injection, mesna, 200 mg Chemotherapy Drugs",129.28,129.28,,,0 HCPCS,J9209,MESNA 1000 MG MDV,129.28,129.28,7.76,109.89,24 HCPCS,J9210,"Injection, emapalumab-lzsg, 1 mg ",,,384.14,1302.56,10 HCPCS,J9211,"Injection, idarubicin hydrochloride, 5 mg ",,,39.76,115.6,10 HCPCS,J9211,"Injection, idarubicin hydrochloride, 5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9212,"Injection, interferon alfacon-1, recombinant, 1 microgram ",,,15.85,20.44,3 HCPCS,J9212,"Injection, interferon alfacon-1, recombinant, 1 microgram Chemotherapy Drugs",,,,,0 HCPCS,J9213,"Injection, interferon, alfa-2a, recombinant, 3 million units ",,,69.87,90.07,3 HCPCS,J9213,"Injection, interferon, alfa-2a, recombinant, 3 million units Chemotherapy Drugs",,,,,0 HCPCS,J9214,"Injection, interferon, alfa-2b, recombinant, 1 million units ",,,45.73,97.81,8 HCPCS,J9214,"Injection, interferon, alfa-2b, recombinant, 1 million units Chemotherapy Drugs",,,,,0 HCPCS,J9215,"Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu ",,,57.57,95.85,8 HCPCS,J9215,"Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu Chemotherapy Drugs",,,,,0 HCPCS,J9216,"Injection, interferon, gamma 1-b, 3 million units ",,,13203.4,26921.98,8 HCPCS,J9216,"Injection, interferon, gamma 1-b, 3 million units Chemotherapy Drugs",,,,,0 HCPCS,J9217,LEUPRO 7.5 MG DEPO INJ,4678.01,4678.01,280.68,3976.31,19 HCPCS,J9217,"Leuprolide acetate (for depot suspension), 7.5 mg ",4678.01,4678.01,176.2,1185.3,10 HCPCS,J9217,"Leuprolide acetate (for depot suspension), 7.5 mg Chemotherapy Drugs",4678.01,4678.01,,,0 HCPCS,J9218,"Leuprolide acetate, per 1 mg ",,,71.81,160.43,8 HCPCS,J9218,"Leuprolide acetate, per 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9219,"Leuprolide acetate implant, 65 mg ",,,11663.96,15037.84,3 HCPCS,J9219,"Leuprolide acetate implant, 65 mg Chemotherapy Drugs",,,,,0 HCPCS,J9220,INDIGOTINDISULF 40MG INJ,1714.99,1714.99,102.9,1457.74,20 HCPCS,J9220,"Injection, indigotindisulfonate sodium, 1 mg ",1714.99,1714.99,19.76,31.82,8 HCPCS,J9223,"Injection, lurbinectedin, 0.1 mg ",,,212.1,643.13,10 HCPCS,J9225,"Histrelin implant (vantas), 50 mg ",,,8785.03,15510.58,8 HCPCS,J9225,"Histrelin implant (vantas), 50 mg Chemotherapy Drugs",,,,,0 HCPCS,J9226,"Histrelin implant (supprelin la), 50 mg ",,,41173.4,142148.42,10 HCPCS,J9227,"Injection, isatuximab-irfc, 10 mg ",,,83.58,258.52,10 HCPCS,J9228,"Injection, ipilimumab, 1 mg ",,,187.17,572.24,10 HCPCS,J9229,"Injection, inotuzumab ozogamicin, 0.1 mg ",,,2816.77,8417.92,10 HCPCS,J9229,"Injection, inotuzumab ozogamicin, 0.1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9230,"Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg ",,,625.24,1003.77,8 HCPCS,J9230,"Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9245,"Injection, melphalan hydrochloride, not otherwise specified, 50 mg ",,,120.67,3728.0,10 HCPCS,J9245,"Injection, melphalan hydrochloride, not otherwise specified, 50 mg Chemotherapy Drugs",,,,,0 HCPCS,J9246,"Injection, melphalan (evomela), 1 mg ",,,19.43,107.57,10 HCPCS,J9248,"Injection, melphalan (hepzato), 1 mg ",,,795.0,2457.9,10 HCPCS,J9249,"Injection, melphalan (apotex), 1 mg ",,,36.85,194.47,8 HCPCS,J9250,"Methotrexate sodium, 5 mg ",,,,,0 HCPCS,J9250,"Methotrexate sodium, 5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9255,"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg ",,,6.61,9.1,5 HCPCS,J9256,"Injection, nipocalimab-aahu, 3 mg ",,,32.67,98.42,7 HCPCS,J9260,"Injection, methotrexate sodium, 50 mg ",19.04,19.04,2.33,7.05,10 HCPCS,J9260,"Injection, methotrexate sodium, 50 mg Chemotherapy Drugs",19.04,19.04,,,0 HCPCS,J9260,METHOTREXATE 50 MG INJ,19.04,19.04,1.14,16.18,24 HCPCS,J9261,"Injection, nelarabine, 50 mg ",,,52.71,394.31,10 HCPCS,J9261,"Injection, nelarabine, 50 mg Chemotherapy Drugs",,,,,0 HCPCS,J9262,"Injection, omacetaxine mepesuccinate, 0.01 mg ",,,6.12,12.11,8 HCPCS,J9262,"Injection, omacetaxine mepesuccinate, 0.01 mg Chemotherapy Drugs",,,,,0 HCPCS,J9263,"Injection, oxaliplatin, 0.5 mg ",1036.25,1036.25,0.08,0.78,10 HCPCS,J9263,"Injection, oxaliplatin, 0.5 mg Chemotherapy Drugs",1036.25,1036.25,,,0 HCPCS,J9263,OXALIPLATIN 100 MG INJ,1036.25,1036.25,62.17,880.81,24 HCPCS,J9264,"Injection, paclitaxel protein-bound particles, 1 mg ",,,6.02,37.81,10 HCPCS,J9264,"Injection, paclitaxel protein-bound particles, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9266,"Injection, pegaspargase, per single dose vial ",,,28424.1,88683.07,10 HCPCS,J9266,"Injection, pegaspargase, per single dose vial Chemotherapy Drugs",,,,,0 HCPCS,J9267,"Injection, paclitaxel, 1 mg ",40.6,40.6,0.15,0.49,10 HCPCS,J9267,"Injection, paclitaxel, 1 mg Chemotherapy Drugs",40.6,40.6,,,0 HCPCS,J9267,PACLITAXEL 30 MG MDV,40.6,40.6,2.44,34.51,24 HCPCS,J9268,"Injection, pentostatin, 10 mg ",,,2626.33,7936.94,10 HCPCS,J9268,"Injection, pentostatin, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9269,"Injection, tagraxofusp-erzs, 10 micrograms ",,,357.28,1087.69,10 HCPCS,J9270,"Injection, plicamycin, 2.5 mg ",,,,,0 HCPCS,J9270,"Injection, plicamycin, 2.5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9271,"Injection, pembrolizumab, 1 mg ",,,61.25,182.71,10 HCPCS,J9271,"Injection, pembrolizumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9272,"Injection, dostarlimab-gxly, 10 mg ",,,247.08,760.72,10 HCPCS,J9273,"Injection, tisotumab vedotin-tftv, 1 mg ",,,196.12,588.59,10 HCPCS,J9274,"Injection, tebentafusp-tebn, 1 microgram ",,,222.49,677.32,10 HCPCS,J9275,"Injection, cosibelimab-ipdl, 2 mg ",,,204.27,281.39,5 HCPCS,J9276,"Injection, zanidatamab-hrii, 2 mg ",,,25.0,78.25,10 HCPCS,J9277,"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph ",,,32.13,32.13,2 HCPCS,J9278,"Injection, carboplatin (avyxa), 1 mg ",,,5.24,5.24,2 HCPCS,J9280,"Injection, mitomycin, 5 mg ",11373.8,11373.8,28.46,229.34,10 HCPCS,J9280,"Injection, mitomycin, 5 mg Chemotherapy Drugs",11373.8,11373.8,,,0 HCPCS,J9280,MITOMYCIN 20 MG INJ,11373.8,11373.8,682.43,9667.73,19 HCPCS,J9281,"Mitomycin pyelocalyceal instillation, 1 mg ",,,323.17,990.35,10 HCPCS,J9282,"Mitomycin, intravesical instillation, 1 mg ",,,278.33,731.43,7 HCPCS,J9285,"Injection, olaratumab, 10 mg ",,,97.04,162.46,8 HCPCS,J9286,"Injection, glofitamab-gxbm, 2.5 mg ",,,2840.68,8644.18,10 HCPCS,J9289,"Injection, nivolumab, 2 mg and hyaluronidase-nvhy ",,,27.73,82.62,10 HCPCS,J9292,"Injection, pemetrexed dipotassium, 10 mg ",,,82.02,259.83,10 HCPCS,J9293,"Injection, mitoxantrone hydrochloride, per 5 mg ",,,38.61,101.01,10 HCPCS,J9293,"Injection, mitoxantrone hydrochloride, per 5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9294,"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg ",,,5.2,31.46,10 HCPCS,J9295,"Injection, necitumumab, 1 mg ",,,5.73,17.88,10 HCPCS,J9295,"Injection, necitumumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9296,"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg ",,,9.66,30.39,10 HCPCS,J9297,"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg ",,,1.46,27.54,10 HCPCS,J9298,"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg ",,,201.76,616.67,10 HCPCS,J9299,"Injection, nivolumab, 1 mg ",,,33.62,102.96,10 HCPCS,J9299,"Injection, nivolumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9301,"Injection, obinutuzumab, 10 mg ",,,81.81,244.8,10 HCPCS,J9301,"Injection, obinutuzumab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9302,"Injection, ofatumumab, 10 mg ",,,114.01,192.0,8 HCPCS,J9303,"Injection, panitumumab, 10 mg ",,,174.39,538.36,10 HCPCS,J9304,"Injection, pemetrexed (pemfexy), 10 mg ",,,7.99,190.3,10 HCPCS,J9305,"Injection, pemetrexed, not otherwise specified, 10 mg ",,,4.04,190.3,10 HCPCS,J9305,"Injection, pemetrexed, not otherwise specified, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9306,"Injection, pertuzumab, 1 mg ",,,17.02,52.7,10 HCPCS,J9306,"Injection, pertuzumab, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9307,"Injection, pralatrexate, 1 mg ",,,392.72,1213.15,10 HCPCS,J9308,"Injection, ramucirumab, 5 mg ",,,75.47,232.28,10 HCPCS,J9308,"Injection, ramucirumab, 5 mg Chemotherapy Drugs",,,,,0 HCPCS,J9309,"Injection, polatuzumab vedotin-piiq, 1 mg ",,,137.23,425.04,10 HCPCS,J9311,"Injection, rituximab 10 mg and hyaluronidase ",,,36.28,127.76,10 HCPCS,J9311,"Injection, rituximab 10 mg and hyaluronidase Chemotherapy Drugs",,,,,0 HCPCS,J9312,"Injection, rituximab, 10 mg ",,,74.16,251.88,10 HCPCS,J9312,"Injection, rituximab, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9312,RITUXIMAB 10 MG INJ,141.58,141.58,8.49,120.34,19 HCPCS,J9312,RITUXIMAB 10 MG INJJW,141.58,141.58,8.49,120.34,19 HCPCS,J9313,"Injection, moxetumomab pasudotox-tdfk, 0.01 mg ",,,42.06,70.23,8 HCPCS,J9314,"Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg ",,,9.17,53.3,10 HCPCS,J9316,"Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg ",,,60.23,197.78,10 HCPCS,J9317,"Injection, sacituzumab govitecan-hziy, 2.5 mg ",,,36.8,113.13,10 HCPCS,J9318,"Injection, romidepsin, non-lyophilized, 0.1 mg ",,,28.52,88.98,10 HCPCS,J9319,"Injection, romidepsin, lyophilized, 0.1 mg ",,,30.8,101.22,10 HCPCS,J9320,"Injection, streptozocin, 1 gram ",,,705.03,4137.12,8 HCPCS,J9320,"Injection, streptozocin, 1 gram Chemotherapy Drugs",,,,,0 HCPCS,J9321,"Injection, epcoritamab-bysp, 0.16 mg ",,,56.92,173.66,10 HCPCS,J9322,"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg ",,,18.76,28.98,8 HCPCS,J9323,"Injection, pemetrexed ditromethamine, 10 mg ",,,21.48,32.26,8 HCPCS,J9324,"Injection, pemetrexed (pemrydi rtu), 10 mg ",,,23.03,249.91,10 HCPCS,J9325,"Injection, talimogene laherparepvec, per 1 million plaque forming units ",,,73.94,229.48,10 HCPCS,J9325,"Injection, talimogene laherparepvec, per 1 million plaque forming units Chemotherapy Drugs",,,,,0 HCPCS,J9326,"Injection, telisotuzumab vedotin-tllv, 1 mg ",,,145.99,438.43,7 HCPCS,J9328,"Injection, temozolomide, 1 mg ",,,10.4,32.42,10 HCPCS,J9329,"Injection, tislelizumab-jsgr, 1mg ",,,58.27,179.15,10 HCPCS,J9330,"Injection, temsirolimus, 1 mg ",,,30.08,118.88,10 HCPCS,J9331,"Injection, sirolimus protein-bound particles, 1 mg ",,,87.11,263.73,10 HCPCS,J9332,"Injection, efgartigimod alfa-fcab, 2mg ",,,32.61,101.09,10 HCPCS,J9333,"Injection, rozanolixizumab-noli, 1 mg ",,,23.4,72.26,10 HCPCS,J9334,"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc ",,,34.33,105.27,10 HCPCS,J9340,"Injection, thiotepa, 15 mg ",,,,,0 HCPCS,J9340,"Injection, thiotepa, 15 mg Chemotherapy Drugs",,,,,0 HCPCS,J9341,"Injection, thiotepa (tepylute), 1 mg ",,,38.55,118.19,10 HCPCS,J9342,"Injection, thiotepa, not otherwise specified, 1 mg ",,,5.74,38.19,10 HCPCS,J9345,"Injection, retifanlimab-dlwr, 1 mg ",,,30.4,93.54,10 HCPCS,J9347,"Injection, tremelimumab-actl, 1 mg ",,,143.23,440.45,10 HCPCS,J9348,"Injection, naxitamab-gqgk, 1 mg ",,,686.09,2140.04,10 HCPCS,J9349,"Injection, tafasitamab-cxix, 2 mg ",,,14.17,43.93,10 HCPCS,J9350,"Injection, mosunetuzumab-axgb, 1 mg ",,,654.54,2036.58,10 HCPCS,J9351,"Injection, topotecan, 0.1 mg ",,,2.11,6.37,10 HCPCS,J9351,"Injection, topotecan, 0.1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9352,"Injection, trabectedin, 0.1 mg ",,,391.07,1195.18,10 HCPCS,J9352,"Injection, trabectedin, 0.1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9353,"Injection, margetuximab-cmkb, 5 mg ",,,53.27,157.4,10 HCPCS,J9354,"Injection, ado-trastuzumab emtansine, 1 mg ",,,42.2,130.57,10 HCPCS,J9354,"Injection, ado-trastuzumab emtansine, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9355,"Injection, trastuzumab, excludes biosimilar, 10 mg ",,,73.43,278.21,10 HCPCS,J9355,"Injection, trastuzumab, excludes biosimilar, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9356,"Injection, trastuzumab, 10 mg and hyaluronidase-oysk ",,,59.91,216.62,10 HCPCS,J9357,"Injection, valrubicin, intravesical, 200 mg ",,,1270.52,4295.58,10 HCPCS,J9357,"Injection, valrubicin, intravesical, 200 mg Chemotherapy Drugs",,,,,0 HCPCS,J9358,"Injection, fam-trastuzumab deruxtecan-nxki, 1 mg ",,,31.26,93.6,10 HCPCS,J9359,"Injection, loncastuximab tesirine-lpyl, 0.075 mg ",,,221.49,676.23,10 HCPCS,J9360,"Injection, vinblastine sulfate, 1 mg ",,,5.15,16.5,10 HCPCS,J9360,"Injection, vinblastine sulfate, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9361,"Injection, efbemalenograstim alfa-vuxw, 0.5 mg ",,,283.87,460.81,8 HCPCS,J9370,VINCRISTINE SULF 1MG INJ,229.62,229.62,13.78,195.18,24 HCPCS,J9370,"Vincristine sulfate, 1 mg ",229.62,229.62,7.45,24.52,10 HCPCS,J9370,"Vincristine sulfate, 1 mg Chemotherapy Drugs",229.62,229.62,,,0 HCPCS,J9371,"Injection, vincristine sulfate liposome, 1 mg ",,,,,0 HCPCS,J9371,"Injection, vincristine sulfate liposome, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9376,"Injection, pozelimab-bbfg, 1 mg ",,,170.97,275.4,8 HCPCS,J9380,"Injection, teclistamab-cqyv, 0.5 mg ",,,34.5,103.8,10 HCPCS,J9381,"Injection, teplizumab-mzwv, 5 mcg ",,,38.39,117.47,10 HCPCS,J9382,"Injection, zenocutuzumab-zbco, 1 mg ",,,33.57,100.78,10 HCPCS,J9390,"Injection, vinorelbine tartrate, 10 mg ",,,4.74,24.38,10 HCPCS,J9390,"Injection, vinorelbine tartrate, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,J9393,505TV FULVES 25 MG INJ,41.64,41.64,2.5,35.39,20 HCPCS,J9393,505TV FULVES 250 MG INJ,417.3,417.3,25.04,354.7,20 HCPCS,J9393,"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg ",,,33.69,63.65,8 HCPCS,J9394,"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg ",,,8.03,27.11,10 HCPCS,J9395,"Injection, fulvestrant, 25 mg ",,,4.94,222.48,10 HCPCS,J9395,"Injection, fulvestrant, 25 mg Chemotherapy Drugs",,,,,0 HCPCS,J9400,"Injection, ziv-aflibercept, 1 mg ",,,8.61,42.9,10 HCPCS,J9400,"Injection, ziv-aflibercept, 1 mg Chemotherapy Drugs",,,,,0 HCPCS,J9600,"Injection, porfimer sodium, 75 mg ",,,42475.55,74223.12,8 HCPCS,J9600,"Injection, porfimer sodium, 75 mg Chemotherapy Drugs",,,,,0 HCPCS,J9601,"Injection, linvoseltamab-gcpt, 1 mg ",,,99.5,99.5,2 HCPCS,J9999,"Not otherwise classified, antineoplastic drugs ",,,,,0 HCPCS,J9999,"Not otherwise classified, antineoplastic drugs Chemotherapy Drugs",,,,,0 HCPCS,K0001,Standard wheelchair ,,,27.95,82.87,50 HCPCS,K0002,Standard hemi (low seat) wheelchair ,,,45.39,131.81,50 HCPCS,K0003,Lightweight wheelchair ,,,43.53,135.04,50 HCPCS,K0004,"High strength, lightweight wheelchair ",,,51.63,192.17,50 HCPCS,K0005,Ultralightweight wheelchair ,,,2582.06,5664.73,50 HCPCS,K0006,Heavy duty wheelchair ,,,75.23,204.31,50 HCPCS,K0007,Extra heavy duty wheelchair ,,,102.08,289.56,50 HCPCS,K0009,Other manual wheelchair/base ,,,99.82,219.0,50 HCPCS,K0010,Standard - weight frame motorized/power wheelchair ,,,505.71,1109.46,50 HCPCS,K0011,"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking ",,,715.47,1569.65,50 HCPCS,K0012,Lightweight portable motorized/power wheelchair ,,,453.79,995.56,50 HCPCS,K0015,"Detachable, non-adjustable height armrest, replacement only, each ",,,16.94,37.17,50 HCPCS,K0017,"Detachable, adjustable height armrest, base, replacement only, each ",,,57.82,126.85,50 HCPCS,K0018,"Detachable, adjustable height armrest, upper portion, replacement only, each ",,,32.68,71.7,50 HCPCS,K0019,"Arm pad, replacement only, each ",,,14.47,31.76,50 HCPCS,K0020,"Fixed, adjustable height armrest, pair ",,,55.93,122.7,50 HCPCS,K0037,"High mount flip-up footrest, each ",,,54.4,119.35,50 HCPCS,K0038,"Leg strap, each ",,,28.9,63.4,50 HCPCS,K0039,"Leg strap, h style, each ",,,62.05,136.14,50 HCPCS,K0040,"Adjustable angle footplate, each ",,,62.87,142.83,50 HCPCS,K0041,"Large size footplate, each ",,,59.3,130.1,50 HCPCS,K0042,"Standard size footplate, replacement only, each ",,,38.08,83.55,50 HCPCS,K0043,"Footrest, lower extension tube, replacement only, each ",,,23.49,51.54,50 HCPCS,K0044,"Footrest, upper hanger bracket, replacement only, each ",,,20.03,43.95,50 HCPCS,K0045,"Footrest, complete assembly, replacement only, each ",,,67.29,147.62,50 HCPCS,K0046,"Elevating legrest, lower extension tube, replacement only, each ",,,23.49,51.54,50 HCPCS,K0047,"Elevating legrest, upper hanger bracket, replacement only, each ",,,83.62,183.46,50 HCPCS,K0050,"Ratchet assembly, replacement only ",,,38.8,85.12,50 HCPCS,K0051,"Cam release assembly, footrest or legrest, replacement only, each ",,,61.38,134.65,50 HCPCS,K0052,"Swingaway, detachable footrests, replacement only, each ",,,83.61,183.44,50 HCPCS,K0053,"Elevating footrests, articulating (telescoping), each ",,,99.51,218.31,50 HCPCS,K0056,"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair ",,,108.92,238.95,50 HCPCS,K0065,"Spoke protectors, each ",,,55.43,121.6,50 HCPCS,K0069,"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each ",,,110.94,243.38,50 HCPCS,K0070,"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each ",,,18.84,41.32,50 HCPCS,K0071,"Front caster assembly, complete, with pneumatic tire, replacement only, each ",,,129.48,284.06,50 HCPCS,K0072,"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each ",,,80.94,177.57,50 HCPCS,K0073,"Caster pin lock, each ",,,41.66,91.4,50 HCPCS,K0077,"Front caster assembly, complete, with solid tire, replacement only, each ",,,63.77,139.9,50 HCPCS,K0098,"Drive belt for power wheelchair, replacement only ",,,28.49,62.5,50 HCPCS,K0105,"Iv hanger, each ",,,117.81,258.45,50 HCPCS,K0195,"Elevating leg rests, pair (for use with capped rental wheelchair base) ",,,12.45,40.32,50 HCPCS,K0455,"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) ",,,369.91,811.54,50 HCPCS,K0552,"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each ",,,3.4,7.46,50 HCPCS,K0601,"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each ",,,1.54,3.38,50 HCPCS,K0602,"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each ",,,8.7,19.09,50 HCPCS,K0603,"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each ",,,0.78,1.72,50 HCPCS,K0604,"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each ",,,8.39,18.4,50 HCPCS,K0605,"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each ",,,20.04,43.97,50 HCPCS,K0606,"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type ",,,3517.12,7716.14,50 HCPCS,K0607,"Replacement battery for automated external defibrillator, garment type only, each ",,,27.14,59.53,50 HCPCS,K0608,"Replacement garment for use with automated external defibrillator, each ",,,169.29,371.39,50 HCPCS,K0609,"Replacement electrodes for use with automated external defibrillator, garment type only, each ",,,1125.8,2469.88,50 HCPCS,K0672,"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each ",,,102.66,225.21,45 HCPCS,K0730,Controlled dose inhalation drug delivery system ,,,240.78,528.23,50 HCPCS,K0733,"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) ",,,33.82,74.2,50 HCPCS,K0738,"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing ",,,46.23,130.62,50 HCPCS,K0739,"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes ",,,19.71,43.24,45 HCPCS,K0800,"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds ",,,997.94,2189.37,50 HCPCS,K0801,"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds ",,,1791.9,3931.21,50 HCPCS,K0802,"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds ",,,2421.18,5311.77,50 HCPCS,K0806,"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds ",,,1713.85,3759.98,50 HCPCS,K0807,"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds ",,,2656.05,5827.06,50 HCPCS,K0808,"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds ",,,4105.83,9007.68,50 HCPCS,K0813,"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds ",,,318.34,698.41,50 HCPCS,K0814,"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds ",,,331.12,726.44,50 HCPCS,K0815,"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds ",,,368.88,811.94,50 HCPCS,K0816,"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds ",,,339.13,768.26,50 HCPCS,K0820,"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,329.86,723.67,50 HCPCS,K0821,"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds ",,,339.13,760.18,50 HCPCS,K0822,"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,368.88,880.68,50 HCPCS,K0823,"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds ",,,339.13,863.11,50 HCPCS,K0824,"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds ",,,524.27,1150.19,50 HCPCS,K0825,"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds ",,,490.61,1076.33,50 HCPCS,K0826,"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds ",,,839.56,1841.88,50 HCPCS,K0827,"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds ",,,745.0,1634.43,50 HCPCS,K0828,"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more ",,,1090.08,2391.51,50 HCPCS,K0829,"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more ",,,1051.85,2307.64,50 HCPCS,K0835,"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,440.36,966.1,50 HCPCS,K0836,"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds ",,,456.75,1002.05,50 HCPCS,K0837,"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds ",,,564.81,1239.13,50 HCPCS,K0838,"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds ",,,500.61,1098.28,50 HCPCS,K0839,"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds ",,,750.27,1646.0,50 HCPCS,K0840,"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more ",,,1151.9,2527.13,50 HCPCS,K0841,"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,496.25,1088.72,50 HCPCS,K0842,"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds ",,,495.53,1087.13,50 HCPCS,K0843,"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds ",,,588.25,1290.56,50 HCPCS,K0848,"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,954.19,2093.37,50 HCPCS,K0849,"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds ",,,917.39,2012.64,50 HCPCS,K0850,"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds ",,,1106.79,2428.17,50 HCPCS,K0851,"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds ",,,1064.2,2334.73,50 HCPCS,K0852,"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds ",,,1278.84,2805.62,50 HCPCS,K0853,"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds ",,,1313.7,2882.1,50 HCPCS,K0854,"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more ",,,1740.37,3818.16,50 HCPCS,K0855,"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more ",,,1644.03,3606.8,50 HCPCS,K0856,"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,1024.19,2246.94,50 HCPCS,K0857,"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds ",,,1044.73,2292.01,50 HCPCS,K0858,"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds ",,,1270.73,2787.82,50 HCPCS,K0859,"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds ",,,1211.9,2658.75,50 HCPCS,K0860,"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds ",,,1815.41,3982.79,50 HCPCS,K0861,"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds ",,,1025.84,2250.58,50 HCPCS,K0862,"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds ",,,1270.73,2787.82,50 HCPCS,K0863,"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds ",,,1815.41,3982.79,50 HCPCS,K0864,"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more ",,,2160.33,4739.5,50 HCPCS,K1004,Low frequency ultrasonic diathermy treatment device for home use ,,,733.96,1130.53,5 HCPCS,K1007,"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and acces",,,93179.38,204424.15,50 HCPCS,K1027,"Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment ",,,146.01,224.9,5 HCPCS,K1030,"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator, replacement only ",,,1176.57,1812.3,11 HCPCS,K1034,"Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count ",,,24.24,38.28,5 HCPCS,K1035,"Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared ",,,52.46,80.81,5 HCPCS,K1036,"Supplies and accessories (e.g., transducer) for low frequency ultrasonic diathermy treatment device, per month ",,,733.96,1130.53,5 HCPCS,K1037,Docking station for use with oral device/appliance used to reduce upper airway collapsibility ,,,116.81,179.92,5 HCPCS,L0112,"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated ",,,1694.66,3717.87,45 HCPCS,L0113,"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment ",,,345.31,757.57,45 HCPCS,L0120,"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) ",,,29.89,65.58,45 HCPCS,L0130,"Cervical, flexible, thermoplastic collar, molded to patient ",,,183.73,403.08,45 HCPCS,L0140,"Cervical, semi-rigid, adjustable (plastic collar) ",,,73.55,161.36,45 HCPCS,L0150,"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece) ",,,121.7,266.99,45 HCPCS,L0160,"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf ",,,235.17,515.94,45 HCPCS,L0170,"Cervical, collar, molded to patient model ",,,770.29,1689.92,45 HCPCS,L0172,"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf ",,,158.72,348.21,45 HCPCS,L0174,"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf ",,,309.36,678.69,45 HCPCS,L0180,"Cervical, multiple post collar, occipital/mandibular supports, adjustable ",,,463.54,1016.95,45 HCPCS,L0190,"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types) ",,,600.26,1316.9,45 HCPCS,L0200,"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension ",,,670.74,1471.52,45 HCPCS,L0220,"Thoracic, rib belt, custom fabricated ",,,183.9,403.45,45 HCPCS,L0450,"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and clo",,,134.09,294.18,45 HCPCS,L0454,"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on",,,419.93,921.27,45 HCPCS,L0455,"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load o",,,248.94,546.14,45 HCPCS,L0456,"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, res",,,1204.21,2641.9,45 HCPCS,L0457,"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, res",,,713.86,1566.12,45 HCPCS,L0458,"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior exte",,,1079.84,2369.04,45 HCPCS,L0460,"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior exte",,,1215.46,2666.58,45 HCPCS,L0462,"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior ex",,,1511.79,3316.68,45 HCPCS,L0464,"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends fro",,,1799.75,3948.43,45 HCPCS,L0466,"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to red",,,482.09,1057.65,45 HCPCS,L0467,"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to red",,,279.18,612.49,45 HCPCS,L0468,"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided ",,,558.12,1224.45,45 HCPCS,L0469,"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided ",,,355.73,780.43,45 HCPCS,L0470,"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic,",,,717.97,1575.13,45 HCPCS,L0472,"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral ",,,501.16,1099.49,45 HCPCS,L0480,"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapul",,,1726.82,3788.43,45 HCPCS,L0482,"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine",,,1746.33,3831.24,45 HCPCS,L0484,"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapul",,,2001.3,4390.6,45 HCPCS,L0486,"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine",,,2159.54,4737.76,45 HCPCS,L0488,"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine",,,1215.46,2666.58,45 HCPCS,L0490,"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at",,,342.49,751.38,45 HCPCS,L0491,"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anteri",,,929.89,2040.07,45 HCPCS,L0492,"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, ante",,,602.66,1322.16,45 HCPCS,L0621,"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf ",,,70.7,155.1,45 HCPCS,L0622,"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated ",,,290.93,638.27,45 HCPCS,L0623,"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pend",,,126.72,278.02,45 HCPCS,L0625,"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closu",,,39.55,86.77,45 HCPCS,L0626,"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes",,,94.38,207.07,45 HCPCS,L0627,"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral disc",,,497.72,1091.94,45 HCPCS,L0628,"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral di",,,60.22,132.12,45 HCPCS,L0630,"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervert",,,196.06,430.13,45 HCPCS,L0631,"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on th",,,1243.0,2727.0,45 HCPCS,L0633,"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/",,,347.22,761.77,45 HCPCS,L0635,"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction t",,,1197.99,2628.25,45 HCPCS,L0636,"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to ",,,1624.05,3562.96,45 HCPCS,L0637,"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lat",,,1471.0,3227.19,45 HCPCS,L0638,"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lat",,,1596.92,3503.45,45 HCPCS,L0639,"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces in",,,1471.0,3227.19,45 HCPCS,L0640,"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces in",,,1266.92,2779.48,45 HCPCS,L0641,"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes",,,55.96,122.77,45 HCPCS,L0642,"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral disc",,,295.11,647.43,45 HCPCS,L0643,"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervert",,,116.26,255.05,45 HCPCS,L0648,"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on th",,,737.0,1616.89,45 HCPCS,L0649,"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/",,,205.87,451.65,45 HCPCS,L0650,"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid l",,,852.75,1870.82,45 HCPCS,L0651,"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces in",,,852.75,1870.82,45 HCPCS,L0700,"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) ",,,2310.96,5069.96,45 HCPCS,L0710,"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type) ",,,2489.5,5461.67,45 HCPCS,L0720,"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patie",,,2263.29,4965.38,45 HCPCS,L0810,"Halo procedure, cervical halo incorporated into jacket vest ",,,3084.19,6766.33,45 HCPCS,L0820,"Halo procedure, cervical halo incorporated into plaster body jacket ",,,2601.69,5707.8,45 HCPCS,L0830,"Halo procedure, cervical halo incorporated into milwaukee type orthosis ",,,4168.53,9145.24,45 HCPCS,L0859,"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material ",,,1829.2,4013.04,45 HCPCS,L0861,"Addition to halo procedure, replacement liner/interface material ",,,260.98,572.57,45 HCPCS,L0970,"Tlso, corset front ",,,163.73,359.2,45 HCPCS,L0972,"Lso, corset front ",,,149.71,328.46,45 HCPCS,L0974,"Tlso, full corset ",,,226.32,496.52,45 HCPCS,L0976,"Lso, full corset ",,,211.93,464.96,45 HCPCS,L0978,Axillary crutch extension ,,,222.05,487.15,45 HCPCS,L0980,"Peroneal straps, prefabricated, off-the-shelf, pair ",,,26.21,57.51,45 HCPCS,L0982,"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4) ",,,24.45,53.64,45 HCPCS,L0984,"Protective body sock, prefabricated, off-the-shelf, each ",,,68.37,150.01,45 HCPCS,L1000,"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model ",,,2485.66,5453.24,45 HCPCS,L1005,"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment ",,,3875.29,8501.92,45 HCPCS,L1006,"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been t",,,1282.91,2814.54,45 HCPCS,L1007,"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated ",,,932.48,1436.32,5 HCPCS,L1010,"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling ",,,89.08,195.44,45 HCPCS,L1020,"Addition to ctlso or scoliosis orthosis, kyphosis pad ",,,123.43,270.79,45 HCPCS,L1025,"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating ",,,140.43,308.1,45 HCPCS,L1030,"Addition to ctlso or scoliosis orthosis, lumbar bolster pad ",,,95.52,209.56,45 HCPCS,L1040,"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad ",,,99.85,219.06,45 HCPCS,L1050,"Addition to ctlso or scoliosis orthosis, sternal pad ",,,120.87,265.18,45 HCPCS,L1060,"Addition to ctlso or scoliosis orthosis, thoracic pad ",,,117.31,257.36,45 HCPCS,L1070,"Addition to ctlso or scoliosis orthosis, trapezius sling ",,,114.76,251.76,45 HCPCS,L1080,"Addition to ctlso or scoliosis orthosis, outrigger ",,,64.55,141.62,45 HCPCS,L1085,"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions ",,,194.93,427.66,45 HCPCS,L1090,"Addition to ctlso or scoliosis orthosis, lumbar sling ",,,115.44,253.27,45 HCPCS,L1100,"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather ",,,198.97,436.51,45 HCPCS,L1110,"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model ",,,290.16,636.57,45 HCPCS,L1120,"Addition to ctlso, scoliosis orthosis, cover for upright, each ",,,52.59,115.37,45 HCPCS,L1200,"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only ",,,2029.29,4452.0,45 HCPCS,L1210,"Addition to tlso, (low profile), lateral thoracic extension ",,,294.67,646.46,45 HCPCS,L1220,"Addition to tlso, (low profile), anterior thoracic extension ",,,285.17,625.63,45 HCPCS,L1230,"Addition to tlso, (low profile), milwaukee type superstructure ",,,640.16,1404.42,45 HCPCS,L1240,"Addition to tlso, (low profile), lumbar derotation pad ",,,94.42,207.15,45 HCPCS,L1250,"Addition to tlso, (low profile), anterior asis pad ",,,91.6,200.96,45 HCPCS,L1260,"Addition to tlso, (low profile), anterior thoracic derotation pad ",,,92.16,202.19,45 HCPCS,L1270,"Addition to tlso, (low profile), abdominal pad ",,,88.62,194.42,45 HCPCS,L1280,"Addition to tlso, (low profile), rib gusset (elastic), each ",,,97.16,213.15,45 HCPCS,L1290,"Addition to tlso, (low profile), lateral trochanteric pad ",,,88.51,194.19,45 HCPCS,L1300,"Other scoliosis procedure, body jacket molded to patient model ",,,2168.33,4757.05,45 HCPCS,L1310,"Other scoliosis procedure, post-operative body jacket ",,,2088.77,4582.51,45 HCPCS,L1320,"Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated ",,,0.57,0.88,5 HCPCS,L1600,"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by",,,193.49,424.5,45 HCPCS,L1610,"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an",,,51.27,112.49,45 HCPCS,L1620,"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an in",,,150.88,331.01,45 HCPCS,L1630,"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated ",,,190.83,418.65,45 HCPCS,L1640,"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated ",,,598.39,1312.79,45 HCPCS,L1650,"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment ",,,274.79,602.86,45 HCPCS,L1652,"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled",,,431.63,946.95,45 HCPCS,L1653,"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf ",,,431.63,946.95,45 HCPCS,L1660,"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment ",,,256.97,563.75,45 HCPCS,L1680,"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated ",,,1622.05,3558.57,45 HCPCS,L1681,"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, mol",,,2054.51,4507.35,45 HCPCS,L1685,"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated ",,,1339.52,2938.75,45 HCPCS,L1686,"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment ",,,1027.26,2253.67,45 HCPCS,L1690,"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment ",,,2341.39,5136.72,45 HCPCS,L1700,"Legg perthes orthosis, (toronto type), custom fabricated ",,,1931.71,4237.93,45 HCPCS,L1710,"Legg perthes orthosis, (newington type), custom fabricated ",,,2483.99,5449.56,45 HCPCS,L1720,"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated ",,,1842.76,4042.8,45 HCPCS,L1730,"Legg perthes orthosis, (scottish rite type), custom fabricated ",,,1458.67,3200.15,45 HCPCS,L1755,"Legg perthes orthosis, (patten bottom type), custom fabricated ",,,1782.96,3911.6,45 HCPCS,L1810,"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ",,,120.44,264.24,45 HCPCS,L1812,"Knee orthosis, elastic with joints, prefabricated, off-the-shelf ",,,68.72,150.76,45 HCPCS,L1820,"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific pat",,,162.02,355.46,45 HCPCS,L1821,"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf ",,,162.02,355.46,45 HCPCS,L1830,"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf ",,,61.92,135.84,45 HCPCS,L1831,"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment ",,,356.35,781.78,45 HCPCS,L1832,"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit",,,684.66,1502.05,45 HCPCS,L1833,"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf ",,,446.06,978.59,45 HCPCS,L1834,"Knee orthosis, without knee joint, rigid, custom fabricated ",,,874.18,1917.84,45 HCPCS,L1836,"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf ",,,87.55,192.08,45 HCPCS,L1840,"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated ",,,1272.31,2791.3,45 HCPCS,L1843,"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, pr",,,1086.41,2383.45,45 HCPCS,L1844,"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, cu",,,1879.37,4123.1,45 HCPCS,L1845,"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, pr",,,1054.79,2314.09,45 HCPCS,L1846,"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, cu",,,1321.81,2899.9,45 HCPCS,L1847,"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specifi",,,696.43,1527.88,45 HCPCS,L1848,"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf ",,,696.43,1527.88,45 HCPCS,L1850,"Knee orthosis, swedish type, prefabricated, off-the-shelf ",,,201.66,442.43,45 HCPCS,L1851,"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustmen",,,588.76,1291.68,45 HCPCS,L1852,"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustmen",,,561.67,1232.23,45 HCPCS,L1860,"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk) ",,,1231.59,2701.95,45 HCPCS,L1900,"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated ",,,390.13,855.89,45 HCPCS,L1902,"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf ",,,119.86,262.97,45 HCPCS,L1904,"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated ",,,529.55,1161.77,45 HCPCS,L1906,"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf ",,,135.44,297.13,45 HCPCS,L1907,"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated ",,,681.31,1494.7,45 HCPCS,L1910,"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment ",,,339.29,744.35,45 HCPCS,L1920,"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated ",,,407.64,894.31,45 HCPCS,L1930,"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment ",,,355.2,779.27,45 HCPCS,L1932,"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific p",,,1080.5,2370.48,45 HCPCS,L1933,"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf ",,,1080.5,2370.48,45 HCPCS,L1940,"Ankle foot orthosis, plastic or other material, custom fabricated ",,,570.24,1251.04,45 HCPCS,L1945,"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated ",,,1042.46,2287.02,45 HCPCS,L1950,"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated ",,,841.65,1846.48,45 HCPCS,L1951,"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a",,,1016.86,2230.86,45 HCPCS,L1952,"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf ",,,1016.86,2230.86,45 HCPCS,L1960,"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated ",,,624.21,1369.44,45 HCPCS,L1970,"Ankle foot orthosis, plastic with ankle joint, custom fabricated ",,,801.33,1758.01,45 HCPCS,L1971,"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment ",,,567.53,1245.09,45 HCPCS,L1980,"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated ",,,432.05,947.87,45 HCPCS,L1990,"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated ",,,501.98,1101.27,45 HCPCS,L2000,"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated ",,,1142.23,2505.91,45 HCPCS,L2005,"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated ",,,4961.46,10884.83,45 HCPCS,L2006,"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type ",,,2789.52,84980.04,50 HCPCS,L2010,"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated ",,,1115.42,2447.09,45 HCPCS,L2020,"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated ",,,1314.93,2884.81,45 HCPCS,L2030,"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated ",,,1153.39,2530.4,45 HCPCS,L2034,"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated ",,,2542.64,5578.24,45 HCPCS,L2035,"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment ",,,209.77,460.21,45 HCPCS,L2036,"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated ",,,2195.45,4816.56,45 HCPCS,L2037,"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated ",,,1875.69,4115.04,45 HCPCS,L2038,"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated ",,,1610.08,3532.32,45 HCPCS,L2040,"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated ",,,199.94,438.64,45 HCPCS,L2050,"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated ",,,636.34,1396.06,45 HCPCS,L2060,"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated ",,,736.25,1615.25,45 HCPCS,L2070,"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated ",,,152.59,334.75,45 HCPCS,L2080,"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated ",,,432.78,949.46,45 HCPCS,L2090,"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated ",,,524.52,1150.72,45 HCPCS,L2106,"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated ",,,942.38,2067.46,45 HCPCS,L2108,"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated ",,,1309.21,2872.25,45 HCPCS,L2112,"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment ",,,637.85,1399.37,45 HCPCS,L2114,"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment ",,,738.39,1619.94,45 HCPCS,L2116,"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment ",,,884.64,1940.78,45 HCPCS,L2126,"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated ",,,1348.51,2958.46,45 HCPCS,L2128,"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated ",,,1931.03,4236.45,45 HCPCS,L2132,"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment ",,,1024.82,2248.32,45 HCPCS,L2134,"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment ",,,1281.76,2812.03,45 HCPCS,L2136,"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment ",,,1451.17,3183.7,45 HCPCS,L2180,"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints ",,,175.84,385.77,45 HCPCS,L2182,"Addition to lower extremity fracture orthosis, drop lock knee joint ",,,129.17,283.39,45 HCPCS,L2184,"Addition to lower extremity fracture orthosis, limited motion knee joint ",,,167.85,368.25,45 HCPCS,L2186,"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type ",,,169.54,371.95,45 HCPCS,L2188,"Addition to lower extremity fracture orthosis, quadrilateral brim ",,,394.52,865.53,45 HCPCS,L2190,"Addition to lower extremity fracture orthosis, waist belt ",,,112.74,247.34,45 HCPCS,L2192,"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt ",,,444.17,974.44,45 HCPCS,L2200,"Addition to lower extremity, limited ankle motion, each joint ",,,71.38,156.61,45 HCPCS,L2210,"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint ",,,75.7,166.07,45 HCPCS,L2220,"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint ",,,98.39,215.86,45 HCPCS,L2221,"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source ",,,1739.35,3815.93,44 HCPCS,L2230,"Addition to lower extremity, split flat caliper stirrups and plate attachment ",,,90.91,199.46,45 HCPCS,L2232,"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only ",,,116.99,256.67,45 HCPCS,L2240,"Addition to lower extremity, round caliper and plate attachment ",,,94.19,206.64,45 HCPCS,L2250,"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment ",,,400.14,877.87,45 HCPCS,L2260,"Addition to lower extremity, reinforced solid stirrup (scott-craig type) ",,,232.97,511.1,45 HCPCS,L2265,"Addition to lower extremity, long tongue stirrup ",,,176.83,387.95,45 HCPCS,L2270,"Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad ",,,60.48,132.68,45 HCPCS,L2275,"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined ",,,147.13,322.78,45 HCPCS,L2280,"Addition to lower extremity, molded inner boot ",,,509.92,1118.71,45 HCPCS,L2300,"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable ",,,404.27,886.92,45 HCPCS,L2310,"Addition to lower extremity, abduction bar-straight ",,,184.72,405.25,45 HCPCS,L2320,"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only ",,,252.82,554.66,45 HCPCS,L2330,"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only ",,,468.67,1028.19,45 HCPCS,L2335,"Addition to lower extremity, anterior swing band ",,,255.83,561.26,45 HCPCS,L2340,"Addition to lower extremity, pre-tibial shell, molded to patient model ",,,624.13,1369.27,45 HCPCS,L2350,"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses) ",,,1069.26,2345.82,45 HCPCS,L2360,"Addition to lower extremity, extended steel shank ",,,77.68,170.43,45 HCPCS,L2370,"Addition to lower extremity, patten bottom ",,,330.49,725.04,45 HCPCS,L2375,"Addition to lower extremity, torsion control, ankle joint and half solid stirrup ",,,169.66,372.21,45 HCPCS,L2380,"Addition to lower extremity, torsion control, straight knee joint, each joint ",,,184.86,405.55,45 HCPCS,L2385,"Addition to lower extremity, straight knee joint, heavy duty, each joint ",,,194.75,427.25,45 HCPCS,L2387,"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint ",,,186.38,408.89,45 HCPCS,L2390,"Addition to lower extremity, offset knee joint, each joint ",,,123.27,270.45,45 HCPCS,L2395,"Addition to lower extremity, offset knee joint, heavy duty, each joint ",,,234.94,515.42,45 HCPCS,L2397,"Addition to lower extremity orthosis, suspension sleeve ",,,131.99,289.56,45 HCPCS,L2405,"Addition to knee joint, drop lock, each ",,,105.58,231.62,45 HCPCS,L2415,"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint ",,,147.07,322.65,45 HCPCS,L2425,"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint ",,,173.57,380.79,45 HCPCS,L2430,"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint ",,,173.57,380.79,45 HCPCS,L2492,"Addition to knee joint, lift loop for drop lock ring ",,,128.17,281.2,45 HCPCS,L2500,"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring ",,,414.28,908.87,45 HCPCS,L2510,"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model ",,,939.61,2061.4,45 HCPCS,L2520,"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted ",,,593.17,1301.35,45 HCPCS,L2525,"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model ",,,1372.75,3011.66,45 HCPCS,L2526,"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted ",,,771.35,1692.24,45 HCPCS,L2530,"Addition to lower extremity, thigh-weight bearing, lacer, non-molded ",,,266.76,585.23,45 HCPCS,L2540,"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model ",,,506.45,1111.1,45 HCPCS,L2550,"Addition to lower extremity, thigh/weight bearing, high roll cuff ",,,323.44,709.59,45 HCPCS,L2570,"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each ",,,715.18,1569.03,45 HCPCS,L2580,"Addition to lower extremity, pelvic control, pelvic sling ",,,522.65,1146.64,45 HCPCS,L2600,"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each ",,,308.39,676.56,45 HCPCS,L2610,"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each ",,,364.65,799.99,45 HCPCS,L2620,"Addition to lower extremity, pelvic control, hip joint, heavy duty, each ",,,352.33,772.97,45 HCPCS,L2622,"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each ",,,460.45,1010.18,45 HCPCS,L2624,"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each ",,,400.42,878.47,45 HCPCS,L2627,"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables ",,,1930.54,4235.37,45 HCPCS,L2628,"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables ",,,1886.73,4139.24,45 HCPCS,L2630,"Addition to lower extremity, pelvic control, band and belt, unilateral ",,,329.75,723.43,45 HCPCS,L2640,"Addition to lower extremity, pelvic control, band and belt, bilateral ",,,433.48,951.01,45 HCPCS,L2650,"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each ",,,162.81,357.18,45 HCPCS,L2660,"Addition to lower extremity, thoracic control, thoracic band ",,,253.51,556.16,45 HCPCS,L2670,"Addition to lower extremity, thoracic control, paraspinal uprights ",,,256.13,561.92,45 HCPCS,L2680,"Addition to lower extremity, thoracic control, lateral support uprights ",,,234.96,515.48,45 HCPCS,L2750,"Addition to lower extremity orthosis, plating chrome or nickel, per bar ",,,123.77,271.54,45 HCPCS,L2755,"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only ",,,158.25,347.18,45 HCPCS,L2760,"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth) ",,,91.23,200.14,45 HCPCS,L2768,"Orthotic side bar disconnect device, per bar ",,,157.72,346.02,45 HCPCS,L2780,"Addition to lower extremity orthosis, non-corrosive finish, per bar ",,,76.21,167.21,45 HCPCS,L2785,"Addition to lower extremity orthosis, drop lock retainer, each ",,,35.69,78.3,45 HCPCS,L2795,"Addition to lower extremity orthosis, knee control, full kneecap ",,,110.31,242.0,45 HCPCS,L2800,"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only ",,,120.12,263.53,45 HCPCS,L2810,"Addition to lower extremity orthosis, knee control, condylar pad ",,,97.9,214.78,45 HCPCS,L2820,"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section ",,,97.79,214.55,45 HCPCS,L2830,"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section ",,,105.8,232.11,45 HCPCS,L2840,"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each ",,,65.6,143.92,45 HCPCS,L2850,"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each ",,,75.03,164.6,45 HCPCS,L3000,"Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each ",,,380.36,834.46,45 HCPCS,L3001,"Foot, insert, removable, molded to patient model, spenco, each ",,,160.12,351.29,45 HCPCS,L3002,"Foot, insert, removable, molded to patient model, plastazote or equal, each ",,,195.52,428.95,45 HCPCS,L3003,"Foot, insert, removable, molded to patient model, silicone gel, each ",,,210.97,462.85,45 HCPCS,L3010,"Foot, insert, removable, molded to patient model, longitudinal arch support, each ",,,210.97,462.85,45 HCPCS,L3020,"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each ",,,240.22,527.01,45 HCPCS,L3030,"Foot, insert, removable, formed to patient foot, each ",,,92.41,202.74,45 HCPCS,L3031,"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each ",,,148.28,325.32,45 HCPCS,L3040,"Foot, arch support, removable, premolded, longitudinal, each ",,,56.98,125.0,45 HCPCS,L3050,"Foot, arch support, removable, premolded, metatarsal, each ",,,56.98,125.0,45 HCPCS,L3060,"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each ",,,89.31,195.93,45 HCPCS,L3070,"Foot, arch support, non-removable attached to shoe, longitudinal, each ",,,38.48,84.43,45 HCPCS,L3080,"Foot, arch support, non-removable attached to shoe, metatarsal, each ",,,38.48,84.43,45 HCPCS,L3090,"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each ",,,49.3,108.17,45 HCPCS,L3100,"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf ",,,52.34,114.83,45 HCPCS,L3140,"Foot, abduction rotation bar, including shoes ",,,107.83,236.56,45 HCPCS,L3150,"Foot, abduction rotation bar, without shoes ",,,98.55,216.2,45 HCPCS,L3161,"Foot, adductus positioning device, adjustable ",,,52.59,81.0,5 HCPCS,L3170,"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each ",,,61.58,135.11,45 HCPCS,L3224,"Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis) ",,,66.22,145.28,45 HCPCS,L3225,"Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis) ",,,77.64,170.32,45 HCPCS,L3300,"Lift, elevation, heel, tapered to metatarsals, per inch ",,,63.12,138.48,45 HCPCS,L3310,"Lift, elevation, heel and sole, neoprene, per inch ",,,98.55,216.2,45 HCPCS,L3330,"Lift, elevation, metal extension (skate) ",,,685.25,1503.34,45 HCPCS,L3332,"Lift, elevation, inside shoe, tapered, up to one-half inch ",,,89.31,195.93,45 HCPCS,L3334,"Lift, elevation, heel, per inch ",,,46.19,101.33,45 HCPCS,L3340,"Heel wedge, sach ",,,103.14,226.29,45 HCPCS,L3350,Heel wedge ,,,27.69,60.76,45 HCPCS,L3360,"Sole wedge, outside sole ",,,43.12,94.6,45 HCPCS,L3370,"Sole wedge, between sole ",,,60.05,131.75,45 HCPCS,L3380,Clubfoot wedge ,,,60.05,131.75,45 HCPCS,L3390,Outflare wedge ,,,60.05,131.75,45 HCPCS,L3400,"Metatarsal bar wedge, rocker ",,,49.3,108.17,45 HCPCS,L3410,"Metatarsal bar wedge, between sole ",,,112.45,246.69,45 HCPCS,L3420,"Full sole and heel wedge, between sole ",,,66.2,145.23,45 HCPCS,L3430,"Heel, counter, plastic reinforced ",,,194.03,425.68,45 HCPCS,L3440,"Heel, counter, leather reinforced ",,,92.41,202.74,45 HCPCS,L3450,"Heel, sach cushion type ",,,127.79,280.36,45 HCPCS,L3455,"Heel, new leather, standard ",,,49.3,108.17,45 HCPCS,L3460,"Heel, new rubber, standard ",,,41.56,91.18,45 HCPCS,L3465,"Heel, thomas with wedge ",,,70.83,155.4,45 HCPCS,L3470,"Heel, thomas extended to ball ",,,75.45,165.53,45 HCPCS,L3480,"Heel, pad and depression for spur ",,,75.45,165.53,45 HCPCS,L3500,"Orthopedic shoe addition, insole, leather ",,,35.46,77.79,45 HCPCS,L3510,"Orthopedic shoe addition, insole, rubber ",,,35.46,77.79,45 HCPCS,L3520,"Orthopedic shoe addition, insole, felt covered with leather ",,,38.48,84.43,45 HCPCS,L3530,"Orthopedic shoe addition, sole, half ",,,38.48,84.43,45 HCPCS,L3540,"Orthopedic shoe addition, sole, full ",,,61.58,135.11,45 HCPCS,L3550,"Orthopedic shoe addition, toe tap standard ",,,10.8,23.69,45 HCPCS,L3560,"Orthopedic shoe addition, toe tap, horseshoe ",,,27.69,60.76,45 HCPCS,L3570,"Orthopedic shoe addition, special extension to instep (leather with eyelets) ",,,103.14,226.29,45 HCPCS,L3580,"Orthopedic shoe addition, convert instep to velcro closure ",,,78.54,172.3,45 HCPCS,L3590,"Orthopedic shoe addition, convert firm shoe counter to soft counter ",,,64.69,141.92,45 HCPCS,L3595,"Orthopedic shoe addition, march bar ",,,50.8,111.46,45 HCPCS,L3600,"Transfer of an orthosis from one shoe to another, caliper plate, existing ",,,92.41,202.74,45 HCPCS,L3610,"Transfer of an orthosis from one shoe to another, caliper plate, new ",,,121.64,266.86,45 HCPCS,L3620,"Transfer of an orthosis from one shoe to another, solid stirrup, existing ",,,92.41,202.74,45 HCPCS,L3630,"Transfer of an orthosis from one shoe to another, solid stirrup, new ",,,121.64,266.86,45 HCPCS,L3640,"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes ",,,52.34,114.83,45 HCPCS,L3650,"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf ",,,71.62,157.12,45 HCPCS,L3660,"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf ",,,113.26,248.48,45 HCPCS,L3670,"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf ",,,129.38,283.84,45 HCPCS,L3671,"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,992.92,2178.34,45 HCPCS,L3674,"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, incl",,,1302.54,2857.61,45 HCPCS,L3675,"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf ",,,193.38,424.26,45 HCPCS,L3702,"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,318.22,698.13,45 HCPCS,L3710,"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf ",,,163.71,359.16,45 HCPCS,L3720,"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated ",,,836.09,1834.27,45 HCPCS,L3730,"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated ",,,1222.92,2682.94,45 HCPCS,L3740,"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated ",,,1570.32,3445.1,45 HCPCS,L3760,"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ",,,551.06,1208.97,45 HCPCS,L3761,"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf ",,,551.06,1208.97,45 HCPCS,L3762,"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf ",,,118.51,260.0,45 HCPCS,L3763,"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,771.47,1692.5,45 HCPCS,L3764,"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,838.24,1839.0,45 HCPCS,L3765,"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,1412.93,3099.81,45 HCPCS,L3766,"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,1496.21,3282.49,45 HCPCS,L3806,"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustmen",,,500.55,1098.16,45 HCPCS,L3807,"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ",,,275.55,604.52,45 HCPCS,L3808,"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment ",,,368.24,807.86,45 HCPCS,L3809,"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type ",,,275.55,604.52,45 HCPCS,L3900,"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated ",,,1440.44,3160.16,45 HCPCS,L3901,"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated ",,,1770.91,3885.16,45 HCPCS,L3904,"Wrist hand finger orthosis, external powered, electric, custom fabricated ",,,3227.1,7079.86,45 HCPCS,L3905,"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,1092.75,2397.36,45 HCPCS,L3906,"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,435.43,955.29,45 HCPCS,L3908,"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf ",,,66.02,144.85,45 HCPCS,L3912,"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf ",,,137.39,301.41,45 HCPCS,L3913,"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,298.46,654.78,45 HCPCS,L3915,"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or oth",,,585.77,1285.1,45 HCPCS,L3916,"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf ",,,585.77,1285.1,45 HCPCS,L3917,"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ",,,116.38,255.31,45 HCPCS,L3918,"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf ",,,116.38,255.31,45 HCPCS,L3919,"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,298.46,654.78,45 HCPCS,L3921,"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,353.92,776.45,45 HCPCS,L3923,"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an ind",,,95.85,210.29,45 HCPCS,L3924,"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf ",,,95.85,210.29,45 HCPCS,L3925,"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf ",,,59.21,129.9,45 HCPCS,L3927,"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, o",,,38.55,84.58,45 HCPCS,L3929,"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded,",,,101.36,222.37,45 HCPCS,L3930,"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf ",,,101.36,222.37,45 HCPCS,L3931,"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment ",,,226.36,496.61,45 HCPCS,L3933,"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment ",,,235.11,515.81,45 HCPCS,L3935,"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment ",,,243.49,534.19,45 HCPCS,L3960,"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment ",,,987.47,2166.38,45 HCPCS,L3961,"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,1851.36,4061.65,45 HCPCS,L3962,"Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment ",,,790.66,1734.62,45 HCPCS,L3967,"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting",,,2185.9,4795.6,45 HCPCS,L3971,"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and",,,2074.87,4552.0,45 HCPCS,L3973,"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft in",,,2185.9,4795.6,45 HCPCS,L3975,"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ",,,1851.36,4061.65,45 HCPCS,L3976,"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes ",,,1851.36,4061.65,45 HCPCS,L3977,"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitt",,,2074.87,4552.0,45 HCPCS,L3978,"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include ",,,2185.9,4795.6,45 HCPCS,L3980,"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment ",,,405.66,889.97,45 HCPCS,L3981,"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments ",,,1109.18,2433.41,45 HCPCS,L3982,"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment ",,,457.78,1004.31,45 HCPCS,L3984,"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment ",,,398.26,873.74,45 HCPCS,L3995,"Addition to upper extremity orthosis, sock, fracture or equal, each ",,,46.98,103.07,45 HCPCS,L4000,Replace girdle for spinal orthosis (ctlso or so) ,,,1517.42,3329.04,45 HCPCS,L4010,Replace trilateral socket brim ,,,775.49,1701.34,45 HCPCS,L4020,"Replace quadrilateral socket brim, molded to patient model ",,,1134.07,2488.0,45 HCPCS,L4030,"Replace quadrilateral socket brim, custom fitted ",,,741.62,1627.01,45 HCPCS,L4040,"Replace molded thigh lacer, for custom fabricated orthosis only ",,,483.37,1060.44,45 HCPCS,L4045,"Replace non-molded thigh lacer, for custom fabricated orthosis only ",,,369.4,810.42,45 HCPCS,L4050,"Replace molded calf lacer, for custom fabricated orthosis only ",,,464.91,1019.96,45 HCPCS,L4055,"Replace non-molded calf lacer, for custom fabricated orthosis only ",,,306.68,672.82,45 HCPCS,L4060,Replace high roll cuff ,,,357.89,785.16,45 HCPCS,L4070,Replace proximal and distal upright for kafo ,,,398.94,875.22,45 HCPCS,L4080,"Replace metal bands kafo, proximal thigh ",,,113.91,249.89,45 HCPCS,L4090,"Replace metal bands kafo-afo, calf or distal thigh ",,,128.65,282.25,45 HCPCS,L4100,"Replace leather cuff kafo, proximal thigh ",,,132.11,289.84,45 HCPCS,L4110,"Replace leather cuff kafo-afo, calf or distal thigh ",,,105.67,231.83,45 HCPCS,L4130,Replace pretibial shell ,,,651.18,1428.61,45 HCPCS,L4205,"Repair of orthotic device, labor component, per 15 minutes ",,,29.35,64.39,45 HCPCS,L4350,"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf ",,,103.53,227.13,45 HCPCS,L4360,"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a s",,,311.82,684.09,45 HCPCS,L4361,"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf ",,,311.82,684.09,45 HCPCS,L4370,"Pneumatic full leg splint, prefabricated, off-the-shelf ",,,212.6,466.42,45 HCPCS,L4386,"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific pa",,,191.96,421.14,45 HCPCS,L4387,"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf ",,,191.96,421.14,45 HCPCS,L4392,"Replacement, soft interface material, static afo ",,,28.52,62.56,45 HCPCS,L4394,"Replace soft interface material, foot drop splint ",,,20.82,45.67,45 HCPCS,L4396,"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molde",,,203.25,445.91,45 HCPCS,L4397,"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf ",,,203.25,445.91,45 HCPCS,L4398,"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf ",,,93.54,205.22,45 HCPCS,L4631,"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, cus",,,1790.95,3929.13,45 HCPCS,L5000,"Partial foot, shoe insert with longitudinal arch, toe filler ",,,808.25,1773.21,45 HCPCS,L5010,"Partial foot, molded socket, ankle height, with toe filler ",,,1835.26,4026.33,45 HCPCS,L5020,"Partial foot, molded socket, tibial tubercle height, with toe filler ",,,2757.0,6048.53,45 HCPCS,L5050,"Ankle, symes, molded socket, sach foot ",,,3470.65,7614.18,45 HCPCS,L5060,"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot ",,,3921.66,8603.63,45 HCPCS,L5100,"Below knee, molded socket, shin, sach foot ",,,3410.49,7482.19,45 HCPCS,L5105,"Below knee, plastic socket, joints and thigh lacer, sach foot ",,,4167.91,9143.89,45 HCPCS,L5150,"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot ",,,4968.08,10899.36,45 HCPCS,L5160,"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot ",,,5227.01,11467.41,45 HCPCS,L5200,"Above knee, molded socket, single axis constant friction knee, shin, sach foot ",,,4542.66,9966.05,45 HCPCS,L5210,"Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each ",,,3357.77,7366.55,45 HCPCS,L5220,"Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each ",,,4218.37,9254.59,45 HCPCS,L5230,"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot ",,,4999.93,10969.24,45 HCPCS,L5250,"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot ",,,6768.97,14850.29,45 HCPCS,L5270,"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot ",,,6431.87,14110.73,45 HCPCS,L5280,"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot ",,,7001.5,15360.44,45 HCPCS,L5301,"Below knee, molded socket, shin, sach foot, endoskeletal system ",,,3308.83,7259.17,45 HCPCS,L5312,"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system ",,,4416.35,9688.93,45 HCPCS,L5321,"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee ",,,4616.32,10127.64,45 HCPCS,L5331,"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot ",,,6949.69,15246.77,45 HCPCS,L5341,"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot ",,,7252.43,15910.95,45 HCPCS,L5400,"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee ",,,1711.04,3753.81,45 HCPCS,L5410,"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment ",,,668.37,1466.32,45 HCPCS,L5420,"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation ",,,2191.24,4807.31,45 HCPCS,L5430,"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment ",,,804.99,1766.05,45 HCPCS,L5450,"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee ",,,651.72,1429.79,45 HCPCS,L5460,"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee ",,,872.28,1913.67,45 HCPCS,L5500,"Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed ",,,1721.7,3777.21,45 HCPCS,L5505,"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed ",,,2782.36,6104.15,45 HCPCS,L5510,"Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model ",,,2046.87,4490.58,45 HCPCS,L5520,"Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed ",,,2300.42,5046.85,45 HCPCS,L5530,"Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model ",,,2377.37,5215.66,45 HCPCS,L5535,"Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket ",,,2382.04,5225.9,45 HCPCS,L5540,"Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model ",,,2553.98,5603.11,45 HCPCS,L5560,"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model ",,,3071.6,6738.72,45 HCPCS,L5570,"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed ",,,3032.67,6653.3,45 HCPCS,L5580,"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model ",,,3386.18,7428.87,45 HCPCS,L5585,"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket ",,,3397.35,7453.36,45 HCPCS,L5590,"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model ",,,3324.05,7292.56,45 HCPCS,L5595,"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model ",,,4830.84,10598.27,45 HCPCS,L5600,"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model ",,,5334.7,11703.68,45 HCPCS,L5610,"Addition to lower extremity, endoskeletal system, above knee, hydracadence system ",,,2878.88,6315.9,45 HCPCS,L5611,"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control ",,,1933.02,4240.81,45 HCPCS,L5613,"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control ",,,2977.43,6532.11,45 HCPCS,L5614,"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control ",,,2047.12,4491.14,45 HCPCS,L5615,"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control ",,,6660.28,14611.83,45 HCPCS,L5616,"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control ",,,2172.62,4766.46,45 HCPCS,L5617,"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each ",,,678.75,1489.09,45 HCPCS,L5618,"Addition to lower extremity, test socket, symes ",,,362.45,795.18,45 HCPCS,L5620,"Addition to lower extremity, test socket, below knee ",,,444.73,975.69,45 HCPCS,L5622,"Addition to lower extremity, test socket, knee disarticulation ",,,579.92,1272.28,45 HCPCS,L5624,"Addition to lower extremity, test socket, above knee ",,,581.57,1275.9,45 HCPCS,L5626,"Addition to lower extremity, test socket, hip disarticulation ",,,638.66,1401.13,45 HCPCS,L5628,"Addition to lower extremity, test socket, hemipelvectomy ",,,689.25,1512.14,45 HCPCS,L5629,"Addition to lower extremity, below knee, acrylic socket ",,,508.37,1115.29,45 HCPCS,L5630,"Addition to lower extremity, symes type, expandable wall socket ",,,620.59,1361.51,45 HCPCS,L5631,"Addition to lower extremity, above knee or knee disarticulation, acrylic socket ",,,702.87,1542.0,45 HCPCS,L5632,"Addition to lower extremity, symes type, 'ptb' brim design socket ",,,266.39,584.43,45 HCPCS,L5634,"Addition to lower extremity, symes type, posterior opening (canadian) socket ",,,364.95,800.66,45 HCPCS,L5636,"Addition to lower extremity, symes type, medial opening socket ",,,305.7,670.67,45 HCPCS,L5637,"Addition to lower extremity, below knee, total contact ",,,462.13,1013.85,45 HCPCS,L5638,"Addition to lower extremity, below knee, leather socket ",,,605.59,1328.59,45 HCPCS,L5639,"Addition to lower extremity, below knee, wood socket ",,,1345.15,2951.09,45 HCPCS,L5640,"Addition to lower extremity, knee disarticulation, leather socket ",,,767.17,1683.08,45 HCPCS,L5642,"Addition to lower extremity, above knee, leather socket ",,,766.65,1681.94,45 HCPCS,L5643,"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame ",,,2008.4,4406.19,45 HCPCS,L5644,"Addition to lower extremity, above knee, wood socket ",,,845.34,1854.57,45 HCPCS,L5645,"Addition to lower extremity, below knee, flexible inner socket, external frame ",,,959.22,2104.42,45 HCPCS,L5646,"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket ",,,853.32,1872.07,45 HCPCS,L5647,"Addition to lower extremity, below knee suction socket ",,,954.36,2093.76,45 HCPCS,L5648,"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket ",,,930.75,2041.96,45 HCPCS,L5649,"Addition to lower extremity, ischial containment/narrow m-l socket ",,,2915.09,6395.35,45 HCPCS,L5650,"Additions to lower extremity, total contact, above knee or knee disarticulation socket ",,,687.31,1507.88,45 HCPCS,L5651,"Addition to lower extremity, above knee, flexible inner socket, external frame ",,,1921.08,4214.62,45 HCPCS,L5652,"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket ",,,610.26,1338.83,45 HCPCS,L5653,"Addition to lower extremity, knee disarticulation, expandable wall socket ",,,714.75,1568.08,45 HCPCS,L5654,"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal) ",,,472.96,1037.61,45 HCPCS,L5655,"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal) ",,,367.94,807.22,45 HCPCS,L5656,"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal) ",,,456.05,1000.52,45 HCPCS,L5657,"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials ",,,114.75,658.59,49 HCPCS,L5658,"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal) ",,,436.23,957.03,45 HCPCS,L5661,"Addition to lower extremity, socket insert, multi-durometer symes ",,,730.11,1601.77,45 HCPCS,L5665,"Addition to lower extremity, socket insert, multi-durometer, below knee ",,,656.52,1440.33,45 HCPCS,L5666,"Addition to lower extremity, below knee, cuff suspension ",,,111.97,245.66,45 HCPCS,L5668,"Addition to lower extremity, below knee, molded distal cushion ",,,161.54,354.41,45 HCPCS,L5670,"Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar) ",,,434.08,952.32,45 HCPCS,L5671,"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert ",,,689.8,1513.34,45 HCPCS,L5672,"Addition to lower extremity, below knee, removable medial brim suspension ",,,357.76,784.88,45 HCPCS,L5673,"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or wit",,,878.96,1928.33,45 HCPCS,L5676,"Additions to lower extremity, below knee, knee joints, single axis, pair ",,,566.2,1242.18,45 HCPCS,L5677,"Additions to lower extremity, below knee, knee joints, polycentric, pair ",,,788.72,1730.36,45 HCPCS,L5678,"Additions to lower extremity, below knee, joint covers, pair ",,,63.51,139.34,45 HCPCS,L5679,"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or wit",,,732.42,1606.85,45 HCPCS,L5680,"Addition to lower extremity, below knee, thigh lacer, nonmolded ",,,391.65,859.23,45 HCPCS,L5681,"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking me",,,1595.77,3500.93,45 HCPCS,L5682,"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded ",,,765.53,1679.47,45 HCPCS,L5683,"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without",,,1595.77,3500.93,45 HCPCS,L5684,"Addition to lower extremity, below knee, fork strap ",,,64.58,141.69,45 HCPCS,L5685,"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each ",,,155.36,340.84,45 HCPCS,L5686,"Addition to lower extremity, below knee, back check (extension control) ",,,64.82,142.2,45 HCPCS,L5688,"Addition to lower extremity, below knee, waist belt, webbing ",,,92.13,202.12,45 HCPCS,L5690,"Addition to lower extremity, below knee, waist belt, padded and lined ",,,129.43,283.95,45 HCPCS,L5692,"Addition to lower extremity, above knee, pelvic control belt, light ",,,212.56,466.33,45 HCPCS,L5694,"Addition to lower extremity, above knee, pelvic control belt, padded and lined ",,,290.21,636.68,45 HCPCS,L5695,"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each ",,,260.88,572.33,45 HCPCS,L5696,"Addition to lower extremity, above knee or knee disarticulation, pelvic joint ",,,266.31,584.24,45 HCPCS,L5697,"Addition to lower extremity, above knee or knee disarticulation, pelvic band ",,,96.31,211.3,45 HCPCS,L5698,"Addition to lower extremity, above knee or knee disarticulation, silesian bandage ",,,143.58,315.0,45 HCPCS,L5699,"All lower extremity prostheses, shoulder harness ",,,223.69,490.76,45 HCPCS,L5700,"Replacement, socket, below knee, molded to patient model ",,,3437.23,7540.87,45 HCPCS,L5701,"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model ",,,4127.87,9056.04,45 HCPCS,L5702,"Replacement, socket, hip disarticulation, including hip joint, molded to patient model ",,,5222.38,11457.26,45 HCPCS,L5703,"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only ",,,3197.61,7015.17,45 HCPCS,L5704,"Custom shaped protective cover, below knee ",,,643.05,1410.77,45 HCPCS,L5705,"Custom shaped protective cover, above knee ",,,1148.95,2520.66,45 HCPCS,L5706,"Custom shaped protective cover, knee disarticulation ",,,1126.31,2470.99,45 HCPCS,L5707,"Custom shaped protective cover, hip disarticulation ",,,1484.91,3257.7,45 HCPCS,L5710,"Addition, exoskeletal knee-shin system, single axis, manual lock ",,,513.51,1126.58,45 HCPCS,L5711,"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material ",,,650.44,1426.98,45 HCPCS,L5712,"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) ",,,681.66,1495.48,45 HCPCS,L5714,"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control ",,,575.89,1263.43,45 HCPCS,L5716,"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock ",,,1017.96,2233.27,45 HCPCS,L5718,"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control ",,,1123.07,2463.88,45 HCPCS,L5722,"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control ",,,1091.78,2395.23,45 HCPCS,L5724,"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control ",,,2414.58,5297.3,45 HCPCS,L5726,"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control ",,,2782.75,6105.01,45 HCPCS,L5728,"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control ",,,2973.03,6522.45,45 HCPCS,L5780,"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control ",,,1582.64,3472.12,45 HCPCS,L5781,"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system ",,,4854.08,10649.25,45 HCPCS,L5782,"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty ",,,5117.25,11226.61,45 HCPCS,L5783,"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) ",,,3087.07,6772.65,45 HCPCS,L5785,"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) ",,,695.01,1524.76,45 HCPCS,L5790,"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) ",,,1150.21,2523.41,45 HCPCS,L5795,"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) ",,,1717.56,3768.11,45 HCPCS,L5810,"Addition, endoskeletal knee-shin system, single axis, manual lock ",,,644.92,1414.87,45 HCPCS,L5811,"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material ",,,955.33,2095.88,45 HCPCS,L5812,"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) ",,,722.91,1585.97,45 HCPCS,L5814,"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock ",,,4505.51,9884.54,45 HCPCS,L5816,"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock ",,,1162.83,2551.1,45 HCPCS,L5818,"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control ",,,1165.95,2557.94,45 HCPCS,L5822,"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control ",,,2043.07,4482.26,45 HCPCS,L5824,"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control ",,,2191.78,4808.5,45 HCPCS,L5826,"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame ",,,3788.55,8311.62,45 HCPCS,L5827,"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping ",,,6867.02,15065.39,45 HCPCS,L5828,"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control ",,,3388.05,7432.96,45 HCPCS,L5830,"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control ",,,2498.62,5481.66,45 HCPCS,L5840,"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control ",,,4209.0,9234.03,45 HCPCS,L5841,"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control ",,,3094.52,6788.99,45 HCPCS,L5845,"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable ",,,2174.44,4770.46,45 HCPCS,L5848,"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability ",,,1304.53,2861.97,45 HCPCS,L5850,"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist ",,,204.63,448.94,45 HCPCS,L5855,"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist ",,,412.37,904.7,45 HCPCS,L5856,"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type ",,,29122.86,63891.98,45 HCPCS,L5857,"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type ",,,10333.9,22671.32,45 HCPCS,L5858,"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type ",,,22546.76,49464.83,45 HCPCS,L5859,"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s) ",,,17602.07,38616.79,45 HCPCS,L5910,"Addition, endoskeletal system, below knee, alignable system ",,,579.37,1271.06,45 HCPCS,L5920,"Addition, endoskeletal system, above knee or hip disarticulation, alignable system ",,,848.79,1862.14,45 HCPCS,L5925,"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock ",,,537.51,1179.23,45 HCPCS,L5926,"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type ",,,806.6,1769.58,45 HCPCS,L5930,"Addition, endoskeletal system, high activity knee control frame ",,,4083.36,8958.38,45 HCPCS,L5940,"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) ",,,802.41,1760.4,45 HCPCS,L5950,"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) ",,,1244.57,2730.44,45 HCPCS,L5960,"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) ",,,1542.16,3383.3,45 HCPCS,L5961,"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control ",,,5720.48,12550.02,45 HCPCS,L5962,"Addition, endoskeletal system, below knee, flexible protective outer surface covering system ",,,761.14,1669.84,45 HCPCS,L5964,"Addition, endoskeletal system, above knee, flexible protective outer surface covering system ",,,1123.61,2465.06,45 HCPCS,L5966,"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system ",,,1431.75,3141.09,45 HCPCS,L5968,"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature ",,,4408.5,9671.71,45 HCPCS,L5970,"All lower extremity prostheses, foot, external keel, sach foot ",,,273.07,599.08,45 HCPCS,L5971,"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only ",,,273.07,599.08,45 HCPCS,L5972,"All lower extremity prostheses, foot, flexible keel ",,,514.08,1127.83,45 HCPCS,L5973,"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source ",,,20872.04,45790.7,45 HCPCS,L5974,"All lower extremity prostheses, foot, single axis ankle/foot ",,,318.03,697.72,45 HCPCS,L5975,"All lower extremity prosthesis, combination single axis ankle and flexible keel foot ",,,562.44,1233.93,45 HCPCS,L5976,"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal) ",,,728.28,1597.75,45 HCPCS,L5978,"All lower extremity prostheses, foot, multiaxial ankle/foot ",,,408.33,895.82,45 HCPCS,L5979,"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system ",,,2737.57,6005.9,45 HCPCS,L5980,"All lower extremity prostheses, flex foot system ",,,4705.2,10322.62,45 HCPCS,L5981,"All lower extremity prostheses, flex-walk system or equal ",,,3593.34,7883.34,45 HCPCS,L5982,"All exoskeletal lower extremity prostheses, axial rotation unit ",,,750.93,1647.46,45 HCPCS,L5984,"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability ",,,806.6,1769.58,45 HCPCS,L5985,"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon ",,,342.55,751.51,45 HCPCS,L5986,"All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) ",,,802.61,1760.83,45 HCPCS,L5987,"All lower extremity prosthesis, shank foot system with vertical loading pylon ",,,8727.15,19146.29,45 HCPCS,L5988,"Addition to lower limb prosthesis, vertical shock reducing pylon feature ",,,2423.52,5316.91,45 HCPCS,L5990,"Addition to lower extremity prosthesis, user adjustable heel height ",,,2200.89,4828.49,45 HCPCS,L5991,"Addition to lower extremity prostheses, osseointegrated external prosthetic connector ",,,11519.9,25273.25,45 HCPCS,L5992,"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only ",,,124.57,273.29,44 HCPCS,L6000,"Partial hand, thumb remaining ",,,1832.4,1832.4,1 HCPCS,L6010,"Partial hand, little and/or ring finger remaining ",,,1843.61,1843.61,1 HCPCS,L6020,"Partial hand, no finger remaining ",,,1833.83,1833.83,1 HCPCS,L6026,"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectr",,,4498.14,9868.37,45 HCPCS,L6028,"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, including palm, for",,,1800.56,3950.22,49 HCPCS,L6029,"Upper extremity addition, test socket/interface, partial hand including fingers ",,,274.13,814.23,49 HCPCS,L6030,"Upper extremity addition, external frame, partial hand including fingers ",,,511.15,1518.24,49 HCPCS,L6031,"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power ",,,1505.73,3303.39,49 HCPCS,L6032,"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal) ",,,274.64,815.73,49 HCPCS,L6033,"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material ",,,329.99,980.14,49 HCPCS,L6034,"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use w",,,360.11,3423.73,49 HCPCS,L6035,"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include",,,1581.19,4357.63,49 HCPCS,L6036,"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment",,,1581.19,4357.63,49 HCPCS,L6037,"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers ",,,1163.31,3455.24,49 HCPCS,L6038,"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material ",,,274.64,794.55,49 HCPCS,L6039,"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thu",,,1808.26,4357.63,49 HCPCS,L6050,"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad ",,,2760.82,6056.89,45 HCPCS,L6055,"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad ",,,3405.7,7471.68,45 HCPCS,L6100,"Below elbow, molded socket, flexible elbow hinge, triceps pad ",,,2832.53,6214.23,45 HCPCS,L6110,"Below elbow, molded socket, (muenster or northwestern suspension types) ",,,3006.78,6596.5,45 HCPCS,L6120,"Below elbow, molded double wall split socket, step-up hinges, half cuff ",,,3390.15,7437.58,45 HCPCS,L6130,"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff ",,,3141.38,6891.8,45 HCPCS,L6200,"Elbow disarticulation, molded socket, outside locking hinge, forearm ",,,3822.09,8385.19,45 HCPCS,L6205,"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm ",,,4369.01,9585.07,45 HCPCS,L6250,"Above elbow, molded double wall socket, internal locking elbow, forearm ",,,3963.53,8695.5,45 HCPCS,L6300,"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm ",,,4772.9,10471.17,45 HCPCS,L6310,"Shoulder disarticulation, passive restoration (complete prosthesis) ",,,3832.25,8407.49,45 HCPCS,L6320,"Shoulder disarticulation, passive restoration (shoulder cap only) ",,,2305.56,5058.11,45 HCPCS,L6350,"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm ",,,4699.38,10309.87,45 HCPCS,L6360,"Interscapular thoracic, passive restoration (complete prosthesis) ",,,3821.45,8383.8,45 HCPCS,L6370,"Interscapular thoracic, passive restoration (shoulder cap only) ",,,2664.24,5845.01,45 HCPCS,L6380,"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow ",,,1574.95,3455.24,45 HCPCS,L6382,"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow ",,,1868.42,4099.08,45 HCPCS,L6384,"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular",,,2316.23,5081.52,45 HCPCS,L6386,"Immediate post surgical or early fitting, each additional cast change and realignment ",,,536.35,1176.69,45 HCPCS,L6388,"Immediate post surgical or early fitting, application of rigid dressing only ",,,599.41,1315.03,45 HCPCS,L6400,"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping ",,,3009.27,6601.96,45 HCPCS,L6450,"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping ",,,3698.97,8115.09,45 HCPCS,L6500,"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping ",,,3732.32,8188.25,45 HCPCS,L6550,"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping ",,,4574.99,10036.97,45 HCPCS,L6570,"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping ",,,5251.2,11520.5,45 HCPCS,L6580,"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, ",,,1971.51,4325.24,45 HCPCS,L6582,"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover",,,1828.38,4011.23,45 HCPCS,L6584,"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to",,,2671.03,5859.91,45 HCPCS,L6586,"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed ",,,2627.97,5765.44,45 HCPCS,L6588,"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, n",,,3618.08,7937.63,45 HCPCS,L6590,"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover,",,,3548.34,7784.63,45 HCPCS,L6600,"Upper extremity additions, polycentric hinge, pair ",,,300.07,658.31,45 HCPCS,L6605,"Upper extremity additions, single pivot hinge, pair ",,,296.28,650.01,45 HCPCS,L6610,"Upper extremity additions, flexible metal hinge, pair ",,,242.64,532.32,45 HCPCS,L6611,"Addition to upper extremity prosthesis, external powered, additional switch, any type ",,,499.49,1095.81,45 HCPCS,L6615,"Upper extremity addition, disconnect locking wrist unit ",,,232.94,511.03,45 HCPCS,L6616,"Upper extremity addition, additional disconnect insert for locking wrist unit, each ",,,99.01,217.21,45 HCPCS,L6620,"Upper extremity addition, flexion/extension wrist unit, with or without friction ",,,402.49,883.0,45 HCPCS,L6621,"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device ",,,2774.85,6087.68,45 HCPCS,L6623,"Upper extremity addition, spring assisted rotational wrist unit with latch release ",,,808.16,1773.0,45 HCPCS,L6624,"Upper extremity addition, flexion/extension and rotation wrist unit ",,,4568.87,10023.54,45 HCPCS,L6625,"Upper extremity addition, rotation wrist unit with cable lock ",,,850.79,1866.52,45 HCPCS,L6628,"Upper extremity addition, quick disconnect hook adapter, otto bock or equal ",,,619.29,1358.65,45 HCPCS,L6629,"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal ",,,212.93,467.15,45 HCPCS,L6630,"Upper extremity addition, stainless steel, any wrist ",,,344.76,756.37,45 HCPCS,L6632,"Upper extremity addition, latex suspension sleeve, each ",,,77.95,171.01,45 HCPCS,L6635,"Upper extremity addition, lift assist for elbow ",,,265.43,582.33,45 HCPCS,L6637,"Upper extremity addition, nudge control elbow lock ",,,517.25,1134.79,45 HCPCS,L6638,"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow ",,,3033.78,6655.73,45 HCPCS,L6640,"Upper extremity additions, shoulder abduction joint, pair ",,,432.74,949.38,45 HCPCS,L6641,"Upper extremity addition, excursion amplifier, pulley type ",,,234.03,513.44,45 HCPCS,L6642,"Upper extremity addition, excursion amplifier, lever type ",,,278.6,611.22,45 HCPCS,L6645,"Upper extremity addition, shoulder flexion-abduction joint, each ",,,483.24,1060.16,45 HCPCS,L6646,"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system ",,,3826.26,8394.35,45 HCPCS,L6647,"Upper extremity addition, shoulder lock mechanism, body powered actuator ",,,629.93,1382.0,45 HCPCS,L6648,"Upper extremity addition, shoulder lock mechanism, external powered actuator ",,,3946.28,8657.66,45 HCPCS,L6650,"Upper extremity addition, shoulder universal joint, each ",,,507.38,1113.12,45 HCPCS,L6655,"Upper extremity addition, standard control cable, extra ",,,111.07,243.68,45 HCPCS,L6660,"Upper extremity addition, heavy duty control cable ",,,123.85,271.72,45 HCPCS,L6665,"Upper extremity addition, teflon, or equal, cable lining ",,,73.67,161.62,45 HCPCS,L6670,"Upper extremity addition, hook to hand, cable adapter ",,,76.71,168.3,45 HCPCS,L6672,"Upper extremity addition, harness, chest or shoulder, saddle type ",,,213.45,468.29,45 HCPCS,L6675,"Upper extremity addition, harness, (e.g., figure of eight type), single cable design ",,,149.69,328.41,45 HCPCS,L6676,"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design ",,,157.37,345.25,45 HCPCS,L6677,"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow ",,,359.9,789.59,45 HCPCS,L6680,"Upper extremity addition, test socket, wrist disarticulation or below elbow ",,,371.14,814.23,45 HCPCS,L6682,"Upper extremity addition, test socket, elbow disarticulation or above elbow ",,,363.42,797.31,45 HCPCS,L6684,"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic ",,,418.21,917.49,45 HCPCS,L6686,"Upper extremity addition, suction socket ",,,777.55,1705.85,45 HCPCS,L6687,"Upper extremity addition, frame type socket, below elbow or wrist disarticulation ",,,692.04,1518.24,45 HCPCS,L6688,"Upper extremity addition, frame type socket, above elbow or elbow disarticulation ",,,817.93,1794.43,45 HCPCS,L6689,"Upper extremity addition, frame type socket, shoulder disarticulation ",,,855.88,1877.7,45 HCPCS,L6690,"Upper extremity addition, frame type socket, interscapular-thoracic ",,,928.66,2037.36,45 HCPCS,L6691,"Upper extremity addition, removable insert, each ",,,414.15,908.59,45 HCPCS,L6692,"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each ",,,853.68,1872.87,45 HCPCS,L6693,"Upper extremity addition, locking elbow, forearm counterbalance ",,,3444.12,7555.98,45 HCPCS,L6694,"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanis",,,878.96,1928.33,45 HCPCS,L6695,"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mech",,,732.42,1606.85,45 HCPCS,L6696,"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or witho",,,1595.77,3500.93,45 HCPCS,L6697,"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use wi",,,1595.77,3500.93,45 HCPCS,L6698,"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert ",,,689.8,1513.34,45 HCPCS,L6700,"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement ",,,28920.0,63446.93,45 HCPCS,L6703,"Terminal device, passive hand/mitt, any material, any size ",,,396.78,870.49,45 HCPCS,L6704,"Terminal device, sport/recreational/work attachment, any material, any size ",,,930.51,2041.42,45 HCPCS,L6706,"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined ",,,482.74,1059.07,45 HCPCS,L6707,"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined ",,,1717.74,3768.52,45 HCPCS,L6708,"Terminal device, hand, mechanical, voluntary opening, any material, any size ",,,1154.46,2532.74,45 HCPCS,L6709,"Terminal device, hand, mechanical, voluntary closing, any material, any size ",,,1693.81,3716.02,45 HCPCS,L6711,"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric ",,,815.62,1789.38,45 HCPCS,L6712,"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric ",,,1501.75,3294.66,45 HCPCS,L6713,"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric ",,,1895.3,4158.06,45 HCPCS,L6714,"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric ",,,1605.33,3521.89,45 HCPCS,L6715,"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement ",,,3830.1,8402.78,45 HCPCS,L6721,"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined ",,,2853.31,6259.81,45 HCPCS,L6722,"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined ",,,2459.74,5396.37,45 HCPCS,L6805,"Addition to terminal device, modifier wrist unit ",,,510.55,1120.09,45 HCPCS,L6810,"Addition to terminal device, precision pinch device ",,,298.39,654.63,45 HCPCS,L6880,"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) ",,,28985.26,63590.12,45 HCPCS,L6881,"Automatic grasp feature, addition to upper limb electric prosthetic terminal device ",,,4959.68,10880.93,45 HCPCS,L6882,"Microprocessor control feature, addition to upper limb prosthetic terminal device ",,,3762.17,8253.74,45 HCPCS,L6883,"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power ",,,2238.7,4911.44,45 HCPCS,L6884,"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power ",,,3359.88,7371.17,45 HCPCS,L6885,"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power ",,,3821.45,8383.8,45 HCPCS,L6890,"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment ",,,221.2,485.28,45 HCPCS,L6895,"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated ",,,669.94,1469.76,45 HCPCS,L6900,"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining ",,,1855.01,4069.67,45 HCPCS,L6905,"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining ",,,1761.5,3864.52,45 HCPCS,L6910,"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining ",,,1735.83,3808.19,45 HCPCS,L6915,"Hand restoration (shading, and measurements included), replacement glove for above ",,,751.08,1647.78,45 HCPCS,L6920,"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device ",,,8791.96,19288.49,45 HCPCS,L6925,"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal dev",,,9283.56,20366.99,45 HCPCS,L6930,"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device ",,,9439.18,20708.41,45 HCPCS,L6935,"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device ",,,10383.0,22779.03,45 HCPCS,L6940,"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control o",,,11796.95,25881.06,45 HCPCS,L6945,"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectroni",,,13345.15,29277.63,45 HCPCS,L6950,"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal",,,12542.43,27516.56,45 HCPCS,L6955,"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control ",,,15739.0,34529.43,45 HCPCS,L6960,"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries",,,15519.48,34047.83,45 HCPCS,L6965,"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batte",,,22671.71,49738.96,45 HCPCS,L6970,"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries a",,,23044.21,50556.17,45 HCPCS,L6975,"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteri",,,23167.89,50827.5,45 HCPCS,L7007,"Electric hand, switch or myoelectric controlled, adult ",,,5504.61,12076.44,45 HCPCS,L7008,"Electric hand, switch or myoelectric, controlled, pediatric ",,,8663.68,19007.05,45 HCPCS,L7009,"Electric hook, switch or myoelectric controlled, adult ",,,5616.45,12321.8,45 HCPCS,L7040,"Prehensile actuator, switch controlled ",,,4509.78,9893.91,45 HCPCS,L7045,"Electric hook, switch or myoelectric controlled, pediatric ",,,2585.61,5672.52,45 HCPCS,L7170,"Electronic elbow, hosmer or equal, switch controlled ",,,9379.76,20578.04,45 HCPCS,L7180,"Electronic elbow, microprocessor sequential control of elbow and terminal device ",,,49007.06,107515.48,45 HCPCS,L7181,"Electronic elbow, microprocessor simultaneous control of elbow and terminal device ",,,48608.78,106641.72,45 HCPCS,L7185,"Electronic elbow, adolescent, variety village or equal, switch controlled ",,,9498.26,20838.01,45 HCPCS,L7186,"Electronic elbow, child, variety village or equal, switch controlled ",,,13708.34,30074.42,45 HCPCS,L7190,"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled ",,,12084.77,26512.51,45 HCPCS,L7191,"Electronic elbow, child, variety village or equal, myoelectronically controlled ",,,14571.52,31968.13,45 HCPCS,L7259,"Electronic wrist rotator, any type ",,,4606.76,10106.68,45 HCPCS,L7360,"Six volt battery, each ",,,288.88,633.78,45 HCPCS,L7362,"Battery charger, six volt, each ",,,347.47,762.3,45 HCPCS,L7364,"Twelve volt battery, each ",,,632.93,1388.58,45 HCPCS,L7366,"Battery charger, twelve volt, each ",,,858.65,1883.77,45 HCPCS,L7367,"Lithium ion battery, rechargeable, replacement ",,,472.29,1036.15,45 HCPCS,L7368,"Lithium ion battery charger, replacement only ",,,612.29,1343.3,45 HCPCS,L7400,"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) ",,,371.82,815.73,45 HCPCS,L7401,"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) ",,,416.25,913.21,45 HCPCS,L7402,"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) ",,,449.51,986.16,45 HCPCS,L7403,"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material ",,,446.76,980.14,45 HCPCS,L7404,"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material ",,,674.27,1479.26,45 HCPCS,L7405,"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material ",,,881.88,1934.74,45 HCPCS,L7406,"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) ",,,3087.07,6772.65,45 HCPCS,L7520,"Repair prosthetic device, labor component, per 15 minutes ",,,39.86,87.44,45 HCPCS,L7700,"Gasket or seal, for use with prosthetic socket insert, any type, each ",,,135.41,297.07,45 HCPCS,L8000,"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type ",,,45.0,98.73,45 HCPCS,L8001,"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type ",,,152.16,333.83,45 HCPCS,L8002,"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type ",,,200.15,439.09,45 HCPCS,L8015,"External breast prosthesis garment, with mastectomy form, post mastectomy ",,,72.71,159.51,45 HCPCS,L8020,"Breast prosthesis, mastectomy form ",,,272.58,598.0,45 HCPCS,L8030,"Breast prosthesis, silicone or equal, without integral adhesive ",,,400.21,878.02,45 HCPCS,L8031,"Breast prosthesis, silicone or equal, with integral adhesive ",,,400.21,878.02,45 HCPCS,L8032,"Nipple prosthesis, prefabricated, reusable, any type, each ",,,47.52,104.25,45 HCPCS,L8033,"Nipple prosthesis, custom fabricated, reusable, any material, any type, each ",,,26.72,41.16,5 HCPCS,L8035,"Custom breast prosthesis, post mastectomy, molded to patient model ",,,4444.55,9750.79,45 HCPCS,L8040,"Nasal prosthesis, provided by a non-physician ",,,2891.57,6343.75,45 HCPCS,L8041,"Midfacial prosthesis, provided by a non-physician ",,,3485.32,7646.37,45 HCPCS,L8042,"Orbital prosthesis, provided by a non-physician ",,,3916.09,8591.42,45 HCPCS,L8043,"Upper facial prosthesis, provided by a non-physician ",,,4386.01,9622.37,45 HCPCS,L8044,"Hemi-facial prosthesis, provided by a non-physician ",,,4855.94,10653.34,45 HCPCS,L8045,"Auricular prosthesis, provided by a non-physician ",,,3040.76,6671.06,45 HCPCS,L8046,"Partial facial prosthesis, provided by a non-physician ",,,3132.85,6873.1,45 HCPCS,L8047,"Nasal septal prosthesis, provided by a non-physician ",,,1605.61,3522.52,45 HCPCS,L8300,"Truss, single with standard pad ",,,101.21,222.05,45 HCPCS,L8310,"Truss, double with standard pads ",,,159.79,350.56,45 HCPCS,L8320,"Truss, addition to standard pad, water pad ",,,73.78,161.87,45 HCPCS,L8330,"Truss, addition to standard pad, scrotal pad ",,,78.97,173.25,45 HCPCS,L8400,"Prosthetic sheath, below knee, each ",,,18.88,41.43,45 HCPCS,L8410,"Prosthetic sheath, above knee, each ",,,27.6,60.54,45 HCPCS,L8415,"Prosthetic sheath, upper limb, each ",,,28.07,61.58,45 HCPCS,L8417,"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each ",,,91.23,200.14,45 HCPCS,L8420,"Prosthetic sock, multiple ply, below knee, each ",,,24.94,54.72,45 HCPCS,L8430,"Prosthetic sock, multiple ply, above knee, each ",,,27.39,60.09,45 HCPCS,L8435,"Prosthetic sock, multiple ply, upper limb, each ",,,28.93,63.47,45 HCPCS,L8440,"Prosthetic shrinker, below knee, each ",,,52.99,116.25,45 HCPCS,L8460,"Prosthetic shrinker, above knee, each ",,,92.2,202.27,45 HCPCS,L8465,"Prosthetic shrinker, upper limb, each ",,,65.7,144.14,45 HCPCS,L8470,"Prosthetic sock, single ply, fitting, below knee, each ",,,9.6,21.07,45 HCPCS,L8480,"Prosthetic sock, single ply, fitting, above knee, each ",,,12.61,27.67,45 HCPCS,L8485,"Prosthetic sock, single ply, fitting, upper limb, each ",,,13.35,29.28,45 HCPCS,L8500,"Artificial larynx, any type ",,,932.72,2046.28,45 HCPCS,L8501,Tracheostomy speaking valve ,5001.5,5001.5,144.92,317.94,45 HCPCS,L8501,VALVE SPEAKING 15MM,5001.5,5001.5,300.09,4251.27,27 HCPCS,L8507,"Tracheo-esophageal voice prosthesis, patient inserted, any type, each ",,,50.81,111.48,45 HCPCS,L8509,"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type ",,,132.5,290.68,45 HCPCS,L8510,Voice amplifier ,,,306.57,672.58,45 HCPCS,L8511,"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each ",,,88.23,193.56,45 HCPCS,L8512,"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10 ",,,2.65,5.8,45 HCPCS,L8513,"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each ",,,6.34,13.91,45 HCPCS,L8514,"Tracheoesophageal puncture dilator, replacement only, each ",,,114.4,250.97,45 HCPCS,L8515,"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each ",,,76.58,168.0,45 HCPCS,L8600,"Implantable breast prosthesis, silicone or equal ",,,749.18,1643.61,45 HCPCS,L8603,"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies ",,,525.37,1152.59,45 HCPCS,L8605,"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies ",,,868.88,1906.21,45 HCPCS,L8606,IMPLNT UROL COAPTITE 1M,14118.0,14118.0,1835.34,12000.3,22 HCPCS,L8606,"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies ",,,264.0,579.19,45 HCPCS,L8606,SYSTEM URETHRAL BULKING,42040.0,42040.0,5465.2,35734.0,22 HCPCS,L8607,IMPL GEL VOC CRD INJ 1ML,22032.0,22032.0,1321.92,18727.2,27 HCPCS,L8607,IMPLANT VOC CRD PROLARYN,19633.0,19633.0,2552.29,16688.05,22 HCPCS,L8607,"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies ",,,52.05,114.19,45 HCPCS,L8607,KIT INJ ORAL NDL 1CC,22648.5,22648.5,1358.91,19251.22,27 HCPCS,L8609,Artificial cornea ,,,7904.24,17340.93,45 HCPCS,L8610,Ocular implant ,,,795.9,1746.1,45 HCPCS,L8612,Aqueous shunt ,,,769.05,1687.21,45 HCPCS,L8613,Ossicula implant ,,,361.13,792.27,45 HCPCS,L8614,"Cochlear device, includes all internal and external components ",,,21633.93,50945.32,49 HCPCS,L8615,"Headset/headpiece for use with cochlear implant device, replacement ",,,547.17,1200.43,45 HCPCS,L8616,"Microphone for use with cochlear implant device, replacement ",,,127.45,279.61,45 HCPCS,L8617,"Transmitting coil for use with cochlear implant device, replacement ",,,111.35,244.28,45 HCPCS,L8618,"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement ",,,31.81,69.79,45 HCPCS,L8619,"Cochlear implant, external speech processor and controller, integrated system, replacement ",,,9968.85,21870.44,45 HCPCS,L8621,"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each ",,,0.75,1.66,45 HCPCS,L8622,"Alkaline battery for use with cochlear implant device, any size, replacement, each ",,,0.39,0.86,45 HCPCS,L8623,"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each ",,,78.45,172.11,45 HCPCS,L8624,"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each ",,,195.62,429.16,45 HCPCS,L8625,"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each ",,,184.65,502.67,51 HCPCS,L8627,"Cochlear implant, external speech processor, component, replacement ",,,8468.05,18577.87,45 HCPCS,L8628,"Cochlear implant, external controller component, replacement ",,,1500.8,3292.57,45 HCPCS,L8629,"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement ",,,217.22,476.55,45 HCPCS,L8630,Metacarpophalangeal joint implant ,,,227.68,886.79,51 HCPCS,L8631,"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes en",,,1453.84,5777.85,51 HCPCS,L8641,Metatarsal joint implant ,,,236.57,921.38,51 HCPCS,L8642,Hallux implant ,,,196.72,766.15,51 HCPCS,L8658,"Interphalangeal joint spacer, silicone or equal, each ",,,206.26,803.33,51 HCPCS,L8659,"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size ",,,1292.31,5135.92,51 HCPCS,L8670,"Vascular graft material, synthetic, implant ",,,667.86,1465.2,45 HCPCS,L8678,"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month ",,,12.58,27.61,50 HCPCS,L8679,"Implantable neurostimulator, pulse generator, any type ",,,10122.62,22207.78,45 HCPCS,L8680,"Implantable neurostimulator electrode, each ",,,293.73,4996.29,8 HCPCS,L8681,"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only ",,,926.72,2839.55,51 HCPCS,L8682,Implantable neurostimulator radiofrequency receiver ,,,5178.47,15867.04,51 HCPCS,L8683,Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver ,,,4558.23,13966.59,51 HCPCS,L8684,"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement ",,,670.64,2054.84,51 HCPCS,L8685,"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension ",,,11894.56,12846.12,6 HCPCS,L8686,"Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension ",,,7023.18,17549.6,8 HCPCS,L8687,"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension ",,,14043.32,15166.79,6 HCPCS,L8688,"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension ",,,9831.68,10618.21,6 HCPCS,L8689,"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only ",,,1498.34,4591.05,51 HCPCS,L8690,"Auditory osseointegrated device, includes all internal and external components ",,,4338.8,12661.26,51 HCPCS,L8691,"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each ",,,1683.65,4583.56,51 HCPCS,L8692,"Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment ",,,3080.41,3326.84,6 HCPCS,L8693,"Auditory osseointegrated device abutment, any length, replacement only ",,,1414.77,4035.81,51 HCPCS,L8694,"Auditory osseointegrated device, transducer/actuator, replacement only, each ",,,923.29,2513.56,51 HCPCS,L8695,"External recharging system for battery (external) for use with implantable neurostimulator, replacement only ",,,11.86,44.31,51 HCPCS,L8696,"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each ",,,262.94,576.87,45 HCPCS,L8701,"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated ",,,34270.7,75185.71,45 HCPCS,L8702,"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated ",,,67425.67,147923.65,45 HCPCS,L8720,"External lower extremity sensory prosthetic device, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg ",,,9124.66,14054.93,5 HCPCS,L8721,"Receptor sole for use with l8720, replacement, each ",,,35.45,54.61,5 HCPCS,M0100,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,36 HCPCS,M0201,"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) ",,,83.07,114.67,5 HCPCS,M0224,"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who e",,,1053.0,1453.5,5 HCPCS,M0235,"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving system",,,1054.17,1455.12,5 HCPCS,M0236,"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving system",,,1054.17,1455.12,5 HCPCS,M0237,"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ve",,,1054.17,1455.12,5 HCPCS,M0238,"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ve",,,1054.17,1455.12,5 HCPCS,M0249,"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, n",,,1053.0,1453.5,5 HCPCS,M0250,"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, n",,,1053.0,1453.5,5 HCPCS,M0301,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,36 HCPCS,P2028,"Cephalin floculation, blood ",,,4.85,34.03,59 HCPCS,P2029,"Congo red, blood ",,,4.85,34.03,59 HCPCS,P2031,Hair analysis (excluding arsenic) ,,,4.85,34.03,62 HCPCS,P2033,"Thymol turbidity, blood ",,,4.85,34.03,59 HCPCS,P2038,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,4.85,34.03,145 HCPCS,P3000,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,18.17,109.51,145 HCPCS,P3001,"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician ",,,65.53,159.1,17 HCPCS,P7001,"Culture, bacterial, urine; quantitative, sensitivity study ",,,32.04,132.22,17 HCPCS,P9010,"Blood (whole), for transfusion, per unit ",,,124.83,313.49,18 HCPCS,P9011,"Blood, split unit ",,,61.2,448.25,18 HCPCS,P9012,CRYOPRECIPITATE,449.0,449.0,26.94,381.65,32 HCPCS,P9012,CRYOPRECIPITATE POOLED,449.37,449.37,26.96,381.96,32 HCPCS,P9012,"Cryoprecipitate, each unit ",,,51.46,69.5,12 HCPCS,P9016,PRBC LR,926.0,926.0,55.56,787.1,32 HCPCS,P9016,"Red blood cells, leukocytes reduced, each unit ",926.0,926.0,1609.21,2173.63,12 HCPCS,P9017,FFP,468.0,468.0,28.08,397.8,32 HCPCS,P9017,"Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit ",468.0,468.0,435.17,587.8,12 HCPCS,P9019,PLTS CONC,225.84,225.84,13.55,191.96,32 HCPCS,P9019,"Platelets, each unit ",225.84,225.84,1058.26,1429.45,12 HCPCS,P9020,"Platelet rich plasma, each unit ",,,1566.8,2116.34,12 HCPCS,P9021,PRBC,925.94,925.94,55.56,787.05,32 HCPCS,P9021,"Red blood cells, each unit ",925.94,925.94,492.99,665.9,12 HCPCS,P9022,PRBC WASH,1405.59,1405.59,84.34,1194.75,32 HCPCS,P9022,"Red blood cells, washed, each unit ",1405.59,1405.59,1110.39,1499.86,12 HCPCS,P9023,"Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit ",,,5.63,255.65,17 HCPCS,P9025,"Plasma, cryoprecipitate reduced, pathogen reduced, each unit ",,,48.3,209.58,11 HCPCS,P9026,"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit ",,,161.3,254.72,5 HCPCS,P9027,"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit ",,,590.8,815.51,5 HCPCS,P9031,PLT CONC LR,486.7,486.7,29.2,413.69,28 HCPCS,P9031,"Platelets, leukocytes reduced, each unit ",486.7,486.7,67.85,1268.99,18 HCPCS,P9032,"Platelets, irradiated, each unit ",,,69.63,421.91,18 HCPCS,P9033,"Platelets, leukocytes reduced, irradiated, each unit ",,,139.94,3109.4,18 HCPCS,P9034,PLTS PHERESIS EACH UNIT,3569.1,3569.1,214.15,3033.74,28 HCPCS,P9034,"Platelets, pheresis, each unit ",3569.1,3569.1,343.82,4121.55,18 HCPCS,P9035,PLTS PHERESIS LR EA UNIT,3569.1,3569.1,214.15,3033.74,28 HCPCS,P9035,"Platelets, pheresis, leukocytes reduced, each unit ",3569.1,3569.1,480.75,5011.53,18 HCPCS,P9036,"Platelets, pheresis, irradiated, each unit ",,,417.71,4235.67,18 HCPCS,P9037,PLTS PH LR IRR EA UNIT,7021.65,7021.65,421.3,5968.4,28 HCPCS,P9037,"Platelets, pheresis, leukocytes reduced, irradiated, each unit ",7021.65,7021.65,483.98,7315.48,18 HCPCS,P9038,"Red blood cells, irradiated, each unit ",,,87.3,117.92,18 HCPCS,P9039,RBC DEGLYCEROLIZED EA UN,2416.52,2416.52,144.99,2054.04,28 HCPCS,P9039,"Red blood cells, deglycerolized, each unit ",2416.52,2416.52,244.66,1800.68,18 HCPCS,P9040,RBC LEUKOREDUC IRR EA UN,1823.4,1823.4,109.4,1549.89,28 HCPCS,P9040,"Red blood cells, leukocytes reduced, irradiated, each unit ",1823.4,1823.4,215.83,2446.22,18 HCPCS,P9041,"Infusion, albumin (human), 5%, 50 ml ",,,10.49,104.36,28 HCPCS,P9043,"Infusion, plasma protein fraction (human), 5%, 50 ml ",,,22.52,200.55,26 HCPCS,P9044,PLASMA CRYO REDUCED,202.02,202.02,12.12,171.72,28 HCPCS,P9044,"Plasma, cryoprecipitate reduced, each unit ",202.02,202.02,50.67,579.65,18 HCPCS,P9045,ALBUMIN INF 5% 250ML INJ,1637.06,1637.06,98.22,1391.5,15 HCPCS,P9045,ALBUMIN INF 5% 500 ML,2463.92,2463.92,147.84,2094.33,15 HCPCS,P9045,"Infusion, albumin (human), 5%, 250 ml ",,,52.45,480.37,28 HCPCS,P9046,"Infusion, albumin (human), 25%, 20 ml ",,,20.98,192.13,28 HCPCS,P9047,ALBUMIN INF 25% 100 ML,2686.4,2686.4,161.18,2283.44,20 HCPCS,P9047,ALBUMIN INF 25% 50ML INJ,1637.06,1637.06,98.22,1391.5,20 HCPCS,P9047,ALBUMIN INF 25% 50ML JW,1637.06,1637.06,98.22,1391.5,20 HCPCS,P9047,"Infusion, albumin (human), 25%, 50 ml ",,,52.45,480.37,28 HCPCS,P9048,"Infusion, plasma protein fraction (human), 5%, 250 ml ",,,47.86,471.05,26 HCPCS,P9050,"Granulocytes, pheresis, each unit ",,,1093.88,7051.04,18 HCPCS,P9051,"Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit ",,,75.0,1832.99,18 HCPCS,P9052,"Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit ",,,446.25,4470.16,18 HCPCS,P9053,"Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit ",,,437.98,4974.6,18 HCPCS,P9054,"Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit ",,,68.0,1245.01,18 HCPCS,P9055,"Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit ",,,374.09,1662.49,18 HCPCS,P9056,"Whole blood, leukocytes reduced, irradiated, each unit ",,,143.49,1062.38,18 HCPCS,P9057,"Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit ",,,203.35,4905.82,18 HCPCS,P9058,"Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit ",,,214.72,650.7,18 HCPCS,P9059,"Fresh frozen plasma between 8-24 hours of collection, each unit ",,,51.0,505.35,18 HCPCS,P9060,"Fresh frozen plasma, donor retested, each unit ",,,51.0,123.8,18 HCPCS,P9070,"Plasma, pooled multiple donor, pathogen reduced, frozen, each unit ",,,65.25,6335.0,17 HCPCS,P9071,"Plasma (single donor), pathogen reduced, frozen, each unit ",,,161.82,255.55,5 HCPCS,P9073,PLATELETS PATH RED EA UN,3569.1,3569.1,214.15,3033.74,27 HCPCS,P9073,"Platelets, pheresis, pathogen-reduced, each unit ",3569.1,3569.1,1236.26,7570.05,17 HCPCS,P9100,PATHOGEN TEST PLATELETS,225.84,225.84,13.55,191.96,24 HCPCS,P9100,Pathogen(s) test for platelets ,225.84,225.84,71.71,455.94,98 HCPCS,P9603,Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled ,,,5.16,6.97,12 HCPCS,P9604,Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge ,,,51.46,69.5,12 HCPCS,P9612,"Catheterization for collection of specimen, single patient, all places of service ",,,7.29,3083.0,272 HCPCS,P9615,Catheterization for collection of specimen(s) (multiple patients) ,,,7.29,3083.0,234 HCPCS,Q0035,Cardiokymography ,,,18.24,107.98,59 HCPCS,Q0083,"Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit ",,,,,0 HCPCS,Q0084,"Chemotherapy administration by infusion technique only, per visit ",,,,,0 HCPCS,Q0085,"Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit ",,,,,0 HCPCS,Q0091,"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory ",,,40.04,63.23,5 HCPCS,Q0092,Set-up portable x-ray equipment ,,,43.14,94.85,5 HCPCS,Q0111,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,18.17,109.51,145 HCPCS,Q0112,All potassium hydroxide (koh) preparations ,,,5.71,40.09,145 HCPCS,Q0113,Pinworm examinations ,,,4.18,29.41,145 HCPCS,Q0114,Fern test ,,,9.55,66.97,145 HCPCS,Q0115,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,24.5,171.95,145 HCPCS,Q0138,"Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) ",,,0.23,5.32,10 HCPCS,Q0139,"Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis) ",,,0.23,5.32,10 HCPCS,Q0144,AZITHROMYCIN 200MG PO,9.72,9.72,0.58,8.26,25 HCPCS,Q0144,AZITHROMYCIN 250 MG PO,452.52,452.52,27.15,384.64,25 HCPCS,Q0144,AZITHROMYCIN 500 MG PO,5.3,5.3,0.32,4.5,41 HCPCS,Q0144,AZITHROMYCIN 600MG PO,754.2,754.2,45.25,641.07,25 HCPCS,Q0144,"Azithromycin dihydrate, oral, capsules/powder, 1 gram ",,,32.81,78.59,8 HCPCS,Q0155,"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 ",,,6.41,10.33,8 HCPCS,Q0161,"Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed",,,0.2,1.03,8 HCPCS,Q0162,ONDANSETRON 4 MG PO,794.74,794.74,47.68,675.53,24 HCPCS,Q0162,"Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage ",794.74,794.74,0.02,0.62,10 HCPCS,Q0163,"Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a ",,,0.04,0.06,8 HCPCS,Q0164,"Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 4",,,0.27,1.09,8 HCPCS,Q0166,"Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a ",,,7.41,22.95,8 HCPCS,Q0167,"Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosag",,,1.65,5.24,10 HCPCS,Q0169,PROMETHAZINE 12.5 MG PO,8.33,8.33,0.5,7.08,25 HCPCS,Q0169,"Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to excee",8.33,8.33,0.12,0.28,8 HCPCS,Q0173,"Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to e",,,2.03,2.62,3 HCPCS,Q0174,"Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a ",,,1.52,1.97,3 HCPCS,Q0175,"Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosag",,,0.55,1.5,8 HCPCS,Q0177,"Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 ho",,,0.08,0.31,8 HCPCS,Q0180,"Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 h",,,148.88,257.88,8 HCPCS,Q0181,"Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour do",,,,,0 HCPCS,Q0224,"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either h",,,7239.0,20208.8,10 HCPCS,Q0234,"Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ",,,,,0 HCPCS,Q0235,"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticos",,,9.68,13.34,5 HCPCS,Q0237,"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, ",,,4.92,11.74,7 HCPCS,Q0238,"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical vent ",,,5.58,5.58,2 HCPCS,Q0249,"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive",,,7.57,21.12,10 HCPCS,Q0477,"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,941.23,2064.95,45 HCPCS,Q0478,"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type ",,,222.94,489.1,45 HCPCS,Q0479,MODULE POWER UNIT,100000.0,100000.0,6000.0,85000.0,27 HCPCS,Q0479,"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only ",100000.0,100000.0,14527.03,31870.52,45 HCPCS,Q0480,"Driver for use with pneumatic ventricular assist device, replacement only ",,,109262.16,239707.8,45 HCPCS,Q0481,KIT HRTMT 3 CONTROLLER,100000.0,100000.0,6000.0,85000.0,43 HCPCS,Q0481,"Microprocessor control unit for use with electric ventricular assist device, replacement only ",100000.0,100000.0,17628.24,38674.2,45 HCPCS,Q0482,"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only ",,,5521.48,12113.44,45 HCPCS,Q0483,"Monitor/display module for use with electric ventricular assist device, replacement only ",,,22746.0,49901.93,45 HCPCS,Q0484,"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,4417.2,9690.8,45 HCPCS,Q0485,CORD AC PWR MOBILE UNIT,2034.0,2034.0,122.04,1728.9,27 HCPCS,Q0485,"Monitor control cable for use with electric ventricular assist device, replacement only ",2034.0,2034.0,426.48,935.64,45 HCPCS,Q0486,"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only ",,,354.94,778.69,45 HCPCS,Q0487,"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only ",,,414.11,908.5,45 HCPCS,Q0489,"Power pack base for use with electric/pneumatic ventricular assist device, replacement only ",,,19719.56,43262.3,45 HCPCS,Q0490,"Emergency power source for use with electric ventricular assist device, replacement only ",,,853.01,1871.4,45 HCPCS,Q0491,"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only ",,,1340.96,2941.91,45 HCPCS,Q0492,"Emergency power supply cable for use with electric ventricular assist device, replacement only ",,,108.06,237.08,45 HCPCS,Q0493,"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only ",,,307.55,674.73,45 HCPCS,Q0494,"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,260.25,570.95,45 HCPCS,Q0495,"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only ",100000.0,100000.0,5067.43,11117.33,45 HCPCS,Q0495,DEVICE VNTRC ASST BTRY,100000.0,100000.0,6000.0,85000.0,27 HCPCS,Q0496,"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,1818.76,3990.14,45 HCPCS,Q0497,"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only ",34429.0,34429.0,567.9,1245.9,45 HCPCS,Q0497,DEVICE VNTRC ASST BTRY,34429.0,34429.0,2065.74,29264.65,27 HCPCS,Q0498,DEVICE VNTRC ASST HLSTR,14127.0,14127.0,847.62,12007.95,27 HCPCS,Q0498,"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,623.12,1367.06,45 HCPCS,Q0498,VEST HOLSTER MEDIUM,14127.0,14127.0,847.62,12007.95,27 HCPCS,Q0498,VEST HOLSTER SMALL,13769.0,13769.0,826.14,11703.65,27 HCPCS,Q0499,BAG EQUIP CONSOLIDATION,11634.0,11634.0,698.04,9888.9,27 HCPCS,Q0499,BAG FOR POCK CONTROLLER,11339.0,11339.0,680.34,9638.15,27 HCPCS,Q0499,"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only ",,,202.48,444.21,45 HCPCS,Q0499,VEST HOLSTER LG,13769.0,13769.0,826.14,11703.65,27 HCPCS,Q0500,"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,37.04,81.27,45 HCPCS,Q0501,BAG EQUIP SHOWER,16114.0,16114.0,966.84,13696.9,27 HCPCS,Q0501,"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only ",16114.0,16114.0,619.58,1359.27,45 HCPCS,Q0502,"Mobility cart for pneumatic ventricular assist device, replacement only ",,,788.74,1730.41,45 HCPCS,Q0503,"Battery for pneumatic ventricular assist device, replacement only, each ",,,1577.57,3461.01,45 HCPCS,Q0504,"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type ",,,832.42,1826.23,45 HCPCS,Q0506,BATTERY REPL LVAD,17761.0,17761.0,1065.66,15096.85,27 HCPCS,Q0506,BATTERY VAD BKUP 11V,17431.0,17431.0,1045.86,14816.35,27 HCPCS,Q0506,"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only ",,,1036.19,2273.28,45 HCPCS,Q0508,CABLE MODULAR LVAD DVC,100000.0,100000.0,6000.0,85000.0,33 HCPCS,Q0508,DEVICE ASST TRAVEL CASE,6273.0,6273.0,376.38,5332.05,49 HCPCS,Q0515,"Injection, sermorelin acetate, 1 microgram ",,,4.36,5.62,3 HCPCS,Q0521,Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription ,,,60.84,83.98,5 HCPCS,Q2004,"Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml ",,,166.6,229.5,5 HCPCS,Q2009,FOSPHEN PE 100 MG INJ,660.3,660.3,39.62,561.25,25 HCPCS,Q2009,FOSPHEN PE 25 MG/ML INJ,61.86,61.86,3.71,52.58,25 HCPCS,Q2009,FOSPHEN PE 50 MG INJ,330.15,330.15,19.81,280.63,25 HCPCS,Q2009,FOSPHEN PE 50 MG INJJW,330.15,330.15,19.81,280.63,25 HCPCS,Q2009,FOSPHEN PE 500 MG INJ,324.8,324.8,19.49,276.08,25 HCPCS,Q2009,"Injection, fosphenytoin, 50 mg phenytoin equivalent ",,,6.43,8.86,8 HCPCS,Q2017,"Injection, teniposide, 50 mg ",,,6161.01,7943.11,3 HCPCS,Q2017,"Injection, teniposide, 50 mg Chemotherapy Drugs",,,,,0 HCPCS,Q2028,"Injection, sculptra, 0.5 mg ",,,1.27,2.06,8 HCPCS,Q2034,"Influenza virus vaccine, split virus, for intramuscular use (agriflu) ",,,,,0 HCPCS,Q2035,"Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) ",,,28.77,42.23,8 HCPCS,Q2036,"Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) ",,,14.68,26.74,8 HCPCS,Q2037,"Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) ",,,30.65,54.66,8 HCPCS,Q2038,"Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) ",,,20.62,37.35,8 HCPCS,Q2039,"Influenza virus vaccine, not otherwise specified ",,,,,0 HCPCS,Q2041,"Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,531849.0,956745.0,7 HCPCS,Q2041,"Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Chemotherapy Drugs",,,,,0 HCPCS,Q2042,"Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,614181.0,1037313.0,7 HCPCS,Q2042,"Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Chemotherapy Drugs",,,,,0 HCPCS,Q2043,"Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion ",,,56269.2,174551.43,10 HCPCS,Q2049,"Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg ",,,656.38,1586.3,8 HCPCS,Q2050,"Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg ",,,71.86,904.2,10 HCPCS,Q2050,"Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,Q2053,"Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,489291.0,1003071.6,7 HCPCS,Q2054,"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,562261.0,1103378.76,7 HCPCS,Q2055,"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,559781.0,1128119.4,7 HCPCS,Q2056,"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,588495.0,1250478.0,7 HCPCS,Q2057,"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose ",,,770620.0,1978603.2,7 HCPCS,Q2058,"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion ",,,1037232.0,1428840.0,5 HCPCS,Q3014,Telehealth originating site facility fee ,,,31.85,31.85,2 HCPCS,Q3027,"Injection, interferon beta-1a, 1 mcg for intramuscular use ",,,112.66,229.07,8 HCPCS,Q3028,"Injection, interferon beta-1a, 1 mcg for subcutaneous use ",,,29.69,132.48,8 HCPCS,Q4001,"Casting supplies, body cast adult, with or without head, plaster ",,,61.11,134.07,50 HCPCS,Q4002,"Cast supplies, body cast adult, with or without head, fiberglass ",,,230.93,506.63,50 HCPCS,Q4003,"Cast supplies, shoulder cast, adult (11 years +), plaster ",,,43.88,96.28,50 HCPCS,Q4004,"Cast supplies, shoulder cast, adult (11 years +), fiberglass ",,,151.93,333.31,50 HCPCS,Q4005,"Cast supplies, long arm cast, adult (11 years +), plaster ",,,16.18,35.5,50 HCPCS,Q4006,"Cast supplies, long arm cast, adult (11 years +), fiberglass ",,,36.46,79.98,50 HCPCS,Q4007,"Cast supplies, long arm cast, pediatric (0-10 years), plaster ",,,8.08,17.74,50 HCPCS,Q4008,"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass ",,,18.22,39.97,50 HCPCS,Q4009,"Cast supplies, short arm cast, adult (11 years +), plaster ",,,10.81,23.71,50 HCPCS,Q4010,"Cast supplies, short arm cast, adult (11 years +), fiberglass ",,,24.3,53.32,50 HCPCS,Q4011,"Cast supplies, short arm cast, pediatric (0-10 years), plaster ",,,5.39,11.82,50 HCPCS,Q4012,"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass ",,,12.18,26.72,50 HCPCS,Q4013,"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster ",,,19.67,43.15,50 HCPCS,Q4014,"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass ",,,33.16,72.76,50 HCPCS,Q4015,"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster ",,,9.85,21.61,50 HCPCS,Q4016,"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass ",,,16.57,36.36,50 HCPCS,Q4017,"Cast supplies, long arm splint, adult (11 years +), plaster ",,,11.37,24.94,50 HCPCS,Q4018,"Cast supplies, long arm splint, adult (11 years +), fiberglass ",,,18.11,39.73,50 HCPCS,Q4019,"Cast supplies, long arm splint, pediatric (0-10 years), plaster ",,,5.68,12.47,50 HCPCS,Q4020,"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass ",,,9.09,19.95,50 HCPCS,Q4021,"Cast supplies, short arm splint, adult (11 years +), plaster ",,,8.42,18.47,50 HCPCS,Q4022,"Cast supplies, short arm splint, adult (11 years +), fiberglass ",,,15.19,33.32,50 HCPCS,Q4023,"Cast supplies, short arm splint, pediatric (0-10 years), plaster ",,,4.22,9.27,50 HCPCS,Q4024,"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass ",,,7.6,16.68,50 HCPCS,Q4025,"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster ",,,47.16,103.46,50 HCPCS,Q4026,"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass ",,,147.31,323.19,50 HCPCS,Q4027,"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster ",,,23.6,51.77,50 HCPCS,Q4028,"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass ",,,73.7,161.68,50 HCPCS,Q4029,"Cast supplies, long leg cast, adult (11 years +), plaster ",,,36.08,79.16,50 HCPCS,Q4030,"Cast supplies, long leg cast, adult (11 years +), fiberglass ",,,94.98,208.38,50 HCPCS,Q4031,"Cast supplies, long leg cast, pediatric (0-10 years), plaster ",,,18.02,39.54,50 HCPCS,Q4032,"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass ",,,47.49,104.19,50 HCPCS,Q4033,"Cast supplies, long leg cylinder cast, adult (11 years +), plaster ",,,33.66,73.85,50 HCPCS,Q4034,"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass ",,,83.68,183.59,50 HCPCS,Q4035,"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster ",,,16.83,36.92,50 HCPCS,Q4036,"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass ",,,41.88,91.87,50 HCPCS,Q4037,"Cast supplies, short leg cast, adult (11 years +), plaster ",,,20.5,44.98,50 HCPCS,Q4038,"Cast supplies, short leg cast, adult (11 years +), fiberglass ",,,51.43,112.83,50 HCPCS,Q4039,"Cast supplies, short leg cast, pediatric (0-10 years), plaster ",,,10.29,22.57,50 HCPCS,Q4040,"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass ",,,25.71,56.39,50 HCPCS,Q4041,"Cast supplies, long leg splint, adult (11 years +), plaster ",,,24.97,54.78,50 HCPCS,Q4042,"Cast supplies, long leg splint, adult (11 years +), fiberglass ",,,42.62,93.5,50 HCPCS,Q4043,"Cast supplies, long leg splint, pediatric (0-10 years), plaster ",,,12.49,27.39,50 HCPCS,Q4044,"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass ",,,21.34,46.83,50 HCPCS,Q4045,"Cast supplies, short leg splint, adult (11 years +), plaster ",,,14.49,31.8,50 HCPCS,Q4046,"Cast supplies, short leg splint, adult (11 years +), fiberglass ",,,23.31,51.15,50 HCPCS,Q4047,"Cast supplies, short leg splint, pediatric (0-10 years), plaster ",,,7.21,15.82,50 HCPCS,Q4048,"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass ",,,11.66,25.59,50 HCPCS,Q4049,"Finger splint, static ",,,2.63,5.76,50 HCPCS,Q4074,"Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms ",,,264.01,495.83,8 HCPCS,Q4081,"Injection, epoetin alfa, 100 units (for esrd on dialysis) ",,,0.73,4.32,10 HCPCS,Q4101,APLIGRAF 1SQCM,1473.0,1473.0,88.38,1252.05,25 HCPCS,Q4101,"Apligraf, per square centimeter (add-on, list separately in addition to primary procedure) ",1473.0,1473.0,66.99,94.54,8 HCPCS,Q4102,"Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,22.97,36.5,8 HCPCS,Q4103,"Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3.02,38.63,8 HCPCS,Q4104,"Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure) ",,,78.83,167.73,8 HCPCS,Q4105,"Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,63.14,125.44,8 HCPCS,Q4106,"Dermagraft, per square centimeter ",,,108.75,140.21,3 HCPCS,Q4107,"Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure) ",,,202.02,278.29,8 HCPCS,Q4108,"Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,76.4,153.25,8 HCPCS,Q4110,PRIMATRIX 1SQCM,2258.5,2258.5,104.82,2159.85,100 HCPCS,Q4110,"Primatrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,103.96,204.08,8 HCPCS,Q4111,"Gammagraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,15.19,22.21,8 HCPCS,Q4112,"Cymetra, injectable, 1 cc ",,,443.67,2720.89,8 HCPCS,Q4113,"Graftjacket xpress, injectable, 1 cc ",,,1846.17,2763.86,8 HCPCS,Q4114,"Integra flowable wound matrix, injectable, 1 cc ",,,3212.4,4811.79,8 HCPCS,Q4115,"Alloskin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,29.46,45.18,8 HCPCS,Q4116,"Alloderm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,69.17,97.06,8 HCPCS,Q4117,"Hyalomatrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,37.42,76.1,8 HCPCS,Q4118,MATRISTEM MICROMATRX 1MG,144.5,144.5,8.28,128.35,50 HCPCS,Q4118,"Matristem micromatrix, 1 mg ",,,6.2,8.61,8 HCPCS,Q4121,"Theraskin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,89.59,152.41,8 HCPCS,Q4122,DERMACELL AWM PORO 1SQCM,2266.5,2266.5,119.52,2159.85,150 HCPCS,Q4122,"Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure) ",,,248.9,320.89,3 HCPCS,Q4123,"Alloskin rt, per square centimeter (add-on, list separately in addition to primary procedure) ",,,173.15,223.24,3 HCPCS,Q4124,"Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,6.0,7.74,3 HCPCS,Q4126,"Memoderm, dermaspan, tranzgraft or integuply, per square centimeter (add-on, list separately in addition to primary procedure) ",,,144.74,186.61,3 HCPCS,Q4127,"Talymed, per square centimeter (add-on, list separately in addition to primary procedure) ",,,165.75,213.69,3 HCPCS,Q4128,FLEX ALLOPATCH HD 1SQCM,1487.5,1487.5,88.74,1271.6,60 HCPCS,Q4128,"Flex hd, or allopatch hd, per square centimeter (add-on, list separately in addition to primary procedure) ",,,74.29,95.78,3 HCPCS,Q4132,"Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure) ",,,215.82,278.24,3 HCPCS,Q4133,GRAFIX STRAVIX PL 1SQCM,6023.0,6023.0,361.38,5119.55,30 HCPCS,Q4133,"Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure) ",6023.0,6023.0,329.56,424.88,3 HCPCS,Q4134,"Hmatrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,392.23,505.69,3 HCPCS,Q4137,"Amnioexcel, amnioexcel plus or biodexcel, per square centimeter (add-on, list separately in addition to primary procedure) ",,,243.74,314.25,3 HCPCS,Q4138,"Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure) ",,,242.97,313.25,3 HCPCS,Q4140,"Biodfence, per square centimeter (add-on, list separately in addition to primary procedure) ",,,398.91,514.3,3 HCPCS,Q4141,"Alloskin ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,156.69,202.02,3 HCPCS,Q4143,"Repriza, per square centimeter (add-on, list separately in addition to primary procedure) ",,,82.09,105.83,3 HCPCS,Q4145,"Epifix, injectable, 1 mg ",,,39.02,60.78,8 HCPCS,Q4147,"Architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,117.52,151.51,3 HCPCS,Q4148,"Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter (add-on, list separately in addition to primary procedure) ",,,305.07,393.31,3 HCPCS,Q4149,"Excellagen, 0.1 cc ",,,58.8,461.45,8 HCPCS,Q4150,"Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure) ",,,205.36,264.76,3 HCPCS,Q4151,"Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure) ",,,332.0,428.03,3 HCPCS,Q4152,DERMAPURE 1SQCM,1779.0,1779.0,98.64,4337.55,120 HCPCS,Q4152,"Dermapure, per square centimeter (add-on, list separately in addition to primary procedure) ",,,109.89,141.68,3 HCPCS,Q4153,"Dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure) ",,,262.81,338.83,3 HCPCS,Q4154,"Biovance, per square centimeter (add-on, list separately in addition to primary procedure) ",,,345.72,445.72,3 HCPCS,Q4155,"Neoxflo or clarixflo, 1 mg ",,,66.09,85.21,3 HCPCS,Q4156,"Neox 100 or clarix 100, per square centimeter (add-on, list separately in addition to primary procedure) ",,,160.57,207.01,3 HCPCS,Q4157,"Revitalon, per square centimeter (add-on, list separately in addition to primary procedure) ",,,431.07,555.77,3 HCPCS,Q4158,"Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure) ",,,160.49,206.92,3 HCPCS,Q4159,"Affinity, per square centimeter (add-on, list separately in addition to primary procedure) ",,,569.11,733.73,3 HCPCS,Q4160,"Nushield, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1282.6,1653.6,3 HCPCS,Q4161,"Bio-connekt wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4002.24,5159.92,3 HCPCS,Q4162,"Woundex flow, bioskin flow, 0.5 cc ",,,4525.4,5834.4,3 HCPCS,Q4163,"Woundex, bioskin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,440.88,568.4,3 HCPCS,Q4164,"Helicoll, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3971.05,5119.7,3 HCPCS,Q4165,"Keramatrix or kerasorb, per square centimeter (add-on, list separately in addition to primary procedure) ",,,109.5,141.18,3 HCPCS,Q4166,"Cytal, per square centimeter (add-on, list separately in addition to primary procedure) ",,,50.46,65.05,3 HCPCS,Q4167,"Truskin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,248.78,320.74,3 HCPCS,Q4168,"Amnioband, 1 mg ",,,41.26,53.2,3 HCPCS,Q4169,"Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure) ",,,5373.78,6928.18,3 HCPCS,Q4170,"Cygnus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,100.55,590.52,8 HCPCS,Q4171,"Interfyl, 1 mg ",,,25.68,33.1,3 HCPCS,Q4173,"Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,862.85,1112.44,3 HCPCS,Q4174,"Palingen or promatrx, 0.36 mg per 0.25 cc ",,,1558.2,3962.09,8 HCPCS,Q4175,"Miroderm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,163.88,211.29,3 HCPCS,Q4176,"Neopatch or therion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,390.83,503.88,3 HCPCS,Q4177,"Floweramnioflo, 0.1 cc ",,,352.8,486.0,8 HCPCS,Q4178,"Floweramniopatch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,225.33,290.5,3 HCPCS,Q4180,"Revita, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2637.97,3401.02,3 HCPCS,Q4182,"Transcyte, per square centimeter (add-on, list separately in addition to primary procedure) ",,,97.09,125.17,3 HCPCS,Q4183,"Surgigraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,265.2,8 HCPCS,Q4184,"Cellesta or cellesta duo, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,249.72,8 HCPCS,Q4185,Cellesta flowable amnion (25 mg per cc); per 0.5 cc ,,,39.02,53.76,5 HCPCS,Q4186,"Epifix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,469.03,8 HCPCS,Q4187,"Epicord, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,754.63,8 HCPCS,Q4188,"Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1521.28,8 HCPCS,Q4189,"Artacent ac, 1 mg ",,,40.71,66.36,8 HCPCS,Q4190,"Artacent ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,312.88,481.93,8 HCPCS,Q4191,"Restorigin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,2278.94,8 HCPCS,Q4192,"Restorigin, 1 cc ",,,14.03,19.33,5 HCPCS,Q4193,"Coll-e-derm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5345.12,8 HCPCS,Q4194,"Novachor, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,2239.47,8 HCPCS,Q4195,PURAPLY 1SQCM,3420.0,3420.0,169.74,3212.15,75 HCPCS,Q4195,"Puraply, per square centimeter (add-on, list separately in addition to primary procedure) ",,,166.66,336.71,8 HCPCS,Q4196,PURAPLY AM 1SQCM,4327.0,4327.0,259.62,3677.95,25 HCPCS,Q4196,"Puraply am, per square centimeter (add-on, list separately in addition to primary procedure) ",4327.0,4327.0,166.66,307.44,8 HCPCS,Q4197,"Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure) ",,,166.66,256.7,8 HCPCS,Q4198,"Genesis amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4199,"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,406.41,8 HCPCS,Q4200,"Skin te, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4201,"Matrion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,247.2,8 HCPCS,Q4202,"Keroxx (2.5g/cc), 1cc ",,,20.05,27.62,5 HCPCS,Q4203,"Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,2718.67,8 HCPCS,Q4204,"Xwrap, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,11777.28,8 HCPCS,Q4205,"Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,3714.17,8 HCPCS,Q4206,"Fluid flow or fluid gf, 1 cc ",,,20.05,27.62,5 HCPCS,Q4208,"Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure) ",,,271.3,1272.96,8 HCPCS,Q4209,"Surgraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4211,"Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q4212,"Allogen, per cc ",,,20.05,27.62,5 HCPCS,Q4213,"Ascent, 0.5 mg ",,,81.83,182.83,8 HCPCS,Q4214,"Cellesta cord, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,417.89,5 HCPCS,Q4216,"Artacent cord, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,417.89,5 HCPCS,Q4217,"Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,992.16,8 HCPCS,Q4218,"Surgicord, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,417.89,8 HCPCS,Q4219,"Surgigraft-dual, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,3182.4,8 HCPCS,Q4220,"Bellacell hd or surederm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,176.64,5 HCPCS,Q4221,"Amniowrap2, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,6118.32,8 HCPCS,Q4222,"Progenamatrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,397.96,8 HCPCS,Q4224,"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,107.41,7 HCPCS,Q4225,"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,4276.68,8 HCPCS,Q4226,"Myown skin, includes harvesting and preparation procedures, per square centimeter ",,,12.69,3818.88,8 HCPCS,Q4227,"Amniocore, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,3636.02,8 HCPCS,Q4229,"Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1030.57,8 HCPCS,Q4230,"Cogenex flowable amnion, per 0.5 cc ",,,14.03,19.33,5 HCPCS,Q4232,"Corplex, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,417.89,8 HCPCS,Q4233,"Surfactor or nudyn, per 0.5 cc ",,,14.03,19.33,5 HCPCS,Q4234,"Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,607.87,8 HCPCS,Q4235,"Amniorepair or altiply, per square centimeter (add-on, list separately in addition to primary procedure) ",,,194.76,406.16,8 HCPCS,Q4236,"Carepatch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1508.99,8 HCPCS,Q4237,"Cryo-cord, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,1324.35,8 HCPCS,Q4238,"Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,5382.12,8 HCPCS,Q4239,"Amnio-maxx or amnio-maxx lite, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,6360.12,8 HCPCS,Q4240,"Corecyte, for topical use only, per 0.5 cc ",,,494.16,680.72,5 HCPCS,Q4241,"Polycyte, for topical use only, per 0.5 cc ",,,494.16,680.72,5 HCPCS,Q4242,"Amniocyte plus, per 0.5 cc ",,,14.03,19.33,5 HCPCS,Q4245,"Amniotext, per cc ",,,14.03,19.33,5 HCPCS,Q4246,"Coretext or protext, per cc ",,,494.16,12809.16,8 HCPCS,Q4247,"Amniotext patch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9759.36,8 HCPCS,Q4248,"Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,8812.44,8 HCPCS,Q4249,"Amniply, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5583.4,8 HCPCS,Q4250,"Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure) ",,,263.69,9053.18,8 HCPCS,Q4251,"Vim, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,477.36,8 HCPCS,Q4252,"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,165.36,8 HCPCS,Q4253,"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,259.52,8 HCPCS,Q4254,"Novafix dl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,1272.96,8 HCPCS,Q4255,"Reguard, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q4256,"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,2537.22,8 HCPCS,Q4257,"Relese, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,2036.3,8 HCPCS,Q4258,"Enverse, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,257.12,8 HCPCS,Q4259,"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,2937.36,8 HCPCS,Q4260,"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4261,"Tag, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1919.61,8 HCPCS,Q4262,"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,196.09,8 HCPCS,Q4263,"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5344.56,8 HCPCS,Q4264,"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1163.42,8 HCPCS,Q4265,"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5316.57,8 HCPCS,Q4266,"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1748.98,8 HCPCS,Q4267,"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,904.86,8 HCPCS,Q4268,"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,3878.57,8 HCPCS,Q4269,"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,7160.4,8 HCPCS,Q4270,"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,10516.9,8 HCPCS,Q4271,"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,3776.7,8 HCPCS,Q4272,"Esano a, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,928.2,8 HCPCS,Q4273,"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4274,"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5716.84,8 HCPCS,Q4275,"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,8347.5,8 HCPCS,Q4276,"Orion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,815.13,8 HCPCS,Q4278,"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,827.14,8 HCPCS,Q4279,"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,7441.2,8 HCPCS,Q4280,"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9025.69,8 HCPCS,Q4281,"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1697.44,8 HCPCS,Q4282,"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1050.69,8 HCPCS,Q4283,"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,1426.84,8 HCPCS,Q4284,"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4285,"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure) ",,,271.3,530.93,8 HCPCS,Q4286,"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,567.65,8 HCPCS,Q4287,"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4288,"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4289,"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,4580.5,8 HCPCS,Q4290,"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,5817.9,8 HCPCS,Q4291,"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9260.78,8 HCPCS,Q4292,"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,3818.88,8 HCPCS,Q4293,"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,4944.26,8 HCPCS,Q4294,"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9094.8,8 HCPCS,Q4295,"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,8003.42,8 HCPCS,Q4296,"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3521.44,18908.81,8 HCPCS,Q4297,"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4107.59,18908.81,8 HCPCS,Q4298,"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure) ",,,5380.07,18908.81,8 HCPCS,Q4299,"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure) ",,,6913.21,18908.81,8 HCPCS,Q4300,"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,6597.86,8 HCPCS,Q4301,"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,5635.78,8 HCPCS,Q4302,"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,3967.39,8 HCPCS,Q4303,"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,10508.16,8 HCPCS,Q4304,"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,266.05,1914.68,8 HCPCS,Q4305,"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4306,"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4307,"American amnion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4308,"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4309,"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3166.69,18908.81,8 HCPCS,Q4310,"Procenta, per 100 mg ",,,3188.01,10248.09,8 HCPCS,Q4311,"Acesso, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,6630.0,8 HCPCS,Q4312,"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,6895.2,8 HCPCS,Q4313,"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8520.07,18908.81,8 HCPCS,Q4314,"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure) ",,,4525.4,18908.81,8 HCPCS,Q4315,"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q4316,"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,13777.83,8 HCPCS,Q4317,"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4318,"E-graft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4319,"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,930.0,6630.0,8 HCPCS,Q4320,"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1116.0,2386.8,8 HCPCS,Q4321,"Renograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9547.2,8 HCPCS,Q4322,"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4334.92,18908.81,8 HCPCS,Q4323,"Alloply, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,4912.56,8 HCPCS,Q4324,"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,5250.96,8 HCPCS,Q4325,"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,6383.08,8 HCPCS,Q4326,"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1953.0,3378.8,8 HCPCS,Q4327,"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4328,"Most, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,11460.73,8 HCPCS,Q4329,"Singlay, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4330,"Total, per square centimeter (add-on, list separately in addition to primary procedure) ",,,114.68,176.64,5 HCPCS,Q4331,"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,5109.16,8 HCPCS,Q4332,"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,5252.43,8 HCPCS,Q4333,"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,937.44,2386.8,8 HCPCS,Q4334,"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4335,"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4336,"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure) ",,,250.31,385.55,5 HCPCS,Q4337,"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4338,"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4339,"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1953.0,6412.66,8 HCPCS,Q4340,"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1953.0,6842.16,8 HCPCS,Q4341,"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,9582.39,8 HCPCS,Q4342,"Theramend, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,6636.58,8 HCPCS,Q4343,"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,9210.55,8 HCPCS,Q4344,"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) ",,,6508.54,18908.81,8 HCPCS,Q4345,"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure) ",,,6171.0,18908.81,8 HCPCS,Q4346,"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4374.72,11138.4,8 HCPCS,Q4347,"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1116.0,7823.4,8 HCPCS,Q4348,"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2437.34,6205.68,8 HCPCS,Q4349,"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4374.72,11138.4,8 HCPCS,Q4350,"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4374.72,11138.4,8 HCPCS,Q4351,"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,4687.2,11934.0,8 HCPCS,Q4352,"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2437.34,6205.68,8 HCPCS,Q4353,"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3687.26,12093.12,8 HCPCS,Q4354,"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,3246.05,8 HCPCS,Q4355,"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,201.51,9547.2,8 HCPCS,Q4356,"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,201.51,7956.0,8 HCPCS,Q4357,"Xwrap plus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,14882.4,8 HCPCS,Q4358,"Xwrap dual, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,18139.68,8 HCPCS,Q4359,"Choriply, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3277.3,8344.25,8 HCPCS,Q4360,"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4361,"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure) ",,,1874.88,4960.8,8 HCPCS,Q4362,"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,15.62,5 HCPCS,Q4363,"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,15.62,5 HCPCS,Q4364,"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,9827.25,8 HCPCS,Q4365,"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4366,"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4367,"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,562.46,1653.6,8 HCPCS,Q4368,"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,15.62,5 HCPCS,Q4369,"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4370,"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure) ",,,10.14,15.62,5 HCPCS,Q4371,"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure) ",,,201.51,310.39,5 HCPCS,Q4372,"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4373,"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2333.61,11431.18,8 HCPCS,Q4375,"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4376,"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4377,"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4378,"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,12252.24,8 HCPCS,Q4379,"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,9069.84,8 HCPCS,Q4380,"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,3258.94,5 HCPCS,Q4382,"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,3258.94,5 HCPCS,Q4383,"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,3258.94,5 HCPCS,Q4384,"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure) ",,,2115.75,3258.94,5 HCPCS,Q4385,"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4386,"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4387,"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4388,"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4389,"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4390,"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure) ",,,12275.88,18908.81,5 HCPCS,Q4391,"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4392,"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure) ",,,266.05,409.81,5 HCPCS,Q4393,"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4394,"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4395,"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure) ",,,7.11,10.94,5 HCPCS,Q4396,"Natalin, per square centimeter (add-on, list separately in addition to primary procedure) ",,,3499.78,5390.78,5 HCPCS,Q4397,"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure) ",,,8.88,13.68,5 HCPCS,Q4398,"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4399,"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4400,"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4401,"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4402,"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4403,"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4404,"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4405,"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4406,"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4407,"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4408,"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4409,"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4410,"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4411,"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4412,"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4413,"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4414,"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4415,"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4416,"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4417,"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4420,"Nuform, per square centimeter (add-on, list separately in addition to primary procedure) ",,,157.65,242.84,5 HCPCS,Q4431,"Pma skin substitute product, not otherwise specified (list in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q4432,"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q4432,510K SKN SUB NOS 1SQCM,2191.0,2191.0,103.14,2117.35,140 HCPCS,Q4433,"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure) ",,,12.69,19.54,5 HCPCS,Q5098,"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg ",,,22.56,36.35,8 HCPCS,Q5099,"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg ",,,3.07,7.43,10 HCPCS,Q5100,"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg ",,,3.21,9.8,10 HCPCS,Q5101,"Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram ",,,0.35,2.43,10 HCPCS,Q5103,"Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg ",,,26.04,242.0,10 HCPCS,Q5104,"Injection, infliximab-abda, biosimilar, (renflexis), 10 mg ",,,26.8,192.67,10 HCPCS,Q5104,RENFLEXIS BS 10 MG INJ,399.5,399.5,23.97,339.57,19 HCPCS,Q5104,RENFLEXIS BS 10 MG INJJW,399.5,399.5,23.97,339.57,19 HCPCS,Q5104,RENFLEXIS BS 100 MG INJ,3995.35,3995.35,239.72,3396.05,19 HCPCS,Q5105,"Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units ",,,0.79,2.89,10 HCPCS,Q5105,"Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units Chemotherapy Drugs",,,,,0 HCPCS,Q5105,RETACRIT BS 10000U ESRD,750.72,750.72,45.04,638.11,24 HCPCS,Q5105,RETACRIT BS 100U ESRD,9.51,9.51,0.57,8.08,24 HCPCS,Q5105,RETACRIT BS 2000U ESRD,189.16,189.16,11.35,160.79,24 HCPCS,Q5105,RETACRIT BS 3000U ESRD,224.86,224.86,13.49,191.13,24 HCPCS,Q5105,RETACRIT BS 4000U ESRD,299.81,299.81,17.99,254.84,24 HCPCS,Q5106,"Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units ",,,7.88,28.94,10 HCPCS,Q5106,"Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units Chemotherapy Drugs",,,,,0 HCPCS,Q5106,RETACRIT BS 10000U NESRD,750.72,750.72,45.04,638.11,19 HCPCS,Q5106,RETACRIT BS 1000U NESRD,95.18,95.18,5.71,80.9,19 HCPCS,Q5106,RETACRIT BS 2000U NESRD,189.16,189.16,11.35,160.79,19 HCPCS,Q5106,RETACRIT BS 3000U NESRD,224.86,224.86,13.49,191.13,19 HCPCS,Q5106,RETACRIT BS 4000U NESRD,299.81,299.81,17.99,254.84,19 HCPCS,Q5106,RETACRIT BS1000U NESRDJW,95.18,95.18,5.71,80.9,19 HCPCS,Q5107,"Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg ",,,23.74,188.38,10 HCPCS,Q5107,"Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg Chemotherapy Drugs",,,,,0 HCPCS,Q5108,"Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg ",,,79.5,904.61,10 HCPCS,Q5108,"Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg Chemotherapy Drugs",,,,,0 HCPCS,Q5110,"Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram ",,,0.28,1.94,10 HCPCS,Q5111,"Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg ",,,135.89,939.38,10 HCPCS,Q5112,"Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg ",,,29.81,278.21,10 HCPCS,Q5113,"Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg ",,,56.02,278.21,10 HCPCS,Q5114,"Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg ",,,35.78,244.81,10 HCPCS,Q5115,"Injection, rituximab-abbs, biosimilar, (truxima), 10 mg ",,,31.28,235.14,10 HCPCS,Q5115,TRUXIMA BS 10 MG INJ,795.93,795.93,47.76,676.54,19 HCPCS,Q5115,TRUXIMA BS 10 MG INJJW,795.93,795.93,47.76,676.54,19 HCPCS,Q5115,TRUXIMA BS 100 MG INJ,7961.66,7961.66,477.7,6767.41,19 HCPCS,Q5115,TRUXIMA BS 500 MG INJ,39802.35,39802.35,2388.14,33832.0,19 HCPCS,Q5116,"Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg ",,,10.43,278.21,10 HCPCS,Q5117,"Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg ",,,56.38,244.7,10 HCPCS,Q5118,"Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg ",,,25.85,170.59,10 HCPCS,Q5119,"Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg ",,,13.69,221.91,10 HCPCS,Q5119,RUXIENCE BS 10 MG INJ,674.58,674.58,40.47,573.39,19 HCPCS,Q5119,RUXIENCE BS 100 MG INJ,6748.14,6748.14,404.89,5735.92,19 HCPCS,Q5119,RUXIENCE BS 500 MG INJ,33741.88,33741.88,2024.51,28680.6,19 HCPCS,Q5120,"Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg ",,,67.74,953.64,10 HCPCS,Q5121,"Injection, infliximab-axxq, biosimilar, (avsola), 10 mg ",,,28.04,134.46,10 HCPCS,Q5122,"Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg ",,,133.31,939.38,10 HCPCS,Q5123,"Injection, rituximab-arrx, biosimilar, (riabni), 10 mg ",,,20.26,221.91,10 HCPCS,Q5124,"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg ",,,70.9,193.91,10 HCPCS,Q5125,"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram ",,,0.32,2.05,10 HCPCS,Q5126,"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg ",,,51.59,193.24,10 HCPCS,Q5127,"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg ",,,158.26,935.63,10 HCPCS,Q5128,"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg ",,,83.48,731.46,10 HCPCS,Q5129,"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg ",,,34.65,182.17,10 HCPCS,Q5130,"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg ",,,112.13,560.25,10 HCPCS,Q5133,"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg ",,,5.26,18.17,10 HCPCS,Q5134,"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg ",,,24.32,72.79,7 HCPCS,Q5135,"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg ",,,4.44,14.63,10 HCPCS,Q5136,"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg ",,,27.91,85.08,10 HCPCS,Q5137,"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg ",,,152.73,475.36,8 HCPCS,Q5138,"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg ",,,4.54,475.36,10 HCPCS,Q5140,"Injection, adalimumab-fkjp, biosimilar, 1 mg ",,,1495.87,2060.64,5 HCPCS,Q5141,"Injection, adalimumab-aaty, biosimilar, 1 mg ",,,1115.46,1536.6,5 HCPCS,Q5142,ADALIM-RYVK BS 40 MG INJ,2506.46,2506.46,150.39,2130.49,41 HCPCS,Q5142,"Injection, adalimumab-ryvk biosimilar, 1 mg ",2506.46,2506.46,25.64,41.28,8 HCPCS,Q5143,"Injection, adalimumab-adbm, biosimilar, 1 mg ",,,170.79,235.28,5 HCPCS,Q5144,"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg ",,,44.39,71.51,8 HCPCS,Q5145,"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg ",,,940.23,1295.22,5 HCPCS,Q5146,"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg ",,,37.87,240.06,10 HCPCS,Q5147,"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg ",,,821.4,2711.53,10 HCPCS,Q5148,"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram ",,,1.02,1.65,10 HCPCS,Q5149,"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg ",,,1851.51,2550.56,5 HCPCS,Q5150,"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg ",,,1851.51,2550.56,5 HCPCS,Q5151,"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg ",,,31.93,96.88,10 HCPCS,Q5152,"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg ",,,41.79,124.55,10 HCPCS,Q5153,"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg ",,,1736.48,2392.09,5 HCPCS,Q5154,"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg ",,,115.46,159.06,5 HCPCS,Q5155,"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg ",,,675.67,930.77,5 HCPCS,Q5156,"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg ",,,4.64,11.74,7 HCPCS,Q5157,"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg ",,,26.21,77.57,7 HCPCS,Q5158,"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg ",,,29.8,79.19,7 HCPCS,Q5159,"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg ",,,62.88,86.62,5 HCPCS,Q5160,"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg ",,,157.27,216.65,5 HCPCS,Q5162,"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg ",,,15.84,15.84,2 HCPCS,Q9950,"Injection, sulfur hexafluoride lipid microspheres, per ml ",,,18.12,78.3,10 HCPCS,Q9953,"Injection, iron-based magnetic resonance contrast agent, per ml ",,,150.16,193.6,3 HCPCS,Q9954,"Oral magnetic resonance contrast agent, per 100 ml ",,,20.44,28.16,5 HCPCS,Q9955,"Injection, perflexane lipid microspheres, per ml ",,,32.06,41.34,3 HCPCS,Q9956,"Injection, octafluoropropane microspheres, per ml ",,,39.96,128.54,10 HCPCS,Q9957,"Injection, perflutren lipid microspheres, per ml ",510.4,510.4,39.96,257.42,10 HCPCS,Q9957,PERFLUT LPDMCS 1.5ML INJ,510.4,510.4,30.62,433.84,24 HCPCS,Q9958,CYSTOGRAFIN 30% 300 ML,296.24,296.24,17.77,251.8,24 HCPCS,Q9958,"High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml ",296.24,296.24,0.08,0.24,10 HCPCS,Q9960,"High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml ",,,0.24,0.87,8 HCPCS,Q9961,"High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml ",,,0.26,0.9,10 HCPCS,Q9962,"High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml ",,,0.44,0.56,3 HCPCS,Q9963,GASTROGRAFIN 37% 120 ML,832.81,832.81,49.97,707.89,24 HCPCS,Q9963,GASTROGRAFIN 37% 30 ML,239.13,239.13,14.35,203.26,24 HCPCS,Q9963,"High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml ",,,0.22,0.69,10 HCPCS,Q9964,"High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml ",,,0.63,0.9,8 HCPCS,Q9965,"Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml ",,,1.16,5.62,10 HCPCS,Q9966,ISOVUE 250 100 ML INJ,176.08,176.08,10.56,149.67,24 HCPCS,Q9966,ISOVUE 250 50 ML INJ,76.14,76.14,4.57,64.72,24 HCPCS,Q9966,ISOVUE-M 200 10 ML INJ,186.79,186.79,11.21,158.77,24 HCPCS,Q9966,ISOVUE-M 200 20 ML INJ,255.79,255.79,15.35,217.42,24 HCPCS,Q9966,"Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml ",,,0.43,1.4,10 HCPCS,Q9966,OMNIPAQUE 240 50 ML INJ,235.05,235.05,14.1,199.79,24 HCPCS,Q9966,VISIPAQUE 270 100 ML INJ,490.2,490.2,29.41,416.67,24 HCPCS,Q9966,VISIPAQUE 270 50 ML INJ,291.9,291.9,17.51,248.11,24 HCPCS,Q9967,ISOVUE 300 100 ML INJ,166.56,166.56,9.99,141.58,24 HCPCS,Q9967,ISOVUE 300 50 ML INJ,83.28,83.28,5.0,70.79,24 HCPCS,Q9967,ISOVUE 370 100 ML INJ,184.41,184.41,11.06,156.75,24 HCPCS,Q9967,ISOVUE 370 150 ML INJ,254.6,254.6,15.28,216.41,24 HCPCS,Q9967,ISOVUE 370 200 ML INJ,655.78,655.78,39.35,557.41,24 HCPCS,Q9967,ISOVUE 370 50 ML INJ,90.42,90.42,5.43,76.86,24 HCPCS,Q9967,ISOVUE-M 300 15 ML INJ,246.27,246.27,14.78,209.33,24 HCPCS,Q9967,"Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml ",,,0.15,0.86,10 HCPCS,Q9967,OMNIPAQUE 300 50 ML INJ,277.35,277.35,16.64,235.75,24 HCPCS,Q9967,OMNIPAQUE 300 500 ML INJ,2537.45,2537.45,152.25,2156.83,24 HCPCS,Q9967,OMNIPAQUE 350 100 ML INJ,259.36,259.36,15.56,220.46,24 HCPCS,Q9967,VISIPAQUE 320 50 ML INJ,317.9,317.9,19.07,270.21,24 HCPCS,Q9968,INDOCYANINE-GN 25 MG INJ,1032.43,1032.43,61.95,877.57,20 HCPCS,Q9968,"Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg ",,,2.27,8.58,8 HCPCS,Q9968,METHYLENE BLUE 50 MG INJ,1140.94,1140.94,68.46,969.8,20 HCPCS,Q9968,NON RAD/CONTRAS 1MGINJJW,22.81,22.81,1.37,19.39,20 HCPCS,Q9968,NON RAD/CONTRAST 1MG INJ,22.81,22.81,1.37,19.39,20 HCPCS,Q9982,"Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries ",,,5169.23,10183.68,8 HCPCS,Q9983,"Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries ",,,5488.0,10820.16,8 HCPCS,Q9991,"Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg ",,,1996.56,6166.84,10 HCPCS,Q9991,"Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg Chemotherapy Drugs",,,,,0 HCPCS,Q9992,"Injection, buprenorphine extended-release (sublocade), greater than 100 mg ",,,1996.56,6166.84,10 HCPCS,Q9992,"Injection, buprenorphine extended-release (sublocade), greater than 100 mg Chemotherapy Drugs",,,,,0 HCPCS,Q9996,"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg ",,,113.81,604.31,8 HCPCS,Q9997,"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg ",,,4.53,49.22,10 HCPCS,Q9998,"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg ",,,11.14,49.22,10 HCPCS,Q9999,"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg ",,,13.29,41.28,10 HCPCS,R0070,"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen ",,,138.92,864.88,17 HCPCS,R0075,"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen ",,,59.63,2096.86,17 HCPCS,R0076,"Transportation of portable ekg to facility or location, per patient ",,,254.66,344.46,12 HCPCS,S0012,"Butorphanol tartrate, nasal spray, 25 mg ",,,81.56,192.97,8 HCPCS,S0013,"Esketamine, nasal spray, 1 mg ",,,36.78,47.42,3 HCPCS,S0014,"Tacrine hydrochloride, 10 mg ",,,4.74,7.74,8 HCPCS,S0021,"Injection, cefoperazone sodium, 1 gram ",,,37.03,47.74,3 HCPCS,S0023,"Injection, cimetidine hydrochloride, 300 mg ",,,4.66,7.61,8 HCPCS,S0034,"Injection, ofloxacin, 400 mg ",,,54.3,70.01,3 HCPCS,S0040,"Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams ",,,26.03,42.43,8 HCPCS,S0074,"Injection, cefotetan disodium, 500 mg ",,,29.89,38.53,3 HCPCS,S0078,"Injection, fosphenytoin sodium, 750 mg ",,,94.96,132.98,8 HCPCS,S0080,"Injection, pentamidine isethionate, 300 mg ",1727.48,1727.48,241.15,310.91,3 HCPCS,S0080,PENTAMIDINE 300 MG INJ,1727.48,1727.48,103.65,1468.36,30 HCPCS,S0081,"Injection, piperacillin sodium, 500 mg ",,,3.39,5.55,8 HCPCS,S0088,IMATINIB 100 MG PO,1321.69,1321.69,79.3,1123.44,25 HCPCS,S0088,"Imatinib, 100 mg ",1321.69,1321.69,7.33,35.42,8 HCPCS,S0088,"Imatinib, 100 mg Chemotherapy Drugs",1321.69,1321.69,,,0 HCPCS,S0090,SILDENAFIL CIT 20 MG PO,129.68,129.68,7.78,110.23,25 HCPCS,S0090,"Sildenafil citrate, 25 mg ",129.68,129.68,0.65,6.45,8 HCPCS,S0091,"Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166) ",,,7.41,22.95,8 HCPCS,S0092,"Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump) ",,,48.96,265.48,8 HCPCS,S0093,"Injection, morphine sulfate, 500 mg (loading dose for infusion pump) ",,,6.7,34.6,8 HCPCS,S0104,"Zidovudine, oral, 100 mg ",,,0.57,4.84,8 HCPCS,S0106,"Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets ",,,32.73,48.98,8 HCPCS,S0108,MERCAPTOPURINE 50 MG PO,28.56,28.56,1.71,24.28,25 HCPCS,S0108,"Mercaptopurine, oral, 50 mg ",28.56,28.56,4.63,9.83,8 HCPCS,S0108,"Mercaptopurine, oral, 50 mg Chemotherapy Drugs",28.56,28.56,,,0 HCPCS,S0109,METHADONE 10 MG PO,19.04,19.04,1.14,16.18,25 HCPCS,S0109,METHADONE 5 MG PO,10.7,10.7,0.64,9.09,25 HCPCS,S0109,"Methadone, oral, 5 mg ",,,0.04,0.97,8 HCPCS,S0117,"Tretinoin, topical, 5 grams ",,,9.27,13.66,8 HCPCS,S0117,"Tretinoin, topical, 5 grams Chemotherapy Drugs",,,,,0 HCPCS,S0119,ONDANSETRON 4 MG PO,5.95,5.95,0.36,5.06,25 HCPCS,S0119,ONDANSETRON 8 MG PO,4.59,4.59,0.28,3.9,25 HCPCS,S0119,"Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) ",,,1.11,2.43,8 HCPCS,S0122,"Injection, menotropins, 75 iu ",,,387.39,803.43,8 HCPCS,S0126,"Injection, follitropin alfa, 75 iu ",,,358.48,768.58,8 HCPCS,S0128,"Injection, follitropin beta, 75 iu ",,,370.44,692.17,8 HCPCS,S0132,"Injection, ganirelix acetate, 250 mcg ",,,259.7,597.82,8 HCPCS,S0136,"Clozapine, 25 mg ",,,0.92,2.06,8 HCPCS,S0137,"Didanosine (ddi), 25 mg ",,,0.86,1.78,8 HCPCS,S0138,FINASTERIDE 5 MG PO,5.95,5.95,0.36,5.06,25 HCPCS,S0138,"Finasteride, 5 mg ",5.95,5.95,0.27,0.47,8 HCPCS,S0139,MINOXIDIL 10 MG PO,53.17,53.17,3.19,45.19,25 HCPCS,S0139,MINOXIDIL 2.5 MG PO,28.44,28.44,1.71,24.17,25 HCPCS,S0139,"Minoxidil, 10 mg ",,,0.73,1.47,8 HCPCS,S0140,"Saquinavir, 200 mg ",,,3.0,3.87,3 HCPCS,S0145,"Injection, pegylated interferon alfa-2a, 180 mcg per ml ",,,2002.12,3543.35,8 HCPCS,S0145,"Injection, pegylated interferon alfa-2a, 180 mcg per ml Chemotherapy Drugs",,,,,0 HCPCS,S0148,"Injection, pegylated interferon alfa-2b, 10 mcg ",,,294.84,478.73,8 HCPCS,S0148,"Injection, pegylated interferon alfa-2b, 10 mcg Chemotherapy Drugs",,,,,0 HCPCS,S0155,"Sterile dilutant for epoprostenol, 50 ml ",,,15.93,46.14,8 HCPCS,S0156,"Exemestane, 25 mg ",,,4.11,19.82,8 HCPCS,S0156,"Exemestane, 25 mg Chemotherapy Drugs",,,,,0 HCPCS,S0157,"Becaplermin gel 0.01%, 0.5 gm ",,,73.09,144.24,8 HCPCS,S0160,"Dextroamphetamine sulfate, 5 mg ",,,1.72,3.38,8 HCPCS,S0169,CALCITRIOL 0.25 MCG PO,74.19,74.19,4.45,63.06,25 HCPCS,S0169,"Calcitrol, 0.25 microgram ",74.19,74.19,0.68,1.51,8 HCPCS,S0170,ANASTROZOLE 1 MG PO,12.31,12.31,0.74,10.46,25 HCPCS,S0170,"Anastrozole, oral, 1 mg ",12.31,12.31,1.19,5.18,8 HCPCS,S0170,"Anastrozole, oral, 1 mg Chemotherapy Drugs",12.31,12.31,,,0 HCPCS,S0172,CHLORAMBUCIL 2 MG PO,159.42,159.42,9.57,135.51,25 HCPCS,S0172,"Chlorambucil, oral, 2 mg ",159.42,159.42,40.92,840.62,8 HCPCS,S0172,"Chlorambucil, oral, 2 mg Chemotherapy Drugs",159.42,159.42,,,0 HCPCS,S0174,"Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180) ",,,72.96,128.93,8 HCPCS,S0175,"Flutamide, oral, 125 mg ",,,2.37,141.74,8 HCPCS,S0175,"Flutamide, oral, 125 mg Chemotherapy Drugs",,,,,0 HCPCS,S0176,HYDROXYUREA 500 MG PO,55.92,55.92,3.36,47.53,25 HCPCS,S0176,"Hydroxyurea, oral, 500 mg ",55.92,55.92,0.99,2.0,8 HCPCS,S0176,"Hydroxyurea, oral, 500 mg Chemotherapy Drugs",55.92,55.92,,,0 HCPCS,S0177,"Levamisole hydrochloride, oral, 50 mg ",,,7.31,9.42,3 HCPCS,S0178,"Lomustine, oral, 10 mg ",,,169.58,386.63,8 HCPCS,S0178,"Lomustine, oral, 10 mg Chemotherapy Drugs",,,,,0 HCPCS,S0179,MEGESTROL ACET 40 MG PO,45.75,45.75,2.75,38.89,25 HCPCS,S0179,MEGESTROL ACET 400MG PO,166.91,166.91,10.01,141.87,25 HCPCS,S0179,"Megestrol acetate, oral, 20 mg ",,,0.18,0.87,8 HCPCS,S0179,"Megestrol acetate, oral, 20 mg Chemotherapy Drugs",,,,,0 HCPCS,S0182,"Procarbazine hydrochloride, oral, 50 mg ",,,197.69,472.65,8 HCPCS,S0182,"Procarbazine hydrochloride, oral, 50 mg Chemotherapy Drugs",,,,,0 HCPCS,S0183,PROCHLORPERAZINE 10MG PO,5.95,5.95,0.36,5.06,25 HCPCS,S0183,PROCHLORPERAZINE 5 MG PO,17.84,17.84,1.07,15.16,25 HCPCS,S0183,"Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164) ",,,0.51,1.09,8 HCPCS,S0183,"Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164) Chemotherapy Drugs",,,,,0 HCPCS,S0187,TAMOXIFEN 10 MG PO,86.85,86.85,5.21,73.82,25 HCPCS,S0187,"Tamoxifen citrate, oral, 10 mg ",86.85,86.85,0.48,1.49,8 HCPCS,S0187,"Tamoxifen citrate, oral, 10 mg Chemotherapy Drugs",86.85,86.85,,,0 HCPCS,S0189,"Testosterone pellet, 75 mg ",,,259.52,334.59,3 HCPCS,S0190,"Mifepristone, oral, 200 mg ",,,88.45,179.28,8 HCPCS,S0191,MISOPROSTOL 100 MCG PO,36.88,36.88,2.21,31.35,25 HCPCS,S0191,MISOPROSTOL 200 MCG PO,46.4,46.4,2.78,39.44,25 HCPCS,S0191,"Misoprostol, oral, 200 mcg ",,,1.49,3.09,8 HCPCS,S0194,"Dialysis/stress vitamin supplement, oral, 100 capsules ",,,24.32,51.79,8 HCPCS,S0285,Colonoscopy consultation performed prior to a screening colonoscopy procedure ,,,77.59,107.11,5 HCPCS,S0390,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,36 HCPCS,S0400,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,13030.0,39 HCPCS,S0601,Screening proctoscopy ,,,343.69,440.76,36 HCPCS,S0610,"Annual gynecological examination, new patient ",,,102.05,140.86,5 HCPCS,S0612,"Annual gynecological examination, established patient ",,,76.75,105.94,5 HCPCS,S0620,Routine ophthalmological examination including refraction; new patient ,,,102.89,142.02,5 HCPCS,S0621,Routine ophthalmological examination including refraction; established patient ,,,81.81,112.92,5 HCPCS,S0630,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,36 HCPCS,S0800,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,36 HCPCS,S0810,Photorefractive keratectomy (prk) ,,,879.04,1127.31,36 HCPCS,S0812,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,36 HCPCS,S1091,"Stent, non-coronary, temporary, with delivery system (propel) ",,,14.15,5489.64,8 HCPCS,S2053,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,36 HCPCS,S2054,Transplantation of multivisceral organs ,,,9913.14,12713.03,36 HCPCS,S2055,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,36 HCPCS,S2060,Lobar lung transplantation ,,,9913.14,12713.03,36 HCPCS,S2061,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,36 HCPCS,S2065,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,36 HCPCS,S2066,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,36 HCPCS,S2067,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,36 HCPCS,S2068,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,36 HCPCS,S2070,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,36 HCPCS,S2079,Laparoscopic esophagomyotomy (heller type) ,,,5202.0,12713.03,48 HCPCS,S2080,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,36 HCPCS,S2083,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,132 HCPCS,S2095,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,132 HCPCS,S2102,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,36 HCPCS,S2103,Adrenal tissue transplant to brain ,,,9913.14,12713.03,36 HCPCS,S2112,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,5202.0,26654.0,51 HCPCS,S2115,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,36 HCPCS,S2117,"Arthroereisis, subtalar ",,,5202.0,12713.03,48 HCPCS,S2118,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,36 HCPCS,S2120,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,36 HCPCS,S2140,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,36 HCPCS,S2142,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,36 HCPCS,S2150,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,36 HCPCS,S2152,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,36 HCPCS,S2205,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,36 HCPCS,S2206,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,36 HCPCS,S2207,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,36 HCPCS,S2208,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,36 HCPCS,S2209,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,36 HCPCS,S2225,"Myringotomy, laser-assisted ",,,2699.0,12713.03,132 HCPCS,S2230,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,36 HCPCS,S2235,Implantation of auditory brain stem implant ,,,9913.14,12713.03,36 HCPCS,S2260,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,36 HCPCS,S2265,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,36 HCPCS,S2266,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,36 HCPCS,S2267,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,36 HCPCS,S2300,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,7026.0,48 HCPCS,S2325,Hip core decompression ,,,9913.14,12713.03,36 HCPCS,S2340,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,36 HCPCS,S2341,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,36 HCPCS,S2342,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,57 HCPCS,S2348,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,36 HCPCS,S2350,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,36 HCPCS,S2351,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,36 HCPCS,S2400,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2401,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2402,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2403,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2404,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2405,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,36 HCPCS,S2409,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,36 HCPCS,S2411,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,36 HCPCS,S2900,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,36 HCPCS,S3600,Stat laboratory request (situations other than s3601) ,,,4.04,6.38,5 HCPCS,S3620,"Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogest",,,190.48,621.1,14 HCPCS,S3630,"Eosinophil count, blood, direct ",,,26.06,35.2,12 HCPCS,S3645,Hiv-1 antibody testing of oral mucosal transudate ,,,123.88,167.33,12 HCPCS,S3650,"Saliva test, hormone level; during menopause ",,,1321.78,1785.38,12 HCPCS,S3652,"Saliva test, hormone level; to assess preterm labor risk ",,,179.09,644.81,17 HCPCS,S3655,Antisperm antibodies test (immunobead) ,,,1050.49,1418.95,12 HCPCS,S3800,Genetic testing for amyotrophic lateral sclerosis (als) ,,,,,0 HCPCS,S3845,Genetic testing for alpha-thalassemia ,,,2.68,3.62,12 HCPCS,S3854,Gene expression profiling panel for use in the management of breast cancer treatment ,,,888.8,1403.6,5 HCPCS,S3861,"Genetic testing, sodium channel, voltage-gated, type v, alpha subunit (scn5a) and variants for suspected brugada syndrome ",,,15225.08,20565.22,12 HCPCS,S3865,Comprehensive gene sequence analysis for hypertrophic cardiomyopathy ,,,29030.76,39213.2,12 HCPCS,S3866,Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (hcm) in an individual with a known hcm mutation in the family ,,,4722.83,6379.35,12 HCPCS,S3870,"Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability ",,,2392.84,3232.12,12 HCPCS,S4013,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,36 HCPCS,S4014,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,36 HCPCS,S4015,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,36 HCPCS,S4024,"Air polymer-type a intrauterine foam, per study dose ",,,1837.38,2959.63,8 HCPCS,S4028,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,36 HCPCS,S4035,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,36 HCPCS,S4037,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,36 HCPCS,S4981,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,36 HCPCS,S4993,Contraceptive pills for birth control ,48.22,48.22,0.27,0.38,5 HCPCS,S4993,NORG/EE 0.25/0.035MG PO,48.22,48.22,2.89,40.99,28 HCPCS,S4995,Smoking cessation gum ,,,0.39,0.54,5 HCPCS,S5000,CIP/DEX0.3/0.1%7.5MLOTIC,1278.96,1278.96,76.74,1087.12,30 HCPCS,S5000,CIPROFLOX 0.3% 3.5 G OPH,1834.56,1834.56,110.07,1559.38,30 HCPCS,S5000,DESMOPRES 0.01% 5MLNASAL,2487.61,2487.61,149.26,2114.47,30 HCPCS,S5000,DIAZEPAM 10 MG RECTAL,1427.67,1427.67,85.66,1213.52,30 HCPCS,S5000,ESTRADIOL 42.5 G VAGINAL,1524.04,1524.04,91.44,1295.43,30 HCPCS,S5000,FLUOCINOND 0.05% 15G TOP,243.47,243.47,5.59,334.73,60 HCPCS,S5000,FLUTICAS 50MCG 16G NASAL,2277.14,2277.14,136.63,1935.57,30 HCPCS,S5000,HYDROCORT 2.5% 30G TOP,12.83,12.83,0.77,10.91,30 HCPCS,S5000,HYDROCORTI 2.5% 30G RECT,2336.76,2336.76,140.21,1986.25,30 HCPCS,S5000,KALETRA 400/100MG LIQPO,141.58,141.58,8.49,120.34,30 HCPCS,S5000,LINEZOL 100MG/5ML LIQPO,214.15,214.15,12.85,182.03,30 HCPCS,S5000,NEO/POLY B/DEX 3.5G OPH,129.68,129.68,7.78,110.23,30 HCPCS,S5000,NEO/POLY B/DEX 5ML OPHTH,171.32,171.32,10.28,145.62,30 HCPCS,S5000,NITROGLY 4.9G SPRAY PO,3369.15,3369.15,202.15,2863.78,30 HCPCS,S5000,OFLOXACIN 0.3% 5ML OTIC,1961.86,1961.86,117.71,1667.58,30 HCPCS,S5000,"Prescription drug, generic ",,,,,0 HCPCS,S5000,TALC STERILE POWD 4GM,1215.91,1215.91,72.95,1033.52,30 HCPCS,S5000,TIMOLOL 0.25% 5 ML OPH,603.35,603.35,36.2,512.85,30 HCPCS,S5000,TIMOLOL 0.5% 5 ML OPH,686.19,686.19,41.17,583.26,30 HCPCS,S5000,TOBR0.3%/DEX0.1%2.5MLOPH,29.74,29.74,1.78,25.28,30 HCPCS,S5000,TOBRAMYCIN 0.3% 5 ML OPH,603.35,603.35,36.2,512.85,30 HCPCS,S5000,TRIFLURIDINE 1%7.5ML OPH,3078.59,3078.59,184.72,2616.8,30 HCPCS,S5001,INOMAX PER HOUR INH,1554.97,1554.97,93.3,1321.72,30 HCPCS,S5001,"Prescription drug, brand name ",1554.97,1554.97,,,0 HCPCS,S5010,"5% dextrose and 0.45% normal saline, 1000 ml ",285.53,285.53,10.25,25.02,8 HCPCS,S5010,D5/0.45NS 1000 ML INJ,285.53,285.53,17.13,242.7,25 HCPCS,S5012,"5% dextrose with potassium chloride, 1000 ml ",,,5.04,15.13,8 HCPCS,S5522,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,36 HCPCS,S5523,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,36 HCPCS,S5550,"Insulin, rapid onset, 5 units ",,,0.58,1.86,8 HCPCS,S5551,"Insulin, most rapid onset (lispro or aspart); 5 units ",,,0.9,1.27,8 HCPCS,S5552,"Insulin, intermediate acting (nph or lente); 5 units ",,,0.58,1.86,8 HCPCS,S5553,"Insulin, long acting; 5 units ",,,2.4,3.43,8 HCPCS,S5561,"Insulin delivery device, reusable pen; 3 ml size ",,,105.73,136.31,3 HCPCS,S5566,Insulin cartridge for use in insulin delivery device other than pump; 300 units ,,,66.33,85.52,3 HCPCS,S5570,"Insulin delivery device, disposable pen (including insulin); 1.5 ml size ",,,246.84,318.24,3 HCPCS,S5571,"Insulin delivery device, disposable pen (including insulin); 3 ml size ",,,78.53,101.24,3 HCPCS,S8030,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,36 HCPCS,S8037,Magnetic resonance cholangiopancreatography (mrcp) ,,,255.97,562.85,5 HCPCS,S8085,Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan) PET Scan,,,2268.0,5672.0,12 HCPCS,S8940,"Equestrian/hippotherapy, per session ",,,157.93,157.93,2 HCPCS,S9002,"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device ",,,431.15,664.11,5 HCPCS,S9034,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,13030.0,39 HCPCS,S9090,"Vertebral axial decompression, per session ",,,387.93,535.47,5 HCPCS,S9122,"Home health aide or certified nurse assistant, providing care in the home; per hour ",,,53.37,53.37,2 HCPCS,S9123,"Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) ",,,187.95,187.95,2 HCPCS,S9124,"Nursing care, in the home; by licensed practical nurse, per hour ",,,165.5,165.5,2 HCPCS,S9432,Medical foods for non-inborn errors of metabolism ,,,4.2,6.47,5 HCPCS,S9900,"Services by a journal-listed christian science practitioner for the purpose of healing, per diem ",,,182.5,182.5,2 HCPCS,T1032,"Services performed by a doula birth worker, per 15 minutes ",,,175.5,242.25,5 HCPCS,T1033,"Services performed by a doula birth worker, per diem ",,,175.5,242.25,5 HCPCS,T4545,"Incontinence product, disposable, penile wrap, each ",,,14.88,22.92,5 HCPCS,U0001,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,30.17,114.58,79 HCPCS,U0002,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,43.1,163.68,79 HCPCS,V2020,"Frames, purchases ",,,80.78,177.22,45 HCPCS,V2100,"Sphere, single vision, plano to plus or minus 4.00, per lens ",,,57.67,126.53,45 HCPCS,V2101,"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens ",,,66.03,144.87,45 HCPCS,V2102,"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens ",,,73.38,160.99,45 HCPCS,V2103,"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens ",,,43.66,95.78,45 HCPCS,V2104,"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens ",,,51.65,113.31,45 HCPCS,V2105,"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,50.55,110.9,45 HCPCS,V2106,"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ",,,60.41,132.53,45 HCPCS,V2107,"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens ",,,65.1,142.82,45 HCPCS,V2108,"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ",,,63.89,140.16,45 HCPCS,V2109,"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,61.26,134.4,45 HCPCS,V2110,"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens ",,,58.85,129.11,45 HCPCS,V2111,"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ",,,68.87,151.1,45 HCPCS,V2112,"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens ",,,89.07,195.41,45 HCPCS,V2113,"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,95.86,210.31,45 HCPCS,V2114,"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens ",,,108.73,238.54,45 HCPCS,V2115,"Lenticular, (myodisc), per lens, single vision ",,,118.33,259.61,45 HCPCS,V2118,"Aniseikonic lens, single vision ",,,87.98,193.03,45 HCPCS,V2121,"Lenticular lens, per lens, single ",,,121.11,265.7,45 HCPCS,V2200,"Sphere, bifocal, plano to plus or minus 4.00d, per lens ",,,71.04,155.85,45 HCPCS,V2201,"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens ",,,74.81,164.13,45 HCPCS,V2202,"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens ",,,85.01,186.49,45 HCPCS,V2203,"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens ",,,69.8,153.12,45 HCPCS,V2204,"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens ",,,71.0,155.77,45 HCPCS,V2205,"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,74.08,162.52,45 HCPCS,V2206,"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ",,,75.75,166.19,45 HCPCS,V2207,"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens ",,,70.57,154.82,45 HCPCS,V2208,"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ",,,78.32,171.83,45 HCPCS,V2209,"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,77.47,169.96,45 HCPCS,V2210,"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens ",,,88.56,194.3,45 HCPCS,V2211,"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ",,,88.6,194.38,45 HCPCS,V2212,"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens ",,,91.49,200.72,45 HCPCS,V2213,"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,97.77,214.51,45 HCPCS,V2214,"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens ",,,100.46,220.4,45 HCPCS,V2215,"Lenticular (myodisc), per lens, bifocal ",,,114.55,251.31,45 HCPCS,V2218,"Aniseikonic, per lens, bifocal ",,,121.35,266.23,45 HCPCS,V2219,Bifocal seg width over 28 mm ,,,61.68,135.32,45 HCPCS,V2220,Bifocal add over 3.25d ,,,56.47,123.88,45 HCPCS,V2221,"Lenticular lens, per lens, bifocal ",,,120.67,264.73,45 HCPCS,V2300,"Sphere, trifocal, plano to plus or minus 4.00d, per lens ",,,92.78,203.54,45 HCPCS,V2301,"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens ",,,121.49,266.54,45 HCPCS,V2302,"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens ",,,122.07,267.8,45 HCPCS,V2303,"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens ",,,88.16,193.41,45 HCPCS,V2304,"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens ",,,86.08,188.86,45 HCPCS,V2305,"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens ",,,106.91,234.54,45 HCPCS,V2306,"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens ",,,128.24,281.35,45 HCPCS,V2307,"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens ",,,96.4,211.5,45 HCPCS,V2308,"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens ",,,100.28,220.01,45 HCPCS,V2309,"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,112.16,246.07,45 HCPCS,V2310,"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens ",,,102.73,225.38,45 HCPCS,V2311,"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens ",,,128.46,281.82,45 HCPCS,V2312,"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens ",,,121.45,266.45,45 HCPCS,V2313,"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens ",,,126.84,278.27,45 HCPCS,V2314,"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens ",,,128.95,282.9,45 HCPCS,V2315,"Lenticular, (myodisc), per lens, trifocal ",,,143.16,314.07,45 HCPCS,V2318,"Aniseikonic lens, trifocal ",,,175.99,386.1,45 HCPCS,V2319,Trifocal seg width over 28 mm ,,,67.27,147.58,45 HCPCS,V2320,Trifocal add over 3.25d ,,,83.81,183.87,45 HCPCS,V2321,"Lenticular lens, per lens, trifocal ",,,142.75,313.17,45 HCPCS,V2410,"Variable asphericity lens, single vision, full field, glass or plastic, per lens ",,,126.9,278.4,45 HCPCS,V2430,"Variable asphericity lens, bifocal, full field, glass or plastic, per lens ",,,146.99,322.48,45 HCPCS,V2500,"Contact lens, pmma, spherical, per lens ",,,121.9,267.44,45 HCPCS,V2501,"Contact lens, pmma, toric or prism ballast, per lens ",,,148.54,325.88,45 HCPCS,V2502,"Contact lens, pmma, bifocal, per lens ",,,182.99,401.45,45 HCPCS,V2503,"Contact lens, pmma, color vision deficiency, per lens ",,,168.53,369.74,45 HCPCS,V2510,"Contact lens, gas permeable, spherical, per lens ",,,176.02,386.16,45 HCPCS,V2511,"Contact lens, gas permeable, toric, prism ballast, per lens ",,,228.27,500.8,45 HCPCS,V2512,"Contact lens, gas permeable, bifocal, per lens ",,,301.34,661.1,45 HCPCS,V2513,"Contact lens, gas permeable, extended wear, per lens ",,,253.0,555.04,45 HCPCS,V2520,"Contact lens, hydrophilic, spherical, per lens ",,,151.47,332.3,45 HCPCS,V2521,"Contact lens, hydrophilic, toric, or prism ballast, per lens ",,,231.63,508.17,45 HCPCS,V2522,"Contact lens, hydrophilic, bifocal, per lens ",,,282.66,620.12,45 HCPCS,V2523,"Contact lens, hydrophilic, extended wear, per lens ",,,220.82,484.46,45 HCPCS,V2524,"Contact lens, hydrophilic, spherical, photochromic additive, per lens ",,,176.52,387.26,45 HCPCS,V2525,"Contact lens, hydrophilic, dual focus, per lens ",,,288.96,445.09,5 HCPCS,V2530,"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325) ",,,341.08,748.29,45 HCPCS,V2531,"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325) ",,,656.84,1441.02,45 HCPCS,V2623,"Prosthetic eye, plastic, custom ",,,1435.94,3150.27,45 HCPCS,V2624,Polishing/resurfacing of ocular prosthesis ,,,95.82,210.23,45 HCPCS,V2625,Enlargement of ocular prosthesis ,,,460.23,1009.68,45 HCPCS,V2626,Reduction of ocular prosthesis ,,,319.16,700.19,45 HCPCS,V2627,Scleral cover shell ,,,1737.5,3811.86,45 HCPCS,V2628,Fabrication and fitting of ocular conformer ,,,451.99,991.6,45 HCPCS,V2630,Anterior chamber intraocular lens ,,,142.82,313.32,45 HCPCS,V2631,Iris supported intraocular lens ,,,142.82,313.32,45 HCPCS,V2632,Posterior chamber intraocular lens ,,,142.82,313.32,45 HCPCS,V2700,"Balance lens, per lens ",,,63.57,139.47,45 HCPCS,V2710,"Slab off prism, glass or plastic, per lens ",,,95.44,209.39,45 HCPCS,V2715,"Prism, per lens ",,,15.76,34.57,45 HCPCS,V2718,"Press-on lens, fresnell prism, per lens ",,,39.13,85.85,45 HCPCS,V2730,"Special base curve, glass or plastic, per lens ",,,33.73,74.0,45 HCPCS,V2744,"Tint, photochromatic, per lens ",,,25.05,54.95,45 HCPCS,V2745,"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens ",,,16.42,36.03,45 HCPCS,V2750,"Anti-reflective coating, per lens ",,,30.53,66.97,45 HCPCS,V2755,"U-v lens, per lens ",,,26.57,58.29,45 HCPCS,V2760,"Scratch resistant coating, per lens ",,,21.28,46.68,45 HCPCS,V2762,"Polarization, any lens material, per lens ",,,72.31,158.65,45 HCPCS,V2770,"Occluder lens, per lens ",,,25.68,56.33,45 HCPCS,V2780,"Oversize lens, per lens ",,,15.03,32.98,45 HCPCS,V2782,"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens ",,,78.09,171.31,45 HCPCS,V2783,"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens ",,,88.03,193.13,45 HCPCS,V2784,"Lens, polycarbonate or equal, any index, per lens ",,,57.26,125.62,45 HCPCS,V2790,"Amniotic membrane for surgical reconstruction, per procedure ",,,517.77,559.19,6 HCPCS,V5010,Assessment for hearing aid ,,,343.51,343.51,2 HCPCS,V5011,Fitting/orientation/checking of hearing aid ,,,772.89,772.89,2 HCPCS,V5014,Repair/modification of a hearing aid ,,,300.57,300.57,2 HCPCS,V5020,Conformity evaluation ,,,420.79,420.79,2 ICD,00F3XZZ,"FRAGMENTATION IN INTRACRANIAL EPIDURAL SPACE, EXTERNAL APPROACH ",,,2905.0,2905.0,5 ICD,00F4XZZ,"FRAGMENTATION IN INTRACRANIAL SUBDURAL SPACE, EXTERNAL APPROACH ",,,2905.0,2905.0,5 ICD,00F5XZZ,"FRAGMENTATION IN INTRACRANIAL SUBARACHNOID SPACE, EXTERNAL APPROACH ",,,2905.0,2905.0,5 ICD,00F6XZZ,"Fragmentation in Cerebral Ventricle, External Approach ",,,2905.0,2905.0,5 ICD,02FNXZZ,"Fragmentation in Pericardium, External Approach ",,,2905.0,2905.0,5 ICD,02HA0QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02HA0QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02HA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02HA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02HA3QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02HA3QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02HA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02HA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02HA4QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02HA4QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02PA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02PA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02PA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02PA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02PA4RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02PA4RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02RK0JZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02RK0JZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02RL0JZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02RL0JZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA0QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA0QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA0RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA3QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA3QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA3RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA4QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA4QZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,02WA4RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,2696.0,191268.0,4 ICD,02WA4RZ,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,2696.0,191268.0,4 ICD,08F4XZZ,"Fragmentation in Right Vitreous, External Approach ",,,2905.0,2905.0,5 ICD,08F5XZZ,"Fragmentation in Left Vitreous, External Approach ",,,2905.0,2905.0,5 ICD,0BF1XZZ,"Fragmentation in Trachea, External Approach ",,,2905.0,2905.0,5 ICD,0BF2XZZ,"Fragmentation in Carina, External Approach ",,,2905.0,2905.0,5 ICD,0BF3XZZ,"Fragmentation in Right Main Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF4XZZ,"Fragmentation in Right Upper Lobe Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF5XZZ,"Fragmentation in Right Middle Lobe Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF6XZZ,"Fragmentation in Right Lower Lobe Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF7XZZ,"Fragmentation in Left Main Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF8XZZ,"Fragmentation in Left Upper Lobe Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BF9XZZ,"Fragmentation in Lingula Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0BFBXZZ,"Fragmentation in Left Lower Lobe Bronchus, External Approach ",,,2905.0,2905.0,5 ICD,0CFBXZZ,"Fragmentation in Right Parotid Duct, External Approach ",,,2905.0,2905.0,5 ICD,0CFCXZZ,"Fragmentation in Left Parotid Duct, External Approach ",,,2905.0,2905.0,5 ICD,0D16079,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D16079,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D16079,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1607A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1607A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1607A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1607B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1607B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1607B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1607L,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1607L,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1607L,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160JL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160JL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160JL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160KL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160KL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160KL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D160ZL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D160ZL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D160ZL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D16479,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D16479,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D16479,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1647A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1647A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1647A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1647B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1647B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1647B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1647L,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1647L,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1647L,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164JL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164JL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164JL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164KL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164KL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164KL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D164ZL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D164ZL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D164ZL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D16879,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D16879,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D16879,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1687A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1687A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1687A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1687B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1687B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1687B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1687L,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D1687L,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D1687L,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168JL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168JL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168JL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168KL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168KL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168KL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D168ZL,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D168ZL,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D168ZL,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D1907A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1907A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1907A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1907B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1907B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1907B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D190ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D190ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D190ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D19479,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D19479,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D19479,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1947A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1947A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1947A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1947B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1947B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1947B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D194ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D194ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D194ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D19879,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D19879,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D19879,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1987A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1987A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1987A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1987B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1987B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1987B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198J9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198J9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198J9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198K9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198K9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198K9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198Z9,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198Z9,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198Z9,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D198ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D198ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D198ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A07A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A07A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A07A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A07B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A07B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A07B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A0ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A0ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A0ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A47A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A47A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A47A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A47B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A47B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A47B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A4ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A4ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A4ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A87A,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A87A,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A87A,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A87B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A87B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A87B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8JA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8JA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8JA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8KA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8KA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8KA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZA,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8ZA,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZA,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZH,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1A8ZH,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1A8ZH,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B07B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B07B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B07B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B0JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B0JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B0JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B0KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B0KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B0KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B0ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B0ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B0ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B47B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B47B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B47B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B4JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B4JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B4JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B4KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B4KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B4KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B4ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B4ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B4ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B87B,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B87B,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B87B,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B8JB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B8JB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B8JB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B8KB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B8KB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B8KB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B8ZB,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B8ZB,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B8ZB,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D1B8ZH,O.R. PROCEDURES FOR OBESITY WITH CC ,,,2476.0,22869.0,4 ICD,0D1B8ZH,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,2476.0,22869.0,4 ICD,0D1B8ZH,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,2476.0,22869.0,4 ICD,0D760DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D760DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D760DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D760ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D760ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D760ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D763DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D763DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D763DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D763ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D763ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D763ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D764DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D764DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D764DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D764ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0D764ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0D764ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0D767DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0D767DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0D767DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0D767ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0D767ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0D767ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0D768DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0D768DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0D768DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0D768ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0D768ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0D768ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0DB60Z3,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0DB60Z3,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0DB60Z3,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0DB60ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB60ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB60ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB63Z3,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB63Z3,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB63Z3,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB63ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB63ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB63ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB64Z3,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB64Z3,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB64Z3,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB67Z3,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB67Z3,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB67Z3,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB67ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB67ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB67ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DB68Z3,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DB68Z3,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DB68Z3,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DF5XZZ,"Fragmentation in Esophagus, External Approach ",,,2905.0,2905.0,5 ICD,0DF6XZZ,"Fragmentation in Stomach, External Approach ",,,2905.0,2905.0,5 ICD,0DF8XZZ,"Fragmentation in Small Intestine, External Approach ",,,2905.0,2905.0,5 ICD,0DF9XZZ,"Fragmentation in Duodenum, External Approach ",,,2905.0,2905.0,5 ICD,0DFAXZZ,"Fragmentation in Jejunum, External Approach ",,,2905.0,2905.0,5 ICD,0DFBXZZ,"Fragmentation in Ileum, External Approach ",,,2905.0,2905.0,5 ICD,0DFEXZZ,"Fragmentation in Large Intestine, External Approach ",,,2905.0,2905.0,5 ICD,0DFFXZZ,"Fragmentation in Right Large Intestine, External Approach ",,,2905.0,2905.0,5 ICD,0DFGXZZ,"Fragmentation in Left Large Intestine, External Approach ",,,2905.0,2905.0,5 ICD,0DFHXZZ,"Fragmentation in Cecum, External Approach ",,,2905.0,2905.0,5 ICD,0DFJXZZ,"Fragmentation in Appendix, External Approach ",,,2905.0,2905.0,5 ICD,0DFKXZZ,"Fragmentation in Ascending Colon, External Approach ",,,2905.0,2905.0,5 ICD,0DFLXZZ,"Fragmentation in Transverse Colon, External Approach ",,,2905.0,2905.0,5 ICD,0DFMXZZ,"Fragmentation in Descending Colon, External Approach ",,,2905.0,2905.0,5 ICD,0DFNXZZ,"Fragmentation in Sigmoid Colon, External Approach ",,,2905.0,2905.0,5 ICD,0DFPXZZ,"Fragmentation in Rectum, External Approach ",,,2905.0,2905.0,5 ICD,0DFQXZZ,"Fragmentation in Anus, External Approach ",,,2905.0,2905.0,5 ICD,0DH60DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DH60DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DH60DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DH63DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DH63DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DH63DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DH64DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DH64DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DH64DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DH67DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0DH67DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0DH67DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0DH68DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0DH68DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0DH68DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0DL60CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,13250.0,6 ICD,0DL60CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,13250.0,6 ICD,0DL60CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,13250.0,6 ICD,0DL60DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL60DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL60DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL60ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL60ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL60ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL63CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL63CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL63CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL63DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL63DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL63DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL63ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL63ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL63ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL64CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL64CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL64CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL64DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL64DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL64DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL64ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL64ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL64ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL67DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL67DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL67DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL67ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL67ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL67ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL68DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL68DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL68DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL68ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL68ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL68ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL70CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL70CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL70CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL70DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL70DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL70DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL70ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL70ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL70ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL73CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL73CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL73CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL73DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL73DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL73DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL73ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL73ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL73ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL74CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL74CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL74CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL74DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL74DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL74DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL74ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL74ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL74ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL77DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL77DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL77DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL77ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL77ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL77ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL78DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL78DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL78DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DL78ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DL78ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DL78ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DP643Z,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DP643Z,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DP643Z,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DP64CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DP64CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DP64CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DQ60ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DQ60ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DQ60ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DQ63ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DQ63ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DQ63ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DQ64ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DQ64ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DQ64ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DQ67ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DQ67ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DQ67ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DQ68ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DQ68ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DQ68ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV60CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV60CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV60CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV60DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV60DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV60DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV60ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV60ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV60ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV63CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV63CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV63CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV63DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV63DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV63DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV63ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV63ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV63ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV64CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV64CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV64CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV64DZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV64DZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV64DZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV64ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV64ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV64ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV67ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV67ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV67ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DV68ZZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DV68ZZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DV68ZZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DW643Z,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DW643Z,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DW643Z,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0DW64CZ,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,0DW64CZ,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,0DW64CZ,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,0FF4XZZ,"Fragmentation in Gallbladder, External Approach ",,,2905.0,2905.0,5 ICD,0FF5XZZ,"Fragmentation in Right Hepatic Duct, External Approach ",,,2905.0,2905.0,5 ICD,0FF6XZZ,"Fragmentation in Left Hepatic Duct, External Approach ",,,2905.0,2905.0,5 ICD,0FF8XZZ,"Fragmentation in Cystic Duct, External Approach ",,,2905.0,2905.0,5 ICD,0FF9XZZ,"Fragmentation in Common Bile Duct, External Approach ",,,2905.0,2905.0,5 ICD,0FFCXZZ,"Fragmentation in Ampulla of Vater, External Approach ",,,2905.0,2905.0,5 ICD,0FFDXZZ,"Fragmentation in Pancreatic Duct, External Approach ",,,2905.0,2905.0,5 ICD,0FFFXZZ,"Fragmentation in Accessory Pancreatic Duct, External Approach ",,,2905.0,2905.0,5 ICD,0TF3XZZ,"Fragmentation in Right Kidney Pelvis, External Approach ",,,2905.0,2905.0,5 ICD,0TF3XZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TF3XZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TF4XZZ,"Fragmentation in Left Kidney Pelvis, External Approach ",,,2905.0,2905.0,5 ICD,0TF4XZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TF4XZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TF6XZZ,"Fragmentation in Right Ureter, External Approach ",,,2905.0,2905.0,5 ICD,0TF6XZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TF6XZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TF7XZZ,"Fragmentation in Left Ureter, External Approach ",,,2905.0,2905.0,5 ICD,0TF7XZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TF7XZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TFBXZZ,"Fragmentation in Bladder, External Approach ",,,2905.0,2905.0,5 ICD,0TFBXZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TFBXZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TFCXZZ,"Fragmentation in Bladder Neck, External Approach ",,,2905.0,2905.0,5 ICD,0TFCXZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0TFCXZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,0TFDXZZ,"Fragmentation in Urethra, External Approach ",,,2905.0,2905.0,5 ICD,0UF5XZZ,"Fragmentation in Right Fallopian Tube, External Approach ",,,2905.0,2905.0,5 ICD,0UF6XZZ,"Fragmentation in Left Fallopian Tube, External Approach ",,,2905.0,2905.0,5 ICD,0UF7XZZ,"Fragmentation in Bilateral Fallopian Tubes, External Approach ",,,2905.0,2905.0,5 ICD,0UF9XZZ,"Fragmentation in Uterus, External Approach ",,,2905.0,2905.0,5 ICD,0WF1XZZ,"Fragmentation in Cranial Cavity, External Approach ",,,2905.0,2905.0,5 ICD,0WF3XZZ,"Fragmentation in Oral Cavity and Throat, External Approach ",,,2905.0,2905.0,5 ICD,0WF9XZZ,"Fragmentation in Right Pleural Cavity, External Approach ",,,2905.0,2905.0,5 ICD,0WFBXZZ,"Fragmentation in Left Pleural Cavity, External Approach ",,,2905.0,2905.0,5 ICD,0WFCXZZ,"Fragmentation in Mediastinum, External Approach ",,,2905.0,2905.0,5 ICD,0WFGXZZ,"Fragmentation in Peritoneal Cavity, External Approach ",,,2905.0,2905.0,5 ICD,0WFJXZZ,"Fragmentation in Pelvic Cavity, External Approach ",,,2905.0,2905.0,5 ICD,0WFPXZZ,"Fragmentation in Gastrointestinal Tract, External Approach ",,,2905.0,2905.0,5 ICD,0WFQXZZ,"Fragmentation in Respiratory Tract, External Approach ",,,2905.0,2905.0,5 ICD,0WFRXZZ,"Fragmentation in Genitourinary Tract, External Approach ",,,2905.0,2905.0,5 ICD,0WFRXZZ,URINARY STONES WITH MCC ,,,2696.0,11435.0,4 ICD,0WFRXZZ,URINARY STONES WITHOUT MCC ,,,2696.0,11435.0,4 ICD,30230G2,"TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30230G3,"TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30230U2,"Transfusion of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells into Peripheral Vein, Open Approach ",,,,,0 ICD,30230U3,"Transfusion of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells into Peripheral Vein, Open Approach ",,,,,0 ICD,30230X2,"TRANSFUSION OF ALLOGENEIC RELATED CORD BLOOD STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30230X3,"TRANSFUSION OF ALLOGENEIC UNRELATED CORD BLOOD STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30230Y2,"TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30230Y3,"TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH ",,,,,0 ICD,30233G2,"TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30233G3,"TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30233U2,"Transfusion of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells into Peripheral Vein, Percutaneous Approach ",,,,,0 ICD,30233U3,"Transfusion of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells into Peripheral Vein, Percutaneous Approach ",,,,,0 ICD,30233X2,"TRANSFUSION OF ALLOGENEIC RELATED CORD BLOOD STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30233X3,"TRANSFUSION OF ALLOGENEIC UNRELATED CORD BLOOD STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30233Y2,"TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30233Y3,"TRANSFUSION OF ALLOGENEIC UNRELATED HAMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30240G2,"TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30240G3,"TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30240U2,"Transfusion of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells into Central Vein, Open Approach ",,,,,0 ICD,30240U3,"Transfusion of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells into Central Vein, Open Approach ",,,,,0 ICD,30240X2,"TRANSFUSION OF ALLOGENEIC RELATED CORD BLOOD STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30240X3,"TRANSFUSION OF ALLOGENEIC UNRELATED CORD BLOOD STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30240Y2,"TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30240Y3,"TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH ",,,,,0 ICD,30243G2,"TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30243G3,"TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30243U2,"Transfusion of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells into Central Vein, Percutaneous Approach ",,,,,0 ICD,30243U3,"Transfusion of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells into Central Vein, Percutaneous Approach ",,,,,0 ICD,30243X2,"TRANSFUSION OF ALLOGENEIC RELATED CORD BLOOD STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30243X3,"TRANSFUSION OF ALLOGENEIC UNRELATED CORD BLOOD STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30243Y2,"TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,30243Y3,"TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH ",,,,,0 ICD,3E0G3GC,O.R. PROCEDURES FOR OBESITY WITH CC ,,,1400.0,22869.0,10 ICD,3E0G3GC,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,1400.0,22869.0,10 ICD,3E0G3GC,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,1400.0,22869.0,10 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4700,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4702,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O4703,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O471,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,1585.0,2262.0,2 ICD,O479,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1585.0,2262.0,2 MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,1275.0,412960.19,107 MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,1275.0,191268.0,107 MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH ",,,995.0,312774.55,63 MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH Pediatric",,,182239.57,234750.71,15 MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC ",,,995.0,204114.23,63 MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC Pediatric",,,118928.12,153196.48,15 MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT ,,,1275.0,151935.53,44 MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC ,,,1275.0,68330.83,44 MS-DRG,007,LUNG TRANSPLANT ,,,1275.0,190834.15,44 MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT ,,,1275.0,82589.39,44 MS-DRG,010,PANCREAS TRANSPLANT ,,,1275.0,105741.12,44 MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC ",,,995.0,80371.62,64 MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC Pediatric",,,46828.9,60322.35,15 MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC ",,,995.0,62126.98,64 MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC Pediatric",,,36198.58,46628.96,15 MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC ",,,995.0,42466.2,64 MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC Pediatric",,,24743.13,31872.71,15 MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT ,,,1275.0,177095.77,44 MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC ,,,1275.0,87380.06,42 MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC ,,,1275.0,80050.37,43 MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,1275.0,603652.36,47 MS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS ,,,1275.0,105135.47,49 MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC ,,,995.0,243243.0,64 MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC Pediatric,,,67561.52,87028.93,15 MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC ,,,995.0,243243.0,64 MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC Pediatric,,,45452.57,58549.43,15 MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ ,,,995.0,243243.0,64 MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ Pediatric,,,27281.16,35142.04,15 MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI ,,,995.0,108108.0,64 MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI Pediatric,,,49200.36,63377.12,15 MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI ,,,995.0,103950.0,64 MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI Pediatric,,,33587.57,43265.61,15 MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC ,,,995.0,105742.6,64 MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC Pediatric,,,39037.97,50286.5,15 MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC ,,,995.0,79002.0,64 MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC Pediatric,,,26695.59,34387.75,15 MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC ,,,995.0,63410.0,64 MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC Pediatric,,,21661.62,27903.27,15 MS-DRG,028,SPINAL PROCEDURES WITH MCC ,,,995.0,88538.31,64 MS-DRG,028,SPINAL PROCEDURES WITH MCC Pediatric,,,51587.26,66451.8,15 MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS ,,,995.0,65738.19,64 MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS Pediatric,,,29292.0,37732.3,15 MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC ,,,995.0,35561.76,64 MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC Pediatric,,,18847.99,24278.91,15 MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC ,,,995.0,66024.65,64 MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC Pediatric,,,38469.57,49554.33,15 MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC ,,,995.0,33444.77,64 MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC Pediatric,,,18296.77,23568.86,15 MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC ,,,995.0,25986.28,64 MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC Pediatric,,,14277.66,18391.67,15 MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC ,,,995.0,60025.55,64 MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC Pediatric,,,33233.83,42809.94,15 MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC ,,,995.0,35303.73,64 MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC Pediatric,,,20524.83,26438.93,15 MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC ,,,995.0,31185.0,64 MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC Pediatric,,,16680.88,21487.37,15 MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC ,,,995.0,49455.71,64 MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC Pediatric,,,28265.97,36410.63,15 MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC ,,,995.0,25029.63,64 MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC Pediatric,,,13931.64,17945.96,15 MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC ,,,995.0,17322.17,64 MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC Pediatric,,,10092.84,13001.03,15 MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC ",,,995.0,77064.11,64 MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC Pediatric",,,33152.26,42704.87,15 MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE ",,,995.0,46853.02,64 MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE Pediatric",,,18878.04,24317.62,15 MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC ",,,995.0,37909.93,64 MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC Pediatric",,,14834.03,19108.36,15 MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC ,,,995.0,38913.97,64 MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC Pediatric,,,15551.82,20032.98,15 MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC ,,,995.0,21037.13,64 MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC Pediatric,,,8407.41,10829.95,15 MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC ,,,995.0,40052.11,64 MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC Pediatric,,,13109.96,16887.51,15 MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC ,,,995.0,26745.13,64 MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC Pediatric,,,8754.29,11276.78,15 MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC ,,,995.0,49909.48,64 MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC Pediatric,,,19946.14,25693.49,15 MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC ,,,995.0,27834.67,64 MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC Pediatric,,,11124.02,14329.34,15 MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC ,,,995.0,36726.9,64 MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC Pediatric,,,14677.77,18907.07,15 MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC ,,,995.0,26659.5,64 MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC Pediatric,,,10654.37,13724.35,15 MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC ,,,995.0,19760.98,64 MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC Pediatric,,,7897.4,10172.99,15 MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,995.0,59233.54,64 MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric",,,23672.46,30493.53,15 MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,995.0,37751.68,64 MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric",,,15087.32,19434.63,15 MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,995.0,30159.24,64 MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric",,,12053.03,15526.03,15 MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC ,,,995.0,43204.32,64 MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC Pediatric,,,17266.45,22241.66,15 MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS ,,,995.0,21705.29,64 MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS Pediatric,,,8674.44,11173.92,15 MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC ,,,995.0,14703.65,64 MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC Pediatric,,,5876.26,7569.46,15 MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC ,,,995.0,31553.55,64 MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC Pediatric,,,12610.26,16243.82,15 MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC ,,,995.0,18570.77,64 MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC Pediatric,,,7421.74,9560.26,15 MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC ,,,995.0,17161.42,64 MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC Pediatric,,,6858.5,8834.73,15 MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC ,,,995.0,35766.56,64 MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC Pediatric,,,14293.97,18412.69,15 MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC ,,,995.0,22042.58,64 MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC Pediatric,,,8809.24,11347.56,15 MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC ,,,995.0,16246.2,64 MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6492.73,8363.57,15 MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC ,,,995.0,34466.78,64 MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC Pediatric,,,13774.52,17743.56,15 MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC ,,,995.0,22145.71,64 MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC Pediatric,,,8850.45,11400.65,15 MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC ,,,995.0,41195.57,64 MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC Pediatric,,,16463.65,21207.55,15 MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC ,,,995.0,17728.6,64 MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC Pediatric,,,7085.17,9126.71,15 MS-DRG,077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC ,,,18922.12,24411.43,5 MS-DRG,078,HYPERTENSIVE ENCEPHALOPATHY WITH CC ,,,11725.57,15127.16,5 MS-DRG,079,HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC ,,,8996.31,11606.14,5 MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC ,,,995.0,38886.04,64 MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC Pediatric,,,15540.66,20018.6,15 MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC ,,,995.0,19241.07,64 MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC Pediatric,,,7689.62,9905.34,15 MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC ,,,995.0,49103.83,64 MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC Pediatric,,,19624.16,25278.74,15 MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC ,,,995.0,29987.37,64 MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC Pediatric,,,11984.34,15437.55,15 MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC ,,,995.0,20534.41,64 MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC Pediatric,,,8206.5,10571.15,15 MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC ,,,995.0,48809.5,64 MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC Pediatric,,,19506.53,25127.21,15 MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC ,,,995.0,27987.21,64 MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC Pediatric,,,11184.98,14407.86,15 MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC ,,,995.0,19651.41,64 MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC Pediatric,,,7853.61,10116.58,15 MS-DRG,088,CONCUSSION WITH MCC ,,,995.0,29042.07,64 MS-DRG,088,CONCUSSION WITH MCC Pediatric,,,11606.55,14950.91,15 MS-DRG,089,CONCUSSION WITH CC ,,,995.0,23602.32,64 MS-DRG,089,CONCUSSION WITH CC Pediatric,,,9432.58,12150.52,15 MS-DRG,090,CONCUSSION WITHOUT CC/MCC ,,,995.0,17685.63,64 MS-DRG,090,CONCUSSION WITHOUT CC/MCC Pediatric,,,7068.0,9104.59,15 MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC ,,,995.0,37730.2,64 MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC Pediatric,,,15078.73,19423.57,15 MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC ,,,995.0,21978.13,64 MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC Pediatric,,,8783.48,11314.38,15 MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC ,,,995.0,17107.71,64 MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC Pediatric,,,6837.03,8807.08,15 MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC ,,,995.0,75610.79,64 MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC Pediatric,,,30217.57,38924.56,15 MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC ,,,995.0,55411.53,64 MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC Pediatric,,,22145.01,28525.95,15 MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC ,,,995.0,55411.53,64 MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC Pediatric,,,22145.01,28525.95,15 MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC ,,,995.0,77595.91,64 MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC Pediatric,,,31010.91,39946.51,15 MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC ,,,995.0,49303.63,64 MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC Pediatric,,,19704.01,25381.59,15 MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC ,,,995.0,29269.8,64 MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC Pediatric,,,11697.57,15068.14,15 MS-DRG,100,SEIZURES WITH MCC ,,,995.0,41610.21,64 MS-DRG,100,SEIZURES WITH MCC Pediatric,,,16629.36,21421.01,15 MS-DRG,101,SEIZURES WITHOUT MCC ,,,995.0,19391.46,64 MS-DRG,101,SEIZURES WITHOUT MCC Pediatric,,,7749.72,9982.76,15 MS-DRG,102,HEADACHES WITH MCC ,,,995.0,24081.42,64 MS-DRG,102,HEADACHES WITH MCC Pediatric,,,9624.05,12397.15,15 MS-DRG,103,HEADACHES WITHOUT MCC ,,,995.0,17967.07,64 MS-DRG,103,HEADACHES WITHOUT MCC Pediatric,,,7180.47,9249.48,15 MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC ,,,995.0,34645.81,64 MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC Pediatric,,,20186.54,26003.17,15 MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC ,,,995.0,21842.84,64 MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC Pediatric,,,11616.86,14964.18,15 MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT ,,,995.0,22618.29,64 MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT Pediatric,,,13178.65,16975.99,15 MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC ,,,995.0,28408.06,64 MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC Pediatric,,,15524.35,19997.59,15 MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC ,,,995.0,15987.09,64 MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,9314.95,11998.99,15 MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC ,,,995.0,24992.34,64 MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC Pediatric,,,9988.09,12866.1,15 MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC ,,,995.0,16882.13,64 MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Pediatric,,,6746.88,8690.95,15 MS-DRG,123,NEUROLOGICAL EYE DISORDERS ,,,995.0,17157.12,64 MS-DRG,123,NEUROLOGICAL EYE DISORDERS Pediatric,,,6856.78,8832.52,15 MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT ,,,995.0,28425.48,64 MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT Pediatric,,,11360.14,14633.49,15 MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC ,,,995.0,16495.42,64 MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC Pediatric,,,6592.33,8491.87,15 MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC ,,,995.0,32343.27,64 MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric,,,18631.62,24000.2,15 MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC ,,,995.0,18944.24,64 MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Pediatric,,,8717.37,11229.22,15 MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC ,,,995.0,22779.86,64 MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC Pediatric,,,12820.62,16514.79,15 MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC ,,,995.0,13306.0,64 MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC Pediatric,,,7608.91,9801.37,15 MS-DRG,139,SALIVARY GLAND PROCEDURES ,,,995.0,18621.33,64 MS-DRG,139,SALIVARY GLAND PROCEDURES Pediatric,,,10609.72,13666.84,15 MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC ,,,995.0,62853.46,64 MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC Pediatric,,,36621.87,47174.22,15 MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC ,,,995.0,33287.84,64 MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC Pediatric,,,18726.92,24122.97,15 MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC ,,,995.0,32005.69,64 MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC Pediatric,,,13706.69,17656.18,15 MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC ",,,995.0,55209.9,64 MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC Pediatric",,,32168.31,41437.4,15 MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC ",,,995.0,26579.27,64 MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC Pediatric",,,14878.68,19165.87,15 MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC ",,,995.0,18477.99,64 MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,10322.95,13297.44,15 MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC ",,,995.0,45490.22,64 MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric",,,18180.0,23418.44,15 MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC ",,,995.0,27316.91,64 MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric",,,10917.1,14062.79,15 MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC ",,,995.0,17124.9,64 MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric",,,6843.9,8815.93,15 MS-DRG,149,DYSEQUILIBRIUM ,,,995.0,16147.37,64 MS-DRG,149,DYSEQUILIBRIUM Pediatric,,,6453.24,8312.7,15 MS-DRG,150,EPISTAXIS WITH MCC ,,,995.0,28605.95,64 MS-DRG,150,EPISTAXIS WITH MCC Pediatric,,,11432.26,14726.39,15 MS-DRG,151,EPISTAXIS WITHOUT MCC ,,,995.0,15769.26,64 MS-DRG,151,EPISTAXIS WITHOUT MCC Pediatric,,,6302.12,8118.04,15 MS-DRG,152,OTITIS MEDIA AND URI WITH MCC ,,,995.0,25398.38,64 MS-DRG,152,OTITIS MEDIA AND URI WITH MCC Pediatric,,,10150.37,13075.13,15 MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC ,,,995.0,15859.49,64 MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC Pediatric,,,6338.19,8164.49,15 MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC ",,,995.0,33590.23,64 MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,15 MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC ",,,995.0,19690.09,64 MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,15 MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC ",,,995.0,14847.59,64 MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,15 MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC ,,,995.0,36883.73,64 MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,15 MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC ,,,995.0,19546.14,64 MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,15 MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC ,,,995.0,15221.41,64 MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,15 MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC ,,,995.0,75547.61,64 MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,15 MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC ,,,995.0,40070.35,64 MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,15 MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC ,,,995.0,28919.58,64 MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,15 MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC ,,,995.0,56183.89,64 MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,15 MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC ,,,995.0,27442.36,64 MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,15 MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,20436.54,64 MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,15 MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY ,,,995.0,43860.23,59 MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,15 MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE ,,,995.0,29510.42,64 MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,15 MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC ,,,995.0,17294.62,64 MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,15 MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC ,,,995.0,33573.05,69 MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,15 MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC ,,,995.0,20968.38,64 MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,15 MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC ,,,995.0,16220.42,64 MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,15 MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC ,,,995.0,46323.95,64 MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,15 MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC ,,,995.0,28093.4,64 MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,15 MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC ,,,995.0,16194.64,64 MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,15 MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC ,,,995.0,32868.37,64 MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,15 MS-DRG,184,MAJOR CHEST TRAUMA WITH CC ,,,995.0,22861.12,64 MS-DRG,184,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,15 MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC ,,,995.0,16897.17,64 MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,15 MS-DRG,186,PLEURAL EFFUSION WITH MCC ,,,995.0,33482.81,64 MS-DRG,186,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,15 MS-DRG,187,PLEURAL EFFUSION WITH CC ,,,995.0,21249.82,64 MS-DRG,187,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,15 MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC ,,,995.0,15408.32,64 MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,15 MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE ,,,995.0,26541.33,64 MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,15 MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC ,,,995.0,23797.83,64 MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,15 MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC ,,,995.0,18111.01,64 MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,15 MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC ,,,995.0,13792.73,64 MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,15 MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC ,,,995.0,28941.0,66 MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,15 MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC ,,,995.0,28941.0,66 MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,15 MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC ,,,995.0,28941.0,66 MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,15 MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC ,,,995.0,40544.6,64 MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,15 MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC ,,,995.0,20390.46,64 MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,15 MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC ,,,995.0,15386.84,64 MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,15 MS-DRG,199,PNEUMOTHORAX WITH MCC ,,,995.0,37899.92,64 MS-DRG,199,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,15 MS-DRG,200,PNEUMOTHORAX WITH CC ,,,995.0,23617.36,64 MS-DRG,200,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,15 MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC ,,,995.0,15363.21,64 MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,15 MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC ,,,995.0,20865.26,64 MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,15 MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC ,,,995.0,14394.28,64 MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,15 MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS ,,,995.0,17346.18,64 MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,15 MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC ,,,995.0,39337.2,64 MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,15 MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC ,,,995.0,20218.59,64 MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,15 MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS ,,,995.0,138243.09,64 MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,15 MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS ,,,995.0,59053.07,64 MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,15 MS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES ,,,995.0,166793.84,68 MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES ,,,995.0,160240.74,71 MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,15 MS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES ,,,995.0,84096.88,68 MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT ,,,995.0,202495.51,76 MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,15 MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,995.0,198952.8,76 MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,83995.12,108197.77,15 MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,995.0,133721.88,76 MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,72722.82,15 MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,995.0,133721.88,76 MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,72722.82,15 MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,995.0,156153.59,76 MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,65925.88,84922.0,15 MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,995.0,108453.15,76 MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,45787.42,58980.77,15 MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,995.0,102502.55,76 MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,55744.61,15 MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC ,,,995.0,106029.0,76 MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,15 MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC ,,,995.0,106029.0,76 MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,15 MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC ,,,995.0,171438.88,76 MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,15 MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC ,,,995.0,162162.0,76 MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,15 MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC ,,,995.0,155480.43,76 MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,15 MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC ,,,995.0,111094.93,76 MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,15 MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC ,,,995.0,119349.72,76 MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,15 MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC ,,,995.0,95291.0,76 MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,15 MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC ,,,995.0,72668.62,64 MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,15 MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC ,,,995.0,42080.2,64 MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,15 MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC ,,,995.0,24027.72,64 MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,15 MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC ,,,995.0,66709.13,76 MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,15 MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC ,,,995.0,55094.0,76 MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,15 MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC ,,,995.0,55094.0,76 MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,15 MS-DRG,245,AICD GENERATOR PROCEDURES ,,,995.0,96956.95,76 MS-DRG,245,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,15 MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC ,,,995.0,44385.5,76 MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,15 MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC ,,,995.0,29106.0,76 MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,15 MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC ,,,995.0,70941.56,64 MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,15 MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC ,,,995.0,52786.72,64 MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,15 MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC ,,,995.0,36234.43,64 MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,15 MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC ,,,995.0,39748.89,64 MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,15 MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC ,,,995.0,25020.25,64 MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,15 MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC ,,,995.0,17581.7,64 MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,15 MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC ,,,995.0,56696.32,64 MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,15 MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC ,,,995.0,37388.32,64 MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,15 MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC ,,,995.0,63840.4,64 MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,15 MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC ,,,995.0,35682.83,64 MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,15 MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC ,,,995.0,30534.16,64 MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,15 MS-DRG,263,VEIN LIGATION AND STRIPPING ,,,995.0,51975.0,64 MS-DRG,263,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,15 MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES ,,,995.0,49227.08,64 MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,15 MS-DRG,265,AICD LEAD PROCEDURES ,,,995.0,54054.0,64 MS-DRG,265,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,15 MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC ,,,995.0,124633.27,64 MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,15 MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC ,,,995.0,96820.39,64 MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,15 MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC ,,,995.0,139875.85,76 MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,15 MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC ,,,995.0,85887.22,76 MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,15 MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC ,,,995.0,107304.11,76 MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,15 MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC ,,,995.0,72324.47,76 MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,15 MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC ,,,995.0,66528.0,76 MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,15 MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC ,,,995.0,83900.29,76 MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,15 MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC ,,,995.0,66943.3,76 MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,15 MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC ,,,995.0,145010.94,71 MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,15 MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR ,,,995.0,122156.22,71 MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,15 MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC ,,,995.0,95291.0,71 MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,15 MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES ,,,995.0,82023.52,59 MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,47791.39,61562.17,15 MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES ,,,995.0,53143.91,59 MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,39886.78,15 MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC ",,,995.0,34462.48,64 MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,15 MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC ",,,995.0,19745.94,64 MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,15 MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC ",,,995.0,15535.08,64 MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,15 MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC ",,,995.0,42555.51,64 MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,15 MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC ",,,995.0,14871.22,64 MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,15 MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC ",,,995.0,13460.0,64 MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,15 MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC ",,,995.0,47539.8,76 MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,15 MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC ",,,995.0,22990.03,76 MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,15 MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC ,,,995.0,58140.0,64 MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,15 MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC ,,,995.0,36671.04,64 MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,15 MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC ,,,995.0,22857.0,64 MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,15 MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC ,,,995.0,27581.16,64 MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,15 MS-DRG,292,HEART FAILURE AND SHOCK WITH CC ,,,995.0,18239.92,64 MS-DRG,292,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,15 MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC ,,,995.0,16632.0,64 MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,15 MS-DRG,294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC ,,,15834.88,20428.59,5 MS-DRG,295,DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC ,,,12147.73,15671.79,5 MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC ",,,995.0,33555.86,64 MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,15 MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC ",,,995.0,13620.86,64 MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,15 MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC ",,,995.0,9777.37,64 MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,15 MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC ,,,995.0,35076.93,64 MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,15 MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC ,,,995.0,22934.17,64 MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,15 MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC ,,,995.0,15462.03,64 MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,15 MS-DRG,302,ATHEROSCLEROSIS WITH MCC ,,,995.0,25707.75,64 MS-DRG,302,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,15 MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC ,,,995.0,14463.03,64 MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,15 MS-DRG,304,HYPERTENSION WITH MCC ,,,995.0,25565.96,64 MS-DRG,304,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,15 MS-DRG,305,HYPERTENSION WITHOUT MCC ,,,995.0,16222.57,64 MS-DRG,305,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,15 MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC ,,,995.0,33854.49,64 MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,15 MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC ,,,995.0,19619.19,64 MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,15 MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC ,,,995.0,25866.74,64 MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,15 MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC ,,,995.0,15805.78,64 MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,15 MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC ,,,995.0,12162.09,64 MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,15 MS-DRG,311,ANGINA PECTORIS ,,,995.0,15079.62,64 MS-DRG,311,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,15 MS-DRG,312,SYNCOPE AND COLLAPSE ,,,995.0,18725.45,64 MS-DRG,312,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,15 MS-DRG,313,CHEST PAIN ,,,995.0,15468.48,64 MS-DRG,313,CHEST PAIN Pediatric,,,6181.92,7963.2,15 MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC ,,,995.0,44798.44,64 MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,15 MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC ,,,995.0,20695.54,64 MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,15 MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,995.0,14654.24,64 MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,15 MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION ,,,995.0,135983.35,59 MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,15 MS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE ,,,995.0,42620.0,68 MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC ,,,995.0,65765.29,64 MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,15 MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC ,,,995.0,36298.1,64 MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,15 MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A ,,,995.0,55332.91,71 MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,15 MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,995.0,41580.0,71 MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,15 MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC ,,,995.0,63768.57,71 MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,15 MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,995.0,46433.14,71 MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,15 MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE ,,,995.0,47308.45,71 MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,15 MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC ",,,995.0,80217.65,64 MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,15 MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC ",,,995.0,38698.76,64 MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,15 MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC ",,,995.0,25151.85,64 MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,15 MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC ,,,995.0,73727.87,64 MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,15 MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC ,,,995.0,38466.39,64 MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,15 MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC ,,,995.0,25809.73,64 MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,15 MS-DRG,332,RECTAL RESECTION WITH MCC ,,,995.0,70271.09,64 MS-DRG,332,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,15 MS-DRG,333,RECTAL RESECTION WITH CC ,,,995.0,61438.25,64 MS-DRG,333,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,15 MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC ,,,995.0,27162.82,64 MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,15 MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC ,,,995.0,59050.8,64 MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,15 MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC ,,,995.0,34573.43,64 MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,15 MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC ,,,995.0,24705.22,64 MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,15 MS-DRG,338,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC ,,,28171.61,42208.46,5 MS-DRG,339,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC ,,,17094.52,25612.07,5 MS-DRG,340,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,12370.21,18533.82,5 MS-DRG,341,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC ,,,23388.89,35042.69,5 MS-DRG,342,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC ,,,14430.74,21621.03,5 MS-DRG,343,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,11164.71,16727.67,5 MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC ,,,995.0,42526.84,64 MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,15 MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC ,,,995.0,23822.51,64 MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,15 MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC ,,,995.0,19244.51,64 MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,15 MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC ,,,995.0,37189.86,64 MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,15 MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC ,,,995.0,20341.48,64 MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,15 MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC ,,,995.0,14776.66,64 MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,15 MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC ,,,995.0,37040.48,64 MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,15 MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC ,,,995.0,22523.35,64 MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,15 MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC ,,,995.0,17208.7,64 MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,15 MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC ,,,995.0,45642.72,64 MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,15 MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC ,,,995.0,26930.85,64 MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,15 MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC ,,,995.0,20524.06,64 MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,15 MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC ,,,995.0,65000.39,64 MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,15 MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC ,,,995.0,34268.57,64 MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,15 MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,20599.45,64 MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,15 MS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC ,,,995.0,50671.21,68 MS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,995.0,42620.0,68 MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC ,,,995.0,34200.38,64 MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,15 MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC ,,,995.0,21488.3,64 MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,15 MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC ,,,995.0,15055.99,64 MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,15 MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC ,,,995.0,38093.28,64 MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,15 MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC ,,,995.0,21935.16,64 MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,15 MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC ,,,995.0,15627.46,64 MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,15 MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC ,,,995.0,56100.24,64 MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,15 MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC ,,,995.0,31729.02,64 MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,15 MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC ,,,995.0,24245.31,64 MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,15 MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC ,,,995.0,39272.75,64 MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,15 MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC ,,,995.0,21069.36,64 MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,15 MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC ,,,995.0,13543.51,64 MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,15 MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC ,,,995.0,42155.9,64 MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,15 MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC ,,,995.0,23277.91,64 MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,15 MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC ,,,995.0,17200.09,64 MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,15 MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC ,,,995.0,29662.96,64 MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,15 MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC ,,,995.0,18364.52,64 MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,15 MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC ,,,995.0,33994.13,64 MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,15 MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC ,,,995.0,20974.83,64 MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,15 MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC ,,,995.0,14637.05,64 MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,15 MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC ,,,995.0,31727.57,64 MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,15 MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC ,,,995.0,16968.06,64 MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,15 MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC ,,,995.0,11687.3,64 MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,15 MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC ",,,995.0,27248.16,64 MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,15 MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC ",,,995.0,16748.93,66 MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,15 MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC ,,,995.0,34359.36,64 MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,15 MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC ,,,995.0,20102.58,64 MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,15 MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,995.0,13943.12,64 MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,15 MS-DRG,397,APPENDIX PROCEDURES WITH MCC ,,,995.0,35291.25,59 MS-DRG,397,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,15 MS-DRG,398,APPENDIX PROCEDURES WITH CC ,,,995.0,22304.41,59 MS-DRG,398,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,15 MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC ,,,995.0,16868.3,59 MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,15 MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL ,,,995.0,93504.77,71 MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,15 MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC ",,,995.0,86574.65,64 MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,15 MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC ",,,995.0,43469.9,64 MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,15 MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC ",,,995.0,32708.03,64 MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,15 MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,995.0,56627.51,64 MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,30614.24,39435.54,15 MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,995.0,32084.69,64 MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,18694.3,24080.94,15 MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,995.0,23664.08,64 MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,17559.96,15 MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC ,,,995.0,56636.56,64 MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,15 MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC ,,,995.0,34365.2,64 MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,15 MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC ,,,995.0,26117.55,64 MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,15 MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC ,,,995.0,54747.42,64 MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,15 MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC ,,,995.0,30656.32,64 MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,15 MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC ,,,995.0,21461.08,64 MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,15 MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC ,,,995.0,36580.26,64 MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,15 MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC ,,,995.0,25485.32,64 MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,15 MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC ,,,995.0,20126.43,64 MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,15 MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC ,,,995.0,53060.47,64 MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,15 MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC ,,,995.0,28782.27,64 MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,15 MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC ,,,995.0,21933.37,64 MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,15 MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC ,,,995.0,63161.05,64 MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,15 MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC ,,,995.0,34464.78,64 MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,15 MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,23277.8,64 MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,15 MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,995.0,256320.05,71 MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,94628.02,121894.47,15 MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,995.0,167882.98,71 MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,61978.9,79837.72,15 MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,995.0,130750.85,71 MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,62179.32,15 MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC ,,,995.0,209536.27,71 MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,15 MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC ,,,995.0,134125.44,71 MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,15 MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC ,,,995.0,42284.81,64 MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,15 MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC ,,,995.0,22691.4,64 MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,15 MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC ,,,995.0,15307.35,64 MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,15 MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC ,,,995.0,48178.48,64 MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,15 MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC ,,,995.0,29669.88,64 MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,15 MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC ,,,995.0,18332.3,64 MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,15 MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC ,,,995.0,35023.22,64 MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,15 MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC ,,,995.0,18072.34,64 MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,15 MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC ,,,995.0,13350.16,64 MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,15 MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC ",,,995.0,38557.33,64 MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,15 MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC ",,,995.0,20738.51,64 MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,15 MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C ",,,995.0,15032.35,64 MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,15 MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC ,,,995.0,35897.62,64 MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,15 MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC ,,,995.0,23512.09,64 MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,15 MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC ,,,995.0,17773.71,64 MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,15 MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL ,,,995.0,155393.97,71 MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,15 MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC ,,,995.0,98628.29,71 MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,15 MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY ,,,995.0,123950.51,71 MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,15 MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC ,,,995.0,75129.41,71 MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,15 MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,995.0,195437.87,76 MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,72151.59,92941.6,15 MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,995.0,138683.82,76 MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,51199.18,65951.89,15 MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,995.0,99851.54,76 MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,46148.96,15 MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC ,,,995.0,135655.93,76 MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,15 MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC ,,,995.0,68451.11,76 MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,15 MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,995.0,88358.0,64 MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,48935.91,63036.47,15 MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,995.0,83160.0,64 MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,26742.81,34448.58,15 MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,995.0,83160.0,64 MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,20170.12,15 MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC ,,,995.0,127855.03,76 MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,15 MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC ,,,995.0,86620.35,76 MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,15 MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC ,,,995.0,67496.38,76 MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,15 MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC ,,,995.0,74501.46,76 MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,15 MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT ,,,995.0,47377.64,76 MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,15 MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC ,,,995.0,112301.08,76 MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,15 MS-DRG,472,CERVICAL SPINAL FUSION WITH CC ,,,995.0,68517.45,76 MS-DRG,472,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,15 MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC ,,,995.0,56777.31,76 MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,15 MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC ,,,995.0,63260.17,64 MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,15 MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC ,,,995.0,33534.72,64 MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,15 MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC ,,,995.0,17507.77,64 MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,15 MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ,,,995.0,50906.99,64 MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,15 MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC ,,,995.0,36238.77,64 MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,15 MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC ,,,995.0,27392.75,64 MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,15 MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC ,,,995.0,71531.91,64 MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,15 MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC ,,,995.0,51445.11,64 MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,15 MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC ,,,995.0,40060.62,64 MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,15 MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES ,,,995.0,68083.41,64 MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,15 MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC ,,,995.0,79264.03,64 MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,15 MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC ,,,995.0,51361.6,64 MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,15 MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC ,,,995.0,29106.0,64 MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,15 MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC ,,,995.0,43447.72,64 MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,15 MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC ,,,995.0,27430.84,64 MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,15 MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC ",,,995.0,54104.7,76 MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,15 MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC ",,,995.0,37371.97,76 MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,15 MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC ",,,995.0,29567.78,76 MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,15 MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,995.0,54952.63,64 MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,31130.26,40100.24,15 MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,995.0,29972.79,64 MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,15488.29,19951.13,15 MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,995.0,22869.0,64 MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,13363.8,15 MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC ,,,995.0,44455.56,64 MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,15 MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT ,,,995.0,29690.09,64 MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,15 MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC ,,,995.0,48126.37,64 MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,15 MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC ,,,995.0,26467.61,64 MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,15 MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC ,,,995.0,20110.62,64 MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,15 MS-DRG,503,FOOT PROCEDURES WITH MCC ,,,995.0,41129.65,64 MS-DRG,503,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,15 MS-DRG,504,FOOT PROCEDURES WITH CC ,,,995.0,27544.53,64 MS-DRG,504,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,15 MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC ,,,995.0,26782.97,64 MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,15 MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES ,,,995.0,22386.04,64 MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,15 MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC ,,,995.0,44368.8,64 MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,15 MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC ,,,995.0,37196.69,64 MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,15 MS-DRG,509,ARTHROSCOPY ,,,16984.74,25447.6,5 MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC ",,,995.0,74189.52,64 MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,15 MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC ",,,995.0,51074.22,64 MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,15 MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ ",,,995.0,40659.93,64 MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,15 MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC ",,,995.0,23719.91,64 MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,15 MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC ",,,995.0,15075.42,64 MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,15 MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC ,,,995.0,47388.51,64 MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,15 MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC ,,,995.0,38462.0,64 MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,15 MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC ,,,995.0,36383.0,64 MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,15 MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST ,,,995.0,71522.79,76 MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,15 MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC ,,,995.0,29574.44,76 MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,15 MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC ,,,995.0,22014.11,76 MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,15 MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC ,,,995.0,70497.85,64 MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,15 MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC ,,,995.0,52014.95,64 MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,15 MS-DRG,533,FRACTURES OF FEMUR WITH MCC ,,,995.0,33680.47,64 MS-DRG,533,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,15 MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC ,,,995.0,17318.25,64 MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,15 MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC ,,,995.0,27542.49,64 MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,15 MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC ,,,995.0,17350.48,64 MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,15 MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC ",,,995.0,20502.18,64 MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,15 MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC ",,,995.0,15474.93,64 MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,15 MS-DRG,539,OSTEOMYELITIS WITH MCC ,,,995.0,42317.03,64 MS-DRG,539,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,15 MS-DRG,540,OSTEOMYELITIS WITH CC ,,,995.0,27849.71,64 MS-DRG,540,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,15 MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC ,,,995.0,16916.5,64 MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,15 MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,995.0,37951.49,64 MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,15167.17,19537.49,15 MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,995.0,22085.55,64 MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,8826.41,11369.68,15 MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,995.0,16211.83,64 MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,8345.88,15 MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC ,,,995.0,53316.84,64 MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,15 MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC ,,,995.0,24779.65,64 MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,15 MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC ,,,995.0,17964.92,64 MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,15 MS-DRG,548,SEPTIC ARTHRITIS WITH MCC ,,,995.0,41483.46,64 MS-DRG,548,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,15 MS-DRG,549,SEPTIC ARTHRITIS WITH CC ,,,995.0,25935.48,64 MS-DRG,549,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,15 MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC ,,,995.0,18779.16,64 MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,15 MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC ,,,995.0,36009.33,64 MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,15 MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC ,,,995.0,20652.57,64 MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,15 MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC ,,,995.0,27849.71,64 MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,15 MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC ,,,995.0,17833.87,64 MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,15 MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ,,,995.0,28397.55,64 MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,15 MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC ,,,995.0,17844.61,64 MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,15 MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC ",,,995.0,31944.56,64 MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,15 MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC ",,,995.0,19189.51,64 MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,15 MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ",,,995.0,40065.51,64 MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,15 MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC ",,,995.0,24193.13,64 MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,15 MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC ",,,995.0,17270.99,64 MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,15 MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT ",,,995.0,30610.4,64 MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,12233.33,15758.29,15 MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT ",,,995.0,19238.92,64 MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,9904.23,15 MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC ,,,995.0,33162.7,64 MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,15 MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC ,,,995.0,20934.01,64 MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,15 MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC ,,,995.0,16097.96,64 MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,15 MS-DRG,570,SKIN DEBRIDEMENT WITH MCC ,,,995.0,43340.05,64 MS-DRG,570,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,15 MS-DRG,571,SKIN DEBRIDEMENT WITH CC ,,,995.0,24896.47,64 MS-DRG,571,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,15 MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC ,,,995.0,16891.88,64 MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,15 MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC ,,,995.0,96541.43,64 MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,15 MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC ,,,995.0,51154.55,64 MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,15 MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ,,,995.0,26604.92,64 MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,15 MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC ,,,995.0,76406.17,64 MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,15 MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC ,,,995.0,39060.72,64 MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,15 MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ,,,995.0,24069.97,64 MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,15 MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC ",,,995.0,47722.54,64 MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,15 MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC ",,,995.0,26085.86,64 MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,15 MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC ",,,995.0,21265.52,64 MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,15 MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC ,,,995.0,50536.64,64 MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,15 MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC ,,,995.0,45232.74,64 MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,15 MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC ",,,995.0,31545.36,64 MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,15 MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC ",,,995.0,28427.22,64 MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,15 MS-DRG,592,SKIN ULCERS WITH MCC ,,,995.0,41577.99,64 MS-DRG,592,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,15 MS-DRG,593,SKIN ULCERS WITH CC ,,,995.0,25486.47,64 MS-DRG,593,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,15 MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC ,,,995.0,18622.33,64 MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,15 MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC ,,,995.0,45561.12,64 MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,15 MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC ,,,995.0,23256.43,64 MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,15 MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC ,,,995.0,35815.98,64 MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,15 MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC ,,,995.0,29675.13,64 MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,15 MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC ,,,995.0,16529.79,64 MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,15 MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC ,,,995.0,22377.73,64 MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,15 MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC ,,,995.0,12997.82,64 MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,15 MS-DRG,602,CELLULITIS WITH MCC ,,,995.0,30535.21,64 MS-DRG,602,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,15 MS-DRG,603,CELLULITIS WITHOUT MCC ,,,995.0,18710.42,66 MS-DRG,603,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,15 MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC ",,,995.0,31626.6,64 MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,15 MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC ",,,995.0,19679.34,64 MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,15 MS-DRG,606,MINOR SKIN DISORDERS WITH MCC ,,,995.0,32509.59,64 MS-DRG,606,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,15 MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC ,,,995.0,19473.1,64 MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,15 MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC ,,,995.0,36058.18,64 MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,15 MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC ,,,995.0,23765.17,64 MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,15 MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,995.0,59845.99,64 MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,29942.82,38570.64,15 MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,995.0,30627.65,64 MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,16058.4,20685.52,15 MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,995.0,20900.07,64 MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,15686.4,15 MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,995.0,91724.04,1516 MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,15 MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC ,,,995.0,50836.73,1516 MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,15 MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,995.0,47917.34,1516 MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,15 MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,995.0,54545.23,64 MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,30559.29,39364.75,15 MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,995.0,28239.06,64 MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,15402.43,19840.53,15 MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,995.0,18448.0,64 MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,13846.01,15 MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC ",,,995.0,44504.19,64 MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,15 MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC ",,,995.0,24940.61,64 MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,15 MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC ",,,995.0,19573.83,64 MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,15 MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC ",,,995.0,55518.47,64 MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,15 MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC ",,,995.0,35388.23,64 MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,15 MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC ",,,995.0,21507.19,64 MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,15 MS-DRG,637,DIABETES WITH MCC ,,,995.0,30866.06,64 MS-DRG,637,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,15 MS-DRG,638,DIABETES WITH CC ,,,995.0,19253.96,64 MS-DRG,638,DIABETES WITH CC Pediatric,,,7694.77,9911.97,15 MS-DRG,639,DIABETES WITHOUT CC/MCC ,,,995.0,13345.86,64 MS-DRG,639,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,15 MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M ",,,995.0,28694.03,64 MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,15 MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU ",,,995.0,16718.85,64 MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,15 MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM ,,,995.0,30552.4,64 MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,15 MS-DRG,643,ENDOCRINE DISORDERS WITH MCC ,,,995.0,35364.81,64 MS-DRG,643,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,15 MS-DRG,644,ENDOCRINE DISORDERS WITH CC ,,,995.0,22021.1,64 MS-DRG,644,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,15 MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC ,,,995.0,16506.16,64 MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,15 MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC ,,,1275.0,245466.0,59 MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC ,,,1275.0,245466.0,59 MS-DRG,652,KIDNEY TRANSPLANT ,,,995.0,245466.0,55 MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC ,,,995.0,82373.87,64 MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,15 MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC ,,,995.0,43800.35,64 MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,15 MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC ,,,995.0,31389.65,64 MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,15 MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC ,,,995.0,55470.51,64 MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,15 MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC ,,,995.0,48002.73,64 MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,15 MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC ,,,995.0,40705.27,64 MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,15 MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC ,,,995.0,53015.0,64 MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,15 MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC ,,,995.0,28067.0,64 MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,15 MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC ,,,995.0,20790.0,64 MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,15 MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC ,,,995.0,45114.26,64 MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,15 MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC ,,,995.0,24134.86,64 MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,15 MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC ,,,995.0,17862.36,64 MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,15 MS-DRG,665,PROSTATECTOMY WITH MCC ,,,995.0,45994.0,64 MS-DRG,665,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,15 MS-DRG,666,PROSTATECTOMY WITH CC ,,,995.0,26250.33,64 MS-DRG,666,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,15 MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC ,,,995.0,16300.96,64 MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,15 MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC ,,,995.0,43029.12,64 MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,15 MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC ,,,995.0,23591.65,64 MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,15 MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC ,,,995.0,14764.59,64 MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,15 MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC ,,,995.0,26878.04,64 MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,15 MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC ,,,995.0,17358.39,64 MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,15 MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC ,,,995.0,61914.78,64 MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,15 MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC ,,,995.0,35960.1,64 MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,15 MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC ,,,995.0,26476.67,64 MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,15 MS-DRG,682,RENAL FAILURE WITH MCC ,,,995.0,31817.8,64 MS-DRG,682,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,15 MS-DRG,683,RENAL FAILURE WITH CC ,,,995.0,18815.69,66 MS-DRG,683,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,15 MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC ,,,995.0,12896.85,64 MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,15 MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC ,,,995.0,47312.85,64 MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,15 MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC ,,,995.0,27484.84,64 MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,15 MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC ,,,995.0,16978.81,64 MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,15 MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC ,,,995.0,28941.0,66 MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,15 MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC ,,,995.0,17391.3,66 MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,15 MS-DRG,693,URINARY STONES WITH MCC ,,,995.0,28885.24,88 MS-DRG,693,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,15 MS-DRG,694,URINARY STONES WITHOUT MCC ,,,995.0,16794.04,88 MS-DRG,694,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,15 MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC ,,,995.0,24573.4,64 MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,15 MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC ,,,995.0,14802.48,64 MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,15 MS-DRG,697,URETHRAL STRICTURE ,,,995.0,23155.46,64 MS-DRG,697,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,15 MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC ,,,995.0,40120.85,70 MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,15 MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC ,,,995.0,21806.26,64 MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,15 MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC ,,,995.0,14821.81,64 MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,15 MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC ,,,995.0,29476.42,64 MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,15 MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC ,,,995.0,22607.97,64 MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,15 MS-DRG,709,PENIS PROCEDURES WITH CC/MCC ,,,995.0,34944.62,64 MS-DRG,709,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,15 MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC ,,,995.0,24166.54,64 MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,15 MS-DRG,711,TESTES PROCEDURES WITH CC/MCC ,,,995.0,32163.71,64 MS-DRG,711,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,15 MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC ,,,995.0,16205.18,64 MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,15 MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC ,,,995.0,22533.91,64 MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,15 MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC ,,,995.0,15581.85,64 MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,15 MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC ,,,995.0,58686.62,64 MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,15 MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC ,,,995.0,21676.66,64 MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,15 MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC ,,,995.0,27858.41,64 MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,15 MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC ,,,995.0,19791.92,64 MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,15 MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC ",,,995.0,47470.24,64 MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,15 MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC ",,,995.0,24549.77,64 MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,15 MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ",,,995.0,14087.06,64 MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,15 MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC ,,,995.0,25140.58,64 MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,15 MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC ,,,995.0,15511.45,64 MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,15 MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC ,,,995.0,31858.62,64 MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,15 MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC ,,,995.0,17427.82,64 MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,15 MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC ,,,995.0,22745.11,64 MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,15 MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,995.0,14437.25,64 MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,15 MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC ",,,995.0,33562.46,64 MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,15 MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC ",,,995.0,21329.81,64 MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,15 MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC ,,,995.0,64289.7,64 MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,15 MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC ,,,995.0,31054.67,64 MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,15 MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC ,,,995.0,22269.86,64 MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,15 MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC ,,,995.0,57700.34,64 MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,15 MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC ,,,995.0,27184.34,64 MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,15 MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT ,,,995.0,21015.01,64 MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,15 MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC ,,,995.0,27037.61,64 MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,15 MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC ,,,995.0,18282.96,64 MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,15 MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC ",,,995.0,30195.54,64 MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,15 MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC ",,,995.0,17654.13,64 MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,15 MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC ",,,995.0,25597.91,64 MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,15 MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC ",,,995.0,14170.08,64 MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,15 MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,995.0,20790.0,64 MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,15 MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC ,,,995.0,40948.53,64 MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,15 MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,22087.28,64 MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,15 MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC ",,,995.0,48309.63,64 MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,15 MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC ",,,995.0,28534.08,64 MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,15 MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ",,,995.0,20635.38,64 MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,15 MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC ",,,995.0,30762.94,64 MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,15 MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC ",,,995.0,21032.84,64 MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,15 MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ",,,995.0,14256.78,64 MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,15 MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC ,,,995.0,21645.13,64 MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,15 MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC ,,,995.0,12256.62,64 MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,15 MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C ,,,995.0,13544.0,105 MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES ,,,995.0,24900.89,64 MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,15 MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,995.0,14775.79,64 MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,15 MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES ,,,995.0,14065.57,64 MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,15 MS-DRG,779,ABORTION WITHOUT D&C ,,,995.0,18074.49,64 MS-DRG,779,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,15 MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC ,,,995.0,28784.97,104 MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC ,,,995.0,17878.0,104 MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC ,,,995.0,17878.0,104 MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC ,,,995.0,20083.54,104 MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC ,,,995.0,17878.0,104 MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC ,,,995.0,17878.0,104 MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY ",,,995.0,71756.0,68 MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE ",,,995.0,76875.0,68 MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS ,,,995.0,71756.0,68 MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS ,,,995.0,21788.53,68 MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS ,,,995.0,35885.48,68 MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS ,,,609.0,13813.32,68 MS-DRG,795,NORMAL NEWBORN ,,,656.0,3356.95,54 MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC ,,,995.0,14871.97,104 MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC ,,,995.0,13544.0,104 MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC ,,,995.0,13544.0,104 MS-DRG,799,SPLENIC PROCEDURES WITH MCC ,,,995.0,77669.12,64 MS-DRG,799,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,15 MS-DRG,800,SPLENIC PROCEDURES WITH CC ,,,995.0,44571.4,64 MS-DRG,800,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,15 MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC ,,,995.0,28129.55,64 MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,15 MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC ,,,995.0,58709.7,64 MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,15 MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC ,,,995.0,28465.4,64 MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,15 MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC ,,,995.0,20610.07,64 MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,15 MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC ,,,995.0,13923.63,104 MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC ,,,995.0,13544.0,104 MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC ,,,995.0,13544.0,104 MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,995.0,47434.52,64 MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,18957.03,24419.37,15 MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,995.0,27196.6,64 MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,10869.02,14000.85,15 MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,995.0,22485.15,64 MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,11575.4,15 MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC ,,,995.0,30169.98,64 MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,15 MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC ,,,995.0,19726.61,64 MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,15 MS-DRG,813,COAGULATION DISORDERS ,,,995.0,32769.55,64 MS-DRG,813,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,15 MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC ,,,995.0,45690.02,64 MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,15 MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC ,,,995.0,21784.78,64 MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,15 MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC ,,,995.0,13577.89,64 MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,15 MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,995.0,34807.31,70 MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,15 MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,995.0,20518.02,70 MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,15 MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,14895.86,70 MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,15 MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC ,,,995.0,153839.57,64 MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,15 MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC ,,,995.0,58720.72,64 MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,15 MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,21132.83,64 MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,15 MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC ,,,995.0,120263.89,64 MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,15 MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC ,,,995.0,59428.95,64 MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,15 MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC ,,,995.0,23665.73,64 MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,15 MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,995.0,122703.37,64 MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,40163.59,51736.47,15 MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,995.0,60625.09,64 MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,19843.96,25561.87,15 MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,995.0,44692.38,64 MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,18844.03,15 MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE ,,,995.0,82889.96,64 MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,27131.76,34949.6,15 MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE ,,,995.0,25025.05,64 MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,16645.3,15 MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,995.0,25834.51,70 MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,15 MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,995.0,15502.85,70 MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,15 MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,11233.98,70 MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,15 MS-DRG,834,ACUTE LEUKEMIA WITH MCC ,,,995.0,144005.57,64 MS-DRG,834,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,15 MS-DRG,835,ACUTE LEUKEMIA WITH CC ,,,995.0,54712.62,64 MS-DRG,835,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,15 MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC ,,,995.0,31988.7,64 MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,15 MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT ,,,995.0,126021.59,64 MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,15 MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE ,,,995.0,54754.59,64 MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,15 MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC ,,,995.0,37874.94,64 MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,15 MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC ,,,995.0,84854.66,64 MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,15 MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC ,,,995.0,42793.25,64 MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,15 MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC ,,,995.0,26503.8,64 MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,15 MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,995.0,42856.28,64 MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,17127.35,22062.49,15 MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,995.0,31933.62,64 MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,10452.6,13464.44,15 MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,995.0,22338.32,64 MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,9418.7,15 MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC ,,,995.0,68003.87,64 MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,15 MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC ,,,995.0,34315.39,64 MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,15 MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC ,,,995.0,18248.51,64 MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,15 MS-DRG,849,RADIOTHERAPY ,,,995.0,58210.9,64 MS-DRG,849,RADIOTHERAPY Pediatric,,,23263.77,29967.07,15 MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES ,,,995.0,227147.34,59 MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,15 MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC ,,,995.0,74959.13,64 MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,15 MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC ,,,995.0,41476.56,70 MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,15 MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,22932.26,64 MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,15 MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC ,,,995.0,70373.59,64 MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,15 MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC ,,,995.0,31723.11,64 MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,15 MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,995.0,20525.77,64 MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,15 MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC ,,,995.0,39180.37,64 MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,15 MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC ,,,995.0,21438.88,64 MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,15 MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS ,,,995.0,19071.35,64 MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,15 MS-DRG,865,VIRAL ILLNESS WITH MCC ,,,995.0,32189.48,64 MS-DRG,865,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,15 MS-DRG,866,VIRAL ILLNESS WITHOUT MCC ,,,995.0,18682.49,64 MS-DRG,866,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,15 MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC ,,,995.0,44970.31,64 MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,15 MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC ,,,995.0,22152.15,64 MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,15 MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC ,,,995.0,15676.87,64 MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,15 MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS ,,,995.0,148493.11,64 MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,15 MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC ,,,995.0,40322.42,71 MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,15 MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC ,,,995.0,29469.0,73 MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,15 MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS ,,,995.0,56953.17,59 MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,15 MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION ,,,995.0,20628.94,59 MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,15 MS-DRG,881,DEPRESSIVE NEUROSES ,,,995.0,20214.3,59 MS-DRG,881,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,15 MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE ,,,995.0,23069.52,59 MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,15 MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL ,,,995.0,42243.99,59 MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,15 MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY ,,,995.0,34565.61,59 MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,15 MS-DRG,885,PSYCHOSES ,,,995.0,30008.85,59 MS-DRG,885,PSYCHOSES Pediatric,,,11992.92,15448.61,15 MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS ,,,995.0,44585.75,59 MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,15 MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES ,,,995.0,23007.22,59 MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,15 MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA ",,,931.0,13253.48,60 MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,15 MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY ",,,931.0,30412.75,60 MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,15 MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC ",,,931.0,37491.73,60 MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,15 MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC ",,,931.0,18966.08,60 MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,15 MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC ,,,995.0,64410.41,64 MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,15 MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC ,,,995.0,29639.32,64 MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,15 MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC ,,,995.0,17235.23,64 MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,15 MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC ,,,995.0,56236.7,64 MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,15 MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC ,,,995.0,24896.85,64 MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,15 MS-DRG,906,HAND PROCEDURES FOR INJURIES ,,,995.0,39945.15,64 MS-DRG,906,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,15 MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC ,,,995.0,59574.39,64 MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,15 MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC ,,,995.0,30938.49,64 MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,15 MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC ,,,995.0,20687.02,64 MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,15 MS-DRG,913,TRAUMATIC INJURY WITH MCC ,,,995.0,35117.75,64 MS-DRG,913,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,15 MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC ,,,995.0,19024.08,64 MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,15 MS-DRG,915,ALLERGIC REACTIONS WITH MCC ,,,995.0,36127.49,64 MS-DRG,915,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,15 MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC ,,,995.0,14314.79,64 MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,15 MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC ,,,995.0,33695.51,64 MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,15 MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC ,,,995.0,18413.94,64 MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,15 MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC ,,,995.0,39332.91,64 MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,15 MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC ,,,995.0,21533.41,64 MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,15 MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC ,,,995.0,14789.59,64 MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,15 MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC ",,,995.0,37584.11,64 MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,15 MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC ",,,995.0,21864.27,64 MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,15 MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT ,,,995.0,314620.97,57 MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,15 MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC ,,,995.0,105696.91,57 MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,15 MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC ,,,995.0,47461.71,57 MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,15 MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT ,,,995.0,57384.93,57 MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,15 MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY ,,,995.0,32575.4,57 MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,15 MS-DRG,935,NON-EXTENSIVE BURNS ,,,995.0,30356.16,57 MS-DRG,935,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,15 MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC ,,,995.0,53469.58,64 MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,15 MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC ,,,995.0,34436.56,64 MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,15 MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ ,,,995.0,29880.19,64 MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,15 MS-DRG,945,REHABILITATION WITH CC/MCC ,,,995.0,22820.17,76 MS-DRG,946,REHABILITATION WITHOUT CC/MCC ,,,995.0,16899.24,76 MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC ,,,995.0,27271.79,64 MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,15 MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC ,,,995.0,17197.94,64 MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,15 MS-DRG,949,AFTERCARE WITH CC/MCC ,,,995.0,25559.51,64 MS-DRG,949,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,15 MS-DRG,950,AFTERCARE WITHOUT CC/MCC ,,,995.0,13485.51,64 MS-DRG,950,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,15 MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS ,,,995.0,11945.1,64 MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,15 MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,995.0,99189.49,64 MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,15 MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ",,,995.0,83891.5,64 MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,15 MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC ,,,995.0,112286.85,64 MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,15 MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC ,,,995.0,63459.81,64 MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,15 MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC ,,,995.0,43384.26,64 MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,15 MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC ,,,995.0,58732.96,64 MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,15 MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC ,,,995.0,32926.38,64 MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,15 MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC ,,,995.0,20205.7,64 MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,15 MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC ,,,995.0,90203.48,64 MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,15 MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC ,,,995.0,45096.49,64 MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,15 MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC ,,,995.0,62002.82,64 MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,15 MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC ,,,995.0,27821.78,64 MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,15 MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC ,,,995.0,19393.61,64 MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,15 MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION ,,,995.0,27879.79,64 MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,15 MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC ,,,995.0,69628.19,64 MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,15 MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ,,,995.0,38274.76,64 MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,15 MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,995.0,25257.5,64 MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,15 MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC ,,,995.0,50520.9,64 MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,15 MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ,,,995.0,25747.87,64 MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,15 MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,995.0,17671.41,64 MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,15 MS-DRG,998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS ,,,995.0,2423.35,45 MS-DRG,999,UNGROUPABLE ,,,995.0,2423.35,45 RC,100, All-inclusive room and board plus ancillary ,,,3705.0,5543.0,12 RC,1001, Behavioral Health Accommodations Residential - Psychiatric ,,,200.0,200.0,1 RC,101, All-inclusive room and board ,,,3705.0,5543.0,12 RC,110, Room & Board - Private (One Bed) General Classification ,,,3705.0,5543.0,12 RC,111, Room & Board - Private (One Bed) Medical/Surgical/GYN ,,,3705.0,5543.0,12 RC,112, Room & Board - Private (One Bed) Obstetrics (OB) ,,,3705.0,5543.0,12 RC,113, Room & Board - Private (One Bed) Pediatric ,,,3705.0,5543.0,12 RC,113,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,3 RC,113,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,3 RC,113,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,3 RC,113,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,3 RC,113,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,3 RC,113,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,3 RC,113,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,3 RC,113,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,3 RC,113,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,3 RC,113,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,3 RC,113,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC Pediatric,,,9988.09,12866.1,3 RC,113,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Pediatric,,,6746.88,8690.95,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,3 RC,113,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,3 RC,113,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,3 RC,113,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,3 RC,113,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,3 RC,113,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,3 RC,113,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,3 RC,113,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,3 RC,113,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,3 RC,113,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,3 RC,113,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,3 RC,113,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,3 RC,113,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,3 RC,113,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,3 RC,113,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,3 RC,113,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,3 RC,113,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,3 RC,113,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,3 RC,113,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,3 RC,113,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,3 RC,113,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,3 RC,113,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,3 RC,113,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,3 RC,113,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,38570.64,9 RC,113,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,3 RC,113,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,3 RC,113,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,3 RC,113,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,3 RC,113,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,3 RC,113,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,3 RC,113,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,3 RC,113,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,3 RC,113,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,3 RC,113,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,3 RC,113,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,3 RC,113,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,3 RC,113,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,3 RC,113,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,3 RC,113,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,3 RC,113,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,3 RC,113,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,3 RC,113,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,3 RC,113,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,3 RC,113,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,39435.54,9 RC,113,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,3 RC,113,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,3 RC,113,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,3 RC,113,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,3 RC,113,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,3 RC,113,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,3 RC,113,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,3 RC,113,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,3 RC,113,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,3 RC,113,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,3 RC,113,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,3 RC,113,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,3 RC,113,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,3 RC,113,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,3 RC,113,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,3 RC,113,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,3 RC,113,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,3 RC,113,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,3 RC,113,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,3 RC,113,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,3 RC,113,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,3 RC,113,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,3 RC,113,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,3 RC,113,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,3 RC,113,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,3 RC,113,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,108197.77,9 RC,113,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,84922.0,9 RC,113,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,3 RC,113,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,3 RC,113,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,3 RC,113,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,3 RC,113,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,3 RC,113,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,3 RC,113,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,3 RC,113,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,3 RC,113,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,3 RC,113,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,3 RC,113,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,3 RC,113,CHEST PAIN Pediatric,,,6181.92,7963.2,3 RC,113,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,3 RC,113,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,3 RC,113,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,3 RC,113,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,3 RC,113,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,3 RC,113,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,3 RC,113,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,3 RC,113,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,3 RC,113,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,3 RC,113,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,3 RC,113,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,3 RC,113,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,3 RC,113,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,3 RC,113,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,3 RC,113,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,3 RC,113,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,3 RC,113,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,3 RC,113,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,3 RC,113,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,3 RC,113,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,3 RC,113,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,3 RC,113,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,3 RC,113,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,3 RC,113,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,3 RC,113,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,3 RC,113,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,3 RC,113,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,3 RC,113,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,3 RC,113,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,3 RC,113,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,3 RC,113,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,3 RC,113,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,3 RC,113,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,3 RC,113,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,3 RC,113,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,3 RC,113,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,3 RC,113,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,3 RC,113,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,3 RC,113,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,3 RC,113,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,3 RC,113,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,3 RC,113,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,3 RC,113,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,3 RC,113,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,3 RC,113,DIABETES WITH CC Pediatric,,,7694.77,9911.97,3 RC,113,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,3 RC,113,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,3 RC,113,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,3 RC,113,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,3 RC,113,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,3 RC,113,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,3 RC,113,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,3 RC,113,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,3 RC,113,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,3 RC,113,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,3 RC,113,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,3 RC,113,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,3 RC,113,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,3 RC,113,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,3 RC,113,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,3 RC,113,DYSEQUILIBRIUM Pediatric,,,6453.24,8312.7,3 RC,113,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric",,,10917.1,14062.79,3 RC,113,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric",,,18180.0,23418.44,3 RC,113,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric",,,6843.9,8815.93,3 RC,113,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,3 RC,113,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,3 RC,113,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,3 RC,113,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,3 RC,113,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,3 RC,113,EPISTAXIS WITH MCC Pediatric,,,11432.26,14726.39,3 RC,113,EPISTAXIS WITHOUT MCC Pediatric,,,6302.12,8118.04,3 RC,113,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,3 RC,113,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,3 RC,113,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,3 RC,113,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,3 RC,113,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,3 RC,113,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,3 RC,113,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,3 RC,113,EXTRAOCULAR PROCEDURES EXCEPT ORBIT Pediatric,,,13178.65,16975.99,3 RC,113,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,3 RC,113,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,3 RC,113,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,3 RC,113,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,3 RC,113,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,3 RC,113,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,15758.29,6 RC,113,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,3 RC,113,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,3 RC,113,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,3 RC,113,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,3 RC,113,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,3 RC,113,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,3 RC,113,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,3 RC,113,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,3 RC,113,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,3 RC,113,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,3 RC,113,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,3 RC,113,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,3 RC,113,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,3 RC,113,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,3 RC,113,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,3 RC,113,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,3 RC,113,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,3 RC,113,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,3 RC,113,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,3 RC,113,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,3 RC,113,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,3 RC,113,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,3 RC,113,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,3 RC,113,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,3 RC,113,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,3 RC,113,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,3 RC,113,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,3 RC,113,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,3 RC,113,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,3 RC,113,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,3 RC,113,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,3 RC,113,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,3 RC,113,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,3 RC,113,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,3 RC,113,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,3 RC,113,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,3 RC,113,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,3 RC,113,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,3 RC,113,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,3 RC,113,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,3 RC,113,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,3 RC,113,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,3 RC,113,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,3 RC,113,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,3 RC,113,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,3 RC,113,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,3 RC,113,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,3 RC,113,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,3 RC,113,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,3 RC,113,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,3 RC,113,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,3 RC,113,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,3 RC,113,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,3 RC,113,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,3 RC,113,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,3 RC,113,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,3 RC,113,INTRAOCULAR PROCEDURES WITH CC/MCC Pediatric,,,15524.35,19997.59,3 RC,113,INTRAOCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,9314.95,11998.99,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,3 RC,113,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,3 RC,113,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,3 RC,113,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,3 RC,113,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,3 RC,113,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,3 RC,113,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,3 RC,113,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,3 RC,113,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,3 RC,113,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,3 RC,113,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,3 RC,113,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,3 RC,113,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,3 RC,113,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,3 RC,113,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,3 RC,113,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,3 RC,113,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,3 RC,113,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,3 RC,113,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,40100.24,9 RC,113,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,3 RC,113,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,3 RC,113,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,3 RC,113,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,3 RC,113,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,3 RC,113,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,3 RC,113,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,3 RC,113,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,3 RC,113,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,3 RC,113,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,3 RC,113,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,3 RC,113,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,3 RC,113,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,3 RC,113,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,3 RC,113,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,3 RC,113,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,3 RC,113,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,3 RC,113,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,3 RC,113,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,3 RC,113,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,3 RC,113,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,3 RC,113,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,3 RC,113,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,3 RC,113,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,3 RC,113,MAJOR HEAD AND NECK PROCEDURES WITH CC Pediatric,,,18726.92,24122.97,3 RC,113,MAJOR HEAD AND NECK PROCEDURES WITH MCC Pediatric,,,36621.87,47174.22,3 RC,113,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC Pediatric,,,13706.69,17656.18,3 RC,113,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,24419.37,9 RC,113,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,3 RC,113,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,3 RC,113,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,3 RC,113,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,3 RC,113,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,3 RC,113,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,3 RC,113,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,3 RC,113,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,3 RC,113,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,3 RC,113,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,3 RC,113,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,3 RC,113,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,3 RC,113,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,3 RC,113,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,3 RC,113,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,3 RC,113,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,3 RC,113,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,3 RC,113,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,3 RC,113,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,3 RC,113,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,3 RC,113,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,3 RC,113,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,3 RC,113,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,3 RC,113,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,3 RC,113,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,3 RC,113,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,3 RC,113,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,3 RC,113,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,3 RC,113,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,3 RC,113,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,3 RC,113,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,3 RC,113,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,3 RC,113,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,3 RC,113,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,3 RC,113,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,3 RC,113,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,3 RC,113,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,3 RC,113,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,3 RC,113,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,3 RC,113,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,3 RC,113,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,3 RC,113,MOUTH PROCEDURES WITH CC/MCC Pediatric,,,12820.62,16514.79,3 RC,113,MOUTH PROCEDURES WITHOUT CC/MCC Pediatric,,,7608.91,9801.37,3 RC,113,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,121894.47,9 RC,113,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,3 RC,113,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,3 RC,113,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,51736.47,9 RC,113,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,34949.6,6 RC,113,NEUROLOGICAL EYE DISORDERS Pediatric,,,6856.78,8832.52,3 RC,113,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,3 RC,113,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,3 RC,113,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,3 RC,113,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,3 RC,113,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,3 RC,113,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,3 RC,113,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,3 RC,113,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,3 RC,113,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,3 RC,113,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,3 RC,113,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,3 RC,113,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,3 RC,113,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,3 RC,113,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,3 RC,113,ORBITAL PROCEDURES WITHOUT CC/MCC Pediatric,,,11616.86,14964.18,3 RC,113,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,3 RC,113,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,3 RC,113,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,3 RC,113,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,3 RC,113,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,3 RC,113,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,3 RC,113,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,3 RC,113,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,3 RC,113,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,3 RC,113,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,3 RC,113,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,3 RC,113,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,3 RC,113,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,3 RC,113,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,3 RC,113,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,3 RC,113,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,3 RC,113,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,3 RC,113,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT Pediatric,,,11360.14,14633.49,3 RC,113,OTHER DISORDERS OF THE EYE WITHOUT MCC Pediatric,,,6592.33,8491.87,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC Pediatric",,,14878.68,19165.87,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC Pediatric",,,32168.31,41437.4,3 RC,113,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,10322.95,13297.44,3 RC,113,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,3 RC,113,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,3 RC,113,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,3 RC,113,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,3 RC,113,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,3 RC,113,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,3 RC,113,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,3 RC,113,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,3 RC,113,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,3 RC,113,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,3 RC,113,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,3 RC,113,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,3 RC,113,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,3 RC,113,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,3 RC,113,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,3 RC,113,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,3 RC,113,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,3 RC,113,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,3 RC,113,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,3 RC,113,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,3 RC,113,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,3 RC,113,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,3 RC,113,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,3 RC,113,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,3 RC,113,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,3 RC,113,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,3 RC,113,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,3 RC,113,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,3 RC,113,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,3 RC,113,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,3 RC,113,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,3 RC,113,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,3 RC,113,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,22062.49,9 RC,113,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,3 RC,113,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,3 RC,113,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,3 RC,113,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,3 RC,113,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,3 RC,113,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,3 RC,113,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,3 RC,113,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,3 RC,113,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,3 RC,113,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,3 RC,113,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,3 RC,113,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,3 RC,113,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,3 RC,113,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,3 RC,113,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,3 RC,113,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,3 RC,113,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,3 RC,113,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,3 RC,113,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,3 RC,113,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,3 RC,113,OTITIS MEDIA AND URI WITH MCC Pediatric,,,10150.37,13075.13,3 RC,113,OTITIS MEDIA AND URI WITHOUT MCC Pediatric,,,6338.19,8164.49,3 RC,113,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,3 RC,113,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,3 RC,113,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,3 RC,113,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,19537.49,9 RC,113,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,3 RC,113,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,3 RC,113,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,3 RC,113,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,3 RC,113,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,3 RC,113,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,3 RC,113,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,3 RC,113,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,3 RC,113,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,3 RC,113,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,3 RC,113,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,3 RC,113,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,3 RC,113,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,3 RC,113,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,3 RC,113,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,3 RC,113,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,3 RC,113,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,3 RC,113,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,3 RC,113,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,3 RC,113,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,3 RC,113,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,3 RC,113,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,3 RC,113,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,3 RC,113,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,3 RC,113,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,3 RC,113,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,3 RC,113,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,3 RC,113,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,3 RC,113,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,3 RC,113,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,3 RC,113,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,3 RC,113,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,3 RC,113,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,3 RC,113,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,3 RC,113,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,3 RC,113,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,3 RC,113,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,3 RC,113,PSYCHOSES Pediatric,,,11992.92,15448.61,3 RC,113,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,3 RC,113,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,3 RC,113,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,3 RC,113,RADIOTHERAPY Pediatric,,,23263.77,29967.07,3 RC,113,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,3 RC,113,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,3 RC,113,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,3 RC,113,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,3 RC,113,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,3 RC,113,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,3 RC,113,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,3 RC,113,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,3 RC,113,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,3 RC,113,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,3 RC,113,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,3 RC,113,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,3 RC,113,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,3 RC,113,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,3 RC,113,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,3 RC,113,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,3 RC,113,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,3 RC,113,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,3 RC,113,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,3 RC,113,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,3 RC,113,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,3 RC,113,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,3 RC,113,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,3 RC,113,SALIVARY GLAND PROCEDURES Pediatric,,,10609.72,13666.84,3 RC,113,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,3 RC,113,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,3 RC,113,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,3 RC,113,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,3 RC,113,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,3 RC,113,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,3 RC,113,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,3 RC,113,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,3 RC,113,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,3 RC,113,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,3 RC,113,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,3 RC,113,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,3 RC,113,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,3 RC,113,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,3 RC,113,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,3 RC,113,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,3 RC,113,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,3 RC,113,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,3 RC,113,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,3 RC,113,SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric,,,18631.62,24000.2,3 RC,113,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Pediatric,,,8717.37,11229.22,3 RC,113,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,3 RC,113,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,3 RC,113,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,3 RC,113,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,3 RC,113,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,3 RC,113,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,3 RC,113,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,3 RC,113,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,3 RC,113,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,3 RC,113,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,39364.75,9 RC,113,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,3 RC,113,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,3 RC,113,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,3 RC,113,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,3 RC,113,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,3 RC,113,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,3 RC,113,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,3 RC,113,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,3 RC,113,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,92941.6,9 RC,113,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,3 RC,113,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,3 RC,113,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,3 RC,113,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,3 RC,113,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,3 RC,113,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,3 RC,113,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,3 RC,113,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,3 RC,113,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,3 RC,113,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,3 RC,113,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,3 RC,113,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,3 RC,113,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,3 RC,113,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,3 RC,113,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,3 RC,113,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,3 RC,113,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,3 RC,113,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,3 RC,113,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,3 RC,113,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,3 RC,113,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,3 RC,113,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,3 RC,113,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,3 RC,113,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,3 RC,113,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,3 RC,113,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,61562.17,6 RC,113,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,3 RC,113,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,3 RC,113,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,3 RC,113,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,3 RC,113,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,3 RC,113,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,3 RC,113,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,3 RC,113,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,3 RC,113,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,3 RC,113,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,3 RC,113,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,3 RC,113,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,3 RC,113,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,3 RC,113,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,3 RC,113,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,3 RC,113,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,3 RC,113,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,3 RC,113,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,63036.47,9 RC,113,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,3 RC,113,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,3 RC,113,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,3 RC,114, Room & Board - Private (One Bed) Psychiatric ,,,525.0,2636.0,17 RC,115, Room & Board - Private (One Bed) Hospice ,,,1199.0,1711.0,2 RC,116, Room & Board - Private (One Bed) Detoxification ,,,450.0,2636.0,16 RC,117, Room & Board - Private (One Bed) Oncology ,,,3705.0,5543.0,12 RC,118, Room & Board - Private (One Bed) Rehabilitation ,,,600.0,2997.0,24 RC,118,REHABILITATION WITH CC/MCC ,,,1243.0,1243.0,3 RC,118,REHABILITATION WITHOUT CC/MCC ,,,1243.0,1243.0,3 RC,119, Room & Board - Private (One Bed) Other ,,,3705.0,5543.0,12 RC,120, Room & Board - Semi-private (Two Beds) General Classification ,,,3705.0,5543.0,12 RC,121, Room & Board - Semi-private (Two Beds) Medical/Surgical/GYN ,,,3705.0,5543.0,12 RC,122, Room & Board - Semi-private (Two Beds) Obstetrics (OB) ,,,3705.0,5543.0,12 RC,123, Room & Board - Semi-private (Two Beds) Pediatric ,,,3705.0,5543.0,12 RC,123,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,3 RC,123,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,3 RC,123,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,3 RC,123,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,3 RC,123,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,3 RC,123,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,3 RC,123,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,3 RC,123,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,3 RC,123,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,3 RC,123,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,3 RC,123,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,3 RC,123,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,3 RC,123,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,3 RC,123,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,3 RC,123,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,3 RC,123,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,3 RC,123,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,3 RC,123,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,3 RC,123,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,3 RC,123,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,3 RC,123,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,3 RC,123,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,3 RC,123,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,3 RC,123,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,3 RC,123,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,3 RC,123,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,3 RC,123,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,3 RC,123,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,3 RC,123,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,3 RC,123,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,3 RC,123,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,3 RC,123,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,3 RC,123,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,38570.64,9 RC,123,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,3 RC,123,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,3 RC,123,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,3 RC,123,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,3 RC,123,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,3 RC,123,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,3 RC,123,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,3 RC,123,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,3 RC,123,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,3 RC,123,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,3 RC,123,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,3 RC,123,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,3 RC,123,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,3 RC,123,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,3 RC,123,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,3 RC,123,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,3 RC,123,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,3 RC,123,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,3 RC,123,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,3 RC,123,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,39435.54,9 RC,123,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,3 RC,123,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,3 RC,123,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,3 RC,123,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,3 RC,123,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,3 RC,123,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,3 RC,123,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,3 RC,123,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,3 RC,123,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,3 RC,123,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,3 RC,123,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,3 RC,123,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,3 RC,123,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,3 RC,123,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,3 RC,123,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,3 RC,123,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,3 RC,123,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,3 RC,123,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,3 RC,123,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,3 RC,123,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,3 RC,123,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,3 RC,123,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,3 RC,123,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,3 RC,123,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,3 RC,123,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,3 RC,123,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,108197.77,9 RC,123,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,84922.0,9 RC,123,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,3 RC,123,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,3 RC,123,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,3 RC,123,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,3 RC,123,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,3 RC,123,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,3 RC,123,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,3 RC,123,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,3 RC,123,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,3 RC,123,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,3 RC,123,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,3 RC,123,CHEST PAIN Pediatric,,,6181.92,7963.2,3 RC,123,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,3 RC,123,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,3 RC,123,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,3 RC,123,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,3 RC,123,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,3 RC,123,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,3 RC,123,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,3 RC,123,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,3 RC,123,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,3 RC,123,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,3 RC,123,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,3 RC,123,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,3 RC,123,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,3 RC,123,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,3 RC,123,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,3 RC,123,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,3 RC,123,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,3 RC,123,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,3 RC,123,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,3 RC,123,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,3 RC,123,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,3 RC,123,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,3 RC,123,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,3 RC,123,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,3 RC,123,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,3 RC,123,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,3 RC,123,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,3 RC,123,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,3 RC,123,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,3 RC,123,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,3 RC,123,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,3 RC,123,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,3 RC,123,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,3 RC,123,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,3 RC,123,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,3 RC,123,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,3 RC,123,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,3 RC,123,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,3 RC,123,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,3 RC,123,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,3 RC,123,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,3 RC,123,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,3 RC,123,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,3 RC,123,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,3 RC,123,DIABETES WITH CC Pediatric,,,7694.77,9911.97,3 RC,123,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,3 RC,123,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,3 RC,123,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,3 RC,123,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,3 RC,123,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,3 RC,123,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,3 RC,123,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,3 RC,123,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,3 RC,123,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,3 RC,123,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,3 RC,123,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,3 RC,123,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,3 RC,123,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,3 RC,123,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,3 RC,123,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,3 RC,123,DYSEQUILIBRIUM Pediatric,,,6453.24,8312.7,3 RC,123,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric",,,10917.1,14062.79,3 RC,123,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric",,,18180.0,23418.44,3 RC,123,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric",,,6843.9,8815.93,3 RC,123,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,3 RC,123,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,3 RC,123,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,3 RC,123,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,3 RC,123,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,3 RC,123,EPISTAXIS WITH MCC Pediatric,,,11432.26,14726.39,3 RC,123,EPISTAXIS WITHOUT MCC Pediatric,,,6302.12,8118.04,3 RC,123,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,3 RC,123,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,3 RC,123,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,3 RC,123,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,3 RC,123,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,3 RC,123,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,3 RC,123,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,3 RC,123,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,3 RC,123,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,3 RC,123,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,3 RC,123,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,3 RC,123,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,3 RC,123,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,15758.29,6 RC,123,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,3 RC,123,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,3 RC,123,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,3 RC,123,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,3 RC,123,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,3 RC,123,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,3 RC,123,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,3 RC,123,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,3 RC,123,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,3 RC,123,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,3 RC,123,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,3 RC,123,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,3 RC,123,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,3 RC,123,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,3 RC,123,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,3 RC,123,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,3 RC,123,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,3 RC,123,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,3 RC,123,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,3 RC,123,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,3 RC,123,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,3 RC,123,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,3 RC,123,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,3 RC,123,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,3 RC,123,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,3 RC,123,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,3 RC,123,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,3 RC,123,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,3 RC,123,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,3 RC,123,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,3 RC,123,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,3 RC,123,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,3 RC,123,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,3 RC,123,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,3 RC,123,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,3 RC,123,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,3 RC,123,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,3 RC,123,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,3 RC,123,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,3 RC,123,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,3 RC,123,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,3 RC,123,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,3 RC,123,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,3 RC,123,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,3 RC,123,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,3 RC,123,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,3 RC,123,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,3 RC,123,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,3 RC,123,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,3 RC,123,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,3 RC,123,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,3 RC,123,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,3 RC,123,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,3 RC,123,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,3 RC,123,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,3 RC,123,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,3 RC,123,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,3 RC,123,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,3 RC,123,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,3 RC,123,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,3 RC,123,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,3 RC,123,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,3 RC,123,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,3 RC,123,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,3 RC,123,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,3 RC,123,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,3 RC,123,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,3 RC,123,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,3 RC,123,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,3 RC,123,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,3 RC,123,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,3 RC,123,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,3 RC,123,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,3 RC,123,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,40100.24,9 RC,123,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,3 RC,123,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,3 RC,123,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,3 RC,123,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,3 RC,123,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,3 RC,123,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,3 RC,123,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,3 RC,123,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,3 RC,123,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,3 RC,123,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,3 RC,123,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,3 RC,123,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,3 RC,123,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,3 RC,123,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,3 RC,123,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,3 RC,123,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,3 RC,123,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,3 RC,123,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,3 RC,123,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,3 RC,123,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,3 RC,123,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,3 RC,123,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,3 RC,123,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,3 RC,123,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,3 RC,123,MAJOR HEAD AND NECK PROCEDURES WITH CC Pediatric,,,18726.92,24122.97,3 RC,123,MAJOR HEAD AND NECK PROCEDURES WITH MCC Pediatric,,,36621.87,47174.22,3 RC,123,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC Pediatric,,,13706.69,17656.18,3 RC,123,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,24419.37,9 RC,123,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,3 RC,123,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,3 RC,123,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,3 RC,123,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,3 RC,123,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,3 RC,123,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,3 RC,123,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,3 RC,123,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,3 RC,123,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,3 RC,123,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,3 RC,123,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,3 RC,123,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,3 RC,123,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,3 RC,123,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,3 RC,123,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,3 RC,123,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,3 RC,123,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,3 RC,123,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,3 RC,123,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,3 RC,123,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,3 RC,123,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,3 RC,123,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,3 RC,123,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,3 RC,123,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,3 RC,123,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,3 RC,123,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,3 RC,123,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,3 RC,123,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,3 RC,123,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,3 RC,123,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,3 RC,123,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,3 RC,123,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,3 RC,123,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,3 RC,123,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,3 RC,123,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,3 RC,123,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,3 RC,123,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,3 RC,123,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,3 RC,123,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,3 RC,123,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,3 RC,123,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,3 RC,123,MOUTH PROCEDURES WITH CC/MCC Pediatric,,,12820.62,16514.79,3 RC,123,MOUTH PROCEDURES WITHOUT CC/MCC Pediatric,,,7608.91,9801.37,3 RC,123,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,121894.47,9 RC,123,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,3 RC,123,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,3 RC,123,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,51736.47,9 RC,123,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,34949.6,6 RC,123,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,3 RC,123,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,3 RC,123,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,3 RC,123,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,3 RC,123,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,3 RC,123,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,3 RC,123,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,3 RC,123,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,3 RC,123,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,3 RC,123,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,3 RC,123,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,3 RC,123,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,3 RC,123,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,3 RC,123,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,3 RC,123,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,3 RC,123,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,3 RC,123,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,3 RC,123,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,3 RC,123,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,3 RC,123,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,3 RC,123,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,3 RC,123,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,3 RC,123,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,3 RC,123,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,3 RC,123,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,3 RC,123,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,3 RC,123,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,3 RC,123,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,3 RC,123,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,3 RC,123,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,3 RC,123,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,3 RC,123,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT Pediatric,,,11360.14,14633.49,3 RC,123,OTHER DISORDERS OF THE EYE WITHOUT MCC Pediatric,,,6592.33,8491.87,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC Pediatric",,,14878.68,19165.87,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC Pediatric",,,32168.31,41437.4,3 RC,123,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,10322.95,13297.44,3 RC,123,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,3 RC,123,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,3 RC,123,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,3 RC,123,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,3 RC,123,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,3 RC,123,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,3 RC,123,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,3 RC,123,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,3 RC,123,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,3 RC,123,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,3 RC,123,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,3 RC,123,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,3 RC,123,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,3 RC,123,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,3 RC,123,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,3 RC,123,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,3 RC,123,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,3 RC,123,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,3 RC,123,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,3 RC,123,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,3 RC,123,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,3 RC,123,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,3 RC,123,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,3 RC,123,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,3 RC,123,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,3 RC,123,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,3 RC,123,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,3 RC,123,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,3 RC,123,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,3 RC,123,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,3 RC,123,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,3 RC,123,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,3 RC,123,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,22062.49,9 RC,123,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,3 RC,123,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,3 RC,123,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,3 RC,123,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,3 RC,123,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,3 RC,123,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,3 RC,123,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,3 RC,123,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,3 RC,123,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,3 RC,123,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,3 RC,123,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,3 RC,123,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,3 RC,123,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,3 RC,123,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,3 RC,123,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,3 RC,123,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,3 RC,123,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,3 RC,123,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,3 RC,123,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,3 RC,123,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,3 RC,123,OTITIS MEDIA AND URI WITH MCC Pediatric,,,10150.37,13075.13,3 RC,123,OTITIS MEDIA AND URI WITHOUT MCC Pediatric,,,6338.19,8164.49,3 RC,123,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,3 RC,123,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,3 RC,123,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,3 RC,123,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,19537.49,9 RC,123,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,3 RC,123,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,3 RC,123,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,3 RC,123,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,3 RC,123,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,3 RC,123,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,3 RC,123,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,3 RC,123,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,3 RC,123,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,3 RC,123,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,3 RC,123,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,3 RC,123,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,3 RC,123,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,3 RC,123,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,3 RC,123,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,3 RC,123,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,3 RC,123,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,3 RC,123,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,3 RC,123,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,3 RC,123,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,3 RC,123,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,3 RC,123,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,3 RC,123,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,3 RC,123,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,3 RC,123,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,3 RC,123,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,3 RC,123,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,3 RC,123,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,3 RC,123,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,3 RC,123,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,3 RC,123,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,3 RC,123,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,3 RC,123,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,3 RC,123,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,3 RC,123,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,3 RC,123,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,3 RC,123,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,3 RC,123,PSYCHOSES Pediatric,,,11992.92,15448.61,3 RC,123,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,3 RC,123,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,3 RC,123,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,3 RC,123,RADIOTHERAPY Pediatric,,,23263.77,29967.07,3 RC,123,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,3 RC,123,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,3 RC,123,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,3 RC,123,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,3 RC,123,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,3 RC,123,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,3 RC,123,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,3 RC,123,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,3 RC,123,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,3 RC,123,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,3 RC,123,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,3 RC,123,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,3 RC,123,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,3 RC,123,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,3 RC,123,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,3 RC,123,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,3 RC,123,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,3 RC,123,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,3 RC,123,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,3 RC,123,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,3 RC,123,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,3 RC,123,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,3 RC,123,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,3 RC,123,SALIVARY GLAND PROCEDURES Pediatric,,,10609.72,13666.84,3 RC,123,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,3 RC,123,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,3 RC,123,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,3 RC,123,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,3 RC,123,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,3 RC,123,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,3 RC,123,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,3 RC,123,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,3 RC,123,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,3 RC,123,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,3 RC,123,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,3 RC,123,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,3 RC,123,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,3 RC,123,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,3 RC,123,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,3 RC,123,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,3 RC,123,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,3 RC,123,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,3 RC,123,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,3 RC,123,SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric,,,18631.62,24000.2,3 RC,123,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Pediatric,,,8717.37,11229.22,3 RC,123,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,3 RC,123,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,3 RC,123,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,3 RC,123,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,3 RC,123,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,3 RC,123,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,3 RC,123,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,3 RC,123,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,3 RC,123,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,3 RC,123,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,39364.75,9 RC,123,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,3 RC,123,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,3 RC,123,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,3 RC,123,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,3 RC,123,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,3 RC,123,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,3 RC,123,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,3 RC,123,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,3 RC,123,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,92941.6,9 RC,123,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,3 RC,123,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,3 RC,123,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,3 RC,123,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,3 RC,123,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,3 RC,123,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,3 RC,123,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,3 RC,123,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,3 RC,123,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,3 RC,123,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,3 RC,123,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,3 RC,123,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,3 RC,123,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,3 RC,123,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,3 RC,123,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,3 RC,123,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,3 RC,123,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,3 RC,123,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,3 RC,123,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,3 RC,123,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,3 RC,123,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,3 RC,123,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,3 RC,123,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,3 RC,123,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,3 RC,123,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,3 RC,123,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,61562.17,6 RC,123,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,3 RC,123,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,3 RC,123,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,3 RC,123,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,3 RC,123,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,3 RC,123,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,3 RC,123,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,3 RC,123,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,3 RC,123,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,3 RC,123,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,3 RC,123,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,3 RC,123,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,3 RC,123,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,3 RC,123,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,3 RC,123,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,3 RC,123,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,3 RC,123,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,3 RC,123,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,63036.47,9 RC,123,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,3 RC,123,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,3 RC,123,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,3 RC,124, Room & Board - Semi-private (Two Beds) Psychiatric ,,,525.0,2636.0,17 RC,125, Room & Board - Semi-private (Two Beds) Hospice ,,,1199.0,1711.0,2 RC,126, Room & Board - Semi-private (Two Beds) Detoxification ,,,450.0,2636.0,16 RC,127, Room & Board - Semi-private (Two Beds) Oncology ,,,3705.0,5543.0,12 RC,128, Room & Board - Semi-private (Two Beds) Rehabilitation ,,,600.0,2997.0,24 RC,128,REHABILITATION WITH CC/MCC ,,,1243.0,1243.0,3 RC,128,REHABILITATION WITHOUT CC/MCC ,,,1243.0,1243.0,3 RC,129, Room & Board - Semi-private (Two Beds) Other ,,,3705.0,5543.0,12 RC,130, Room & Board - Three and Four Beds General Classification ,,,3705.0,5543.0,12 RC,131, Room & Board - Three and Four Beds Medical/Surgical/GYN ,,,3705.0,5543.0,12 RC,132, Room & Board - Three and Four Beds Obstetrics (OB) ,,,3705.0,5543.0,12 RC,133, Room & Board - Three and Four Beds Pediatric ,,,3705.0,5543.0,12 RC,133,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,3 RC,133,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,3 RC,133,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,3 RC,133,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,3 RC,133,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,3 RC,133,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,3 RC,133,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,3 RC,133,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,3 RC,133,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,3 RC,133,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,3 RC,133,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,3 RC,133,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,3 RC,133,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,3 RC,133,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,3 RC,133,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,3 RC,133,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,3 RC,133,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,3 RC,133,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,3 RC,133,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,3 RC,133,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,3 RC,133,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,3 RC,133,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,3 RC,133,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,3 RC,133,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,3 RC,133,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,3 RC,133,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,3 RC,133,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,3 RC,133,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,3 RC,133,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,3 RC,133,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,3 RC,133,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,3 RC,133,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,3 RC,133,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,38570.64,9 RC,133,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,3 RC,133,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,3 RC,133,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,3 RC,133,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,3 RC,133,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,3 RC,133,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,3 RC,133,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,3 RC,133,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,3 RC,133,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,3 RC,133,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,3 RC,133,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,3 RC,133,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,3 RC,133,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,3 RC,133,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,3 RC,133,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,3 RC,133,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,3 RC,133,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,3 RC,133,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,3 RC,133,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,3 RC,133,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,39435.54,9 RC,133,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,3 RC,133,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,3 RC,133,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,3 RC,133,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,3 RC,133,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,3 RC,133,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,3 RC,133,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,3 RC,133,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,3 RC,133,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,3 RC,133,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,3 RC,133,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,3 RC,133,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,3 RC,133,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,3 RC,133,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,3 RC,133,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,3 RC,133,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,3 RC,133,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,3 RC,133,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,3 RC,133,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,3 RC,133,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,3 RC,133,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,3 RC,133,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,3 RC,133,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,3 RC,133,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,3 RC,133,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,3 RC,133,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,108197.77,9 RC,133,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,84922.0,9 RC,133,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,3 RC,133,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,3 RC,133,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,3 RC,133,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,3 RC,133,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,3 RC,133,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,3 RC,133,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,3 RC,133,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,3 RC,133,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,3 RC,133,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,3 RC,133,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,3 RC,133,CHEST PAIN Pediatric,,,6181.92,7963.2,3 RC,133,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,3 RC,133,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,3 RC,133,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,3 RC,133,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,3 RC,133,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,3 RC,133,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,3 RC,133,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,3 RC,133,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,3 RC,133,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,3 RC,133,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,3 RC,133,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,3 RC,133,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,3 RC,133,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,3 RC,133,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,3 RC,133,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,3 RC,133,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,3 RC,133,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,3 RC,133,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,3 RC,133,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,3 RC,133,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,3 RC,133,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,3 RC,133,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,3 RC,133,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,3 RC,133,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,3 RC,133,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,3 RC,133,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,3 RC,133,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,3 RC,133,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,3 RC,133,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,3 RC,133,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,3 RC,133,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,3 RC,133,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,3 RC,133,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,3 RC,133,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,3 RC,133,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,3 RC,133,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,3 RC,133,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,3 RC,133,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,3 RC,133,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,3 RC,133,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,3 RC,133,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,3 RC,133,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,3 RC,133,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,3 RC,133,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,3 RC,133,DIABETES WITH CC Pediatric,,,7694.77,9911.97,3 RC,133,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,3 RC,133,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,3 RC,133,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,3 RC,133,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,3 RC,133,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,3 RC,133,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,3 RC,133,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,3 RC,133,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,3 RC,133,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,3 RC,133,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,3 RC,133,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,3 RC,133,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,3 RC,133,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,3 RC,133,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,3 RC,133,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,3 RC,133,DYSEQUILIBRIUM Pediatric,,,6453.24,8312.7,3 RC,133,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric",,,10917.1,14062.79,3 RC,133,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric",,,18180.0,23418.44,3 RC,133,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric",,,6843.9,8815.93,3 RC,133,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,3 RC,133,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,3 RC,133,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,3 RC,133,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,3 RC,133,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,3 RC,133,EPISTAXIS WITH MCC Pediatric,,,11432.26,14726.39,3 RC,133,EPISTAXIS WITHOUT MCC Pediatric,,,6302.12,8118.04,3 RC,133,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,3 RC,133,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,3 RC,133,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,3 RC,133,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,3 RC,133,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,3 RC,133,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,3 RC,133,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,3 RC,133,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,3 RC,133,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,3 RC,133,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,3 RC,133,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,3 RC,133,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,3 RC,133,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,15758.29,6 RC,133,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,3 RC,133,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,3 RC,133,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,3 RC,133,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,3 RC,133,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,3 RC,133,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,3 RC,133,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,3 RC,133,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,3 RC,133,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,3 RC,133,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,3 RC,133,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,3 RC,133,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,3 RC,133,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,3 RC,133,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,3 RC,133,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,3 RC,133,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,3 RC,133,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,3 RC,133,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,3 RC,133,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,3 RC,133,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,3 RC,133,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,3 RC,133,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,3 RC,133,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,3 RC,133,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,3 RC,133,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,3 RC,133,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,3 RC,133,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,3 RC,133,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,3 RC,133,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,3 RC,133,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,3 RC,133,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,3 RC,133,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,3 RC,133,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,3 RC,133,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,3 RC,133,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,3 RC,133,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,3 RC,133,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,3 RC,133,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,3 RC,133,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,3 RC,133,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,3 RC,133,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,3 RC,133,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,3 RC,133,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,3 RC,133,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,3 RC,133,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,3 RC,133,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,3 RC,133,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,3 RC,133,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,3 RC,133,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,3 RC,133,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,3 RC,133,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,3 RC,133,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,3 RC,133,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,3 RC,133,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,3 RC,133,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,3 RC,133,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,3 RC,133,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,3 RC,133,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,3 RC,133,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,3 RC,133,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,3 RC,133,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,3 RC,133,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,3 RC,133,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,3 RC,133,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,3 RC,133,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,3 RC,133,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,3 RC,133,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,3 RC,133,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,3 RC,133,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,3 RC,133,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,3 RC,133,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,3 RC,133,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,3 RC,133,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,3 RC,133,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,40100.24,9 RC,133,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,3 RC,133,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,3 RC,133,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,3 RC,133,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,3 RC,133,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,3 RC,133,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,3 RC,133,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,3 RC,133,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,3 RC,133,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,3 RC,133,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,3 RC,133,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,3 RC,133,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,3 RC,133,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,3 RC,133,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,3 RC,133,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,3 RC,133,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,3 RC,133,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,3 RC,133,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,3 RC,133,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,3 RC,133,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,3 RC,133,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,3 RC,133,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,3 RC,133,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,3 RC,133,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,3 RC,133,MAJOR HEAD AND NECK PROCEDURES WITH CC Pediatric,,,18726.92,24122.97,3 RC,133,MAJOR HEAD AND NECK PROCEDURES WITH MCC Pediatric,,,36621.87,47174.22,3 RC,133,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC Pediatric,,,13706.69,17656.18,3 RC,133,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,24419.37,9 RC,133,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,3 RC,133,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,3 RC,133,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,3 RC,133,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,3 RC,133,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,3 RC,133,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,3 RC,133,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,3 RC,133,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,3 RC,133,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,3 RC,133,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,3 RC,133,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,3 RC,133,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,3 RC,133,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,3 RC,133,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,3 RC,133,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,3 RC,133,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,3 RC,133,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,3 RC,133,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,3 RC,133,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,3 RC,133,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,3 RC,133,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,3 RC,133,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,3 RC,133,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,3 RC,133,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,3 RC,133,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,3 RC,133,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,3 RC,133,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,3 RC,133,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,3 RC,133,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,3 RC,133,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,3 RC,133,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,3 RC,133,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,3 RC,133,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,3 RC,133,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,3 RC,133,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,3 RC,133,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,3 RC,133,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,3 RC,133,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,3 RC,133,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,3 RC,133,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,3 RC,133,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,3 RC,133,MOUTH PROCEDURES WITH CC/MCC Pediatric,,,12820.62,16514.79,3 RC,133,MOUTH PROCEDURES WITHOUT CC/MCC Pediatric,,,7608.91,9801.37,3 RC,133,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,121894.47,9 RC,133,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,3 RC,133,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,3 RC,133,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,51736.47,9 RC,133,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,34949.6,6 RC,133,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,3 RC,133,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,3 RC,133,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,3 RC,133,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,3 RC,133,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,3 RC,133,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,3 RC,133,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,3 RC,133,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,3 RC,133,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,3 RC,133,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,3 RC,133,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,3 RC,133,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,3 RC,133,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,3 RC,133,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,3 RC,133,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,3 RC,133,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,3 RC,133,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,3 RC,133,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,3 RC,133,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,3 RC,133,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,3 RC,133,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,3 RC,133,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,3 RC,133,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,3 RC,133,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,3 RC,133,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,3 RC,133,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,3 RC,133,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,3 RC,133,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,3 RC,133,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,3 RC,133,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,3 RC,133,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC Pediatric",,,14878.68,19165.87,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC Pediatric",,,32168.31,41437.4,3 RC,133,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,10322.95,13297.44,3 RC,133,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,3 RC,133,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,3 RC,133,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,3 RC,133,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,3 RC,133,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,3 RC,133,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,3 RC,133,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,3 RC,133,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,3 RC,133,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,3 RC,133,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,3 RC,133,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,3 RC,133,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,3 RC,133,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,3 RC,133,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,3 RC,133,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,3 RC,133,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,3 RC,133,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,3 RC,133,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,3 RC,133,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,3 RC,133,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,3 RC,133,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,3 RC,133,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,3 RC,133,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,3 RC,133,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,3 RC,133,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,3 RC,133,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,3 RC,133,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,3 RC,133,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,3 RC,133,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,3 RC,133,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,3 RC,133,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,3 RC,133,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,3 RC,133,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,22062.49,9 RC,133,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,3 RC,133,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,3 RC,133,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,3 RC,133,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,3 RC,133,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,3 RC,133,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,3 RC,133,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,3 RC,133,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,3 RC,133,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,3 RC,133,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,3 RC,133,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,3 RC,133,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,3 RC,133,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,3 RC,133,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,3 RC,133,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,3 RC,133,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,3 RC,133,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,3 RC,133,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,3 RC,133,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,3 RC,133,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,3 RC,133,OTITIS MEDIA AND URI WITH MCC Pediatric,,,10150.37,13075.13,3 RC,133,OTITIS MEDIA AND URI WITHOUT MCC Pediatric,,,6338.19,8164.49,3 RC,133,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,3 RC,133,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,3 RC,133,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,3 RC,133,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,19537.49,9 RC,133,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,3 RC,133,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,3 RC,133,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,3 RC,133,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,3 RC,133,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,3 RC,133,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,3 RC,133,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,3 RC,133,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,3 RC,133,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,3 RC,133,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,3 RC,133,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,3 RC,133,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,3 RC,133,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,3 RC,133,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,3 RC,133,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,3 RC,133,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,3 RC,133,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,3 RC,133,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,3 RC,133,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,3 RC,133,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,3 RC,133,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,3 RC,133,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,3 RC,133,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,3 RC,133,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,3 RC,133,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,3 RC,133,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,3 RC,133,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,3 RC,133,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,3 RC,133,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,3 RC,133,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,3 RC,133,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,3 RC,133,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,3 RC,133,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,3 RC,133,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,3 RC,133,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,3 RC,133,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,3 RC,133,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,3 RC,133,PSYCHOSES Pediatric,,,11992.92,15448.61,3 RC,133,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,3 RC,133,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,3 RC,133,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,3 RC,133,RADIOTHERAPY Pediatric,,,23263.77,29967.07,3 RC,133,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,3 RC,133,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,3 RC,133,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,3 RC,133,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,3 RC,133,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,3 RC,133,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,3 RC,133,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,3 RC,133,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,3 RC,133,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,3 RC,133,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,3 RC,133,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,3 RC,133,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,3 RC,133,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,3 RC,133,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,3 RC,133,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,3 RC,133,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,3 RC,133,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,3 RC,133,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,3 RC,133,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,3 RC,133,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,3 RC,133,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,3 RC,133,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,3 RC,133,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,3 RC,133,SALIVARY GLAND PROCEDURES Pediatric,,,10609.72,13666.84,3 RC,133,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,3 RC,133,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,3 RC,133,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,3 RC,133,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,3 RC,133,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,3 RC,133,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,3 RC,133,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,3 RC,133,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,3 RC,133,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,3 RC,133,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,3 RC,133,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,3 RC,133,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,3 RC,133,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,3 RC,133,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,3 RC,133,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,3 RC,133,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,3 RC,133,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,3 RC,133,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,3 RC,133,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,3 RC,133,SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric,,,18631.62,24000.2,3 RC,133,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Pediatric,,,8717.37,11229.22,3 RC,133,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,3 RC,133,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,3 RC,133,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,3 RC,133,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,3 RC,133,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,3 RC,133,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,3 RC,133,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,3 RC,133,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,3 RC,133,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,3 RC,133,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,39364.75,9 RC,133,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,3 RC,133,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,3 RC,133,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,3 RC,133,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,3 RC,133,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,3 RC,133,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,3 RC,133,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,3 RC,133,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,3 RC,133,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,92941.6,9 RC,133,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,3 RC,133,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,3 RC,133,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,3 RC,133,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,3 RC,133,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,3 RC,133,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,3 RC,133,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,3 RC,133,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,3 RC,133,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,3 RC,133,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,3 RC,133,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,3 RC,133,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,3 RC,133,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,3 RC,133,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,3 RC,133,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,3 RC,133,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,3 RC,133,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,3 RC,133,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,3 RC,133,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,3 RC,133,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,3 RC,133,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,3 RC,133,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,3 RC,133,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,3 RC,133,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,3 RC,133,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,3 RC,133,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,61562.17,6 RC,133,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,3 RC,133,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,3 RC,133,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,3 RC,133,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,3 RC,133,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,3 RC,133,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,3 RC,133,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,3 RC,133,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,3 RC,133,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,3 RC,133,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,3 RC,133,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,3 RC,133,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,3 RC,133,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,3 RC,133,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,3 RC,133,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,3 RC,133,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,3 RC,133,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,3 RC,133,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,63036.47,9 RC,133,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,3 RC,133,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,3 RC,133,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,3 RC,134, Room & Board - Three and Four Beds Psychiatriac ,,,525.0,2636.0,17 RC,135, Room & Board - Three and Four Beds Hospice ,,,1199.0,1711.0,2 RC,136, Room & Board - Three and Four Beds Detoxification ,,,450.0,2636.0,16 RC,137, Room & Board - Three and Four Beds Oncology ,,,3705.0,5543.0,12 RC,138, Room & Board - Three and Four Beds Rehabilitation ,,,600.0,2997.0,24 RC,138,REHABILITATION WITH CC/MCC ,,,1243.0,1243.0,3 RC,138,REHABILITATION WITHOUT CC/MCC ,,,1243.0,1243.0,3 RC,139, Room & Board - Three and Four Beds Other ,,,3705.0,5543.0,12 RC,140, Room & Board - Deluxe Private General Classification ,,,3705.0,5543.0,12 RC,141, Room & Board - Deluxe Private Medical/Surgical/GYN ,,,3705.0,5543.0,12 RC,142, Room & Board - Deluxe Private Obstetrics (OB) ,,,3705.0,5543.0,12 RC,143, Room & Board - Deluxe Private Pediatric ,,,3705.0,5543.0,12 RC,143,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,3 RC,143,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,3 RC,143,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,3 RC,143,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,3 RC,143,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,3 RC,143,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,3 RC,143,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,3 RC,143,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,3 RC,143,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,3 RC,143,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,3 RC,143,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,3 RC,143,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,3 RC,143,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,3 RC,143,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,3 RC,143,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,3 RC,143,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,3 RC,143,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,3 RC,143,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,3 RC,143,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,3 RC,143,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,3 RC,143,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,3 RC,143,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,3 RC,143,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,3 RC,143,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,3 RC,143,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,3 RC,143,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,3 RC,143,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,3 RC,143,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,3 RC,143,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,3 RC,143,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,3 RC,143,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,3 RC,143,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,3 RC,143,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,38570.64,9 RC,143,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,3 RC,143,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,3 RC,143,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,3 RC,143,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,3 RC,143,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,3 RC,143,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,3 RC,143,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,3 RC,143,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,3 RC,143,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,3 RC,143,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,3 RC,143,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,3 RC,143,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,3 RC,143,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,3 RC,143,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,3 RC,143,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,3 RC,143,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,3 RC,143,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,3 RC,143,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,3 RC,143,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,3 RC,143,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,39435.54,9 RC,143,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,3 RC,143,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,3 RC,143,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,3 RC,143,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,3 RC,143,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,3 RC,143,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,3 RC,143,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,3 RC,143,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,3 RC,143,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,3 RC,143,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,3 RC,143,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,3 RC,143,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,3 RC,143,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,3 RC,143,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,3 RC,143,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,3 RC,143,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,3 RC,143,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,3 RC,143,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,3 RC,143,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,3 RC,143,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,3 RC,143,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,3 RC,143,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,3 RC,143,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,3 RC,143,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,3 RC,143,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,3 RC,143,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,108197.77,9 RC,143,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,84922.0,9 RC,143,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,3 RC,143,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,3 RC,143,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,3 RC,143,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,3 RC,143,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,3 RC,143,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,3 RC,143,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,3 RC,143,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,3 RC,143,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,3 RC,143,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,3 RC,143,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,3 RC,143,CHEST PAIN Pediatric,,,6181.92,7963.2,3 RC,143,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,3 RC,143,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,3 RC,143,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,3 RC,143,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,3 RC,143,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,3 RC,143,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,3 RC,143,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,3 RC,143,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,3 RC,143,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,3 RC,143,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,3 RC,143,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,3 RC,143,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,3 RC,143,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,3 RC,143,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,3 RC,143,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,3 RC,143,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,3 RC,143,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,3 RC,143,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,3 RC,143,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,3 RC,143,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,3 RC,143,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,3 RC,143,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,3 RC,143,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,3 RC,143,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,3 RC,143,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,3 RC,143,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,3 RC,143,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,3 RC,143,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,3 RC,143,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,3 RC,143,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,3 RC,143,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,3 RC,143,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,3 RC,143,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,3 RC,143,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,3 RC,143,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,3 RC,143,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,3 RC,143,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,3 RC,143,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,3 RC,143,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,3 RC,143,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,3 RC,143,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,3 RC,143,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,3 RC,143,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,3 RC,143,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,3 RC,143,DIABETES WITH CC Pediatric,,,7694.77,9911.97,3 RC,143,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,3 RC,143,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,3 RC,143,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,3 RC,143,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,3 RC,143,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,3 RC,143,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,3 RC,143,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,3 RC,143,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,3 RC,143,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,3 RC,143,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,3 RC,143,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,3 RC,143,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,3 RC,143,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,3 RC,143,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,3 RC,143,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,3 RC,143,DYSEQUILIBRIUM Pediatric,,,6453.24,8312.7,3 RC,143,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric",,,10917.1,14062.79,3 RC,143,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric",,,18180.0,23418.44,3 RC,143,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric",,,6843.9,8815.93,3 RC,143,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,3 RC,143,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,3 RC,143,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,3 RC,143,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,3 RC,143,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,3 RC,143,EPISTAXIS WITH MCC Pediatric,,,11432.26,14726.39,3 RC,143,EPISTAXIS WITHOUT MCC Pediatric,,,6302.12,8118.04,3 RC,143,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,3 RC,143,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,3 RC,143,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,3 RC,143,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,3 RC,143,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,3 RC,143,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,3 RC,143,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,3 RC,143,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,3 RC,143,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,3 RC,143,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,3 RC,143,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,3 RC,143,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,3 RC,143,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,15758.29,6 RC,143,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,3 RC,143,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,3 RC,143,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,3 RC,143,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,3 RC,143,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,3 RC,143,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,3 RC,143,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,3 RC,143,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,3 RC,143,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,3 RC,143,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,3 RC,143,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,3 RC,143,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,3 RC,143,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,3 RC,143,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,3 RC,143,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,3 RC,143,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,3 RC,143,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,3 RC,143,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,3 RC,143,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,3 RC,143,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,3 RC,143,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,3 RC,143,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,3 RC,143,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,3 RC,143,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,3 RC,143,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,3 RC,143,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,3 RC,143,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,3 RC,143,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,3 RC,143,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,3 RC,143,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,3 RC,143,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,3 RC,143,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,3 RC,143,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,3 RC,143,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,3 RC,143,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,3 RC,143,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,3 RC,143,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,3 RC,143,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,3 RC,143,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,3 RC,143,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,3 RC,143,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,3 RC,143,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,3 RC,143,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,3 RC,143,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,3 RC,143,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,3 RC,143,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,3 RC,143,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,3 RC,143,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,3 RC,143,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,3 RC,143,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,3 RC,143,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,3 RC,143,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,3 RC,143,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,3 RC,143,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,3 RC,143,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,3 RC,143,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,3 RC,143,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,3 RC,143,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,3 RC,143,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,3 RC,143,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,3 RC,143,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,3 RC,143,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,3 RC,143,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,3 RC,143,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,3 RC,143,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,3 RC,143,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,3 RC,143,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,3 RC,143,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,3 RC,143,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,3 RC,143,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,3 RC,143,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,3 RC,143,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,3 RC,143,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,3 RC,143,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,40100.24,9 RC,143,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,3 RC,143,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,3 RC,143,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,3 RC,143,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,3 RC,143,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,3 RC,143,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,3 RC,143,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,3 RC,143,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,3 RC,143,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,3 RC,143,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,3 RC,143,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,3 RC,143,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,3 RC,143,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,3 RC,143,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,3 RC,143,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,3 RC,143,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,3 RC,143,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,3 RC,143,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,3 RC,143,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,3 RC,143,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,3 RC,143,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,3 RC,143,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,3 RC,143,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,3 RC,143,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,3 RC,143,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,24419.37,9 RC,143,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,3 RC,143,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,3 RC,143,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,3 RC,143,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,3 RC,143,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,3 RC,143,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,3 RC,143,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,3 RC,143,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,3 RC,143,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,3 RC,143,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,3 RC,143,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,3 RC,143,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,3 RC,143,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,3 RC,143,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,3 RC,143,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,3 RC,143,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,3 RC,143,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,3 RC,143,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,3 RC,143,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,3 RC,143,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,3 RC,143,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,3 RC,143,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,3 RC,143,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,3 RC,143,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,3 RC,143,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,3 RC,143,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,3 RC,143,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,3 RC,143,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,3 RC,143,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,3 RC,143,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,3 RC,143,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,3 RC,143,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,3 RC,143,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,3 RC,143,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,3 RC,143,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,3 RC,143,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,3 RC,143,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,3 RC,143,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,3 RC,143,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,3 RC,143,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,3 RC,143,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,3 RC,143,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,121894.47,9 RC,143,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,3 RC,143,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,3 RC,143,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,51736.47,9 RC,143,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,34949.6,6 RC,143,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,3 RC,143,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,3 RC,143,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,3 RC,143,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,3 RC,143,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,3 RC,143,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,3 RC,143,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,3 RC,143,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,3 RC,143,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,3 RC,143,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,3 RC,143,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,3 RC,143,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,3 RC,143,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,3 RC,143,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,3 RC,143,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,3 RC,143,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,3 RC,143,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,3 RC,143,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,3 RC,143,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,3 RC,143,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,3 RC,143,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,3 RC,143,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,3 RC,143,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,3 RC,143,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,3 RC,143,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,3 RC,143,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,3 RC,143,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,3 RC,143,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,3 RC,143,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,3 RC,143,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,3 RC,143,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,3 RC,143,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,3 RC,143,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,3 RC,143,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,3 RC,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC Pediatric",,,14878.68,19165.87,3 RC,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,10322.95,13297.44,3 RC,143,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,3 RC,143,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,3 RC,143,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,3 RC,143,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,3 RC,143,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,3 RC,143,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,3 RC,143,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,3 RC,143,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,3 RC,143,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,3 RC,143,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,3 RC,143,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,3 RC,143,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,3 RC,143,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,3 RC,143,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,3 RC,143,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,3 RC,143,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,3 RC,143,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,3 RC,143,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,3 RC,143,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,3 RC,143,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,3 RC,143,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,3 RC,143,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,3 RC,143,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,3 RC,143,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,3 RC,143,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,3 RC,143,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,3 RC,143,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,3 RC,143,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,3 RC,143,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,3 RC,143,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,3 RC,143,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,3 RC,143,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,3 RC,143,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,22062.49,9 RC,143,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,3 RC,143,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,3 RC,143,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,3 RC,143,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,3 RC,143,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,3 RC,143,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,3 RC,143,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,3 RC,143,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,3 RC,143,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,3 RC,143,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,3 RC,143,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,3 RC,143,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,3 RC,143,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,3 RC,143,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,3 RC,143,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,3 RC,143,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,3 RC,143,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,3 RC,143,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,3 RC,143,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,3 RC,143,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,3 RC,143,OTITIS MEDIA AND URI WITH MCC Pediatric,,,10150.37,13075.13,3 RC,143,OTITIS MEDIA AND URI WITHOUT MCC Pediatric,,,6338.19,8164.49,3 RC,143,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,3 RC,143,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,3 RC,143,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,3 RC,143,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,19537.49,9 RC,143,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,3 RC,143,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,3 RC,143,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,3 RC,143,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,3 RC,143,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,3 RC,143,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,3 RC,143,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,3 RC,143,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,3 RC,143,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,3 RC,143,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,3 RC,143,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,3 RC,143,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,3 RC,143,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,3 RC,143,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,3 RC,143,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,3 RC,143,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,3 RC,143,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,3 RC,143,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,3 RC,143,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,3 RC,143,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,3 RC,143,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,3 RC,143,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,3 RC,143,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,3 RC,143,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,3 RC,143,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,3 RC,143,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,3 RC,143,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,3 RC,143,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,3 RC,143,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,3 RC,143,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,3 RC,143,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,3 RC,143,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,3 RC,143,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,3 RC,143,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,3 RC,143,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,3 RC,143,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,3 RC,143,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,3 RC,143,PSYCHOSES Pediatric,,,11992.92,15448.61,3 RC,143,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,3 RC,143,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,3 RC,143,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,3 RC,143,RADIOTHERAPY Pediatric,,,23263.77,29967.07,3 RC,143,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,3 RC,143,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,3 RC,143,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,3 RC,143,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,3 RC,143,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,3 RC,143,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,3 RC,143,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,3 RC,143,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,3 RC,143,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,3 RC,143,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,3 RC,143,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,3 RC,143,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,3 RC,143,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,3 RC,143,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,3 RC,143,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,3 RC,143,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,3 RC,143,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,3 RC,143,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,3 RC,143,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,3 RC,143,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,3 RC,143,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,3 RC,143,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,3 RC,143,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,3 RC,143,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,3 RC,143,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,3 RC,143,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,3 RC,143,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,3 RC,143,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,3 RC,143,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,3 RC,143,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,3 RC,143,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,3 RC,143,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,3 RC,143,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,3 RC,143,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,3 RC,143,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,3 RC,143,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,3 RC,143,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,3 RC,143,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,3 RC,143,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,3 RC,143,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,3 RC,143,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,3 RC,143,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,3 RC,143,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,3 RC,143,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,3 RC,143,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,3 RC,143,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,3 RC,143,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,3 RC,143,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,3 RC,143,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,3 RC,143,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,3 RC,143,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,3 RC,143,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,39364.75,9 RC,143,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,3 RC,143,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,3 RC,143,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,3 RC,143,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,3 RC,143,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,3 RC,143,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,3 RC,143,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,3 RC,143,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,3 RC,143,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,92941.6,9 RC,143,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,3 RC,143,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,3 RC,143,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,3 RC,143,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,3 RC,143,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,3 RC,143,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,3 RC,143,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,3 RC,143,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,3 RC,143,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,3 RC,143,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,3 RC,143,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,3 RC,143,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,3 RC,143,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,3 RC,143,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,3 RC,143,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,3 RC,143,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,3 RC,143,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,3 RC,143,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,3 RC,143,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,3 RC,143,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,3 RC,143,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,3 RC,143,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,3 RC,143,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,3 RC,143,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,3 RC,143,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,3 RC,143,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,61562.17,6 RC,143,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,3 RC,143,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,3 RC,143,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,3 RC,143,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,3 RC,143,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,3 RC,143,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,3 RC,143,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,3 RC,143,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,3 RC,143,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,3 RC,143,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,3 RC,143,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,3 RC,143,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,3 RC,143,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,3 RC,143,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,3 RC,143,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,3 RC,143,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,3 RC,143,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,3 RC,143,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,63036.47,9 RC,143,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,3 RC,143,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,3 RC,143,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,3 RC,144, Room & Board - Deluxe Private Psychiatric ,,,525.0,2636.0,17 RC,145, Room & Board - Deluxe Private Hospice ,,,1199.0,1711.0,2 RC,146, Room & Board - Deluxe Private Detoxification ,,,450.0,2636.0,16 RC,147, Room & Board - Deluxe Private Oncology ,,,3705.0,5543.0,12 RC,148, Room & Board - Deluxe Private Rehabilitation ,,,600.0,2997.0,24 RC,148,REHABILITATION WITH CC/MCC ,,,1243.0,1243.0,3 RC,148,REHABILITATION WITHOUT CC/MCC ,,,1243.0,1243.0,3 RC,149, Room & Board - Deluxe Private Other ,,,3705.0,5543.0,12 RC,150, Room & Board - Ward General Classification ,,,3705.0,5543.0,12 RC,151, Room & Board - Ward Medical/Surgical/GYN ,,,3705.0,5543.0,12 RC,152, Room & Board - Ward Obstetrics (OB) ,,,3705.0,5543.0,12 RC,153, Room & Board - Ward Pediatric ,,,3705.0,5543.0,12 RC,153,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Pediatric",,,8609.18,11089.86,3 RC,153,ABORTION WITHOUT D&C Pediatric,,,7223.4,9304.78,3 RC,153,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION Pediatric,,,8244.28,10619.81,3 RC,153,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Pediatric,,,14655.44,18878.31,3 RC,153,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC Pediatric,,,23235.43,29930.57,3 RC,153,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC Pediatric,,,7982.4,10282.48,3 RC,153,ACUTE LEUKEMIA WITH CC Pediatric,,,17908.68,23068.95,3 RC,153,ACUTE LEUKEMIA WITH MCC Pediatric,,,47136.28,60718.29,3 RC,153,ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric,,,74350.47,95774.07,3 RC,153,ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,10470.63,13487.67,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric",,,7891.39,10165.25,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric",,,13772.8,17741.35,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric",,,6208.54,7997.49,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric",,,5943.23,7655.73,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric",,,17007.15,21907.65,3 RC,153,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC Pediatric",,,5142.16,6623.83,3 RC,153,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric,,,18818.79,24241.31,3 RC,153,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric,,,12014.39,15476.26,3 RC,153,AFTERCARE WITH CC/MCC Pediatric,,,10214.76,13158.08,3 RC,153,AFTERCARE WITHOUT CC/MCC Pediatric,,,5389.43,6942.36,3 RC,153,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric",,,9668.69,12454.67,3 RC,153,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric",,,16012.03,20625.79,3 RC,153,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric",,,6902.29,8891.13,3 RC,153,AICD GENERATOR PROCEDURES Pediatric,,,39172.77,50460.14,3 RC,153,AICD LEAD PROCEDURES Pediatric,,,31065.87,40017.29,3 RC,153,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Pediatric",,,12154.34,15656.54,3 RC,153,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric",,,14983.43,19300.81,3 RC,153,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric",,,7579.72,9763.77,3 RC,153,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Pediatric",,,5296.7,6822.91,3 RC,153,ALLERGIC REACTIONS WITH MCC Pediatric,,,14438.22,18598.5,3 RC,153,ALLERGIC REACTIONS WITHOUT MCC Pediatric,,,5720.85,7369.28,3 RC,153,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric,,,24474.39,31526.53,3 RC,153,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric,,,42257.72,54434.0,3 RC,153,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric,,,11886.46,15311.46,3 RC,153,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,19539.16,25169.24,3 RC,153,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,36858.84,47479.47,3 RC,153,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Pediatric,,,10133.2,13053.01,3 RC,153,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric",,,12177.52,38570.64,9 RC,153,ANAL AND STOMAL PROCEDURES WITH CC Pediatric,,,11237.36,14475.33,3 RC,153,ANAL AND STOMAL PROCEDURES WITH MCC Pediatric,,,19710.02,25389.34,3 RC,153,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Pediatric,,,7474.97,9628.84,3 RC,153,ANGINA PECTORIS Pediatric,,,6026.51,7763.01,3 RC,153,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric,,,59053.65,76069.57,3 RC,153,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Pediatric,,,36260.4,46708.59,3 RC,153,APPENDIX PROCEDURES WITH CC Pediatric,,,12995.77,16740.42,3 RC,153,APPENDIX PROCEDURES WITH MCC Pediatric,,,20562.61,26487.59,3 RC,153,APPENDIX PROCEDURES WITHOUT CC/MCC Pediatric,,,9828.39,12660.38,3 RC,153,ATHEROSCLEROSIS WITH MCC Pediatric,,,10274.01,13234.4,3 RC,153,ATHEROSCLEROSIS WITHOUT MCC Pediatric,,,5780.1,7445.59,3 RC,153,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric,,,17173.72,22122.21,3 RC,153,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric,,,32088.46,41334.54,3 RC,153,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Pediatric,,,12826.63,16522.53,3 RC,153,BEHAVIORAL AND DEVELOPMENTAL DISORDERS Pediatric,,,17818.53,22952.82,3 RC,153,BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric,,,10047.34,12942.41,3 RC,153,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric,,,6199.09,7985.32,3 RC,153,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric,,,47420.48,61084.38,3 RC,153,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric,,,22838.76,29419.6,3 RC,153,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric,,,13631.99,39435.54,9 RC,153,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric,,,21114.69,27198.75,3 RC,153,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,29661.2,38207.88,3 RC,153,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric,,,15960.52,20559.43,3 RC,153,BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric,,,11130.03,14337.08,3 RC,153,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric,,,7127.24,9180.91,3 RC,153,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric",,,18380.05,23676.14,3 RC,153,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,16563.25,21335.85,3 RC,153,BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric,,,8338.72,10741.47,3 RC,153,BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric,,,5752.62,7410.2,3 RC,153,"CARDIAC ARREST, UNEXPLAINED WITH CC Pediatric",,,5443.52,7012.04,3 RC,153,"CARDIAC ARREST, UNEXPLAINED WITH MCC Pediatric",,,13410.47,17274.61,3 RC,153,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Pediatric",,,3907.49,5033.41,3 RC,153,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Pediatric,,,6316.72,8136.84,3 RC,153,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC Pediatric,,,10337.54,13316.24,3 RC,153,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric,,,4860.53,6261.07,3 RC,153,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric,,,13529.82,17428.35,3 RC,153,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric,,,7840.74,10099.99,3 RC,153,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric,,,61221.61,78862.22,3 RC,153,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric,,,51572.67,66433.0,3 RC,153,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Pediatric,,,39654.44,51080.61,3 RC,153,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Pediatric,,,26978.07,34751.63,3 RC,153,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC Pediatric,,,17361.75,22364.43,3 RC,153,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric,,,16231.83,20908.93,3 RC,153,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric,,,27928.54,35975.97,3 RC,153,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric,,,13994.32,18026.69,3 RC,153,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric,,,56455.53,108197.77,9 RC,153,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Pediatric,,,43275.16,84922.0,9 RC,153,CELLULITIS WITH MCC Pediatric,,,12203.28,15719.58,3 RC,153,CELLULITIS WITHOUT MCC Pediatric,,,7477.55,9632.15,3 RC,153,CERVICAL SPINAL FUSION WITH CC Pediatric,,,25295.21,32583.87,3 RC,153,CERVICAL SPINAL FUSION WITH MCC Pediatric,,,41459.22,53405.42,3 RC,153,CERVICAL SPINAL FUSION WITHOUT CC/MCC Pediatric,,,20961.0,27000.78,3 RC,153,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric,,,41249.72,53135.56,3 RC,153,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric,,,17922.42,23086.64,3 RC,153,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,12397.33,15969.53,3 RC,153,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric,,,11232.21,14468.69,3 RC,153,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric,,,22259.2,28673.05,3 RC,153,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric,,,7292.95,9394.36,3 RC,153,CHEST PAIN Pediatric,,,6181.92,7963.2,3 RC,153,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric,,,17744.69,22857.7,3 RC,153,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric,,,30588.48,39402.36,3 RC,153,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11705.29,15078.1,3 RC,153,CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric,,,18052.06,23253.65,3 RC,153,CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric,,,28362.13,36534.5,3 RC,153,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Pediatric,,,14257.05,18365.13,3 RC,153,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric,,,7238.0,9323.58,3 RC,153,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Pediatric,,,9510.71,12251.16,3 RC,153,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Pediatric,,,5512.21,7100.52,3 RC,153,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric",,,18999.1,24473.57,3 RC,153,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric",,,9187.88,11835.31,3 RC,153,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Pediatric,,,9068.53,11681.57,3 RC,153,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Pediatric,,,16898.97,21768.29,3 RC,153,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric,,,6117.53,7880.25,3 RC,153,COAGULATION DISORDERS Pediatric,,,13096.23,16869.82,3 RC,153,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric,,,77356.43,99646.18,3 RC,153,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric,,,49516.32,63784.13,3 RC,153,COMPLICATED PEPTIC ULCER WITH CC Pediatric,,,9302.93,11983.51,3 RC,153,COMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,16847.45,21701.93,3 RC,153,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric,,,6873.95,8854.64,3 RC,153,COMPLICATIONS OF TREATMENT WITH CC Pediatric,,,8605.75,11085.44,3 RC,153,COMPLICATIONS OF TREATMENT WITH MCC Pediatric,,,15719.25,20248.65,3 RC,153,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric,,,5910.6,7613.7,3 RC,153,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES Pediatric,,,93365.02,120267.55,3 RC,153,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Pediatric,,,57410.29,73952.69,3 RC,153,CONNECTIVE TISSUE DISORDERS WITH CC Pediatric,,,9903.09,12756.6,3 RC,153,CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric,,,21307.88,27447.6,3 RC,153,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Pediatric,,,7179.61,9248.37,3 RC,153,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Pediatric,,,65641.69,84555.91,3 RC,153,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric,,,46902.74,60417.46,3 RC,153,CORONARY BYPASS WITH PTCA WITH MCC Pediatric,,,72379.12,93234.69,3 RC,153,CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric,,,52053.48,67052.36,3 RC,153,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric,,,50387.8,64906.72,3 RC,153,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC Pediatric,,,35965.04,46328.13,3 RC,153,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric,,,37155.06,47861.04,3 RC,153,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,27054.49,34850.06,3 RC,153,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric,,,27564.49,35507.02,3 RC,153,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric,,,57793.22,74445.97,3 RC,153,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Pediatric",,,17593.57,22663.05,3 RC,153,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Pediatric",,,9766.57,12580.75,3 RC,153,DENTAL AND ORAL DISEASES WITH CC Pediatric,,,7811.54,10062.39,3 RC,153,DENTAL AND ORAL DISEASES WITH MCC Pediatric,,,14740.44,18987.81,3 RC,153,DENTAL AND ORAL DISEASES WITHOUT CC/MCC Pediatric,,,6083.18,7836.01,3 RC,153,DEPRESSIVE NEUROSES Pediatric,,,8078.57,10406.35,3 RC,153,DIABETES WITH CC Pediatric,,,7694.77,9911.97,3 RC,153,DIABETES WITH MCC Pediatric,,,12335.51,15889.9,3 RC,153,DIABETES WITHOUT CC/MCC Pediatric,,,5333.62,6870.47,3 RC,153,DIGESTIVE MALIGNANCY WITH CC Pediatric,,,10385.63,13378.18,3 RC,153,DIGESTIVE MALIGNANCY WITH MCC Pediatric,,,18362.88,23654.02,3 RC,153,DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric,,,7936.04,10222.76,3 RC,153,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Pediatric",,,8288.07,10676.22,3 RC,153,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Pediatric",,,15409.29,19849.38,3 RC,153,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Pediatric",,,6007.62,7738.68,3 RC,153,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC Pediatric,,,7222.54,9303.67,3 RC,153,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric,,,13996.9,18030.01,3 RC,153,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,5335.34,6872.68,3 RC,153,DISORDERS OF PERSONALITY AND IMPULSE CONTROL Pediatric,,,16882.65,21747.28,3 RC,153,DISORDERS OF THE BILIARY TRACT WITH CC Pediatric,,,9396.52,12104.06,3 RC,153,DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric,,,14346.35,18480.15,3 RC,153,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Pediatric,,,7103.2,9149.94,3 RC,153,ENDOCRINE DISORDERS WITH CC Pediatric,,,8800.65,11336.5,3 RC,153,ENDOCRINE DISORDERS WITH MCC Pediatric,,,14133.41,18205.87,3 RC,153,ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric,,,6596.62,8497.4,3 RC,153,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Pediatric,,,52618.44,67780.1,3 RC,153,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Pediatric,,,40876.23,52654.45,3 RC,153,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Pediatric",,,10889.62,14027.4,3 RC,153,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Pediatric",,,6693.65,8622.38,3 RC,153,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric,,,183315.39,236136.53,3 RC,153,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Pediatric,,,33435.6,43069.85,3 RC,153,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,21108.68,27191.01,3 RC,153,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,40283.79,51891.31,3 RC,153,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,14716.4,18956.84,3 RC,153,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric,,,11911.36,15343.54,3 RC,153,FEVER AND INFLAMMATORY CONDITIONS Pediatric,,,7621.79,9817.96,3 RC,153,FOOT PROCEDURES WITH CC Pediatric,,,16048.95,20673.35,3 RC,153,FOOT PROCEDURES WITH MCC Pediatric,,,23964.38,30869.57,3 RC,153,FOOT PROCEDURES WITHOUT CC/MCC Pediatric,,,15392.98,19828.37,3 RC,153,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric",,,7688.76,15758.29,6 RC,153,FRACTURES OF FEMUR WITH MCC Pediatric,,,13460.27,17338.76,3 RC,153,FRACTURES OF FEMUR WITHOUT MCC Pediatric,,,6921.17,8915.47,3 RC,153,FRACTURES OF HIP AND PELVIS WITH MCC Pediatric,,,11007.25,14178.92,3 RC,153,FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric,,,6934.05,8932.06,3 RC,153,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric,,,61584.8,79330.06,3 RC,153,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC Pediatric,,,27653.79,35622.05,3 RC,153,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Pediatric,,,18980.21,24449.24,3 RC,153,GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric,,,8420.29,10846.54,3 RC,153,GASTROINTESTINAL HEMORRHAGE WITH MCC Pediatric,,,15695.21,20217.68,3 RC,153,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Pediatric,,,5412.61,6972.22,3 RC,153,GASTROINTESTINAL OBSTRUCTION WITH CC Pediatric,,,6781.22,8735.19,3 RC,153,GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric,,,12679.8,16333.41,3 RC,153,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Pediatric,,,4670.78,6016.64,3 RC,153,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Pediatric",,,13516.94,17411.76,3 RC,153,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric",,,8777.47,11306.64,3 RC,153,HAND PROCEDURES FOR INJURIES Pediatric,,,16865.48,21725.16,3 RC,153,HEART FAILURE AND SHOCK WITH CC Pediatric,,,7289.51,9389.94,3 RC,153,HEART FAILURE AND SHOCK WITH MCC Pediatric,,,11022.71,14198.83,3 RC,153,HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric,,,4859.68,6259.96,3 RC,153,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric,,,14918.18,19216.75,3 RC,153,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric,,,29253.36,37682.53,3 RC,153,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric,,,12016.11,15478.47,3 RC,153,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Pediatric,,,14445.09,18607.34,3 RC,153,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC Pediatric,,,24916.57,32096.12,3 RC,153,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric,,,11548.17,14875.7,3 RC,153,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Pediatric,,,17983.38,23165.17,3 RC,153,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric,,,25005.01,32210.04,3 RC,153,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Pediatric,,,14003.77,18038.86,3 RC,153,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric,,,24643.54,31744.41,3 RC,153,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Pediatric,,,18182.57,23421.76,3 RC,153,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric,,,52557.48,67701.58,3 RC,153,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric,,,22644.72,29169.64,3 RC,153,HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric,,,11118.87,14322.7,3 RC,153,HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric,,,24779.2,31919.16,3 RC,153,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Pediatric,,,7750.58,9983.86,3 RC,153,HIV WITH OR WITHOUT OTHER RELATED CONDITION Pediatric,,,11142.05,14352.56,3 RC,153,HYPERTENSION WITH MCC Pediatric,,,10217.34,13161.4,3 RC,153,HYPERTENSION WITHOUT MCC Pediatric,,,6483.29,8351.41,3 RC,153,INBORN AND OTHER DISORDERS OF METABOLISM Pediatric,,,12210.15,15728.43,3 RC,153,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,8405.69,10827.74,3 RC,153,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,12294.29,15836.81,3 RC,153,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5697.67,7339.42,3 RC,153,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Pediatric,,,17155.69,22098.99,3 RC,153,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Pediatric,,,42402.82,54620.92,3 RC,153,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12854.96,16559.03,3 RC,153,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric,,,12732.18,16400.87,3 RC,153,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Pediatric,,,6964.96,8971.87,3 RC,153,INFLAMMATORY BOWEL DISEASE WITH CC Pediatric,,,8382.51,10797.88,3 RC,153,INFLAMMATORY BOWEL DISEASE WITH MCC Pediatric,,,13585.63,17500.24,3 RC,153,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Pediatric,,,5849.64,7535.18,3 RC,153,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric,,,13089.36,16860.97,3 RC,153,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Pediatric,,,21395.45,27560.41,3 RC,153,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric,,,10026.73,12915.87,3 RC,153,INTERSTITIAL LUNG DISEASE WITH CC Pediatric,,,8148.97,10497.05,3 RC,153,INTERSTITIAL LUNG DISEASE WITH MCC Pediatric,,,16203.5,20872.43,3 RC,153,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric,,,6149.29,7921.17,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Pediatric,,,15712.38,20239.8,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric,,,27336.11,35212.83,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric,,,13323.75,17162.91,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric,,,11348.12,14618.0,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Pediatric,,,21816.17,28102.35,3 RC,153,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric,,,8889.94,11451.52,3 RC,153,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric,,,9962.34,12832.92,3 RC,153,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric,,,6950.37,8953.07,3 RC,153,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Pediatric,,,8996.41,11588.67,3 RC,153,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric,,,15486.57,19948.92,3 RC,153,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC Pediatric,,,6785.52,8740.72,3 RC,153,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Pediatric,,,9820.67,12650.43,3 RC,153,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,5915.75,7620.34,3 RC,153,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC Pediatric,,,17954.18,23127.57,3 RC,153,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric,,,27707.88,35691.73,3 RC,153,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,13447.39,17322.17,3 RC,153,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Pediatric,,,15187.78,19564.03,3 RC,153,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric,,,9588.84,12351.81,3 RC,153,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric,,,14524.08,18709.1,3 RC,153,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric,,,20489.63,26393.58,3 RC,153,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric,,,11726.76,15105.75,3 RC,153,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric",,,32309.12,41618.78,3 RC,153,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric,,,10374.46,40100.24,9 RC,153,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric,,,25902.24,33365.81,3 RC,153,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric,,,17299.07,22283.69,3 RC,153,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric",,,21774.95,28049.27,3 RC,153,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric",,,31524.36,40607.9,3 RC,153,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric",,,17227.81,22191.89,3 RC,153,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric,,,19220.62,24758.92,3 RC,153,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Pediatric,,,50355.17,64864.69,3 RC,153,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,10337.54,13316.24,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric,,,14007.2,18043.28,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Pediatric,,,27774.85,35777.99,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Pediatric,,,19452.44,25057.54,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Pediatric,,,39365.09,50707.89,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric,,,11585.95,14924.36,3 RC,153,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric,,,8675.29,11175.02,3 RC,153,MAJOR BLADDER PROCEDURES WITH CC Pediatric,,,24034.79,30960.26,3 RC,153,MAJOR BLADDER PROCEDURES WITH MCC Pediatric,,,44616.29,57472.18,3 RC,153,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,18173.13,23409.6,3 RC,153,MAJOR CHEST PROCEDURES WITH CC Pediatric,,,21671.06,27915.44,3 RC,153,MAJOR CHEST PROCEDURES WITH MCC Pediatric,,,38480.73,49568.71,3 RC,153,MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric,,,16435.32,21171.05,3 RC,153,MAJOR CHEST TRAUMA WITH CC Pediatric,,,9136.36,11768.95,3 RC,153,MAJOR CHEST TRAUMA WITH MCC Pediatric,,,13135.72,16920.69,3 RC,153,MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric,,,6752.89,8698.69,3 RC,153,MAJOR ESOPHAGEAL DISORDERS WITH CC Pediatric,,,8587.72,11062.21,3 RC,153,MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric,,,13668.05,17606.41,3 RC,153,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Pediatric,,,6017.07,7750.85,3 RC,153,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Pediatric,,,8766.31,11292.26,3 RC,153,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric,,,15223.84,19610.49,3 RC,153,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric,,,6245.46,8045.04,3 RC,153,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric,,,8986.11,24419.37,9 RC,153,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Pediatric,,,26043.06,33547.19,3 RC,153,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Pediatric,,,16561.54,21333.63,3 RC,153,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES Pediatric,,,23799.53,30657.21,3 RC,153,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Pediatric,,,17174.58,22123.32,3 RC,153,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric,,,13172.64,16968.25,3 RC,153,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric,,,15509.75,19978.78,3 RC,153,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric,,,13002.64,16749.26,3 RC,153,MAJOR SKIN DISORDERS WITH MCC Pediatric,,,18208.33,23454.94,3 RC,153,MAJOR SKIN DISORDERS WITHOUT MCC Pediatric,,,9294.34,11972.45,3 RC,153,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,20582.36,26513.03,3 RC,153,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,39465.55,50837.29,3 RC,153,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,14449.38,18612.87,3 RC,153,MAJOR THUMB OR JOINT PROCEDURES Pediatric,,,11584.23,14922.15,3 RC,153,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Pediatric,,,9711.62,12509.97,3 RC,153,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric,,,15769.91,20313.9,3 RC,153,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Pediatric,,,7326.43,9437.5,3 RC,153,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9339.85,12031.07,3 RC,153,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15812.84,20369.2,3 RC,153,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,8246.85,10623.13,3 RC,153,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric",,,9811.22,12638.26,3 RC,153,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric",,,15538.08,20015.28,3 RC,153,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric",,,5629.84,7252.04,3 RC,153,MALIGNANT BREAST DISORDERS WITH CC Pediatric,,,9713.34,12512.18,3 RC,153,MALIGNANT BREAST DISORDERS WITH MCC Pediatric,,,14313.72,18438.13,3 RC,153,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,6606.07,8509.56,3 RC,153,MASTECTOMY FOR MALIGNANCY WITH CC/MCC Pediatric,,,16541.79,21308.2,3 RC,153,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,14805.7,19071.86,3 RC,153,MEDICAL BACK PROBLEMS WITH MCC Pediatric,,,14390.99,18537.67,3 RC,153,MEDICAL BACK PROBLEMS WITHOUT MCC Pediatric,,,8253.72,10631.98,3 RC,153,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Pediatric,,,8650.4,11142.95,3 RC,153,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,4898.31,6309.73,3 RC,153,MINOR BLADDER PROCEDURES WITH CC Pediatric,,,13052.44,16813.41,3 RC,153,MINOR BLADDER PROCEDURES WITH MCC Pediatric,,,26286.04,33860.19,3 RC,153,MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric,,,8988.68,11578.71,3 RC,153,MINOR SKIN DISORDERS WITH MCC Pediatric,,,12992.34,16735.99,3 RC,153,MINOR SKIN DISORDERS WITHOUT MCC Pediatric,,,7782.35,10024.78,3 RC,153,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Pediatric,,,12919.35,16641.98,3 RC,153,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric,,,22175.92,28565.77,3 RC,153,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric,,,10184.71,13119.37,3 RC,153,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric",,,11467.46,14771.74,3 RC,153,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Pediatric",,,6681.63,8606.89,3 RC,153,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric,,,48270.49,121894.47,9 RC,153,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric,,,57368.22,73898.5,3 RC,153,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,36411.51,46903.25,3 RC,153,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric,,,14628.83,51736.47,9 RC,153,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric,,,12921.93,34949.6,6 RC,153,NEUROSES EXCEPT DEPRESSIVE Pediatric,,,9219.65,11876.23,3 RC,153,NON-EXTENSIVE BURNS Pediatric,,,17687.16,22783.6,3 RC,153,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric,,,14111.95,18178.22,3 RC,153,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric,,,29436.24,37918.1,3 RC,153,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric,,,10296.33,13263.15,3 RC,153,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric,,,8943.18,11520.1,3 RC,153,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric,,,5194.53,6691.3,3 RC,153,O.R. PROCEDURES FOR OBESITY WITH CC Pediatric,,,13740.18,17699.32,3 RC,153,O.R. PROCEDURES FOR OBESITY WITH MCC Pediatric,,,24791.22,31934.64,3 RC,153,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC Pediatric,,,12951.12,16682.9,3 RC,153,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Pediatric,,,20064.62,25846.11,3 RC,153,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric,,,31154.3,40131.21,3 RC,153,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Pediatric,,,17409.83,22426.36,3 RC,153,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric,,,33184.03,42745.79,3 RC,153,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Pediatric,,,13814.02,17794.43,3 RC,153,OSTEOMYELITIS WITH CC Pediatric,,,11130.03,14337.08,3 RC,153,OSTEOMYELITIS WITH MCC Pediatric,,,16911.84,21784.88,3 RC,153,OSTEOMYELITIS WITHOUT CC/MCC Pediatric,,,6760.62,8708.64,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric,,,9952.89,12820.75,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric,,,19589.82,25234.5,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,7383.1,9510.49,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric,,,6195.66,7980.9,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric,,,10324.66,13299.65,3 RC,153,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,4489.62,5783.27,3 RC,153,OTHER CARDIOTHORACIC PROCEDURES WITH MCC Pediatric,,,42478.38,54718.24,3 RC,153,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC Pediatric,,,27041.61,34833.47,3 RC,153,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric,,,8270.89,10654.1,3 RC,153,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,17903.53,23062.31,3 RC,153,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5856.51,7544.03,3 RC,153,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES Pediatric,,,28682.39,36947.04,3 RC,153,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric,,,8033.92,10348.84,3 RC,153,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Pediatric,,,13731.59,17688.26,3 RC,153,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5572.31,7177.94,3 RC,153,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,19966.74,25720.03,3 RC,153,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,37716.58,48584.37,3 RC,153,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12002.37,15460.77,3 RC,153,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric",,,7869.07,10136.49,3 RC,153,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric",,,13424.21,17292.31,3 RC,153,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Pediatric",,,5933.78,7643.57,3 RC,153,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric",,,18707.18,24097.53,3 RC,153,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Pediatric",,,31998.3,41218.41,3 RC,153,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric",,,12531.27,16142.07,3 RC,153,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric,,,38318.46,49359.67,3 RC,153,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric,,,20651.91,26602.62,3 RC,153,OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric,,,4773.82,6149.36,3 RC,153,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Pediatric,,,22045.41,28397.66,3 RC,153,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12671.22,16322.35,3 RC,153,OTHER HEART ASSIST SYSTEM IMPLANT Pediatric,,,85490.8,110124.42,3 RC,153,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Pediatric,,,18785.31,24198.17,3 RC,153,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric,,,35657.66,45932.18,3 RC,153,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,12881.58,16593.32,3 RC,153,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric,,,8853.02,11403.97,3 RC,153,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Pediatric,,,17972.22,23150.79,3 RC,153,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric,,,6265.2,8070.48,3 RC,153,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric",,,15020.35,19348.36,3 RC,153,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Pediatric",,,8737.97,11255.76,3 RC,153,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric,,,8714.79,11225.9,3 RC,153,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric,,,14204.68,18297.66,3 RC,153,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Pediatric,,,5923.48,7630.29,3 RC,153,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric,,,20079.22,25864.92,3 RC,153,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric,,,36074.94,46469.7,3 RC,153,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric,,,14093.06,18153.88,3 RC,153,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric,,,30534.39,39332.68,3 RC,153,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric,,,45302.31,58355.88,3 RC,153,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,21920.06,28236.18,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric,,,9090.0,11709.22,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric,,,5769.79,7432.32,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric,,,16231.83,20908.93,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric,,,11531.86,14854.69,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC Pediatric,,,19209.46,24744.54,3 RC,153,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Pediatric,,,12630.01,16269.26,3 RC,153,OTHER MENTAL DISORDER DIAGNOSES Pediatric,,,9194.75,11844.15,3 RC,153,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,13158.9,16950.56,3 RC,153,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,23472.41,30235.83,3 RC,153,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,8075.13,10401.93,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Pediatric,,,8366.2,10776.86,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric,,,13253.35,17072.22,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Pediatric,,,6433.49,8287.26,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Pediatric,,,17842.57,22983.79,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Pediatric,,,27362.72,35247.11,3 RC,153,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric,,,13194.11,16995.9,3 RC,153,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric,,,7311.84,22062.49,9 RC,153,OTHER O.R. PROCEDURES FOR INJURIES WITH CC Pediatric,,,17130.79,22066.91,3 RC,153,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric,,,32964.23,42462.66,3 RC,153,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric,,,11270.84,14518.46,3 RC,153,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Pediatric,,,36180.55,46605.73,3 RC,153,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric,,,65424.46,84276.09,3 RC,153,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Pediatric,,,25278.04,32561.75,3 RC,153,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric,,,15960.52,20559.43,3 RC,153,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Pediatric,,,34207.48,44064.15,3 RC,153,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric,,,11642.62,14997.36,3 RC,153,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric,,,15720.97,20250.86,3 RC,153,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric,,,8080.28,10408.57,3 RC,153,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Pediatric,,,15483.99,19945.6,3 RC,153,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric,,,32091.89,41338.96,3 RC,153,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11731.91,15112.38,3 RC,153,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC Pediatric",,,14836.61,19111.68,3 RC,153,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric",,,27805.76,35817.81,3 RC,153,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric",,,12390.46,15960.69,3 RC,153,OTHER VASCULAR PROCEDURES WITH CC Pediatric,,,22285.82,28707.34,3 RC,153,OTHER VASCULAR PROCEDURES WITH MCC Pediatric,,,29950.54,38580.6,3 RC,153,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric,,,15297.68,19705.6,3 RC,153,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric",,,24901.12,32076.21,3 RC,153,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric",,,46969.71,60503.73,3 RC,153,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Pediatric",,,19057.49,24548.78,3 RC,153,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric,,,6479.0,19537.49,9 RC,153,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Pediatric",,,18288.18,23557.8,3 RC,153,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Pediatric",,,11552.46,14881.23,3 RC,153,PENIS PROCEDURES WITH CC/MCC Pediatric,,,19980.48,25737.73,3 RC,153,PENIS PROCEDURES WITHOUT CC/MCC Pediatric,,,12030.7,15497.27,3 RC,153,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC Pediatric,,,35421.54,45628.03,3 RC,153,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Pediatric,,,28262.54,36406.2,3 RC,153,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Pediatric,,,23360.79,30092.05,3 RC,153,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,15137.12,19498.78,3 RC,153,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Pediatric,,,18738.94,24138.45,3 RC,153,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric,,,12831.78,16529.17,3 RC,153,PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric,,,9165.55,11806.55,3 RC,153,PERIPHERAL VASCULAR DISORDERS WITH MCC Pediatric,,,14018.36,18057.66,3 RC,153,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Pediatric,,,6179.34,7959.88,3 RC,153,PERITONEAL ADHESIOLYSIS WITH CC Pediatric,,,18105.3,23322.22,3 RC,153,PERITONEAL ADHESIOLYSIS WITH MCC Pediatric,,,30659.75,39494.15,3 RC,153,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Pediatric,,,13179.51,16977.1,3 RC,153,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Pediatric,,,18295.91,23567.75,3 RC,153,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric,,,27413.38,35312.37,3 RC,153,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Pediatric,,,15519.2,19990.95,3 RC,153,PLEURAL EFFUSION WITH CC Pediatric,,,8492.41,10939.45,3 RC,153,PLEURAL EFFUSION WITH MCC Pediatric,,,13381.28,17237.01,3 RC,153,PLEURAL EFFUSION WITHOUT CC/MCC Pediatric,,,6157.88,7932.23,3 RC,153,PNEUMOTHORAX WITH CC Pediatric,,,9438.59,12158.26,3 RC,153,PNEUMOTHORAX WITH MCC Pediatric,,,15146.56,19510.95,3 RC,153,PNEUMOTHORAX WITHOUT CC/MCC Pediatric,,,6139.85,7909.01,3 RC,153,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC Pediatric,,,13466.28,17346.5,3 RC,153,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC Pediatric,,,7359.06,9479.53,3 RC,153,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Pediatric,,,15658.29,20170.12,3 RC,153,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Pediatric,,,8567.97,11036.77,3 RC,153,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric,,,18386.92,23684.99,3 RC,153,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Pediatric,,,39055.14,50308.62,3 RC,153,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric,,,11959.44,15405.47,3 RC,153,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Pediatric,,,14508.62,18689.19,3 RC,153,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric,,,5621.25,7240.98,3 RC,153,PROSTATECTOMY WITH CC Pediatric,,,15019.49,19347.26,3 RC,153,PROSTATECTOMY WITH MCC Pediatric,,,26798.62,34520.47,3 RC,153,PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9497.83,12234.57,3 RC,153,PSYCHOSES Pediatric,,,11992.92,15448.61,3 RC,153,PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric,,,10607.14,13663.52,3 RC,153,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric,,,11793.73,15192.02,3 RC,153,PULMONARY EMBOLISM WITHOUT MCC Pediatric,,,6911.73,8903.3,3 RC,153,RADIOTHERAPY Pediatric,,,23263.77,29967.07,3 RC,153,RECTAL RESECTION WITH CC Pediatric,,,20110.13,25904.73,3 RC,153,RECTAL RESECTION WITH MCC Pediatric,,,31087.33,40044.94,3 RC,153,RECTAL RESECTION WITHOUT CC/MCC Pediatric,,,14063.01,18115.17,3 RC,153,RED BLOOD CELL DISORDERS WITH MCC Pediatric,,,12057.32,15531.56,3 RC,153,RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric,,,7883.67,10155.29,3 RC,153,RENAL FAILURE WITH CC Pediatric,,,7519.62,9686.35,3 RC,153,RENAL FAILURE WITH MCC Pediatric,,,12715.87,16379.86,3 RC,153,RENAL FAILURE WITHOUT CC/MCC Pediatric,,,5154.18,6639.32,3 RC,153,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric,,,8379.94,10794.56,3 RC,153,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Pediatric,,,13417.34,17283.46,3 RC,153,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Pediatric,,,6482.43,8350.3,3 RC,153,RESPIRATORY NEOPLASMS WITH CC Pediatric,,,9195.61,11845.26,3 RC,153,RESPIRATORY NEOPLASMS WITH MCC Pediatric,,,15162.88,19531.96,3 RC,153,RESPIRATORY NEOPLASMS WITHOUT CC/MCC Pediatric,,,6472.13,8337.03,3 RC,153,RESPIRATORY SIGNS AND SYMPTOMS Pediatric,,,6932.34,8929.84,3 RC,153,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric,,,23600.34,30400.62,3 RC,153,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Pediatric,,,55248.33,71167.78,3 RC,153,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric,,,8706.2,11214.84,3 RC,153,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Pediatric,,,18259.85,23521.3,3 RC,153,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Pediatric,,,5426.35,6989.92,3 RC,153,REVISION OF HIP OR KNEE REPLACEMENT WITH CC Pediatric,,,30279.39,39004.2,3 RC,153,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric,,,44693.56,57571.72,3 RC,153,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Pediatric,,,23594.33,30392.88,3 RC,153,SEPTIC ARTHRITIS WITH CC Pediatric,,,10365.02,13351.63,3 RC,153,SEPTIC ARTHRITIS WITH MCC Pediatric,,,16578.71,21355.75,3 RC,153,SEPTIC ARTHRITIS WITHOUT CC/MCC Pediatric,,,7505.02,9667.55,3 RC,153,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric,,,59344.71,76444.51,3 RC,153,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric,,,16678.31,21484.05,3 RC,153,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric,,,8786.05,11317.7,3 RC,153,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric",,,17853.73,22998.16,3 RC,153,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric",,,25934.01,33406.73,3 RC,153,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric",,,14213.26,18308.72,3 RC,153,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric,,,11348.97,14619.11,3 RC,153,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC Pediatric,,,7131.53,9186.44,3 RC,153,SIGNS AND SYMPTOMS WITH MCC Pediatric,,,10899.07,14039.56,3 RC,153,SIGNS AND SYMPTOMS WITHOUT MCC Pediatric,,,6873.09,8853.53,3 RC,153,SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric,,,6919.46,8913.25,3 RC,153,SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric,,,11285.44,14537.26,3 RC,153,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric,,,5396.3,6951.21,3 RC,153,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric,,,34520.01,44466.73,3 RC,153,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric,,,45759.95,58945.38,3 RC,153,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric,,,27736.21,35728.22,3 RC,153,SKIN DEBRIDEMENT WITH CC Pediatric,,,14506.05,18685.87,3 RC,153,SKIN DEBRIDEMENT WITH MCC Pediatric,,,25252.28,32528.57,3 RC,153,SKIN DEBRIDEMENT WITHOUT CC/MCC Pediatric,,,9842.13,12678.08,3 RC,153,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,22758.91,29316.74,3 RC,153,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,42081.7,54207.27,3 RC,153,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,13792.55,17766.78,3 RC,153,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric,,,29805.44,38393.68,3 RC,153,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Pediatric,,,56250.32,72458.48,3 RC,153,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric,,,15429.04,19874.82,3 RC,153,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric",,,10748.81,39364.75,9 RC,153,SKIN GRAFTS FOR INJURIES WITH CC/MCC Pediatric,,,31537.24,40624.49,3 RC,153,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,12736.47,16406.4,3 RC,153,SKIN ULCERS WITH CC Pediatric,,,10185.57,13120.48,3 RC,153,SKIN ULCERS WITH MCC Pediatric,,,16616.49,21404.42,3 RC,153,SKIN ULCERS WITHOUT CC/MCC Pediatric,,,7442.34,9586.81,3 RC,153,SOFT TISSUE PROCEDURES WITH CC Pediatric,,,15009.19,19333.99,3 RC,153,SOFT TISSUE PROCEDURES WITH MCC Pediatric,,,27172.97,35002.69,3 RC,153,SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric,,,11555.9,14885.65,3 RC,153,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric",,,35825.94,92941.6,9 RC,153,SPLENIC PROCEDURES WITH CC Pediatric,,,24121.51,31071.96,3 RC,153,SPLENIC PROCEDURES WITH MCC Pediatric,,,38885.14,50089.63,3 RC,153,SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric,,,16389.82,21112.43,3 RC,153,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric",,,8193.62,10554.56,3 RC,153,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric",,,6184.5,7966.52,3 RC,153,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric",,,20985.9,27032.85,3 RC,153,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC Pediatric",,,42821.82,55160.64,3 RC,153,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC Pediatric",,,13757.35,17721.44,3 RC,153,SYNCOPE AND COLLAPSE Pediatric,,,7483.56,9639.9,3 RC,153,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Pediatric",,,12766.52,16445.11,3 RC,153,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC Pediatric",,,7669.02,9878.79,3 RC,153,TESTES PROCEDURES WITH CC/MCC Pediatric,,,17891.51,23046.83,3 RC,153,TESTES PROCEDURES WITHOUT CC/MCC Pediatric,,,9442.02,12162.68,3 RC,153,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC Pediatric",,,12873.85,16583.36,3 RC,153,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric",,,25930.58,33402.31,3 RC,153,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric",,,11404.78,14691.0,3 RC,153,TRANSURETHRAL PROCEDURES WITH CC Pediatric,,,13325.47,17165.12,3 RC,153,TRANSURETHRAL PROCEDURES WITH MCC Pediatric,,,25071.12,32295.2,3 RC,153,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,8391.1,10808.94,3 RC,153,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric,,,12908.19,16627.6,3 RC,153,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric,,,9078.84,11694.84,3 RC,153,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Pediatric",,,12639.45,16281.43,3 RC,153,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Pediatric",,,7864.78,10130.96,3 RC,153,TRAUMATIC INJURY WITH MCC Pediatric,,,14034.68,18078.68,3 RC,153,TRAUMATIC INJURY WITHOUT MCC Pediatric,,,7602.9,9793.63,3 RC,153,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric,,,30964.55,61562.17,6 RC,153,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric,,,25555.37,32918.98,3 RC,153,UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric,,,11854.69,15270.54,3 RC,153,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC Pediatric,,,7339.31,9454.09,3 RC,153,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC Pediatric,,,14578.17,18778.77,3 RC,153,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Pediatric,,,23159.88,29833.24,3 RC,153,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Pediatric,,,9377.63,12079.73,3 RC,153,URETHRAL PROCEDURES WITH CC/MCC Pediatric,,,15411.87,19852.7,3 RC,153,URETHRAL PROCEDURES WITHOUT CC/MCC Pediatric,,,9268.59,11939.27,3 RC,153,URETHRAL STRICTURE Pediatric,,,9253.99,11920.47,3 RC,153,URINARY STONES WITH MCC Pediatric,,,11543.88,14870.17,3 RC,153,URINARY STONES WITHOUT MCC Pediatric,,,6711.68,8645.6,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Pediatric,,,15753.59,20292.89,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric,,,10652.65,13722.14,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC Pediatric,,,15537.23,20014.18,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC Pediatric,,,30761.92,39625.77,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT Pediatric,,,12244.49,15772.67,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Pediatric,,,17692.31,22790.24,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Pediatric,,,30690.66,39533.97,3 RC,153,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Pediatric,,,12608.54,16241.61,3 RC,153,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric",,,14914.74,19212.33,3 RC,153,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric",,,7381.38,9508.28,3 RC,153,VEIN LIGATION AND STRIPPING Pediatric,,,26250.84,33814.84,3 RC,153,VIRAL ILLNESS WITH MCC Pediatric,,,12864.4,16571.2,3 RC,153,VIRAL ILLNESS WITHOUT MCC Pediatric,,,7466.39,9617.78,3 RC,153,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric,,,15658.29,63036.47,9 RC,153,WOUND DEBRIDEMENTS FOR INJURIES WITH CC Pediatric,,,16437.9,21174.37,3 RC,153,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric,,,36032.01,46414.4,3 RC,153,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric,,,10042.19,12935.78,3 RC,154, Room & Board - Ward Psychiatric ,,,525.0,2636.0,17 RC,155, Room & Board - Ward Hospice ,,,1199.0,1711.0,2 RC,156, Room & Board - Ward Detoxification ,,,450.0,2636.0,16 RC,157, Room & Board - Ward Oncology ,,,3705.0,5543.0,12 RC,158, Room & Board - Ward Rehabilitation ,,,600.0,2997.0,24 RC,158,REHABILITATION WITH CC/MCC ,,,1243.0,1243.0,3 RC,158,REHABILITATION WITHOUT CC/MCC ,,,1243.0,1243.0,3 RC,159, Room & Board - Ward Other ,,,3705.0,5543.0,12 RC,160, Room & Board - Other General Classification ,,,3705.0,5543.0,12 RC,164, Room & Board - Other Sterile Environment ,,,3705.0,5543.0,12 RC,167, Room & Board - Other Self Care ,,,3705.0,5543.0,12 RC,169, Room & Board - Other Other ,,,3705.0,5543.0,12 RC,170, Nursery General Classification ,,,436.0,1167.0,24 RC,171, Nursery Newborn - Level I ,,,436.0,1167.0,24 RC,172, Nursery Newborn - Level II ,,,1331.0,5916.0,21 RC,172,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE ",,,4000.0,4000.0,3 RC,172,FULL TERM NEONATE WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,172,NEONATE WITH OTHER SIGNIFICANT PROBLEMS ,,,4000.0,4000.0,3 RC,172,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY ",,,4000.0,4000.0,3 RC,172,PREMATURITY WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,172,PREMATURITY WITHOUT MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,173, Nursery Newborn - Level III ,,,1331.0,5916.0,21 RC,173,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE ",,,4000.0,4000.0,3 RC,173,FULL TERM NEONATE WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,173,NEONATE WITH OTHER SIGNIFICANT PROBLEMS ,,,4000.0,4000.0,3 RC,173,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY ",,,4000.0,4000.0,3 RC,173,PREMATURITY WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,173,PREMATURITY WITHOUT MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,174, Nursery Newborn - Level IV ,,,1331.0,7123.0,21 RC,174,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE ",,,4000.0,4000.0,3 RC,174,FULL TERM NEONATE WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,174,NEONATE WITH OTHER SIGNIFICANT PROBLEMS ,,,4000.0,4000.0,3 RC,174,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY ",,,4000.0,4000.0,3 RC,174,PREMATURITY WITH MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,174,PREMATURITY WITHOUT MAJOR PROBLEMS ,,,4000.0,4000.0,3 RC,179, Nursery Other Nursery ,,,475.0,1167.0,18 RC,190, Subacute Care General Classification ,,,1912.0,3389.0,16 RC,191, Subacute Care - Level I ,,,1839.0,3389.0,17 RC,192, Subacute Care - Level II ,,,1839.0,3389.0,17 RC,193, Subacute Care - Level III ,,,1839.0,3389.0,17 RC,194, Subacute Care - Level IV ,,,1912.0,3389.0,16 RC,199, Subacute Care Other Subacute Care ,,,1912.0,3389.0,16 RC,200, Intensive Care Unit General Classification ,,,1331.0,8944.0,17 RC,201, Intensive Care Unit Surgical ,,,1331.0,8944.0,17 RC,202, Intensive Care Unit Medical ,,,1331.0,8944.0,18 RC,203, Intersive Care Unit Pediatric ,,,1331.0,8944.0,17 RC,204, Intensive Care Unit Psychiatric ,,,525.0,2636.0,21 RC,206, Intensive Care Unit Intermediate ICU ,,,1234.0,6762.0,18 RC,207, Intensive Care Unit Burn Care ,,,1331.0,8944.0,18 RC,207,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT ,,,208786.76,208786.76,1 RC,207,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT ,,,39743.18,39743.18,1 RC,207,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC ,,,71491.56,71491.56,1 RC,207,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC ,,,33222.11,33222.11,1 RC,207,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY ,,,23439.52,23439.52,1 RC,207,NON-EXTENSIVE BURNS ,,,21981.14,21981.14,1 RC,208, Intensive Care Unit Trauma ,,,750.0,8944.0,21 RC,209, Intensive Care Unit Other Intensive Care ,,,1331.0,8944.0,18 RC,210, Coronary Care Unit General Classification ,,,1331.0,8944.0,18 RC,2101, Alternative Therapy Services Acupuncture ,,,,,0 RC,2103, Alternative Therapy Services Massage ,,,,,0 RC,211, Coronary Care Unit Myocardial Infarction ,,,1331.0,8944.0,18 RC,212, Coronary Care Unit Pulmonary Care ,,,1331.0,8944.0,18 RC,213, Coronary Care Unit Heart Transplant ,,,1331.0,8944.0,18 RC,214, Coronary Care Unit Intermediate CCU ,,,1234.0,6762.0,18 RC,219, Coronary Care Unit Other Coronary CCU ,,,1331.0,8944.0,18 RC,230, Incremental Nursing Charge General Classification ,,,,,0 RC,231, Incremental Nursing Charge Nursery ,,,,,0 RC,232, Incremental Nursing Charge OB ,,,,,0 RC,233, Incremental Nursing Charge ICU ,,,,,0 RC,234, Incremental Nursing Charge CCU ,,,,,0 RC,235, Incremental Nursing Charge Hospice ,,,,,0 RC,239, Incremental Nursing Charge Other ,,,,,0 RC,240, All Inclusive Ancillary General Classification ,,,,,0 RC,241, All Inclusive Ancillary Basic ,,,,,0 RC,242, All Inclusive Ancillary Comprehensive ,,,,,0 RC,243, All Inclusive Ancillary Specialty ,,,,,0 RC,249, All Inclusive Ancillary Other ,,,,,0 RC,250, Pharmacy General Classification ,,,,,0 RC,251, Pharmacy Generic Drugs ,,,,,0 RC,252, Pharmacy ,,,,,0 RC,254, Pharmacy ,,,,,0 RC,255, Pharmacy ,,,,,0 RC,257, Pharmacy ,,,,,0 RC,258, Pharmacy ,,,,,0 RC,259, Pharmacy ,,,,,0 RC,260, IV Therapy General Classification ,,,,,0 RC,261, IV Therapy Infusion Pump ,,,,,0 RC,262, IV Therapy/Pharmacy Services ,,,,,0 RC,263, IV Therapy/Drug/Supply/Delivery ,,,,,0 RC,264, IV Therapy/Supplies ,,,,,0 RC,269, IV Therapy Other ,,,,,0 RC,270, Medical/Surgical Supplies and Devices General Classification ,,,,,0 RC,271, Medical/Surgical Supplies and Devices Non-Sterile Supply ,,,,,0 RC,272, Medical/Surgical Supplies and Devices Sterile Supply ,,,,,0 RC,274, Medical/Surgical Supplies and Devices Prosthetic/Orthotic Devices ,,,,,0 RC,275, Medical/Surgical Supplies and Devices Pacemaker ,,,,,0 RC,276, Medical/Surgical Supplies and Devices Intraocular Lens ,,,,,0 RC,278, Medical/Surgical Supplies and Devices Other Implant ,,,,,0 RC,278,"Brachytherapy source, non-stranded, yttrium-90, per source ",100000.0,100000.0,17480.0,24948.0,2 RC,279, Medical/Surgical Supplies and Devices Other Supplies/Devices ,,,,,0 RC,280, Oncology General Classification ,,,481.0,686.0,2 RC,289, Oncology Other ,,,481.0,686.0,2 RC,300, Laboratory General Classification ,,,,,0 RC,300,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,300,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,300,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,300,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,300,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,300,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,300,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,300,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,300,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,300,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,300,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,300,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,300,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,300,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,300,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,300,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,300,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,Acetaminophen ,,,15.97,98.82,4 RC,300,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,300,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,300,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,300,Acetylcholinesterase ,,,10.53,64.67,4 RC,300,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,300,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,300,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,300,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,300,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,300,Adalimumab ,,,33.05,204.79,4 RC,300,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,300,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,300,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,300,Albumin; ischemia modified ,,,29.08,179.62,4 RC,300,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,300,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,300,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,300,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,300,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,300,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,300,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,300,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,300,Alcohols ,,,9.61,127.56,4 RC,300,Aldolase ,,,8.32,52.12,4 RC,300,Aldosterone ,,,34.91,215.56,4 RC,300,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,300,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,300,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,300,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,300,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,300,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,300,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,300,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,300,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,300,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,300,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,300,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,300,Aluminum ,,,21.83,134.7,4 RC,300,Amikacin ,,,12.92,80.85,4 RC,300,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,300,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,300,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,300,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,300,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,300,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,300,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,300,Amiodarone ,,,15.97,98.82,4 RC,300,Ammonia ,,,12.48,77.23,4 RC,300,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,300,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,300,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,300,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,300,Amylase ,,,5.55,34.15,4 RC,300,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,300,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,300,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,300,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,300,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,300,Androstanediol glucuronide ,,,24.7,152.67,4 RC,300,Androstenedione ,,,25.09,154.51,4 RC,300,Androsterone ,,,21.89,134.7,4 RC,300,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,300,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,300,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,300,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,300,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,300,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,300,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,300,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,300,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,300,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,300,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,300,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,300,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,300,Angiotensin II ,,,17.58,109.59,4 RC,300,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,300,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,300,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,300,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,300,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,300,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,300,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,300,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,300,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,300,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,300,Antibody; Aspergillus ,,,12.89,79.01,4 RC,300,Antibody; Bartonella ,,,8.72,53.9,4 RC,300,Antibody; Blastomyces ,,,11.06,68.24,4 RC,300,Antibody; Bordetella ,,,11.3,70.08,4 RC,300,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,300,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,300,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,300,Antibody; Brucella ,,,7.65,46.7,4 RC,300,Antibody; Campylobacter ,,,11.24,70.08,4 RC,300,Antibody; Candida ,,,10.29,62.89,4 RC,300,Antibody; Chlamydia ,,,10.13,62.89,4 RC,300,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,300,Antibody; Coccidioides ,,,9.82,61.1,4 RC,300,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,300,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,300,Antibody; Diphtheria ,,,13.04,80.85,4 RC,300,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,300,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,300,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,300,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,300,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,300,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,300,Antibody; HIV-1 ,,,7.62,46.7,4 RC,300,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,300,Antibody; HIV-2 ,,,11.59,71.87,4 RC,300,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,300,Antibody; HTLV-I ,,,7.79,48.49,4 RC,300,Antibody; HTLV-II ,,,12.0,73.66,4 RC,300,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,300,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,300,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,300,Antibody; Legionella ,,,13.11,80.85,4 RC,300,Antibody; Leishmania ,,,10.5,64.67,4 RC,300,Antibody; Leptospira ,,,13.88,86.21,4 RC,300,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,300,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,300,Antibody; Nocardia ,,,13.7,84.43,4 RC,300,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,300,Antibody; Rickettsia ,,,16.57,102.39,4 RC,300,Antibody; Salmonella ,,,11.3,70.08,4 RC,300,Antibody; Shigella ,,,20.97,129.34,4 RC,300,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,300,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,300,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,300,Antibody; Trichinella ,,,10.76,66.46,4 RC,300,Antibody; West Nile virus ,,,12.33,75.44,4 RC,300,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,300,Antibody; Yersinia ,,,11.3,70.08,4 RC,300,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,300,Antibody; actinomyces ,,,8.72,53.9,4 RC,300,Antibody; adenovirus ,,,11.03,68.24,4 RC,300,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,300,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,300,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,300,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,300,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,300,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,300,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,300,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,300,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,300,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,300,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,300,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,300,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,300,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,300,Antibody; histoplasma ,,,11.81,73.66,4 RC,300,Antibody; influenza virus ,,,11.61,71.87,4 RC,300,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,300,Antibody; mucormycosis ,,,12.85,79.01,4 RC,300,Antibody; mumps ,,,11.18,70.08,4 RC,300,Antibody; mycoplasma ,,,11.34,70.08,4 RC,300,Antibody; parvovirus ,,,12.88,79.01,4 RC,300,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,300,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,300,Antibody; rotavirus ,,,15.62,96.98,4 RC,300,Antibody; rubella ,,,12.33,75.44,4 RC,300,Antibody; rubeola ,,,11.04,68.24,4 RC,300,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,300,Antibody; tetanus ,,,12.68,79.01,4 RC,300,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,300,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,300,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,300,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,300,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,300,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,300,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,300,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,300,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,300,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,300,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,300,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,300,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,300,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,300,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,300,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,300,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,300,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,300,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,300,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,300,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,300,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,300,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,300,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,300,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,300,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,300,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,300,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,300,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,300,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,300,"Apolipoprotein, each ",,,18.07,111.38,4 RC,300,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,300,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,300,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,300,Arsenic ,,,16.25,100.61,4 RC,300,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,300,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,300,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,300,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,300,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,300,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,300,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,300,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,300,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,300,"B cells, total count ",,,32.32,199.37,4 RC,300,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,300,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,300,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,300,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,300,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,300,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,300,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,300,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,300,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,300,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,300,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,300,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,300,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,300,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,300,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,300,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,300,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,300,Barbiturates ,,,9.34,127.56,4 RC,300,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,300,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,300,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,300,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,300,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,300,Beta-2 microglobulin ,,,13.86,86.21,4 RC,300,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,300,Bile acids; total ,,,14.67,91.62,4 RC,300,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,300,Bilirubin; direct ,,,4.3,26.95,4 RC,300,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,300,Bilirubin; total ,,,4.3,26.95,4 RC,300,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,300,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,300,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,300,Bleeding time ,,,4.13,25.17,4 RC,300,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,300,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,300,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,300,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,300,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,300,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,300,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,300,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,300,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,300,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,300,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,300,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,300,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,300,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,300,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,300,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,300,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,300,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,300,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,300,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,300,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,300,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,300,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,300,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,300,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,300,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,300,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,300,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,300,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,300,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,300,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,300,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,300,Bone age studies ,,,61.64,79.3,3 RC,300,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,300,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,300,Bradykinin ,,,4.42,26.95,4 RC,300,Buprenorphine ,,,14.01,14.01,1 RC,300,C-peptide ,,,17.83,109.59,4 RC,300,C-reactive protein; ,,,4.44,26.95,4 RC,300,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,300,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,300,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,300,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,300,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,300,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,300,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,300,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,300,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,300,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,300,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,300,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,300,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,300,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,300,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,300,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,300,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,300,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,300,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,300,Cadmium ,,,20.26,125.72,4 RC,300,Caffeine ,,,33.05,204.79,4 RC,300,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,300,Calcitonin ,,,22.95,141.9,4 RC,300,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,300,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,300,Calcium; ionized ,,,11.72,71.87,4 RC,300,Calcium; total ,,,4.42,26.95,4 RC,300,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,300,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,300,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,300,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,300,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,300,"Calprotectin, fecal ",,,16.82,104.18,4 RC,300,"Cannabinoids, natural ",,,11.5,127.56,4 RC,300,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,300,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,300,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,300,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,300,Carbamazepine; free ,,,11.35,70.08,4 RC,300,Carbamazepine; total ,,,12.48,77.23,4 RC,300,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,300,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,300,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,300,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,300,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,300,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,300,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,300,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,300,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,300,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,300,Carotene ,,,7.89,48.49,4 RC,300,Catecholamines; blood ,,,24.92,154.51,4 RC,300,Catecholamines; fractionated ,,,21.63,134.7,4 RC,300,Catecholamines; total urine ,,,23.39,145.53,4 RC,300,Cathepsin-D ,,,15.47,95.19,4 RC,300,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,300,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,300,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,300,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,300,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,300,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,300,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,300,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,300,Ceruloplasmin ,,,9.2,57.47,4 RC,300,Chemiluminescent assay ,,,12.1,75.44,4 RC,300,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,300,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,300,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,300,Chloramphenicol ,,,10.85,66.46,4 RC,300,Chloride; blood ,,,3.94,25.17,4 RC,300,Chloride; other source ,,,4.28,26.95,4 RC,300,Chloride; urine ,,,4.93,30.52,4 RC,300,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,300,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,300,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,300,Cholinesterase; RBC ,,,8.4,52.12,4 RC,300,Cholinesterase; serum ,,,6.74,41.29,4 RC,300,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,300,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,300,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,300,Chromium ,,,17.38,107.81,4 RC,300,Chromogenic substrate assay ,,,10.19,62.89,4 RC,300,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,300,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,300,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,300,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,300,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,300,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,300,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,300,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,300,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,300,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,300,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,300,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,300,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,300,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,300,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,300,Citrate ,,,23.82,147.31,4 RC,300,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,300,Clot retraction ,,,13.96,86.21,4 RC,300,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,300,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,300,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,300,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,300,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,300,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,300,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,300,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,300,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,300,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,300,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,300,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,300,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,300,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,300,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,300,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,300,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,300,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,300,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,300,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,300,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,300,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,300,Clozapine ,,,17.27,105.96,4 RC,300,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,300,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,300,Coagulation time; activated ,,,3.67,23.38,4 RC,300,Coagulation time; other methods ,,,3.85,23.38,4 RC,300,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,300,Cocaine ,,,10.46,127.56,4 RC,300,Cold agglutinin; screen ,,,6.92,43.13,4 RC,300,Cold agglutinin; titer ,,,6.91,43.13,4 RC,300,"Collagen cross links, any method ",,,16.0,98.82,4 RC,300,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,300,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,300,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,300,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,300,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,300,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,300,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,300,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,300,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,300,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,300,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,300,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,300,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,300,"Complement; antigen, each component ",,,10.28,62.89,4 RC,300,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,300,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,300,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,300,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,300,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,300,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,300,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,300,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,300,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,300,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,300,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,300,Copper ,,,10.63,66.46,4 RC,300,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,300,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,300,Corticosterone ,,,19.3,118.58,4 RC,300,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,300,Cortisol; free ,,,14.32,88.0,4 RC,300,Cortisol; total ,,,13.96,86.21,4 RC,300,Creatine ,,,3.98,25.17,4 RC,300,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,300,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,300,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,300,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,300,Creatinine; blood ,,,4.39,26.95,4 RC,300,Creatinine; clearance ,,,8.11,50.28,4 RC,300,Creatinine; other source ,,,4.44,26.95,4 RC,300,Cryofibrinogen ,,,12.12,75.44,4 RC,300,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,300,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,300,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,300,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,300,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,300,Cryopreservation; sperm ,,,442.57,570.33,3 RC,300,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,300,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,300,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,300,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,300,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,300,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,300,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,300,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,300,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,300,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,300,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,300,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,300,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,300,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,300,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,300,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,300,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,300,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,300,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,300,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,300,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,300,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,300,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,300,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,300,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,300,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,300,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,300,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,300,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,300,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,300,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,300,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,300,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,300,"Culture, typing; other methods ",,,6.63,41.29,4 RC,300,Cyanide ,,,16.63,102.39,4 RC,300,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,300,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,300,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,300,Cyclosporine ,,,15.46,95.19,4 RC,300,Cystatin C ,,,15.87,98.82,4 RC,300,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,300,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,300,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,300,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,300,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,300,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,300,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,300,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,300,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,300,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,300,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,300,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,300,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,300,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,300,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,300,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,300,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,300,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,300,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,300,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,300,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,300,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,300,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,300,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,300,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,300,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,300,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,300,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,300,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,300,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,300,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,300,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,300,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,300,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,300,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,300,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,300,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,300,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,300,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,300,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,300,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,300,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,300,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,300,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,300,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,300,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,300,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,300,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,300,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,300,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,300,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,300,Dibucaine number ,,,10.5,64.67,4 RC,300,Digoxin; free ,,,11.38,70.08,4 RC,300,Digoxin; total ,,,11.38,70.08,4 RC,300,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,300,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,300,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,300,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,300,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,300,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,300,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,300,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,300,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,300,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,300,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,300,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,300,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,300,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,300,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,300,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,300,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,300,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,300,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,300,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,300,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,300,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,300,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,300,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,300,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,300,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,300,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,300,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,300,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,300,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,300,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,300,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,300,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,300,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,300,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,300,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,300,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,300,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,300,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,300,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,300,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,300,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,300,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,300,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,300,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,300,Erythropoietin ,,,16.1,98.82,4 RC,300,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,300,Estradiol; total ,,,23.94,147.31,4 RC,300,Estriol ,,,20.72,127.56,4 RC,300,Estrogens; fractionated ,,,27.67,170.64,4 RC,300,Estrogens; total ,,,18.59,114.95,4 RC,300,Estrone ,,,21.38,132.92,4 RC,300,Ethosuximide ,,,14.0,86.21,4 RC,300,Ethylene glycol ,,,12.77,79.01,4 RC,300,Etiocholanolone ,,,22.48,138.33,4 RC,300,Euglobulin lysis ,,,7.2,44.92,4 RC,300,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,300,Everolimus ,,,11.76,73.66,4 RC,300,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,300,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,300,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,300,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,300,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,300,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,300,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,300,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,300,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,300,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,300,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,300,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,300,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,300,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,300,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,300,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,300,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,300,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,300,Factor inhibitor test ,,,11.03,68.24,4 RC,300,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,300,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,300,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,300,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,300,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,300,Felbamate ,,,15.97,98.82,4 RC,300,Fentanyl ,,,13.07,127.56,4 RC,300,Fern test ,,,40.44,52.12,3 RC,300,Ferritin ,,,11.68,71.87,4 RC,300,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,300,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,300,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,300,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,300,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,300,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,300,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,300,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,300,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,300,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,300,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,300,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,300,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,300,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,300,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,300,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,300,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,300,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,300,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,300,Fibrinogen; activity ,,,8.32,52.12,4 RC,300,Fibrinogen; antigen ,,,12.39,77.23,4 RC,300,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,300,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,300,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,300,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,300,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,300,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,300,Flecainide ,,,15.97,98.82,4 RC,300,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,300,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,300,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,300,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,300,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,300,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,300,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,300,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,300,Fluoride ,,,15.88,98.82,4 RC,300,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,300,Folic acid; RBC ,,,15.13,93.41,4 RC,300,Folic acid; serum ,,,12.6,77.23,4 RC,300,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,300,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,300,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,300,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,300,"Fructose, semen ",,,14.86,91.62,4 RC,300,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,300,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,300,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,300,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,300,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,300,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,300,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,300,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,300,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,300,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,300,"Galactokinase, RBC ",,,18.4,113.16,4 RC,300,Galactose ,,,9.6,59.26,4 RC,300,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,300,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,300,Galectin-3 ,,,182.6,235.31,3 RC,300,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,300,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,300,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,300,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,300,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,300,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,300,"Gases, blood, pH only ",,,9.42,57.47,4 RC,300,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,300,Gastrin ,,,15.11,93.41,4 RC,300,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,300,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,300,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,300,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,300,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,300,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,300,Gentamicin ,,,14.04,86.21,4 RC,300,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,300,Glucagon ,,,12.24,75.44,4 RC,300,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,300,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,300,Glucagon tolerance test ,,,15.23,93.41,4 RC,300,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,300,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,300,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,300,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,300,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,300,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,300,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,300,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,300,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,300,"Glucosidase, beta ",,,18.4,113.16,4 RC,300,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,300,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,300,Glutathione ,,,13.24,82.64,4 RC,300,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,300,Glycated protein ,,,14.36,88.0,4 RC,300,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,300,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,300,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,300,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,300,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,300,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,300,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,300,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,300,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,300,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,300,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,300,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,300,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,300,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,300,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,300,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,300,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,300,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,300,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,300,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,300,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,300,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,300,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,300,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,300,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,300,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,300,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,300,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,300,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,300,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,300,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,300,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,300,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,300,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,300,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,300,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,300,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,300,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,300,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,300,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,300,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,300,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,Haloperidol ,,,13.53,84.43,4 RC,300,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,300,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,300,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,300,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,300,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,300,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,300,Heinz bodies; direct ,,,3.6,21.54,4 RC,300,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,300,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,300,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,300,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,300,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,300,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,300,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,300,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,300,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,300,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,300,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,300,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,300,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,300,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,300,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,300,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,300,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,300,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,300,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,300,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,300,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,300,Hemoglobin; plasma ,,,6.26,39.51,4 RC,300,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,300,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,300,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,300,Hemoglobin; urine ,,,3.39,21.54,4 RC,300,"Hemolysin, acid ",,,7.6,46.7,4 RC,300,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,300,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,300,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,300,Heparin assay ,,,11.22,70.08,4 RC,300,Heparin neutralization ,,,10.15,62.89,4 RC,300,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,300,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,300,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,300,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,300,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,300,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,300,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,300,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,300,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,300,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,300,Hepatitis C antibody; ,,,12.23,75.44,4 RC,300,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,300,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,300,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,300,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,300,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,300,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,300,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,300,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,300,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,300,Heroin metabolite ,,,13.63,127.56,4 RC,300,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,300,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,300,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,300,Histamine ,,,25.31,156.3,4 RC,300,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,300,Homocysteine ,,,15.35,95.19,4 RC,300,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,300,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,300,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,300,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,300,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,300,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,300,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,300,Hydroxychloroquine ,,,15.97,98.82,4 RC,300,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,300,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,300,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,300,Hydroxyproline; free ,,,19.41,120.36,4 RC,300,Hydroxyproline; total ,,,20.82,129.34,4 RC,300,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,300,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,300,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,300,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,300,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,300,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,300,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,300,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,300,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,300,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,300,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,300,Immune complex assay ,,,20.88,129.34,4 RC,300,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,300,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,300,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,300,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,300,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,300,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,300,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,300,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,300,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,300,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,300,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,300,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,300,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,300,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,300,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,300,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,300,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,300,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,300,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,300,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,300,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,300,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,300,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,300,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,300,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,300,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,300,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,300,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,300,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,300,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,300,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,300,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,300,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,300,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,300,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,300,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,300,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,300,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,300,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,300,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,300,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,300,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,300,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,300,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,300,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,300,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,300,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,300,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,300,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,300,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,300,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,300,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,300,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,300,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,300,Infliximab ,,,33.05,204.79,4 RC,300,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,300,Inhibin A ,,,13.36,82.64,4 RC,300,Insemination of oocytes ,,,442.57,570.33,3 RC,300,Insulin antibodies ,,,18.34,113.16,4 RC,300,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,300,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,300,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,300,Insulin; free ,,,11.1,68.24,4 RC,300,Insulin; total ,,,9.79,61.1,4 RC,300,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,300,Intrinsic factor ,,,16.98,104.18,4 RC,300,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,300,Iron ,,,5.54,34.15,4 RC,300,Iron binding capacity ,,,7.49,46.7,4 RC,300,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,300,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,300,Islet cell antibody ,,,20.2,125.72,4 RC,300,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,300,Itraconazole ,,,23.23,143.69,4 RC,300,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,300,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,300,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,300,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,300,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,300,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,300,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,300,Ketamine and norketamine ,,,10.54,127.56,4 RC,300,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,300,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,300,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,300,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,300,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,300,Lacosamide ,,,23.23,143.69,4 RC,300,Lactate (lactic acid) ,,,9.91,61.1,4 RC,300,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,300,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,300,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,300,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,300,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,300,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,300,Lamotrigine ,,,11.35,70.08,4 RC,300,Lead ,,,10.37,64.67,4 RC,300,Leflunomide ,,,33.05,204.79,4 RC,300,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,300,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,300,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,300,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,300,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,300,Leukocyte transfusion ,,,305.26,393.39,3 RC,300,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,300,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,300,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,300,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,300,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,300,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,300,Levetiracetam ,,,11.35,70.08,4 RC,300,Lidocaine ,,,12.59,77.23,4 RC,300,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,300,Lipase ,,,5.91,35.94,4 RC,300,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,300,Lipoprotein (a) ,,,12.27,75.44,4 RC,300,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,300,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,300,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,300,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,300,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,300,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,300,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,300,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,300,Lithium ,,,5.66,35.94,4 RC,300,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,300,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,300,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,300,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,300,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,300,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,300,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,300,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,300,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,300,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,300,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,300,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,300,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,300,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,300,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,300,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,300,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,300,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,300,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,300,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,300,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,300,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,300,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,300,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,300,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,300,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,300,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,300,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,300,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,300,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,300,Magnesium ,,,5.74,35.94,4 RC,300,Malate dehydrogenase ,,,6.31,39.51,4 RC,300,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,300,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,300,Manganese ,,,22.84,141.9,4 RC,300,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,300,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,300,"Meat fibers, feces ",,,4.15,25.17,4 RC,300,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,300,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,300,"Mercury, quantitative ",,,13.93,86.21,4 RC,300,Metanephrines ,,,14.51,89.84,4 RC,300,Methadone ,,,11.24,127.56,4 RC,300,Methemalbumin ,,,9.2,57.47,4 RC,300,Methotrexate ,,,33.05,204.79,4 RC,300,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,300,Methylphenidate ,,,9.29,127.56,4 RC,300,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,300,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,300,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,300,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,300,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,300,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,300,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,300,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,300,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,300,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,300,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,300,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,300,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,300,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,300,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,300,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,300,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,300,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,300,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,300,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,300,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,300,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,300,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,300,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,300,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,300,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,300,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,300,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,300,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,300,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,300,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,300,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,300,Muramidase ,,,16.07,98.82,4 RC,300,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,300,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,300,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,300,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,300,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,300,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,300,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,300,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,300,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,300,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,300,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,300,Myoglobin ,,,11.07,68.24,4 RC,300,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,300,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,300,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,300,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,300,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,300,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,300,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,300,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,300,Natriuretic peptide ,,,33.64,208.36,4 RC,300,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,300,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,300,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,300,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,300,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,300,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,300,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,300,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,300,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,300,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,300,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,300,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,300,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,300,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,300,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,300,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,300,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,300,Nerve teasing preparations ,,,499.29,643.43,3 RC,300,"Neutralization test, viral ",,,14.48,89.84,4 RC,300,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,300,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,300,Nickel ,,,21.0,129.34,4 RC,300,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,300,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,300,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,300,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,300,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,300,Nucleotidase 5'- ,,,9.56,59.26,4 RC,300,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,300,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,300,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,300,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,300,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,300,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,300,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,300,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,300,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,300,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,300,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,300,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,300,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,300,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,300,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,300,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,300,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,300,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,300,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,300,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,300,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,300,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,300,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,300,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,300,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,300,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,300,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,300,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,300,"Opiates, 1 or more ",,,14.57,127.56,4 RC,300,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,300,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,300,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,300,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,300,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,300,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,300,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,300,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,300,Osmolality; blood ,,,5.66,35.94,4 RC,300,Osmolality; urine ,,,5.84,35.94,4 RC,300,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,300,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,300,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,300,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,300,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,300,Oxalate ,,,12.38,77.23,4 RC,300,Oxcarbazepine ,,,11.35,70.08,4 RC,300,Oxycodone ,,,12.15,127.56,4 RC,300,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,300,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,300,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,300,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,300,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,300,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,300,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,300,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,300,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,300,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,300,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,300,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,300,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,300,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,300,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,300,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,300,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,300,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,300,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,300,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,300,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,300,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,300,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,300,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,300,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,300,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,300,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,300,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,300,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,300,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,300,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,300,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,300,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,300,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,300,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,300,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,300,Phenobarbital ,,,13.11,80.85,4 RC,300,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,300,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,300,Phenytoin; free ,,,11.79,73.66,4 RC,300,Phenytoin; total ,,,11.35,70.08,4 RC,300,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,300,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,300,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,300,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,300,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,300,Phosphatidylglycerol ,,,14.16,88.0,4 RC,300,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,300,Phosphohexose isomerase ,,,9.19,57.47,4 RC,300,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,300,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,300,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,300,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,300,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,300,Pinworm examinations ,,,18.14,23.38,3 RC,300,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,300,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,300,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,300,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,300,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,300,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,300,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,300,Posaconazole ,,,23.23,143.69,4 RC,300,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,300,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,300,Potassium; urine ,,,4.05,25.17,4 RC,300,Prealbumin ,,,12.51,77.23,4 RC,300,Pregabalin ,,,7.07,127.56,4 RC,300,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,300,Pregnanediol ,,,18.23,113.16,4 RC,300,Pregnanetriol ,,,18.03,111.38,4 RC,300,Pregnenolone ,,,17.71,109.59,4 RC,300,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,300,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,300,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,300,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,300,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,300,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,300,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,300,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,300,Primidone ,,,14.22,88.0,4 RC,300,Procainamide; ,,,51.41,317.95,4 RC,300,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,300,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,300,Progesterone ,,,17.87,111.38,4 RC,300,Proinsulin ,,,22.87,141.9,4 RC,300,Prolactin ,,,16.61,102.39,4 RC,300,Propoxyphene ,,,10.72,127.56,4 RC,300,"Prostaglandin, each ",,,35.79,220.97,4 RC,300,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,300,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,300,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,300,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,300,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,300,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,300,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,300,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,300,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,300,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,300,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,300,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,300,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,300,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,300,Prothrombin time; ,,,3.67,23.38,4 RC,300,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,300,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,300,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,300,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,300,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,300,Pyruvate ,,,12.4,77.23,4 RC,300,Pyruvate kinase ,,,8.09,50.28,4 RC,300,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,300,Quinidine ,,,12.51,77.23,4 RC,300,Quinine ,,,9.97,61.1,4 RC,300,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,300,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,300,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,300,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,300,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,300,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,300,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,300,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,300,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,300,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,300,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,300,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,300,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,300,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,300,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,300,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,300,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,300,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,300,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,300,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,300,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,300,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,300,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,300,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,300,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,300,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,300,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,300,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,300,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,300,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,300,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,300,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,300,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,300,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,300,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,300,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,300,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,300,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,300,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,300,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,300,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,300,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,300,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,300,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,300,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,300,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,300,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,300,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,300,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,300,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,300,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,300,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,300,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,300,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,300,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,300,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,300,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,300,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,300,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,300,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,300,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,300,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,300,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,300,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,300,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,300,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,300,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,300,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,300,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,300,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,300,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,300,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,300,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,300,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,300,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,300,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,300,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,300,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,300,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,300,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,300,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,300,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,300,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,300,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,300,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,300,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,300,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,300,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,300,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,300,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,300,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,300,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,300,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,300,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,300,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,300,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,300,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,300,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,300,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,300,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,300,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,300,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,300,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,300,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,300,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,300,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,300,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,300,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,300,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,300,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,300,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,300,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,300,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,300,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,300,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,300,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,300,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,300,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,300,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,300,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,300,Receptor assay; estrogen ,,,75.3,465.26,4 RC,300,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,300,Receptor assay; progesterone ,,,55.59,343.11,4 RC,300,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,300,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,300,Renin ,,,18.84,116.79,4 RC,300,Reptilase test ,,,8.44,52.12,4 RC,300,Reticulated platelet assay ,,,30.62,188.6,4 RC,300,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,300,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,300,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,300,Rufinamide ,,,23.23,143.69,4 RC,300,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,300,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,300,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,300,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,300,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,300,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,300,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,300,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,300,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,300,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,300,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,300,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,300,Salicylate ,,,15.97,98.82,4 RC,300,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,300,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,300,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,300,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,300,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,300,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,300,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,300,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,300,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,300,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,300,Selenium ,,,21.88,134.7,4 RC,300,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,300,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,300,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,300,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,300,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,300,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,300,Serotonin ,,,26.54,163.49,4 RC,300,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,300,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,300,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,300,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,300,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,300,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,300,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,300,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,300,Sialic acid ,,,11.52,71.87,4 RC,300,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,300,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,300,Silica ,,,21.6,132.92,4 RC,300,Sirolimus ,,,11.76,73.66,4 RC,300,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,300,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,300,Skin test; candida ,,,79.46,102.39,3 RC,300,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,300,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,300,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,300,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,300,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,300,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,300,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,300,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,300,Sodium; other source ,,,4.16,25.17,4 RC,300,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,300,Sodium; urine ,,,4.33,26.95,4 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,300,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,300,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,300,Somatomedin ,,,18.22,113.16,4 RC,300,Somatostatin ,,,15.67,96.98,4 RC,300,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,300,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,300,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,300,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,300,Specific gravity (except urine) ,,,2.82,17.97,4 RC,300,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,300,Sperm antibodies ,,,43.21,55.69,3 RC,300,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,300,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,300,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,300,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,300,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,300,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,300,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,300,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,300,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,300,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,300,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,300,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,300,"Stimulants, synthetic ",,,12.05,127.56,4 RC,300,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,300,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,300,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,300,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,300,"Streptokinase, antibody ",,,10.84,66.46,4 RC,300,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,300,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,300,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,300,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,300,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,300,"Sulfate, urine ",,,4.7,28.74,4 RC,300,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,300,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,300,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,300,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,300,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,300,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,300,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,300,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,300,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,300,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,300,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,300,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,300,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,300,T cells; total count ,,,32.32,199.37,4 RC,300,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,300,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,300,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,300,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,300,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,300,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,300,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,300,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,300,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,300,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,300,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,300,Tacrolimus ,,,11.76,73.66,4 RC,300,Tapentadol ,,,10.83,127.56,4 RC,300,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,300,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,300,Testosterone; free ,,,21.82,134.7,4 RC,300,Testosterone; total ,,,22.11,136.54,4 RC,300,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,300,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,300,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,300,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,300,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,300,Theophylline ,,,12.12,75.44,4 RC,300,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,300,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,300,Thiocyanate ,,,9.97,61.1,4 RC,300,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,300,Thrombin time; plasma ,,,4.95,30.52,4 RC,300,Thrombin time; titer ,,,5.87,35.94,4 RC,300,Thrombomodulin ,,,14.8,91.62,4 RC,300,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,300,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,300,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,300,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,300,Thyroglobulin ,,,13.76,84.43,4 RC,300,Thyroglobulin antibody ,,,13.63,84.43,4 RC,300,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,300,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,300,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,300,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,300,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,300,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,300,Thyroxine; free ,,,7.73,48.49,4 RC,300,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,300,Thyroxine; total ,,,5.89,35.94,4 RC,300,Tiagabine ,,,23.23,143.69,4 RC,300,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,300,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,300,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,300,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,300,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,300,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,300,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,300,Tobramycin ,,,13.82,86.21,4 RC,300,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,300,Topiramate ,,,10.21,62.89,4 RC,300,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,300,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,300,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,300,Tramadol ,,,10.54,127.56,4 RC,300,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,300,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,300,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,300,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,300,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,300,Transferrin ,,,10.93,68.24,4 RC,300,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,300,Triglycerides ,,,4.92,30.52,4 RC,300,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,300,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,300,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,300,"Troponin, qualitative ",,,8.65,53.9,4 RC,300,"Troponin, quantitative ",,,10.68,66.46,4 RC,300,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,300,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,300,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,300,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,300,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,300,Tyrosine ,,,9.11,55.69,4 RC,300,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,300,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,300,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,300,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,300,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,300,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,300,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,300,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,300,Unlisted immunology procedure ,,,99.55,128.28,3 RC,300,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,300,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,300,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,300,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,300,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,300,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,300,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,300,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,300,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,300,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,300,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,300,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,300,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,300,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,300,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,300,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,300,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,300,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,300,Uric acid; blood ,,,3.88,23.38,4 RC,300,Uric acid; other source ,,,4.36,26.95,4 RC,300,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,300,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,300,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,300,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,300,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,300,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,300,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,300,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,300,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,300,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,300,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,300,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,300,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,300,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,300,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,300,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,300,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,300,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,300,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,300,Vancomycin ,,,11.6,71.87,4 RC,300,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,300,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,300,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,300,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,300,Vedolizumab ,,,33.05,204.79,4 RC,300,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,300,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,300,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,300,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,300,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,300,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,300,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,300,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,300,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,300,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,300,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,300,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,300,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,300,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,300,Very long chain fatty acids ,,,16.92,104.18,4 RC,300,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,300,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,300,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,300,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,300,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,300,Viscosity ,,,10.0,61.1,4 RC,300,Vitamin A ,,,9.95,61.1,4 RC,300,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,300,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,300,Vitamin K ,,,11.75,71.87,4 RC,300,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,300,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,300,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,300,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,300,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,300,Voriconazole ,,,23.23,143.69,4 RC,300,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,300,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,300,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,300,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,300,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,300,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,300,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,300,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,300,Zinc ,,,9.76,61.1,4 RC,300,Zonisamide ,,,11.35,70.08,4 RC,300,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,300,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,300,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,301, Laboratory Chemistry ,,,,,0 RC,301,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,301,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,301,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,301,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,301,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,301,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,301,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,301,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,301,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,301,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,301,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,301,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,301,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,301,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,301,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,301,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,Acetaminophen ,1304.28,1304.28,15.97,98.82,4 RC,301,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,301,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,301,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,301,Acetylcholinesterase ,,,10.53,64.67,4 RC,301,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,301,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,301,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,301,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,301,Adalimumab ,,,33.05,204.79,4 RC,301,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,301,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,301,Albumin; ischemia modified ,,,29.08,179.62,4 RC,301,"Albumin; other source, quantitative, each specimen ",948.0,948.0,6.67,41.29,4 RC,301,"Albumin; serum, plasma or whole blood ",346.0,346.0,4.24,26.95,4 RC,301,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,301,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,301,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,301,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,301,Aldolase ,992.0,992.0,8.32,52.12,4 RC,301,Aldosterone ,,,34.91,215.56,4 RC,301,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,301,"Alkaloids, not otherwise specified ",494.54,494.54,17.43,127.56,4 RC,301,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,301,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,301,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,301,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,301,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,301,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,301,Alpha-1-antitrypsin; total ,410.0,410.0,11.52,71.87,4 RC,301,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,301,Alpha-fetoprotein (AFP); serum ,1401.0,1401.0,14.37,88.0,4 RC,301,Aluminum ,,,21.83,134.7,4 RC,301,Amikacin ,,,12.92,80.85,4 RC,301,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,301,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,301,"Amino acids, 6 or more amino acids, quantitative, each specimen ",1772.46,1772.46,14.45,89.84,4 RC,301,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,301,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,301,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,301,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,301,Amiodarone ,1547.0,1547.0,15.97,98.82,4 RC,301,Ammonia ,597.0,597.0,12.48,77.23,4 RC,301,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,301,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,301,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,301,Amylase ,,,5.55,34.15,4 RC,301,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,301,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,301,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,301,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,301,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,301,Androstanediol glucuronide ,,,24.7,152.67,4 RC,301,Androstenedione ,,,25.09,154.51,4 RC,301,Androsterone ,,,21.89,134.7,4 RC,301,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,301,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,301,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,301,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,301,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,301,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,301,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,301,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,301,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,301,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,301,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,301,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,301,Angiotensin I - converting enzyme (ACE) ,1350.44,1350.44,12.51,77.23,4 RC,301,Angiotensin II ,,,17.58,109.59,4 RC,301,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,301,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,301,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,301,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,301,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,301,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,301,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,301,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,301,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,301,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,301,Antibody; Aspergillus ,,,12.89,79.01,4 RC,301,Antibody; Bartonella ,,,8.72,53.9,4 RC,301,Antibody; Blastomyces ,,,11.06,68.24,4 RC,301,Antibody; Bordetella ,,,11.3,70.08,4 RC,301,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,301,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,301,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,301,Antibody; Brucella ,,,7.65,46.7,4 RC,301,Antibody; Campylobacter ,,,11.24,70.08,4 RC,301,Antibody; Candida ,,,10.29,62.89,4 RC,301,Antibody; Chlamydia ,,,10.13,62.89,4 RC,301,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,301,Antibody; Coccidioides ,,,9.82,61.1,4 RC,301,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,301,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,301,Antibody; Diphtheria ,,,13.04,80.85,4 RC,301,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,301,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,301,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,301,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,301,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,301,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,301,Antibody; HIV-1 ,,,7.62,46.7,4 RC,301,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,301,Antibody; HIV-2 ,,,11.59,71.87,4 RC,301,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,301,Antibody; HTLV-I ,,,7.79,48.49,4 RC,301,Antibody; HTLV-II ,,,12.0,73.66,4 RC,301,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,301,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,301,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,301,Antibody; Legionella ,,,13.11,80.85,4 RC,301,Antibody; Leishmania ,,,10.5,64.67,4 RC,301,Antibody; Leptospira ,,,13.88,86.21,4 RC,301,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,301,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,301,Antibody; Nocardia ,,,13.7,84.43,4 RC,301,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,301,Antibody; Rickettsia ,,,16.57,102.39,4 RC,301,Antibody; Salmonella ,,,11.3,70.08,4 RC,301,Antibody; Shigella ,,,20.97,129.34,4 RC,301,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,301,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,301,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,301,Antibody; Trichinella ,,,10.76,66.46,4 RC,301,Antibody; West Nile virus ,,,12.33,75.44,4 RC,301,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,301,Antibody; Yersinia ,,,11.3,70.08,4 RC,301,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,301,Antibody; actinomyces ,,,8.72,53.9,4 RC,301,Antibody; adenovirus ,,,11.03,68.24,4 RC,301,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,301,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,301,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,301,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,301,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,301,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,301,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,301,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,301,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,301,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,301,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,301,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,301,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,301,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,301,Antibody; histoplasma ,,,11.81,73.66,4 RC,301,Antibody; influenza virus ,,,11.61,71.87,4 RC,301,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,301,Antibody; mucormycosis ,,,12.85,79.01,4 RC,301,Antibody; mumps ,,,11.18,70.08,4 RC,301,Antibody; mycoplasma ,,,11.34,70.08,4 RC,301,Antibody; parvovirus ,,,12.88,79.01,4 RC,301,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,301,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,301,Antibody; rotavirus ,,,15.62,96.98,4 RC,301,Antibody; rubella ,,,12.33,75.44,4 RC,301,Antibody; rubeola ,,,11.04,68.24,4 RC,301,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,301,Antibody; tetanus ,,,12.68,79.01,4 RC,301,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,301,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,301,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,301,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,301,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,301,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,301,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,301,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,301,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,301,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,301,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,301,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,301,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,301,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,301,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,301,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,301,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,301,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,301,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,301,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,301,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,301,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,301,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,301,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,301,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,301,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,301,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,301,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,301,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,301,"Apolipoprotein, each ",,,18.07,111.38,4 RC,301,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,301,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,301,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,301,Arsenic ,873.04,873.04,16.25,100.61,4 RC,301,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,301,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,301,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,301,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,301,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,301,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,301,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,301,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,301,"B cells, total count ",,,32.32,199.37,4 RC,301,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,301,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,301,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,301,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,301,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,301,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,301,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,301,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,301,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,301,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,301,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,301,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,301,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,301,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,301,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,301,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,301,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,301,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,301,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,301,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,301,Beta-2 microglobulin ,594.77,594.77,13.86,86.21,4 RC,301,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,301,Bile acids; total ,,,14.67,91.62,4 RC,301,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,301,Bilirubin; direct ,702.0,702.0,4.3,26.95,4 RC,301,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,301,Bilirubin; total ,,,4.3,26.95,4 RC,301,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,301,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,301,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,301,Bleeding time ,,,4.13,25.17,4 RC,301,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,301,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,301,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,301,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,301,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,301,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,301,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,301,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,301,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,301,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,301,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,301,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,301,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,301,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,301,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,301,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,301,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,301,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,301,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,301,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,301,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,301,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,301,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,301,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,301,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,301,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,301,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,301,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,301,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,301,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,301,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,301,Bone age studies ,,,61.64,79.3,3 RC,301,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,301,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,301,Bradykinin ,,,4.42,26.95,4 RC,301,Buprenorphine ,,,14.01,14.01,1 RC,301,C-peptide ,673.0,673.0,17.83,109.59,4 RC,301,C-reactive protein; ,,,4.44,26.95,4 RC,301,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,301,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,301,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,301,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,301,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,301,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,301,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,301,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,301,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,301,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,301,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,301,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,301,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,301,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,301,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,301,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,301,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,301,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,301,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,301,Cadmium ,,,20.26,125.72,4 RC,301,Caffeine ,,,33.05,204.79,4 RC,301,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,301,Calcitonin ,1001.0,1001.0,22.95,141.9,4 RC,301,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,301,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,301,Calcium; ionized ,1817.0,1817.0,11.72,71.87,4 RC,301,Calcium; total ,,,4.42,26.95,4 RC,301,"Calcium; urine quantitative, timed specimen ",532.79,532.79,5.17,32.31,4 RC,301,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,301,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,301,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,301,"Calprotectin, fecal ",1657.72,1657.72,16.82,104.18,4 RC,301,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,301,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,301,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,301,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,301,Carbamazepine; free ,,,11.35,70.08,4 RC,301,Carbamazepine; total ,1109.0,1109.0,12.48,77.23,4 RC,301,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,301,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,301,Carboxyhemoglobin; quantitative ,1024.7,1024.7,10.56,64.67,4 RC,301,Carcinoembryonic antigen (CEA) ,1252.0,1252.0,16.25,100.61,4 RC,301,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,301,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,301,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,301,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,301,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,301,Carotene ,,,7.89,48.49,4 RC,301,Catecholamines; blood ,,,24.92,154.51,4 RC,301,Catecholamines; fractionated ,,,21.63,134.7,4 RC,301,Catecholamines; total urine ,,,23.39,145.53,4 RC,301,Cathepsin-D ,,,15.47,95.19,4 RC,301,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,301,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,301,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,301,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,301,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,301,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,301,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,301,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,301,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,301,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,301,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,301,Chloramphenicol ,,,10.85,66.46,4 RC,301,Chloride; other source ,,,4.28,26.95,4 RC,301,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,301,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,301,"Cholesterol, serum or whole blood, total ",707.0,707.0,3.72,23.38,4 RC,301,Cholinesterase; RBC ,,,8.4,52.12,4 RC,301,Cholinesterase; serum ,,,6.74,41.29,4 RC,301,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,301,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,301,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,301,Chromium ,,,17.38,107.81,4 RC,301,Chromogenic substrate assay ,,,10.19,62.89,4 RC,301,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,301,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,301,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,301,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,301,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,301,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,301,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,301,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,301,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,301,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,301,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,301,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,301,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,301,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,301,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,301,Citrate ,,,23.82,147.31,4 RC,301,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,301,Clot retraction ,,,13.96,86.21,4 RC,301,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,301,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,301,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,301,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,301,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,301,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,301,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,301,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,301,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,301,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,301,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,301,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,301,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,301,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,301,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,301,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,301,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,301,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,301,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,301,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,301,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,301,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,301,Clozapine ,,,17.27,105.96,4 RC,301,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,301,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,301,Coagulation time; activated ,,,3.67,23.38,4 RC,301,Coagulation time; other methods ,,,3.85,23.38,4 RC,301,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,301,Cold agglutinin; screen ,,,6.92,43.13,4 RC,301,Cold agglutinin; titer ,,,6.91,43.13,4 RC,301,"Collagen cross links, any method ",,,16.0,98.82,4 RC,301,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,301,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,301,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,301,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,301,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,301,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,301,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,301,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,301,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,301,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,301,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,301,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,301,"Complement; antigen, each component ",,,10.28,62.89,4 RC,301,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,301,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,301,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,301,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,301,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,301,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,301,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,301,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,301,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,301,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,301,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,301,Copper ,,,10.63,66.46,4 RC,301,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,301,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,301,Corticosterone ,,,19.3,118.58,4 RC,301,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,301,Cortisol; free ,1447.0,1447.0,14.32,88.0,4 RC,301,Cortisol; total ,,,13.96,86.21,4 RC,301,Creatine ,,,3.98,25.17,4 RC,301,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,301,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,301,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,301,Creatinine; other source ,,,4.44,26.95,4 RC,301,Cryofibrinogen ,,,12.12,75.44,4 RC,301,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,301,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,301,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,301,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,301,Cryopreservation; sperm ,,,442.57,570.33,3 RC,301,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,301,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,301,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,301,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,301,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,301,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,301,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,301,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,301,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,301,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,301,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,301,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,301,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,301,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,301,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,301,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,301,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,301,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,301,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,301,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,301,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,301,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,301,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,301,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,301,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,301,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,301,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,301,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,301,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,301,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,301,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,301,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,301,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,301,"Culture, typing; other methods ",,,6.63,41.29,4 RC,301,Cyanide ,,,16.63,102.39,4 RC,301,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,301,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,301,Cystatin C ,,,15.87,98.82,4 RC,301,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,301,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,301,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,301,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,301,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,301,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,301,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,301,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,301,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,301,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,301,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,301,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,301,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,301,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,301,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,301,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,301,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,301,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,301,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,301,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,301,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,301,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,301,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,301,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,301,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,301,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,301,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,301,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,301,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,301,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,301,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,301,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,301,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,301,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,301,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,301,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,301,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,301,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,301,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,301,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,301,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,301,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,301,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,301,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,301,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,301,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,301,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,301,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,301,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,301,Dibucaine number ,,,10.5,64.67,4 RC,301,Digoxin; free ,,,11.38,70.08,4 RC,301,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,301,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,301,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,301,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,301,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,134.17,1309.57,12 RC,301,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,301,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,301,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,301,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,301,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,301,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,301,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,301,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,301,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,301,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,301,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,301,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,301,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,301,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,301,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,301,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,301,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,301,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,301,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,301,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,301,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,301,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,301,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,301,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,301,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,301,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,301,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,301,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,301,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,301,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,301,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,301,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,301,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,301,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,301,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,301,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,301,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,301,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,301,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,301,Estrogens; fractionated ,,,27.67,170.64,4 RC,301,Ethosuximide ,,,14.0,86.21,4 RC,301,Ethylene glycol ,658.08,658.08,12.77,79.01,4 RC,301,Etiocholanolone ,,,22.48,138.33,4 RC,301,Euglobulin lysis ,,,7.2,44.92,4 RC,301,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",377.17,377.17,84.06,520.95,4 RC,301,Everolimus ,,,11.76,73.66,4 RC,301,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,301,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,301,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,301,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,301,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,301,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,301,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,301,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,301,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,301,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,301,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,301,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,301,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,301,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,301,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,301,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,301,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,301,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,301,Factor inhibitor test ,,,11.03,68.24,4 RC,301,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,301,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,301,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,301,Felbamate ,,,15.97,98.82,4 RC,301,Fern test ,,,40.44,52.12,3 RC,301,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,301,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,301,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,301,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,301,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,301,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,301,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,301,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,301,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,301,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,301,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,301,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,301,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,301,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,301,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,301,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,301,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,301,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,301,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,301,Fibrinogen; activity ,,,8.32,52.12,4 RC,301,Fibrinogen; antigen ,,,12.39,77.23,4 RC,301,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,301,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,301,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,301,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,301,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,301,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,301,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,301,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,301,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,301,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,301,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,301,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,301,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,301,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,301,Fluoride ,,,15.88,98.82,4 RC,301,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,301,Folic acid; RBC ,,,15.13,93.41,4 RC,301,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,301,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,301,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,301,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,301,"Fructose, semen ",,,14.86,91.62,4 RC,301,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,301,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,301,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,301,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,301,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,301,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,301,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,301,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,301,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,301,"Gabapentin, whole blood, serum, or plasma ",900.73,900.73,18.56,114.95,4 RC,301,"Galactokinase, RBC ",,,18.4,113.16,4 RC,301,Galactose ,,,9.6,59.26,4 RC,301,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,301,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,301,Galectin-3 ,,,182.6,235.31,3 RC,301,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,301,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,301,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,301,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",2650.0,2650.0,67.49,416.77,4 RC,301,"Gases, blood, pH only ",,,9.42,57.47,4 RC,301,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,301,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,301,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,301,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,301,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,301,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,301,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,301,Gentamicin ,,,14.04,86.21,4 RC,301,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,301,Glucagon ,,,12.24,75.44,4 RC,301,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,301,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,301,Glucagon tolerance test ,,,15.23,93.41,4 RC,301,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,301,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,301,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,301,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,301,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,301,"Glucosidase, beta ",,,18.4,113.16,4 RC,301,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,301,Glutathione ,,,13.24,82.64,4 RC,301,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,301,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,301,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,301,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,301,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,301,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,301,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,301,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,301,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,301,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,301,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,301,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,301,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,301,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,301,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,301,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,301,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,301,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,301,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,301,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,301,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,301,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,301,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,301,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,301,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,301,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,301,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,301,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,301,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,301,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,301,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,301,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,301,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,301,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,301,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,301,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,301,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,301,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,301,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,301,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,Haloperidol ,,,13.53,84.43,4 RC,301,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,301,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,301,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,301,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,301,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,301,Heinz bodies; direct ,,,3.6,21.54,4 RC,301,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,301,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,301,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,301,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,301,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,301,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,301,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,301,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",133.2,133.2,15.47,95.19,4 RC,301,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,301,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,301,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,301,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,301,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,301,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,301,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,301,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,301,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,301,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,301,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,301,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,301,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,301,Hemoglobin; urine ,,,3.39,21.54,4 RC,301,"Hemolysin, acid ",,,7.6,46.7,4 RC,301,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,301,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,301,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,301,Heparin assay ,,,11.22,70.08,4 RC,301,Heparin neutralization ,,,10.15,62.89,4 RC,301,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,301,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,301,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,301,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,301,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,301,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,301,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,301,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,301,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,301,Hepatitis C antibody; ,,,12.23,75.44,4 RC,301,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,301,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,301,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,301,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,301,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,301,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,301,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,301,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,301,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,301,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,301,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,301,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,301,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,301,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,301,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,301,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,301,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,301,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,301,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,301,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,301,Hydroxychloroquine ,,,15.97,98.82,4 RC,301,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,301,"Hydroxyindolacetic acid, 5-(HIAA) ",754.0,754.0,11.06,68.24,4 RC,301,"Hydroxyprogesterone, 17-d ",466.85,466.85,23.28,143.69,4 RC,301,Hydroxyproline; free ,,,19.41,120.36,4 RC,301,Hydroxyproline; total ,,,20.82,129.34,4 RC,301,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,301,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,301,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,301,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,301,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,301,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,301,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,301,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,301,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,301,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,301,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,301,Immune complex assay ,,,20.88,129.34,4 RC,301,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,301,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,301,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,301,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,301,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,301,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,301,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,301,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,301,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,301,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,301,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,301,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,301,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,301,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,301,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,301,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,301,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,301,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,301,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,301,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,301,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,301,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,301,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,301,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,301,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,301,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,301,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,301,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,301,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,301,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,301,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,301,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,301,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,301,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,301,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,301,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,301,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,301,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,301,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,301,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,301,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,301,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,301,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,301,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,301,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,301,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,301,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,301,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,301,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,301,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,301,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,301,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,301,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,301,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,301,Infliximab ,,,33.05,204.79,4 RC,301,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,301,Inhibin A ,,,13.36,82.64,4 RC,301,Insemination of oocytes ,,,442.57,570.33,3 RC,301,Insulin antibodies ,,,18.34,113.16,4 RC,301,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,301,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,301,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,301,Insulin; free ,,,11.1,68.24,4 RC,301,Interleukin-6 (IL-6) ,718.75,718.75,14.8,91.62,4 RC,301,Intrinsic factor ,,,16.98,104.18,4 RC,301,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,301,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,301,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,301,Islet cell antibody ,,,20.2,125.72,4 RC,301,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,301,Itraconazole ,,,23.23,143.69,4 RC,301,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,301,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,301,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,301,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,301,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,301,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,301,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,301,Ketamine and norketamine ,,,10.54,127.56,4 RC,301,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,301,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",134.52,134.52,7.0,43.13,4 RC,301,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,301,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,301,Lacosamide ,,,23.23,143.69,4 RC,301,Lactate (lactic acid) ,,,9.91,61.1,4 RC,301,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,301,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,301,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,301,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,301,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,301,Lamotrigine ,,,11.35,70.08,4 RC,301,Leflunomide ,,,33.05,204.79,4 RC,301,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,301,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,301,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,301,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,301,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,301,Leukocyte transfusion ,,,305.26,393.39,3 RC,301,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,301,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,301,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,301,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,301,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,301,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,301,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,301,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,301,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,301,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,301,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,301,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,301,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,301,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,301,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,301,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,301,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,301,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,301,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,301,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,301,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,301,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,301,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,301,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,301,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,301,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,301,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,301,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,301,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,301,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,301,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,301,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,301,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,301,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,301,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,301,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,301,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,301,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,301,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,301,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,301,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,301,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,301,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,301,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,301,Magnesium ,,,5.74,35.94,4 RC,301,Malate dehydrogenase ,,,6.31,39.51,4 RC,301,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,301,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,301,Manganese ,,,22.84,141.9,4 RC,301,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,301,"Meat fibers, feces ",,,4.15,25.17,4 RC,301,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,301,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,301,Metanephrines ,1580.0,1580.0,14.51,89.84,4 RC,301,Methemalbumin ,,,9.2,57.47,4 RC,301,Methylphenidate ,,,9.29,127.56,4 RC,301,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,301,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,301,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,301,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,301,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,301,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,301,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,301,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,301,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,301,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,301,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,301,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,301,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,301,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,301,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,301,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,301,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,301,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,301,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,301,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,301,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,301,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,301,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,301,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,301,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,301,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,301,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,301,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,301,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,301,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,301,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,301,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,301,Muramidase ,,,16.07,98.82,4 RC,301,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,301,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,301,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,301,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,301,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,301,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,301,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,301,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,301,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,301,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,301,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,301,Myoglobin ,,,11.07,68.24,4 RC,301,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,301,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,301,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,301,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,301,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,301,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,301,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,301,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,301,Natriuretic peptide ,,,33.64,208.36,4 RC,301,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,301,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,301,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,301,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,301,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,301,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,301,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,301,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,301,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,301,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,301,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,301,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,301,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,301,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,301,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,301,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,301,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,301,Nerve teasing preparations ,,,499.29,643.43,3 RC,301,"Neutralization test, viral ",,,14.48,89.84,4 RC,301,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,301,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,301,Nickel ,,,21.0,129.34,4 RC,301,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,301,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,301,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,301,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,301,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,301,Nucleotidase 5'- ,,,9.56,59.26,4 RC,301,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,301,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,301,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,301,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,301,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,301,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,301,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,301,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,301,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,301,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,301,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,301,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,301,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,301,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,301,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,301,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,301,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,301,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,301,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,301,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,301,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,301,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,301,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,301,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,301,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,301,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,301,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,301,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,301,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,301,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,301,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,301,"Organic acid, single, quantitative ",1906.98,1906.98,18.18,113.16,4 RC,301,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,301,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,301,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,301,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,301,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,301,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,301,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,301,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,301,Oxcarbazepine ,,,11.35,70.08,4 RC,301,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,301,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,301,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,301,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,301,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,301,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,301,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,301,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,301,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,301,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,301,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,301,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,301,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,301,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,301,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,301,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,301,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,301,Parathormone (parathyroid hormone) ,2311.84,2311.84,35.37,219.18,4 RC,301,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,301,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,301,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,301,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,301,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,301,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,301,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,301,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,301,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,301,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,301,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,301,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,301,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,301,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,301,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,301,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,301,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,301,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,301,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,301,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,301,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,301,"Phosphatase, alkaline; ",808.0,808.0,4.44,26.95,4 RC,301,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,301,"Phosphatase, alkaline; isoenzymes ",1612.88,1612.88,12.67,79.01,4 RC,301,Phosphatidylglycerol ,,,14.16,88.0,4 RC,301,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,301,Phosphohexose isomerase ,,,9.19,57.47,4 RC,301,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,301,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,301,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,301,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,301,Pinworm examinations ,,,18.14,23.38,3 RC,301,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,301,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,301,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,301,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,301,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,301,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,301,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,301,Posaconazole ,,,23.23,143.69,4 RC,301,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,301,Pregabalin ,,,7.07,127.56,4 RC,301,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,301,Pregnanediol ,,,18.23,113.16,4 RC,301,Pregnanetriol ,,,18.03,111.38,4 RC,301,Pregnenolone ,,,17.71,109.59,4 RC,301,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,301,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,301,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,301,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,301,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,301,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,301,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,301,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,301,Primidone ,,,14.22,88.0,4 RC,301,Procainamide; ,,,51.41,317.95,4 RC,301,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,301,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,301,Proinsulin ,,,22.87,141.9,4 RC,301,"Prostaglandin, each ",,,35.79,220.97,4 RC,301,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,301,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,301,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,301,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,301,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,301,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,301,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,301,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,301,Prothrombin time; ,,,3.67,23.38,4 RC,301,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,301,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,301,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,301,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,301,Pyruvate ,,,12.4,77.23,4 RC,301,Pyruvate kinase ,,,8.09,50.28,4 RC,301,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,301,Quinidine ,,,12.51,77.23,4 RC,301,Quinine ,,,9.97,61.1,4 RC,301,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,301,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,301,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,301,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,301,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,301,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,301,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,301,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,301,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,301,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,301,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,301,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,301,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,301,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,301,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,301,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,301,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,301,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,301,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,301,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,301,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,301,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,301,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,301,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,301,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,301,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,301,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,301,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,301,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,301,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,301,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,301,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,301,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,301,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,301,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,301,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,301,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,301,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,301,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,301,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,301,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,301,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,301,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,301,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,301,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,301,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,301,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,301,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,301,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,301,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,301,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,301,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,301,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,301,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,301,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,301,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,301,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,301,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,301,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,301,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,301,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,301,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,301,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,301,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,301,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,301,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,301,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,301,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,301,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,301,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,301,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,301,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,301,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,301,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,301,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,301,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,301,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,301,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,301,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,301,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,301,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,301,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,301,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,301,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,301,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,301,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,301,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,301,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,301,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,301,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,301,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,301,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,301,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,301,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,301,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,301,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,301,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,301,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,301,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,301,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,301,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,301,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,301,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,301,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,301,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,301,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,301,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,301,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,301,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,301,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,301,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,301,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,301,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,301,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,301,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,301,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,301,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,301,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,301,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,301,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,301,Receptor assay; estrogen ,,,75.3,465.26,4 RC,301,Receptor assay; progesterone ,,,55.59,343.11,4 RC,301,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,301,Reptilase test ,,,8.44,52.12,4 RC,301,Reticulated platelet assay ,,,30.62,188.6,4 RC,301,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,301,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,301,Rufinamide ,,,23.23,143.69,4 RC,301,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,301,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,301,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,301,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,301,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,301,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,301,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,301,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,301,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,301,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,301,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,301,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,301,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,301,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,301,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,301,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,301,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,301,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,301,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,301,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,301,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,301,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,301,Selenium ,,,21.88,134.7,4 RC,301,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,301,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,301,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,301,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,301,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,301,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,301,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,301,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,301,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,301,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,301,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,301,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,301,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,301,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,301,Sialic acid ,,,11.52,71.87,4 RC,301,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,301,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,301,Silica ,,,21.6,132.92,4 RC,301,Sirolimus ,510.37,510.37,11.76,73.66,4 RC,301,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,301,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,301,Skin test; candida ,,,79.46,102.39,3 RC,301,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,301,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,301,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,301,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,301,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,301,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,301,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,301,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,301,Sodium; other source ,,,4.16,25.17,4 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,301,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,301,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,301,Somatomedin ,1976.87,1976.87,18.22,113.16,4 RC,301,Somatostatin ,,,15.67,96.98,4 RC,301,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,301,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,301,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,301,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,301,Specific gravity (except urine) ,,,2.82,17.97,4 RC,301,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,301,Sperm antibodies ,,,43.21,55.69,3 RC,301,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,301,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,301,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,301,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,301,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,301,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,301,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,301,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,301,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,301,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,301,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,301,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,301,"Stimulants, synthetic ",,,12.05,127.56,4 RC,301,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,301,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,301,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,301,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,301,"Streptokinase, antibody ",,,10.84,66.46,4 RC,301,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,301,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,301,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,301,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,301,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,301,"Sulfate, urine ",,,4.7,28.74,4 RC,301,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,301,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,301,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,301,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,301,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,301,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,301,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,301,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,301,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,301,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,301,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,301,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,301,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,301,T cells; total count ,,,32.32,199.37,4 RC,301,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,301,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,301,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,301,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,301,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,301,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,301,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,301,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,301,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,301,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,301,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,301,Tacrolimus ,736.0,736.0,11.76,73.66,4 RC,301,Tapentadol ,,,10.83,127.56,4 RC,301,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,301,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,301,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,301,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,301,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,301,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,301,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,301,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,301,Thiocyanate ,,,9.97,61.1,4 RC,301,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,301,Thrombin time; plasma ,,,4.95,30.52,4 RC,301,Thrombin time; titer ,,,5.87,35.94,4 RC,301,Thrombomodulin ,,,14.8,91.62,4 RC,301,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,301,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,301,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,301,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,301,Thyroglobulin antibody ,,,13.63,84.43,4 RC,301,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,301,Thyroid stimulating immune globulins (TSI) ,639.61,639.61,43.57,269.46,4 RC,301,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,301,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,301,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,301,Tiagabine ,,,23.23,143.69,4 RC,301,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,301,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,301,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,301,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,301,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,301,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,301,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,301,Tobramycin ,,,13.82,86.21,4 RC,301,Topiramate ,,,10.21,62.89,4 RC,301,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,301,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,301,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,301,Tramadol ,,,10.54,127.56,4 RC,301,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,301,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,301,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,301,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,301,Triglycerides ,,,4.92,30.52,4 RC,301,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,301,"Troponin, qualitative ",,,8.65,53.9,4 RC,301,"Troponin, quantitative ",,,10.68,66.46,4 RC,301,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,301,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,301,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,301,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,301,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,301,Tyrosine ,,,9.11,55.69,4 RC,301,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,301,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,301,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,301,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,301,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,301,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,301,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,301,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,301,Unlisted immunology procedure ,,,99.55,128.28,3 RC,301,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,301,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,301,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,301,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,301,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,301,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,301,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,301,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,301,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,301,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,301,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,301,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,301,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,301,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,301,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,301,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,301,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,301,Uric acid; other source ,,,4.36,26.95,4 RC,301,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,301,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,301,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,301,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,301,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,301,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,301,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,301,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,301,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,301,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,301,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,301,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,301,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,301,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,301,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,301,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,301,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,301,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,301,Vancomycin ,,,11.6,71.87,4 RC,301,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,301,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,301,"Vasopressin (antidiuretic hormone, ADH) ",498.5,498.5,29.08,179.62,4 RC,301,Vedolizumab ,,,33.05,204.79,4 RC,301,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,301,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,301,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,301,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,301,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,301,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,301,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,301,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,301,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,301,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,301,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,301,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,301,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,301,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,301,Very long chain fatty acids ,,,16.92,104.18,4 RC,301,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,301,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,301,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,301,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,301,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,301,Viscosity ,,,10.0,61.1,4 RC,301,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",172.77,172.77,25.36,156.3,4 RC,301,Vitamin K ,749.07,749.07,11.75,71.87,4 RC,301,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,301,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,301,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,301,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,301,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,301,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,301,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,301,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,301,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,301,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,301,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,301,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,301,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,301,Zonisamide ,,,11.35,70.08,4 RC,301,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,301,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,302, Laboratory Immunology ,,,,,0 RC,302,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,302,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,302,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,302,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,302,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,302,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,302,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,302,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,302,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,302,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,302,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,302,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,302,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,302,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,302,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,302,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,302,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,Acetaminophen ,,,15.97,98.82,4 RC,302,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,302,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,302,Acetylcholinesterase ,,,10.53,64.67,4 RC,302,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,302,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,302,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,302,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,302,Adalimumab ,,,33.05,204.79,4 RC,302,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,302,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,302,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,302,Albumin; ischemia modified ,,,29.08,179.62,4 RC,302,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,302,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,302,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,302,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,302,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,302,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,302,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,302,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,302,Alcohols ,,,9.61,127.56,4 RC,302,Aldolase ,,,8.32,52.12,4 RC,302,Aldosterone ,,,34.91,215.56,4 RC,302,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,302,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,302,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,302,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,302,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,302,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,302,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,302,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,302,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,302,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,302,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,302,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,302,Aluminum ,,,21.83,134.7,4 RC,302,Amikacin ,,,12.92,80.85,4 RC,302,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,302,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,302,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,302,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,302,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,302,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,302,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,302,Amiodarone ,,,15.97,98.82,4 RC,302,Ammonia ,,,12.48,77.23,4 RC,302,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,302,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,302,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,302,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,302,Amylase ,,,5.55,34.15,4 RC,302,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,302,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,302,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,302,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,302,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,302,Androstanediol glucuronide ,,,24.7,152.67,4 RC,302,Androstenedione ,,,25.09,154.51,4 RC,302,Androsterone ,,,21.89,134.7,4 RC,302,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,302,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,302,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,302,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,302,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,302,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,302,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,302,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,302,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,302,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,302,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,302,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,302,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,302,Angiotensin II ,,,17.58,109.59,4 RC,302,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,302,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,302,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,302,Antibody identification; leukocyte antibodies ,895.46,895.46,12.89,79.01,4 RC,302,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,302,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,302,"Antibody screen, RBC, each serum technique ",597.41,597.41,40.44,52.12,3 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,302,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,302,Antibody; Aspergillus ,,,12.89,79.01,4 RC,302,Antibody; Bartonella ,,,8.72,53.9,4 RC,302,Antibody; Blastomyces ,775.0,775.0,11.06,68.24,4 RC,302,Antibody; Bordetella ,,,11.3,70.08,4 RC,302,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,302,Antibody; Borrelia burgdorferi (Lyme disease) ,495.86,495.86,14.6,89.84,4 RC,302,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,302,Antibody; Brucella ,,,7.65,46.7,4 RC,302,Antibody; Campylobacter ,,,11.24,70.08,4 RC,302,Antibody; Candida ,,,10.29,62.89,4 RC,302,Antibody; Chlamydia ,,,10.13,62.89,4 RC,302,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,302,Antibody; Coxiella burnetii (Q fever) ,1325.39,1325.39,10.38,64.67,4 RC,302,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,302,Antibody; Diphtheria ,,,13.04,80.85,4 RC,302,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,302,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,302,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,302,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,302,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,302,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,302,Antibody; HTLV-I ,,,7.79,48.49,4 RC,302,Antibody; HTLV-II ,,,12.0,73.66,4 RC,302,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,302,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,302,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,302,Antibody; Leishmania ,,,10.5,64.67,4 RC,302,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,302,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,302,Antibody; Nocardia ,,,13.7,84.43,4 RC,302,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,302,Antibody; Rickettsia ,,,16.57,102.39,4 RC,302,Antibody; Salmonella ,,,11.3,70.08,4 RC,302,Antibody; Shigella ,,,20.97,129.34,4 RC,302,Antibody; Trichinella ,,,10.76,66.46,4 RC,302,Antibody; West Nile virus ,,,12.33,75.44,4 RC,302,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,302,Antibody; Yersinia ,,,11.3,70.08,4 RC,302,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,302,Antibody; actinomyces ,,,8.72,53.9,4 RC,302,Antibody; adenovirus ,,,11.03,68.24,4 RC,302,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,302,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,302,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,302,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,302,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,302,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,302,"Antibody; herpes simplex, type 1 ",141.11,141.11,11.3,70.08,4 RC,302,"Antibody; herpes simplex, type 2 ",96.27,96.27,16.57,102.39,4 RC,302,Antibody; influenza virus ,,,11.61,71.87,4 RC,302,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,302,Antibody; mucormycosis ,,,12.85,79.01,4 RC,302,Antibody; mumps ,,,11.18,70.08,4 RC,302,Antibody; mycoplasma ,,,11.34,70.08,4 RC,302,Antibody; parvovirus ,,,12.88,79.01,4 RC,302,"Antibody; protozoa, not elsewhere specified ",410.15,410.15,10.62,66.46,4 RC,302,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,302,Antibody; rotavirus ,,,15.62,96.98,4 RC,302,Antibody; rubella ,,,12.33,75.44,4 RC,302,Antibody; rubeola ,,,11.04,68.24,4 RC,302,Antibody; tetanus ,,,12.68,79.01,4 RC,302,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,302,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,302,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,302,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,302,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,302,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,302,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,302,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,302,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,302,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,302,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,302,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,302,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,302,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",497.18,497.18,4.44,26.95,4 RC,302,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,302,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,302,Antinuclear antibodies (ANA); ,1170.0,1170.0,10.36,64.67,4 RC,302,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,302,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,302,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,302,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,302,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,302,Antistreptolysin 0; titer ,716.11,716.11,6.25,39.51,4 RC,302,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,302,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,302,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,302,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,302,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,302,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,302,"Apolipoprotein, each ",,,18.07,111.38,4 RC,302,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,302,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,302,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,302,Arsenic ,,,16.25,100.61,4 RC,302,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,302,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,302,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,302,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,302,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,302,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,302,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,302,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,302,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,302,"B cells, total count ",,,32.32,199.37,4 RC,302,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,302,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,302,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,302,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,302,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,302,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,302,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,302,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,302,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,302,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,302,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,302,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,302,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,302,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,302,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,302,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,302,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,302,Barbiturates ,,,9.34,127.56,4 RC,302,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,302,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,302,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,302,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,302,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,302,Beta-2 microglobulin ,,,13.86,86.21,4 RC,302,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,302,Bile acids; total ,,,14.67,91.62,4 RC,302,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,302,Bilirubin; direct ,,,4.3,26.95,4 RC,302,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,302,Bilirubin; total ,,,4.3,26.95,4 RC,302,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,302,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,302,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,302,Bleeding time ,,,4.13,25.17,4 RC,302,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,302,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,302,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,302,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,302,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,302,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,302,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,302,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,302,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,302,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,302,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,302,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,302,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,302,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,302,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,302,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,302,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,302,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,302,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,302,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,302,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,302,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,302,"Blood typing, serologic; ABO ",347.0,347.0,2.56,16.18,4 RC,302,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",347.0,347.0,3.28,19.75,4 RC,302,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,302,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,302,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,302,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,302,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,302,Bone age studies ,,,61.64,79.3,3 RC,302,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,302,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,302,Bradykinin ,,,4.42,26.95,4 RC,302,Buprenorphine ,,,14.01,14.01,1 RC,302,C-peptide ,,,17.83,109.59,4 RC,302,C-reactive protein; ,253.0,253.0,4.44,26.95,4 RC,302,C-reactive protein; high sensitivity (hsCRP) ,298.0,298.0,11.1,68.24,4 RC,302,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,302,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,302,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,302,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,302,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,302,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,302,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,302,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,302,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,302,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,302,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,302,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,302,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,302,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,302,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,302,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,302,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,302,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,302,Cadmium ,,,20.26,125.72,4 RC,302,Caffeine ,,,33.05,204.79,4 RC,302,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,302,Calcitonin ,,,22.95,141.9,4 RC,302,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,302,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,302,Calcium; ionized ,,,11.72,71.87,4 RC,302,Calcium; total ,,,4.42,26.95,4 RC,302,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,302,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,302,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,302,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,302,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,302,"Calprotectin, fecal ",,,16.82,104.18,4 RC,302,"Cannabinoids, natural ",,,11.5,127.56,4 RC,302,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,302,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,302,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,302,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,302,Carbamazepine; free ,,,11.35,70.08,4 RC,302,Carbamazepine; total ,,,12.48,77.23,4 RC,302,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,302,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,302,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,302,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,302,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,302,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,302,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,302,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,302,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,302,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,302,Carotene ,,,7.89,48.49,4 RC,302,Catecholamines; blood ,,,24.92,154.51,4 RC,302,Catecholamines; fractionated ,,,21.63,134.7,4 RC,302,Catecholamines; total urine ,,,23.39,145.53,4 RC,302,Cathepsin-D ,,,15.47,95.19,4 RC,302,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,302,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,302,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,302,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,302,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,302,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,302,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,302,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,302,Ceruloplasmin ,,,9.2,57.47,4 RC,302,Chemiluminescent assay ,,,12.1,75.44,4 RC,302,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,302,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,302,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,302,Chloramphenicol ,,,10.85,66.46,4 RC,302,Chloride; blood ,,,3.94,25.17,4 RC,302,Chloride; other source ,,,4.28,26.95,4 RC,302,Chloride; urine ,,,4.93,30.52,4 RC,302,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,302,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,302,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,302,Cholinesterase; RBC ,,,8.4,52.12,4 RC,302,Cholinesterase; serum ,,,6.74,41.29,4 RC,302,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,302,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,302,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,302,Chromium ,,,17.38,107.81,4 RC,302,Chromogenic substrate assay ,,,10.19,62.89,4 RC,302,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,302,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,302,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,302,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,302,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,302,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,302,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,302,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,302,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,302,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,302,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,302,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,302,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,302,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,302,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,302,Citrate ,,,23.82,147.31,4 RC,302,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,302,Clot retraction ,,,13.96,86.21,4 RC,302,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,302,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,302,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,302,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,302,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,302,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,302,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,302,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,302,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,302,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,302,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,302,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,302,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,302,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,302,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,302,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,302,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,302,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,302,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,302,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,302,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,302,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,302,Clozapine ,,,17.27,105.96,4 RC,302,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,302,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,302,Coagulation time; activated ,,,3.67,23.38,4 RC,302,Coagulation time; other methods ,,,3.85,23.38,4 RC,302,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,302,Cocaine ,,,10.46,127.56,4 RC,302,Cold agglutinin; screen ,,,6.92,43.13,4 RC,302,"Collagen cross links, any method ",,,16.0,98.82,4 RC,302,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,302,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,302,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,302,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,302,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,302,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,302,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,302,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,302,Compatibility test each unit; antiglobulin technique ,957.45,957.45,150.55,194.02,3 RC,302,Compatibility test each unit; incubation technique ,957.45,957.45,126.87,163.49,3 RC,302,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,302,"Complement; antigen, each component ",,,10.28,62.89,4 RC,302,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,302,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,302,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,302,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,302,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,302,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,302,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,302,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,302,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,302,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,302,Copper ,,,10.63,66.46,4 RC,302,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,302,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,302,Corticosterone ,,,19.3,118.58,4 RC,302,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,302,Cortisol; free ,,,14.32,88.0,4 RC,302,Cortisol; total ,,,13.96,86.21,4 RC,302,Creatine ,,,3.98,25.17,4 RC,302,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,302,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,302,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,302,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,302,Creatinine; blood ,,,4.39,26.95,4 RC,302,Creatinine; clearance ,,,8.11,50.28,4 RC,302,Creatinine; other source ,,,4.44,26.95,4 RC,302,Cryofibrinogen ,,,12.12,75.44,4 RC,302,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,302,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,302,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,302,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,302,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,302,Cryopreservation; sperm ,,,442.57,570.33,3 RC,302,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,302,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,302,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,302,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,302,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,302,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,302,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,302,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,302,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,302,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,302,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,302,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,302,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,302,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,302,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,302,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,302,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,302,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,302,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,302,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,302,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,302,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,302,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,302,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,302,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,302,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,302,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,302,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,302,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,302,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,302,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,302,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,302,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,302,"Culture, typing; other methods ",,,6.63,41.29,4 RC,302,Cyanide ,,,16.63,102.39,4 RC,302,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,302,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,302,"Cyclic citrullinated peptide (CCP), antibody ",454.0,454.0,11.1,68.24,4 RC,302,Cyclosporine ,,,15.46,95.19,4 RC,302,Cystatin C ,,,15.87,98.82,4 RC,302,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,302,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,302,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,302,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,302,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,302,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,302,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,302,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,302,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,302,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,302,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,302,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,302,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,302,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,302,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,302,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,302,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,302,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,302,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,302,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,302,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,302,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,302,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,302,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,302,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,302,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,302,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,302,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,302,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,302,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,302,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,302,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,302,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,302,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,302,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,302,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,302,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,302,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,302,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,302,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,302,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,302,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,302,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,302,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,302,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,302,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,302,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,302,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,302,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,302,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,302,Dibucaine number ,,,10.5,64.67,4 RC,302,Digoxin; free ,,,11.38,70.08,4 RC,302,Digoxin; total ,,,11.38,70.08,4 RC,302,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,302,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,302,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,302,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,302,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,302,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,302,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,302,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,302,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,302,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,302,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,302,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,302,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,302,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,302,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,302,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,302,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,302,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,302,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,302,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,302,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,302,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,302,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,302,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,302,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,302,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,302,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,302,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,302,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,302,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,302,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,302,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,302,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,302,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,302,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,302,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,302,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,302,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,302,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,302,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,302,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,302,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,302,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,302,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,302,Erythropoietin ,,,16.1,98.82,4 RC,302,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,302,Estradiol; total ,,,23.94,147.31,4 RC,302,Estriol ,,,20.72,127.56,4 RC,302,Estrogens; fractionated ,,,27.67,170.64,4 RC,302,Estrogens; total ,,,18.59,114.95,4 RC,302,Estrone ,,,21.38,132.92,4 RC,302,Ethosuximide ,,,14.0,86.21,4 RC,302,Ethylene glycol ,,,12.77,79.01,4 RC,302,Etiocholanolone ,,,22.48,138.33,4 RC,302,Euglobulin lysis ,,,7.2,44.92,4 RC,302,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,302,Everolimus ,,,11.76,73.66,4 RC,302,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,302,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,302,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,302,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,302,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,302,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,302,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,302,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,302,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,302,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,302,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,302,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,302,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,302,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,302,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,302,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,302,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,302,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,302,Factor inhibitor test ,,,11.03,68.24,4 RC,302,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,302,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,302,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,302,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,302,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,302,Felbamate ,,,15.97,98.82,4 RC,302,Fentanyl ,,,13.07,127.56,4 RC,302,Fern test ,,,40.44,52.12,3 RC,302,Ferritin ,,,11.68,71.87,4 RC,302,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,302,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,302,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,302,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,302,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,302,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,302,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,302,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,302,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,302,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,302,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,302,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,302,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,302,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,302,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,302,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,302,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,302,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,302,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,302,Fibrinogen; activity ,,,8.32,52.12,4 RC,302,Fibrinogen; antigen ,,,12.39,77.23,4 RC,302,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,302,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,302,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,302,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,302,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,302,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,302,Flecainide ,,,15.97,98.82,4 RC,302,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,302,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,302,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,302,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,302,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,302,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,302,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,302,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,302,Fluoride ,,,15.88,98.82,4 RC,302,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,302,Folic acid; RBC ,,,15.13,93.41,4 RC,302,Folic acid; serum ,,,12.6,77.23,4 RC,302,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,302,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,302,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,302,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,302,"Fructose, semen ",,,14.86,91.62,4 RC,302,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,302,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,302,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,302,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,302,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,302,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,302,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,302,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,302,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,302,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,302,"Galactokinase, RBC ",,,18.4,113.16,4 RC,302,Galactose ,,,9.6,59.26,4 RC,302,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,302,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,302,Galectin-3 ,,,182.6,235.31,3 RC,302,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,302,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,302,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,302,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,302,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,302,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,302,"Gases, blood, pH only ",,,9.42,57.47,4 RC,302,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,302,Gastrin ,,,15.11,93.41,4 RC,302,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,302,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,302,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,302,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,302,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,302,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,302,Gentamicin ,,,14.04,86.21,4 RC,302,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,302,Glucagon ,,,12.24,75.44,4 RC,302,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,302,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,302,Glucagon tolerance test ,,,15.23,93.41,4 RC,302,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,302,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,302,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,302,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,302,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,302,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,302,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,302,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,302,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,302,"Glucosidase, beta ",,,18.4,113.16,4 RC,302,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,302,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,302,Glutathione ,,,13.24,82.64,4 RC,302,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,302,Glycated protein ,,,14.36,88.0,4 RC,302,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,302,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,302,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,302,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,302,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,302,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,302,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,302,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,302,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,302,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,302,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,302,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,302,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,302,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,302,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,302,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,302,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,302,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,302,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,302,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,302,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,302,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,302,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,302,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,302,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,302,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,302,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,302,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,302,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,302,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,302,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,302,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,302,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,302,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,302,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,302,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,302,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,302,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,302,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,302,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,302,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,302,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,Haloperidol ,,,13.53,84.43,4 RC,302,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,302,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,302,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,302,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,302,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,302,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,302,Heinz bodies; direct ,,,3.6,21.54,4 RC,302,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,302,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,302,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,302,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,302,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,302,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,302,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,302,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,302,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,302,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,302,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,302,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,302,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,302,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,302,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,302,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,302,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,302,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,302,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,302,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,302,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,302,Hemoglobin; plasma ,,,6.26,39.51,4 RC,302,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,302,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,302,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,302,Hemoglobin; urine ,,,3.39,21.54,4 RC,302,"Hemolysin, acid ",,,7.6,46.7,4 RC,302,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,302,Heparin assay ,,,11.22,70.08,4 RC,302,Heparin neutralization ,,,10.15,62.89,4 RC,302,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,302,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,302,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,302,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,302,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,302,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,302,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,302,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,302,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,302,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,302,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,302,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,302,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,302,Heroin metabolite ,,,13.63,127.56,4 RC,302,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,302,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,302,Histamine ,,,25.31,156.3,4 RC,302,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,302,Homocysteine ,,,15.35,95.19,4 RC,302,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,302,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,302,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,302,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,302,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,302,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,302,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,302,Hydroxychloroquine ,,,15.97,98.82,4 RC,302,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,302,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,302,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,302,Hydroxyproline; free ,,,19.41,120.36,4 RC,302,Hydroxyproline; total ,,,20.82,129.34,4 RC,302,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,302,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,302,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,302,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,302,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,302,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,302,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,302,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,302,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,302,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,302,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,302,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,302,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,302,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,302,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,302,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,302,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,302,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,302,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,302,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,302,"Immunoassay for tumor antigen, quantitative; CA 125 ",960.0,960.0,17.83,109.59,4 RC,302,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,302,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",1423.0,1423.0,17.83,109.59,4 RC,302,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,302,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,302,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,302,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,302,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,302,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,302,Immunofixation electrophoresis; serum ,44.84,44.84,19.15,118.58,4 RC,302,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,302,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,302,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,302,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,302,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,302,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,302,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,302,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,302,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,302,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,302,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,302,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,302,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,302,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,302,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,302,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,302,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,302,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,302,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,302,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,302,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,302,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,302,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,302,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,302,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,302,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,302,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,302,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,302,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,302,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,302,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,302,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,302,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,302,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,302,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,302,Infliximab ,,,33.05,204.79,4 RC,302,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,302,Inhibin A ,,,13.36,82.64,4 RC,302,Insemination of oocytes ,,,442.57,570.33,3 RC,302,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,302,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,302,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,302,Insulin; free ,,,11.1,68.24,4 RC,302,Insulin; total ,,,9.79,61.1,4 RC,302,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,302,Intrinsic factor ,,,16.98,104.18,4 RC,302,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,302,Iron ,,,5.54,34.15,4 RC,302,Iron binding capacity ,,,7.49,46.7,4 RC,302,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,302,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,302,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,302,Itraconazole ,,,23.23,143.69,4 RC,302,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,302,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,302,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,302,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,302,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,302,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,302,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,302,Ketamine and norketamine ,,,10.54,127.56,4 RC,302,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,302,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,302,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,302,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,302,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,302,Lacosamide ,,,23.23,143.69,4 RC,302,Lactate (lactic acid) ,,,9.91,61.1,4 RC,302,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,302,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,302,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,302,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,302,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,302,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,302,Lamotrigine ,,,11.35,70.08,4 RC,302,Lead ,,,10.37,64.67,4 RC,302,Leflunomide ,,,33.05,204.79,4 RC,302,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,302,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,302,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,302,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,302,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,302,Leukocyte transfusion ,,,305.26,393.39,3 RC,302,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,302,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,302,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,302,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,302,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,302,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,302,Levetiracetam ,,,11.35,70.08,4 RC,302,Lidocaine ,,,12.59,77.23,4 RC,302,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,302,Lipase ,,,5.91,35.94,4 RC,302,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,302,Lipoprotein (a) ,,,12.27,75.44,4 RC,302,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,302,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,302,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,302,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,302,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,302,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,302,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,302,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,302,Lithium ,,,5.66,35.94,4 RC,302,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,302,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,302,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,302,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,302,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,302,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,302,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,302,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,302,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,302,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,302,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,302,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,302,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,302,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,302,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,302,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,302,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,302,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,302,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,302,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,302,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,302,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,302,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,302,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,302,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,302,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,302,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,302,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,302,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,302,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,302,Magnesium ,,,5.74,35.94,4 RC,302,Malate dehydrogenase ,,,6.31,39.51,4 RC,302,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,302,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,302,Manganese ,,,22.84,141.9,4 RC,302,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,302,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,302,"Meat fibers, feces ",,,4.15,25.17,4 RC,302,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,302,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,302,"Mercury, quantitative ",,,13.93,86.21,4 RC,302,Metanephrines ,,,14.51,89.84,4 RC,302,Methadone ,,,11.24,127.56,4 RC,302,Methemalbumin ,,,9.2,57.47,4 RC,302,Methotrexate ,,,33.05,204.79,4 RC,302,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,302,Methylphenidate ,,,9.29,127.56,4 RC,302,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,302,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,302,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,302,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,302,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,302,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,302,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,302,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,302,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,302,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,302,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,302,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,302,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,302,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,302,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,302,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,302,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,302,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,302,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,302,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,302,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,302,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,302,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,302,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,302,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,302,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,302,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,302,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,302,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,302,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,302,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,302,Muramidase ,,,16.07,98.82,4 RC,302,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,302,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,302,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,302,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,302,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,302,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,302,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,302,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,302,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,302,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,302,Myoglobin ,,,11.07,68.24,4 RC,302,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,302,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,302,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,302,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,302,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,302,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,302,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,302,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,302,Natriuretic peptide ,,,33.64,208.36,4 RC,302,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,302,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,302,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,302,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,302,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,302,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,302,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,302,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,302,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,302,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,302,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,302,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,302,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,302,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,302,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,302,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,302,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,302,Nerve teasing preparations ,,,499.29,643.43,3 RC,302,"Neutralization test, viral ",,,14.48,89.84,4 RC,302,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,302,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,302,Nickel ,,,21.0,129.34,4 RC,302,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,302,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,302,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,302,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,302,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,302,Nucleotidase 5'- ,,,9.56,59.26,4 RC,302,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,302,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,302,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,302,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,302,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,302,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,302,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,302,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,302,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,302,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,302,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,302,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,302,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,302,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,302,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,302,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,302,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,302,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,302,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,302,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,302,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,302,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,302,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,302,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,302,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,302,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,302,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,302,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,302,"Opiates, 1 or more ",,,14.57,127.56,4 RC,302,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,302,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,302,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,302,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,302,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,302,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,302,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,302,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,302,Osmolality; blood ,,,5.66,35.94,4 RC,302,Osmolality; urine ,,,5.84,35.94,4 RC,302,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,302,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,302,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,302,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,302,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,302,Oxalate ,,,12.38,77.23,4 RC,302,Oxcarbazepine ,,,11.35,70.08,4 RC,302,Oxycodone ,,,12.15,127.56,4 RC,302,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,302,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,302,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,302,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,302,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,302,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,302,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,302,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,302,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,302,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,302,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,302,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,302,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,302,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,302,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,302,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,302,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,302,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,302,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,302,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,302,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,302,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,302,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,302,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,302,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,302,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,302,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,302,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,302,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,302,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,302,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,302,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,302,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,302,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,302,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,302,Phenobarbital ,,,13.11,80.85,4 RC,302,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,302,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,302,Phenytoin; free ,,,11.79,73.66,4 RC,302,Phenytoin; total ,,,11.35,70.08,4 RC,302,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,302,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,302,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,302,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,302,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,302,Phosphatidylglycerol ,,,14.16,88.0,4 RC,302,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,302,Phosphohexose isomerase ,,,9.19,57.47,4 RC,302,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,302,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,302,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,302,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,302,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,302,Pinworm examinations ,,,18.14,23.38,3 RC,302,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,302,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,302,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,302,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,302,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,302,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,302,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,302,Posaconazole ,,,23.23,143.69,4 RC,302,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,302,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,302,Potassium; urine ,,,4.05,25.17,4 RC,302,Prealbumin ,,,12.51,77.23,4 RC,302,Pregabalin ,,,7.07,127.56,4 RC,302,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,302,Pregnanediol ,,,18.23,113.16,4 RC,302,Pregnanetriol ,,,18.03,111.38,4 RC,302,Pregnenolone ,,,17.71,109.59,4 RC,302,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,302,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",422.02,422.02,164.5,211.98,3 RC,302,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",422.02,422.02,117.08,150.88,3 RC,302,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",466.85,466.85,140.77,181.41,3 RC,302,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,302,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",750.39,750.39,140.77,181.41,3 RC,302,Primidone ,,,14.22,88.0,4 RC,302,Procainamide; ,,,51.41,317.95,4 RC,302,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,302,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,302,Progesterone ,,,17.87,111.38,4 RC,302,Proinsulin ,,,22.87,141.9,4 RC,302,Prolactin ,,,16.61,102.39,4 RC,302,Propoxyphene ,,,10.72,127.56,4 RC,302,"Prostaglandin, each ",,,35.79,220.97,4 RC,302,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,302,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,302,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,302,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,302,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,302,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,302,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,302,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,302,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,302,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,302,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,302,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,302,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,302,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,302,Prothrombin time; ,,,3.67,23.38,4 RC,302,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,302,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,302,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,302,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,302,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,302,Pyruvate ,,,12.4,77.23,4 RC,302,Pyruvate kinase ,,,8.09,50.28,4 RC,302,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,302,Quinidine ,,,12.51,77.23,4 RC,302,Quinine ,,,9.97,61.1,4 RC,302,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,302,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,302,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,302,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,302,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,302,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,302,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,302,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,302,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,302,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,302,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,302,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,302,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,302,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,302,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,302,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,302,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,302,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,302,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,302,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,302,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,302,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,302,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,302,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,302,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,302,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,302,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,302,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,302,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,302,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,302,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,302,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,302,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,302,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,302,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,302,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,302,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,302,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,302,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,302,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,302,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,302,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,302,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,302,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,302,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,302,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,302,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,302,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,302,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,302,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,302,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,302,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,302,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,302,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,302,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,302,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,302,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,302,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,302,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,302,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,302,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,302,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,302,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,302,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,302,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,302,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,302,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,302,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,302,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,302,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,302,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,302,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,302,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,302,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,302,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,302,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,302,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,302,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,302,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,302,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,302,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,302,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,302,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,302,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,302,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,302,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,302,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,302,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,302,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,302,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,302,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,302,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,302,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,302,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,302,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,302,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,302,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,302,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,302,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,302,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,302,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,302,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,302,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,302,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,302,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,302,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,302,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,302,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,302,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,302,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,302,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,302,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,302,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,302,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,302,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,302,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,302,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,302,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,302,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,302,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,302,Receptor assay; estrogen ,,,75.3,465.26,4 RC,302,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,302,Receptor assay; progesterone ,,,55.59,343.11,4 RC,302,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,302,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,302,Renin ,,,18.84,116.79,4 RC,302,Reptilase test ,,,8.44,52.12,4 RC,302,Reticulated platelet assay ,,,30.62,188.6,4 RC,302,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,302,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,302,Rufinamide ,,,23.23,143.69,4 RC,302,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,302,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,302,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,302,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,302,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,302,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,302,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,302,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,302,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,302,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,302,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,302,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,302,Salicylate ,,,15.97,98.82,4 RC,302,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,302,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,302,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,302,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,302,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,302,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,302,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,302,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,302,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,302,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,302,Selenium ,,,21.88,134.7,4 RC,302,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,302,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,302,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,302,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,302,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,302,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,302,Serotonin ,,,26.54,163.49,4 RC,302,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,302,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,302,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,302,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,302,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,302,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,302,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,302,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,302,Sialic acid ,,,11.52,71.87,4 RC,302,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,302,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,302,Silica ,,,21.6,132.92,4 RC,302,Sirolimus ,,,11.76,73.66,4 RC,302,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,302,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,302,Skin test; candida ,,,79.46,102.39,3 RC,302,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,302,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,302,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,302,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,302,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,302,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,302,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,302,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,302,Sodium; other source ,,,4.16,25.17,4 RC,302,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,302,Sodium; urine ,,,4.33,26.95,4 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,302,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,302,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,302,Somatomedin ,,,18.22,113.16,4 RC,302,Somatostatin ,,,15.67,96.98,4 RC,302,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,302,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,302,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,302,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,302,Specific gravity (except urine) ,,,2.82,17.97,4 RC,302,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,302,Sperm antibodies ,,,43.21,55.69,3 RC,302,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,302,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,302,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,302,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,302,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,302,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,302,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,302,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,302,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,302,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,302,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,302,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,302,"Stimulants, synthetic ",,,12.05,127.56,4 RC,302,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,302,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,302,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,302,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,302,"Streptokinase, antibody ",,,10.84,66.46,4 RC,302,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,302,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,302,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,302,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,302,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,302,"Sulfate, urine ",,,4.7,28.74,4 RC,302,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,302,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,302,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,302,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,302,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,302,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,302,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,302,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,302,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,302,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,302,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,302,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,302,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,302,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,302,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,302,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,302,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,302,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,302,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,302,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,302,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,302,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,302,Tacrolimus ,,,11.76,73.66,4 RC,302,Tapentadol ,,,10.83,127.56,4 RC,302,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,302,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,302,Testosterone; free ,,,21.82,134.7,4 RC,302,Testosterone; total ,,,22.11,136.54,4 RC,302,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,302,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,302,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,302,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,302,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,302,Theophylline ,,,12.12,75.44,4 RC,302,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,302,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,302,Thiocyanate ,,,9.97,61.1,4 RC,302,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,302,Thrombin time; plasma ,,,4.95,30.52,4 RC,302,Thrombin time; titer ,,,5.87,35.94,4 RC,302,Thrombomodulin ,,,14.8,91.62,4 RC,302,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,302,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,302,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,302,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,302,Thyroglobulin ,,,13.76,84.43,4 RC,302,Thyroglobulin antibody ,948.21,948.21,13.63,84.43,4 RC,302,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,302,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,302,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,302,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,302,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,302,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,302,Thyroxine; free ,,,7.73,48.49,4 RC,302,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,302,Thyroxine; total ,,,5.89,35.94,4 RC,302,Tiagabine ,,,23.23,143.69,4 RC,302,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,302,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,302,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,302,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,302,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,302,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,302,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,302,Tobramycin ,,,13.82,86.21,4 RC,302,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,302,Topiramate ,,,10.21,62.89,4 RC,302,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,302,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,302,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,302,Tramadol ,,,10.54,127.56,4 RC,302,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,302,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,302,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,302,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,302,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,302,Transferrin ,,,10.93,68.24,4 RC,302,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,302,Triglycerides ,,,4.92,30.52,4 RC,302,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,302,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,302,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,302,"Troponin, qualitative ",,,8.65,53.9,4 RC,302,"Troponin, quantitative ",,,10.68,66.46,4 RC,302,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,302,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,302,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,302,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,302,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",733.24,733.24,53.1,328.72,4 RC,302,Tyrosine ,,,9.11,55.69,4 RC,302,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,302,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,302,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,302,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,302,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,302,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,302,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,302,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,302,Unlisted immunology procedure ,,,99.55,128.28,3 RC,302,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,302,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,302,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,302,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,302,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,302,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,302,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,302,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,302,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,302,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,302,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,302,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,302,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,302,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,302,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,302,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,302,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,302,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,302,Uric acid; blood ,,,3.88,23.38,4 RC,302,Uric acid; other source ,,,4.36,26.95,4 RC,302,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,302,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,302,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,302,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,302,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,302,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,302,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,302,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,302,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,302,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,302,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,302,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,302,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,302,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,302,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,302,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,302,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,302,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,302,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,302,Vancomycin ,,,11.6,71.87,4 RC,302,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,302,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,302,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,302,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,302,Vedolizumab ,,,33.05,204.79,4 RC,302,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,302,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,302,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,302,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,302,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,302,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,302,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,302,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,302,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,302,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,302,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,302,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,302,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,302,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,302,Very long chain fatty acids ,,,16.92,104.18,4 RC,302,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,302,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,302,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,302,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,302,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,302,Viscosity ,,,10.0,61.1,4 RC,302,Vitamin A ,,,9.95,61.1,4 RC,302,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,302,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,302,Vitamin K ,,,11.75,71.87,4 RC,302,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,302,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,302,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,302,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,302,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,302,Voriconazole ,,,23.23,143.69,4 RC,302,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,302,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,302,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,302,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,302,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,302,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,302,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,302,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,302,Zinc ,,,9.76,61.1,4 RC,302,Zonisamide ,,,11.35,70.08,4 RC,302,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,302,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,302,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,303, Laboratory Renal Patient (Home) ,,,,,0 RC,303,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,303,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,303,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,303,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,303,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,303,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,303,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,303,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,303,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,303,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,303,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,303,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,303,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,303,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,303,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,303,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,303,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,Acetaminophen ,,,15.97,98.82,4 RC,303,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,303,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,303,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,303,Acetylcholinesterase ,,,10.53,64.67,4 RC,303,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,303,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,303,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,303,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,303,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,303,Adalimumab ,,,33.05,204.79,4 RC,303,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,303,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,303,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,303,Albumin; ischemia modified ,,,29.08,179.62,4 RC,303,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,303,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,303,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,303,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,303,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,303,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,303,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,303,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,303,Alcohols ,,,9.61,127.56,4 RC,303,Aldolase ,,,8.32,52.12,4 RC,303,Aldosterone ,,,34.91,215.56,4 RC,303,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,303,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,303,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,303,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,303,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,303,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,303,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,303,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,303,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,303,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,303,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,303,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,303,Aluminum ,,,21.83,134.7,4 RC,303,Amikacin ,,,12.92,80.85,4 RC,303,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,303,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,303,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,303,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,303,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,303,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,303,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,303,Amiodarone ,,,15.97,98.82,4 RC,303,Ammonia ,,,12.48,77.23,4 RC,303,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,303,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,303,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,303,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,303,Amylase ,,,5.55,34.15,4 RC,303,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,303,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,303,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,303,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,303,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,303,Androstanediol glucuronide ,,,24.7,152.67,4 RC,303,Androstenedione ,,,25.09,154.51,4 RC,303,Androsterone ,,,21.89,134.7,4 RC,303,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,303,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,303,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,303,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,303,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,303,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,303,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,303,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,303,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,303,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,303,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,303,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,303,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,303,Angiotensin II ,,,17.58,109.59,4 RC,303,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,303,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,303,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,303,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,303,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,303,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,303,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,303,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,303,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,303,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,303,Antibody; Aspergillus ,,,12.89,79.01,4 RC,303,Antibody; Bartonella ,,,8.72,53.9,4 RC,303,Antibody; Blastomyces ,,,11.06,68.24,4 RC,303,Antibody; Bordetella ,,,11.3,70.08,4 RC,303,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,303,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,303,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,303,Antibody; Brucella ,,,7.65,46.7,4 RC,303,Antibody; Campylobacter ,,,11.24,70.08,4 RC,303,Antibody; Candida ,,,10.29,62.89,4 RC,303,Antibody; Chlamydia ,,,10.13,62.89,4 RC,303,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,303,Antibody; Coccidioides ,,,9.82,61.1,4 RC,303,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,303,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,303,Antibody; Diphtheria ,,,13.04,80.85,4 RC,303,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,303,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,303,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,303,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,303,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,303,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,303,Antibody; HIV-1 ,,,7.62,46.7,4 RC,303,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,303,Antibody; HIV-2 ,,,11.59,71.87,4 RC,303,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,303,Antibody; HTLV-I ,,,7.79,48.49,4 RC,303,Antibody; HTLV-II ,,,12.0,73.66,4 RC,303,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,303,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,303,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,303,Antibody; Legionella ,,,13.11,80.85,4 RC,303,Antibody; Leishmania ,,,10.5,64.67,4 RC,303,Antibody; Leptospira ,,,13.88,86.21,4 RC,303,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,303,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,303,Antibody; Nocardia ,,,13.7,84.43,4 RC,303,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,303,Antibody; Rickettsia ,,,16.57,102.39,4 RC,303,Antibody; Salmonella ,,,11.3,70.08,4 RC,303,Antibody; Shigella ,,,20.97,129.34,4 RC,303,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,303,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,303,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,303,Antibody; Trichinella ,,,10.76,66.46,4 RC,303,Antibody; West Nile virus ,,,12.33,75.44,4 RC,303,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,303,Antibody; Yersinia ,,,11.3,70.08,4 RC,303,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,303,Antibody; actinomyces ,,,8.72,53.9,4 RC,303,Antibody; adenovirus ,,,11.03,68.24,4 RC,303,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,303,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,303,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,303,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,303,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,303,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,303,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,303,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,303,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,303,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,303,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,303,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,303,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,303,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,303,Antibody; histoplasma ,,,11.81,73.66,4 RC,303,Antibody; influenza virus ,,,11.61,71.87,4 RC,303,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,303,Antibody; mucormycosis ,,,12.85,79.01,4 RC,303,Antibody; mumps ,,,11.18,70.08,4 RC,303,Antibody; mycoplasma ,,,11.34,70.08,4 RC,303,Antibody; parvovirus ,,,12.88,79.01,4 RC,303,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,303,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,303,Antibody; rotavirus ,,,15.62,96.98,4 RC,303,Antibody; rubella ,,,12.33,75.44,4 RC,303,Antibody; rubeola ,,,11.04,68.24,4 RC,303,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,303,Antibody; tetanus ,,,12.68,79.01,4 RC,303,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,303,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,303,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,303,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,303,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,303,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,303,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,303,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,303,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,303,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,303,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,303,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,303,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,303,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,303,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,303,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,303,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,303,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,303,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,303,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,303,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,303,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,303,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,303,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,303,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,303,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,303,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,303,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,303,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,303,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,303,"Apolipoprotein, each ",,,18.07,111.38,4 RC,303,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,303,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,303,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,303,Arsenic ,,,16.25,100.61,4 RC,303,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,303,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,303,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,303,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,303,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,303,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,303,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,303,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,303,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,303,"B cells, total count ",,,32.32,199.37,4 RC,303,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,303,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,303,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,303,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,303,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,303,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,303,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,303,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,303,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,303,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,303,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,303,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,303,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,303,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,303,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,303,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,303,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,303,Barbiturates ,,,9.34,127.56,4 RC,303,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,303,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,303,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,303,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,303,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,303,Beta-2 microglobulin ,,,13.86,86.21,4 RC,303,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,303,Bile acids; total ,,,14.67,91.62,4 RC,303,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,303,Bilirubin; direct ,,,4.3,26.95,4 RC,303,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,303,Bilirubin; total ,,,4.3,26.95,4 RC,303,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,303,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,303,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,303,Bleeding time ,,,4.13,25.17,4 RC,303,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,303,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,303,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,303,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,303,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,303,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,303,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,303,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,303,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,303,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,303,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,303,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,303,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,303,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,303,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,303,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,303,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,303,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,303,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,303,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,303,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,303,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,303,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,303,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,303,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,303,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,303,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,303,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,303,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,303,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,303,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,303,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,303,Bone age studies ,,,61.64,79.3,3 RC,303,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,303,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,303,Bradykinin ,,,4.42,26.95,4 RC,303,Buprenorphine ,,,14.01,14.01,1 RC,303,C-peptide ,,,17.83,109.59,4 RC,303,C-reactive protein; ,,,4.44,26.95,4 RC,303,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,303,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,303,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,303,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,303,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,303,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,303,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,303,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,303,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,303,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,303,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,303,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,303,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,303,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,303,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,303,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,303,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,303,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,303,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,303,Cadmium ,,,20.26,125.72,4 RC,303,Caffeine ,,,33.05,204.79,4 RC,303,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,303,Calcitonin ,,,22.95,141.9,4 RC,303,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,303,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,303,Calcium; ionized ,,,11.72,71.87,4 RC,303,Calcium; total ,,,4.42,26.95,4 RC,303,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,303,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,303,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,303,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,303,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,303,"Calprotectin, fecal ",,,16.82,104.18,4 RC,303,"Cannabinoids, natural ",,,11.5,127.56,4 RC,303,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,303,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,303,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,303,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,303,Carbamazepine; free ,,,11.35,70.08,4 RC,303,Carbamazepine; total ,,,12.48,77.23,4 RC,303,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,303,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,303,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,303,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,303,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,303,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,303,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,303,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,303,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,303,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,303,Carotene ,,,7.89,48.49,4 RC,303,Catecholamines; blood ,,,24.92,154.51,4 RC,303,Catecholamines; fractionated ,,,21.63,134.7,4 RC,303,Catecholamines; total urine ,,,23.39,145.53,4 RC,303,Cathepsin-D ,,,15.47,95.19,4 RC,303,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,303,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,303,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,303,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,303,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,303,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,303,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,303,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,303,Ceruloplasmin ,,,9.2,57.47,4 RC,303,Chemiluminescent assay ,,,12.1,75.44,4 RC,303,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,303,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,303,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,303,Chloramphenicol ,,,10.85,66.46,4 RC,303,Chloride; blood ,,,3.94,25.17,4 RC,303,Chloride; other source ,,,4.28,26.95,4 RC,303,Chloride; urine ,,,4.93,30.52,4 RC,303,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,303,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,303,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,303,Cholinesterase; RBC ,,,8.4,52.12,4 RC,303,Cholinesterase; serum ,,,6.74,41.29,4 RC,303,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,303,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,303,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,303,Chromium ,,,17.38,107.81,4 RC,303,Chromogenic substrate assay ,,,10.19,62.89,4 RC,303,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,303,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,303,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,303,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,303,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,303,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,303,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,303,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,303,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,303,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,303,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,303,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,303,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,303,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,303,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,303,Citrate ,,,23.82,147.31,4 RC,303,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,303,Clot retraction ,,,13.96,86.21,4 RC,303,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,303,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,303,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,303,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,303,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,303,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,303,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,303,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,303,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,303,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,303,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,303,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,303,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,303,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,303,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,303,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,303,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,303,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,303,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,303,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,303,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,303,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,303,Clozapine ,,,17.27,105.96,4 RC,303,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,303,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,303,Coagulation time; activated ,,,3.67,23.38,4 RC,303,Coagulation time; other methods ,,,3.85,23.38,4 RC,303,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,303,Cocaine ,,,10.46,127.56,4 RC,303,Cold agglutinin; screen ,,,6.92,43.13,4 RC,303,Cold agglutinin; titer ,,,6.91,43.13,4 RC,303,"Collagen cross links, any method ",,,16.0,98.82,4 RC,303,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,303,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,303,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,303,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,303,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,303,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,303,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,303,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,303,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,303,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,303,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,303,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,303,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,303,"Complement; antigen, each component ",,,10.28,62.89,4 RC,303,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,303,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,303,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,303,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,303,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,303,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,303,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,303,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,303,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,303,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,303,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,303,Copper ,,,10.63,66.46,4 RC,303,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,303,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,303,Corticosterone ,,,19.3,118.58,4 RC,303,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,303,Cortisol; free ,,,14.32,88.0,4 RC,303,Cortisol; total ,,,13.96,86.21,4 RC,303,Creatine ,,,3.98,25.17,4 RC,303,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,303,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,303,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,303,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,303,Creatinine; blood ,,,4.39,26.95,4 RC,303,Creatinine; clearance ,,,8.11,50.28,4 RC,303,Creatinine; other source ,,,4.44,26.95,4 RC,303,Cryofibrinogen ,,,12.12,75.44,4 RC,303,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,303,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,303,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,303,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,303,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,303,Cryopreservation; sperm ,,,442.57,570.33,3 RC,303,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,303,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,303,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,303,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,303,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,303,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,303,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,303,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,303,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,303,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,303,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,303,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,303,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,303,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,303,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,303,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,303,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,303,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,303,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,303,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,303,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,303,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,303,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,303,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,303,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,303,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,303,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,303,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,303,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,303,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,303,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,303,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,303,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,303,"Culture, typing; other methods ",,,6.63,41.29,4 RC,303,Cyanide ,,,16.63,102.39,4 RC,303,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,303,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,303,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,303,Cyclosporine ,,,15.46,95.19,4 RC,303,Cystatin C ,,,15.87,98.82,4 RC,303,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,303,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,303,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,303,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,303,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,303,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,303,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,303,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,303,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,303,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,303,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,303,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,303,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,303,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,303,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,303,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,303,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,303,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,303,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,303,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,303,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,303,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,303,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,303,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,303,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,303,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,303,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,303,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,303,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,303,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,303,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,303,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,303,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,303,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,303,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,303,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,303,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,303,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,303,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,303,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,303,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,303,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,303,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,303,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,303,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,303,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,303,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,303,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,303,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,303,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,303,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,303,Dibucaine number ,,,10.5,64.67,4 RC,303,Digoxin; free ,,,11.38,70.08,4 RC,303,Digoxin; total ,,,11.38,70.08,4 RC,303,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,303,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,303,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,303,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,303,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,303,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,303,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,303,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,303,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,303,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,303,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,303,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,303,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,303,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,303,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,303,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,303,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,303,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,303,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,303,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,303,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,303,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,303,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,303,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,303,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,303,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,303,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,303,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,303,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,303,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,303,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,303,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,303,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,303,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,303,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,303,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,303,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,303,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,303,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,303,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,303,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,303,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,303,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,303,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,303,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,303,Erythropoietin ,,,16.1,98.82,4 RC,303,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,303,Estradiol; total ,,,23.94,147.31,4 RC,303,Estriol ,,,20.72,127.56,4 RC,303,Estrogens; fractionated ,,,27.67,170.64,4 RC,303,Estrogens; total ,,,18.59,114.95,4 RC,303,Estrone ,,,21.38,132.92,4 RC,303,Ethosuximide ,,,14.0,86.21,4 RC,303,Ethylene glycol ,,,12.77,79.01,4 RC,303,Etiocholanolone ,,,22.48,138.33,4 RC,303,Euglobulin lysis ,,,7.2,44.92,4 RC,303,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,303,Everolimus ,,,11.76,73.66,4 RC,303,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,303,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,303,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,303,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,303,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,303,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,303,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,303,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,303,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,303,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,303,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,303,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,303,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,303,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,303,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,303,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,303,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,303,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,303,Factor inhibitor test ,,,11.03,68.24,4 RC,303,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,303,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,303,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,303,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,303,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,303,Felbamate ,,,15.97,98.82,4 RC,303,Fentanyl ,,,13.07,127.56,4 RC,303,Fern test ,,,40.44,52.12,3 RC,303,Ferritin ,,,11.68,71.87,4 RC,303,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,303,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,303,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,303,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,303,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,303,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,303,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,303,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,303,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,303,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,303,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,303,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,303,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,303,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,303,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,303,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,303,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,303,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,303,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,303,Fibrinogen; activity ,,,8.32,52.12,4 RC,303,Fibrinogen; antigen ,,,12.39,77.23,4 RC,303,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,303,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,303,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,303,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,303,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,303,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,303,Flecainide ,,,15.97,98.82,4 RC,303,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,303,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,303,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,303,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,303,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,303,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,303,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,303,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,303,Fluoride ,,,15.88,98.82,4 RC,303,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,303,Folic acid; RBC ,,,15.13,93.41,4 RC,303,Folic acid; serum ,,,12.6,77.23,4 RC,303,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,303,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,303,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,303,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,303,"Fructose, semen ",,,14.86,91.62,4 RC,303,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,303,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,303,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,303,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,303,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,303,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,303,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,303,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,303,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,303,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,303,"Galactokinase, RBC ",,,18.4,113.16,4 RC,303,Galactose ,,,9.6,59.26,4 RC,303,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,303,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,303,Galectin-3 ,,,182.6,235.31,3 RC,303,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,303,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,303,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,303,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,303,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,303,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,303,"Gases, blood, pH only ",,,9.42,57.47,4 RC,303,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,303,Gastrin ,,,15.11,93.41,4 RC,303,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,303,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,303,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,303,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,303,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,303,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,303,Gentamicin ,,,14.04,86.21,4 RC,303,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,303,Glucagon ,,,12.24,75.44,4 RC,303,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,303,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,303,Glucagon tolerance test ,,,15.23,93.41,4 RC,303,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,303,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,303,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,303,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,303,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,303,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,303,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,303,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,303,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,303,"Glucosidase, beta ",,,18.4,113.16,4 RC,303,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,303,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,303,Glutathione ,,,13.24,82.64,4 RC,303,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,303,Glycated protein ,,,14.36,88.0,4 RC,303,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,303,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,303,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,303,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,303,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,303,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,303,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,303,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,303,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,303,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,303,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,303,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,303,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,303,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,303,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,303,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,303,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,303,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,303,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,303,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,303,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,303,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,303,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,303,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,303,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,303,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,303,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,303,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,303,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,303,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,303,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,303,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,303,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,303,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,303,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,303,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,303,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,303,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,303,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,303,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,303,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,303,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,Haloperidol ,,,13.53,84.43,4 RC,303,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,303,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,303,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,303,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,303,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,303,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,303,Heinz bodies; direct ,,,3.6,21.54,4 RC,303,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,303,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,303,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,303,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,303,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,303,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,303,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,303,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,303,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,303,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,303,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,303,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,303,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,303,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,303,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,303,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,303,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,303,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,303,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,303,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,303,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,303,Hemoglobin; plasma ,,,6.26,39.51,4 RC,303,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,303,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,303,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,303,Hemoglobin; urine ,,,3.39,21.54,4 RC,303,"Hemolysin, acid ",,,7.6,46.7,4 RC,303,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,303,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,303,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,303,Heparin assay ,,,11.22,70.08,4 RC,303,Heparin neutralization ,,,10.15,62.89,4 RC,303,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,303,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,303,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,303,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,303,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,303,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,303,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,303,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,303,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,303,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,303,Hepatitis C antibody; ,,,12.23,75.44,4 RC,303,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,303,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,303,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,303,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,303,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,303,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,303,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,303,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,303,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,303,Heroin metabolite ,,,13.63,127.56,4 RC,303,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,303,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,303,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,303,Histamine ,,,25.31,156.3,4 RC,303,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,303,Homocysteine ,,,15.35,95.19,4 RC,303,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,303,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,303,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,303,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,303,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,303,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,303,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,303,Hydroxychloroquine ,,,15.97,98.82,4 RC,303,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,303,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,303,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,303,Hydroxyproline; free ,,,19.41,120.36,4 RC,303,Hydroxyproline; total ,,,20.82,129.34,4 RC,303,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,303,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,303,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,303,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,303,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,303,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,303,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,303,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,303,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,303,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,303,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,303,Immune complex assay ,,,20.88,129.34,4 RC,303,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,303,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,303,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,303,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,303,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,303,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,303,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,303,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,303,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,303,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,303,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,303,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,303,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,303,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,303,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,303,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,303,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,303,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,303,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,303,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,303,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,303,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,303,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,303,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,303,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,303,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,303,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,303,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,303,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,303,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,303,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,303,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,303,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,303,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,303,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,303,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,303,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,303,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,303,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,303,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,303,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,303,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,303,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,303,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,303,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,303,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,303,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,303,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,303,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,303,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,303,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,303,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,303,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,303,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,303,Infliximab ,,,33.05,204.79,4 RC,303,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,303,Inhibin A ,,,13.36,82.64,4 RC,303,Insemination of oocytes ,,,442.57,570.33,3 RC,303,Insulin antibodies ,,,18.34,113.16,4 RC,303,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,303,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,303,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,303,Insulin; free ,,,11.1,68.24,4 RC,303,Insulin; total ,,,9.79,61.1,4 RC,303,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,303,Intrinsic factor ,,,16.98,104.18,4 RC,303,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,303,Iron ,,,5.54,34.15,4 RC,303,Iron binding capacity ,,,7.49,46.7,4 RC,303,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,303,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,303,Islet cell antibody ,,,20.2,125.72,4 RC,303,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,303,Itraconazole ,,,23.23,143.69,4 RC,303,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,303,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,303,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,303,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,303,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,303,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,303,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,303,Ketamine and norketamine ,,,10.54,127.56,4 RC,303,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,303,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,303,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,303,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,303,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,303,Lacosamide ,,,23.23,143.69,4 RC,303,Lactate (lactic acid) ,,,9.91,61.1,4 RC,303,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,303,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,303,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,303,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,303,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,303,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,303,Lamotrigine ,,,11.35,70.08,4 RC,303,Lead ,,,10.37,64.67,4 RC,303,Leflunomide ,,,33.05,204.79,4 RC,303,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,303,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,303,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,303,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,303,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,303,Leukocyte transfusion ,,,305.26,393.39,3 RC,303,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,303,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,303,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,303,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,303,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,303,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,303,Levetiracetam ,,,11.35,70.08,4 RC,303,Lidocaine ,,,12.59,77.23,4 RC,303,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,303,Lipase ,,,5.91,35.94,4 RC,303,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,303,Lipoprotein (a) ,,,12.27,75.44,4 RC,303,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,303,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,303,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,303,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,303,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,303,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,303,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,303,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,303,Lithium ,,,5.66,35.94,4 RC,303,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,303,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,303,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,303,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,303,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,303,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,303,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,303,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,303,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,303,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,303,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,303,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,303,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,303,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,303,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,303,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,303,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,303,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,303,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,303,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,303,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,303,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,303,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,303,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,303,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,303,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,303,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,303,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,303,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,303,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,303,Magnesium ,,,5.74,35.94,4 RC,303,Malate dehydrogenase ,,,6.31,39.51,4 RC,303,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,303,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,303,Manganese ,,,22.84,141.9,4 RC,303,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,303,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,303,"Meat fibers, feces ",,,4.15,25.17,4 RC,303,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,303,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,303,"Mercury, quantitative ",,,13.93,86.21,4 RC,303,Metanephrines ,,,14.51,89.84,4 RC,303,Methadone ,,,11.24,127.56,4 RC,303,Methemalbumin ,,,9.2,57.47,4 RC,303,Methotrexate ,,,33.05,204.79,4 RC,303,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,303,Methylphenidate ,,,9.29,127.56,4 RC,303,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,303,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,303,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,303,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,303,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,303,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,303,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,303,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,303,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,303,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,303,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,303,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,303,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,303,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,303,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,303,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,303,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,303,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,303,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,303,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,303,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,303,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,303,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,303,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,303,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,303,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,303,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,303,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,303,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,303,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,303,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,303,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,303,Muramidase ,,,16.07,98.82,4 RC,303,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,303,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,303,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,303,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,303,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,303,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,303,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,303,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,303,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,303,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,303,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,303,Myoglobin ,,,11.07,68.24,4 RC,303,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,303,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,303,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,303,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,303,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,303,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,303,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,303,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,303,Natriuretic peptide ,,,33.64,208.36,4 RC,303,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,303,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,303,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,303,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,303,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,303,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,303,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,303,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,303,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,303,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,303,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,303,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,303,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,303,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,303,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,303,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,303,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,303,Nerve teasing preparations ,,,499.29,643.43,3 RC,303,"Neutralization test, viral ",,,14.48,89.84,4 RC,303,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,303,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,303,Nickel ,,,21.0,129.34,4 RC,303,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,303,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,303,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,303,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,303,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,303,Nucleotidase 5'- ,,,9.56,59.26,4 RC,303,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,303,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,303,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,303,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,303,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,303,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,303,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,303,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,303,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,303,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,303,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,303,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,303,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,303,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,303,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,303,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,303,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,303,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,303,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,303,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,303,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,303,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,303,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,303,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,303,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,303,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,303,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,303,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,303,"Opiates, 1 or more ",,,14.57,127.56,4 RC,303,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,303,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,303,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,303,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,303,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,303,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,303,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,303,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,303,Osmolality; blood ,,,5.66,35.94,4 RC,303,Osmolality; urine ,,,5.84,35.94,4 RC,303,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,303,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,303,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,303,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,303,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,303,Oxalate ,,,12.38,77.23,4 RC,303,Oxcarbazepine ,,,11.35,70.08,4 RC,303,Oxycodone ,,,12.15,127.56,4 RC,303,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,303,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,303,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,303,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,303,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,303,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,303,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,303,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,303,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,303,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,303,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,303,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,303,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,303,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,303,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,303,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,303,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,303,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,303,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,303,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,303,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,303,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,303,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,303,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,303,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,303,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,303,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,303,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,303,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,303,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,303,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,303,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,303,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,303,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,303,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,303,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,303,Phenobarbital ,,,13.11,80.85,4 RC,303,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,303,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,303,Phenytoin; free ,,,11.79,73.66,4 RC,303,Phenytoin; total ,,,11.35,70.08,4 RC,303,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,303,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,303,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,303,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,303,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,303,Phosphatidylglycerol ,,,14.16,88.0,4 RC,303,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,303,Phosphohexose isomerase ,,,9.19,57.47,4 RC,303,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,303,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,303,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,303,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,303,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,303,Pinworm examinations ,,,18.14,23.38,3 RC,303,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,303,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,303,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,303,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,303,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,303,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,303,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,303,Posaconazole ,,,23.23,143.69,4 RC,303,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,303,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,303,Potassium; urine ,,,4.05,25.17,4 RC,303,Prealbumin ,,,12.51,77.23,4 RC,303,Pregabalin ,,,7.07,127.56,4 RC,303,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,303,Pregnanediol ,,,18.23,113.16,4 RC,303,Pregnanetriol ,,,18.03,111.38,4 RC,303,Pregnenolone ,,,17.71,109.59,4 RC,303,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,303,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,303,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,303,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,303,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,303,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,303,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,303,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,303,Primidone ,,,14.22,88.0,4 RC,303,Procainamide; ,,,51.41,317.95,4 RC,303,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,303,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,303,Progesterone ,,,17.87,111.38,4 RC,303,Proinsulin ,,,22.87,141.9,4 RC,303,Prolactin ,,,16.61,102.39,4 RC,303,Propoxyphene ,,,10.72,127.56,4 RC,303,"Prostaglandin, each ",,,35.79,220.97,4 RC,303,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,303,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,303,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,303,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,303,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,303,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,303,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,303,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,303,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,303,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,303,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,303,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,303,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,303,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,303,Prothrombin time; ,,,3.67,23.38,4 RC,303,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,303,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,303,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,303,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,303,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,303,Pyruvate ,,,12.4,77.23,4 RC,303,Pyruvate kinase ,,,8.09,50.28,4 RC,303,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,303,Quinidine ,,,12.51,77.23,4 RC,303,Quinine ,,,9.97,61.1,4 RC,303,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,303,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,303,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,303,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,303,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,303,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,303,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,303,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,303,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,303,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,303,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,303,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,303,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,303,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,303,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,303,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,303,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,303,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,303,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,303,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,303,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,303,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,303,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,303,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,303,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,303,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,303,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,303,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,303,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,303,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,303,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,303,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,303,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,303,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,303,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,303,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,303,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,303,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,303,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,303,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,303,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,303,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,303,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,303,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,303,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,303,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,303,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,303,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,303,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,303,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,303,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,303,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,303,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,303,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,303,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,303,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,303,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,303,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,303,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,303,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,303,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,303,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,303,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,303,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,303,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,303,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,303,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,303,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,303,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,303,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,303,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,303,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,303,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,303,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,303,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,303,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,303,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,303,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,303,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,303,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,303,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,303,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,303,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,303,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,303,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,303,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,303,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,303,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,303,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,303,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,303,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,303,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,303,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,303,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,303,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,303,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,303,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,303,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,303,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,303,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,303,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,303,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,303,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,303,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,303,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,303,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,303,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,303,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,303,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,303,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,303,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,303,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,303,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,303,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,303,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,303,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,303,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,303,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,303,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,303,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,303,Receptor assay; estrogen ,,,75.3,465.26,4 RC,303,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,303,Receptor assay; progesterone ,,,55.59,343.11,4 RC,303,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,303,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,303,Renin ,,,18.84,116.79,4 RC,303,Reptilase test ,,,8.44,52.12,4 RC,303,Reticulated platelet assay ,,,30.62,188.6,4 RC,303,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,303,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,303,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,303,Rufinamide ,,,23.23,143.69,4 RC,303,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,303,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,303,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,303,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,303,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,303,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,303,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,303,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,303,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,303,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,303,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,303,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,303,Salicylate ,,,15.97,98.82,4 RC,303,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,303,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,303,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,303,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,303,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,303,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,303,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,303,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,303,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,303,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,303,Selenium ,,,21.88,134.7,4 RC,303,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,303,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,303,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,303,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,303,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,303,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,303,Serotonin ,,,26.54,163.49,4 RC,303,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,303,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,303,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,303,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,303,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,303,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,303,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,303,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,303,Sialic acid ,,,11.52,71.87,4 RC,303,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,303,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,303,Silica ,,,21.6,132.92,4 RC,303,Sirolimus ,,,11.76,73.66,4 RC,303,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,303,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,303,Skin test; candida ,,,79.46,102.39,3 RC,303,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,303,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,303,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,303,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,303,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,303,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,303,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,303,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,303,Sodium; other source ,,,4.16,25.17,4 RC,303,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,303,Sodium; urine ,,,4.33,26.95,4 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,303,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,303,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,303,Somatomedin ,,,18.22,113.16,4 RC,303,Somatostatin ,,,15.67,96.98,4 RC,303,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,303,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,303,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,303,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,303,Specific gravity (except urine) ,,,2.82,17.97,4 RC,303,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,303,Sperm antibodies ,,,43.21,55.69,3 RC,303,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,303,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,303,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,303,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,303,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,303,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,303,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,303,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,303,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,303,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,303,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,303,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,303,"Stimulants, synthetic ",,,12.05,127.56,4 RC,303,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,303,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,303,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,303,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,303,"Streptokinase, antibody ",,,10.84,66.46,4 RC,303,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,303,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,303,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,303,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,303,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,303,"Sulfate, urine ",,,4.7,28.74,4 RC,303,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,303,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,303,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,303,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,303,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,303,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,303,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,303,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,303,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,303,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,303,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,303,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,303,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,303,T cells; total count ,,,32.32,199.37,4 RC,303,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,303,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,303,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,303,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,303,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,303,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,303,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,303,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,303,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,303,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,303,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,303,Tacrolimus ,,,11.76,73.66,4 RC,303,Tapentadol ,,,10.83,127.56,4 RC,303,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,303,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,303,Testosterone; free ,,,21.82,134.7,4 RC,303,Testosterone; total ,,,22.11,136.54,4 RC,303,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,303,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,303,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,303,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,303,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,303,Theophylline ,,,12.12,75.44,4 RC,303,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,303,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,303,Thiocyanate ,,,9.97,61.1,4 RC,303,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,303,Thrombin time; plasma ,,,4.95,30.52,4 RC,303,Thrombin time; titer ,,,5.87,35.94,4 RC,303,Thrombomodulin ,,,14.8,91.62,4 RC,303,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,303,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,303,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,303,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,303,Thyroglobulin ,,,13.76,84.43,4 RC,303,Thyroglobulin antibody ,,,13.63,84.43,4 RC,303,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,303,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,303,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,303,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,303,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,303,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,303,Thyroxine; free ,,,7.73,48.49,4 RC,303,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,303,Thyroxine; total ,,,5.89,35.94,4 RC,303,Tiagabine ,,,23.23,143.69,4 RC,303,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,303,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,303,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,303,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,303,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,303,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,303,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,303,Tobramycin ,,,13.82,86.21,4 RC,303,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,303,Topiramate ,,,10.21,62.89,4 RC,303,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,303,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,303,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,303,Tramadol ,,,10.54,127.56,4 RC,303,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,303,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,303,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,303,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,303,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,303,Transferrin ,,,10.93,68.24,4 RC,303,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,303,Triglycerides ,,,4.92,30.52,4 RC,303,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,303,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,303,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,303,"Troponin, qualitative ",,,8.65,53.9,4 RC,303,"Troponin, quantitative ",,,10.68,66.46,4 RC,303,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,303,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,303,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,303,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,303,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,303,Tyrosine ,,,9.11,55.69,4 RC,303,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,303,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,303,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,303,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,303,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,303,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,303,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,303,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,303,Unlisted immunology procedure ,,,99.55,128.28,3 RC,303,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,303,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,303,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,303,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,303,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,303,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,303,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,303,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,303,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,303,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,303,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,303,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,303,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,303,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,303,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,303,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,303,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,303,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,303,Uric acid; blood ,,,3.88,23.38,4 RC,303,Uric acid; other source ,,,4.36,26.95,4 RC,303,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,303,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,303,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,303,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,303,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,303,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,303,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,303,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,303,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,303,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,303,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,303,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,303,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,303,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,303,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,303,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,303,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,303,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,303,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,303,Vancomycin ,,,11.6,71.87,4 RC,303,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,303,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,303,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,303,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,303,Vedolizumab ,,,33.05,204.79,4 RC,303,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,303,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,303,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,303,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,303,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,303,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,303,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,303,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,303,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,303,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,303,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,303,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,303,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,303,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,303,Very long chain fatty acids ,,,16.92,104.18,4 RC,303,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,303,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,303,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,303,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,303,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,303,Viscosity ,,,10.0,61.1,4 RC,303,Vitamin A ,,,9.95,61.1,4 RC,303,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,303,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,303,Vitamin K ,,,11.75,71.87,4 RC,303,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,303,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,303,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,303,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,303,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,303,Voriconazole ,,,23.23,143.69,4 RC,303,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,303,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,303,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,303,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,303,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,303,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,303,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,303,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,303,Zinc ,,,9.76,61.1,4 RC,303,Zonisamide ,,,11.35,70.08,4 RC,303,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,303,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,303,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,304, Laboratory Non-Routine Dialysis ,,,,,0 RC,304,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,304,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,304,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,304,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,304,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,304,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,304,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,304,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,304,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,304,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,304,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,304,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,304,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,304,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,304,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,304,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,304,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,Acetaminophen ,,,15.97,98.82,4 RC,304,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,304,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,304,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,304,Acetylcholinesterase ,,,10.53,64.67,4 RC,304,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,304,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,304,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,304,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,304,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,304,Adalimumab ,,,33.05,204.79,4 RC,304,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,304,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,304,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,304,Albumin; ischemia modified ,,,29.08,179.62,4 RC,304,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,304,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,304,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,304,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,304,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,304,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,304,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,304,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,304,Alcohols ,,,9.61,127.56,4 RC,304,Aldolase ,,,8.32,52.12,4 RC,304,Aldosterone ,,,34.91,215.56,4 RC,304,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,304,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,304,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,304,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,304,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,304,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,304,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,304,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,304,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,304,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,304,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,304,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,304,Aluminum ,,,21.83,134.7,4 RC,304,Amikacin ,,,12.92,80.85,4 RC,304,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,304,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,304,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,304,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,304,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,304,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,304,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,304,Amiodarone ,,,15.97,98.82,4 RC,304,Ammonia ,,,12.48,77.23,4 RC,304,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,304,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,304,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,304,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,304,Amylase ,,,5.55,34.15,4 RC,304,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,304,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,304,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,304,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,304,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,304,Androstanediol glucuronide ,,,24.7,152.67,4 RC,304,Androstenedione ,,,25.09,154.51,4 RC,304,Androsterone ,,,21.89,134.7,4 RC,304,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,304,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,304,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,304,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,304,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,304,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,304,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,304,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,304,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,304,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,304,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,304,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,304,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,304,Angiotensin II ,,,17.58,109.59,4 RC,304,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,304,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,304,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,304,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,304,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,304,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,304,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,304,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,304,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,304,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,304,Antibody; Aspergillus ,,,12.89,79.01,4 RC,304,Antibody; Bartonella ,,,8.72,53.9,4 RC,304,Antibody; Blastomyces ,,,11.06,68.24,4 RC,304,Antibody; Bordetella ,,,11.3,70.08,4 RC,304,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,304,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,304,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,304,Antibody; Brucella ,,,7.65,46.7,4 RC,304,Antibody; Campylobacter ,,,11.24,70.08,4 RC,304,Antibody; Candida ,,,10.29,62.89,4 RC,304,Antibody; Chlamydia ,,,10.13,62.89,4 RC,304,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,304,Antibody; Coccidioides ,,,9.82,61.1,4 RC,304,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,304,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,304,Antibody; Diphtheria ,,,13.04,80.85,4 RC,304,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,304,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,304,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,304,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,304,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,304,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,304,Antibody; HIV-1 ,,,7.62,46.7,4 RC,304,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,304,Antibody; HIV-2 ,,,11.59,71.87,4 RC,304,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,304,Antibody; HTLV-I ,,,7.79,48.49,4 RC,304,Antibody; HTLV-II ,,,12.0,73.66,4 RC,304,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,304,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,304,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,304,Antibody; Legionella ,,,13.11,80.85,4 RC,304,Antibody; Leishmania ,,,10.5,64.67,4 RC,304,Antibody; Leptospira ,,,13.88,86.21,4 RC,304,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,304,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,304,Antibody; Nocardia ,,,13.7,84.43,4 RC,304,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,304,Antibody; Rickettsia ,,,16.57,102.39,4 RC,304,Antibody; Salmonella ,,,11.3,70.08,4 RC,304,Antibody; Shigella ,,,20.97,129.34,4 RC,304,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,304,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,304,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,304,Antibody; Trichinella ,,,10.76,66.46,4 RC,304,Antibody; West Nile virus ,,,12.33,75.44,4 RC,304,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,304,Antibody; Yersinia ,,,11.3,70.08,4 RC,304,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,304,Antibody; actinomyces ,,,8.72,53.9,4 RC,304,Antibody; adenovirus ,,,11.03,68.24,4 RC,304,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,304,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,304,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,304,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,304,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,304,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,304,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,304,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,304,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,304,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,304,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,304,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,304,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,304,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,304,Antibody; histoplasma ,,,11.81,73.66,4 RC,304,Antibody; influenza virus ,,,11.61,71.87,4 RC,304,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,304,Antibody; mucormycosis ,,,12.85,79.01,4 RC,304,Antibody; mumps ,,,11.18,70.08,4 RC,304,Antibody; mycoplasma ,,,11.34,70.08,4 RC,304,Antibody; parvovirus ,,,12.88,79.01,4 RC,304,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,304,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,304,Antibody; rotavirus ,,,15.62,96.98,4 RC,304,Antibody; rubella ,,,12.33,75.44,4 RC,304,Antibody; rubeola ,,,11.04,68.24,4 RC,304,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,304,Antibody; tetanus ,,,12.68,79.01,4 RC,304,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,304,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,304,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,304,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,304,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,304,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,304,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,304,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,304,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,304,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,304,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,304,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,304,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,304,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,304,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,304,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,304,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,304,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,304,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,304,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,304,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,304,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,304,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,304,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,304,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,304,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,304,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,304,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,304,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,304,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,304,"Apolipoprotein, each ",,,18.07,111.38,4 RC,304,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,304,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,304,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,304,Arsenic ,,,16.25,100.61,4 RC,304,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,304,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,304,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,304,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,304,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,304,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,304,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,304,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,304,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,304,"B cells, total count ",,,32.32,199.37,4 RC,304,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,304,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,304,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,304,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,304,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,304,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,304,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,304,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,304,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,304,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,304,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,304,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,304,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,304,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,304,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,304,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,304,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,304,Barbiturates ,,,9.34,127.56,4 RC,304,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,304,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,304,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,304,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,304,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,304,Beta-2 microglobulin ,,,13.86,86.21,4 RC,304,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,304,Bile acids; total ,,,14.67,91.62,4 RC,304,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,304,Bilirubin; direct ,,,4.3,26.95,4 RC,304,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,304,Bilirubin; total ,,,4.3,26.95,4 RC,304,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,304,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,304,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,304,Bleeding time ,,,4.13,25.17,4 RC,304,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,304,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,304,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,304,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,304,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,304,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,304,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,304,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,304,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,304,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,304,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,304,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,304,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,304,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,304,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,304,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,304,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,304,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,304,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,304,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,304,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,304,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,304,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,304,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,304,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,304,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,304,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,304,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,304,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,304,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,304,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,304,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,304,Bone age studies ,,,61.64,79.3,3 RC,304,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,304,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,304,Bradykinin ,,,4.42,26.95,4 RC,304,Buprenorphine ,,,14.01,14.01,1 RC,304,C-peptide ,,,17.83,109.59,4 RC,304,C-reactive protein; ,,,4.44,26.95,4 RC,304,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,304,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,304,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,304,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,304,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,304,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,304,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,304,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,304,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,304,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,304,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,304,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,304,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,304,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,304,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,304,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,304,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,304,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,304,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,304,Cadmium ,,,20.26,125.72,4 RC,304,Caffeine ,,,33.05,204.79,4 RC,304,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,304,Calcitonin ,,,22.95,141.9,4 RC,304,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,304,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,304,Calcium; ionized ,,,11.72,71.87,4 RC,304,Calcium; total ,,,4.42,26.95,4 RC,304,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,304,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,304,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,304,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,304,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,304,"Calprotectin, fecal ",,,16.82,104.18,4 RC,304,"Cannabinoids, natural ",,,11.5,127.56,4 RC,304,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,304,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,304,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,304,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,304,Carbamazepine; free ,,,11.35,70.08,4 RC,304,Carbamazepine; total ,,,12.48,77.23,4 RC,304,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,304,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,304,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,304,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,304,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,304,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,304,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,304,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,304,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,304,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,304,Carotene ,,,7.89,48.49,4 RC,304,Catecholamines; blood ,,,24.92,154.51,4 RC,304,Catecholamines; fractionated ,,,21.63,134.7,4 RC,304,Catecholamines; total urine ,,,23.39,145.53,4 RC,304,Cathepsin-D ,,,15.47,95.19,4 RC,304,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,304,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,304,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,304,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,304,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,304,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,304,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,304,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,304,Ceruloplasmin ,,,9.2,57.47,4 RC,304,Chemiluminescent assay ,,,12.1,75.44,4 RC,304,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,304,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,304,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,304,Chloramphenicol ,,,10.85,66.46,4 RC,304,Chloride; blood ,,,3.94,25.17,4 RC,304,Chloride; other source ,,,4.28,26.95,4 RC,304,Chloride; urine ,,,4.93,30.52,4 RC,304,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,304,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,304,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,304,Cholinesterase; RBC ,,,8.4,52.12,4 RC,304,Cholinesterase; serum ,,,6.74,41.29,4 RC,304,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,304,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,304,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,304,Chromium ,,,17.38,107.81,4 RC,304,Chromogenic substrate assay ,,,10.19,62.89,4 RC,304,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,304,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,304,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,304,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,304,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,304,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,304,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,304,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,304,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,304,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,304,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,304,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,304,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,304,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,304,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,304,Citrate ,,,23.82,147.31,4 RC,304,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,304,Clot retraction ,,,13.96,86.21,4 RC,304,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,304,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,304,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,304,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,304,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,304,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,304,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,304,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,304,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,304,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,304,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,304,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,304,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,304,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,304,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,304,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,304,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,304,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,304,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,304,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,304,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,304,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,304,Clozapine ,,,17.27,105.96,4 RC,304,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,304,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,304,Coagulation time; activated ,,,3.67,23.38,4 RC,304,Coagulation time; other methods ,,,3.85,23.38,4 RC,304,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,304,Cocaine ,,,10.46,127.56,4 RC,304,Cold agglutinin; screen ,,,6.92,43.13,4 RC,304,Cold agglutinin; titer ,,,6.91,43.13,4 RC,304,"Collagen cross links, any method ",,,16.0,98.82,4 RC,304,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,304,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,304,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,304,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,304,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,304,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,304,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,304,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,304,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,304,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,304,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,304,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,304,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,304,"Complement; antigen, each component ",,,10.28,62.89,4 RC,304,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,304,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,304,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,304,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,304,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,304,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,304,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,304,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,304,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,304,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,304,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,304,Copper ,,,10.63,66.46,4 RC,304,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,304,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,304,Corticosterone ,,,19.3,118.58,4 RC,304,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,304,Cortisol; free ,,,14.32,88.0,4 RC,304,Cortisol; total ,,,13.96,86.21,4 RC,304,Creatine ,,,3.98,25.17,4 RC,304,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,304,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,304,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,304,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,304,Creatinine; blood ,,,4.39,26.95,4 RC,304,Creatinine; clearance ,,,8.11,50.28,4 RC,304,Creatinine; other source ,,,4.44,26.95,4 RC,304,Cryofibrinogen ,,,12.12,75.44,4 RC,304,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,304,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,304,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,304,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,304,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,304,Cryopreservation; sperm ,,,442.57,570.33,3 RC,304,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,304,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,304,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,304,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,304,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,304,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,304,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,304,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,304,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,304,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,304,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,304,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,304,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,304,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,304,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,304,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,304,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,304,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,304,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,304,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,304,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,304,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,304,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,304,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,304,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,304,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,304,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,304,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,304,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,304,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,304,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,304,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,304,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,304,"Culture, typing; other methods ",,,6.63,41.29,4 RC,304,Cyanide ,,,16.63,102.39,4 RC,304,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,304,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,304,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,304,Cyclosporine ,,,15.46,95.19,4 RC,304,Cystatin C ,,,15.87,98.82,4 RC,304,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,304,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,304,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,304,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,304,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,304,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,304,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,304,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,304,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,304,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,304,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,304,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,304,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,304,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,304,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,304,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,304,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,304,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,304,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,304,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,304,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,304,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,304,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,304,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,304,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,304,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,304,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,304,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,304,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,304,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,304,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,304,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,304,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,304,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,304,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,304,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,304,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,304,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,304,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,304,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,304,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,304,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,304,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,304,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,304,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,304,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,304,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,304,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,304,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,304,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,304,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,304,Dibucaine number ,,,10.5,64.67,4 RC,304,Digoxin; free ,,,11.38,70.08,4 RC,304,Digoxin; total ,,,11.38,70.08,4 RC,304,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,304,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,304,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,304,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,304,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,304,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,304,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,304,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,304,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,304,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,304,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,304,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,304,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,304,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,304,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,304,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,304,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,304,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,304,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,304,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,304,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,304,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,304,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,304,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,304,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,304,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,304,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,304,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,304,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,304,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,304,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,304,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,304,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,304,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,304,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,304,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,304,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,304,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,304,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,304,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,304,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,304,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,304,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,304,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,304,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,304,Erythropoietin ,,,16.1,98.82,4 RC,304,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,304,Estradiol; total ,,,23.94,147.31,4 RC,304,Estriol ,,,20.72,127.56,4 RC,304,Estrogens; fractionated ,,,27.67,170.64,4 RC,304,Estrogens; total ,,,18.59,114.95,4 RC,304,Estrone ,,,21.38,132.92,4 RC,304,Ethosuximide ,,,14.0,86.21,4 RC,304,Ethylene glycol ,,,12.77,79.01,4 RC,304,Etiocholanolone ,,,22.48,138.33,4 RC,304,Euglobulin lysis ,,,7.2,44.92,4 RC,304,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,304,Everolimus ,,,11.76,73.66,4 RC,304,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,304,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,304,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,304,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,304,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,304,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,304,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,304,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,304,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,304,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,304,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,304,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,304,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,304,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,304,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,304,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,304,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,304,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,304,Factor inhibitor test ,,,11.03,68.24,4 RC,304,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,304,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,304,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,304,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,304,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,304,Felbamate ,,,15.97,98.82,4 RC,304,Fentanyl ,,,13.07,127.56,4 RC,304,Fern test ,,,40.44,52.12,3 RC,304,Ferritin ,,,11.68,71.87,4 RC,304,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,304,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,304,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,304,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,304,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,304,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,304,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,304,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,304,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,304,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,304,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,304,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,304,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,304,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,304,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,304,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,304,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,304,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,304,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,304,Fibrinogen; activity ,,,8.32,52.12,4 RC,304,Fibrinogen; antigen ,,,12.39,77.23,4 RC,304,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,304,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,304,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,304,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,304,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,304,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,304,Flecainide ,,,15.97,98.82,4 RC,304,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,304,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,304,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,304,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,304,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,304,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,304,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,304,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,304,Fluoride ,,,15.88,98.82,4 RC,304,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,304,Folic acid; RBC ,,,15.13,93.41,4 RC,304,Folic acid; serum ,,,12.6,77.23,4 RC,304,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,304,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,304,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,304,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,304,"Fructose, semen ",,,14.86,91.62,4 RC,304,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,304,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,304,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,304,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,304,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,304,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,304,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,304,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,304,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,304,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,304,"Galactokinase, RBC ",,,18.4,113.16,4 RC,304,Galactose ,,,9.6,59.26,4 RC,304,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,304,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,304,Galectin-3 ,,,182.6,235.31,3 RC,304,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,304,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,304,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,304,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,304,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,304,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,304,"Gases, blood, pH only ",,,9.42,57.47,4 RC,304,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,304,Gastrin ,,,15.11,93.41,4 RC,304,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,304,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,304,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,304,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,304,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,304,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,304,Gentamicin ,,,14.04,86.21,4 RC,304,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,304,Glucagon ,,,12.24,75.44,4 RC,304,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,304,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,304,Glucagon tolerance test ,,,15.23,93.41,4 RC,304,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,304,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,304,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,304,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,304,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,304,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,304,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,304,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,304,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,304,"Glucosidase, beta ",,,18.4,113.16,4 RC,304,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,304,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,304,Glutathione ,,,13.24,82.64,4 RC,304,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,304,Glycated protein ,,,14.36,88.0,4 RC,304,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,304,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,304,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,304,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,304,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,304,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,304,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,304,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,304,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,304,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,304,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,304,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,304,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,304,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,304,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,304,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,304,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,304,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,304,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,304,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,304,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,304,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,304,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,304,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,304,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,304,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,304,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,304,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,304,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,304,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,304,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,304,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,304,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,304,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,304,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,304,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,304,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,304,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,304,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,304,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,304,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,304,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,Haloperidol ,,,13.53,84.43,4 RC,304,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,304,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,304,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,304,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,304,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,304,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,304,Heinz bodies; direct ,,,3.6,21.54,4 RC,304,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,304,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,304,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,304,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,304,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,304,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,304,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,304,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,304,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,304,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,304,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,304,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,304,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,304,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,304,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,304,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,304,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,304,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,304,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,304,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,304,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,304,Hemoglobin; plasma ,,,6.26,39.51,4 RC,304,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,304,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,304,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,304,Hemoglobin; urine ,,,3.39,21.54,4 RC,304,"Hemolysin, acid ",,,7.6,46.7,4 RC,304,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,304,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,304,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,304,Heparin assay ,,,11.22,70.08,4 RC,304,Heparin neutralization ,,,10.15,62.89,4 RC,304,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,304,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,304,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,304,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,304,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,304,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,304,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,304,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,304,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,304,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,304,Hepatitis C antibody; ,,,12.23,75.44,4 RC,304,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,304,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,304,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,304,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,304,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,304,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,304,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,304,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,304,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,304,Heroin metabolite ,,,13.63,127.56,4 RC,304,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,304,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,304,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,304,Histamine ,,,25.31,156.3,4 RC,304,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,304,Homocysteine ,,,15.35,95.19,4 RC,304,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,304,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,304,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,304,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,304,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,304,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,304,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,304,Hydroxychloroquine ,,,15.97,98.82,4 RC,304,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,304,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,304,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,304,Hydroxyproline; free ,,,19.41,120.36,4 RC,304,Hydroxyproline; total ,,,20.82,129.34,4 RC,304,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,304,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,304,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,304,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,304,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,304,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,304,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,304,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,304,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,304,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,304,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,304,Immune complex assay ,,,20.88,129.34,4 RC,304,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,304,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,304,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,304,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,304,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,304,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,304,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,304,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,304,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,304,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,304,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,304,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,304,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,304,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,304,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,304,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,304,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,304,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,304,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,304,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,304,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,304,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,304,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,304,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,304,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,304,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,304,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,304,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,304,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,304,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,304,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,304,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,304,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,304,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,304,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,304,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,304,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,304,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,304,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,304,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,304,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,304,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,304,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,304,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,304,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,304,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,304,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,304,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,304,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,304,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,304,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,304,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,304,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,304,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,304,Infliximab ,,,33.05,204.79,4 RC,304,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,304,Inhibin A ,,,13.36,82.64,4 RC,304,Insemination of oocytes ,,,442.57,570.33,3 RC,304,Insulin antibodies ,,,18.34,113.16,4 RC,304,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,304,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,304,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,304,Insulin; free ,,,11.1,68.24,4 RC,304,Insulin; total ,,,9.79,61.1,4 RC,304,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,304,Intrinsic factor ,,,16.98,104.18,4 RC,304,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,304,Iron ,,,5.54,34.15,4 RC,304,Iron binding capacity ,,,7.49,46.7,4 RC,304,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,304,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,304,Islet cell antibody ,,,20.2,125.72,4 RC,304,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,304,Itraconazole ,,,23.23,143.69,4 RC,304,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,304,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,304,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,304,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,304,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,304,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,304,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,304,Ketamine and norketamine ,,,10.54,127.56,4 RC,304,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,304,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,304,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,304,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,304,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,304,Lacosamide ,,,23.23,143.69,4 RC,304,Lactate (lactic acid) ,,,9.91,61.1,4 RC,304,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,304,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,304,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,304,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,304,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,304,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,304,Lamotrigine ,,,11.35,70.08,4 RC,304,Lead ,,,10.37,64.67,4 RC,304,Leflunomide ,,,33.05,204.79,4 RC,304,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,304,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,304,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,304,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,304,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,304,Leukocyte transfusion ,,,305.26,393.39,3 RC,304,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,304,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,304,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,304,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,304,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,304,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,304,Levetiracetam ,,,11.35,70.08,4 RC,304,Lidocaine ,,,12.59,77.23,4 RC,304,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,304,Lipase ,,,5.91,35.94,4 RC,304,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,304,Lipoprotein (a) ,,,12.27,75.44,4 RC,304,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,304,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,304,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,304,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,304,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,304,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,304,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,304,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,304,Lithium ,,,5.66,35.94,4 RC,304,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,304,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,304,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,304,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,304,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,304,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,304,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,304,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,304,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,304,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,304,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,304,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,304,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,304,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,304,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,304,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,304,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,304,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,304,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,304,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,304,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,304,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,304,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,304,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,304,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,304,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,304,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,304,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,304,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,304,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,304,Magnesium ,,,5.74,35.94,4 RC,304,Malate dehydrogenase ,,,6.31,39.51,4 RC,304,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,304,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,304,Manganese ,,,22.84,141.9,4 RC,304,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,304,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,304,"Meat fibers, feces ",,,4.15,25.17,4 RC,304,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,304,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,304,"Mercury, quantitative ",,,13.93,86.21,4 RC,304,Metanephrines ,,,14.51,89.84,4 RC,304,Methadone ,,,11.24,127.56,4 RC,304,Methemalbumin ,,,9.2,57.47,4 RC,304,Methotrexate ,,,33.05,204.79,4 RC,304,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,304,Methylphenidate ,,,9.29,127.56,4 RC,304,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,304,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,304,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,304,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,304,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,304,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,304,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,304,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,304,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,304,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,304,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,304,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,304,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,304,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,304,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,304,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,304,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,304,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,304,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,304,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,304,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,304,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,304,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,304,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,304,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,304,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,304,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,304,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,304,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,304,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,304,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,304,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,304,Muramidase ,,,16.07,98.82,4 RC,304,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,304,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,304,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,304,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,304,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,304,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,304,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,304,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,304,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,304,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,304,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,304,Myoglobin ,,,11.07,68.24,4 RC,304,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,304,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,304,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,304,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,304,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,304,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,304,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,304,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,304,Natriuretic peptide ,,,33.64,208.36,4 RC,304,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,304,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,304,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,304,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,304,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,304,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,304,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,304,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,304,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,304,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,304,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,304,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,304,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,304,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,304,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,304,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,304,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,304,Nerve teasing preparations ,,,499.29,643.43,3 RC,304,"Neutralization test, viral ",,,14.48,89.84,4 RC,304,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,304,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,304,Nickel ,,,21.0,129.34,4 RC,304,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,304,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,304,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,304,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,304,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,304,Nucleotidase 5'- ,,,9.56,59.26,4 RC,304,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,304,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,304,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,304,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,304,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,304,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,304,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,304,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,304,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,304,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,304,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,304,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,304,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,304,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,304,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,304,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,304,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,304,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,304,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,304,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,304,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,304,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,304,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,304,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,304,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,304,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,304,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,304,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,304,"Opiates, 1 or more ",,,14.57,127.56,4 RC,304,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,304,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,304,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,304,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,304,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,304,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,304,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,304,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,304,Osmolality; blood ,,,5.66,35.94,4 RC,304,Osmolality; urine ,,,5.84,35.94,4 RC,304,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,304,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,304,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,304,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,304,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,304,Oxalate ,,,12.38,77.23,4 RC,304,Oxcarbazepine ,,,11.35,70.08,4 RC,304,Oxycodone ,,,12.15,127.56,4 RC,304,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,304,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,304,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,304,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,304,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,304,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,304,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,304,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,304,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,304,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,304,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,304,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,304,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,304,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,304,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,304,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,304,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,304,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,304,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,304,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,304,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,304,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,304,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,304,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,304,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,304,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,304,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,304,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,304,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,304,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,304,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,304,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,304,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,304,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,304,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,304,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,304,Phenobarbital ,,,13.11,80.85,4 RC,304,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,304,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,304,Phenytoin; free ,,,11.79,73.66,4 RC,304,Phenytoin; total ,,,11.35,70.08,4 RC,304,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,304,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,304,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,304,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,304,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,304,Phosphatidylglycerol ,,,14.16,88.0,4 RC,304,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,304,Phosphohexose isomerase ,,,9.19,57.47,4 RC,304,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,304,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,304,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,304,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,304,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,304,Pinworm examinations ,,,18.14,23.38,3 RC,304,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,304,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,304,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,304,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,304,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,304,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,304,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,304,Posaconazole ,,,23.23,143.69,4 RC,304,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,304,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,304,Potassium; urine ,,,4.05,25.17,4 RC,304,Prealbumin ,,,12.51,77.23,4 RC,304,Pregabalin ,,,7.07,127.56,4 RC,304,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,304,Pregnanediol ,,,18.23,113.16,4 RC,304,Pregnanetriol ,,,18.03,111.38,4 RC,304,Pregnenolone ,,,17.71,109.59,4 RC,304,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,304,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,304,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,304,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,304,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,304,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,304,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,304,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,304,Primidone ,,,14.22,88.0,4 RC,304,Procainamide; ,,,51.41,317.95,4 RC,304,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,304,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,304,Progesterone ,,,17.87,111.38,4 RC,304,Proinsulin ,,,22.87,141.9,4 RC,304,Prolactin ,,,16.61,102.39,4 RC,304,Propoxyphene ,,,10.72,127.56,4 RC,304,"Prostaglandin, each ",,,35.79,220.97,4 RC,304,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,304,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,304,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,304,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,304,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,304,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,304,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,304,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,304,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,304,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,304,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,304,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,304,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,304,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,304,Prothrombin time; ,,,3.67,23.38,4 RC,304,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,304,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,304,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,304,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,304,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,304,Pyruvate ,,,12.4,77.23,4 RC,304,Pyruvate kinase ,,,8.09,50.28,4 RC,304,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,304,Quinidine ,,,12.51,77.23,4 RC,304,Quinine ,,,9.97,61.1,4 RC,304,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,304,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,304,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,304,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,304,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,304,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,304,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,304,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,304,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,304,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,304,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,304,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,304,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,304,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,304,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,304,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,304,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,304,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,304,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,304,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,304,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,304,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,304,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,304,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,304,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,304,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,304,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,304,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,304,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,304,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,304,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,304,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,304,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,304,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,304,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,304,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,304,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,304,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,304,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,304,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,304,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,304,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,304,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,304,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,304,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,304,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,304,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,304,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,304,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,304,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,304,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,304,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,304,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,304,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,304,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,304,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,304,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,304,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,304,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,304,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,304,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,304,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,304,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,304,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,304,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,304,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,304,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,304,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,304,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,304,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,304,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,304,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,304,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,304,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,304,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,304,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,304,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,304,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,304,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,304,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,304,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,304,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,304,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,304,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,304,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,304,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,304,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,304,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,304,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,304,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,304,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,304,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,304,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,304,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,304,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,304,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,304,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,304,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,304,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,304,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,304,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,304,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,304,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,304,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,304,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,304,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,304,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,304,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,304,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,304,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,304,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,304,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,304,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,304,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,304,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,304,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,304,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,304,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,304,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,304,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,304,Receptor assay; estrogen ,,,75.3,465.26,4 RC,304,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,304,Receptor assay; progesterone ,,,55.59,343.11,4 RC,304,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,304,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,304,Renin ,,,18.84,116.79,4 RC,304,Reptilase test ,,,8.44,52.12,4 RC,304,Reticulated platelet assay ,,,30.62,188.6,4 RC,304,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,304,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,304,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,304,Rufinamide ,,,23.23,143.69,4 RC,304,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,304,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,304,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,304,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,304,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,304,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,304,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,304,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,304,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,304,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,304,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,304,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,304,Salicylate ,,,15.97,98.82,4 RC,304,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,304,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,304,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,304,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,304,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,304,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,304,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,304,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,304,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,304,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,304,Selenium ,,,21.88,134.7,4 RC,304,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,304,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,304,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,304,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,304,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,304,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,304,Serotonin ,,,26.54,163.49,4 RC,304,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,304,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,304,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,304,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,304,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,304,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,304,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,304,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,304,Sialic acid ,,,11.52,71.87,4 RC,304,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,304,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,304,Silica ,,,21.6,132.92,4 RC,304,Sirolimus ,,,11.76,73.66,4 RC,304,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,304,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,304,Skin test; candida ,,,79.46,102.39,3 RC,304,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,304,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,304,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,304,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,304,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,304,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,304,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,304,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,304,Sodium; other source ,,,4.16,25.17,4 RC,304,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,304,Sodium; urine ,,,4.33,26.95,4 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,304,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,304,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,304,Somatomedin ,,,18.22,113.16,4 RC,304,Somatostatin ,,,15.67,96.98,4 RC,304,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,304,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,304,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,304,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,304,Specific gravity (except urine) ,,,2.82,17.97,4 RC,304,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,304,Sperm antibodies ,,,43.21,55.69,3 RC,304,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,304,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,304,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,304,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,304,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,304,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,304,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,304,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,304,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,304,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,304,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,304,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,304,"Stimulants, synthetic ",,,12.05,127.56,4 RC,304,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,304,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,304,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,304,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,304,"Streptokinase, antibody ",,,10.84,66.46,4 RC,304,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,304,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,304,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,304,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,304,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,304,"Sulfate, urine ",,,4.7,28.74,4 RC,304,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,304,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,304,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,304,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,304,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,304,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,304,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,304,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,304,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,304,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,304,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,304,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,304,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,304,T cells; total count ,,,32.32,199.37,4 RC,304,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,304,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,304,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,304,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,304,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,304,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,304,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,304,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,304,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,304,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,304,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,304,Tacrolimus ,,,11.76,73.66,4 RC,304,Tapentadol ,,,10.83,127.56,4 RC,304,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,304,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,304,Testosterone; free ,,,21.82,134.7,4 RC,304,Testosterone; total ,,,22.11,136.54,4 RC,304,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,304,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,304,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,304,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,304,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,304,Theophylline ,,,12.12,75.44,4 RC,304,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,304,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,304,Thiocyanate ,,,9.97,61.1,4 RC,304,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,304,Thrombin time; plasma ,,,4.95,30.52,4 RC,304,Thrombin time; titer ,,,5.87,35.94,4 RC,304,Thrombomodulin ,,,14.8,91.62,4 RC,304,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,304,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,304,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,304,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,304,Thyroglobulin ,,,13.76,84.43,4 RC,304,Thyroglobulin antibody ,,,13.63,84.43,4 RC,304,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,304,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,304,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,304,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,304,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,304,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,304,Thyroxine; free ,,,7.73,48.49,4 RC,304,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,304,Thyroxine; total ,,,5.89,35.94,4 RC,304,Tiagabine ,,,23.23,143.69,4 RC,304,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,304,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,304,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,304,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,304,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,304,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,304,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,304,Tobramycin ,,,13.82,86.21,4 RC,304,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,304,Topiramate ,,,10.21,62.89,4 RC,304,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,304,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,304,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,304,Tramadol ,,,10.54,127.56,4 RC,304,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,304,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,304,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,304,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,304,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,304,Transferrin ,,,10.93,68.24,4 RC,304,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,304,Triglycerides ,,,4.92,30.52,4 RC,304,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,304,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,304,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,304,"Troponin, qualitative ",,,8.65,53.9,4 RC,304,"Troponin, quantitative ",,,10.68,66.46,4 RC,304,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,304,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,304,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,304,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,304,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,304,Tyrosine ,,,9.11,55.69,4 RC,304,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,304,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,304,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,304,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,304,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,304,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,304,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,304,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,304,Unlisted immunology procedure ,,,99.55,128.28,3 RC,304,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,304,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,304,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,304,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,304,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,304,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,304,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,304,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,304,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,304,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,304,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,304,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,304,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,304,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,304,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,304,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,304,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,304,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,304,Uric acid; blood ,,,3.88,23.38,4 RC,304,Uric acid; other source ,,,4.36,26.95,4 RC,304,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,304,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,304,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,304,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,304,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,304,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,304,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,304,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,304,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,304,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,304,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,304,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,304,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,304,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,304,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,304,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,304,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,304,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,304,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,304,Vancomycin ,,,11.6,71.87,4 RC,304,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,304,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,304,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,304,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,304,Vedolizumab ,,,33.05,204.79,4 RC,304,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,304,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,304,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,304,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,304,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,304,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,304,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,304,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,304,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,304,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,304,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,304,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,304,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,304,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,304,Very long chain fatty acids ,,,16.92,104.18,4 RC,304,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,304,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,304,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,304,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,304,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,304,Viscosity ,,,10.0,61.1,4 RC,304,Vitamin A ,,,9.95,61.1,4 RC,304,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,304,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,304,Vitamin K ,,,11.75,71.87,4 RC,304,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,304,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,304,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,304,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,304,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,304,Voriconazole ,,,23.23,143.69,4 RC,304,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,304,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,304,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,304,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,304,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,304,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,304,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,304,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,304,Zinc ,,,9.76,61.1,4 RC,304,Zonisamide ,,,11.35,70.08,4 RC,304,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,304,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,304,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,305, Laboratory Hematology ,,,,,0 RC,305,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,305,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,305,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,305,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,305,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,305,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,305,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,305,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,305,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,305,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,305,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,305,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,305,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,305,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,305,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,305,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,305,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,Acetaminophen ,,,15.97,98.82,4 RC,305,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,305,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,305,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,305,Acetylcholinesterase ,,,10.53,64.67,4 RC,305,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,305,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,305,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,305,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,305,Adalimumab ,,,33.05,204.79,4 RC,305,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,305,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,305,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,305,Albumin; ischemia modified ,,,29.08,179.62,4 RC,305,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,305,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,305,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,305,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,305,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,305,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,305,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,305,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,305,Alcohols ,,,9.61,127.56,4 RC,305,Aldolase ,,,8.32,52.12,4 RC,305,Aldosterone ,,,34.91,215.56,4 RC,305,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,305,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,305,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,305,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,305,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,305,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,305,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,305,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,305,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,305,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,305,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,305,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,305,Aluminum ,,,21.83,134.7,4 RC,305,Amikacin ,,,12.92,80.85,4 RC,305,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,305,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,305,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,305,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,305,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,305,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,305,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,305,Amiodarone ,,,15.97,98.82,4 RC,305,Ammonia ,,,12.48,77.23,4 RC,305,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,305,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,305,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,305,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,305,Amylase ,,,5.55,34.15,4 RC,305,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,305,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,305,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,305,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,305,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,305,Androstanediol glucuronide ,,,24.7,152.67,4 RC,305,Androstenedione ,,,25.09,154.51,4 RC,305,Androsterone ,,,21.89,134.7,4 RC,305,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,305,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,305,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,305,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,305,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,305,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,305,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,305,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,305,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,305,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,305,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,305,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,305,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,305,Angiotensin II ,,,17.58,109.59,4 RC,305,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,305,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,305,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,305,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,305,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,305,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,305,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,305,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,305,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,305,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,305,Antibody; Aspergillus ,,,12.89,79.01,4 RC,305,Antibody; Bartonella ,,,8.72,53.9,4 RC,305,Antibody; Blastomyces ,,,11.06,68.24,4 RC,305,Antibody; Bordetella ,,,11.3,70.08,4 RC,305,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,305,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,305,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,305,Antibody; Brucella ,,,7.65,46.7,4 RC,305,Antibody; Campylobacter ,,,11.24,70.08,4 RC,305,Antibody; Candida ,,,10.29,62.89,4 RC,305,Antibody; Chlamydia ,,,10.13,62.89,4 RC,305,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,305,Antibody; Coccidioides ,,,9.82,61.1,4 RC,305,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,305,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,305,Antibody; Diphtheria ,,,13.04,80.85,4 RC,305,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,305,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,305,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,305,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,305,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,305,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,305,Antibody; HIV-1 ,,,7.62,46.7,4 RC,305,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,305,Antibody; HIV-2 ,,,11.59,71.87,4 RC,305,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,305,Antibody; HTLV-I ,,,7.79,48.49,4 RC,305,Antibody; HTLV-II ,,,12.0,73.66,4 RC,305,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,305,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,305,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,305,Antibody; Legionella ,,,13.11,80.85,4 RC,305,Antibody; Leishmania ,,,10.5,64.67,4 RC,305,Antibody; Leptospira ,,,13.88,86.21,4 RC,305,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,305,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,305,Antibody; Nocardia ,,,13.7,84.43,4 RC,305,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,305,Antibody; Rickettsia ,,,16.57,102.39,4 RC,305,Antibody; Salmonella ,,,11.3,70.08,4 RC,305,Antibody; Shigella ,,,20.97,129.34,4 RC,305,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,305,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,305,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,305,Antibody; Trichinella ,,,10.76,66.46,4 RC,305,Antibody; West Nile virus ,,,12.33,75.44,4 RC,305,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,305,Antibody; Yersinia ,,,11.3,70.08,4 RC,305,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,305,Antibody; actinomyces ,,,8.72,53.9,4 RC,305,Antibody; adenovirus ,,,11.03,68.24,4 RC,305,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,305,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,305,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,305,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,305,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,305,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,305,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,305,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,305,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,305,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,305,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,305,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,305,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,305,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,305,Antibody; histoplasma ,,,11.81,73.66,4 RC,305,Antibody; influenza virus ,,,11.61,71.87,4 RC,305,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,305,Antibody; mucormycosis ,,,12.85,79.01,4 RC,305,Antibody; mumps ,,,11.18,70.08,4 RC,305,Antibody; mycoplasma ,,,11.34,70.08,4 RC,305,Antibody; parvovirus ,,,12.88,79.01,4 RC,305,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,305,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,305,Antibody; rotavirus ,,,15.62,96.98,4 RC,305,Antibody; rubella ,,,12.33,75.44,4 RC,305,Antibody; rubeola ,,,11.04,68.24,4 RC,305,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,305,Antibody; tetanus ,,,12.68,79.01,4 RC,305,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,305,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,305,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,305,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,305,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,305,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,305,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,305,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,305,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,305,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,305,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,305,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,305,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,305,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,305,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,305,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,305,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,305,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,305,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,305,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,305,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,305,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,305,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,305,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,305,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,305,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,305,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,305,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,305,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,305,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,305,"Apolipoprotein, each ",,,18.07,111.38,4 RC,305,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,305,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,305,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,305,Arsenic ,,,16.25,100.61,4 RC,305,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,305,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,305,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,305,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,305,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,305,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,305,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,305,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,305,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,305,"B cells, total count ",,,32.32,199.37,4 RC,305,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,305,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,305,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,305,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,305,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,305,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,305,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,305,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,305,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,305,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,305,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,305,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,305,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,305,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,305,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,305,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,305,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,305,Barbiturates ,,,9.34,127.56,4 RC,305,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,305,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,305,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,305,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,305,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,305,Beta-2 microglobulin ,,,13.86,86.21,4 RC,305,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,305,Bile acids; total ,,,14.67,91.62,4 RC,305,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,305,Bilirubin; direct ,,,4.3,26.95,4 RC,305,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,305,Bilirubin; total ,,,4.3,26.95,4 RC,305,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,305,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,305,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,305,Bleeding time ,,,4.13,25.17,4 RC,305,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,305,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,305,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,305,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,305,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,305,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,305,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,305,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,305,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,305,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,305,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,305,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,305,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,305,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",534.11,534.11,4.77,28.74,4 RC,305,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,305,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,305,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,305,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,305,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,305,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,305,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,305,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,305,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,305,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,305,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,305,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,305,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,305,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,305,Bone age studies ,,,61.64,79.3,3 RC,305,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,305,"Bone marrow, smear interpretation ",1499.0,1499.0,134.49,173.31,3 RC,305,Bradykinin ,,,4.42,26.95,4 RC,305,Buprenorphine ,,,14.01,14.01,1 RC,305,C-peptide ,,,17.83,109.59,4 RC,305,C-reactive protein; ,,,4.44,26.95,4 RC,305,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,305,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,305,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,305,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,305,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,305,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,305,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,305,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,305,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,305,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,305,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,305,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,305,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,305,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,305,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,305,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,305,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,305,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,305,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,305,Cadmium ,,,20.26,125.72,4 RC,305,Caffeine ,,,33.05,204.79,4 RC,305,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,305,Calcitonin ,,,22.95,141.9,4 RC,305,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,305,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,305,Calcium; ionized ,,,11.72,71.87,4 RC,305,Calcium; total ,,,4.42,26.95,4 RC,305,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,305,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,305,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,305,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,305,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,305,"Calprotectin, fecal ",,,16.82,104.18,4 RC,305,"Cannabinoids, natural ",,,11.5,127.56,4 RC,305,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,305,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,305,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,305,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,305,Carbamazepine; free ,,,11.35,70.08,4 RC,305,Carbamazepine; total ,,,12.48,77.23,4 RC,305,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,305,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,305,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,305,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,305,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,305,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,305,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,305,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,305,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,305,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,305,Carotene ,,,7.89,48.49,4 RC,305,Catecholamines; blood ,,,24.92,154.51,4 RC,305,Catecholamines; fractionated ,,,21.63,134.7,4 RC,305,Catecholamines; total urine ,,,23.39,145.53,4 RC,305,Cathepsin-D ,,,15.47,95.19,4 RC,305,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,305,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,305,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,305,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,305,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,305,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,305,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,305,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,305,Ceruloplasmin ,,,9.2,57.47,4 RC,305,Chemiluminescent assay ,,,12.1,75.44,4 RC,305,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,305,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,305,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,305,Chloramphenicol ,,,10.85,66.46,4 RC,305,Chloride; blood ,,,3.94,25.17,4 RC,305,Chloride; other source ,,,4.28,26.95,4 RC,305,Chloride; urine ,,,4.93,30.52,4 RC,305,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,305,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,305,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,305,Cholinesterase; RBC ,,,8.4,52.12,4 RC,305,Cholinesterase; serum ,,,6.74,41.29,4 RC,305,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,305,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,305,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,305,Chromium ,,,17.38,107.81,4 RC,305,Chromogenic substrate assay ,,,10.19,62.89,4 RC,305,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,305,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,305,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,305,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,305,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,305,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,305,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,305,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,305,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,305,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,305,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,305,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,305,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,305,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,305,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,305,Citrate ,,,23.82,147.31,4 RC,305,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,305,Clot retraction ,,,13.96,86.21,4 RC,305,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,305,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,305,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,305,"Clotting; factor VIII, VW factor antigen ",1515.3,1515.3,19.66,122.15,4 RC,305,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,305,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,305,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,305,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,305,Clozapine ,,,17.27,105.96,4 RC,305,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,305,Coagulation time; activated ,,,3.67,23.38,4 RC,305,Coagulation time; other methods ,,,3.85,23.38,4 RC,305,Cocaine ,,,10.46,127.56,4 RC,305,Cold agglutinin; screen ,,,6.92,43.13,4 RC,305,Cold agglutinin; titer ,,,6.91,43.13,4 RC,305,"Collagen cross links, any method ",,,16.0,98.82,4 RC,305,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,305,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,305,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,305,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,305,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,305,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,305,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,305,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,305,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,305,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,305,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,305,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,305,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,305,"Complement; antigen, each component ",,,10.28,62.89,4 RC,305,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,305,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,305,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,305,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,305,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,305,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,305,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,305,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,305,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,305,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,305,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,305,Copper ,,,10.63,66.46,4 RC,305,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,305,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,305,Corticosterone ,,,19.3,118.58,4 RC,305,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,305,Cortisol; free ,,,14.32,88.0,4 RC,305,Cortisol; total ,,,13.96,86.21,4 RC,305,Creatine ,,,3.98,25.17,4 RC,305,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,305,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,305,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,305,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,305,Creatinine; blood ,,,4.39,26.95,4 RC,305,Creatinine; clearance ,,,8.11,50.28,4 RC,305,Creatinine; other source ,,,4.44,26.95,4 RC,305,Cryofibrinogen ,,,12.12,75.44,4 RC,305,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,305,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,305,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,305,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,305,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,305,Cryopreservation; sperm ,,,442.57,570.33,3 RC,305,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,305,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,305,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,305,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,305,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,305,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,305,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,305,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,305,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,305,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,305,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,305,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,305,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,305,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,305,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,305,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,305,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,305,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,305,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,305,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,305,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,305,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,305,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,305,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,305,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,305,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,305,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,305,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,305,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,305,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,305,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,305,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,305,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,305,"Culture, typing; other methods ",,,6.63,41.29,4 RC,305,Cyanide ,,,16.63,102.39,4 RC,305,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,305,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,305,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,305,Cyclosporine ,,,15.46,95.19,4 RC,305,Cystatin C ,,,15.87,98.82,4 RC,305,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,305,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,305,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,305,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,305,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,305,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,305,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,305,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,305,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,305,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,305,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,305,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,305,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,305,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,305,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,305,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,305,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,305,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,305,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,305,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,305,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,305,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,305,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,305,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,305,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,305,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,305,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,305,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,305,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,305,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,305,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,305,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,305,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,305,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,305,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,305,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,305,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,305,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,305,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,305,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,305,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,305,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,305,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,305,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,305,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,305,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,305,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,305,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,305,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,305,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,305,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,305,Dibucaine number ,,,10.5,64.67,4 RC,305,Digoxin; free ,,,11.38,70.08,4 RC,305,Digoxin; total ,,,11.38,70.08,4 RC,305,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,305,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,305,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,305,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,305,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,305,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,305,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,305,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,305,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,305,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,305,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,305,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,305,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,305,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,305,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,305,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,305,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,305,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,305,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,305,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,305,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,305,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,305,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,305,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,305,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,305,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,305,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,305,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,305,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,305,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,305,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,305,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,305,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,305,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,305,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,305,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,305,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,305,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,305,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,305,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,305,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,305,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,305,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,305,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,305,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,305,Erythropoietin ,,,16.1,98.82,4 RC,305,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,305,Estradiol; total ,,,23.94,147.31,4 RC,305,Estriol ,,,20.72,127.56,4 RC,305,Estrogens; fractionated ,,,27.67,170.64,4 RC,305,Estrogens; total ,,,18.59,114.95,4 RC,305,Estrone ,,,21.38,132.92,4 RC,305,Ethosuximide ,,,14.0,86.21,4 RC,305,Ethylene glycol ,,,12.77,79.01,4 RC,305,Etiocholanolone ,,,22.48,138.33,4 RC,305,Euglobulin lysis ,,,7.2,44.92,4 RC,305,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,305,Everolimus ,,,11.76,73.66,4 RC,305,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,305,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,305,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,305,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,305,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,305,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,305,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,305,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,305,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,305,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,305,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,305,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,305,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,305,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,305,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,305,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,305,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,305,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,305,Factor inhibitor test ,,,11.03,68.24,4 RC,305,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,305,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,305,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,305,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,305,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,305,Felbamate ,,,15.97,98.82,4 RC,305,Fentanyl ,,,13.07,127.56,4 RC,305,Fern test ,,,40.44,52.12,3 RC,305,Ferritin ,,,11.68,71.87,4 RC,305,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,305,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,305,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,305,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,305,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,305,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,305,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,305,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,305,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,305,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,305,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,305,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,305,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,305,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,305,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,305,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,305,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,305,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,305,Fibrinogen; antigen ,,,12.39,77.23,4 RC,305,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,305,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,305,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,305,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,305,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,305,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,305,Flecainide ,,,15.97,98.82,4 RC,305,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,305,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,305,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,305,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,305,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,305,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,305,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,305,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,305,Fluoride ,,,15.88,98.82,4 RC,305,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,305,Folic acid; RBC ,,,15.13,93.41,4 RC,305,Folic acid; serum ,,,12.6,77.23,4 RC,305,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,305,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,305,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,305,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,305,"Fructose, semen ",,,14.86,91.62,4 RC,305,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,305,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,305,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,305,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,305,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,305,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,305,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,305,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,305,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,305,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,305,"Galactokinase, RBC ",,,18.4,113.16,4 RC,305,Galactose ,,,9.6,59.26,4 RC,305,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,305,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,305,Galectin-3 ,,,182.6,235.31,3 RC,305,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,305,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,305,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,305,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,305,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,305,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,305,"Gases, blood, pH only ",,,9.42,57.47,4 RC,305,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,305,Gastrin ,,,15.11,93.41,4 RC,305,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,305,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,305,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,305,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,305,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,305,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,305,Gentamicin ,,,14.04,86.21,4 RC,305,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,305,Glucagon ,,,12.24,75.44,4 RC,305,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,305,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,305,Glucagon tolerance test ,,,15.23,93.41,4 RC,305,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,305,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,305,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,305,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,305,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,305,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,305,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,305,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,305,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,305,"Glucosidase, beta ",,,18.4,113.16,4 RC,305,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,305,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,305,Glutathione ,,,13.24,82.64,4 RC,305,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,305,Glycated protein ,,,14.36,88.0,4 RC,305,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,305,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,305,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,305,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,305,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,305,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,305,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,305,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,305,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,305,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,305,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,305,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,305,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,305,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,305,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,305,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,305,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,305,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,305,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,305,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,305,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,305,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,305,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,305,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,305,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,305,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,305,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,305,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,305,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,305,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,305,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,305,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,305,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,305,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,305,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,305,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,305,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,305,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,305,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,305,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,305,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,305,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,Haloperidol ,,,13.53,84.43,4 RC,305,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,305,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,305,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,305,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,305,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,305,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,305,Heinz bodies; direct ,,,3.6,21.54,4 RC,305,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,305,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,305,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,305,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,305,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,305,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,305,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,305,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,305,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,305,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,305,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,305,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,305,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,305,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,305,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,305,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,305,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,305,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,305,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,305,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,305,Hemoglobin; plasma ,,,6.26,39.51,4 RC,305,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,305,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,305,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,305,Hemoglobin; urine ,,,3.39,21.54,4 RC,305,"Hemolysin, acid ",,,7.6,46.7,4 RC,305,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,305,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,305,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,305,Heparin neutralization ,,,10.15,62.89,4 RC,305,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,305,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,305,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,305,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,305,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,305,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,305,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,305,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,305,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,305,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,305,Hepatitis C antibody; ,,,12.23,75.44,4 RC,305,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,305,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,305,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,305,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,305,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,305,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,305,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,305,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,305,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,305,Heroin metabolite ,,,13.63,127.56,4 RC,305,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,305,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,305,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,305,Histamine ,,,25.31,156.3,4 RC,305,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,305,Homocysteine ,,,15.35,95.19,4 RC,305,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,305,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,305,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,305,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,305,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,305,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,305,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,305,Hydroxychloroquine ,,,15.97,98.82,4 RC,305,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,305,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,305,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,305,Hydroxyproline; free ,,,19.41,120.36,4 RC,305,Hydroxyproline; total ,,,20.82,129.34,4 RC,305,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,305,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,305,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,305,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,305,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,305,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,305,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,305,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,305,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,305,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,305,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,305,Immune complex assay ,,,20.88,129.34,4 RC,305,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,305,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,305,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,305,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,305,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,305,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,305,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,305,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,305,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,305,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,305,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,305,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,305,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,305,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,305,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,305,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,305,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,305,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,305,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,305,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,305,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,305,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,305,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,305,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,305,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,305,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,305,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,305,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,305,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,305,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,305,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,305,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,305,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,305,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,305,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,305,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,305,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,305,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,305,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,305,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,305,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,305,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,305,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,305,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,305,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,305,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,305,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,305,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,305,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,305,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,305,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,305,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,305,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,305,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,305,Infliximab ,,,33.05,204.79,4 RC,305,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,305,Inhibin A ,,,13.36,82.64,4 RC,305,Insemination of oocytes ,,,442.57,570.33,3 RC,305,Insulin antibodies ,,,18.34,113.16,4 RC,305,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,305,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,305,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,305,Insulin; free ,,,11.1,68.24,4 RC,305,Insulin; total ,,,9.79,61.1,4 RC,305,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,305,Intrinsic factor ,,,16.98,104.18,4 RC,305,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,305,Iron ,,,5.54,34.15,4 RC,305,Iron binding capacity ,,,7.49,46.7,4 RC,305,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,305,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,305,Islet cell antibody ,,,20.2,125.72,4 RC,305,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,305,Itraconazole ,,,23.23,143.69,4 RC,305,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,305,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,305,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,305,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,305,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,305,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,305,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,305,Ketamine and norketamine ,,,10.54,127.56,4 RC,305,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,305,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,305,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,305,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,305,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,305,Lacosamide ,,,23.23,143.69,4 RC,305,Lactate (lactic acid) ,,,9.91,61.1,4 RC,305,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,305,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,305,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,305,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,305,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,305,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,305,Lamotrigine ,,,11.35,70.08,4 RC,305,Lead ,,,10.37,64.67,4 RC,305,Leflunomide ,,,33.05,204.79,4 RC,305,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,305,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,305,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,305,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,305,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,305,Leukocyte transfusion ,,,305.26,393.39,3 RC,305,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,305,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,305,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,305,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,305,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,305,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,305,Levetiracetam ,,,11.35,70.08,4 RC,305,Lidocaine ,,,12.59,77.23,4 RC,305,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,305,Lipase ,,,5.91,35.94,4 RC,305,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,305,Lipoprotein (a) ,,,12.27,75.44,4 RC,305,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,305,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,305,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,305,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,305,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,305,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,305,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,305,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,305,Lithium ,,,5.66,35.94,4 RC,305,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,305,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,305,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,305,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,305,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,305,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,305,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,305,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,305,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,305,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,305,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,305,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,305,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,305,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,305,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,305,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,305,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,305,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,305,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,305,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,305,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,305,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,305,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,305,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,305,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,305,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,305,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,305,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,305,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,305,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,305,Magnesium ,,,5.74,35.94,4 RC,305,Malate dehydrogenase ,,,6.31,39.51,4 RC,305,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,305,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,305,Manganese ,,,22.84,141.9,4 RC,305,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,305,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,305,"Meat fibers, feces ",,,4.15,25.17,4 RC,305,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,305,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,305,"Mercury, quantitative ",,,13.93,86.21,4 RC,305,Metanephrines ,,,14.51,89.84,4 RC,305,Methadone ,,,11.24,127.56,4 RC,305,Methemalbumin ,,,9.2,57.47,4 RC,305,Methotrexate ,,,33.05,204.79,4 RC,305,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,305,Methylphenidate ,,,9.29,127.56,4 RC,305,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,305,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,305,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,305,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,305,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,305,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,305,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,305,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,305,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,305,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,305,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,305,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,305,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,305,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,305,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,305,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,305,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,305,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,305,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,305,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,305,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,305,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,305,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,305,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,305,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,305,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,305,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,305,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,305,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,305,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,305,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,305,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,305,Muramidase ,,,16.07,98.82,4 RC,305,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,305,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,305,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,305,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,305,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,305,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,305,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,305,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,305,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,305,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,305,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,305,Myoglobin ,,,11.07,68.24,4 RC,305,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,305,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,305,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,305,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,305,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,305,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,305,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,305,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,305,Natriuretic peptide ,,,33.64,208.36,4 RC,305,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,305,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,305,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,305,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,305,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,305,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,305,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,305,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,305,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,305,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,305,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,305,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,305,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,305,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,305,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,305,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,305,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,305,Nerve teasing preparations ,,,499.29,643.43,3 RC,305,"Neutralization test, viral ",,,14.48,89.84,4 RC,305,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,305,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,305,Nickel ,,,21.0,129.34,4 RC,305,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,305,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,305,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,305,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,305,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,305,Nucleotidase 5'- ,,,9.56,59.26,4 RC,305,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,305,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,305,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,305,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,305,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,305,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,305,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,305,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,305,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,305,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,305,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,305,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,305,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,305,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,305,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,305,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,305,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,305,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,305,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,305,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,305,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,305,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,305,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,305,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,305,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,305,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,305,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,305,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,305,"Opiates, 1 or more ",,,14.57,127.56,4 RC,305,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,305,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,305,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,305,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,305,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,305,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,305,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,305,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,305,Osmolality; blood ,,,5.66,35.94,4 RC,305,Osmolality; urine ,,,5.84,35.94,4 RC,305,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,305,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,305,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,305,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,305,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,305,Oxalate ,,,12.38,77.23,4 RC,305,Oxcarbazepine ,,,11.35,70.08,4 RC,305,Oxycodone ,,,12.15,127.56,4 RC,305,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,305,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,305,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,305,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,305,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,305,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,305,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,305,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,305,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,305,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,305,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,305,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,305,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,305,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,305,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,305,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,305,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,305,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,305,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,305,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,305,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,305,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,305,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,305,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,305,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,305,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,305,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,305,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,305,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,305,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,305,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,305,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,305,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,305,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,305,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,305,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,305,Phenobarbital ,,,13.11,80.85,4 RC,305,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,305,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,305,Phenytoin; free ,,,11.79,73.66,4 RC,305,Phenytoin; total ,,,11.35,70.08,4 RC,305,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,305,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,305,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,305,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,305,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,305,Phosphatidylglycerol ,,,14.16,88.0,4 RC,305,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,305,Phosphohexose isomerase ,,,9.19,57.47,4 RC,305,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,305,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,305,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,305,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,305,Pinworm examinations ,,,18.14,23.38,3 RC,305,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,305,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,305,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,305,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,305,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,305,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,305,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,305,Posaconazole ,,,23.23,143.69,4 RC,305,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,305,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,305,Potassium; urine ,,,4.05,25.17,4 RC,305,Prealbumin ,,,12.51,77.23,4 RC,305,Pregabalin ,,,7.07,127.56,4 RC,305,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,305,Pregnanediol ,,,18.23,113.16,4 RC,305,Pregnanetriol ,,,18.03,111.38,4 RC,305,Pregnenolone ,,,17.71,109.59,4 RC,305,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,305,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,305,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,305,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,305,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,305,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,305,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,305,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,305,Primidone ,,,14.22,88.0,4 RC,305,Procainamide; ,,,51.41,317.95,4 RC,305,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,305,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,305,Progesterone ,,,17.87,111.38,4 RC,305,Proinsulin ,,,22.87,141.9,4 RC,305,Prolactin ,,,16.61,102.39,4 RC,305,Propoxyphene ,,,10.72,127.56,4 RC,305,"Prostaglandin, each ",,,35.79,220.97,4 RC,305,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,305,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,305,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,305,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,305,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,305,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,305,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,305,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,305,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,305,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,305,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,305,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,305,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,305,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,305,Prothrombin time; ,,,3.67,23.38,4 RC,305,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,305,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,305,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,305,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,305,Pyruvate ,,,12.4,77.23,4 RC,305,Pyruvate kinase ,,,8.09,50.28,4 RC,305,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,305,Quinidine ,,,12.51,77.23,4 RC,305,Quinine ,,,9.97,61.1,4 RC,305,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,305,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,305,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,305,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,305,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,305,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,305,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,305,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,305,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,305,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,305,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,305,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,305,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,305,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,305,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,305,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,305,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,305,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,305,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,305,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,305,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,305,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,305,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,305,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,305,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,305,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,305,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,305,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,305,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,305,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,305,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,305,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,305,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,305,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,305,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,305,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,305,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,305,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,305,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,305,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,305,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,305,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,305,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,305,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,305,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,305,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,305,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,305,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,305,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,305,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,305,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,305,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,305,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,305,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,305,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,305,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,305,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,305,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,305,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,305,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,305,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,305,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,305,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,305,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,305,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,305,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,305,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,305,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,305,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,305,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,305,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,305,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,305,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,305,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,305,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,305,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,305,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,305,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,305,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,305,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,305,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,305,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,305,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,305,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,305,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,305,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,305,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,305,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,305,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,305,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,305,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,305,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,305,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,305,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,305,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,305,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,305,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,305,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,305,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,305,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,305,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,305,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,305,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,305,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,305,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,305,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,305,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,305,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,305,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,305,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,305,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,305,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,305,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,305,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,305,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,305,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,305,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,305,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,305,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,305,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,305,Receptor assay; estrogen ,,,75.3,465.26,4 RC,305,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,305,Receptor assay; progesterone ,,,55.59,343.11,4 RC,305,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,305,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,305,Renin ,,,18.84,116.79,4 RC,305,Reptilase test ,,,8.44,52.12,4 RC,305,Reticulated platelet assay ,,,30.62,188.6,4 RC,305,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,305,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,305,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,305,Rufinamide ,,,23.23,143.69,4 RC,305,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,305,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,305,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,305,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,305,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,305,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,305,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,305,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,305,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,305,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,305,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,305,Salicylate ,,,15.97,98.82,4 RC,305,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,305,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,305,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,305,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,305,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,305,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,305,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,305,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,305,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,305,Selenium ,,,21.88,134.7,4 RC,305,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,305,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,305,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,305,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,305,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,305,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,305,Serotonin ,,,26.54,163.49,4 RC,305,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,305,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,305,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,305,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,305,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,305,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,305,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,305,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,305,Sialic acid ,,,11.52,71.87,4 RC,305,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,305,Silica ,,,21.6,132.92,4 RC,305,Sirolimus ,,,11.76,73.66,4 RC,305,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,305,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,305,Skin test; candida ,,,79.46,102.39,3 RC,305,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,305,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,305,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,305,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,305,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,305,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,305,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,305,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,305,Sodium; other source ,,,4.16,25.17,4 RC,305,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,305,Sodium; urine ,,,4.33,26.95,4 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,305,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,305,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,305,Somatomedin ,,,18.22,113.16,4 RC,305,Somatostatin ,,,15.67,96.98,4 RC,305,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,305,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,305,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,305,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,305,Specific gravity (except urine) ,,,2.82,17.97,4 RC,305,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,305,Sperm antibodies ,,,43.21,55.69,3 RC,305,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,305,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,305,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,305,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,305,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,305,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,305,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,305,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,305,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,305,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,305,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,305,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,305,"Stimulants, synthetic ",,,12.05,127.56,4 RC,305,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,305,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,305,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,305,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,305,"Streptokinase, antibody ",,,10.84,66.46,4 RC,305,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,305,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,305,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,305,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,305,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,305,"Sulfate, urine ",,,4.7,28.74,4 RC,305,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,305,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,305,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,305,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,305,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,305,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,305,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,305,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,305,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,305,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,305,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,305,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,305,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,305,T cells; total count ,,,32.32,199.37,4 RC,305,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,305,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,305,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,305,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,305,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,305,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,305,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,305,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,305,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,305,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,305,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,305,Tacrolimus ,,,11.76,73.66,4 RC,305,Tapentadol ,,,10.83,127.56,4 RC,305,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,305,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,305,Testosterone; free ,,,21.82,134.7,4 RC,305,Testosterone; total ,,,22.11,136.54,4 RC,305,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,305,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,305,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,305,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,305,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,305,Theophylline ,,,12.12,75.44,4 RC,305,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,305,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,305,Thiocyanate ,,,9.97,61.1,4 RC,305,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,305,Thrombin time; titer ,,,5.87,35.94,4 RC,305,Thrombomodulin ,,,14.8,91.62,4 RC,305,"Thromboplastin inhibition, tissue ",792.59,792.59,8.25,50.28,4 RC,305,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,305,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,305,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,305,Thyroglobulin ,,,13.76,84.43,4 RC,305,Thyroglobulin antibody ,,,13.63,84.43,4 RC,305,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,305,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,305,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,305,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,305,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,305,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,305,Thyroxine; free ,,,7.73,48.49,4 RC,305,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,305,Thyroxine; total ,,,5.89,35.94,4 RC,305,Tiagabine ,,,23.23,143.69,4 RC,305,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,305,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,305,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,305,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,305,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,305,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,305,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,305,Tobramycin ,,,13.82,86.21,4 RC,305,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,305,Topiramate ,,,10.21,62.89,4 RC,305,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,305,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,305,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,305,Tramadol ,,,10.54,127.56,4 RC,305,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,305,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,305,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,305,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,305,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,305,Transferrin ,,,10.93,68.24,4 RC,305,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,305,Triglycerides ,,,4.92,30.52,4 RC,305,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,305,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,305,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,305,"Troponin, qualitative ",,,8.65,53.9,4 RC,305,"Troponin, quantitative ",,,10.68,66.46,4 RC,305,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,305,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,305,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,305,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,305,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,305,Tyrosine ,,,9.11,55.69,4 RC,305,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,305,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,305,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,305,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,305,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,305,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,305,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,305,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,305,Unlisted immunology procedure ,,,99.55,128.28,3 RC,305,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,305,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,305,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,305,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,305,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,305,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,305,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,305,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,305,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,305,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,305,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,305,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,305,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,305,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,305,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,305,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,305,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,305,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,305,Uric acid; blood ,,,3.88,23.38,4 RC,305,Uric acid; other source ,,,4.36,26.95,4 RC,305,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,305,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,305,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,305,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,305,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,305,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,305,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,305,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,305,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,305,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,305,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,305,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,305,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,305,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,305,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,305,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,305,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,305,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,305,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,305,Vancomycin ,,,11.6,71.87,4 RC,305,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,305,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,305,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,305,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,305,Vedolizumab ,,,33.05,204.79,4 RC,305,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,305,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,305,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,305,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,305,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,305,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,305,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,305,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,305,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,305,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,305,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,305,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,305,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,305,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,305,Very long chain fatty acids ,,,16.92,104.18,4 RC,305,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,305,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,305,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,305,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,305,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,305,Viscosity ,,,10.0,61.1,4 RC,305,Vitamin A ,,,9.95,61.1,4 RC,305,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,305,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,305,Vitamin K ,,,11.75,71.87,4 RC,305,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,305,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,305,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,305,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,305,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,305,Voriconazole ,,,23.23,143.69,4 RC,305,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,305,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,305,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,305,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,305,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,305,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,305,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,305,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,305,Zinc ,,,9.76,61.1,4 RC,305,Zonisamide ,,,11.35,70.08,4 RC,305,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,305,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,305,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,306, Laboratory Bacteriology & Microbiology ,,,,,0 RC,306,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,306,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,306,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,306,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,306,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,306,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,306,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,306,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,306,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,306,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,306,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,306,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,306,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,306,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,306,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,306,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,306,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,Acetaminophen ,,,15.97,98.82,4 RC,306,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,306,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,306,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,306,Acetylcholinesterase ,,,10.53,64.67,4 RC,306,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,306,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,306,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,306,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,306,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,306,Adalimumab ,,,33.05,204.79,4 RC,306,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,306,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,306,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,306,Albumin; ischemia modified ,,,29.08,179.62,4 RC,306,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,306,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,306,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,306,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,306,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,306,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,306,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,306,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,306,Alcohols ,,,9.61,127.56,4 RC,306,Aldolase ,,,8.32,52.12,4 RC,306,Aldosterone ,,,34.91,215.56,4 RC,306,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,306,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,306,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,306,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,306,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,306,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,306,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,306,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,306,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,306,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,306,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,306,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,306,Aluminum ,,,21.83,134.7,4 RC,306,Amikacin ,,,12.92,80.85,4 RC,306,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,306,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,306,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,306,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,306,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,306,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,306,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,306,Amiodarone ,,,15.97,98.82,4 RC,306,Ammonia ,,,12.48,77.23,4 RC,306,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,306,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,306,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,306,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,306,Amylase ,,,5.55,34.15,4 RC,306,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,306,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,306,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,306,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,306,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,306,Androstanediol glucuronide ,,,24.7,152.67,4 RC,306,Androstenedione ,,,25.09,154.51,4 RC,306,Androsterone ,,,21.89,134.7,4 RC,306,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,306,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,306,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,306,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,306,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,306,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,306,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,306,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,306,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,306,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,306,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,306,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,306,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,306,Angiotensin II ,,,17.58,109.59,4 RC,306,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,306,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,306,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,306,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,306,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,306,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,306,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,306,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,306,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,306,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,306,Antibody; Aspergillus ,,,12.89,79.01,4 RC,306,Antibody; Bartonella ,,,8.72,53.9,4 RC,306,Antibody; Blastomyces ,,,11.06,68.24,4 RC,306,Antibody; Bordetella ,,,11.3,70.08,4 RC,306,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,306,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,306,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,306,Antibody; Brucella ,,,7.65,46.7,4 RC,306,Antibody; Campylobacter ,,,11.24,70.08,4 RC,306,Antibody; Candida ,,,10.29,62.89,4 RC,306,Antibody; Chlamydia ,,,10.13,62.89,4 RC,306,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,306,Antibody; Coccidioides ,,,9.82,61.1,4 RC,306,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,306,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,306,Antibody; Diphtheria ,,,13.04,80.85,4 RC,306,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,306,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,306,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,306,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,306,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,306,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,306,Antibody; HIV-1 ,,,7.62,46.7,4 RC,306,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,306,Antibody; HIV-2 ,,,11.59,71.87,4 RC,306,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,306,Antibody; HTLV-I ,,,7.79,48.49,4 RC,306,Antibody; HTLV-II ,,,12.0,73.66,4 RC,306,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,306,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,306,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,306,Antibody; Legionella ,,,13.11,80.85,4 RC,306,Antibody; Leishmania ,,,10.5,64.67,4 RC,306,Antibody; Leptospira ,,,13.88,86.21,4 RC,306,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,306,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,306,Antibody; Nocardia ,,,13.7,84.43,4 RC,306,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,306,Antibody; Rickettsia ,,,16.57,102.39,4 RC,306,Antibody; Salmonella ,,,11.3,70.08,4 RC,306,Antibody; Shigella ,,,20.97,129.34,4 RC,306,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,306,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,306,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,306,Antibody; Trichinella ,,,10.76,66.46,4 RC,306,Antibody; West Nile virus ,,,12.33,75.44,4 RC,306,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,306,Antibody; Yersinia ,,,11.3,70.08,4 RC,306,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,306,Antibody; actinomyces ,,,8.72,53.9,4 RC,306,Antibody; adenovirus ,,,11.03,68.24,4 RC,306,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,306,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,306,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,306,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,306,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,306,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,306,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,306,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,306,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,306,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,306,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,306,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,306,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,306,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,306,Antibody; histoplasma ,,,11.81,73.66,4 RC,306,Antibody; influenza virus ,,,11.61,71.87,4 RC,306,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,306,Antibody; mucormycosis ,,,12.85,79.01,4 RC,306,Antibody; mumps ,,,11.18,70.08,4 RC,306,Antibody; mycoplasma ,,,11.34,70.08,4 RC,306,Antibody; parvovirus ,,,12.88,79.01,4 RC,306,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,306,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,306,Antibody; rotavirus ,,,15.62,96.98,4 RC,306,Antibody; rubella ,,,12.33,75.44,4 RC,306,Antibody; rubeola ,,,11.04,68.24,4 RC,306,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,306,Antibody; tetanus ,,,12.68,79.01,4 RC,306,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,306,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,306,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,306,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,306,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,306,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,306,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,306,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,306,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,306,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,306,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,306,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,306,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,306,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,306,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,306,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,306,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,306,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,306,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,306,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,306,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,306,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,306,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,306,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,306,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,306,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,306,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,306,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,306,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,306,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,306,"Apolipoprotein, each ",,,18.07,111.38,4 RC,306,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,306,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,306,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,306,Arsenic ,,,16.25,100.61,4 RC,306,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,306,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,306,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,306,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,306,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,306,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,306,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,306,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,306,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,306,"B cells, total count ",,,32.32,199.37,4 RC,306,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,306,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,306,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,306,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,306,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,306,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,306,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,306,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,306,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,306,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,306,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,306,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,306,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,306,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,306,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,306,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,306,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,306,Barbiturates ,,,9.34,127.56,4 RC,306,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,306,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,306,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,306,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,306,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,306,Beta-2 microglobulin ,,,13.86,86.21,4 RC,306,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,306,Bile acids; total ,,,14.67,91.62,4 RC,306,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,306,Bilirubin; direct ,,,4.3,26.95,4 RC,306,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,306,Bilirubin; total ,,,4.3,26.95,4 RC,306,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,306,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,306,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,306,Bleeding time ,,,4.13,25.17,4 RC,306,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,306,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,306,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,306,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,306,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,306,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,306,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,306,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,306,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,306,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,306,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,306,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,306,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,306,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,306,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,306,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,306,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,306,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,306,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,306,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,306,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,306,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,306,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,306,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,306,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,306,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,306,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,306,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,306,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,306,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,306,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,306,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,306,Bone age studies ,,,61.64,79.3,3 RC,306,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,306,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,306,Bradykinin ,,,4.42,26.95,4 RC,306,Buprenorphine ,,,14.01,14.01,1 RC,306,C-peptide ,,,17.83,109.59,4 RC,306,C-reactive protein; ,,,4.44,26.95,4 RC,306,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,306,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,306,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,306,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,306,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,306,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,306,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,306,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,306,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,306,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,306,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,306,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,306,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,306,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,306,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,306,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,306,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,306,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,306,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,306,Cadmium ,,,20.26,125.72,4 RC,306,Caffeine ,,,33.05,204.79,4 RC,306,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,306,Calcitonin ,,,22.95,141.9,4 RC,306,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,306,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,306,Calcium; ionized ,,,11.72,71.87,4 RC,306,Calcium; total ,,,4.42,26.95,4 RC,306,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,306,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,306,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,306,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,306,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,306,"Calprotectin, fecal ",,,16.82,104.18,4 RC,306,"Cannabinoids, natural ",,,11.5,127.56,4 RC,306,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,306,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,306,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,306,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,306,Carbamazepine; free ,,,11.35,70.08,4 RC,306,Carbamazepine; total ,,,12.48,77.23,4 RC,306,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,306,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,306,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,306,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,306,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,306,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,306,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,306,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,306,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,306,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,306,Carotene ,,,7.89,48.49,4 RC,306,Catecholamines; blood ,,,24.92,154.51,4 RC,306,Catecholamines; fractionated ,,,21.63,134.7,4 RC,306,Catecholamines; total urine ,,,23.39,145.53,4 RC,306,Cathepsin-D ,,,15.47,95.19,4 RC,306,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,306,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,306,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,306,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,306,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,306,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,306,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,306,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,306,Ceruloplasmin ,,,9.2,57.47,4 RC,306,Chemiluminescent assay ,,,12.1,75.44,4 RC,306,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,306,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,306,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,306,Chloramphenicol ,,,10.85,66.46,4 RC,306,Chloride; blood ,,,3.94,25.17,4 RC,306,Chloride; other source ,,,4.28,26.95,4 RC,306,Chloride; urine ,,,4.93,30.52,4 RC,306,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,306,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,306,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,306,Cholinesterase; RBC ,,,8.4,52.12,4 RC,306,Cholinesterase; serum ,,,6.74,41.29,4 RC,306,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,306,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,306,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,306,Chromium ,,,17.38,107.81,4 RC,306,Chromogenic substrate assay ,,,10.19,62.89,4 RC,306,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,306,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,306,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,306,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,306,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,306,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,306,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,306,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,306,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,306,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,306,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,306,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,306,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,306,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,306,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,306,Citrate ,,,23.82,147.31,4 RC,306,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,306,Clot retraction ,,,13.96,86.21,4 RC,306,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,306,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,306,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,306,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,306,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,306,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,306,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,306,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,306,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,306,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,306,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,306,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,306,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,306,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,306,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,306,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,306,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,306,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,306,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,306,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,306,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,306,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,306,Clozapine ,,,17.27,105.96,4 RC,306,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,306,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,306,Coagulation time; activated ,,,3.67,23.38,4 RC,306,Coagulation time; other methods ,,,3.85,23.38,4 RC,306,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,306,Cocaine ,,,10.46,127.56,4 RC,306,Cold agglutinin; screen ,,,6.92,43.13,4 RC,306,Cold agglutinin; titer ,,,6.91,43.13,4 RC,306,"Collagen cross links, any method ",,,16.0,98.82,4 RC,306,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,306,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,306,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,306,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,306,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,306,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,306,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,306,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,306,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,306,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,306,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,306,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,306,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,306,"Complement; antigen, each component ",,,10.28,62.89,4 RC,306,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,306,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,306,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,306,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,306,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,306,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,306,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,306,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,306,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,306,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,306,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,306,Copper ,,,10.63,66.46,4 RC,306,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,306,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,306,Corticosterone ,,,19.3,118.58,4 RC,306,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,306,Cortisol; free ,,,14.32,88.0,4 RC,306,Cortisol; total ,,,13.96,86.21,4 RC,306,Creatine ,,,3.98,25.17,4 RC,306,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,306,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,306,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,306,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,306,Creatinine; blood ,,,4.39,26.95,4 RC,306,Creatinine; clearance ,,,8.11,50.28,4 RC,306,Creatinine; other source ,,,4.44,26.95,4 RC,306,Cryofibrinogen ,,,12.12,75.44,4 RC,306,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,306,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,306,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,306,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,306,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,306,Cryopreservation; sperm ,,,442.57,570.33,3 RC,306,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,306,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,306,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,306,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",1140.75,1140.75,6.93,43.13,4 RC,306,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",1140.75,1140.75,6.93,43.13,4 RC,306,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,306,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,306,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,306,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",964.04,964.04,6.61,41.29,4 RC,306,"Culture, fungi, definitive identification, each organism; mold ",882.27,882.27,8.84,53.9,4 RC,306,"Culture, mycobacterial, definitive identification, each isolate ",1208.01,1208.01,12.52,77.23,4 RC,306,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,306,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,306,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,306,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,306,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,306,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,306,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,306,Cyanide ,,,16.63,102.39,4 RC,306,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,306,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,306,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,306,Cyclosporine ,,,15.46,95.19,4 RC,306,Cystatin C ,,,15.87,98.82,4 RC,306,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,306,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,306,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,306,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,306,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,306,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,306,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,306,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,306,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,306,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,306,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,306,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,306,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,306,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,306,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,306,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,306,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,306,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,306,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,306,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,306,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,306,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,306,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,306,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,306,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,306,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,306,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,306,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,306,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,306,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,306,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,306,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,306,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,306,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,306,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,306,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,306,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,306,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,306,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,306,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,306,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,306,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,306,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,306,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,306,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,306,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,306,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,306,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,306,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,306,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,306,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,306,Dibucaine number ,,,10.5,64.67,4 RC,306,Digoxin; free ,,,11.38,70.08,4 RC,306,Digoxin; total ,,,11.38,70.08,4 RC,306,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,306,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,306,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,306,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,306,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,306,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,306,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,306,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,306,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,306,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,306,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,306,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,306,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,306,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,306,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,306,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,306,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,306,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,306,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,306,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,306,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,306,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,306,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,306,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,306,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,306,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,306,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,306,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,306,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,306,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,306,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,306,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,306,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,306,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,306,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,306,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,306,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,306,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,306,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,306,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,306,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,306,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,306,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,306,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,306,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,306,Erythropoietin ,,,16.1,98.82,4 RC,306,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,306,Estradiol; total ,,,23.94,147.31,4 RC,306,Estriol ,,,20.72,127.56,4 RC,306,Estrogens; fractionated ,,,27.67,170.64,4 RC,306,Estrogens; total ,,,18.59,114.95,4 RC,306,Estrone ,,,21.38,132.92,4 RC,306,Ethosuximide ,,,14.0,86.21,4 RC,306,Ethylene glycol ,,,12.77,79.01,4 RC,306,Etiocholanolone ,,,22.48,138.33,4 RC,306,Euglobulin lysis ,,,7.2,44.92,4 RC,306,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,306,Everolimus ,,,11.76,73.66,4 RC,306,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,306,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,306,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,306,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,306,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,306,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,306,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,306,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,306,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,306,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,306,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,306,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,306,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,306,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,306,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,306,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,306,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,306,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,306,Factor inhibitor test ,,,11.03,68.24,4 RC,306,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,306,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,306,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,306,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,306,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,306,Felbamate ,,,15.97,98.82,4 RC,306,Fentanyl ,,,13.07,127.56,4 RC,306,Fern test ,,,40.44,52.12,3 RC,306,Ferritin ,,,11.68,71.87,4 RC,306,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,306,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,306,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,306,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,306,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,306,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,306,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,306,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,306,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,306,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,306,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,306,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,306,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,306,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,306,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,306,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,306,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,306,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,306,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,306,Fibrinogen; activity ,,,8.32,52.12,4 RC,306,Fibrinogen; antigen ,,,12.39,77.23,4 RC,306,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,306,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,306,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,306,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,306,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,306,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,306,Flecainide ,,,15.97,98.82,4 RC,306,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,306,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,306,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,306,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,306,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,306,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,306,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,306,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,306,Fluoride ,,,15.88,98.82,4 RC,306,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,306,Folic acid; RBC ,,,15.13,93.41,4 RC,306,Folic acid; serum ,,,12.6,77.23,4 RC,306,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,306,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,306,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,306,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,306,"Fructose, semen ",,,14.86,91.62,4 RC,306,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,306,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,306,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,306,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,306,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,306,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,306,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,306,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,306,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,306,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,306,"Galactokinase, RBC ",,,18.4,113.16,4 RC,306,Galactose ,,,9.6,59.26,4 RC,306,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,306,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,306,Galectin-3 ,,,182.6,235.31,3 RC,306,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,306,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,306,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,306,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,306,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,306,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,306,"Gases, blood, pH only ",,,9.42,57.47,4 RC,306,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,306,Gastrin ,,,15.11,93.41,4 RC,306,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,306,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,306,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,306,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,306,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,306,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,306,Gentamicin ,,,14.04,86.21,4 RC,306,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,306,Glucagon ,,,12.24,75.44,4 RC,306,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,306,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,306,Glucagon tolerance test ,,,15.23,93.41,4 RC,306,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,306,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,306,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,306,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,306,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,306,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,306,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,306,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,306,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,306,"Glucosidase, beta ",,,18.4,113.16,4 RC,306,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,306,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,306,Glutathione ,,,13.24,82.64,4 RC,306,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,306,Glycated protein ,,,14.36,88.0,4 RC,306,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,306,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,306,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,306,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,306,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,306,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,306,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,306,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,306,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,306,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,306,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,306,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,306,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,306,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,306,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,306,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,306,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,306,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,306,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,306,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,306,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,306,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,306,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,306,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,306,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,306,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,306,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,306,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,306,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,306,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,306,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,306,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,306,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,306,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,306,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,306,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,306,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,306,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,306,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,306,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,306,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,306,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,Haloperidol ,,,13.53,84.43,4 RC,306,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,306,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,306,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,306,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,306,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,306,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,306,Heinz bodies; direct ,,,3.6,21.54,4 RC,306,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,306,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,306,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,306,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,306,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,306,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,306,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,306,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,306,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,306,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,306,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,306,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,306,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,306,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,306,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,306,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,306,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,306,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,306,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,306,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,306,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,306,Hemoglobin; plasma ,,,6.26,39.51,4 RC,306,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,306,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,306,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,306,Hemoglobin; urine ,,,3.39,21.54,4 RC,306,"Hemolysin, acid ",,,7.6,46.7,4 RC,306,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,306,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,306,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,306,Heparin assay ,,,11.22,70.08,4 RC,306,Heparin neutralization ,,,10.15,62.89,4 RC,306,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,306,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,306,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,306,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,306,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,306,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,306,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,306,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,306,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,306,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,306,Hepatitis C antibody; ,,,12.23,75.44,4 RC,306,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,306,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,306,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,306,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,306,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,306,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,306,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,306,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,306,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,306,Heroin metabolite ,,,13.63,127.56,4 RC,306,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,306,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,306,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,306,Histamine ,,,25.31,156.3,4 RC,306,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,306,Homocysteine ,,,15.35,95.19,4 RC,306,"Homogenization, tissue, for culture ",850.63,850.63,5.04,30.52,4 RC,306,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,306,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,306,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,306,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,306,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,306,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,306,Hydroxychloroquine ,,,15.97,98.82,4 RC,306,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,306,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,306,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,306,Hydroxyproline; free ,,,19.41,120.36,4 RC,306,Hydroxyproline; total ,,,20.82,129.34,4 RC,306,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,306,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,306,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,306,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,306,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,306,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,306,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,306,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,306,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,306,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,306,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,306,Immune complex assay ,,,20.88,129.34,4 RC,306,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,306,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,306,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,306,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,306,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,306,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,306,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,306,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,306,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,306,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,306,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,306,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,306,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,306,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,306,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,306,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,306,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,306,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,306,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,306,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,306,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,306,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,306,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,306,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,306,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,306,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,306,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,306,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,306,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,306,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,306,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,306,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",700.28,700.28,8.85,127.56,97 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,306,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,306,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,306,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,306,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,306,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,306,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,306,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",1746.0,1746.0,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",145.07,145.07,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",1099.0,1099.0,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",138.47,138.47,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",1124.92,1124.92,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",803.14,803.14,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",1808.06,1808.06,36.71,226.32,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,154.51,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",3066.19,3066.19,122.21,2209.51,12 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,306,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,306,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,306,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,1008.87,1008.87,111.68,691.59,4 RC,306,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,306,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,306,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",2498.0,2498.0,220.59,1365.26,4 RC,306,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,306,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,1035.25,1035.25,220.59,1365.26,4 RC,306,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,306,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,306,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",586.87,586.87,22.34,138.33,4 RC,306,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",3961.65,3961.65,418.68,2590.35,4 RC,306,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,306,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,306,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,306,Infliximab ,,,33.05,204.79,4 RC,306,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,306,Inhibin A ,,,13.36,82.64,4 RC,306,Insemination of oocytes ,,,442.57,570.33,3 RC,306,Insulin antibodies ,,,18.34,113.16,4 RC,306,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,306,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,306,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,306,Insulin; free ,,,11.1,68.24,4 RC,306,Insulin; total ,,,9.79,61.1,4 RC,306,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,306,Intrinsic factor ,,,16.98,104.18,4 RC,306,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,306,Iron ,,,5.54,34.15,4 RC,306,Iron binding capacity ,,,7.49,46.7,4 RC,306,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,306,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,306,Islet cell antibody ,,,20.2,125.72,4 RC,306,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,306,Itraconazole ,,,23.23,143.69,4 RC,306,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,306,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,306,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,306,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,306,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,306,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,306,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,306,Ketamine and norketamine ,,,10.54,127.56,4 RC,306,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,306,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,306,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,306,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,306,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,306,Lacosamide ,,,23.23,143.69,4 RC,306,Lactate (lactic acid) ,,,9.91,61.1,4 RC,306,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,306,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,306,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,306,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,306,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,306,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,306,Lamotrigine ,,,11.35,70.08,4 RC,306,Lead ,,,10.37,64.67,4 RC,306,Leflunomide ,,,33.05,204.79,4 RC,306,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,306,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,306,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,306,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,306,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,306,Leukocyte transfusion ,,,305.26,393.39,3 RC,306,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,306,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,306,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,306,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,306,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,306,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,306,Levetiracetam ,,,11.35,70.08,4 RC,306,Lidocaine ,,,12.59,77.23,4 RC,306,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,306,Lipase ,,,5.91,35.94,4 RC,306,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,306,Lipoprotein (a) ,,,12.27,75.44,4 RC,306,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,306,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,306,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,306,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,306,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,306,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,306,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,306,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,306,Lithium ,,,5.66,35.94,4 RC,306,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,306,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,306,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,306,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,306,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,306,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,306,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,306,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,306,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,306,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,306,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,306,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,306,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,306,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,306,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,306,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,306,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,306,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,306,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,306,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,306,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,306,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,306,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,306,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,306,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,306,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,306,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,306,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,306,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,306,Macroscopic examination; parasite ,257.16,257.16,3.69,23.38,4 RC,306,Magnesium ,,,5.74,35.94,4 RC,306,Malate dehydrogenase ,,,6.31,39.51,4 RC,306,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,306,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,306,Manganese ,,,22.84,141.9,4 RC,306,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,306,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,306,"Meat fibers, feces ",,,4.15,25.17,4 RC,306,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,306,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,306,"Mercury, quantitative ",,,13.93,86.21,4 RC,306,Metanephrines ,,,14.51,89.84,4 RC,306,Methadone ,,,11.24,127.56,4 RC,306,Methemalbumin ,,,9.2,57.47,4 RC,306,Methotrexate ,,,33.05,204.79,4 RC,306,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,306,Methylphenidate ,,,9.29,127.56,4 RC,306,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,306,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,306,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,306,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,306,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,306,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,306,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,306,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,306,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,306,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,306,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,306,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,306,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,306,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,306,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,306,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,306,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,306,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,306,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,306,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,306,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,306,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,306,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,306,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,306,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,306,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,306,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,306,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,306,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,306,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,306,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,306,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,306,Muramidase ,,,16.07,98.82,4 RC,306,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,306,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,306,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,306,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,306,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,306,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,306,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,306,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,306,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,306,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,306,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,306,Myoglobin ,,,11.07,68.24,4 RC,306,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,306,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,306,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,306,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,306,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,306,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,306,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,306,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,306,Natriuretic peptide ,,,33.64,208.36,4 RC,306,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,306,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,306,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,306,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,306,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,306,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,306,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,306,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,306,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,306,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,306,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,306,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,306,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,306,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,306,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,306,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,306,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,306,Nerve teasing preparations ,,,499.29,643.43,3 RC,306,"Neutralization test, viral ",,,14.48,89.84,4 RC,306,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,306,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,306,Nickel ,,,21.0,129.34,4 RC,306,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,306,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,306,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,306,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,306,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,306,Nucleotidase 5'- ,,,9.56,59.26,4 RC,306,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,306,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,306,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,306,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,306,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,306,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,306,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,306,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,306,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,306,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,306,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,306,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,306,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,306,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,306,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,306,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,306,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,306,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,306,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,306,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,306,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,306,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,306,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,306,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,306,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,306,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,306,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,306,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,306,"Opiates, 1 or more ",,,14.57,127.56,4 RC,306,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,306,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,306,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,306,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,306,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,306,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,306,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,306,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,306,Osmolality; blood ,,,5.66,35.94,4 RC,306,Osmolality; urine ,,,5.84,35.94,4 RC,306,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,306,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,306,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,306,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,306,Oxalate ,,,12.38,77.23,4 RC,306,Oxcarbazepine ,,,11.35,70.08,4 RC,306,Oxycodone ,,,12.15,127.56,4 RC,306,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,306,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,306,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,306,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,306,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,306,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,306,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,306,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,306,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,306,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,306,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,306,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,306,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,306,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,306,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,306,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,306,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,306,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,306,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,306,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,306,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,306,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,306,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,306,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,306,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,306,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,306,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,306,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,306,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,306,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,306,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,306,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,306,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,306,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,306,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,306,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,306,Phenobarbital ,,,13.11,80.85,4 RC,306,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,306,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,306,Phenytoin; free ,,,11.79,73.66,4 RC,306,Phenytoin; total ,,,11.35,70.08,4 RC,306,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,306,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,306,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,306,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,306,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,306,Phosphatidylglycerol ,,,14.16,88.0,4 RC,306,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,306,Phosphohexose isomerase ,,,9.19,57.47,4 RC,306,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,306,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,306,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,306,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,306,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,306,Pinworm examinations ,,,18.14,23.38,3 RC,306,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,306,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,306,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,306,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,306,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,306,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,306,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,306,Posaconazole ,,,23.23,143.69,4 RC,306,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,306,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,306,Potassium; urine ,,,4.05,25.17,4 RC,306,Prealbumin ,,,12.51,77.23,4 RC,306,Pregabalin ,,,7.07,127.56,4 RC,306,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,306,Pregnanediol ,,,18.23,113.16,4 RC,306,Pregnanetriol ,,,18.03,111.38,4 RC,306,Pregnenolone ,,,17.71,109.59,4 RC,306,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,306,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,306,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,306,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,306,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,306,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,306,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,306,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,306,Primidone ,,,14.22,88.0,4 RC,306,Procainamide; ,,,51.41,317.95,4 RC,306,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,306,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,306,Progesterone ,,,17.87,111.38,4 RC,306,Proinsulin ,,,22.87,141.9,4 RC,306,Prolactin ,,,16.61,102.39,4 RC,306,Propoxyphene ,,,10.72,127.56,4 RC,306,"Prostaglandin, each ",,,35.79,220.97,4 RC,306,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,306,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,306,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,306,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,306,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,306,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,306,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,306,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,306,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,306,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,306,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,306,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,306,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,306,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,306,Prothrombin time; ,,,3.67,23.38,4 RC,306,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,306,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,306,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,306,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,306,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,306,Pyruvate ,,,12.4,77.23,4 RC,306,Pyruvate kinase ,,,8.09,50.28,4 RC,306,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,306,Quinidine ,,,12.51,77.23,4 RC,306,Quinine ,,,9.97,61.1,4 RC,306,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,306,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,306,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,306,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,306,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,306,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,306,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,306,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,306,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,306,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,306,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,306,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,306,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,306,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,306,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,306,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,306,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,306,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,306,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,306,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,306,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,306,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,306,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,306,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,306,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,306,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,306,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,306,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,306,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,306,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,306,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,306,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,306,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,306,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,306,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,306,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,306,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,306,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,306,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,306,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,306,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,306,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,306,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,306,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,306,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,306,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,306,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,306,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,306,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,306,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,306,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,306,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,306,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,306,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,306,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,306,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,306,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,306,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,306,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,306,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,306,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,306,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,306,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,306,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,306,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,306,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,306,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,306,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,306,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,306,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,306,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,306,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,306,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,306,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,306,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,306,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,306,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,306,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,306,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,306,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,306,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,306,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,306,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,306,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,306,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,306,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,306,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,306,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,306,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,306,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,306,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,306,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,306,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,306,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,306,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,306,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,306,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,306,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,306,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,306,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,306,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,306,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,306,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,306,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,306,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,306,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,306,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,306,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,306,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,306,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,306,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,306,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,306,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,306,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,306,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,306,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,306,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,306,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,306,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,306,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,306,Receptor assay; estrogen ,,,75.3,465.26,4 RC,306,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,306,Receptor assay; progesterone ,,,55.59,343.11,4 RC,306,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,306,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,306,Renin ,,,18.84,116.79,4 RC,306,Reptilase test ,,,8.44,52.12,4 RC,306,Reticulated platelet assay ,,,30.62,188.6,4 RC,306,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,306,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,306,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,306,Rufinamide ,,,23.23,143.69,4 RC,306,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,306,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,306,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,306,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,306,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,306,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,306,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,306,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,306,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,306,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,306,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,306,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,306,Salicylate ,,,15.97,98.82,4 RC,306,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,306,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,306,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,306,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,306,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,306,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,306,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,306,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,306,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,306,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,306,Selenium ,,,21.88,134.7,4 RC,306,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,306,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,306,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,306,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,306,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,306,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,306,Serotonin ,,,26.54,163.49,4 RC,306,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,306,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,306,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,306,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,306,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,306,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,306,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,306,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,306,Sialic acid ,,,11.52,71.87,4 RC,306,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,306,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,306,Silica ,,,21.6,132.92,4 RC,306,Sirolimus ,,,11.76,73.66,4 RC,306,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,306,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,306,Skin test; candida ,,,79.46,102.39,3 RC,306,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,306,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,306,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,306,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,306,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",34.29,34.29,15.4,95.19,4 RC,306,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,306,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,306,Sodium; other source ,,,4.16,25.17,4 RC,306,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,306,Sodium; urine ,,,4.33,26.95,4 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,306,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,306,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,306,Somatomedin ,,,18.22,113.16,4 RC,306,Somatostatin ,,,15.67,96.98,4 RC,306,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,306,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,306,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,306,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,306,Specific gravity (except urine) ,,,2.82,17.97,4 RC,306,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,306,Sperm antibodies ,,,43.21,55.69,3 RC,306,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,306,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,306,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,306,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,306,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,306,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,306,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,306,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,306,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,306,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,306,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,306,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,306,"Stimulants, synthetic ",,,12.05,127.56,4 RC,306,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,306,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,306,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,306,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,306,"Streptokinase, antibody ",,,10.84,66.46,4 RC,306,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,306,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,306,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,306,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,306,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,306,"Sulfate, urine ",,,4.7,28.74,4 RC,306,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,306,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,306,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",669.95,669.95,4.07,25.17,4 RC,306,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,306,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,306,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",978.55,978.55,6.26,39.51,4 RC,306,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,306,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,306,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,306,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,306,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,306,T cells; total count ,,,32.32,199.37,4 RC,306,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,306,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,306,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,306,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,306,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,306,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,306,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,306,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,306,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,306,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,306,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,306,Tacrolimus ,,,11.76,73.66,4 RC,306,Tapentadol ,,,10.83,127.56,4 RC,306,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,306,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,306,Testosterone; free ,,,21.82,134.7,4 RC,306,Testosterone; total ,,,22.11,136.54,4 RC,306,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,306,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,306,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,306,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,306,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,306,Theophylline ,,,12.12,75.44,4 RC,306,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,306,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,306,Thiocyanate ,,,9.97,61.1,4 RC,306,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,306,Thrombin time; plasma ,,,4.95,30.52,4 RC,306,Thrombin time; titer ,,,5.87,35.94,4 RC,306,Thrombomodulin ,,,14.8,91.62,4 RC,306,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,306,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,306,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,306,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,306,Thyroglobulin ,,,13.76,84.43,4 RC,306,Thyroglobulin antibody ,,,13.63,84.43,4 RC,306,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,306,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,306,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,306,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,306,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,306,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,306,Thyroxine; free ,,,7.73,48.49,4 RC,306,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,306,Thyroxine; total ,,,5.89,35.94,4 RC,306,Tiagabine ,,,23.23,143.69,4 RC,306,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,306,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,306,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,306,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,306,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,306,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,306,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,306,Tobramycin ,,,13.82,86.21,4 RC,306,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,306,Topiramate ,,,10.21,62.89,4 RC,306,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,306,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,306,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,306,Tramadol ,,,10.54,127.56,4 RC,306,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,306,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,306,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,306,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,306,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,306,Transferrin ,,,10.93,68.24,4 RC,306,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,306,Triglycerides ,,,4.92,30.52,4 RC,306,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,306,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,306,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,306,"Troponin, qualitative ",,,8.65,53.9,4 RC,306,"Troponin, quantitative ",,,10.68,66.46,4 RC,306,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,306,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,306,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,306,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,306,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,306,Tyrosine ,,,9.11,55.69,4 RC,306,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,306,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,306,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,306,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,306,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,306,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,306,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,306,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,306,Unlisted immunology procedure ,,,99.55,128.28,3 RC,306,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,306,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,306,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,306,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,306,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,306,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,306,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,306,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,306,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,306,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,306,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,306,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,306,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,306,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,306,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,306,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,306,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,306,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,306,Uric acid; blood ,,,3.88,23.38,4 RC,306,Uric acid; other source ,,,4.36,26.95,4 RC,306,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,306,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,306,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,306,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,306,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,306,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,306,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,306,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,306,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,306,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,306,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,306,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,306,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,306,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,306,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,306,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,306,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,306,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,306,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,306,Vancomycin ,,,11.6,71.87,4 RC,306,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,306,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,306,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,306,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,306,Vedolizumab ,,,33.05,204.79,4 RC,306,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,306,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,306,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,306,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,306,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,306,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,306,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,306,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,306,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,306,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,306,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,306,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,306,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,306,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,306,Very long chain fatty acids ,,,16.92,104.18,4 RC,306,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,306,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,306,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,306,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,306,Viscosity ,,,10.0,61.1,4 RC,306,Vitamin A ,,,9.95,61.1,4 RC,306,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,306,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,306,Vitamin K ,,,11.75,71.87,4 RC,306,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,306,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,306,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,306,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,306,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,306,Voriconazole ,,,23.23,143.69,4 RC,306,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,306,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,306,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,306,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,306,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,306,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,306,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,306,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,306,Zinc ,,,9.76,61.1,4 RC,306,Zonisamide ,,,11.35,70.08,4 RC,306,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,306,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,306,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,307, Laboratory Urology ,,,,,0 RC,307,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,307,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,307,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,307,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,307,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,307,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,307,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,307,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,307,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,307,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,307,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,307,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,307,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,307,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,307,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,307,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,307,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,Acetaminophen ,,,15.97,98.82,4 RC,307,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,307,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,307,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,307,Acetylcholinesterase ,,,10.53,64.67,4 RC,307,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,307,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,307,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,307,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,307,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,307,Adalimumab ,,,33.05,204.79,4 RC,307,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,307,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,307,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,307,Albumin; ischemia modified ,,,29.08,179.62,4 RC,307,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,307,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,307,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,307,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,307,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,307,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,307,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,307,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,307,Alcohols ,,,9.61,127.56,4 RC,307,Aldolase ,,,8.32,52.12,4 RC,307,Aldosterone ,,,34.91,215.56,4 RC,307,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,307,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,307,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,307,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,307,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,307,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,307,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,307,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,307,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,307,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,307,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,307,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,307,Aluminum ,,,21.83,134.7,4 RC,307,Amikacin ,,,12.92,80.85,4 RC,307,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,307,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,307,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,307,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,307,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,307,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,307,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,307,Amiodarone ,,,15.97,98.82,4 RC,307,Ammonia ,,,12.48,77.23,4 RC,307,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,307,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,307,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,307,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,307,Amylase ,,,5.55,34.15,4 RC,307,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,307,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,307,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,307,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,307,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,307,Androstanediol glucuronide ,,,24.7,152.67,4 RC,307,Androstenedione ,,,25.09,154.51,4 RC,307,Androsterone ,,,21.89,134.7,4 RC,307,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,307,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,307,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,307,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,307,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,307,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,307,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,307,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,307,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,307,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,307,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,307,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,307,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,307,Angiotensin II ,,,17.58,109.59,4 RC,307,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,307,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,307,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,307,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,307,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,307,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,307,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,307,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,307,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,307,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,307,Antibody; Aspergillus ,,,12.89,79.01,4 RC,307,Antibody; Bartonella ,,,8.72,53.9,4 RC,307,Antibody; Blastomyces ,,,11.06,68.24,4 RC,307,Antibody; Bordetella ,,,11.3,70.08,4 RC,307,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,307,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,307,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,307,Antibody; Brucella ,,,7.65,46.7,4 RC,307,Antibody; Campylobacter ,,,11.24,70.08,4 RC,307,Antibody; Candida ,,,10.29,62.89,4 RC,307,Antibody; Chlamydia ,,,10.13,62.89,4 RC,307,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,307,Antibody; Coccidioides ,,,9.82,61.1,4 RC,307,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,307,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,307,Antibody; Diphtheria ,,,13.04,80.85,4 RC,307,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,307,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,307,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,307,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,307,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,307,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,307,Antibody; HIV-1 ,,,7.62,46.7,4 RC,307,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,307,Antibody; HIV-2 ,,,11.59,71.87,4 RC,307,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,307,Antibody; HTLV-I ,,,7.79,48.49,4 RC,307,Antibody; HTLV-II ,,,12.0,73.66,4 RC,307,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,307,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,307,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,307,Antibody; Legionella ,,,13.11,80.85,4 RC,307,Antibody; Leishmania ,,,10.5,64.67,4 RC,307,Antibody; Leptospira ,,,13.88,86.21,4 RC,307,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,307,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,307,Antibody; Nocardia ,,,13.7,84.43,4 RC,307,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,307,Antibody; Rickettsia ,,,16.57,102.39,4 RC,307,Antibody; Salmonella ,,,11.3,70.08,4 RC,307,Antibody; Shigella ,,,20.97,129.34,4 RC,307,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,307,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,307,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,307,Antibody; Trichinella ,,,10.76,66.46,4 RC,307,Antibody; West Nile virus ,,,12.33,75.44,4 RC,307,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,307,Antibody; Yersinia ,,,11.3,70.08,4 RC,307,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,307,Antibody; actinomyces ,,,8.72,53.9,4 RC,307,Antibody; adenovirus ,,,11.03,68.24,4 RC,307,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,307,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,307,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,307,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,307,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,307,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,307,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,307,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,307,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,307,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,307,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,307,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,307,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,307,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,307,Antibody; histoplasma ,,,11.81,73.66,4 RC,307,Antibody; influenza virus ,,,11.61,71.87,4 RC,307,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,307,Antibody; mucormycosis ,,,12.85,79.01,4 RC,307,Antibody; mumps ,,,11.18,70.08,4 RC,307,Antibody; mycoplasma ,,,11.34,70.08,4 RC,307,Antibody; parvovirus ,,,12.88,79.01,4 RC,307,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,307,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,307,Antibody; rotavirus ,,,15.62,96.98,4 RC,307,Antibody; rubella ,,,12.33,75.44,4 RC,307,Antibody; rubeola ,,,11.04,68.24,4 RC,307,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,307,Antibody; tetanus ,,,12.68,79.01,4 RC,307,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,307,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,307,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,307,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,307,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,307,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,307,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,307,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,307,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,307,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,307,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,307,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,307,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,307,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,307,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,307,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,307,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,307,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,307,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,307,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,307,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,307,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,307,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,307,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,307,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,307,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,307,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,307,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,307,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,307,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,307,"Apolipoprotein, each ",,,18.07,111.38,4 RC,307,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,307,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,307,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,307,Arsenic ,,,16.25,100.61,4 RC,307,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,307,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,307,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,307,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,307,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,307,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,307,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,307,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,307,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,307,"B cells, total count ",,,32.32,199.37,4 RC,307,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,307,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,307,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,307,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,307,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,307,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,307,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,307,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,307,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,307,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,307,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,307,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,307,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,307,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,307,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,307,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,307,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,307,Barbiturates ,,,9.34,127.56,4 RC,307,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,307,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,307,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,307,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,307,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,307,Beta-2 microglobulin ,,,13.86,86.21,4 RC,307,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,307,Bile acids; total ,,,14.67,91.62,4 RC,307,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,307,Bilirubin; direct ,,,4.3,26.95,4 RC,307,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,307,Bilirubin; total ,,,4.3,26.95,4 RC,307,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,307,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,307,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,307,Bleeding time ,,,4.13,25.17,4 RC,307,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,307,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,307,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,307,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,307,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,307,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,307,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,307,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,307,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,307,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,307,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,307,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,307,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,307,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,307,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,307,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,307,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,307,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,307,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,307,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,307,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,307,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,307,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,307,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,307,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,307,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,307,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,307,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,307,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,307,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,307,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,307,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,307,Bone age studies ,,,61.64,79.3,3 RC,307,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,307,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,307,Bradykinin ,,,4.42,26.95,4 RC,307,Buprenorphine ,,,14.01,14.01,1 RC,307,C-peptide ,,,17.83,109.59,4 RC,307,C-reactive protein; ,,,4.44,26.95,4 RC,307,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,307,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,307,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,307,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,307,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,307,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,307,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,307,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,307,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,307,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,307,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,307,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,307,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,307,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,307,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,307,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,307,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,307,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,307,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,307,Cadmium ,,,20.26,125.72,4 RC,307,Caffeine ,,,33.05,204.79,4 RC,307,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,307,Calcitonin ,,,22.95,141.9,4 RC,307,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,307,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,307,Calcium; ionized ,,,11.72,71.87,4 RC,307,Calcium; total ,,,4.42,26.95,4 RC,307,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,307,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,307,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,307,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,307,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,307,"Calprotectin, fecal ",,,16.82,104.18,4 RC,307,"Cannabinoids, natural ",,,11.5,127.56,4 RC,307,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,307,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,307,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,307,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,307,Carbamazepine; free ,,,11.35,70.08,4 RC,307,Carbamazepine; total ,,,12.48,77.23,4 RC,307,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,307,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,307,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,307,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,307,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,307,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,307,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,307,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,307,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,307,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,307,Carotene ,,,7.89,48.49,4 RC,307,Catecholamines; blood ,,,24.92,154.51,4 RC,307,Catecholamines; fractionated ,,,21.63,134.7,4 RC,307,Catecholamines; total urine ,,,23.39,145.53,4 RC,307,Cathepsin-D ,,,15.47,95.19,4 RC,307,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,307,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,307,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,307,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,307,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,307,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,307,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,307,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,307,Ceruloplasmin ,,,9.2,57.47,4 RC,307,Chemiluminescent assay ,,,12.1,75.44,4 RC,307,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,307,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,307,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,307,Chloramphenicol ,,,10.85,66.46,4 RC,307,Chloride; blood ,,,3.94,25.17,4 RC,307,Chloride; other source ,,,4.28,26.95,4 RC,307,Chloride; urine ,,,4.93,30.52,4 RC,307,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,307,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,307,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,307,Cholinesterase; RBC ,,,8.4,52.12,4 RC,307,Cholinesterase; serum ,,,6.74,41.29,4 RC,307,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,307,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,307,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,307,Chromium ,,,17.38,107.81,4 RC,307,Chromogenic substrate assay ,,,10.19,62.89,4 RC,307,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,307,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,307,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,307,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,307,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,307,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,307,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,307,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,307,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,307,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,307,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,307,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,307,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,307,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,307,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,307,Citrate ,,,23.82,147.31,4 RC,307,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,307,Clot retraction ,,,13.96,86.21,4 RC,307,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,307,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,307,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,307,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,307,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,307,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,307,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,307,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,307,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,307,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,307,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,307,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,307,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,307,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,307,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,307,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,307,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,307,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,307,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,307,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,307,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,307,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,307,Clozapine ,,,17.27,105.96,4 RC,307,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,307,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,307,Coagulation time; activated ,,,3.67,23.38,4 RC,307,Coagulation time; other methods ,,,3.85,23.38,4 RC,307,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,307,Cocaine ,,,10.46,127.56,4 RC,307,Cold agglutinin; screen ,,,6.92,43.13,4 RC,307,Cold agglutinin; titer ,,,6.91,43.13,4 RC,307,"Collagen cross links, any method ",,,16.0,98.82,4 RC,307,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,307,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,307,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,307,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,307,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,307,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,307,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,307,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,307,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,307,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,307,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,307,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,307,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,307,"Complement; antigen, each component ",,,10.28,62.89,4 RC,307,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,307,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,307,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,307,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,307,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,307,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,307,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,307,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,307,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,307,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,307,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,307,Copper ,,,10.63,66.46,4 RC,307,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,307,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,307,Corticosterone ,,,19.3,118.58,4 RC,307,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,307,Cortisol; free ,,,14.32,88.0,4 RC,307,Cortisol; total ,,,13.96,86.21,4 RC,307,Creatine ,,,3.98,25.17,4 RC,307,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,307,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,307,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,307,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,307,Creatinine; blood ,,,4.39,26.95,4 RC,307,Creatinine; clearance ,,,8.11,50.28,4 RC,307,Creatinine; other source ,,,4.44,26.95,4 RC,307,Cryofibrinogen ,,,12.12,75.44,4 RC,307,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,307,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,307,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,307,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,307,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,307,Cryopreservation; sperm ,,,442.57,570.33,3 RC,307,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,307,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,307,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,307,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,307,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,307,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,307,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,307,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,307,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,307,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,307,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,307,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,307,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,307,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,307,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,307,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,307,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,307,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,307,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,307,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,307,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,307,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,307,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,307,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,307,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,307,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,307,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,307,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,307,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,307,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,307,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,307,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,307,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,307,"Culture, typing; other methods ",,,6.63,41.29,4 RC,307,Cyanide ,,,16.63,102.39,4 RC,307,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,307,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,307,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,307,Cyclosporine ,,,15.46,95.19,4 RC,307,Cystatin C ,,,15.87,98.82,4 RC,307,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,307,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,307,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,307,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,307,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,307,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,307,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,307,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,307,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,307,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,307,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,307,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,307,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,307,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,307,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,307,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,307,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,307,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,307,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,307,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,307,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,307,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,307,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,307,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,307,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,307,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,307,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,307,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,307,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,307,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,307,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,307,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,307,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,307,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,307,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,307,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,307,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,307,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,307,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,307,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,307,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,307,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,307,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,307,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,307,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,307,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,307,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,307,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,307,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,307,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,307,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,307,Dibucaine number ,,,10.5,64.67,4 RC,307,Digoxin; free ,,,11.38,70.08,4 RC,307,Digoxin; total ,,,11.38,70.08,4 RC,307,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,307,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,307,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,307,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,307,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,307,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,307,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,307,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,307,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,307,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,307,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,307,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,307,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,307,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,307,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,307,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,307,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,307,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,307,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,307,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,307,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,307,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,307,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,307,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,307,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,307,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,307,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,307,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,307,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,307,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,307,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,307,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,307,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,307,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,307,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,307,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,307,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,307,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,307,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,307,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,307,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,307,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,307,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,307,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,307,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,307,Erythropoietin ,,,16.1,98.82,4 RC,307,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,307,Estradiol; total ,,,23.94,147.31,4 RC,307,Estriol ,,,20.72,127.56,4 RC,307,Estrogens; fractionated ,,,27.67,170.64,4 RC,307,Estrogens; total ,,,18.59,114.95,4 RC,307,Estrone ,,,21.38,132.92,4 RC,307,Ethosuximide ,,,14.0,86.21,4 RC,307,Ethylene glycol ,,,12.77,79.01,4 RC,307,Etiocholanolone ,,,22.48,138.33,4 RC,307,Euglobulin lysis ,,,7.2,44.92,4 RC,307,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,307,Everolimus ,,,11.76,73.66,4 RC,307,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,307,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,307,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,307,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,307,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,307,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,307,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,307,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,307,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,307,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,307,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,307,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,307,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,307,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,307,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,307,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,307,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,307,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,307,Factor inhibitor test ,,,11.03,68.24,4 RC,307,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,307,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,307,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,307,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,307,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,307,Felbamate ,,,15.97,98.82,4 RC,307,Fentanyl ,,,13.07,127.56,4 RC,307,Fern test ,,,40.44,52.12,3 RC,307,Ferritin ,,,11.68,71.87,4 RC,307,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,307,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,307,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,307,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,307,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,307,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,307,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,307,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,307,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,307,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,307,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,307,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,307,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,307,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,307,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,307,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,307,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,307,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,307,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,307,Fibrinogen; activity ,,,8.32,52.12,4 RC,307,Fibrinogen; antigen ,,,12.39,77.23,4 RC,307,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,307,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,307,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,307,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,307,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,307,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,307,Flecainide ,,,15.97,98.82,4 RC,307,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,307,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,307,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,307,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,307,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,307,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,307,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,307,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,307,Fluoride ,,,15.88,98.82,4 RC,307,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,307,Folic acid; RBC ,,,15.13,93.41,4 RC,307,Folic acid; serum ,,,12.6,77.23,4 RC,307,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,307,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,307,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,307,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,307,"Fructose, semen ",,,14.86,91.62,4 RC,307,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,307,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,307,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,307,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,307,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,307,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,307,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,307,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,307,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,307,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,307,"Galactokinase, RBC ",,,18.4,113.16,4 RC,307,Galactose ,,,9.6,59.26,4 RC,307,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,307,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,307,Galectin-3 ,,,182.6,235.31,3 RC,307,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,307,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,307,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,307,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,307,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,307,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,307,"Gases, blood, pH only ",,,9.42,57.47,4 RC,307,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,307,Gastrin ,,,15.11,93.41,4 RC,307,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,307,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,307,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,307,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,307,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,307,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,307,Gentamicin ,,,14.04,86.21,4 RC,307,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,307,Glucagon ,,,12.24,75.44,4 RC,307,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,307,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,307,Glucagon tolerance test ,,,15.23,93.41,4 RC,307,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,307,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,307,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,307,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,307,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,307,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,307,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,307,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,307,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,307,"Glucosidase, beta ",,,18.4,113.16,4 RC,307,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,307,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,307,Glutathione ,,,13.24,82.64,4 RC,307,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,307,Glycated protein ,,,14.36,88.0,4 RC,307,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,307,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,307,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,307,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,307,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,307,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,307,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,307,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,307,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,307,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,307,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,307,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,307,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,307,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,307,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,307,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,307,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,307,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,307,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,307,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,307,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,307,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,307,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,307,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,307,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,307,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,307,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,307,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,307,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,307,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,307,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,307,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,307,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,307,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,307,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,307,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,307,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,307,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,307,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,307,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,307,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,307,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,Haloperidol ,,,13.53,84.43,4 RC,307,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,307,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,307,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,307,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,307,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,307,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,307,Heinz bodies; direct ,,,3.6,21.54,4 RC,307,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,307,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,307,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,307,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,307,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,307,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,307,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,307,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,307,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,307,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,307,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,307,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,307,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,307,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,307,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,307,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,307,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,307,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,307,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,307,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,307,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,307,Hemoglobin; plasma ,,,6.26,39.51,4 RC,307,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,307,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,307,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,307,Hemoglobin; urine ,,,3.39,21.54,4 RC,307,"Hemolysin, acid ",,,7.6,46.7,4 RC,307,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,307,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,307,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,307,Heparin assay ,,,11.22,70.08,4 RC,307,Heparin neutralization ,,,10.15,62.89,4 RC,307,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,307,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,307,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,307,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,307,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,307,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,307,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,307,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,307,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,307,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,307,Hepatitis C antibody; ,,,12.23,75.44,4 RC,307,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,307,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,307,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,307,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,307,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,307,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,307,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,307,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,307,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,307,Heroin metabolite ,,,13.63,127.56,4 RC,307,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,307,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,307,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,307,Histamine ,,,25.31,156.3,4 RC,307,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,307,Homocysteine ,,,15.35,95.19,4 RC,307,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,307,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,307,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,307,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,307,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,307,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,307,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,307,Hydroxychloroquine ,,,15.97,98.82,4 RC,307,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,307,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,307,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,307,Hydroxyproline; free ,,,19.41,120.36,4 RC,307,Hydroxyproline; total ,,,20.82,129.34,4 RC,307,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,307,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,307,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,307,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,307,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,307,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,307,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,307,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,307,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,307,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,307,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,307,Immune complex assay ,,,20.88,129.34,4 RC,307,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,307,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,307,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,307,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,307,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,307,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,307,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,307,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,307,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,307,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,307,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,307,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,307,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,307,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,307,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,307,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,307,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,307,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,307,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,307,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,307,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,307,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,307,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,307,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,307,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,307,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,307,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,307,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,307,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,307,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,307,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,307,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,307,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,307,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,307,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,307,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,307,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,307,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,307,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,307,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,307,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,307,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,307,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,307,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,307,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,307,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,307,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,307,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,307,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,307,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,307,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,307,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,307,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,307,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,307,Infliximab ,,,33.05,204.79,4 RC,307,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,307,Inhibin A ,,,13.36,82.64,4 RC,307,Insemination of oocytes ,,,442.57,570.33,3 RC,307,Insulin antibodies ,,,18.34,113.16,4 RC,307,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,307,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,307,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,307,Insulin; free ,,,11.1,68.24,4 RC,307,Insulin; total ,,,9.79,61.1,4 RC,307,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,307,Intrinsic factor ,,,16.98,104.18,4 RC,307,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,307,Iron ,,,5.54,34.15,4 RC,307,Iron binding capacity ,,,7.49,46.7,4 RC,307,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,307,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,307,Islet cell antibody ,,,20.2,125.72,4 RC,307,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,307,Itraconazole ,,,23.23,143.69,4 RC,307,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,307,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,307,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,307,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,307,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,307,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,307,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,307,Ketamine and norketamine ,,,10.54,127.56,4 RC,307,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,307,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,307,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,307,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,307,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,307,Lacosamide ,,,23.23,143.69,4 RC,307,Lactate (lactic acid) ,,,9.91,61.1,4 RC,307,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,307,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,307,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,307,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,307,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,307,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,307,Lamotrigine ,,,11.35,70.08,4 RC,307,Lead ,,,10.37,64.67,4 RC,307,Leflunomide ,,,33.05,204.79,4 RC,307,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,307,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,307,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,307,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,307,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,307,Leukocyte transfusion ,,,305.26,393.39,3 RC,307,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,307,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,307,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,307,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,307,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,307,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,307,Levetiracetam ,,,11.35,70.08,4 RC,307,Lidocaine ,,,12.59,77.23,4 RC,307,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,307,Lipase ,,,5.91,35.94,4 RC,307,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,307,Lipoprotein (a) ,,,12.27,75.44,4 RC,307,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,307,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,307,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,307,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,307,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,307,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,307,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,307,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,307,Lithium ,,,5.66,35.94,4 RC,307,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,307,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,307,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,307,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,307,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,307,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,307,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,307,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,307,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,307,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,307,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,307,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,307,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,307,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,307,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,307,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,307,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,307,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,307,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,307,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,307,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,307,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,307,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,307,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,307,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,307,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,307,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,307,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,307,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,307,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,307,Magnesium ,,,5.74,35.94,4 RC,307,Malate dehydrogenase ,,,6.31,39.51,4 RC,307,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,307,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,307,Manganese ,,,22.84,141.9,4 RC,307,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,307,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,307,"Meat fibers, feces ",,,4.15,25.17,4 RC,307,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,307,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,307,"Mercury, quantitative ",,,13.93,86.21,4 RC,307,Metanephrines ,,,14.51,89.84,4 RC,307,Methadone ,,,11.24,127.56,4 RC,307,Methemalbumin ,,,9.2,57.47,4 RC,307,Methotrexate ,,,33.05,204.79,4 RC,307,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,307,Methylphenidate ,,,9.29,127.56,4 RC,307,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,307,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,307,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,307,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,307,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,307,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,307,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,307,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,307,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,307,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,307,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,307,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,307,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,307,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,307,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,307,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,307,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,307,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,307,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,307,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,307,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,307,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,307,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,307,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,307,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,307,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,307,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,307,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,307,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,307,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,307,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,307,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,307,Muramidase ,,,16.07,98.82,4 RC,307,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,307,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,307,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,307,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,307,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,307,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,307,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,307,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,307,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,307,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,307,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,307,Myoglobin ,,,11.07,68.24,4 RC,307,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,307,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,307,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,307,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,307,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,307,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,307,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,307,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,307,Natriuretic peptide ,,,33.64,208.36,4 RC,307,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,307,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,307,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,307,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,307,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,307,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,307,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,307,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,307,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,307,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,307,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,307,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,307,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,307,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,307,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,307,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,307,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,307,Nerve teasing preparations ,,,499.29,643.43,3 RC,307,"Neutralization test, viral ",,,14.48,89.84,4 RC,307,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,307,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,307,Nickel ,,,21.0,129.34,4 RC,307,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,307,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,307,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,307,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,307,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,307,Nucleotidase 5'- ,,,9.56,59.26,4 RC,307,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,307,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,307,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,307,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,307,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,307,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,307,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,307,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,307,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,307,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,307,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,307,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,307,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,307,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,307,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,307,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,307,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,307,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,307,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,307,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,307,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,307,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,307,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,307,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,307,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,307,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,307,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,307,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,307,"Opiates, 1 or more ",,,14.57,127.56,4 RC,307,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,307,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,307,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,307,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,307,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,307,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,307,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,307,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,307,Osmolality; blood ,,,5.66,35.94,4 RC,307,Osmolality; urine ,,,5.84,35.94,4 RC,307,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,307,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,307,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,307,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,307,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,307,Oxalate ,,,12.38,77.23,4 RC,307,Oxcarbazepine ,,,11.35,70.08,4 RC,307,Oxycodone ,,,12.15,127.56,4 RC,307,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,307,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,307,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,307,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,307,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,307,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,307,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,307,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,307,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,307,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,307,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,307,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,307,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,307,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,307,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,307,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,307,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,307,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,307,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,307,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,307,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,307,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,307,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,307,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,307,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,307,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,307,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,307,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,307,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,307,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,307,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,307,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,307,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,307,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,307,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,307,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,307,Phenobarbital ,,,13.11,80.85,4 RC,307,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,307,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,307,Phenytoin; free ,,,11.79,73.66,4 RC,307,Phenytoin; total ,,,11.35,70.08,4 RC,307,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,307,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,307,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,307,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,307,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,307,Phosphatidylglycerol ,,,14.16,88.0,4 RC,307,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,307,Phosphohexose isomerase ,,,9.19,57.47,4 RC,307,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,307,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,307,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,307,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,307,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,307,Pinworm examinations ,,,18.14,23.38,3 RC,307,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,307,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,307,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,307,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,307,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,307,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,307,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,307,Posaconazole ,,,23.23,143.69,4 RC,307,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,307,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,307,Potassium; urine ,,,4.05,25.17,4 RC,307,Prealbumin ,,,12.51,77.23,4 RC,307,Pregabalin ,,,7.07,127.56,4 RC,307,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,307,Pregnanediol ,,,18.23,113.16,4 RC,307,Pregnanetriol ,,,18.03,111.38,4 RC,307,Pregnenolone ,,,17.71,109.59,4 RC,307,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,307,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,307,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,307,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,307,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,307,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,307,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,307,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,307,Primidone ,,,14.22,88.0,4 RC,307,Procainamide; ,,,51.41,317.95,4 RC,307,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,307,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,307,Progesterone ,,,17.87,111.38,4 RC,307,Proinsulin ,,,22.87,141.9,4 RC,307,Prolactin ,,,16.61,102.39,4 RC,307,Propoxyphene ,,,10.72,127.56,4 RC,307,"Prostaglandin, each ",,,35.79,220.97,4 RC,307,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,307,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,307,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,307,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,307,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,307,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,307,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,307,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,307,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,307,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,307,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,307,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,307,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,307,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,307,Prothrombin time; ,,,3.67,23.38,4 RC,307,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,307,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,307,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,307,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,307,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,307,Pyruvate ,,,12.4,77.23,4 RC,307,Pyruvate kinase ,,,8.09,50.28,4 RC,307,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,307,Quinidine ,,,12.51,77.23,4 RC,307,Quinine ,,,9.97,61.1,4 RC,307,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,307,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,307,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,307,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,307,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,307,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,307,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,307,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,307,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,307,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,307,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,307,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,307,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,307,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,307,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,307,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,307,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,307,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,307,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,307,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,307,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,307,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,307,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,307,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,307,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,307,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,307,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,307,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,307,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,307,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,307,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,307,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,307,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,307,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,307,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,307,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,307,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,307,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,307,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,307,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,307,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,307,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,307,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,307,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,307,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,307,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,307,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,307,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,307,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,307,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,307,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,307,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,307,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,307,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,307,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,307,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,307,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,307,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,307,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,307,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,307,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,307,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,307,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,307,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,307,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,307,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,307,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,307,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,307,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,307,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,307,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,307,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,307,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,307,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,307,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,307,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,307,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,307,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,307,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,307,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,307,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,307,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,307,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,307,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,307,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,307,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,307,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,307,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,307,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,307,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,307,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,307,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,307,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,307,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,307,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,307,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,307,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,307,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,307,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,307,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,307,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,307,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,307,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,307,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,307,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,307,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,307,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,307,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,307,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,307,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,307,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,307,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,307,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,307,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,307,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,307,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,307,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,307,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,307,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,307,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,307,Receptor assay; estrogen ,,,75.3,465.26,4 RC,307,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,307,Receptor assay; progesterone ,,,55.59,343.11,4 RC,307,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,307,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,307,Renin ,,,18.84,116.79,4 RC,307,Reptilase test ,,,8.44,52.12,4 RC,307,Reticulated platelet assay ,,,30.62,188.6,4 RC,307,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,307,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,307,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,307,Rufinamide ,,,23.23,143.69,4 RC,307,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,307,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,307,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,307,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,307,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,307,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,307,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,307,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,307,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,307,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,307,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,307,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,307,Salicylate ,,,15.97,98.82,4 RC,307,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,307,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,307,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,307,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,307,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,307,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,307,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,307,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,307,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,307,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,307,Selenium ,,,21.88,134.7,4 RC,307,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,307,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,307,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,307,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,307,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,307,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,307,Serotonin ,,,26.54,163.49,4 RC,307,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,307,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,307,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,307,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,307,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,307,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,307,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,307,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,307,Sialic acid ,,,11.52,71.87,4 RC,307,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,307,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,307,Silica ,,,21.6,132.92,4 RC,307,Sirolimus ,,,11.76,73.66,4 RC,307,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,307,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,307,Skin test; candida ,,,79.46,102.39,3 RC,307,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,307,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,307,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,307,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,307,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,307,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,307,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,307,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,307,Sodium; other source ,,,4.16,25.17,4 RC,307,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,307,Sodium; urine ,,,4.33,26.95,4 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,307,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,307,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,307,Somatomedin ,,,18.22,113.16,4 RC,307,Somatostatin ,,,15.67,96.98,4 RC,307,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,307,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,307,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,307,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,307,Specific gravity (except urine) ,,,2.82,17.97,4 RC,307,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,307,Sperm antibodies ,,,43.21,55.69,3 RC,307,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,307,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,307,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,307,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,307,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,307,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,307,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,307,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,307,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,307,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,307,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,307,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,307,"Stimulants, synthetic ",,,12.05,127.56,4 RC,307,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,307,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,307,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,307,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,307,"Streptokinase, antibody ",,,10.84,66.46,4 RC,307,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,307,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,307,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,307,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,307,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,307,"Sulfate, urine ",,,4.7,28.74,4 RC,307,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,307,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,307,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,307,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,307,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,307,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,307,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,307,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,307,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,307,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,307,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,307,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,307,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,307,T cells; total count ,,,32.32,199.37,4 RC,307,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,307,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,307,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,307,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,307,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,307,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,307,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,307,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,307,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,307,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,307,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,307,Tacrolimus ,,,11.76,73.66,4 RC,307,Tapentadol ,,,10.83,127.56,4 RC,307,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,307,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,307,Testosterone; free ,,,21.82,134.7,4 RC,307,Testosterone; total ,,,22.11,136.54,4 RC,307,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,307,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,307,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,307,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,307,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,307,Theophylline ,,,12.12,75.44,4 RC,307,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,307,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,307,Thiocyanate ,,,9.97,61.1,4 RC,307,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,307,Thrombin time; plasma ,,,4.95,30.52,4 RC,307,Thrombin time; titer ,,,5.87,35.94,4 RC,307,Thrombomodulin ,,,14.8,91.62,4 RC,307,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,307,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,307,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,307,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,307,Thyroglobulin ,,,13.76,84.43,4 RC,307,Thyroglobulin antibody ,,,13.63,84.43,4 RC,307,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,307,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,307,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,307,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,307,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,307,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,307,Thyroxine; free ,,,7.73,48.49,4 RC,307,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,307,Thyroxine; total ,,,5.89,35.94,4 RC,307,Tiagabine ,,,23.23,143.69,4 RC,307,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,307,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,307,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,307,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,307,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,307,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,307,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,307,Tobramycin ,,,13.82,86.21,4 RC,307,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,307,Topiramate ,,,10.21,62.89,4 RC,307,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,307,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,307,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,307,Tramadol ,,,10.54,127.56,4 RC,307,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,307,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,307,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,307,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,307,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,307,Transferrin ,,,10.93,68.24,4 RC,307,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,307,Triglycerides ,,,4.92,30.52,4 RC,307,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,307,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,307,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,307,"Troponin, qualitative ",,,8.65,53.9,4 RC,307,"Troponin, quantitative ",,,10.68,66.46,4 RC,307,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,307,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,307,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,307,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,307,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,307,Tyrosine ,,,9.11,55.69,4 RC,307,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,307,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,307,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,307,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,307,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,307,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,307,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,307,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,307,Unlisted immunology procedure ,,,99.55,128.28,3 RC,307,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,307,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,307,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,307,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,307,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,307,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,307,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,307,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,307,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,307,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,307,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,307,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,307,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,307,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,307,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,307,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,307,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,307,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,307,Uric acid; blood ,,,3.88,23.38,4 RC,307,Uric acid; other source ,,,4.36,26.95,4 RC,307,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,12.55,4 RC,307,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,307,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,307,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,307,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,307,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,307,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,307,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,307,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,307,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,307,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,307,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,307,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,307,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,307,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,307,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,307,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,307,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,307,Vancomycin ,,,11.6,71.87,4 RC,307,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,307,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,307,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,307,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,307,Vedolizumab ,,,33.05,204.79,4 RC,307,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,307,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,307,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,307,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,307,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,307,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,307,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,307,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,307,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,307,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,307,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,307,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,307,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,307,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,307,Very long chain fatty acids ,,,16.92,104.18,4 RC,307,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,307,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,307,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,307,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,307,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,307,Viscosity ,,,10.0,61.1,4 RC,307,Vitamin A ,,,9.95,61.1,4 RC,307,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,307,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,307,Vitamin K ,,,11.75,71.87,4 RC,307,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,307,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,307,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,307,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,307,Voriconazole ,,,23.23,143.69,4 RC,307,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,307,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,307,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,307,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,307,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,307,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,307,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,307,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,307,Zinc ,,,9.76,61.1,4 RC,307,Zonisamide ,,,11.35,70.08,4 RC,307,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,307,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,307,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,309, Laboratory Other ,,,,,0 RC,309,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,309,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,309,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,309,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,309,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,309,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,309,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,309,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,309,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,309,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,309,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,309,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,309,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,309,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,309,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,309,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,309,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,Acetaminophen ,,,15.97,98.82,4 RC,309,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,309,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,309,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,309,Acetylcholinesterase ,,,10.53,64.67,4 RC,309,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,309,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,309,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,309,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,309,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,309,Adalimumab ,,,33.05,204.79,4 RC,309,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,309,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,309,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,309,Albumin; ischemia modified ,,,29.08,179.62,4 RC,309,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,309,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,309,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,309,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,309,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,309,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,309,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,309,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,309,Alcohols ,,,9.61,127.56,4 RC,309,Aldolase ,,,8.32,52.12,4 RC,309,Aldosterone ,,,34.91,215.56,4 RC,309,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,309,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,309,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,309,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,309,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,309,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,309,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,309,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,309,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,309,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,309,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,309,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,309,Aluminum ,,,21.83,134.7,4 RC,309,Amikacin ,,,12.92,80.85,4 RC,309,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,309,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,309,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,309,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,309,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,309,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,309,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,309,Amiodarone ,,,15.97,98.82,4 RC,309,Ammonia ,,,12.48,77.23,4 RC,309,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,309,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,309,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,309,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,309,Amylase ,,,5.55,34.15,4 RC,309,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,309,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,309,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,309,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,309,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,309,Androstanediol glucuronide ,,,24.7,152.67,4 RC,309,Androstenedione ,,,25.09,154.51,4 RC,309,Androsterone ,,,21.89,134.7,4 RC,309,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,309,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,309,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,309,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,309,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,309,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,309,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,309,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,309,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,309,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,309,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,309,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,309,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,309,Angiotensin II ,,,17.58,109.59,4 RC,309,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,309,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,309,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,309,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,309,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,309,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,309,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,309,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,309,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,309,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,309,Antibody; Aspergillus ,,,12.89,79.01,4 RC,309,Antibody; Bartonella ,,,8.72,53.9,4 RC,309,Antibody; Blastomyces ,,,11.06,68.24,4 RC,309,Antibody; Bordetella ,,,11.3,70.08,4 RC,309,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,309,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,309,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,309,Antibody; Brucella ,,,7.65,46.7,4 RC,309,Antibody; Campylobacter ,,,11.24,70.08,4 RC,309,Antibody; Candida ,,,10.29,62.89,4 RC,309,Antibody; Chlamydia ,,,10.13,62.89,4 RC,309,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,309,Antibody; Coccidioides ,,,9.82,61.1,4 RC,309,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,309,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,309,Antibody; Diphtheria ,,,13.04,80.85,4 RC,309,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,309,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,309,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,309,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,309,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,309,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,309,Antibody; HIV-1 ,,,7.62,46.7,4 RC,309,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,309,Antibody; HIV-2 ,,,11.59,71.87,4 RC,309,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,309,Antibody; HTLV-I ,,,7.79,48.49,4 RC,309,Antibody; HTLV-II ,,,12.0,73.66,4 RC,309,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,309,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,309,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,309,Antibody; Legionella ,,,13.11,80.85,4 RC,309,Antibody; Leishmania ,,,10.5,64.67,4 RC,309,Antibody; Leptospira ,,,13.88,86.21,4 RC,309,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,309,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,309,Antibody; Nocardia ,,,13.7,84.43,4 RC,309,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,309,Antibody; Rickettsia ,,,16.57,102.39,4 RC,309,Antibody; Salmonella ,,,11.3,70.08,4 RC,309,Antibody; Shigella ,,,20.97,129.34,4 RC,309,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,309,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,309,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,309,Antibody; Trichinella ,,,10.76,66.46,4 RC,309,Antibody; West Nile virus ,,,12.33,75.44,4 RC,309,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,309,Antibody; Yersinia ,,,11.3,70.08,4 RC,309,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,309,Antibody; actinomyces ,,,8.72,53.9,4 RC,309,Antibody; adenovirus ,,,11.03,68.24,4 RC,309,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,309,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,309,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,309,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,309,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,309,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,309,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,309,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,309,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,309,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,309,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,309,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,309,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,309,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,309,Antibody; histoplasma ,,,11.81,73.66,4 RC,309,Antibody; influenza virus ,,,11.61,71.87,4 RC,309,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,309,Antibody; mucormycosis ,,,12.85,79.01,4 RC,309,Antibody; mumps ,,,11.18,70.08,4 RC,309,Antibody; mycoplasma ,,,11.34,70.08,4 RC,309,Antibody; parvovirus ,,,12.88,79.01,4 RC,309,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,309,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,309,Antibody; rotavirus ,,,15.62,96.98,4 RC,309,Antibody; rubella ,,,12.33,75.44,4 RC,309,Antibody; rubeola ,,,11.04,68.24,4 RC,309,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,309,Antibody; tetanus ,,,12.68,79.01,4 RC,309,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,309,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,309,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,309,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,309,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,309,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,309,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,309,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,309,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,309,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,309,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,309,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,309,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,309,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,309,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,309,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,309,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,309,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,309,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,309,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,309,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,309,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,309,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,309,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,309,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,309,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,309,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,309,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,309,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,309,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,309,"Apolipoprotein, each ",,,18.07,111.38,4 RC,309,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,309,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,309,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,309,Arsenic ,,,16.25,100.61,4 RC,309,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,309,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,309,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,309,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,309,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,309,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,309,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,309,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,309,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,309,"B cells, total count ",,,32.32,199.37,4 RC,309,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,309,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,309,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,309,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,309,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,309,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,309,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,309,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,309,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,309,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,309,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,309,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,309,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,309,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,309,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,309,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,309,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,309,Barbiturates ,,,9.34,127.56,4 RC,309,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,309,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,309,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,309,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,309,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,309,Beta-2 microglobulin ,,,13.86,86.21,4 RC,309,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,309,Bile acids; total ,,,14.67,91.62,4 RC,309,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,309,Bilirubin; direct ,,,4.3,26.95,4 RC,309,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,309,Bilirubin; total ,,,4.3,26.95,4 RC,309,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,309,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,309,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,309,Bleeding time ,,,4.13,25.17,4 RC,309,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,309,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,309,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,309,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,309,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,309,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,309,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,309,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,309,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,309,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,309,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,309,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,309,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,309,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,309,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,309,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,309,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,309,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,309,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,309,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,309,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,309,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,309,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,309,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,309,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,309,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,309,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,309,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,309,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,309,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,309,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,309,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,309,Bone age studies ,,,61.64,79.3,3 RC,309,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,309,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,309,Bradykinin ,,,4.42,26.95,4 RC,309,Buprenorphine ,,,14.01,14.01,1 RC,309,C-peptide ,,,17.83,109.59,4 RC,309,C-reactive protein; ,,,4.44,26.95,4 RC,309,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,309,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,309,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,309,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,309,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,309,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,309,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,309,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,309,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,309,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,309,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,309,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,309,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,309,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,309,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,309,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,309,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,309,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,309,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,309,Cadmium ,,,20.26,125.72,4 RC,309,Caffeine ,,,33.05,204.79,4 RC,309,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,309,Calcitonin ,,,22.95,141.9,4 RC,309,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,309,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,309,Calcium; ionized ,,,11.72,71.87,4 RC,309,Calcium; total ,,,4.42,26.95,4 RC,309,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,309,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,309,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,309,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,309,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,309,"Calprotectin, fecal ",,,16.82,104.18,4 RC,309,"Cannabinoids, natural ",,,11.5,127.56,4 RC,309,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,309,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,309,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,309,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,309,Carbamazepine; free ,,,11.35,70.08,4 RC,309,Carbamazepine; total ,,,12.48,77.23,4 RC,309,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,309,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,309,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,309,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,309,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,309,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,309,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,309,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,309,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,309,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,309,Carotene ,,,7.89,48.49,4 RC,309,Catecholamines; blood ,,,24.92,154.51,4 RC,309,Catecholamines; fractionated ,,,21.63,134.7,4 RC,309,Catecholamines; total urine ,,,23.39,145.53,4 RC,309,Cathepsin-D ,,,15.47,95.19,4 RC,309,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,309,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,309,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,309,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,309,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,309,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,309,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,309,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,309,Ceruloplasmin ,,,9.2,57.47,4 RC,309,Chemiluminescent assay ,,,12.1,75.44,4 RC,309,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,309,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,309,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,309,Chloramphenicol ,,,10.85,66.46,4 RC,309,Chloride; blood ,,,3.94,25.17,4 RC,309,Chloride; other source ,,,4.28,26.95,4 RC,309,Chloride; urine ,,,4.93,30.52,4 RC,309,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,309,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,309,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,309,Cholinesterase; RBC ,,,8.4,52.12,4 RC,309,Cholinesterase; serum ,,,6.74,41.29,4 RC,309,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,309,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,309,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,309,Chromium ,,,17.38,107.81,4 RC,309,Chromogenic substrate assay ,,,10.19,62.89,4 RC,309,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,309,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,309,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,309,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,309,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,309,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,309,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,309,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,309,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,309,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,309,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,309,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,309,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,309,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,309,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,309,Citrate ,,,23.82,147.31,4 RC,309,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,309,Clot retraction ,,,13.96,86.21,4 RC,309,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,309,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,309,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,309,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,309,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,309,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,309,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,309,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,309,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,309,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,309,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,309,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,309,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,309,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,309,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,309,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,309,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,309,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,309,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,309,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,309,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,309,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,309,Clozapine ,,,17.27,105.96,4 RC,309,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,309,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,309,Coagulation time; activated ,,,3.67,23.38,4 RC,309,Coagulation time; other methods ,,,3.85,23.38,4 RC,309,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,309,Cocaine ,,,10.46,127.56,4 RC,309,Cold agglutinin; screen ,,,6.92,43.13,4 RC,309,Cold agglutinin; titer ,,,6.91,43.13,4 RC,309,"Collagen cross links, any method ",,,16.0,98.82,4 RC,309,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,309,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,309,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,309,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,309,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,309,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,309,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,309,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,309,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,309,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,309,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,309,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,309,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,309,"Complement; antigen, each component ",,,10.28,62.89,4 RC,309,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,309,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,309,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,309,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,309,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,309,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,309,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,309,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,309,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,309,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,309,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,309,Copper ,,,10.63,66.46,4 RC,309,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,309,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,309,Corticosterone ,,,19.3,118.58,4 RC,309,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,309,Cortisol; free ,,,14.32,88.0,4 RC,309,Cortisol; total ,,,13.96,86.21,4 RC,309,Creatine ,,,3.98,25.17,4 RC,309,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,309,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,309,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,309,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,309,Creatinine; blood ,,,4.39,26.95,4 RC,309,Creatinine; clearance ,,,8.11,50.28,4 RC,309,Creatinine; other source ,,,4.44,26.95,4 RC,309,Cryofibrinogen ,,,12.12,75.44,4 RC,309,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,309,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,309,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,309,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,309,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,309,Cryopreservation; sperm ,,,442.57,570.33,3 RC,309,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,309,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,309,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,309,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,309,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,309,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,309,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,309,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,309,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,309,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,309,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,309,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,309,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,309,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,309,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,309,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,309,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,309,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,309,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,309,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,309,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,309,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,309,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,309,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,309,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,309,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,309,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,309,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,309,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,309,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,309,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,309,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,309,"Culture, typing; other methods ",,,6.63,41.29,4 RC,309,Cyanide ,,,16.63,102.39,4 RC,309,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,309,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,309,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,309,Cyclosporine ,,,15.46,95.19,4 RC,309,Cystatin C ,,,15.87,98.82,4 RC,309,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,309,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,309,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,309,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,309,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,309,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,309,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,309,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,309,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,309,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,309,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,309,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,309,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,309,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,309,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,309,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,309,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,309,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,309,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,309,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,309,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,309,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,309,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,309,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,309,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,309,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,309,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,309,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,309,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,309,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,309,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,309,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,309,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,309,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,309,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,309,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,309,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,309,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,309,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,309,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,309,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,309,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,309,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,309,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,309,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,309,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,309,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,309,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,309,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,309,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,309,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,309,Dibucaine number ,,,10.5,64.67,4 RC,309,Digoxin; free ,,,11.38,70.08,4 RC,309,Digoxin; total ,,,11.38,70.08,4 RC,309,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,309,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,309,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,309,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,309,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,309,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,309,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,309,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,309,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,309,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,309,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,309,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,309,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,309,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,309,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,309,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,309,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,309,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,309,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,309,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,309,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,309,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,309,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,309,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,309,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,309,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,309,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,309,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,309,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,309,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,309,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,309,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,309,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,309,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,309,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,309,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,309,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,309,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,309,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,309,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,309,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,309,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,309,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,309,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,309,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,309,Erythropoietin ,,,16.1,98.82,4 RC,309,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,309,Estradiol; total ,,,23.94,147.31,4 RC,309,Estriol ,,,20.72,127.56,4 RC,309,Estrogens; fractionated ,,,27.67,170.64,4 RC,309,Estrogens; total ,,,18.59,114.95,4 RC,309,Estrone ,,,21.38,132.92,4 RC,309,Ethosuximide ,,,14.0,86.21,4 RC,309,Ethylene glycol ,,,12.77,79.01,4 RC,309,Etiocholanolone ,,,22.48,138.33,4 RC,309,Euglobulin lysis ,,,7.2,44.92,4 RC,309,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,309,Everolimus ,,,11.76,73.66,4 RC,309,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,309,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,309,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,309,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,309,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,309,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,309,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,309,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,309,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,309,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,309,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,309,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,309,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,309,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,309,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,309,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,309,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,309,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,309,Factor inhibitor test ,,,11.03,68.24,4 RC,309,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,309,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,309,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,309,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,309,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,309,Felbamate ,,,15.97,98.82,4 RC,309,Fentanyl ,,,13.07,127.56,4 RC,309,Fern test ,,,40.44,52.12,3 RC,309,Ferritin ,,,11.68,71.87,4 RC,309,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,309,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,309,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,309,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,309,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,309,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,309,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,309,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,309,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,309,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,309,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,309,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,309,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,309,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,309,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,309,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,309,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,309,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,309,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,309,Fibrinogen; activity ,,,8.32,52.12,4 RC,309,Fibrinogen; antigen ,,,12.39,77.23,4 RC,309,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,309,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,309,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,309,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,309,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,309,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,309,Flecainide ,,,15.97,98.82,4 RC,309,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,309,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,309,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,309,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,309,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,309,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,309,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,309,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,309,Fluoride ,,,15.88,98.82,4 RC,309,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,309,Folic acid; RBC ,,,15.13,93.41,4 RC,309,Folic acid; serum ,,,12.6,77.23,4 RC,309,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,309,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,309,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,309,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,309,"Fructose, semen ",,,14.86,91.62,4 RC,309,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,309,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,309,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,309,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,309,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,309,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,309,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,309,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,309,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,309,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,309,"Galactokinase, RBC ",,,18.4,113.16,4 RC,309,Galactose ,,,9.6,59.26,4 RC,309,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,309,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,309,Galectin-3 ,,,182.6,235.31,3 RC,309,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,309,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,309,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,309,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,309,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,309,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,309,"Gases, blood, pH only ",,,9.42,57.47,4 RC,309,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,309,Gastrin ,,,15.11,93.41,4 RC,309,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,309,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,309,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,309,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,309,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,309,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,309,Gentamicin ,,,14.04,86.21,4 RC,309,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,309,Glucagon ,,,12.24,75.44,4 RC,309,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,309,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,309,Glucagon tolerance test ,,,15.23,93.41,4 RC,309,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,309,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,309,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,309,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,309,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,309,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,309,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,309,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,309,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,309,"Glucosidase, beta ",,,18.4,113.16,4 RC,309,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,309,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,309,Glutathione ,,,13.24,82.64,4 RC,309,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,309,Glycated protein ,,,14.36,88.0,4 RC,309,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,309,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,309,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,309,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,309,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,309,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,309,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,309,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,309,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,309,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,309,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,309,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,309,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,309,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,309,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,309,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,309,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,309,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,309,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,309,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,309,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,309,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,309,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,309,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,309,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,309,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,309,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,309,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,309,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,309,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,309,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,309,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,309,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,309,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,309,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,309,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,309,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,309,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,309,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,309,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,309,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,309,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,Haloperidol ,,,13.53,84.43,4 RC,309,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,309,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,309,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,309,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,309,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,309,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,309,Heinz bodies; direct ,,,3.6,21.54,4 RC,309,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,309,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,309,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,309,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,309,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,309,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,309,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,309,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,309,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,309,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,309,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,309,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,309,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,309,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,309,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,309,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,309,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,309,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,309,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,309,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,309,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,309,Hemoglobin; plasma ,,,6.26,39.51,4 RC,309,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,309,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,309,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,309,Hemoglobin; urine ,,,3.39,21.54,4 RC,309,"Hemolysin, acid ",,,7.6,46.7,4 RC,309,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,309,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,309,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,309,Heparin assay ,,,11.22,70.08,4 RC,309,Heparin neutralization ,,,10.15,62.89,4 RC,309,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,309,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,309,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,309,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,309,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,309,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,309,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,309,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,309,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,309,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,309,Hepatitis C antibody; ,,,12.23,75.44,4 RC,309,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,309,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,309,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,309,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,309,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,309,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,309,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,309,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,309,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,309,Heroin metabolite ,,,13.63,127.56,4 RC,309,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,309,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,309,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,309,Histamine ,,,25.31,156.3,4 RC,309,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,309,Homocysteine ,,,15.35,95.19,4 RC,309,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,309,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,309,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,309,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,309,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,309,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,309,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,309,Hydroxychloroquine ,,,15.97,98.82,4 RC,309,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,309,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,309,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,309,Hydroxyproline; free ,,,19.41,120.36,4 RC,309,Hydroxyproline; total ,,,20.82,129.34,4 RC,309,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,309,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,309,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,309,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,309,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,309,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,309,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,309,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,309,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,309,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,309,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,309,Immune complex assay ,,,20.88,129.34,4 RC,309,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,309,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,309,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,309,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,309,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,309,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,309,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,309,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,309,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,309,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,309,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,309,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,309,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,309,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,309,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,309,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,309,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,309,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,309,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,309,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,309,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,309,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,309,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,309,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,309,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,309,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,309,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,309,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,309,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,309,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,309,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,309,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,309,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,309,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,309,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,309,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,309,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,309,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,309,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,309,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,309,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,309,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,309,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,309,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,309,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,309,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,309,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,309,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,309,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,309,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,309,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,309,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,309,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,309,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,309,Infliximab ,,,33.05,204.79,4 RC,309,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,309,Inhibin A ,,,13.36,82.64,4 RC,309,Insemination of oocytes ,,,442.57,570.33,3 RC,309,Insulin antibodies ,,,18.34,113.16,4 RC,309,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,309,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,309,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,309,Insulin; free ,,,11.1,68.24,4 RC,309,Insulin; total ,,,9.79,61.1,4 RC,309,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,309,Intrinsic factor ,,,16.98,104.18,4 RC,309,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,309,Iron ,,,5.54,34.15,4 RC,309,Iron binding capacity ,,,7.49,46.7,4 RC,309,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,309,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,309,Islet cell antibody ,,,20.2,125.72,4 RC,309,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,309,Itraconazole ,,,23.23,143.69,4 RC,309,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,309,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,309,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,309,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,309,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,309,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,309,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,309,Ketamine and norketamine ,,,10.54,127.56,4 RC,309,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,309,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,309,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,309,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,309,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,309,Lacosamide ,,,23.23,143.69,4 RC,309,Lactate (lactic acid) ,,,9.91,61.1,4 RC,309,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,309,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,309,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,309,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,309,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,309,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,309,Lamotrigine ,,,11.35,70.08,4 RC,309,Lead ,,,10.37,64.67,4 RC,309,Leflunomide ,,,33.05,204.79,4 RC,309,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,309,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,309,"Leukocyte assessment, fecal, qualitative or semiquantitative ",505.1,505.1,3.66,23.38,4 RC,309,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,309,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,309,Leukocyte transfusion ,,,305.26,393.39,3 RC,309,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,309,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,309,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,309,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,309,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,309,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,309,Levetiracetam ,,,11.35,70.08,4 RC,309,Lidocaine ,,,12.59,77.23,4 RC,309,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,309,Lipase ,,,5.91,35.94,4 RC,309,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,309,Lipoprotein (a) ,,,12.27,75.44,4 RC,309,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,309,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,309,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,309,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,309,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,309,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,309,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,309,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,309,Lithium ,,,5.66,35.94,4 RC,309,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,309,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,309,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,309,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,309,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,309,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,309,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,309,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,309,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,309,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,309,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,309,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,309,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,309,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,309,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,309,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,309,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,309,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,309,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,309,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,309,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,309,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,309,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,309,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,309,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,309,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,309,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,309,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,309,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,309,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,309,Magnesium ,,,5.74,35.94,4 RC,309,Malate dehydrogenase ,,,6.31,39.51,4 RC,309,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,309,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,309,Manganese ,,,22.84,141.9,4 RC,309,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,309,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,309,"Meat fibers, feces ",,,4.15,25.17,4 RC,309,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,309,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,309,"Mercury, quantitative ",,,13.93,86.21,4 RC,309,Metanephrines ,,,14.51,89.84,4 RC,309,Methadone ,,,11.24,127.56,4 RC,309,Methemalbumin ,,,9.2,57.47,4 RC,309,Methotrexate ,,,33.05,204.79,4 RC,309,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,309,Methylphenidate ,,,9.29,127.56,4 RC,309,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,309,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,309,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,309,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,309,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,309,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,309,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,309,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,309,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,309,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,309,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,309,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,309,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,309,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,309,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,309,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,309,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,309,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,309,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,309,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,309,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,309,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,309,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,309,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,309,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,309,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,309,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,309,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,309,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,309,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,309,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,309,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,309,Muramidase ,,,16.07,98.82,4 RC,309,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,309,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,309,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,309,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,309,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,309,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,309,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,309,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,309,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,309,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,309,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,309,Myoglobin ,,,11.07,68.24,4 RC,309,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,309,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,309,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,309,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,309,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,309,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,309,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,309,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,309,Natriuretic peptide ,,,33.64,208.36,4 RC,309,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,309,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,309,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,309,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,309,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,309,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,309,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,309,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,309,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,309,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,309,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,309,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,309,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,309,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,309,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,309,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,309,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,309,Nerve teasing preparations ,,,499.29,643.43,3 RC,309,"Neutralization test, viral ",,,14.48,89.84,4 RC,309,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,309,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,309,Nickel ,,,21.0,129.34,4 RC,309,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,309,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,309,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,309,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,309,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,309,Nucleotidase 5'- ,,,9.56,59.26,4 RC,309,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,309,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,309,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,309,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,309,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,309,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,309,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,309,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,309,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,309,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,309,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,309,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,309,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,309,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,309,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,309,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,309,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,309,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,309,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,309,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,309,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,309,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,309,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,309,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,309,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,309,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,309,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,309,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,309,"Opiates, 1 or more ",,,14.57,127.56,4 RC,309,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,309,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,309,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,309,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,309,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,309,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,309,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,309,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,309,Osmolality; blood ,,,5.66,35.94,4 RC,309,Osmolality; urine ,,,5.84,35.94,4 RC,309,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,309,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,309,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,309,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,309,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,309,Oxalate ,,,12.38,77.23,4 RC,309,Oxcarbazepine ,,,11.35,70.08,4 RC,309,Oxycodone ,,,12.15,127.56,4 RC,309,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,309,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,309,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,309,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,309,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,309,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,309,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,309,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,309,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,309,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,309,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,309,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,309,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,309,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,309,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,309,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,309,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,309,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,309,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,309,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,309,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,309,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,309,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,309,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,309,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,309,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,309,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,309,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,309,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,309,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,309,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,309,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,309,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,309,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,309,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,309,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,309,Phenobarbital ,,,13.11,80.85,4 RC,309,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,309,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,309,Phenytoin; free ,,,11.79,73.66,4 RC,309,Phenytoin; total ,,,11.35,70.08,4 RC,309,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,309,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,309,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,309,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,309,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,309,Phosphatidylglycerol ,,,14.16,88.0,4 RC,309,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,309,Phosphohexose isomerase ,,,9.19,57.47,4 RC,309,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,309,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,309,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,309,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,309,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,309,Pinworm examinations ,,,18.14,23.38,3 RC,309,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,309,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,309,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,309,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,309,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,309,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,309,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,309,Posaconazole ,,,23.23,143.69,4 RC,309,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,309,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,309,Potassium; urine ,,,4.05,25.17,4 RC,309,Prealbumin ,,,12.51,77.23,4 RC,309,Pregabalin ,,,7.07,127.56,4 RC,309,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,309,Pregnanediol ,,,18.23,113.16,4 RC,309,Pregnanetriol ,,,18.03,111.38,4 RC,309,Pregnenolone ,,,17.71,109.59,4 RC,309,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,309,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,309,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,309,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,309,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,309,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,309,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,309,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,309,Primidone ,,,14.22,88.0,4 RC,309,Procainamide; ,,,51.41,317.95,4 RC,309,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,309,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,309,Progesterone ,,,17.87,111.38,4 RC,309,Proinsulin ,,,22.87,141.9,4 RC,309,Prolactin ,,,16.61,102.39,4 RC,309,Propoxyphene ,,,10.72,127.56,4 RC,309,"Prostaglandin, each ",,,35.79,220.97,4 RC,309,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,309,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,309,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,309,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,309,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,309,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,309,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,309,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,309,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,309,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,309,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,309,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,309,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,309,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,309,Prothrombin time; ,,,3.67,23.38,4 RC,309,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,309,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,309,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,309,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,309,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,309,Pyruvate ,,,12.4,77.23,4 RC,309,Pyruvate kinase ,,,8.09,50.28,4 RC,309,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,309,Quinidine ,,,12.51,77.23,4 RC,309,Quinine ,,,9.97,61.1,4 RC,309,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,309,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,309,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,309,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,309,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,309,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,309,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,309,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,309,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,309,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,309,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,309,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,309,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,309,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,309,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,309,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,309,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,309,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,309,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,309,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,309,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,309,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,309,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,309,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,309,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,309,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,309,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,309,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,309,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,309,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,309,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,309,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,309,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,309,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,309,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,309,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,309,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,309,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,309,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,309,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,309,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,309,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,309,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,309,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,309,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,309,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,309,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,309,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,309,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,309,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,309,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,309,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,309,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,309,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,309,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,309,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,309,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,309,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,309,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,309,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,309,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,309,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,309,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,309,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,309,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,309,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,309,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,309,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,309,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,309,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,309,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,309,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,309,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,309,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,309,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,309,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,309,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,309,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,309,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,309,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,309,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,309,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,309,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,309,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,309,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,309,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,309,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,309,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,309,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,309,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,309,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,309,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,309,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,309,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,309,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,309,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,309,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,309,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,309,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,309,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,309,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,309,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,309,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,309,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,309,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,309,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,309,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,309,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,309,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,309,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,309,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,309,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,309,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,309,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,309,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,309,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,309,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,309,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,309,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,309,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,309,Receptor assay; estrogen ,,,75.3,465.26,4 RC,309,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,309,Receptor assay; progesterone ,,,55.59,343.11,4 RC,309,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,309,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,309,Renin ,,,18.84,116.79,4 RC,309,Reptilase test ,,,8.44,52.12,4 RC,309,Reticulated platelet assay ,,,30.62,188.6,4 RC,309,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,309,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,309,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,309,Rufinamide ,,,23.23,143.69,4 RC,309,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,309,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,309,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,309,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,309,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,309,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,309,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,309,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,309,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,309,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,309,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,309,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,309,Salicylate ,,,15.97,98.82,4 RC,309,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,309,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,309,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,309,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,309,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,309,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,309,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,309,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,309,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,309,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,309,Selenium ,,,21.88,134.7,4 RC,309,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,309,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,309,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,309,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,309,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,309,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,309,Serotonin ,,,26.54,163.49,4 RC,309,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,309,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,309,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,309,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,309,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,309,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,309,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,309,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,309,Sialic acid ,,,11.52,71.87,4 RC,309,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,309,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,309,Silica ,,,21.6,132.92,4 RC,309,Sirolimus ,,,11.76,73.66,4 RC,309,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,309,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,309,Skin test; candida ,,,79.46,102.39,3 RC,309,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,309,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,309,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,309,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,309,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,309,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,309,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,309,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,309,Sodium; other source ,,,4.16,25.17,4 RC,309,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,309,Sodium; urine ,,,4.33,26.95,4 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,309,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,309,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,309,Somatomedin ,,,18.22,113.16,4 RC,309,Somatostatin ,,,15.67,96.98,4 RC,309,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,309,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,309,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,309,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,309,Specific gravity (except urine) ,,,2.82,17.97,4 RC,309,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,309,Sperm antibodies ,,,43.21,55.69,3 RC,309,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,309,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,309,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,309,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,309,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,309,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,309,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,309,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,309,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,309,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,309,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,309,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,309,"Stimulants, synthetic ",,,12.05,127.56,4 RC,309,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,309,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,309,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,309,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,309,"Streptokinase, antibody ",,,10.84,66.46,4 RC,309,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,309,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,309,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,309,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,309,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,309,"Sulfate, urine ",,,4.7,28.74,4 RC,309,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,309,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,309,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,309,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,309,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,309,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,309,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,309,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,309,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,309,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,309,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,309,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,309,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,309,T cells; total count ,,,32.32,199.37,4 RC,309,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,309,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,309,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,309,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,309,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,309,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,309,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,309,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,309,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,309,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,309,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,309,Tacrolimus ,,,11.76,73.66,4 RC,309,Tapentadol ,,,10.83,127.56,4 RC,309,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,309,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,309,Testosterone; free ,,,21.82,134.7,4 RC,309,Testosterone; total ,,,22.11,136.54,4 RC,309,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,309,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,309,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,309,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,309,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,309,Theophylline ,,,12.12,75.44,4 RC,309,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,309,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,309,Thiocyanate ,,,9.97,61.1,4 RC,309,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,309,Thrombin time; plasma ,,,4.95,30.52,4 RC,309,Thrombin time; titer ,,,5.87,35.94,4 RC,309,Thrombomodulin ,,,14.8,91.62,4 RC,309,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,309,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,309,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,309,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,309,Thyroglobulin ,,,13.76,84.43,4 RC,309,Thyroglobulin antibody ,,,13.63,84.43,4 RC,309,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,309,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,309,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,309,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,309,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,309,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,309,Thyroxine; free ,,,7.73,48.49,4 RC,309,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,309,Thyroxine; total ,,,5.89,35.94,4 RC,309,Tiagabine ,,,23.23,143.69,4 RC,309,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,309,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,309,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,309,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,309,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,309,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,309,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,309,Tobramycin ,,,13.82,86.21,4 RC,309,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,309,Topiramate ,,,10.21,62.89,4 RC,309,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,309,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,309,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,309,Tramadol ,,,10.54,127.56,4 RC,309,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,309,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,309,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,309,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,309,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,309,Transferrin ,,,10.93,68.24,4 RC,309,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,309,Triglycerides ,,,4.92,30.52,4 RC,309,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,309,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,309,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,309,"Troponin, qualitative ",,,8.65,53.9,4 RC,309,"Troponin, quantitative ",,,10.68,66.46,4 RC,309,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,309,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,309,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,309,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,309,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,309,Tyrosine ,,,9.11,55.69,4 RC,309,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,309,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,309,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,309,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,309,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,309,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,309,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,309,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,309,Unlisted immunology procedure ,,,99.55,128.28,3 RC,309,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,309,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,309,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,309,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,309,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,309,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,309,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,309,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,309,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,309,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,309,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,309,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,309,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,309,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,309,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,309,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,309,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,309,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,309,Uric acid; blood ,,,3.88,23.38,4 RC,309,Uric acid; other source ,,,4.36,26.95,4 RC,309,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,309,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,309,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,309,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,309,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,309,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,309,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,309,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,309,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,309,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,309,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,309,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,309,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,309,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,309,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,309,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,309,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,309,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,309,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,309,Vancomycin ,,,11.6,71.87,4 RC,309,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,309,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,309,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,309,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,309,Vedolizumab ,,,33.05,204.79,4 RC,309,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,309,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,309,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,309,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,309,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,309,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,309,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,309,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,309,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,309,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,309,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,309,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,309,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,309,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,309,Very long chain fatty acids ,,,16.92,104.18,4 RC,309,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,309,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,309,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,309,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,309,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,309,Viscosity ,,,10.0,61.1,4 RC,309,Vitamin A ,,,9.95,61.1,4 RC,309,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,309,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,309,Vitamin K ,,,11.75,71.87,4 RC,309,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,309,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,309,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,309,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,309,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,309,Voriconazole ,,,23.23,143.69,4 RC,309,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,309,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,309,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,309,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,309,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,309,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,309,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,309,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,309,Zinc ,,,9.76,61.1,4 RC,309,Zonisamide ,,,11.35,70.08,4 RC,309,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,309,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,309,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,310, Laboratory Pathology General Classification ,,,,,0 RC,310,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,310,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,310,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,310,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,310,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,310,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,310,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,310,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,310,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,310,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,310,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,310,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,310,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,310,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,310,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,310,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,310,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,Acetaminophen ,,,15.97,98.82,4 RC,310,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,310,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,310,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,310,Acetylcholinesterase ,,,10.53,64.67,4 RC,310,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,310,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,310,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,310,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,310,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,310,Adalimumab ,,,33.05,204.79,4 RC,310,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,310,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,310,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,310,Albumin; ischemia modified ,,,29.08,179.62,4 RC,310,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,310,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,310,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,310,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,310,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,310,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,310,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,310,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,310,Alcohols ,,,9.61,127.56,4 RC,310,Aldolase ,,,8.32,52.12,4 RC,310,Aldosterone ,,,34.91,215.56,4 RC,310,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,310,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,310,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,310,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,310,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,310,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,310,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,310,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,310,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,310,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,310,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,310,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,310,Aluminum ,,,21.83,134.7,4 RC,310,Amikacin ,,,12.92,80.85,4 RC,310,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,310,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,310,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,310,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,310,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,310,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,310,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,310,Amiodarone ,,,15.97,98.82,4 RC,310,Ammonia ,,,12.48,77.23,4 RC,310,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,310,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,310,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,310,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,310,Amylase ,,,5.55,34.15,4 RC,310,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,310,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,310,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,310,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,310,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,310,Androstanediol glucuronide ,,,24.7,152.67,4 RC,310,Androstenedione ,,,25.09,154.51,4 RC,310,Androsterone ,,,21.89,134.7,4 RC,310,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,310,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,310,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,310,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,310,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,310,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,310,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,310,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,310,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,310,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,310,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,310,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,310,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,310,Angiotensin II ,,,17.58,109.59,4 RC,310,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,310,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,310,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,310,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,310,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,310,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,310,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,310,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,310,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,310,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,310,Antibody; Aspergillus ,,,12.89,79.01,4 RC,310,Antibody; Bartonella ,,,8.72,53.9,4 RC,310,Antibody; Blastomyces ,,,11.06,68.24,4 RC,310,Antibody; Bordetella ,,,11.3,70.08,4 RC,310,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,310,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,310,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,310,Antibody; Brucella ,,,7.65,46.7,4 RC,310,Antibody; Campylobacter ,,,11.24,70.08,4 RC,310,Antibody; Candida ,,,10.29,62.89,4 RC,310,Antibody; Chlamydia ,,,10.13,62.89,4 RC,310,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,310,Antibody; Coccidioides ,,,9.82,61.1,4 RC,310,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,310,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,310,Antibody; Diphtheria ,,,13.04,80.85,4 RC,310,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,310,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,310,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,310,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,310,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,310,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,310,Antibody; HIV-1 ,,,7.62,46.7,4 RC,310,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,310,Antibody; HIV-2 ,,,11.59,71.87,4 RC,310,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,310,Antibody; HTLV-I ,,,7.79,48.49,4 RC,310,Antibody; HTLV-II ,,,12.0,73.66,4 RC,310,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,310,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,310,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,310,Antibody; Legionella ,,,13.11,80.85,4 RC,310,Antibody; Leishmania ,,,10.5,64.67,4 RC,310,Antibody; Leptospira ,,,13.88,86.21,4 RC,310,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,310,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,310,Antibody; Nocardia ,,,13.7,84.43,4 RC,310,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,310,Antibody; Rickettsia ,,,16.57,102.39,4 RC,310,Antibody; Salmonella ,,,11.3,70.08,4 RC,310,Antibody; Shigella ,,,20.97,129.34,4 RC,310,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,310,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,310,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,310,Antibody; Trichinella ,,,10.76,66.46,4 RC,310,Antibody; West Nile virus ,,,12.33,75.44,4 RC,310,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,310,Antibody; Yersinia ,,,11.3,70.08,4 RC,310,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,310,Antibody; actinomyces ,,,8.72,53.9,4 RC,310,Antibody; adenovirus ,,,11.03,68.24,4 RC,310,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,310,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,310,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,310,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,310,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,310,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,310,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,310,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,310,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,310,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,310,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,310,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,310,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,310,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,310,Antibody; histoplasma ,,,11.81,73.66,4 RC,310,Antibody; influenza virus ,,,11.61,71.87,4 RC,310,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,310,Antibody; mucormycosis ,,,12.85,79.01,4 RC,310,Antibody; mumps ,,,11.18,70.08,4 RC,310,Antibody; mycoplasma ,,,11.34,70.08,4 RC,310,Antibody; parvovirus ,,,12.88,79.01,4 RC,310,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,310,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,310,Antibody; rotavirus ,,,15.62,96.98,4 RC,310,Antibody; rubella ,,,12.33,75.44,4 RC,310,Antibody; rubeola ,,,11.04,68.24,4 RC,310,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,310,Antibody; tetanus ,,,12.68,79.01,4 RC,310,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,310,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,310,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,310,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,310,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,310,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,310,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,310,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,310,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,310,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,310,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,310,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,310,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,310,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,310,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,310,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,310,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,310,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,310,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,310,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,310,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,310,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,310,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,310,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,310,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,310,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,310,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,310,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,310,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,310,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,310,"Apolipoprotein, each ",,,18.07,111.38,4 RC,310,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,310,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,310,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,310,Arsenic ,,,16.25,100.61,4 RC,310,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,310,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,310,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,310,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,310,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,310,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,310,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,310,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,310,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,310,"B cells, total count ",,,32.32,199.37,4 RC,310,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,310,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,310,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,310,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,310,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,310,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,310,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,310,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,310,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,310,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,310,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,310,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,310,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,310,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,310,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,310,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,310,Barbiturates ,,,9.34,127.56,4 RC,310,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,310,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,310,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,310,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,310,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,310,Beta-2 microglobulin ,,,13.86,86.21,4 RC,310,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,310,Bile acids; total ,,,14.67,91.62,4 RC,310,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,310,Bilirubin; direct ,,,4.3,26.95,4 RC,310,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,310,Bilirubin; total ,,,4.3,26.95,4 RC,310,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,310,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,310,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,310,Bleeding time ,,,4.13,25.17,4 RC,310,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,310,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,310,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,310,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,310,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,310,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,310,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,310,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,310,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,310,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,310,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,310,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,310,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,310,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,310,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,310,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,310,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,310,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,310,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,310,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,310,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,310,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,310,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,310,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,310,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,310,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,310,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,310,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,310,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,310,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,310,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,310,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,310,Bone age studies ,,,61.64,79.3,3 RC,310,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,310,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,310,Bradykinin ,,,4.42,26.95,4 RC,310,Buprenorphine ,,,14.01,14.01,1 RC,310,C-peptide ,,,17.83,109.59,4 RC,310,C-reactive protein; ,,,4.44,26.95,4 RC,310,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,310,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,310,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,310,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,310,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,310,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,310,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,310,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,310,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,310,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,310,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,310,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,310,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,310,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,310,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,310,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,310,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,310,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,310,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,310,Cadmium ,,,20.26,125.72,4 RC,310,Caffeine ,,,33.05,204.79,4 RC,310,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,310,Calcitonin ,,,22.95,141.9,4 RC,310,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,310,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,310,Calcium; ionized ,,,11.72,71.87,4 RC,310,Calcium; total ,,,4.42,26.95,4 RC,310,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,310,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,310,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,310,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,310,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,310,"Calprotectin, fecal ",,,16.82,104.18,4 RC,310,"Cannabinoids, natural ",,,11.5,127.56,4 RC,310,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,310,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,310,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,310,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,310,Carbamazepine; free ,,,11.35,70.08,4 RC,310,Carbamazepine; total ,,,12.48,77.23,4 RC,310,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,310,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,310,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,310,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,310,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,310,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,310,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,310,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,310,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,310,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,310,Carotene ,,,7.89,48.49,4 RC,310,Catecholamines; blood ,,,24.92,154.51,4 RC,310,Catecholamines; fractionated ,,,21.63,134.7,4 RC,310,Catecholamines; total urine ,,,23.39,145.53,4 RC,310,Cathepsin-D ,,,15.47,95.19,4 RC,310,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,310,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,310,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,310,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,310,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,310,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,310,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,310,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,310,Ceruloplasmin ,,,9.2,57.47,4 RC,310,Chemiluminescent assay ,,,12.1,75.44,4 RC,310,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,310,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,310,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,310,Chloramphenicol ,,,10.85,66.46,4 RC,310,Chloride; blood ,,,3.94,25.17,4 RC,310,Chloride; other source ,,,4.28,26.95,4 RC,310,Chloride; urine ,,,4.93,30.52,4 RC,310,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,310,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,310,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,310,Cholinesterase; RBC ,,,8.4,52.12,4 RC,310,Cholinesterase; serum ,,,6.74,41.29,4 RC,310,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,310,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,310,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,310,Chromium ,,,17.38,107.81,4 RC,310,Chromogenic substrate assay ,,,10.19,62.89,4 RC,310,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,310,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,310,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,310,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,310,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,310,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,310,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,310,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,310,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,310,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,310,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,310,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,310,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,310,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,310,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,310,Citrate ,,,23.82,147.31,4 RC,310,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,310,Clot retraction ,,,13.96,86.21,4 RC,310,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,310,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,310,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,310,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,310,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,310,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,310,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,310,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,310,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,310,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,310,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,310,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,310,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,310,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,310,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,310,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,310,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,310,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,310,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,310,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,310,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,310,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,310,Clozapine ,,,17.27,105.96,4 RC,310,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,310,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,310,Coagulation time; activated ,,,3.67,23.38,4 RC,310,Coagulation time; other methods ,,,3.85,23.38,4 RC,310,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,310,Cocaine ,,,10.46,127.56,4 RC,310,Cold agglutinin; screen ,,,6.92,43.13,4 RC,310,Cold agglutinin; titer ,,,6.91,43.13,4 RC,310,"Collagen cross links, any method ",,,16.0,98.82,4 RC,310,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,310,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,310,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,310,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,310,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,310,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,310,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,310,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,310,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,310,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,310,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,310,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,310,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,310,"Complement; antigen, each component ",,,10.28,62.89,4 RC,310,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,310,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,310,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,310,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,310,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,310,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,310,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,310,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,310,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,310,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,310,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,310,Copper ,,,10.63,66.46,4 RC,310,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,310,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,310,Corticosterone ,,,19.3,118.58,4 RC,310,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,310,Cortisol; free ,,,14.32,88.0,4 RC,310,Cortisol; total ,,,13.96,86.21,4 RC,310,Creatine ,,,3.98,25.17,4 RC,310,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,310,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,310,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,310,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,310,Creatinine; blood ,,,4.39,26.95,4 RC,310,Creatinine; clearance ,,,8.11,50.28,4 RC,310,Creatinine; other source ,,,4.44,26.95,4 RC,310,Cryofibrinogen ,,,12.12,75.44,4 RC,310,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,310,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,310,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,310,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,310,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,310,Cryopreservation; sperm ,,,442.57,570.33,3 RC,310,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,310,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,310,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,310,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,310,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,310,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,310,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,310,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,310,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,310,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,310,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,310,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,310,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,310,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,310,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,310,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,310,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,310,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,310,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,310,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,310,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,310,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,310,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,310,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,310,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,310,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,310,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,310,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,310,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,310,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,310,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,310,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,310,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,310,"Culture, typing; other methods ",,,6.63,41.29,4 RC,310,Cyanide ,,,16.63,102.39,4 RC,310,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,310,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,310,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,310,Cyclosporine ,,,15.46,95.19,4 RC,310,Cystatin C ,,,15.87,98.82,4 RC,310,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,310,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,310,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,310,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,310,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,310,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,310,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,310,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,310,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,310,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,310,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,310,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,310,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,310,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,310,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,310,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,310,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,310,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,310,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,310,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,310,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,310,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,310,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,310,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,310,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,310,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,310,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,310,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,310,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,310,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,310,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,310,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,310,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,310,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,310,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,310,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,310,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,310,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,310,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,310,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,310,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,310,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,310,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,702.0,702.0,34.55,44.53,3 RC,310,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,310,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,310,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,310,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,310,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,310,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,310,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,310,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,310,Dibucaine number ,,,10.5,64.67,4 RC,310,Digoxin; free ,,,11.38,70.08,4 RC,310,Digoxin; total ,,,11.38,70.08,4 RC,310,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,310,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,310,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,310,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,310,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,310,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,310,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,310,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,310,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,310,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,310,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,310,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,310,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,310,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,310,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,310,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,310,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,310,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,310,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,310,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,310,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,310,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,310,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,310,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,310,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,310,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,310,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,310,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,310,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,310,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,310,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,310,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,310,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,310,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,310,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,310,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,310,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,310,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,310,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,310,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,310,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,310,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,310,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,310,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,310,Erythropoietin ,,,16.1,98.82,4 RC,310,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,310,Estradiol; total ,,,23.94,147.31,4 RC,310,Estriol ,,,20.72,127.56,4 RC,310,Estrogens; fractionated ,,,27.67,170.64,4 RC,310,Estrogens; total ,,,18.59,114.95,4 RC,310,Estrone ,,,21.38,132.92,4 RC,310,Ethosuximide ,,,14.0,86.21,4 RC,310,Ethylene glycol ,,,12.77,79.01,4 RC,310,Etiocholanolone ,,,22.48,138.33,4 RC,310,Euglobulin lysis ,,,7.2,44.92,4 RC,310,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,310,Everolimus ,,,11.76,73.66,4 RC,310,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,310,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,310,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,310,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,310,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,310,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",2215.57,2215.57,56.28,348.47,4 RC,310,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",2216.0,2216.0,62.86,389.82,4 RC,310,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,310,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,310,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,310,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,310,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,310,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,310,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,310,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,310,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,310,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,310,Factor inhibitor test ,,,11.03,68.24,4 RC,310,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,310,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,310,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,310,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,310,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,310,Felbamate ,,,15.97,98.82,4 RC,310,Fentanyl ,,,13.07,127.56,4 RC,310,Fern test ,,,40.44,52.12,3 RC,310,Ferritin ,,,11.68,71.87,4 RC,310,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,310,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,310,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,310,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,310,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,310,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,310,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,310,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,310,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,310,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,310,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,310,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,310,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,310,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,310,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,310,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,310,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,310,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,310,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,310,Fibrinogen; activity ,,,8.32,52.12,4 RC,310,Fibrinogen; antigen ,,,12.39,77.23,4 RC,310,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,310,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,310,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,310,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,310,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,310,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,310,Flecainide ,,,15.97,98.82,4 RC,310,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,310,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,310,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,310,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,310,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,310,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,310,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,310,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,310,Fluoride ,,,15.88,98.82,4 RC,310,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,310,Folic acid; RBC ,,,15.13,93.41,4 RC,310,Folic acid; serum ,,,12.6,77.23,4 RC,310,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,310,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,310,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,310,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,310,"Fructose, semen ",,,14.86,91.62,4 RC,310,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,310,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,310,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,310,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,310,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,310,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,310,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,310,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,310,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,310,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,310,"Galactokinase, RBC ",,,18.4,113.16,4 RC,310,Galactose ,,,9.6,59.26,4 RC,310,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,310,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,310,Galectin-3 ,,,182.6,235.31,3 RC,310,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,310,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,310,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,310,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,310,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,310,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,310,"Gases, blood, pH only ",,,9.42,57.47,4 RC,310,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,310,Gastrin ,,,15.11,93.41,4 RC,310,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,310,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,310,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,310,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,310,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,310,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,310,Gentamicin ,,,14.04,86.21,4 RC,310,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,310,Glucagon ,,,12.24,75.44,4 RC,310,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,310,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,310,Glucagon tolerance test ,,,15.23,93.41,4 RC,310,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,310,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,310,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,310,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,310,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,310,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,310,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,310,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,310,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,310,"Glucosidase, beta ",,,18.4,113.16,4 RC,310,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,310,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,310,Glutathione ,,,13.24,82.64,4 RC,310,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,310,Glycated protein ,,,14.36,88.0,4 RC,310,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,310,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,310,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,310,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,310,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,310,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,310,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,310,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,310,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,310,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,310,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,310,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,310,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,310,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,310,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,310,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,310,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,310,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,310,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,310,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,310,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,310,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,310,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,310,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,310,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,310,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,310,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,310,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,310,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",154.3,154.3,63.69,393.39,4 RC,310,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,310,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,310,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,310,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,310,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,310,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,310,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,310,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,310,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,310,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,310,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,310,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,310,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,Haloperidol ,,,13.53,84.43,4 RC,310,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,310,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,310,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,310,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,310,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,310,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,310,Heinz bodies; direct ,,,3.6,21.54,4 RC,310,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,310,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,310,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,310,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,310,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,310,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,310,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,310,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,310,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,310,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,310,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,310,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,310,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,310,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,310,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,310,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,310,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,310,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,310,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,310,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,310,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,310,Hemoglobin; plasma ,,,6.26,39.51,4 RC,310,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,310,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,310,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,310,Hemoglobin; urine ,,,3.39,21.54,4 RC,310,"Hemolysin, acid ",,,7.6,46.7,4 RC,310,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,310,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,310,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,310,Heparin assay ,,,11.22,70.08,4 RC,310,Heparin neutralization ,,,10.15,62.89,4 RC,310,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,310,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,310,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,310,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,310,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,310,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,310,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,310,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,310,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,310,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,310,Hepatitis C antibody; ,,,12.23,75.44,4 RC,310,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,310,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,310,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,310,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,310,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,310,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,310,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,310,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,310,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,310,Heroin metabolite ,,,13.63,127.56,4 RC,310,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,310,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,310,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,310,Histamine ,,,25.31,156.3,4 RC,310,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,310,Homocysteine ,,,15.35,95.19,4 RC,310,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,310,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,310,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,310,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,310,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,310,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,310,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,310,Hydroxychloroquine ,,,15.97,98.82,4 RC,310,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,310,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,310,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,310,Hydroxyproline; free ,,,19.41,120.36,4 RC,310,Hydroxyproline; total ,,,20.82,129.34,4 RC,310,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,310,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,310,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,310,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,310,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,310,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,310,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,310,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,310,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,310,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,310,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,310,Immune complex assay ,,,20.88,129.34,4 RC,310,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,310,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,310,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,310,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,310,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,310,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,310,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,310,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,310,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,310,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,310,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,310,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,310,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,310,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,310,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,310,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,310,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,310,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,310,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,310,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,310,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,310,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,310,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",1005.0,1005.0,243.95,314.38,3 RC,310,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",4335.0,4335.0,543.37,700.23,3 RC,310,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",4109.0,4109.0,274.35,353.55,3 RC,310,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,310,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,310,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",2385.69,2385.69,575.15,741.19,3 RC,310,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,310,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,310,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,310,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,310,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,310,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,310,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,310,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,310,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,310,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,310,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,310,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,310,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,310,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,310,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,310,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,310,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,310,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,310,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,310,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,310,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,310,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,310,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,310,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,310,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,310,Infliximab ,,,33.05,204.79,4 RC,310,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,310,Inhibin A ,,,13.36,82.64,4 RC,310,Insemination of oocytes ,,,442.57,570.33,3 RC,310,Insulin antibodies ,,,18.34,113.16,4 RC,310,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,310,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,310,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,310,Insulin; free ,,,11.1,68.24,4 RC,310,Insulin; total ,,,9.79,61.1,4 RC,310,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,310,Intrinsic factor ,,,16.98,104.18,4 RC,310,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,310,Iron ,,,5.54,34.15,4 RC,310,Iron binding capacity ,,,7.49,46.7,4 RC,310,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,310,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,310,Islet cell antibody ,,,20.2,125.72,4 RC,310,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,310,Itraconazole ,,,23.23,143.69,4 RC,310,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",1747.0,1747.0,78.53,485.01,4 RC,310,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,310,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,310,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,310,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,310,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,310,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",2484.6,2484.6,165.58,1023.93,4 RC,310,Ketamine and norketamine ,,,10.54,127.56,4 RC,310,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,310,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,310,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,310,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,310,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,310,Lacosamide ,,,23.23,143.69,4 RC,310,Lactate (lactic acid) ,,,9.91,61.1,4 RC,310,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,310,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,310,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,310,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,310,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,310,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,310,Lamotrigine ,,,11.35,70.08,4 RC,310,Lead ,,,10.37,64.67,4 RC,310,Leflunomide ,,,33.05,204.79,4 RC,310,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,310,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,310,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,310,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,310,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,310,Leukocyte transfusion ,,,305.26,393.39,3 RC,310,"Level I - Surgical pathology, gross examination only ",597.0,597.0,48.5,62.5,3 RC,310,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",1452.0,1452.0,108.47,139.78,3 RC,310,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",1452.0,1452.0,130.77,168.52,3 RC,310,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",1853.0,1853.0,144.71,186.48,3 RC,310,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",2555.0,2555.0,870.11,1121.3,3 RC,310,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",2751.0,2751.0,1229.72,1584.72,3 RC,310,Levetiracetam ,,,11.35,70.08,4 RC,310,Lidocaine ,,,12.59,77.23,4 RC,310,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,310,Lipase ,,,5.91,35.94,4 RC,310,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,310,Lipoprotein (a) ,,,12.27,75.44,4 RC,310,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,310,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,310,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,310,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,310,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,310,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,310,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,310,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,310,Lithium ,,,5.66,35.94,4 RC,310,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,310,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,310,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,310,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,310,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,310,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,310,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,310,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,310,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,310,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,310,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,310,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,310,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,310,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,310,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,310,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,310,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,310,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,310,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,310,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,310,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,310,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,310,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,310,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,310,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,310,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,310,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,310,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,310,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,310,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,310,Magnesium ,,,5.74,35.94,4 RC,310,Malate dehydrogenase ,,,6.31,39.51,4 RC,310,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,310,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,310,Manganese ,,,22.84,141.9,4 RC,310,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,310,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,310,"Meat fibers, feces ",,,4.15,25.17,4 RC,310,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,310,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,310,"Mercury, quantitative ",,,13.93,86.21,4 RC,310,Metanephrines ,,,14.51,89.84,4 RC,310,Methadone ,,,11.24,127.56,4 RC,310,Methemalbumin ,,,9.2,57.47,4 RC,310,Methotrexate ,,,33.05,204.79,4 RC,310,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,310,Methylphenidate ,,,9.29,127.56,4 RC,310,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,310,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,310,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,310,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,310,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,310,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,310,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,310,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,310,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,310,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,310,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,310,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,310,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,310,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,310,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,310,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,310,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,310,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,310,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,310,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,310,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,310,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,310,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,310,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,310,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,310,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,310,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,310,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,310,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,310,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,310,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,310,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,310,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,310,Muramidase ,,,16.07,98.82,4 RC,310,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,310,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,310,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,310,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,310,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,310,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,310,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,310,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,310,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,310,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,310,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,310,Myoglobin ,,,11.07,68.24,4 RC,310,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,310,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,310,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,310,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,310,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,310,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,310,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,310,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,310,Natriuretic peptide ,,,33.64,208.36,4 RC,310,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,310,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,310,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,310,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,310,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,310,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,310,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,310,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,310,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,310,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,310,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,310,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,310,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,310,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,310,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,310,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,310,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,310,Nerve teasing preparations ,,,499.29,643.43,3 RC,310,"Neutralization test, viral ",,,14.48,89.84,4 RC,310,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,310,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,310,Nickel ,,,21.0,129.34,4 RC,310,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,310,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,310,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,310,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,310,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,310,Nucleotidase 5'- ,,,9.56,59.26,4 RC,310,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,310,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,310,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,310,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,310,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,310,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,310,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,310,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,310,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,310,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,310,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,310,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,310,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,310,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,310,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,310,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,310,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,310,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,310,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,310,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,310,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,310,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,310,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,310,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,310,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,310,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,310,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,310,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,310,"Opiates, 1 or more ",,,14.57,127.56,4 RC,310,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,310,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,310,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,310,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,310,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,310,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,310,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,310,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,310,Osmolality; blood ,,,5.66,35.94,4 RC,310,Osmolality; urine ,,,5.84,35.94,4 RC,310,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,310,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,310,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,310,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,310,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,310,Oxalate ,,,12.38,77.23,4 RC,310,Oxcarbazepine ,,,11.35,70.08,4 RC,310,Oxycodone ,,,12.15,127.56,4 RC,310,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,310,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,310,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,310,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,310,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,310,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,310,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,310,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,310,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,310,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,310,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,310,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,310,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,310,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,310,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,310,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,310,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,310,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,310,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,310,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,310,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,310,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,310,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,310,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,310,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,310,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,310,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",1883.0,1883.0,80.84,104.18,3 RC,310,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",3242.0,3242.0,133.54,172.09,3 RC,310,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,675.0,675.0,102.88,132.58,3 RC,310,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",2246.0,2246.0,171.16,220.58,3 RC,310,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,310,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,310,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,310,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,310,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,310,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,310,Phenobarbital ,,,13.11,80.85,4 RC,310,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,310,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,310,Phenytoin; free ,,,11.79,73.66,4 RC,310,Phenytoin; total ,,,11.35,70.08,4 RC,310,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,310,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,310,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,310,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,310,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,310,Phosphatidylglycerol ,,,14.16,88.0,4 RC,310,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,310,Phosphohexose isomerase ,,,9.19,57.47,4 RC,310,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,310,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,310,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,310,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,310,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,310,Pinworm examinations ,,,18.14,23.38,3 RC,310,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,310,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,310,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,310,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,310,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,310,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,310,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,310,Posaconazole ,,,23.23,143.69,4 RC,310,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,310,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,310,Potassium; urine ,,,4.05,25.17,4 RC,310,Prealbumin ,,,12.51,77.23,4 RC,310,Pregabalin ,,,7.07,127.56,4 RC,310,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,310,Pregnanediol ,,,18.23,113.16,4 RC,310,Pregnanetriol ,,,18.03,111.38,4 RC,310,Pregnenolone ,,,17.71,109.59,4 RC,310,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,310,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,310,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,310,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,310,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,310,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,310,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,310,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,310,Primidone ,,,14.22,88.0,4 RC,310,Procainamide; ,,,51.41,317.95,4 RC,310,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,310,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,310,Progesterone ,,,17.87,111.38,4 RC,310,Proinsulin ,,,22.87,141.9,4 RC,310,Prolactin ,,,16.61,102.39,4 RC,310,Propoxyphene ,,,10.72,127.56,4 RC,310,"Prostaglandin, each ",,,35.79,220.97,4 RC,310,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,310,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,310,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,310,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,310,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,310,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,310,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,310,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,310,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,310,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,310,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,310,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,310,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,310,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,310,Prothrombin time; ,,,3.67,23.38,4 RC,310,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,310,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,310,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,310,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,310,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,310,Pyruvate ,,,12.4,77.23,4 RC,310,Pyruvate kinase ,,,8.09,50.28,4 RC,310,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,310,Quinidine ,,,12.51,77.23,4 RC,310,Quinine ,,,9.97,61.1,4 RC,310,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,310,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,310,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,310,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,310,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,310,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,310,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,310,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,310,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,310,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,310,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,310,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,310,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,310,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,310,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,310,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,310,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,310,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,310,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,310,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,310,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,310,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,310,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,310,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,310,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,310,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,310,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,310,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,310,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,310,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,310,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,310,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,310,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,310,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,310,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,310,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,310,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,310,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,310,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,310,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,310,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,310,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,310,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,310,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,310,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,310,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,310,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,310,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,310,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,310,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,310,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,310,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,310,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,310,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,310,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,310,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,310,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,310,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,310,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,310,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,310,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,310,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,310,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,310,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,310,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,310,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,310,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,310,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,310,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,310,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,310,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,310,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,310,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,310,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,310,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,310,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,310,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,310,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,310,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,310,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,310,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,310,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,310,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,310,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,310,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,310,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,310,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,310,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,310,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,310,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,310,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,310,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,310,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,310,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,310,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,310,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,310,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,310,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,310,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,310,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,310,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,310,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,310,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,310,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,310,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,310,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,310,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,310,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,310,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,310,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,310,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,310,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,310,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,310,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,310,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,310,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,310,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,310,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,310,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,310,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,310,Receptor assay; estrogen ,,,75.3,465.26,4 RC,310,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,310,Receptor assay; progesterone ,,,55.59,343.11,4 RC,310,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,310,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,310,Renin ,,,18.84,116.79,4 RC,310,Reptilase test ,,,8.44,52.12,4 RC,310,Reticulated platelet assay ,,,30.62,188.6,4 RC,310,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,310,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,310,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,310,Rufinamide ,,,23.23,143.69,4 RC,310,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,310,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,310,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,310,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,310,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,310,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,310,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,310,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,310,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,310,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,310,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,310,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,310,Salicylate ,,,15.97,98.82,4 RC,310,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,310,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,310,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,310,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,310,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,310,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,310,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,310,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,310,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,310,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,310,Selenium ,,,21.88,134.7,4 RC,310,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,310,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,310,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,310,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,310,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,310,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,310,Serotonin ,,,26.54,163.49,4 RC,310,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,310,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,310,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,310,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,310,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,310,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,310,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,310,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,310,Sialic acid ,,,11.52,71.87,4 RC,310,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,310,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,310,Silica ,,,21.6,132.92,4 RC,310,Sirolimus ,,,11.76,73.66,4 RC,310,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,310,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,310,Skin test; candida ,,,79.46,102.39,3 RC,310,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,310,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,310,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,310,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,310,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,310,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,310,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,310,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,310,Sodium; other source ,,,4.16,25.17,4 RC,310,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,310,Sodium; urine ,,,4.33,26.95,4 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,310,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,310,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,310,Somatomedin ,,,18.22,113.16,4 RC,310,Somatostatin ,,,15.67,96.98,4 RC,310,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",895.0,895.0,359.35,463.08,3 RC,310,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",1112.0,1112.0,291.06,375.09,3 RC,310,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,310,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,310,Specific gravity (except urine) ,,,2.82,17.97,4 RC,310,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,310,Sperm antibodies ,,,43.21,55.69,3 RC,310,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,310,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,310,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,310,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,310,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,310,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,310,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,310,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,310,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,310,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,310,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,310,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,310,"Stimulants, synthetic ",,,12.05,127.56,4 RC,310,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,310,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,310,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,310,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,310,"Streptokinase, antibody ",,,10.84,66.46,4 RC,310,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,310,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,310,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,310,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,310,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,310,"Sulfate, urine ",,,4.7,28.74,4 RC,310,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,310,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,310,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,310,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,310,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,310,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,310,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,310,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,310,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,310,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,310,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,310,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,310,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,310,T cells; total count ,,,32.32,199.37,4 RC,310,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,310,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,310,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,310,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,310,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,310,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,310,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,310,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,310,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,310,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,310,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,310,Tacrolimus ,,,11.76,73.66,4 RC,310,Tapentadol ,,,10.83,127.56,4 RC,310,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,310,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,310,Testosterone; free ,,,21.82,134.7,4 RC,310,Testosterone; total ,,,22.11,136.54,4 RC,310,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,310,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,310,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,310,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,310,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,310,Theophylline ,,,12.12,75.44,4 RC,310,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,310,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,310,Thiocyanate ,,,9.97,61.1,4 RC,310,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,310,Thrombin time; plasma ,,,4.95,30.52,4 RC,310,Thrombin time; titer ,,,5.87,35.94,4 RC,310,Thrombomodulin ,,,14.8,91.62,4 RC,310,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,310,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,310,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,310,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,310,Thyroglobulin ,,,13.76,84.43,4 RC,310,Thyroglobulin antibody ,,,13.63,84.43,4 RC,310,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,310,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,310,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,310,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,310,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,310,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,310,Thyroxine; free ,,,7.73,48.49,4 RC,310,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,310,Thyroxine; total ,,,5.89,35.94,4 RC,310,Tiagabine ,,,23.23,143.69,4 RC,310,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,310,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,310,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,310,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,310,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,310,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,310,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,310,Tobramycin ,,,13.82,86.21,4 RC,310,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,310,Topiramate ,,,10.21,62.89,4 RC,310,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,310,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,310,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,310,Tramadol ,,,10.54,127.56,4 RC,310,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,310,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,310,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,310,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,310,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,310,Transferrin ,,,10.93,68.24,4 RC,310,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,310,Triglycerides ,,,4.92,30.52,4 RC,310,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,310,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,310,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,310,"Troponin, qualitative ",,,8.65,53.9,4 RC,310,"Troponin, quantitative ",,,10.68,66.46,4 RC,310,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,310,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,310,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,310,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,310,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,310,Tyrosine ,,,9.11,55.69,4 RC,310,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,310,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,310,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,310,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,310,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,310,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,310,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,310,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,310,Unlisted immunology procedure ,,,99.55,128.28,3 RC,310,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,310,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,310,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,310,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,310,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,310,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,310,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,310,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,310,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,310,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,310,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,310,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,310,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,310,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,310,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,310,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,310,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,310,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,310,Uric acid; blood ,,,3.88,23.38,4 RC,310,Uric acid; other source ,,,4.36,26.95,4 RC,310,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,310,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,310,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,310,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,310,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,310,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,310,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,310,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,310,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,310,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,310,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,310,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,310,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,310,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,310,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,310,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,310,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,310,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,310,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,310,Vancomycin ,,,11.6,71.87,4 RC,310,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,310,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,310,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,310,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,310,Vedolizumab ,,,33.05,204.79,4 RC,310,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,310,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,310,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,310,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,310,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,310,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,310,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,310,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,310,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,310,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,310,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,310,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,310,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,310,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,310,Very long chain fatty acids ,,,16.92,104.18,4 RC,310,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,310,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,310,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,310,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,310,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,310,Viscosity ,,,10.0,61.1,4 RC,310,Vitamin A ,,,9.95,61.1,4 RC,310,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,310,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,310,Vitamin K ,,,11.75,71.87,4 RC,310,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,310,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,310,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,310,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,310,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,310,Voriconazole ,,,23.23,143.69,4 RC,310,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,310,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,310,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,310,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,310,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,310,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,310,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,310,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,310,Zinc ,,,9.76,61.1,4 RC,310,Zonisamide ,,,11.35,70.08,4 RC,310,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,310,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,310,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,311, Laboratory Pathology Cytology ,,,,,0 RC,311,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,311,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,311,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,311,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,311,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,311,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,311,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,311,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,311,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,311,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,311,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,311,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,311,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,311,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,311,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,311,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,311,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,Acetaminophen ,,,15.97,98.82,4 RC,311,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,311,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,311,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,311,Acetylcholinesterase ,,,10.53,64.67,4 RC,311,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,311,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,311,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,311,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,311,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,311,Adalimumab ,,,33.05,204.79,4 RC,311,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,311,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,311,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,311,Albumin; ischemia modified ,,,29.08,179.62,4 RC,311,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,311,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,311,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,311,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,311,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,311,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,311,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,311,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,311,Alcohols ,,,9.61,127.56,4 RC,311,Aldolase ,,,8.32,52.12,4 RC,311,Aldosterone ,,,34.91,215.56,4 RC,311,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,311,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,311,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,311,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,311,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,311,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,311,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,311,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,311,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,311,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,311,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,311,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,311,Aluminum ,,,21.83,134.7,4 RC,311,Amikacin ,,,12.92,80.85,4 RC,311,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,311,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,311,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,311,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,311,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,311,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,311,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,311,Amiodarone ,,,15.97,98.82,4 RC,311,Ammonia ,,,12.48,77.23,4 RC,311,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,311,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,311,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,311,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,311,Amylase ,,,5.55,34.15,4 RC,311,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,311,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,311,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,311,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,311,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,311,Androstanediol glucuronide ,,,24.7,152.67,4 RC,311,Androstenedione ,,,25.09,154.51,4 RC,311,Androsterone ,,,21.89,134.7,4 RC,311,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,311,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,311,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,311,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,311,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,311,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,311,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,311,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,311,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,311,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,311,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,311,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,311,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,311,Angiotensin II ,,,17.58,109.59,4 RC,311,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,311,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,311,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,311,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,311,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,311,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,311,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,311,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,311,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,311,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,311,Antibody; Aspergillus ,,,12.89,79.01,4 RC,311,Antibody; Bartonella ,,,8.72,53.9,4 RC,311,Antibody; Blastomyces ,,,11.06,68.24,4 RC,311,Antibody; Bordetella ,,,11.3,70.08,4 RC,311,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,311,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,311,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,311,Antibody; Brucella ,,,7.65,46.7,4 RC,311,Antibody; Campylobacter ,,,11.24,70.08,4 RC,311,Antibody; Candida ,,,10.29,62.89,4 RC,311,Antibody; Chlamydia ,,,10.13,62.89,4 RC,311,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,311,Antibody; Coccidioides ,,,9.82,61.1,4 RC,311,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,311,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,311,Antibody; Diphtheria ,,,13.04,80.85,4 RC,311,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,311,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,311,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,311,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,311,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,311,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,311,Antibody; HIV-1 ,,,7.62,46.7,4 RC,311,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,311,Antibody; HIV-2 ,,,11.59,71.87,4 RC,311,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,311,Antibody; HTLV-I ,,,7.79,48.49,4 RC,311,Antibody; HTLV-II ,,,12.0,73.66,4 RC,311,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,311,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,311,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,311,Antibody; Legionella ,,,13.11,80.85,4 RC,311,Antibody; Leishmania ,,,10.5,64.67,4 RC,311,Antibody; Leptospira ,,,13.88,86.21,4 RC,311,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,311,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,311,Antibody; Nocardia ,,,13.7,84.43,4 RC,311,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,311,Antibody; Rickettsia ,,,16.57,102.39,4 RC,311,Antibody; Salmonella ,,,11.3,70.08,4 RC,311,Antibody; Shigella ,,,20.97,129.34,4 RC,311,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,311,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,311,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,311,Antibody; Trichinella ,,,10.76,66.46,4 RC,311,Antibody; West Nile virus ,,,12.33,75.44,4 RC,311,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,311,Antibody; Yersinia ,,,11.3,70.08,4 RC,311,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,311,Antibody; actinomyces ,,,8.72,53.9,4 RC,311,Antibody; adenovirus ,,,11.03,68.24,4 RC,311,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,311,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,311,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,311,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,311,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,311,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,311,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,311,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,311,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,311,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,311,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,311,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,311,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,311,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,311,Antibody; histoplasma ,,,11.81,73.66,4 RC,311,Antibody; influenza virus ,,,11.61,71.87,4 RC,311,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,311,Antibody; mucormycosis ,,,12.85,79.01,4 RC,311,Antibody; mumps ,,,11.18,70.08,4 RC,311,Antibody; mycoplasma ,,,11.34,70.08,4 RC,311,Antibody; parvovirus ,,,12.88,79.01,4 RC,311,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,311,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,311,Antibody; rotavirus ,,,15.62,96.98,4 RC,311,Antibody; rubella ,,,12.33,75.44,4 RC,311,Antibody; rubeola ,,,11.04,68.24,4 RC,311,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,311,Antibody; tetanus ,,,12.68,79.01,4 RC,311,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,311,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,311,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,311,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,311,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,311,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,311,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,311,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,311,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,311,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,311,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,311,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,311,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,311,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,311,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,311,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,311,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,311,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,311,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,311,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,311,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,311,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,311,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,311,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,311,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,311,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,311,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,311,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,311,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,311,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,311,"Apolipoprotein, each ",,,18.07,111.38,4 RC,311,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,311,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,311,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,311,Arsenic ,,,16.25,100.61,4 RC,311,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,311,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,311,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,311,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,311,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,311,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,311,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,311,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,311,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,311,"B cells, total count ",,,32.32,199.37,4 RC,311,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,311,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,311,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,311,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,311,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,311,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,311,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,311,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,311,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,311,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,311,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,311,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,311,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,311,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,311,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,311,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,311,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,311,Barbiturates ,,,9.34,127.56,4 RC,311,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,311,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,311,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,311,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,311,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,311,Beta-2 microglobulin ,,,13.86,86.21,4 RC,311,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,311,Bile acids; total ,,,14.67,91.62,4 RC,311,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,311,Bilirubin; direct ,,,4.3,26.95,4 RC,311,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,311,Bilirubin; total ,,,4.3,26.95,4 RC,311,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,311,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,311,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,311,Bleeding time ,,,4.13,25.17,4 RC,311,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,311,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,311,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,311,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,311,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,311,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,311,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,311,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,311,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,311,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,311,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,311,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,311,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,311,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,311,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,311,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,311,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,311,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,311,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,311,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,311,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,311,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,311,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,311,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,311,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,311,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,311,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,311,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,311,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,311,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,311,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,311,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,311,Bone age studies ,,,61.64,79.3,3 RC,311,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,311,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,311,Bradykinin ,,,4.42,26.95,4 RC,311,Buprenorphine ,,,14.01,14.01,1 RC,311,C-peptide ,,,17.83,109.59,4 RC,311,C-reactive protein; ,,,4.44,26.95,4 RC,311,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,311,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,311,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,311,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,311,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,311,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,311,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,311,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,311,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,311,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,311,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,311,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,311,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,311,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,311,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,311,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,311,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,311,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,311,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,311,Cadmium ,,,20.26,125.72,4 RC,311,Caffeine ,,,33.05,204.79,4 RC,311,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,311,Calcitonin ,,,22.95,141.9,4 RC,311,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,311,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,311,Calcium; ionized ,,,11.72,71.87,4 RC,311,Calcium; total ,,,4.42,26.95,4 RC,311,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,311,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,311,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,311,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,311,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,311,"Calprotectin, fecal ",,,16.82,104.18,4 RC,311,"Cannabinoids, natural ",,,11.5,127.56,4 RC,311,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,311,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,311,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,311,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,311,Carbamazepine; free ,,,11.35,70.08,4 RC,311,Carbamazepine; total ,,,12.48,77.23,4 RC,311,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,311,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,311,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,311,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,311,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,311,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,311,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,311,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,311,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,311,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,311,Carotene ,,,7.89,48.49,4 RC,311,Catecholamines; blood ,,,24.92,154.51,4 RC,311,Catecholamines; fractionated ,,,21.63,134.7,4 RC,311,Catecholamines; total urine ,,,23.39,145.53,4 RC,311,Cathepsin-D ,,,15.47,95.19,4 RC,311,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,311,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,311,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,311,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,311,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,311,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,311,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,311,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,311,Ceruloplasmin ,,,9.2,57.47,4 RC,311,Chemiluminescent assay ,,,12.1,75.44,4 RC,311,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,311,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,311,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,311,Chloramphenicol ,,,10.85,66.46,4 RC,311,Chloride; blood ,,,3.94,25.17,4 RC,311,Chloride; other source ,,,4.28,26.95,4 RC,311,Chloride; urine ,,,4.93,30.52,4 RC,311,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,311,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,311,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,311,Cholinesterase; RBC ,,,8.4,52.12,4 RC,311,Cholinesterase; serum ,,,6.74,41.29,4 RC,311,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,311,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,311,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,311,Chromium ,,,17.38,107.81,4 RC,311,Chromogenic substrate assay ,,,10.19,62.89,4 RC,311,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,311,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,311,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,311,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,311,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,311,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,311,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,311,"Chromosome analysis; additional karyotypes, each study ",1528.47,1528.47,28.67,177.83,4 RC,311,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,311,Chromosome analysis; analyze 20-25 cells ,1192.19,1192.19,123.9,767.03,4 RC,311,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",9625.86,9625.86,107.52,664.63,4 RC,311,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,311,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,311,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,311,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,311,Citrate ,,,23.82,147.31,4 RC,311,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,311,Clot retraction ,,,13.96,86.21,4 RC,311,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,311,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,311,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,311,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,311,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,311,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,311,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,311,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,311,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,311,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,311,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,311,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,311,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,311,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,311,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,311,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,311,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,311,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,311,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,311,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,311,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,311,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,311,Clozapine ,,,17.27,105.96,4 RC,311,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,311,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,311,Coagulation time; activated ,,,3.67,23.38,4 RC,311,Coagulation time; other methods ,,,3.85,23.38,4 RC,311,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,311,Cocaine ,,,10.46,127.56,4 RC,311,Cold agglutinin; screen ,,,6.92,43.13,4 RC,311,Cold agglutinin; titer ,,,6.91,43.13,4 RC,311,"Collagen cross links, any method ",,,16.0,98.82,4 RC,311,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,311,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,311,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,311,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,311,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,311,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,311,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,311,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,311,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,311,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,311,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,311,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,311,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,311,"Complement; antigen, each component ",,,10.28,62.89,4 RC,311,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,311,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,311,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,311,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,311,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,311,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,311,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,311,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,311,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,311,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,311,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,311,Copper ,,,10.63,66.46,4 RC,311,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,311,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,311,Corticosterone ,,,19.3,118.58,4 RC,311,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,311,Cortisol; free ,,,14.32,88.0,4 RC,311,Cortisol; total ,,,13.96,86.21,4 RC,311,Creatine ,,,3.98,25.17,4 RC,311,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,311,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,311,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,311,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,311,Creatinine; blood ,,,4.39,26.95,4 RC,311,Creatinine; clearance ,,,8.11,50.28,4 RC,311,Creatinine; other source ,,,4.44,26.95,4 RC,311,Cryofibrinogen ,,,12.12,75.44,4 RC,311,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,311,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,311,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,311,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,311,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,311,Cryopreservation; sperm ,,,442.57,570.33,3 RC,311,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,311,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,311,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,311,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,311,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,311,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,311,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,311,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,311,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,311,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,311,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,311,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,311,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,311,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,311,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,311,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,311,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,311,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,311,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,311,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,311,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,311,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,311,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,311,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,311,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,311,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,311,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,311,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,311,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,311,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,311,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,311,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,311,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,311,"Culture, typing; other methods ",,,6.63,41.29,4 RC,311,Cyanide ,,,16.63,102.39,4 RC,311,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,311,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,311,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,311,Cyclosporine ,,,15.46,95.19,4 RC,311,Cystatin C ,,,15.87,98.82,4 RC,311,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,311,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,311,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,311,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,311,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,311,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,311,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,311,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,311,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,311,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,311,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,311,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,311,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,311,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,311,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",226.0,226.0,183.72,236.76,3 RC,311,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,311,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",808.0,808.0,86.12,110.99,3 RC,311,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",1039.0,1039.0,386.41,497.96,3 RC,311,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,311,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",1039.0,1039.0,176.49,227.44,3 RC,311,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,311,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,311,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,311,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,311,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,311,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,311,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,311,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,311,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,311,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,311,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,311,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,311,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,311,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,311,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,311,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,311,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,311,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,311,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,311,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,311,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,311,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,311,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,311,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,311,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,311,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,311,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,311,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,311,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,311,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,311,Dibucaine number ,,,10.5,64.67,4 RC,311,Digoxin; free ,,,11.38,70.08,4 RC,311,Digoxin; total ,,,11.38,70.08,4 RC,311,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,311,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,311,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,311,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,311,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,311,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,311,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,311,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,311,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,311,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,311,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,311,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,311,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,311,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,311,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,311,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,311,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,311,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,311,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,311,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,311,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,311,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,311,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,311,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,311,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,311,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,311,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,311,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,311,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,311,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,311,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,311,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,311,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,311,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,311,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,311,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,311,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,311,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,311,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,311,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,311,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,311,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,311,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,311,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,311,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,311,Erythropoietin ,,,16.1,98.82,4 RC,311,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,311,Estradiol; total ,,,23.94,147.31,4 RC,311,Estriol ,,,20.72,127.56,4 RC,311,Estrogens; fractionated ,,,27.67,170.64,4 RC,311,Estrogens; total ,,,18.59,114.95,4 RC,311,Estrone ,,,21.38,132.92,4 RC,311,Ethosuximide ,,,14.0,86.21,4 RC,311,Ethylene glycol ,,,12.77,79.01,4 RC,311,Etiocholanolone ,,,22.48,138.33,4 RC,311,Euglobulin lysis ,,,7.2,44.92,4 RC,311,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,311,Everolimus ,,,11.76,73.66,4 RC,311,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,311,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,311,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,311,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,311,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,311,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,311,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,311,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,311,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,311,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,311,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,311,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,311,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,311,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,311,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,311,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,311,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,311,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,311,Factor inhibitor test ,,,11.03,68.24,4 RC,311,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,311,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,311,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,311,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,311,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,311,Felbamate ,,,15.97,98.82,4 RC,311,Fentanyl ,,,13.07,127.56,4 RC,311,Fern test ,,,40.44,52.12,3 RC,311,Ferritin ,,,11.68,71.87,4 RC,311,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,311,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,311,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,311,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,311,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,311,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,311,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,311,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,311,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,311,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,311,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,311,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,311,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,311,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,311,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,311,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,311,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,311,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,311,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,311,Fibrinogen; activity ,,,8.32,52.12,4 RC,311,Fibrinogen; antigen ,,,12.39,77.23,4 RC,311,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,311,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,311,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,311,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,311,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,311,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,311,Flecainide ,,,15.97,98.82,4 RC,311,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,311,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",109.46,109.46,98.98,127.56,3 RC,311,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",799.19,799.19,308.9,398.08,3 RC,311,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,311,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,311,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,311,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,311,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,311,Fluoride ,,,15.88,98.82,4 RC,311,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,311,Folic acid; RBC ,,,15.13,93.41,4 RC,311,Folic acid; serum ,,,12.6,77.23,4 RC,311,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,311,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,311,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,311,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,311,"Fructose, semen ",,,14.86,91.62,4 RC,311,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,311,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,311,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,311,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,311,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,311,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,311,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,311,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,311,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,311,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,311,"Galactokinase, RBC ",,,18.4,113.16,4 RC,311,Galactose ,,,9.6,59.26,4 RC,311,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,311,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,311,Galectin-3 ,,,182.6,235.31,3 RC,311,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,311,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,311,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,311,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,311,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,311,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,311,"Gases, blood, pH only ",,,9.42,57.47,4 RC,311,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,311,Gastrin ,,,15.11,93.41,4 RC,311,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,311,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,311,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,311,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,311,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,311,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,311,Gentamicin ,,,14.04,86.21,4 RC,311,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,311,Glucagon ,,,12.24,75.44,4 RC,311,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,311,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,311,Glucagon tolerance test ,,,15.23,93.41,4 RC,311,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,311,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,311,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,311,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,311,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,311,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,311,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,311,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,311,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,311,"Glucosidase, beta ",,,18.4,113.16,4 RC,311,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,311,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,311,Glutathione ,,,13.24,82.64,4 RC,311,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,311,Glycated protein ,,,14.36,88.0,4 RC,311,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,311,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,311,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,311,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,311,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,311,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,311,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,311,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,311,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,311,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,311,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,311,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,311,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,311,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,311,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,311,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,311,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,311,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,311,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,311,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,311,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,311,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,311,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,311,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,311,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,311,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,311,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,311,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,311,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,311,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,311,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,311,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,311,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,311,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,311,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,311,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,311,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,311,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,311,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,311,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,311,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,311,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,Haloperidol ,,,13.53,84.43,4 RC,311,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,311,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,311,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,311,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,311,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,311,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,311,Heinz bodies; direct ,,,3.6,21.54,4 RC,311,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,311,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,311,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,311,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,311,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,311,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,311,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,311,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,311,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,311,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,311,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,311,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,311,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,311,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,311,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,311,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,311,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,311,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,311,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,311,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,311,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,311,Hemoglobin; plasma ,,,6.26,39.51,4 RC,311,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,311,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,311,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,311,Hemoglobin; urine ,,,3.39,21.54,4 RC,311,"Hemolysin, acid ",,,7.6,46.7,4 RC,311,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,311,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,311,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,311,Heparin assay ,,,11.22,70.08,4 RC,311,Heparin neutralization ,,,10.15,62.89,4 RC,311,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,311,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,311,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,311,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,311,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,311,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,311,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,311,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,311,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,311,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,311,Hepatitis C antibody; ,,,12.23,75.44,4 RC,311,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,311,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,311,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,311,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,311,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,311,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,311,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,311,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,311,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,311,Heroin metabolite ,,,13.63,127.56,4 RC,311,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,311,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,311,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,311,Histamine ,,,25.31,156.3,4 RC,311,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,311,Homocysteine ,,,15.35,95.19,4 RC,311,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,311,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,311,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,311,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,311,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,311,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,311,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,311,Hydroxychloroquine ,,,15.97,98.82,4 RC,311,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,311,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,311,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,311,Hydroxyproline; free ,,,19.41,120.36,4 RC,311,Hydroxyproline; total ,,,20.82,129.34,4 RC,311,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,311,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,311,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,311,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,311,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,311,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,311,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,311,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,311,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,311,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,311,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,311,Immune complex assay ,,,20.88,129.34,4 RC,311,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,311,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,311,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,311,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,311,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,311,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,311,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,311,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,311,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,311,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,311,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,311,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,311,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,311,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,311,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,311,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,311,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,311,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,311,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,311,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,311,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,311,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,311,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,311,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,311,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,311,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,311,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,311,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,311,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,311,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,311,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,311,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,311,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,311,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,311,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,311,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,311,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,311,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,311,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,311,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,311,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,311,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,311,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,311,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,311,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,311,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,311,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,311,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,311,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,311,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,311,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,311,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,311,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,311,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,311,Infliximab ,,,33.05,204.79,4 RC,311,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,311,Inhibin A ,,,13.36,82.64,4 RC,311,Insemination of oocytes ,,,442.57,570.33,3 RC,311,Insulin antibodies ,,,18.34,113.16,4 RC,311,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,311,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,311,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,311,Insulin; free ,,,11.1,68.24,4 RC,311,Insulin; total ,,,9.79,61.1,4 RC,311,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,311,Intrinsic factor ,,,16.98,104.18,4 RC,311,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,311,Iron ,,,5.54,34.15,4 RC,311,Iron binding capacity ,,,7.49,46.7,4 RC,311,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,311,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,311,Islet cell antibody ,,,20.2,125.72,4 RC,311,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,311,Itraconazole ,,,23.23,143.69,4 RC,311,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,311,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,311,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,311,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,311,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,311,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,311,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,311,Ketamine and norketamine ,,,10.54,127.56,4 RC,311,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,311,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,311,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,311,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,311,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,311,Lacosamide ,,,23.23,143.69,4 RC,311,Lactate (lactic acid) ,,,9.91,61.1,4 RC,311,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,311,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,311,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,311,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,311,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,311,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,311,Lamotrigine ,,,11.35,70.08,4 RC,311,Lead ,,,10.37,64.67,4 RC,311,Leflunomide ,,,33.05,204.79,4 RC,311,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,311,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,311,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,311,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,311,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,311,Leukocyte transfusion ,,,305.26,393.39,3 RC,311,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,311,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,311,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,311,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,311,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,311,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,311,Levetiracetam ,,,11.35,70.08,4 RC,311,Lidocaine ,,,12.59,77.23,4 RC,311,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,311,Lipase ,,,5.91,35.94,4 RC,311,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,311,Lipoprotein (a) ,,,12.27,75.44,4 RC,311,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,311,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,311,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,311,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,311,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,311,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,311,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,311,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,311,Lithium ,,,5.66,35.94,4 RC,311,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,311,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,311,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,311,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,311,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,311,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,311,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,311,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,311,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,311,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,311,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,311,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,311,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,311,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,311,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,311,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,311,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,311,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,311,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,311,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,311,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,311,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,311,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,311,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,311,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,311,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,311,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,311,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,311,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,311,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,311,Magnesium ,,,5.74,35.94,4 RC,311,Malate dehydrogenase ,,,6.31,39.51,4 RC,311,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,311,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,311,Manganese ,,,22.84,141.9,4 RC,311,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,311,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,311,"Meat fibers, feces ",,,4.15,25.17,4 RC,311,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,311,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,311,"Mercury, quantitative ",,,13.93,86.21,4 RC,311,Metanephrines ,,,14.51,89.84,4 RC,311,Methadone ,,,11.24,127.56,4 RC,311,Methemalbumin ,,,9.2,57.47,4 RC,311,Methotrexate ,,,33.05,204.79,4 RC,311,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,311,Methylphenidate ,,,9.29,127.56,4 RC,311,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,311,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,311,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,311,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,311,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,311,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,311,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,311,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,311,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,311,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,311,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,311,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,311,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,311,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,311,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,311,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,311,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,311,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,311,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,311,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,311,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,311,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,311,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,311,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,311,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,311,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,311,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,311,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,311,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,311,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,311,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,311,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,311,Muramidase ,,,16.07,98.82,4 RC,311,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,311,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,311,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,311,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,311,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,311,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,311,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,311,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,311,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,311,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,311,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,311,Myoglobin ,,,11.07,68.24,4 RC,311,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,311,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,311,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,311,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,311,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,311,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,311,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,311,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,311,Natriuretic peptide ,,,33.64,208.36,4 RC,311,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,311,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,311,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,311,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,311,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,311,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,311,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,311,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,311,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,311,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,311,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,311,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,311,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,311,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,311,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,311,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,311,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,311,Nerve teasing preparations ,,,499.29,643.43,3 RC,311,"Neutralization test, viral ",,,14.48,89.84,4 RC,311,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,311,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,311,Nickel ,,,21.0,129.34,4 RC,311,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,311,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,311,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,311,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,311,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,311,Nucleotidase 5'- ,,,9.56,59.26,4 RC,311,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,311,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,311,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,311,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,311,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,311,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,311,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,311,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,311,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,311,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,311,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,311,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,311,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,311,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,311,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,311,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,311,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,311,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,311,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,311,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,311,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,311,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,311,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,311,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,311,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,311,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,311,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,311,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,311,"Opiates, 1 or more ",,,14.57,127.56,4 RC,311,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,311,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,311,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,311,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,311,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,311,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,311,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,311,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,311,Osmolality; blood ,,,5.66,35.94,4 RC,311,Osmolality; urine ,,,5.84,35.94,4 RC,311,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,311,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,311,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,311,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,311,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,311,Oxalate ,,,12.38,77.23,4 RC,311,Oxcarbazepine ,,,11.35,70.08,4 RC,311,Oxycodone ,,,12.15,127.56,4 RC,311,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,311,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,311,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,311,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,311,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,311,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,311,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,311,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,311,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,311,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,311,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,311,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,311,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,311,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,311,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,311,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,311,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,311,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,311,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,311,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,311,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,311,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,311,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,311,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,311,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,311,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,311,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,311,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,311,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,311,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,311,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,311,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,311,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,311,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,311,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,311,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,311,Phenobarbital ,,,13.11,80.85,4 RC,311,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,311,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,311,Phenytoin; free ,,,11.79,73.66,4 RC,311,Phenytoin; total ,,,11.35,70.08,4 RC,311,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,311,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,311,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,311,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,311,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,311,Phosphatidylglycerol ,,,14.16,88.0,4 RC,311,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,311,Phosphohexose isomerase ,,,9.19,57.47,4 RC,311,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,311,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,311,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,311,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,311,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,311,Pinworm examinations ,,,18.14,23.38,3 RC,311,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,311,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,311,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,311,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,311,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,311,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,311,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,311,Posaconazole ,,,23.23,143.69,4 RC,311,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,311,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,311,Potassium; urine ,,,4.05,25.17,4 RC,311,Prealbumin ,,,12.51,77.23,4 RC,311,Pregabalin ,,,7.07,127.56,4 RC,311,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,311,Pregnanediol ,,,18.23,113.16,4 RC,311,Pregnanetriol ,,,18.03,111.38,4 RC,311,Pregnenolone ,,,17.71,109.59,4 RC,311,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,311,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,311,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,311,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,311,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,311,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,311,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,311,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,311,Primidone ,,,14.22,88.0,4 RC,311,Procainamide; ,,,51.41,317.95,4 RC,311,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,311,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,311,Progesterone ,,,17.87,111.38,4 RC,311,Proinsulin ,,,22.87,141.9,4 RC,311,Prolactin ,,,16.61,102.39,4 RC,311,Propoxyphene ,,,10.72,127.56,4 RC,311,"Prostaglandin, each ",,,35.79,220.97,4 RC,311,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,311,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,311,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,311,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,311,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,311,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,311,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,311,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,311,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,311,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,311,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,311,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,311,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,311,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,311,Prothrombin time; ,,,3.67,23.38,4 RC,311,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,311,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,311,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,311,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,311,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,311,Pyruvate ,,,12.4,77.23,4 RC,311,Pyruvate kinase ,,,8.09,50.28,4 RC,311,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,311,Quinidine ,,,12.51,77.23,4 RC,311,Quinine ,,,9.97,61.1,4 RC,311,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,311,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,311,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,311,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,311,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,311,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,311,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,311,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,311,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,311,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,311,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,311,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,311,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,311,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,311,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,311,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,311,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,311,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,311,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,311,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,311,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,311,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,311,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,311,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,311,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,311,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,311,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,311,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,311,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,311,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,311,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,311,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,311,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,311,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,311,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,311,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,311,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,311,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,311,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,311,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,311,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,311,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,311,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,311,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,311,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,311,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,311,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,311,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,311,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,311,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,311,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,311,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,311,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,311,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,311,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,311,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,311,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,311,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,311,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,311,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,311,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,311,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,311,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,311,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,311,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,311,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,311,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,311,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,311,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,311,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,311,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,311,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,311,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,311,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,311,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,311,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,311,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,311,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,311,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,311,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,311,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,311,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,311,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,311,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,311,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,311,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,311,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,311,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,311,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,311,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,311,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,311,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,311,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,311,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,311,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,311,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,311,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,311,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,311,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,311,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,311,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,311,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,311,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,311,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,311,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,311,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,311,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,311,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,311,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,311,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,311,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,311,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,311,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,311,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,311,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,311,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,311,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,311,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,311,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,311,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,311,Receptor assay; estrogen ,,,75.3,465.26,4 RC,311,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,311,Receptor assay; progesterone ,,,55.59,343.11,4 RC,311,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,311,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,311,Renin ,,,18.84,116.79,4 RC,311,Reptilase test ,,,8.44,52.12,4 RC,311,Reticulated platelet assay ,,,30.62,188.6,4 RC,311,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,311,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,311,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,311,Rufinamide ,,,23.23,143.69,4 RC,311,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,311,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,311,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,311,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,311,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,311,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,311,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,311,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,311,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,311,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,311,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,311,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,311,Salicylate ,,,15.97,98.82,4 RC,311,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,311,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,311,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,311,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,311,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,311,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,311,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,311,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,311,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,311,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,311,Selenium ,,,21.88,134.7,4 RC,311,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,311,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,311,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,311,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,311,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,311,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,311,Serotonin ,,,26.54,163.49,4 RC,311,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,311,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,311,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,311,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,311,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,311,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,311,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,311,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,311,Sialic acid ,,,11.52,71.87,4 RC,311,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,311,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,311,Silica ,,,21.6,132.92,4 RC,311,Sirolimus ,,,11.76,73.66,4 RC,311,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,311,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,311,Skin test; candida ,,,79.46,102.39,3 RC,311,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,311,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,311,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,311,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,311,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,311,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,311,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,311,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,311,Sodium; other source ,,,4.16,25.17,4 RC,311,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,311,Sodium; urine ,,,4.33,26.95,4 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,311,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,311,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,311,Somatomedin ,,,18.22,113.16,4 RC,311,Somatostatin ,,,15.67,96.98,4 RC,311,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,311,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,311,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,311,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,311,Specific gravity (except urine) ,,,2.82,17.97,4 RC,311,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,311,Sperm antibodies ,,,43.21,55.69,3 RC,311,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,311,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,311,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,311,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,311,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,311,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,311,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,311,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,311,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,311,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,311,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,311,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,311,"Stimulants, synthetic ",,,12.05,127.56,4 RC,311,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,311,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,311,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,311,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,311,"Streptokinase, antibody ",,,10.84,66.46,4 RC,311,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,311,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,311,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,311,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,311,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,311,"Sulfate, urine ",,,4.7,28.74,4 RC,311,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,311,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,311,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,311,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,311,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,311,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,311,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,311,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,311,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,311,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,311,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,311,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,311,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,311,T cells; total count ,,,32.32,199.37,4 RC,311,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,311,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,311,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,311,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,311,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,311,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,311,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,311,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,311,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,311,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,311,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,311,Tacrolimus ,,,11.76,73.66,4 RC,311,Tapentadol ,,,10.83,127.56,4 RC,311,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,311,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,311,Testosterone; free ,,,21.82,134.7,4 RC,311,Testosterone; total ,,,22.11,136.54,4 RC,311,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,311,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,311,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,311,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,311,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,311,Theophylline ,,,12.12,75.44,4 RC,311,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,311,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,311,Thiocyanate ,,,9.97,61.1,4 RC,311,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,311,Thrombin time; plasma ,,,4.95,30.52,4 RC,311,Thrombin time; titer ,,,5.87,35.94,4 RC,311,Thrombomodulin ,,,14.8,91.62,4 RC,311,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,311,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,311,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,311,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,311,Thyroglobulin ,,,13.76,84.43,4 RC,311,Thyroglobulin antibody ,,,13.63,84.43,4 RC,311,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,311,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,311,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,311,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,311,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,311,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,311,Thyroxine; free ,,,7.73,48.49,4 RC,311,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,311,Thyroxine; total ,,,5.89,35.94,4 RC,311,Tiagabine ,,,23.23,143.69,4 RC,311,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",5892.35,5892.35,123.17,761.67,4 RC,311,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,311,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,311,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,311,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,311,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,311,Tobramycin ,,,13.82,86.21,4 RC,311,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,311,Topiramate ,,,10.21,62.89,4 RC,311,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,311,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,311,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,311,Tramadol ,,,10.54,127.56,4 RC,311,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,311,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,311,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,311,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,311,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,311,Transferrin ,,,10.93,68.24,4 RC,311,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,311,Triglycerides ,,,4.92,30.52,4 RC,311,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,311,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,311,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,311,"Troponin, qualitative ",,,8.65,53.9,4 RC,311,"Troponin, quantitative ",,,10.68,66.46,4 RC,311,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,311,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,311,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,311,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,311,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,311,Tyrosine ,,,9.11,55.69,4 RC,311,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,311,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,311,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,311,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,311,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,311,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,311,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,311,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,311,Unlisted immunology procedure ,,,99.55,128.28,3 RC,311,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,311,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,311,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,311,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,311,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,311,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,311,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,311,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,311,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,311,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,311,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,311,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,311,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,311,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,311,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,311,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,311,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,311,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,311,Uric acid; blood ,,,3.88,23.38,4 RC,311,Uric acid; other source ,,,4.36,26.95,4 RC,311,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,311,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,311,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,311,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,311,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,311,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,311,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,311,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,311,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,311,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,311,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,311,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,311,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,311,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,311,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,311,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,311,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,311,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,311,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,311,Vancomycin ,,,11.6,71.87,4 RC,311,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,311,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,311,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,311,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,311,Vedolizumab ,,,33.05,204.79,4 RC,311,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,311,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,311,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,311,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,311,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,311,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,311,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,311,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,311,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,311,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,311,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,311,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,311,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,311,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,311,Very long chain fatty acids ,,,16.92,104.18,4 RC,311,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,311,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,311,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,311,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,311,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,311,Viscosity ,,,10.0,61.1,4 RC,311,Vitamin A ,,,9.95,61.1,4 RC,311,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,311,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,311,Vitamin K ,,,11.75,71.87,4 RC,311,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,311,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,311,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,311,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,311,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,311,Voriconazole ,,,23.23,143.69,4 RC,311,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,311,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,311,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,311,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,311,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,311,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,311,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,311,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,311,Zinc ,,,9.76,61.1,4 RC,311,Zonisamide ,,,11.35,70.08,4 RC,311,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,311,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,311,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,312, Laboratory Pathology Histology ,,,,,0 RC,312,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,312,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,312,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,312,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,312,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,312,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,312,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,312,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,312,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,312,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,312,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,312,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,312,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,312,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,312,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,312,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,312,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,Acetaminophen ,,,15.97,98.82,4 RC,312,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,312,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,312,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,312,Acetylcholinesterase ,,,10.53,64.67,4 RC,312,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,312,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,312,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,312,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,312,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,312,Adalimumab ,,,33.05,204.79,4 RC,312,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,312,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,312,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,312,Albumin; ischemia modified ,,,29.08,179.62,4 RC,312,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,312,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,312,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,312,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,312,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,312,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,312,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,312,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,312,Alcohols ,,,9.61,127.56,4 RC,312,Aldolase ,,,8.32,52.12,4 RC,312,Aldosterone ,,,34.91,215.56,4 RC,312,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,312,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,312,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,312,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,312,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,312,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,312,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,312,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,312,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,312,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,312,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,312,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,312,Aluminum ,,,21.83,134.7,4 RC,312,Amikacin ,,,12.92,80.85,4 RC,312,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,312,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,312,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,312,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,312,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,312,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,312,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,312,Amiodarone ,,,15.97,98.82,4 RC,312,Ammonia ,,,12.48,77.23,4 RC,312,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,312,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,312,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,312,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,312,Amylase ,,,5.55,34.15,4 RC,312,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,312,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,312,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,312,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,312,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,312,Androstanediol glucuronide ,,,24.7,152.67,4 RC,312,Androstenedione ,,,25.09,154.51,4 RC,312,Androsterone ,,,21.89,134.7,4 RC,312,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,312,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,312,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,312,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,312,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,312,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,312,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,312,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,312,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,312,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,312,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,312,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,312,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,312,Angiotensin II ,,,17.58,109.59,4 RC,312,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,312,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,312,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,312,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,312,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,312,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,312,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,312,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,312,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,312,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,312,Antibody; Aspergillus ,,,12.89,79.01,4 RC,312,Antibody; Bartonella ,,,8.72,53.9,4 RC,312,Antibody; Blastomyces ,,,11.06,68.24,4 RC,312,Antibody; Bordetella ,,,11.3,70.08,4 RC,312,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,312,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,312,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,312,Antibody; Brucella ,,,7.65,46.7,4 RC,312,Antibody; Campylobacter ,,,11.24,70.08,4 RC,312,Antibody; Candida ,,,10.29,62.89,4 RC,312,Antibody; Chlamydia ,,,10.13,62.89,4 RC,312,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,312,Antibody; Coccidioides ,,,9.82,61.1,4 RC,312,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,312,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,312,Antibody; Diphtheria ,,,13.04,80.85,4 RC,312,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,312,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,312,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,312,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,312,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,312,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,312,Antibody; HIV-1 ,,,7.62,46.7,4 RC,312,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,312,Antibody; HIV-2 ,,,11.59,71.87,4 RC,312,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,312,Antibody; HTLV-I ,,,7.79,48.49,4 RC,312,Antibody; HTLV-II ,,,12.0,73.66,4 RC,312,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,312,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,312,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,312,Antibody; Legionella ,,,13.11,80.85,4 RC,312,Antibody; Leishmania ,,,10.5,64.67,4 RC,312,Antibody; Leptospira ,,,13.88,86.21,4 RC,312,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,312,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,312,Antibody; Nocardia ,,,13.7,84.43,4 RC,312,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,312,Antibody; Rickettsia ,,,16.57,102.39,4 RC,312,Antibody; Salmonella ,,,11.3,70.08,4 RC,312,Antibody; Shigella ,,,20.97,129.34,4 RC,312,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,312,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,312,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,312,Antibody; Trichinella ,,,10.76,66.46,4 RC,312,Antibody; West Nile virus ,,,12.33,75.44,4 RC,312,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,312,Antibody; Yersinia ,,,11.3,70.08,4 RC,312,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,312,Antibody; actinomyces ,,,8.72,53.9,4 RC,312,Antibody; adenovirus ,,,11.03,68.24,4 RC,312,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,312,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,312,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,312,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,312,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,312,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,312,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,312,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,312,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,312,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,312,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,312,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,312,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,312,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,312,Antibody; histoplasma ,,,11.81,73.66,4 RC,312,Antibody; influenza virus ,,,11.61,71.87,4 RC,312,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,312,Antibody; mucormycosis ,,,12.85,79.01,4 RC,312,Antibody; mumps ,,,11.18,70.08,4 RC,312,Antibody; mycoplasma ,,,11.34,70.08,4 RC,312,Antibody; parvovirus ,,,12.88,79.01,4 RC,312,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,312,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,312,Antibody; rotavirus ,,,15.62,96.98,4 RC,312,Antibody; rubella ,,,12.33,75.44,4 RC,312,Antibody; rubeola ,,,11.04,68.24,4 RC,312,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,312,Antibody; tetanus ,,,12.68,79.01,4 RC,312,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,312,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,312,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,312,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,312,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,312,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,312,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,312,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,312,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,312,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,312,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,312,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,312,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,312,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,312,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,312,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,312,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,312,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,312,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,312,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,312,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,312,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,312,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,312,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,312,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,312,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,312,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,312,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,312,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,312,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,312,"Apolipoprotein, each ",,,18.07,111.38,4 RC,312,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,312,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,312,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,312,Arsenic ,,,16.25,100.61,4 RC,312,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,312,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,312,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,312,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,312,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,312,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,312,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,312,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,312,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,312,"B cells, total count ",,,32.32,199.37,4 RC,312,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,312,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,312,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,312,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,312,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,312,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,312,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,312,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,312,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,312,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,312,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,312,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,312,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,312,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,312,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,312,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,312,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,312,Barbiturates ,,,9.34,127.56,4 RC,312,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,312,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,312,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,312,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,312,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,312,Beta-2 microglobulin ,,,13.86,86.21,4 RC,312,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,312,Bile acids; total ,,,14.67,91.62,4 RC,312,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,312,Bilirubin; direct ,,,4.3,26.95,4 RC,312,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,312,Bilirubin; total ,,,4.3,26.95,4 RC,312,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,312,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,312,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,312,Bleeding time ,,,4.13,25.17,4 RC,312,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,312,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,312,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,312,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,312,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,312,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,312,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,312,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,312,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,312,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,312,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,312,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,312,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,312,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,312,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,312,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,312,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,312,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,312,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,312,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,312,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,312,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,312,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,312,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,312,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,312,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,312,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,312,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,312,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,312,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,312,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,312,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,312,Bone age studies ,,,61.64,79.3,3 RC,312,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,312,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,312,Bradykinin ,,,4.42,26.95,4 RC,312,Buprenorphine ,,,14.01,14.01,1 RC,312,C-peptide ,,,17.83,109.59,4 RC,312,C-reactive protein; ,,,4.44,26.95,4 RC,312,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,312,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,312,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,312,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,312,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,312,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,312,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,312,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,312,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,312,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,312,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,312,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,312,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,312,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,312,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,312,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,312,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,312,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,312,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,312,Cadmium ,,,20.26,125.72,4 RC,312,Caffeine ,,,33.05,204.79,4 RC,312,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,312,Calcitonin ,,,22.95,141.9,4 RC,312,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,312,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,312,Calcium; ionized ,,,11.72,71.87,4 RC,312,Calcium; total ,,,4.42,26.95,4 RC,312,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,312,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,312,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,312,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,312,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,312,"Calprotectin, fecal ",,,16.82,104.18,4 RC,312,"Cannabinoids, natural ",,,11.5,127.56,4 RC,312,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,312,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,312,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,312,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,312,Carbamazepine; free ,,,11.35,70.08,4 RC,312,Carbamazepine; total ,,,12.48,77.23,4 RC,312,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,312,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,312,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,312,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,312,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,312,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,312,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,312,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,312,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,312,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,312,Carotene ,,,7.89,48.49,4 RC,312,Catecholamines; blood ,,,24.92,154.51,4 RC,312,Catecholamines; fractionated ,,,21.63,134.7,4 RC,312,Catecholamines; total urine ,,,23.39,145.53,4 RC,312,Cathepsin-D ,,,15.47,95.19,4 RC,312,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,312,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,312,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,312,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,312,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,312,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,312,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,312,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,312,Ceruloplasmin ,,,9.2,57.47,4 RC,312,Chemiluminescent assay ,,,12.1,75.44,4 RC,312,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,312,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,312,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,312,Chloramphenicol ,,,10.85,66.46,4 RC,312,Chloride; blood ,,,3.94,25.17,4 RC,312,Chloride; other source ,,,4.28,26.95,4 RC,312,Chloride; urine ,,,4.93,30.52,4 RC,312,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,312,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,312,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,312,Cholinesterase; RBC ,,,8.4,52.12,4 RC,312,Cholinesterase; serum ,,,6.74,41.29,4 RC,312,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,312,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,312,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,312,Chromium ,,,17.38,107.81,4 RC,312,Chromogenic substrate assay ,,,10.19,62.89,4 RC,312,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,312,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,312,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,312,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,312,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,312,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,312,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,312,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,312,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,312,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,312,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,312,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,312,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,312,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,312,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,312,Citrate ,,,23.82,147.31,4 RC,312,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,312,Clot retraction ,,,13.96,86.21,4 RC,312,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,312,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,312,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,312,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,312,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,312,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,312,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,312,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,312,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,312,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,312,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,312,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,312,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,312,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,312,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,312,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,312,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,312,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,312,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,312,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,312,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,312,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,312,Clozapine ,,,17.27,105.96,4 RC,312,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,312,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,312,Coagulation time; activated ,,,3.67,23.38,4 RC,312,Coagulation time; other methods ,,,3.85,23.38,4 RC,312,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,312,Cocaine ,,,10.46,127.56,4 RC,312,Cold agglutinin; screen ,,,6.92,43.13,4 RC,312,Cold agglutinin; titer ,,,6.91,43.13,4 RC,312,"Collagen cross links, any method ",,,16.0,98.82,4 RC,312,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,312,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,312,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,312,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,312,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,312,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,312,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,312,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,312,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,312,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,312,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,312,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,312,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,312,"Complement; antigen, each component ",,,10.28,62.89,4 RC,312,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,312,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,312,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,312,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,312,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,312,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,312,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,312,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,312,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,312,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,312,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,312,Copper ,,,10.63,66.46,4 RC,312,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,312,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,312,Corticosterone ,,,19.3,118.58,4 RC,312,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,312,Cortisol; free ,,,14.32,88.0,4 RC,312,Cortisol; total ,,,13.96,86.21,4 RC,312,Creatine ,,,3.98,25.17,4 RC,312,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,312,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,312,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,312,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,312,Creatinine; blood ,,,4.39,26.95,4 RC,312,Creatinine; clearance ,,,8.11,50.28,4 RC,312,Creatinine; other source ,,,4.44,26.95,4 RC,312,Cryofibrinogen ,,,12.12,75.44,4 RC,312,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,312,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,312,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,312,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,312,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,312,Cryopreservation; sperm ,,,442.57,570.33,3 RC,312,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,312,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,312,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,312,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,312,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,312,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,312,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,312,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,312,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,312,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,312,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,312,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,312,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,312,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,312,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,312,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,312,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,312,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,312,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,312,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,312,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,312,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,312,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,312,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,312,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,312,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,312,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,312,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,312,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,312,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,312,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,312,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,312,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,312,"Culture, typing; other methods ",,,6.63,41.29,4 RC,312,Cyanide ,,,16.63,102.39,4 RC,312,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,312,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,312,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,312,Cyclosporine ,,,15.46,95.19,4 RC,312,Cystatin C ,,,15.87,98.82,4 RC,312,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,312,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,312,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,312,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,312,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,312,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,312,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,312,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,312,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,312,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,312,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,312,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,312,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,312,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,312,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,312,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,312,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,312,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,312,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,312,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,312,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,312,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,312,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,312,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,312,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,312,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,312,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,312,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,312,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,312,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,312,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,312,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,312,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,312,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,312,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,312,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,312,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,312,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,312,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,312,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,312,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,312,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,312,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,312,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,312,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,312,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,312,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,312,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,312,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,312,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,312,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,312,Dibucaine number ,,,10.5,64.67,4 RC,312,Digoxin; free ,,,11.38,70.08,4 RC,312,Digoxin; total ,,,11.38,70.08,4 RC,312,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,312,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,312,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,312,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,312,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,312,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,312,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,312,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,312,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,312,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,312,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,312,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,312,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,312,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,312,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,312,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,312,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,312,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,312,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,312,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,312,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,312,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,312,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,312,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,312,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,312,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,312,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,312,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,312,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,312,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,312,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,312,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,312,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,312,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,312,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,312,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,312,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,312,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,312,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,312,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,312,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,312,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,312,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,312,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,312,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,312,Erythropoietin ,,,16.1,98.82,4 RC,312,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,312,Estradiol; total ,,,23.94,147.31,4 RC,312,Estriol ,,,20.72,127.56,4 RC,312,Estrogens; fractionated ,,,27.67,170.64,4 RC,312,Estrogens; total ,,,18.59,114.95,4 RC,312,Estrone ,,,21.38,132.92,4 RC,312,Ethosuximide ,,,14.0,86.21,4 RC,312,Ethylene glycol ,,,12.77,79.01,4 RC,312,Etiocholanolone ,,,22.48,138.33,4 RC,312,Euglobulin lysis ,,,7.2,44.92,4 RC,312,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,312,Everolimus ,,,11.76,73.66,4 RC,312,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,312,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,312,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,312,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,312,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,312,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,312,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,312,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,312,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,312,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,312,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,312,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,312,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,312,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,312,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,312,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,312,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,312,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,312,Factor inhibitor test ,,,11.03,68.24,4 RC,312,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,312,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,312,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,312,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,312,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,312,Felbamate ,,,15.97,98.82,4 RC,312,Fentanyl ,,,13.07,127.56,4 RC,312,Fern test ,,,40.44,52.12,3 RC,312,Ferritin ,,,11.68,71.87,4 RC,312,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,312,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,312,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,312,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,312,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,312,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,312,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,312,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,312,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,312,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,312,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,312,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,312,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,312,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,312,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,312,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,312,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,312,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,312,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,312,Fibrinogen; activity ,,,8.32,52.12,4 RC,312,Fibrinogen; antigen ,,,12.39,77.23,4 RC,312,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,312,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,312,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,312,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,312,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,312,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,312,Flecainide ,,,15.97,98.82,4 RC,312,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,312,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,312,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,312,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,312,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,312,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,312,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,312,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,312,Fluoride ,,,15.88,98.82,4 RC,312,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,312,Folic acid; RBC ,,,15.13,93.41,4 RC,312,Folic acid; serum ,,,12.6,77.23,4 RC,312,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,312,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,312,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,312,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,312,"Fructose, semen ",,,14.86,91.62,4 RC,312,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,312,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,312,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,312,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,312,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,312,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,312,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,312,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,312,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,312,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,312,"Galactokinase, RBC ",,,18.4,113.16,4 RC,312,Galactose ,,,9.6,59.26,4 RC,312,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,312,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,312,Galectin-3 ,,,182.6,235.31,3 RC,312,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,312,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,312,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,312,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,312,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,312,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,312,"Gases, blood, pH only ",,,9.42,57.47,4 RC,312,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,312,Gastrin ,,,15.11,93.41,4 RC,312,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,312,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,312,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,312,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,312,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,312,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,312,Gentamicin ,,,14.04,86.21,4 RC,312,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,312,Glucagon ,,,12.24,75.44,4 RC,312,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,312,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,312,Glucagon tolerance test ,,,15.23,93.41,4 RC,312,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,312,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,312,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,312,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,312,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,312,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,312,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,312,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,312,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,312,"Glucosidase, beta ",,,18.4,113.16,4 RC,312,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,312,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,312,Glutathione ,,,13.24,82.64,4 RC,312,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,312,Glycated protein ,,,14.36,88.0,4 RC,312,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,312,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,312,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,312,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,312,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,312,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,312,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,312,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,312,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,312,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,312,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,312,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,312,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,312,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,312,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,312,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,312,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,312,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,312,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,312,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,312,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,312,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,312,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,312,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,312,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,312,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,312,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,312,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,312,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,312,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,312,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,312,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,312,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,312,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,312,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,312,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,312,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,312,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,312,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,312,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,312,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,312,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,Haloperidol ,,,13.53,84.43,4 RC,312,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,312,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,312,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,312,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,312,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,312,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,312,Heinz bodies; direct ,,,3.6,21.54,4 RC,312,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,312,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,312,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,312,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,312,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,312,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,312,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,312,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,312,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,312,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,312,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,312,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,312,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,312,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,312,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,312,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,312,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,312,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,312,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,312,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,312,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,312,Hemoglobin; plasma ,,,6.26,39.51,4 RC,312,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,312,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,312,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,312,Hemoglobin; urine ,,,3.39,21.54,4 RC,312,"Hemolysin, acid ",,,7.6,46.7,4 RC,312,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,312,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,312,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,312,Heparin assay ,,,11.22,70.08,4 RC,312,Heparin neutralization ,,,10.15,62.89,4 RC,312,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,312,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,312,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,312,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,312,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,312,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,312,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,312,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,312,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,312,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,312,Hepatitis C antibody; ,,,12.23,75.44,4 RC,312,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,312,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,312,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,312,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,312,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,312,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,312,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,312,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,312,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,312,Heroin metabolite ,,,13.63,127.56,4 RC,312,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,312,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,312,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,312,Histamine ,,,25.31,156.3,4 RC,312,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,312,Homocysteine ,,,15.35,95.19,4 RC,312,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,312,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,312,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,312,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,312,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,312,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,312,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,312,Hydroxychloroquine ,,,15.97,98.82,4 RC,312,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,312,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,312,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,312,Hydroxyproline; free ,,,19.41,120.36,4 RC,312,Hydroxyproline; total ,,,20.82,129.34,4 RC,312,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,312,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,312,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,312,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,312,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,312,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,312,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,312,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,312,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,312,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,312,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,312,Immune complex assay ,,,20.88,129.34,4 RC,312,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,312,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,312,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,312,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,312,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,312,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,312,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,312,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,312,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,312,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,312,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,312,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,312,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,312,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,312,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,312,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,312,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,312,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,312,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,312,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,312,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,312,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,312,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,312,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,312,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,312,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,312,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,312,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,312,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,312,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,312,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,312,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,312,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,312,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,312,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,312,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,312,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,312,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,312,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,312,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,312,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,312,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,312,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,312,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,312,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,312,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,312,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,312,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,312,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,312,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,312,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,312,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,312,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,312,Infliximab ,,,33.05,204.79,4 RC,312,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,312,Inhibin A ,,,13.36,82.64,4 RC,312,Insemination of oocytes ,,,442.57,570.33,3 RC,312,Insulin antibodies ,,,18.34,113.16,4 RC,312,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,312,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,312,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,312,Insulin; free ,,,11.1,68.24,4 RC,312,Insulin; total ,,,9.79,61.1,4 RC,312,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,312,Intrinsic factor ,,,16.98,104.18,4 RC,312,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,312,Iron ,,,5.54,34.15,4 RC,312,Iron binding capacity ,,,7.49,46.7,4 RC,312,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,312,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,312,Islet cell antibody ,,,20.2,125.72,4 RC,312,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,312,Itraconazole ,,,23.23,143.69,4 RC,312,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,312,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,312,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,312,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,312,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,312,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,312,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,312,Ketamine and norketamine ,,,10.54,127.56,4 RC,312,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,312,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,312,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,312,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,312,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,312,Lacosamide ,,,23.23,143.69,4 RC,312,Lactate (lactic acid) ,,,9.91,61.1,4 RC,312,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,312,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,312,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,312,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,312,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,312,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,312,Lamotrigine ,,,11.35,70.08,4 RC,312,Lead ,,,10.37,64.67,4 RC,312,Leflunomide ,,,33.05,204.79,4 RC,312,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,312,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,312,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,312,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,312,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,312,Leukocyte transfusion ,,,305.26,393.39,3 RC,312,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,312,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,312,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,312,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,312,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,312,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,312,Levetiracetam ,,,11.35,70.08,4 RC,312,Lidocaine ,,,12.59,77.23,4 RC,312,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,312,Lipase ,,,5.91,35.94,4 RC,312,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,312,Lipoprotein (a) ,,,12.27,75.44,4 RC,312,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,312,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,312,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,312,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,312,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,312,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,312,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,312,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,312,Lithium ,,,5.66,35.94,4 RC,312,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,312,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,312,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,312,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,312,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,312,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,312,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,312,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,312,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,312,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,312,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,312,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,312,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,312,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,312,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,312,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,312,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,312,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,312,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,312,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,312,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,312,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,312,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,312,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,312,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,312,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,312,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,312,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,312,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,312,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,312,Magnesium ,,,5.74,35.94,4 RC,312,Malate dehydrogenase ,,,6.31,39.51,4 RC,312,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,312,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,312,Manganese ,,,22.84,141.9,4 RC,312,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,312,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,312,"Meat fibers, feces ",,,4.15,25.17,4 RC,312,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,312,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,312,"Mercury, quantitative ",,,13.93,86.21,4 RC,312,Metanephrines ,,,14.51,89.84,4 RC,312,Methadone ,,,11.24,127.56,4 RC,312,Methemalbumin ,,,9.2,57.47,4 RC,312,Methotrexate ,,,33.05,204.79,4 RC,312,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,312,Methylphenidate ,,,9.29,127.56,4 RC,312,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,312,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,312,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,312,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,312,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,312,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,312,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,312,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,312,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,312,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,312,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,312,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,312,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,312,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,312,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,312,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,312,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,312,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,312,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,312,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,312,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,312,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,312,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,312,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,312,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,312,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,312,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,312,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,312,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,312,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,312,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,312,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,312,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,312,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,312,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,312,Muramidase ,,,16.07,98.82,4 RC,312,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,312,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,312,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,312,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,312,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,312,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,312,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,312,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,312,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,312,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,312,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,312,Myoglobin ,,,11.07,68.24,4 RC,312,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,312,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,312,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,312,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,312,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,312,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,312,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,312,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,312,Natriuretic peptide ,,,33.64,208.36,4 RC,312,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,312,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,312,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,312,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,312,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,312,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,312,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,312,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,312,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,312,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,312,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,312,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,312,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,312,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,312,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,312,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,312,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,312,Nerve teasing preparations ,,,499.29,643.43,3 RC,312,"Neutralization test, viral ",,,14.48,89.84,4 RC,312,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,312,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,312,Nickel ,,,21.0,129.34,4 RC,312,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,312,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,312,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,312,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,312,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,312,Nucleotidase 5'- ,,,9.56,59.26,4 RC,312,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,312,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,312,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,312,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,312,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,312,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,312,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,312,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,312,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,312,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,312,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,312,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,312,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,312,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,312,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,312,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,312,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,312,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,312,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,312,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,312,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,312,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,312,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,312,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,312,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,312,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,312,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,312,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,312,"Opiates, 1 or more ",,,14.57,127.56,4 RC,312,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,312,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,312,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,312,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,312,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,312,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,312,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,312,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,312,Osmolality; blood ,,,5.66,35.94,4 RC,312,Osmolality; urine ,,,5.84,35.94,4 RC,312,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,312,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,312,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,312,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,312,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,312,Oxalate ,,,12.38,77.23,4 RC,312,Oxcarbazepine ,,,11.35,70.08,4 RC,312,Oxycodone ,,,12.15,127.56,4 RC,312,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,312,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,312,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,312,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,312,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,312,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,312,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,312,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,312,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,312,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,312,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,312,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,312,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,312,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,312,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,312,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,312,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,312,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,312,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,312,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,312,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,312,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,312,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,312,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,312,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,312,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,312,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,312,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,312,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,312,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,312,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,312,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,312,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,312,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,312,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,312,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,312,Phenobarbital ,,,13.11,80.85,4 RC,312,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,312,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,312,Phenytoin; free ,,,11.79,73.66,4 RC,312,Phenytoin; total ,,,11.35,70.08,4 RC,312,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,312,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,312,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,312,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,312,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,312,Phosphatidylglycerol ,,,14.16,88.0,4 RC,312,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,312,Phosphohexose isomerase ,,,9.19,57.47,4 RC,312,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,312,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,312,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,312,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,312,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,312,Pinworm examinations ,,,18.14,23.38,3 RC,312,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,312,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,312,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,312,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,312,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,312,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,312,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,312,Posaconazole ,,,23.23,143.69,4 RC,312,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,312,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,312,Potassium; urine ,,,4.05,25.17,4 RC,312,Prealbumin ,,,12.51,77.23,4 RC,312,Pregabalin ,,,7.07,127.56,4 RC,312,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,312,Pregnanediol ,,,18.23,113.16,4 RC,312,Pregnanetriol ,,,18.03,111.38,4 RC,312,Pregnenolone ,,,17.71,109.59,4 RC,312,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,312,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,312,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,312,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,312,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,312,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,312,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,312,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,312,Primidone ,,,14.22,88.0,4 RC,312,Procainamide; ,,,51.41,317.95,4 RC,312,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,312,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,312,Progesterone ,,,17.87,111.38,4 RC,312,Proinsulin ,,,22.87,141.9,4 RC,312,Prolactin ,,,16.61,102.39,4 RC,312,Propoxyphene ,,,10.72,127.56,4 RC,312,"Prostaglandin, each ",,,35.79,220.97,4 RC,312,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,312,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,312,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,312,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,312,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,312,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,312,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,312,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,312,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,312,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,312,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,312,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,312,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,312,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,312,Prothrombin time; ,,,3.67,23.38,4 RC,312,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,312,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,312,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,312,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,312,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,312,Pyruvate ,,,12.4,77.23,4 RC,312,Pyruvate kinase ,,,8.09,50.28,4 RC,312,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,312,Quinidine ,,,12.51,77.23,4 RC,312,Quinine ,,,9.97,61.1,4 RC,312,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,312,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,312,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,312,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,312,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,312,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,312,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,312,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,312,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,312,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,312,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,312,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,312,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,312,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,312,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,312,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,312,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,312,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,312,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,312,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,312,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,312,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,312,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,312,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,312,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,312,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,312,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,312,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,312,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,312,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,312,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,312,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,312,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,312,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,312,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,312,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,312,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,312,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,312,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,312,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,312,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,312,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,312,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,312,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,312,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,312,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,312,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,312,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,312,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,312,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,312,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,312,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,312,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,312,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,312,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,312,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,312,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,312,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,312,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,312,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,312,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,312,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,312,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,312,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,312,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,312,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,312,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,312,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,312,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,312,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,312,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,312,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,312,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,312,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,312,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,312,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,312,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,312,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,312,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,312,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,312,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,312,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,312,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,312,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,312,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,312,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,312,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,312,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,312,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,312,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,312,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,312,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,312,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,312,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,312,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,312,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,312,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,312,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,312,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,312,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,312,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,312,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,312,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,312,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,312,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,312,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,312,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,312,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,312,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,312,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,312,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,312,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,312,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,312,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,312,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,312,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,312,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,312,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,312,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,312,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,312,Receptor assay; estrogen ,,,75.3,465.26,4 RC,312,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,312,Receptor assay; progesterone ,,,55.59,343.11,4 RC,312,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,312,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,312,Renin ,,,18.84,116.79,4 RC,312,Reptilase test ,,,8.44,52.12,4 RC,312,Reticulated platelet assay ,,,30.62,188.6,4 RC,312,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,312,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,312,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,312,Rufinamide ,,,23.23,143.69,4 RC,312,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,312,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,312,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,312,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,312,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,312,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,312,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,312,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,312,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,312,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,312,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,312,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,312,Salicylate ,,,15.97,98.82,4 RC,312,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,312,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,312,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,312,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,312,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,312,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,312,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,312,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,312,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,312,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,312,Selenium ,,,21.88,134.7,4 RC,312,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,312,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,312,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,312,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,312,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,312,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,312,Serotonin ,,,26.54,163.49,4 RC,312,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,312,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,312,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,312,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,312,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,312,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,312,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,312,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,312,Sialic acid ,,,11.52,71.87,4 RC,312,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,312,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,312,Silica ,,,21.6,132.92,4 RC,312,Sirolimus ,,,11.76,73.66,4 RC,312,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,312,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,312,Skin test; candida ,,,79.46,102.39,3 RC,312,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,312,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,312,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,312,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,312,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,312,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,312,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,312,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,312,Sodium; other source ,,,4.16,25.17,4 RC,312,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,312,Sodium; urine ,,,4.33,26.95,4 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,312,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,312,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,312,Somatomedin ,,,18.22,113.16,4 RC,312,Somatostatin ,,,15.67,96.98,4 RC,312,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,312,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,312,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,312,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,312,Specific gravity (except urine) ,,,2.82,17.97,4 RC,312,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,312,Sperm antibodies ,,,43.21,55.69,3 RC,312,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,312,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,312,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,312,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,312,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,312,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,312,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,312,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,312,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,312,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,312,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,312,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,312,"Stimulants, synthetic ",,,12.05,127.56,4 RC,312,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,312,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,312,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,312,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,312,"Streptokinase, antibody ",,,10.84,66.46,4 RC,312,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,312,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,312,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,312,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,312,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,312,"Sulfate, urine ",,,4.7,28.74,4 RC,312,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,312,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,312,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,312,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,312,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,312,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,312,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,312,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,312,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,312,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,312,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,312,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,312,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,312,T cells; total count ,,,32.32,199.37,4 RC,312,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,312,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,312,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,312,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,312,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,312,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,312,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,312,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,312,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,312,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,312,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,312,Tacrolimus ,,,11.76,73.66,4 RC,312,Tapentadol ,,,10.83,127.56,4 RC,312,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,312,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,312,Testosterone; free ,,,21.82,134.7,4 RC,312,Testosterone; total ,,,22.11,136.54,4 RC,312,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,312,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,312,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,312,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,312,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,312,Theophylline ,,,12.12,75.44,4 RC,312,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,312,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,312,Thiocyanate ,,,9.97,61.1,4 RC,312,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,312,Thrombin time; plasma ,,,4.95,30.52,4 RC,312,Thrombin time; titer ,,,5.87,35.94,4 RC,312,Thrombomodulin ,,,14.8,91.62,4 RC,312,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,312,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,312,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,312,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,312,Thyroglobulin ,,,13.76,84.43,4 RC,312,Thyroglobulin antibody ,,,13.63,84.43,4 RC,312,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,312,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,312,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,312,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,312,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,312,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,312,Thyroxine; free ,,,7.73,48.49,4 RC,312,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,312,Thyroxine; total ,,,5.89,35.94,4 RC,312,Tiagabine ,,,23.23,143.69,4 RC,312,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,312,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,312,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,312,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,312,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,312,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,312,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,312,Tobramycin ,,,13.82,86.21,4 RC,312,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,312,Topiramate ,,,10.21,62.89,4 RC,312,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,312,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,312,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,312,Tramadol ,,,10.54,127.56,4 RC,312,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,312,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,312,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,312,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,312,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,312,Transferrin ,,,10.93,68.24,4 RC,312,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,312,Triglycerides ,,,4.92,30.52,4 RC,312,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,312,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,312,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,312,"Troponin, qualitative ",,,8.65,53.9,4 RC,312,"Troponin, quantitative ",,,10.68,66.46,4 RC,312,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,312,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,312,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,312,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,312,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,312,Tyrosine ,,,9.11,55.69,4 RC,312,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,312,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,312,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,312,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,312,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,312,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,312,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,312,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,312,Unlisted immunology procedure ,,,99.55,128.28,3 RC,312,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,312,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,312,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,312,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,312,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,312,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,312,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,312,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,312,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,312,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,312,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,312,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,312,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,312,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,312,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,312,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,312,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,312,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,312,Uric acid; blood ,,,3.88,23.38,4 RC,312,Uric acid; other source ,,,4.36,26.95,4 RC,312,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,312,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,312,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,312,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,312,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,312,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,312,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,312,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,312,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,312,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,312,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,312,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,312,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,312,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,312,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,312,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,312,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,312,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,312,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,312,Vancomycin ,,,11.6,71.87,4 RC,312,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,312,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,312,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,312,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,312,Vedolizumab ,,,33.05,204.79,4 RC,312,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,312,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,312,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,312,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,312,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,312,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,312,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,312,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,312,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,312,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,312,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,312,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,312,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,312,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,312,Very long chain fatty acids ,,,16.92,104.18,4 RC,312,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,312,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,312,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,312,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,312,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,312,Viscosity ,,,10.0,61.1,4 RC,312,Vitamin A ,,,9.95,61.1,4 RC,312,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,312,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,312,Vitamin K ,,,11.75,71.87,4 RC,312,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,312,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,312,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,312,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,312,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,312,Voriconazole ,,,23.23,143.69,4 RC,312,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,312,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,312,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,312,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,312,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,312,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,312,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,312,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,312,Zinc ,,,9.76,61.1,4 RC,312,Zonisamide ,,,11.35,70.08,4 RC,312,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,312,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,312,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,314, Laboratory Pathology Biopsy ,,,,,0 RC,314,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,314,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,314,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,314,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,314,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,314,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,314,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,314,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,314,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,314,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,314,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,314,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,314,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,314,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,314,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,314,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,314,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,Acetaminophen ,,,15.97,98.82,4 RC,314,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,314,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,314,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,314,Acetylcholinesterase ,,,10.53,64.67,4 RC,314,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,314,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,314,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,314,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,314,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,314,Adalimumab ,,,33.05,204.79,4 RC,314,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,314,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,314,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,314,Albumin; ischemia modified ,,,29.08,179.62,4 RC,314,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,314,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,314,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,314,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,314,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,314,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,314,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,314,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,314,Alcohols ,,,9.61,127.56,4 RC,314,Aldolase ,,,8.32,52.12,4 RC,314,Aldosterone ,,,34.91,215.56,4 RC,314,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,314,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,314,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,314,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,314,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,314,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,314,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,314,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,314,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,314,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,314,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,314,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,314,Aluminum ,,,21.83,134.7,4 RC,314,Amikacin ,,,12.92,80.85,4 RC,314,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,314,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,314,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,314,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,314,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,314,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,314,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,314,Amiodarone ,,,15.97,98.82,4 RC,314,Ammonia ,,,12.48,77.23,4 RC,314,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,314,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,314,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,314,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,314,Amylase ,,,5.55,34.15,4 RC,314,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,314,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,314,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,314,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,314,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,314,Androstanediol glucuronide ,,,24.7,152.67,4 RC,314,Androstenedione ,,,25.09,154.51,4 RC,314,Androsterone ,,,21.89,134.7,4 RC,314,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,314,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,314,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,314,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,314,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,314,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,314,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,314,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,314,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,314,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,314,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,314,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,314,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,314,Angiotensin II ,,,17.58,109.59,4 RC,314,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,314,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,314,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,314,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,314,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,314,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,314,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,314,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,314,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,314,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,314,Antibody; Aspergillus ,,,12.89,79.01,4 RC,314,Antibody; Bartonella ,,,8.72,53.9,4 RC,314,Antibody; Blastomyces ,,,11.06,68.24,4 RC,314,Antibody; Bordetella ,,,11.3,70.08,4 RC,314,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,314,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,314,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,314,Antibody; Brucella ,,,7.65,46.7,4 RC,314,Antibody; Campylobacter ,,,11.24,70.08,4 RC,314,Antibody; Candida ,,,10.29,62.89,4 RC,314,Antibody; Chlamydia ,,,10.13,62.89,4 RC,314,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,314,Antibody; Coccidioides ,,,9.82,61.1,4 RC,314,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,314,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,314,Antibody; Diphtheria ,,,13.04,80.85,4 RC,314,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,314,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,314,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,314,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,314,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,314,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,314,Antibody; HIV-1 ,,,7.62,46.7,4 RC,314,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,314,Antibody; HIV-2 ,,,11.59,71.87,4 RC,314,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,314,Antibody; HTLV-I ,,,7.79,48.49,4 RC,314,Antibody; HTLV-II ,,,12.0,73.66,4 RC,314,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,314,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,314,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,314,Antibody; Legionella ,,,13.11,80.85,4 RC,314,Antibody; Leishmania ,,,10.5,64.67,4 RC,314,Antibody; Leptospira ,,,13.88,86.21,4 RC,314,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,314,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,314,Antibody; Nocardia ,,,13.7,84.43,4 RC,314,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,314,Antibody; Rickettsia ,,,16.57,102.39,4 RC,314,Antibody; Salmonella ,,,11.3,70.08,4 RC,314,Antibody; Shigella ,,,20.97,129.34,4 RC,314,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,314,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,314,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,314,Antibody; Trichinella ,,,10.76,66.46,4 RC,314,Antibody; West Nile virus ,,,12.33,75.44,4 RC,314,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,314,Antibody; Yersinia ,,,11.3,70.08,4 RC,314,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,314,Antibody; actinomyces ,,,8.72,53.9,4 RC,314,Antibody; adenovirus ,,,11.03,68.24,4 RC,314,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,314,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,314,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,314,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,314,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,314,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,314,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,314,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,314,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,314,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,314,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,314,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,314,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,314,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,314,Antibody; histoplasma ,,,11.81,73.66,4 RC,314,Antibody; influenza virus ,,,11.61,71.87,4 RC,314,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,314,Antibody; mucormycosis ,,,12.85,79.01,4 RC,314,Antibody; mumps ,,,11.18,70.08,4 RC,314,Antibody; mycoplasma ,,,11.34,70.08,4 RC,314,Antibody; parvovirus ,,,12.88,79.01,4 RC,314,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,314,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,314,Antibody; rotavirus ,,,15.62,96.98,4 RC,314,Antibody; rubella ,,,12.33,75.44,4 RC,314,Antibody; rubeola ,,,11.04,68.24,4 RC,314,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,314,Antibody; tetanus ,,,12.68,79.01,4 RC,314,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,314,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,314,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,314,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,314,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,314,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,314,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,314,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,314,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,314,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,314,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,314,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,314,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,314,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,314,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,314,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,314,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,314,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,314,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,314,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,314,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,314,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,314,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,314,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,314,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,314,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,314,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,314,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,314,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,314,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,314,"Apolipoprotein, each ",,,18.07,111.38,4 RC,314,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,314,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,314,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,314,Arsenic ,,,16.25,100.61,4 RC,314,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,314,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,314,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,314,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,314,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,314,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,314,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,314,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,314,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,314,"B cells, total count ",,,32.32,199.37,4 RC,314,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,314,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,314,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,314,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,314,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,314,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,314,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,314,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,314,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,314,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,314,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,314,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,314,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,314,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,314,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,314,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,314,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,314,Barbiturates ,,,9.34,127.56,4 RC,314,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,314,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,314,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,314,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,314,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,314,Beta-2 microglobulin ,,,13.86,86.21,4 RC,314,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,314,Bile acids; total ,,,14.67,91.62,4 RC,314,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,314,Bilirubin; direct ,,,4.3,26.95,4 RC,314,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,314,Bilirubin; total ,,,4.3,26.95,4 RC,314,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,314,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,314,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,314,Bleeding time ,,,4.13,25.17,4 RC,314,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,314,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,314,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,314,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,314,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,314,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,314,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,314,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,314,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,314,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,314,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,314,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,314,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,314,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,314,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,314,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,314,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,314,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,314,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,314,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,314,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,314,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,314,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,314,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,314,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,314,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,314,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,314,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,314,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,314,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,314,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,314,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,314,Bone age studies ,,,61.64,79.3,3 RC,314,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,314,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,314,Bradykinin ,,,4.42,26.95,4 RC,314,Buprenorphine ,,,14.01,14.01,1 RC,314,C-peptide ,,,17.83,109.59,4 RC,314,C-reactive protein; ,,,4.44,26.95,4 RC,314,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,314,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,314,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,314,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,314,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,314,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,314,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,314,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,314,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,314,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,314,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,314,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,314,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,314,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,314,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,314,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,314,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,314,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,314,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,314,Cadmium ,,,20.26,125.72,4 RC,314,Caffeine ,,,33.05,204.79,4 RC,314,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,314,Calcitonin ,,,22.95,141.9,4 RC,314,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,314,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,314,Calcium; ionized ,,,11.72,71.87,4 RC,314,Calcium; total ,,,4.42,26.95,4 RC,314,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,314,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,314,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,314,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,314,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,314,"Calprotectin, fecal ",,,16.82,104.18,4 RC,314,"Cannabinoids, natural ",,,11.5,127.56,4 RC,314,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,314,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,314,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,314,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,314,Carbamazepine; free ,,,11.35,70.08,4 RC,314,Carbamazepine; total ,,,12.48,77.23,4 RC,314,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,314,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,314,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,314,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,314,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,314,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,314,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,314,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,314,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,314,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,314,Carotene ,,,7.89,48.49,4 RC,314,Catecholamines; blood ,,,24.92,154.51,4 RC,314,Catecholamines; fractionated ,,,21.63,134.7,4 RC,314,Catecholamines; total urine ,,,23.39,145.53,4 RC,314,Cathepsin-D ,,,15.47,95.19,4 RC,314,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,314,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,314,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,314,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,314,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,314,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,314,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,314,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,314,Ceruloplasmin ,,,9.2,57.47,4 RC,314,Chemiluminescent assay ,,,12.1,75.44,4 RC,314,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,314,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,314,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,314,Chloramphenicol ,,,10.85,66.46,4 RC,314,Chloride; blood ,,,3.94,25.17,4 RC,314,Chloride; other source ,,,4.28,26.95,4 RC,314,Chloride; urine ,,,4.93,30.52,4 RC,314,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,314,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,314,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,314,Cholinesterase; RBC ,,,8.4,52.12,4 RC,314,Cholinesterase; serum ,,,6.74,41.29,4 RC,314,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,314,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,314,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,314,Chromium ,,,17.38,107.81,4 RC,314,Chromogenic substrate assay ,,,10.19,62.89,4 RC,314,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,314,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,314,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,314,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,314,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,314,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,314,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,314,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,314,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,314,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,314,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,314,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,314,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,314,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,314,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,314,Citrate ,,,23.82,147.31,4 RC,314,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,314,Clot retraction ,,,13.96,86.21,4 RC,314,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,314,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,314,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,314,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,314,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,314,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,314,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,314,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,314,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,314,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,314,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,314,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,314,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,314,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,314,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,314,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,314,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,314,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,314,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,314,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,314,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,314,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,314,Clozapine ,,,17.27,105.96,4 RC,314,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,314,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,314,Coagulation time; activated ,,,3.67,23.38,4 RC,314,Coagulation time; other methods ,,,3.85,23.38,4 RC,314,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,314,Cocaine ,,,10.46,127.56,4 RC,314,Cold agglutinin; screen ,,,6.92,43.13,4 RC,314,Cold agglutinin; titer ,,,6.91,43.13,4 RC,314,"Collagen cross links, any method ",,,16.0,98.82,4 RC,314,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,314,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,314,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,314,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,314,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,314,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,314,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,314,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,314,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,314,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,314,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,314,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,314,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,314,"Complement; antigen, each component ",,,10.28,62.89,4 RC,314,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,314,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,314,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,314,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,314,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,314,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,314,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,314,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,314,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,314,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,314,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,314,Copper ,,,10.63,66.46,4 RC,314,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,314,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,314,Corticosterone ,,,19.3,118.58,4 RC,314,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,314,Cortisol; free ,,,14.32,88.0,4 RC,314,Cortisol; total ,,,13.96,86.21,4 RC,314,Creatine ,,,3.98,25.17,4 RC,314,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,314,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,314,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,314,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,314,Creatinine; blood ,,,4.39,26.95,4 RC,314,Creatinine; clearance ,,,8.11,50.28,4 RC,314,Creatinine; other source ,,,4.44,26.95,4 RC,314,Cryofibrinogen ,,,12.12,75.44,4 RC,314,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,314,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,314,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,314,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,314,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,314,Cryopreservation; sperm ,,,442.57,570.33,3 RC,314,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,314,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,314,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,314,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,314,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,314,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,314,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,314,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,314,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,314,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,314,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,314,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,314,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,314,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,314,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,314,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,314,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,314,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,314,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,314,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,314,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,314,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,314,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,314,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,314,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,314,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,314,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,314,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,314,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,314,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,314,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,314,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,314,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,314,"Culture, typing; other methods ",,,6.63,41.29,4 RC,314,Cyanide ,,,16.63,102.39,4 RC,314,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,314,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,314,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,314,Cyclosporine ,,,15.46,95.19,4 RC,314,Cystatin C ,,,15.87,98.82,4 RC,314,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,314,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,314,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,314,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,314,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,314,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,314,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,314,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,314,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,314,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,314,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,314,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,314,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,314,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,314,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,314,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,314,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,314,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,314,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,314,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,314,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,314,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,314,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,314,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,314,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,314,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,314,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,314,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,314,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,314,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,314,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,314,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,314,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,314,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,314,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,314,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,314,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,314,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,314,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,314,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,314,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,314,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,314,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,314,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,314,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,314,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,314,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,314,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,314,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,314,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,314,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,314,Dibucaine number ,,,10.5,64.67,4 RC,314,Digoxin; free ,,,11.38,70.08,4 RC,314,Digoxin; total ,,,11.38,70.08,4 RC,314,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,314,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,314,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,314,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,314,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,314,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,314,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,314,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,314,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,314,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,314,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,314,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,314,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,314,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,314,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,314,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,314,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,314,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,314,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,314,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,314,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,314,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,314,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,314,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,314,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,314,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,314,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,314,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,314,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,314,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,314,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,314,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,314,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,314,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,314,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,314,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,314,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,314,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,314,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,314,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,314,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,314,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,314,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,314,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,314,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,314,Erythropoietin ,,,16.1,98.82,4 RC,314,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,314,Estradiol; total ,,,23.94,147.31,4 RC,314,Estriol ,,,20.72,127.56,4 RC,314,Estrogens; fractionated ,,,27.67,170.64,4 RC,314,Estrogens; total ,,,18.59,114.95,4 RC,314,Estrone ,,,21.38,132.92,4 RC,314,Ethosuximide ,,,14.0,86.21,4 RC,314,Ethylene glycol ,,,12.77,79.01,4 RC,314,Etiocholanolone ,,,22.48,138.33,4 RC,314,Euglobulin lysis ,,,7.2,44.92,4 RC,314,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,314,Everolimus ,,,11.76,73.66,4 RC,314,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,314,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,314,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,314,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,314,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,314,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,314,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,314,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,314,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,314,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,314,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,314,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,314,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,314,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,314,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,314,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,314,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,314,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,314,Factor inhibitor test ,,,11.03,68.24,4 RC,314,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,314,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,314,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,314,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,314,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,314,Felbamate ,,,15.97,98.82,4 RC,314,Fentanyl ,,,13.07,127.56,4 RC,314,Fern test ,,,40.44,52.12,3 RC,314,Ferritin ,,,11.68,71.87,4 RC,314,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,314,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,314,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,314,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,314,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,314,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,314,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,314,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,314,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,314,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,314,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,314,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,314,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,314,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,314,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,314,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,314,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,314,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,314,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,314,Fibrinogen; activity ,,,8.32,52.12,4 RC,314,Fibrinogen; antigen ,,,12.39,77.23,4 RC,314,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,314,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,314,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,314,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,314,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,314,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,314,Flecainide ,,,15.97,98.82,4 RC,314,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,314,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,314,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,314,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,314,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,314,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,314,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,314,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,314,Fluoride ,,,15.88,98.82,4 RC,314,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,314,Folic acid; RBC ,,,15.13,93.41,4 RC,314,Folic acid; serum ,,,12.6,77.23,4 RC,314,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,314,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,314,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,314,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,314,"Fructose, semen ",,,14.86,91.62,4 RC,314,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,314,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,314,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,314,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,314,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,314,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,314,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,314,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,314,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,314,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,314,"Galactokinase, RBC ",,,18.4,113.16,4 RC,314,Galactose ,,,9.6,59.26,4 RC,314,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,314,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,314,Galectin-3 ,,,182.6,235.31,3 RC,314,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,314,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,314,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,314,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,314,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,314,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,314,"Gases, blood, pH only ",,,9.42,57.47,4 RC,314,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,314,Gastrin ,,,15.11,93.41,4 RC,314,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,314,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,314,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,314,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,314,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,314,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,314,Gentamicin ,,,14.04,86.21,4 RC,314,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,314,Glucagon ,,,12.24,75.44,4 RC,314,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,314,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,314,Glucagon tolerance test ,,,15.23,93.41,4 RC,314,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,314,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,314,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,314,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,314,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,314,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,314,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,314,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,314,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,314,"Glucosidase, beta ",,,18.4,113.16,4 RC,314,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,314,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,314,Glutathione ,,,13.24,82.64,4 RC,314,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,314,Glycated protein ,,,14.36,88.0,4 RC,314,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,314,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,314,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,314,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,314,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,314,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,314,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,314,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,314,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,314,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,314,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,314,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,314,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,314,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,314,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,314,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,314,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,314,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,314,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,314,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,314,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,314,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,314,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,314,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,314,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,314,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,314,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,314,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,314,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,314,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,314,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,314,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,314,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,314,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,314,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,314,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,314,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,314,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,314,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,314,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,314,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,314,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,Haloperidol ,,,13.53,84.43,4 RC,314,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,314,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,314,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,314,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,314,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,314,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,314,Heinz bodies; direct ,,,3.6,21.54,4 RC,314,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,314,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,314,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,314,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,314,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,314,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,314,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,314,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,314,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,314,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,314,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,314,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,314,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,314,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,314,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,314,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,314,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,314,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,314,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,314,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,314,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,314,Hemoglobin; plasma ,,,6.26,39.51,4 RC,314,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,314,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,314,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,314,Hemoglobin; urine ,,,3.39,21.54,4 RC,314,"Hemolysin, acid ",,,7.6,46.7,4 RC,314,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,314,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,314,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,314,Heparin assay ,,,11.22,70.08,4 RC,314,Heparin neutralization ,,,10.15,62.89,4 RC,314,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,314,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,314,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,314,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,314,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,314,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,314,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,314,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,314,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,314,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,314,Hepatitis C antibody; ,,,12.23,75.44,4 RC,314,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,314,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,314,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,314,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,314,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,314,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,314,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,314,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,314,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,314,Heroin metabolite ,,,13.63,127.56,4 RC,314,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,314,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,314,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,314,Histamine ,,,25.31,156.3,4 RC,314,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,314,Homocysteine ,,,15.35,95.19,4 RC,314,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,314,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,314,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,314,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,314,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,314,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,314,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,314,Hydroxychloroquine ,,,15.97,98.82,4 RC,314,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,314,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,314,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,314,Hydroxyproline; free ,,,19.41,120.36,4 RC,314,Hydroxyproline; total ,,,20.82,129.34,4 RC,314,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,314,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,314,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,314,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,314,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,314,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,314,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,314,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,314,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,314,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,314,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,314,Immune complex assay ,,,20.88,129.34,4 RC,314,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,314,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,314,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,314,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,314,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,314,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,314,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,314,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,314,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,314,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,314,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,314,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,314,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,314,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,314,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,314,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,314,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,314,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,314,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,314,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,314,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,314,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,314,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,314,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,314,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,314,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,314,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,314,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,314,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,314,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,314,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,314,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,314,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,314,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,314,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,314,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,314,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,314,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,314,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,314,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,314,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,314,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,314,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,314,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,314,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,314,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,314,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,314,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,314,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,314,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,314,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,314,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,314,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,314,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,314,Infliximab ,,,33.05,204.79,4 RC,314,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,314,Inhibin A ,,,13.36,82.64,4 RC,314,Insemination of oocytes ,,,442.57,570.33,3 RC,314,Insulin antibodies ,,,18.34,113.16,4 RC,314,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,314,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,314,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,314,Insulin; free ,,,11.1,68.24,4 RC,314,Insulin; total ,,,9.79,61.1,4 RC,314,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,314,Intrinsic factor ,,,16.98,104.18,4 RC,314,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,314,Iron ,,,5.54,34.15,4 RC,314,Iron binding capacity ,,,7.49,46.7,4 RC,314,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,314,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,314,Islet cell antibody ,,,20.2,125.72,4 RC,314,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,314,Itraconazole ,,,23.23,143.69,4 RC,314,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,314,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,314,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,314,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,314,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,314,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,314,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,314,Ketamine and norketamine ,,,10.54,127.56,4 RC,314,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,314,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,314,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,314,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,314,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,314,Lacosamide ,,,23.23,143.69,4 RC,314,Lactate (lactic acid) ,,,9.91,61.1,4 RC,314,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,314,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,314,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,314,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,314,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,314,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,314,Lamotrigine ,,,11.35,70.08,4 RC,314,Lead ,,,10.37,64.67,4 RC,314,Leflunomide ,,,33.05,204.79,4 RC,314,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,314,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,314,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,314,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,314,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,314,Leukocyte transfusion ,,,305.26,393.39,3 RC,314,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,314,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,314,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,314,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,314,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,314,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,314,Levetiracetam ,,,11.35,70.08,4 RC,314,Lidocaine ,,,12.59,77.23,4 RC,314,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,314,Lipase ,,,5.91,35.94,4 RC,314,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,314,Lipoprotein (a) ,,,12.27,75.44,4 RC,314,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,314,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,314,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,314,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,314,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,314,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,314,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,314,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,314,Lithium ,,,5.66,35.94,4 RC,314,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,314,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,314,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,314,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,314,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,314,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,314,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,314,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,314,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,314,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,314,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,314,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,314,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,314,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,314,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,314,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,314,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,314,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,314,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,314,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,314,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,314,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,314,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,314,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,314,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,314,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,314,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,314,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,314,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,314,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,314,Magnesium ,,,5.74,35.94,4 RC,314,Malate dehydrogenase ,,,6.31,39.51,4 RC,314,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,314,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,314,Manganese ,,,22.84,141.9,4 RC,314,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,314,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,314,"Meat fibers, feces ",,,4.15,25.17,4 RC,314,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,314,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,314,"Mercury, quantitative ",,,13.93,86.21,4 RC,314,Metanephrines ,,,14.51,89.84,4 RC,314,Methadone ,,,11.24,127.56,4 RC,314,Methemalbumin ,,,9.2,57.47,4 RC,314,Methotrexate ,,,33.05,204.79,4 RC,314,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,314,Methylphenidate ,,,9.29,127.56,4 RC,314,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,314,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,314,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,314,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,314,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,314,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,314,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,314,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,314,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,314,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,314,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,314,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,314,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,314,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,314,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,314,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,314,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,314,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,314,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,314,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,314,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,314,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,314,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,314,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,314,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,314,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,314,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,314,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,314,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,314,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,314,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,314,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,314,Muramidase ,,,16.07,98.82,4 RC,314,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,314,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,314,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,314,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,314,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,314,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,314,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,314,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,314,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,314,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,314,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,314,Myoglobin ,,,11.07,68.24,4 RC,314,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,314,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,314,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,314,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,314,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,314,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,314,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,314,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,314,Natriuretic peptide ,,,33.64,208.36,4 RC,314,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,314,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,314,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,314,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,314,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,314,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,314,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,314,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,314,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,314,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,314,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,314,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,314,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,314,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,314,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,314,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,314,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,314,Nerve teasing preparations ,,,499.29,643.43,3 RC,314,"Neutralization test, viral ",,,14.48,89.84,4 RC,314,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,314,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,314,Nickel ,,,21.0,129.34,4 RC,314,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,314,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,314,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,314,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,314,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,314,Nucleotidase 5'- ,,,9.56,59.26,4 RC,314,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,314,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,314,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,314,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,314,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,314,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,314,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,314,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,314,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,314,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,314,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,314,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,314,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,314,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,314,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,314,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,314,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,314,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,314,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,314,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,314,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,314,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,314,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,314,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,314,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,314,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,314,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,314,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,314,"Opiates, 1 or more ",,,14.57,127.56,4 RC,314,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,314,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,314,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,314,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,314,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,314,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,314,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,314,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,314,Osmolality; blood ,,,5.66,35.94,4 RC,314,Osmolality; urine ,,,5.84,35.94,4 RC,314,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,314,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,314,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,314,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,314,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,314,Oxalate ,,,12.38,77.23,4 RC,314,Oxcarbazepine ,,,11.35,70.08,4 RC,314,Oxycodone ,,,12.15,127.56,4 RC,314,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,314,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,314,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,314,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,314,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,314,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,314,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,314,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,314,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,314,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,314,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,314,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,314,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,314,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,314,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,314,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,314,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,314,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,314,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,314,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,314,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,314,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,314,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,314,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,314,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,314,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,314,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,314,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,314,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,314,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,314,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,314,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,314,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,314,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,314,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,314,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,314,Phenobarbital ,,,13.11,80.85,4 RC,314,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,314,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,314,Phenytoin; free ,,,11.79,73.66,4 RC,314,Phenytoin; total ,,,11.35,70.08,4 RC,314,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,314,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,314,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,314,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,314,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,314,Phosphatidylglycerol ,,,14.16,88.0,4 RC,314,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,314,Phosphohexose isomerase ,,,9.19,57.47,4 RC,314,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,314,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,314,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,314,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,314,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,314,Pinworm examinations ,,,18.14,23.38,3 RC,314,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,314,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,314,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,314,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,314,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,314,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,314,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,314,Posaconazole ,,,23.23,143.69,4 RC,314,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,314,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,314,Potassium; urine ,,,4.05,25.17,4 RC,314,Prealbumin ,,,12.51,77.23,4 RC,314,Pregabalin ,,,7.07,127.56,4 RC,314,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,314,Pregnanediol ,,,18.23,113.16,4 RC,314,Pregnanetriol ,,,18.03,111.38,4 RC,314,Pregnenolone ,,,17.71,109.59,4 RC,314,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,314,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,314,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,314,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,314,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,314,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,314,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,314,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,314,Primidone ,,,14.22,88.0,4 RC,314,Procainamide; ,,,51.41,317.95,4 RC,314,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,314,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,314,Progesterone ,,,17.87,111.38,4 RC,314,Proinsulin ,,,22.87,141.9,4 RC,314,Prolactin ,,,16.61,102.39,4 RC,314,Propoxyphene ,,,10.72,127.56,4 RC,314,"Prostaglandin, each ",,,35.79,220.97,4 RC,314,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,314,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,314,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,314,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,314,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,314,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,314,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,314,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,314,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,314,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,314,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,314,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,314,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,314,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,314,Prothrombin time; ,,,3.67,23.38,4 RC,314,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,314,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,314,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,314,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,314,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,314,Pyruvate ,,,12.4,77.23,4 RC,314,Pyruvate kinase ,,,8.09,50.28,4 RC,314,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,314,Quinidine ,,,12.51,77.23,4 RC,314,Quinine ,,,9.97,61.1,4 RC,314,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,314,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,314,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,314,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,314,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,314,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,314,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,314,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,314,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,314,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,314,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,314,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,314,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,314,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,314,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,314,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,314,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,314,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,314,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,314,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,314,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,314,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,314,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,314,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,314,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,314,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,314,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,314,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,314,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,314,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,314,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,314,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,314,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,314,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,314,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,314,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,314,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,314,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,314,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,314,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,314,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,314,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,314,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,314,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,314,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,314,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,314,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,314,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,314,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,314,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,314,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,314,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,314,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,314,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,314,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,314,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,314,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,314,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,314,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,314,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,314,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,314,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,314,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,314,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,314,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,314,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,314,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,314,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,314,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,314,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,314,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,314,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,314,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,314,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,314,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,314,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,314,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,314,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,314,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,314,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,314,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,314,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,314,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,314,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,314,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,314,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,314,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,314,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,314,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,314,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,314,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,314,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,314,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,314,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,314,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,314,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,314,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,314,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,314,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,314,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,314,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,314,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,314,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,314,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,314,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,314,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,314,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,314,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,314,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,314,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,314,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,314,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,314,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,314,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,314,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,314,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,314,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,314,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,314,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,314,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,314,Receptor assay; estrogen ,,,75.3,465.26,4 RC,314,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,314,Receptor assay; progesterone ,,,55.59,343.11,4 RC,314,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,314,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,314,Renin ,,,18.84,116.79,4 RC,314,Reptilase test ,,,8.44,52.12,4 RC,314,Reticulated platelet assay ,,,30.62,188.6,4 RC,314,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,314,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,314,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,314,Rufinamide ,,,23.23,143.69,4 RC,314,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,314,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,314,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,314,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,314,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,314,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,314,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,314,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,314,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,314,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,314,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,314,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,314,Salicylate ,,,15.97,98.82,4 RC,314,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,314,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,314,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,314,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,314,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,314,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,314,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,314,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,314,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,314,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,314,Selenium ,,,21.88,134.7,4 RC,314,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,314,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,314,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,314,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,314,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,314,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,314,Serotonin ,,,26.54,163.49,4 RC,314,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,314,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,314,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,314,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,314,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,314,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,314,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,314,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,314,Sialic acid ,,,11.52,71.87,4 RC,314,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,314,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,314,Silica ,,,21.6,132.92,4 RC,314,Sirolimus ,,,11.76,73.66,4 RC,314,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,314,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,314,Skin test; candida ,,,79.46,102.39,3 RC,314,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,314,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,314,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,314,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,314,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,314,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,314,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,314,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,314,Sodium; other source ,,,4.16,25.17,4 RC,314,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,314,Sodium; urine ,,,4.33,26.95,4 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,314,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,314,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,314,Somatomedin ,,,18.22,113.16,4 RC,314,Somatostatin ,,,15.67,96.98,4 RC,314,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,314,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,314,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,314,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,314,Specific gravity (except urine) ,,,2.82,17.97,4 RC,314,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,314,Sperm antibodies ,,,43.21,55.69,3 RC,314,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,314,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,314,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,314,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,314,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,314,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,314,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,314,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,314,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,314,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,314,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,314,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,314,"Stimulants, synthetic ",,,12.05,127.56,4 RC,314,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,314,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,314,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,314,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,314,"Streptokinase, antibody ",,,10.84,66.46,4 RC,314,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,314,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,314,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,314,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,314,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,314,"Sulfate, urine ",,,4.7,28.74,4 RC,314,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,314,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,314,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,314,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,314,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,314,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,314,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,314,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,314,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,314,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,314,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,314,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,314,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,314,T cells; total count ,,,32.32,199.37,4 RC,314,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,314,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,314,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,314,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,314,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,314,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,314,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,314,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,314,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,314,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,314,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,314,Tacrolimus ,,,11.76,73.66,4 RC,314,Tapentadol ,,,10.83,127.56,4 RC,314,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,314,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,314,Testosterone; free ,,,21.82,134.7,4 RC,314,Testosterone; total ,,,22.11,136.54,4 RC,314,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,314,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,314,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,314,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,314,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,314,Theophylline ,,,12.12,75.44,4 RC,314,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,314,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,314,Thiocyanate ,,,9.97,61.1,4 RC,314,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,314,Thrombin time; plasma ,,,4.95,30.52,4 RC,314,Thrombin time; titer ,,,5.87,35.94,4 RC,314,Thrombomodulin ,,,14.8,91.62,4 RC,314,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,314,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,314,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,314,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,314,Thyroglobulin ,,,13.76,84.43,4 RC,314,Thyroglobulin antibody ,,,13.63,84.43,4 RC,314,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,314,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,314,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,314,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,314,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,314,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,314,Thyroxine; free ,,,7.73,48.49,4 RC,314,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,314,Thyroxine; total ,,,5.89,35.94,4 RC,314,Tiagabine ,,,23.23,143.69,4 RC,314,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,314,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,314,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,314,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,314,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,314,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,314,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,314,Tobramycin ,,,13.82,86.21,4 RC,314,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,314,Topiramate ,,,10.21,62.89,4 RC,314,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,314,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,314,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,314,Tramadol ,,,10.54,127.56,4 RC,314,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,314,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,314,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,314,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,314,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,314,Transferrin ,,,10.93,68.24,4 RC,314,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,314,Triglycerides ,,,4.92,30.52,4 RC,314,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,314,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,314,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,314,"Troponin, qualitative ",,,8.65,53.9,4 RC,314,"Troponin, quantitative ",,,10.68,66.46,4 RC,314,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,314,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,314,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,314,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,314,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,314,Tyrosine ,,,9.11,55.69,4 RC,314,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,314,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,314,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,314,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,314,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,314,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,314,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,314,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,314,Unlisted immunology procedure ,,,99.55,128.28,3 RC,314,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,314,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,314,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,314,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,314,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,314,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,314,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,314,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,314,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,314,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,314,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,314,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,314,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,314,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,314,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,314,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,314,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,314,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,314,Uric acid; blood ,,,3.88,23.38,4 RC,314,Uric acid; other source ,,,4.36,26.95,4 RC,314,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,314,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,314,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,314,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,314,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,314,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,314,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,314,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,314,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,314,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,314,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,314,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,314,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,314,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,314,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,314,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,314,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,314,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,314,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,314,Vancomycin ,,,11.6,71.87,4 RC,314,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,314,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,314,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,314,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,314,Vedolizumab ,,,33.05,204.79,4 RC,314,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,314,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,314,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,314,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,314,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,314,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,314,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,314,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,314,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,314,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,314,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,314,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,314,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,314,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,314,Very long chain fatty acids ,,,16.92,104.18,4 RC,314,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,314,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,314,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,314,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,314,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,314,Viscosity ,,,10.0,61.1,4 RC,314,Vitamin A ,,,9.95,61.1,4 RC,314,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,314,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,314,Vitamin K ,,,11.75,71.87,4 RC,314,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,314,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,314,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,314,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,314,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,314,Voriconazole ,,,23.23,143.69,4 RC,314,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,314,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,314,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,314,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,314,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,314,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,314,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,314,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,314,Zinc ,,,9.76,61.1,4 RC,314,Zonisamide ,,,11.35,70.08,4 RC,314,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,314,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,314,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,319, Laboratory Pathology Other ,,,,,0 RC,319,17-hydroxypregnenolone ,,,19.54,120.36,4 RC,319,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,319,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,257.04,1589.8,4 RC,319,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,74.51,461.69,4 RC,319,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,67.05,414.98,4 RC,319,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,27.95,172.48,4 RC,319,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,319,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,171.36,1059.87,4 RC,319,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,668.3,4135.23,4 RC,319,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,239.9,1483.78,4 RC,319,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,319,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,319,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,319,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,40.48,249.71,4 RC,319,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,319,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,319,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,Acetaminophen ,,,15.97,98.82,4 RC,319,Acetylcholine receptor (AChR); binding antibody ,,,15.77,15.77,1 RC,319,Acetylcholine receptor (AChR); blocking antibody ,,,15.77,15.77,1 RC,319,Acetylcholine receptor (AChR); modulating antibody ,,,10.32,10.32,1 RC,319,Acetylcholinesterase ,,,10.53,64.67,4 RC,319,"Actin (smooth muscle) antibody (ASMA), each ",,,9.88,64.67,4 RC,319,Activated Protein C (APC) resistance assay ,,,13.13,80.85,4 RC,319,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,8.24,253.28,4 RC,319,"Acylcarnitines; qualitative, each specimen ",,,14.13,88.0,4 RC,319,"Acylcarnitines; quantitative, each specimen ",,,14.45,89.84,4 RC,319,Adalimumab ,,,33.05,204.79,4 RC,319,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,22.1,136.54,4 RC,319,Adrenocorticotropic hormone (ACTH) ,,,33.09,204.79,4 RC,319,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,5.98,37.72,4 RC,319,Albumin; ischemia modified ,,,29.08,179.62,4 RC,319,"Albumin; other source, quantitative, each specimen ",,,6.67,41.29,4 RC,319,"Albumin; serum, plasma or whole blood ",,,4.24,26.95,4 RC,319,"Albumin; urine (eg, microalbumin), quantitative ",,,4.96,30.52,4 RC,319,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,5.33,32.31,4 RC,319,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,14.8,91.62,4 RC,319,Alcohol (ethanol); breath ,,,25.7,159.87,4 RC,319,Alcohol biomarkers; 1 or 2 ,,,11.54,11.54,1 RC,319,Alcohol biomarkers; 3 or more ,,,9.77,9.77,1 RC,319,Alcohols ,,,9.61,127.56,4 RC,319,Aldolase ,,,8.32,52.12,4 RC,319,Aldosterone ,,,34.91,215.56,4 RC,319,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,107.53,664.63,4 RC,319,"Alkaloids, not otherwise specified ",,,17.43,127.56,4 RC,319,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,319,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,6.82,43.13,4 RC,319,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,4.47,26.95,4 RC,319,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,15.36,95.19,4 RC,319,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,6.7,41.29,4 RC,319,Alpha-1-antitrypsin; phenotype ,,,12.39,77.23,4 RC,319,Alpha-1-antitrypsin; total ,,,11.52,71.87,4 RC,319,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,55.18,341.33,4 RC,319,Alpha-fetoprotein (AFP); amniotic fluid ,,,14.57,89.84,4 RC,319,Alpha-fetoprotein (AFP); serum ,,,14.37,88.0,4 RC,319,Aluminum ,,,21.83,134.7,4 RC,319,Amikacin ,,,12.92,80.85,4 RC,319,"Amines, vaginal fluid, qualitative ",,,5.13,32.31,4 RC,319,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,16.8,104.18,4 RC,319,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,14.45,89.84,4 RC,319,"Amino acids; multiple, qualitative, each specimen ",,,11.88,73.66,4 RC,319,"Amino acids; single, qualitative, each specimen ",,,12.15,75.44,4 RC,319,"Amino acids; single, quantitative, each specimen ",,,19.69,122.15,4 RC,319,"Aminolevulinic acid, delta (ALA) ",,,14.1,88.0,4 RC,319,Amiodarone ,,,15.97,98.82,4 RC,319,Ammonia ,,,12.48,77.23,4 RC,319,Amniotic fluid scan (spectrophotometric) ,,,8.01,50.28,4 RC,319,Amphetamines; 1 or 2 ,,,12.98,127.56,4 RC,319,Amphetamines; 3 or 4 ,,,11.14,11.14,1 RC,319,Amphetamines; 5 or more ,,,7.91,7.91,1 RC,319,Amylase ,,,5.55,34.15,4 RC,319,Anabolic steroids; 1 or 2 ,,,19.0,127.56,4 RC,319,Anabolic steroids; 3 or more ,,,21.31,21.31,1 RC,319,"Analgesics, non-opioid; 1 or 2 ",,,9.82,127.56,4 RC,319,"Analgesics, non-opioid; 3-5 ",,,4.37,4.37,1 RC,319,"Analgesics, non-opioid; 6 or more ",,,6.99,6.99,1 RC,319,Androstanediol glucuronide ,,,24.7,152.67,4 RC,319,Androstenedione ,,,25.09,154.51,4 RC,319,Androsterone ,,,21.89,134.7,4 RC,319,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,319,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,319,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,319,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,319,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,319,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,319,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,319,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,319,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,319,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,319,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,319,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,319,Angiotensin I - converting enzyme (ACE) ,,,12.51,77.23,4 RC,319,Angiotensin II ,,,17.58,109.59,4 RC,319,"Animal inoculation, small animal, with observation and dissection ",,,14.43,89.84,4 RC,319,Anti-mullerian hormone (AMH) ,,,33.09,33.09,1 RC,319,Anti-phosphatidylserine (phospholipid) antibody ,,,13.77,84.43,4 RC,319,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,319,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,319,Antibody identification; leukocyte antibodies ,,,12.89,79.01,4 RC,319,Antibody identification; platelet antibodies ,,,15.74,96.98,4 RC,319,Antibody identification; platelet associated immunoglobulin assay ,,,10.68,66.46,4 RC,319,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,70.16,506.55,8 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,277.39,1726.28,8 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,55.0,339.49,4 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,306.36,1895.14,4 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,276.72,1711.94,4 RC,319,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,55.0,339.49,4 RC,319,Antibody; Aspergillus ,,,12.89,79.01,4 RC,319,Antibody; Bartonella ,,,8.72,53.9,4 RC,319,Antibody; Blastomyces ,,,11.06,68.24,4 RC,319,Antibody; Bordetella ,,,11.3,70.08,4 RC,319,Antibody; Borrelia (relapsing fever) ,,,11.46,70.08,4 RC,319,Antibody; Borrelia burgdorferi (Lyme disease) ,,,14.6,89.84,4 RC,319,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,13.27,82.64,4 RC,319,Antibody; Brucella ,,,7.65,46.7,4 RC,319,Antibody; Campylobacter ,,,11.24,70.08,4 RC,319,Antibody; Candida ,,,10.29,62.89,4 RC,319,Antibody; Chlamydia ,,,10.13,62.89,4 RC,319,"Antibody; Chlamydia, IgM ",,,10.86,66.46,4 RC,319,Antibody; Coccidioides ,,,9.82,61.1,4 RC,319,Antibody; Coxiella burnetii (Q fever) ,,,10.38,64.67,4 RC,319,Antibody; Cryptococcus ,,,12.34,77.23,4 RC,319,Antibody; Diphtheria ,,,13.04,80.85,4 RC,319,Antibody; Ehrlichia ,,,8.72,53.9,4 RC,319,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,11.24,70.08,4 RC,319,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,13.1,80.85,4 RC,319,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,15.54,96.98,4 RC,319,Antibody; Francisella tularensis ,,,12.13,75.44,4 RC,319,Antibody; Giardia lamblia ,,,12.61,77.23,4 RC,319,Antibody; HIV-1 ,,,7.62,46.7,4 RC,319,"Antibody; HIV-1 and HIV-2, single result ",,,11.75,71.87,4 RC,319,Antibody; HIV-2 ,,,11.59,71.87,4 RC,319,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,16.57,102.39,4 RC,319,Antibody; HTLV-I ,,,7.79,48.49,4 RC,319,Antibody; HTLV-II ,,,12.0,73.66,4 RC,319,Antibody; Haemophilus influenza ,,,13.58,84.43,4 RC,319,Antibody; Helicobacter pylori ,,,14.43,89.84,4 RC,319,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,319,Antibody; Legionella ,,,13.11,80.85,4 RC,319,Antibody; Leishmania ,,,10.5,64.67,4 RC,319,Antibody; Leptospira ,,,13.88,86.21,4 RC,319,Antibody; Listeria monocytogenes ,,,11.3,70.08,4 RC,319,Antibody; Neisseria meningitidis ,,,11.3,70.08,4 RC,319,Antibody; Nocardia ,,,13.7,84.43,4 RC,319,Antibody; Plasmodium (malaria) ,,,11.3,70.08,4 RC,319,Antibody; Rickettsia ,,,16.57,102.39,4 RC,319,Antibody; Salmonella ,,,11.3,70.08,4 RC,319,Antibody; Shigella ,,,20.97,129.34,4 RC,319,Antibody; Toxoplasma ,,,12.33,75.44,4 RC,319,"Antibody; Toxoplasma, IgM ",,,12.34,77.23,4 RC,319,Antibody; Treponema pallidum ,,,11.34,70.08,4 RC,319,Antibody; Trichinella ,,,10.76,66.46,4 RC,319,Antibody; West Nile virus ,,,12.33,75.44,4 RC,319,"Antibody; West Nile virus, IgM ",,,14.43,89.84,4 RC,319,Antibody; Yersinia ,,,11.3,70.08,4 RC,319,"Antibody; Zika virus, IgM ",,,14.43,89.84,4 RC,319,Antibody; actinomyces ,,,8.72,53.9,4 RC,319,Antibody; adenovirus ,,,11.03,68.24,4 RC,319,"Antibody; bacterium, not elsewhere specified ",,,11.04,68.24,4 RC,319,Antibody; cytomegalovirus (CMV) ,,,12.33,75.44,4 RC,319,"Antibody; cytomegalovirus (CMV), IgM ",,,14.43,89.84,4 RC,319,"Antibody; encephalitis, California (La Crosse) ",,,11.3,70.08,4 RC,319,"Antibody; encephalitis, Eastern equine ",,,11.3,70.08,4 RC,319,"Antibody; encephalitis, St. Louis ",,,11.3,70.08,4 RC,319,"Antibody; encephalitis, Western equine ",,,11.3,70.08,4 RC,319,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,11.17,68.24,4 RC,319,"Antibody; fungus, not elsewhere specified ",,,10.5,64.67,4 RC,319,"Antibody; helminth, not elsewhere specified ",,,11.15,68.24,4 RC,319,"Antibody; hepatitis, delta agent ",,,14.7,91.62,4 RC,319,"Antibody; herpes simplex, non-specific type test ",,,12.33,75.44,4 RC,319,"Antibody; herpes simplex, type 1 ",,,11.3,70.08,4 RC,319,"Antibody; herpes simplex, type 2 ",,,16.57,102.39,4 RC,319,Antibody; histoplasma ,,,11.81,73.66,4 RC,319,Antibody; influenza virus ,,,11.61,71.87,4 RC,319,Antibody; lymphocytic choriomeningitis ,,,11.03,68.24,4 RC,319,Antibody; mucormycosis ,,,12.85,79.01,4 RC,319,Antibody; mumps ,,,11.18,70.08,4 RC,319,Antibody; mycoplasma ,,,11.34,70.08,4 RC,319,Antibody; parvovirus ,,,12.88,79.01,4 RC,319,"Antibody; protozoa, not elsewhere specified ",,,10.62,66.46,4 RC,319,Antibody; respiratory syncytial virus ,,,13.62,84.43,4 RC,319,Antibody; rotavirus ,,,15.62,96.98,4 RC,319,Antibody; rubella ,,,12.33,75.44,4 RC,319,Antibody; rubeola ,,,11.04,68.24,4 RC,319,Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ,,,42.97,42.97,1 RC,319,Antibody; tetanus ,,,12.68,79.01,4 RC,319,Antibody; varicella-zoster ,,,11.04,68.24,4 RC,319,"Antibody; virus, not elsewhere specified ",,,11.04,68.24,4 RC,319,"Antidepressants, not otherwise specified ",,,10.92,10.92,1 RC,319,"Antidepressants, serotonergic class; 1 or 2 ",,,16.97,127.56,4 RC,319,"Antidepressants, serotonergic class; 3-5 ",,,12.77,12.77,1 RC,319,"Antidepressants, serotonergic class; 6 or more ",,,8.17,8.17,1 RC,319,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,4.28,127.56,4 RC,319,"Antidepressants, tricyclic and other cyclicals; 3-5 ",,,17.39,17.39,1 RC,319,"Antidepressants, tricyclic and other cyclicals; 6 or more ",,,8.86,8.86,1 RC,319,"Antiepileptics, not otherwise specified; 1-3 ",,,4.28,127.56,4 RC,319,"Antiepileptics, not otherwise specified; 4-6 ",,,6.56,6.56,1 RC,319,"Antiepileptics, not otherwise specified; 7 or more ",,,5.67,5.67,1 RC,319,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,4.62,28.74,4 RC,319,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,4.44,26.95,4 RC,319,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,4.9,30.52,4 RC,319,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,10.32,64.67,4 RC,319,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,10.32,64.67,4 RC,319,Antinuclear antibodies (ANA); ,,,10.36,64.67,4 RC,319,Antinuclear antibodies (ANA); titer ,,,9.56,59.26,4 RC,319,"Antipsychotics, not otherwise specified; 1-3 ",,,12.0,127.56,4 RC,319,"Antipsychotics, not otherwise specified; 4-6 ",,,27.7,27.7,1 RC,319,"Antipsychotics, not otherwise specified; 7 or more ",,,7.07,7.07,1 RC,319,Antistreptolysin 0; screen ,,,4.95,30.52,4 RC,319,Antistreptolysin 0; titer ,,,6.25,39.51,4 RC,319,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,1156.84,7156.68,4 RC,319,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,431.83,2671.2,4 RC,319,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,319,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,319,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,319,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,319,"Apolipoprotein, each ",,,18.07,111.38,4 RC,319,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,319,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,9.88,61.1,4 RC,319,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,319,Arsenic ,,,16.25,100.61,4 RC,319,"Ascorbic acid (Vitamin C), blood ",,,8.48,52.12,4 RC,319,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,319,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,319,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,319,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,319,"Atomic absorption spectroscopy, each analyte ",,,13.63,84.43,4 RC,319,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,319,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,319,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,319,"B cells, total count ",,,32.32,199.37,4 RC,319,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,81.39,502.98,4 RC,319,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,140.48,869.42,4 RC,319,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,124.1,767.03,4 RC,319,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,183.89,1137.09,4 RC,319,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,33.68,208.36,4 RC,319,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,150.29,930.52,4 RC,319,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,258.19,1596.94,4 RC,319,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,242.37,1499.96,4 RC,319,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,319,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,376.99,2331.66,4 RC,319,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,500.56,3096.9,4 RC,319,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,400.98,2480.76,4 RC,319,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,1563.56,9673.38,4 RC,319,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,242.37,1499.96,4 RC,319,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,158.61,980.8,4 RC,319,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,321.51,1988.54,4 RC,319,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,150.29,930.52,4 RC,319,Barbiturates ,,,9.34,127.56,4 RC,319,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,9.93,73.66,4 RC,319,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,9.93,44.92,4 RC,319,Benzodiazepines; 1-12 ,,,13.8,127.56,4 RC,319,Benzodiazepines; 13 or more ,,,19.74,19.74,1 RC,319,"Beta 2 Glycoprotein I antibody, each ",,,21.81,134.7,4 RC,319,Beta-2 microglobulin ,,,13.86,86.21,4 RC,319,Bile acids; cholylglycine ,,,22.78,140.11,4 RC,319,Bile acids; total ,,,14.67,91.62,4 RC,319,"Bilirubin, total, transcutaneous ",,,4.3,26.95,4 RC,319,Bilirubin; direct ,,,4.3,26.95,4 RC,319,"Bilirubin; feces, qualitative ",,,3.91,23.38,4 RC,319,Bilirubin; total ,,,4.3,26.95,4 RC,319,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,319,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,319,"Biotinidase, each specimen ",,,14.45,89.84,4 RC,319,Bleeding time ,,,4.13,25.17,4 RC,319,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,319,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,319,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,319,Blood count; automated differential WBC count ,,,5.54,34.15,4 RC,319,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,3.25,19.75,4 RC,319,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,2.94,17.97,4 RC,319,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,5.54,34.15,4 RC,319,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,6.66,41.29,4 RC,319,Blood count; hematocrit (Hct) ,,,2.03,12.55,4 RC,319,Blood count; hemoglobin (Hgb) ,,,2.03,12.55,4 RC,319,"Blood count; leukocyte (WBC), automated ",,,2.17,12.55,4 RC,319,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,3.69,23.38,4 RC,319,"Blood count; manual differential WBC count, buffy coat ",,,4.35,26.95,4 RC,319,"Blood count; platelet, automated ",,,3.84,23.38,4 RC,319,"Blood count; red blood cell (RBC), automated ",,,2.59,16.18,4 RC,319,"Blood count; reticulocyte, automated ",,,3.42,21.54,4 RC,319,"Blood count; reticulocyte, manual ",,,3.69,23.38,4 RC,319,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,4.77,28.74,4 RC,319,Blood count; spun microhematocrit ,,,6.0,37.72,4 RC,319,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,319,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,319,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,319,"Blood typing, serologic; ABO ",,,2.56,16.18,4 RC,319,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,3.28,19.75,4 RC,319,"Blood typing, serologic; Rh (D) ",,,2.56,16.18,4 RC,319,"Blood typing, serologic; Rh phenotyping, complete ",,,6.64,41.29,4 RC,319,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,14.0,86.21,4 RC,319,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,5.44,34.15,4 RC,319,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,13.64,84.43,4 RC,319,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,3.62,21.54,4 RC,319,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,3.75,23.38,4 RC,319,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,4.56,28.74,4 RC,319,Bone age studies ,,,61.64,79.3,3 RC,319,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,319,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,319,Bradykinin ,,,4.42,26.95,4 RC,319,Buprenorphine ,,,14.01,14.01,1 RC,319,C-peptide ,,,17.83,109.59,4 RC,319,C-reactive protein; ,,,4.44,26.95,4 RC,319,C-reactive protein; high sensitivity (hsCRP) ,,,11.1,68.24,4 RC,319,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,117.38,725.73,4 RC,319,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,725.09,4485.54,4 RC,319,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,158.68,982.58,4 RC,319,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,104.21,644.88,4 RC,319,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,319,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,207.26,1282.62,4 RC,319,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,476.89,2951.43,4 RC,319,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,372.77,2306.55,4 RC,319,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,427.54,2646.04,4 RC,319,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,144.59,894.59,4 RC,319,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,83.29,515.54,4 RC,319,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,319,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,319,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,249.63,1544.88,4 RC,319,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,149.78,926.95,4 RC,319,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,386.34,2390.97,4 RC,319,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,319,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,319,Cadmium ,,,20.26,125.72,4 RC,319,Caffeine ,,,33.05,204.79,4 RC,319,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,319,Calcitonin ,,,22.95,141.9,4 RC,319,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,68.86,425.75,4 RC,319,Calcium; after calcium infusion test ,,,11.43,70.08,4 RC,319,Calcium; ionized ,,,11.72,71.87,4 RC,319,Calcium; total ,,,4.42,26.95,4 RC,319,"Calcium; urine quantitative, timed specimen ",,,5.17,32.31,4 RC,319,Calculus; X-ray diffraction ,,,10.73,66.46,4 RC,319,Calculus; infrared spectroscopy ,,,11.06,68.24,4 RC,319,Calculus; qualitative analysis ,,,9.92,61.1,4 RC,319,"Calculus; quantitative analysis, chemical ",,,11.03,68.24,4 RC,319,"Calprotectin, fecal ",,,16.82,104.18,4 RC,319,"Cannabinoids, natural ",,,11.5,127.56,4 RC,319,"Cannabinoids, synthetic; 1-3 ",,,10.96,127.56,4 RC,319,"Cannabinoids, synthetic; 4-6 ",,,14.14,14.14,1 RC,319,"Cannabinoids, synthetic; 7 or more ",,,13.79,13.79,1 RC,319,"Carbamazepine; -10,11-epoxide ",,,15.97,98.82,4 RC,319,Carbamazepine; free ,,,11.35,70.08,4 RC,319,Carbamazepine; total ,,,12.48,77.23,4 RC,319,Carbohydrate deficient transferrin ,,,15.47,95.19,4 RC,319,Carbon dioxide (bicarbonate) ,,,4.18,25.17,4 RC,319,Carboxyhemoglobin; qualitative ,,,12.06,75.44,4 RC,319,Carboxyhemoglobin; quantitative ,,,10.56,64.67,4 RC,319,Carcinoembryonic antigen (CEA) ,,,16.25,100.61,4 RC,319,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,319,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,319,"Cardiolipin (phospholipid) antibody, each Ig class ",,,21.81,134.7,4 RC,319,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,319,"Carnitine (total and free), quantitative, each specimen ",,,14.45,89.84,4 RC,319,Carotene ,,,7.89,48.49,4 RC,319,Catecholamines; blood ,,,24.92,154.51,4 RC,319,Catecholamines; fractionated ,,,21.63,134.7,4 RC,319,Catecholamines; total urine ,,,23.39,145.53,4 RC,319,Cathepsin-D ,,,15.47,95.19,4 RC,319,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,319,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,319,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,319,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,4.04,25.17,4 RC,319,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,4.79,30.52,4 RC,319,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,319,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,116.4,720.32,4 RC,319,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,319,Ceruloplasmin ,,,9.2,57.47,4 RC,319,Chemiluminescent assay ,,,12.1,75.44,4 RC,319,"Chemotaxis assay, specify method ",,,13.7,84.43,4 RC,319,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,223.44,1383.17,4 RC,319,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,177.76,1099.37,4 RC,319,Chloramphenicol ,,,10.85,66.46,4 RC,319,Chloride; blood ,,,3.94,25.17,4 RC,319,Chloride; other source ,,,4.28,26.95,4 RC,319,Chloride; urine ,,,4.93,30.52,4 RC,319,"Chlorinated hydrocarbons, screen ",,,5.15,32.31,4 RC,319,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,319,"Cholesterol, serum or whole blood, total ",,,3.72,23.38,4 RC,319,Cholinesterase; RBC ,,,8.4,52.12,4 RC,319,Cholinesterase; serum ,,,6.74,41.29,4 RC,319,"Chondroitin B sulfate, quantitative ",,,17.7,109.59,4 RC,319,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,47.89,296.41,4 RC,319,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,44.25,273.03,4 RC,319,Chromium ,,,17.38,107.81,4 RC,319,Chromogenic substrate assay ,,,10.19,62.89,4 RC,319,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,148.37,917.97,4 RC,319,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,148.37,917.97,4 RC,319,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,148.37,917.97,4 RC,319,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,161.57,998.76,4 RC,319,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,148.79,919.75,4 RC,319,"Chromosome analysis; additional cells counted, each study ",,,23.05,141.9,4 RC,319,Chromosome analysis; additional high resolution study ,,,29.5,183.25,4 RC,319,"Chromosome analysis; additional karyotypes, each study ",,,28.67,177.83,4 RC,319,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,58.77,362.87,4 RC,319,Chromosome analysis; analyze 20-25 cells ,,,123.9,767.03,4 RC,319,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,107.52,664.63,4 RC,319,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,128.76,797.61,4 RC,319,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,226.49,1401.14,4 RC,319,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,319,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,319,Citrate ,,,23.82,147.31,4 RC,319,"Clot lysis time, whole blood dilution ",,,17.45,107.81,4 RC,319,Clot retraction ,,,13.96,86.21,4 RC,319,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,10.15,62.89,4 RC,319,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,9.26,57.47,4 RC,319,"Clotting inhibitors or anticoagulants; protein C, activity ",,,11.86,73.66,4 RC,319,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,10.29,62.89,4 RC,319,"Clotting inhibitors or anticoagulants; protein S, free ",,,13.13,80.85,4 RC,319,"Clotting inhibitors or anticoagulants; protein S, total ",,,9.95,61.1,4 RC,319,"Clotting; factor II, prothrombin, specific ",,,11.12,68.24,4 RC,319,Clotting; factor IX (PTC or Christmas) ,,,16.31,100.61,4 RC,319,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,15.13,93.41,4 RC,319,"Clotting; factor VII (proconvertin, stable factor) ",,,15.34,95.19,4 RC,319,"Clotting; factor VIII (AHG), 1-stage ",,,15.34,95.19,4 RC,319,Clotting; factor VIII related antigen ,,,17.49,107.81,4 RC,319,"Clotting; factor VIII, VW factor antigen ",,,19.66,122.15,4 RC,319,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,19.66,122.15,4 RC,319,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,19.66,122.15,4 RC,319,Clotting; factor X (Stuart-Prower) ,,,15.34,95.19,4 RC,319,Clotting; factor XI (PTA) ,,,15.34,95.19,4 RC,319,Clotting; factor XII (Hageman) ,,,16.57,102.39,4 RC,319,Clotting; factor XIII (fibrin stabilizing) ,,,14.0,86.21,4 RC,319,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,7.8,48.49,4 RC,319,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,16.22,100.61,4 RC,319,Clotting; prekallikrein assay (Fletcher factor assay) ,,,16.22,100.61,4 RC,319,Clozapine ,,,17.27,105.96,4 RC,319,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,26.44,163.49,4 RC,319,Coagulation time; Lee and White ,,,4.02,25.17,4 RC,319,Coagulation time; activated ,,,3.67,23.38,4 RC,319,Coagulation time; other methods ,,,3.85,23.38,4 RC,319,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,319,Cocaine ,,,10.46,127.56,4 RC,319,Cold agglutinin; screen ,,,6.92,43.13,4 RC,319,Cold agglutinin; titer ,,,6.91,43.13,4 RC,319,"Collagen cross links, any method ",,,16.0,98.82,4 RC,319,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,319,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,319,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,319,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,95.19,4 RC,319,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,20.64,127.56,4 RC,319,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,496.5,3071.79,4 RC,319,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,261.16,1614.91,4 RC,319,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,199.7,1235.91,4 RC,319,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,319,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,319,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,319,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,319,"Complement fixation tests, each antigen ",,,8.58,53.9,4 RC,319,"Complement; antigen, each component ",,,10.28,62.89,4 RC,319,"Complement; functional activity, each component ",,,10.28,62.89,4 RC,319,Complement; total hemolytic (CH50) ,,,17.41,107.81,4 RC,319,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,34.15,4 RC,319,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,319,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,41.29,4 RC,319,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,319,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,9.61,55.69,4 RC,319,"Concentration (any type), for infectious agents ",,,5.72,35.94,4 RC,319,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,319,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,319,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,319,Copper ,,,10.63,66.46,4 RC,319,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,319,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,319,Corticosterone ,,,19.3,118.58,4 RC,319,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,686.83,4250.17,4 RC,319,Cortisol; free ,,,14.32,88.0,4 RC,319,Cortisol; total ,,,13.96,86.21,4 RC,319,Creatine ,,,3.98,25.17,4 RC,319,"Creatine kinase (CK), (CPK); MB fraction only ",,,9.89,61.1,4 RC,319,"Creatine kinase (CK), (CPK); isoenzymes ",,,11.47,71.87,4 RC,319,"Creatine kinase (CK), (CPK); isoforms ",,,10.17,62.89,4 RC,319,"Creatine kinase (CK), (CPK); total ",,,5.58,34.15,4 RC,319,Creatinine; blood ,,,4.39,26.95,4 RC,319,Creatinine; clearance ,,,8.11,50.28,4 RC,319,Creatinine; other source ,,,4.44,26.95,4 RC,319,Cryofibrinogen ,,,12.12,75.44,4 RC,319,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,5.54,34.15,4 RC,319,"Cryopreservation, freezing and storage of cells, each cell line ",,,11.2,70.08,4 RC,319,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,319,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,319,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,319,Cryopreservation; sperm ,,,442.57,570.33,3 RC,319,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,6.28,39.51,4 RC,319,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,319,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,319,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,319,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,6.93,43.13,4 RC,319,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,7.38,44.92,4 RC,319,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,8.11,50.28,4 RC,319,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,8.84,53.9,4 RC,319,"Culture, bacterial; quantitative colony count, urine ",,,6.92,43.13,4 RC,319,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.48,52.12,4 RC,319,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,8.27,52.12,4 RC,319,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,8.09,50.28,4 RC,319,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,8.09,50.28,4 RC,319,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,6.94,43.13,4 RC,319,"Culture, chlamydia, any source ",,,16.79,104.18,4 RC,319,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,17.53,107.81,4 RC,319,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,7.2,44.92,4 RC,319,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,6.61,41.29,4 RC,319,"Culture, fungi, definitive identification, each organism; mold ",,,8.84,53.9,4 RC,319,"Culture, fungi, definitive identification, each organism; yeast ",,,8.84,53.9,4 RC,319,"Culture, mycobacterial, definitive identification, each isolate ",,,12.52,77.23,4 RC,319,"Culture, mycoplasma, any source ",,,13.19,80.85,4 RC,319,"Culture, presumptive, pathogenic organisms, screening only; ",,,5.68,35.94,4 RC,319,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,23.19,143.69,4 RC,319,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,9.25,57.47,4 RC,319,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,10.73,66.46,4 RC,319,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,30.07,186.82,4 RC,319,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,17.18,105.96,4 RC,319,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,98.84,610.79,4 RC,319,"Culture, typing; identification by pulse field gel typing ",,,6.63,41.29,4 RC,319,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,186.83,1155.06,4 RC,319,"Culture, typing; immunofluorescent method, each antiserum ",,,4.77,28.74,4 RC,319,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,4.44,26.95,4 RC,319,"Culture, typing; other methods ",,,6.63,41.29,4 RC,319,Cyanide ,,,16.63,102.39,4 RC,319,Cyanocobalamin (Vitamin B-12); ,,,12.92,80.85,4 RC,319,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,12.27,75.44,4 RC,319,"Cyclic citrullinated peptide (CCP), antibody ",,,11.1,68.24,4 RC,319,Cyclosporine ,,,15.46,95.19,4 RC,319,Cystatin C ,,,15.87,98.82,4 RC,319,"Cystine and homocystine, urine, qualitative ",,,8.18,50.28,4 RC,319,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,319,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,319,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,993.89,6148.94,4 RC,319,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,993.89,6148.94,4 RC,319,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,319,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,319,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,43.32,267.67,4 RC,319,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,13.71,91.62,4 RC,319,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,17.36,107.81,4 RC,319,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,21.74,134.7,4 RC,319,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,19.74,122.15,4 RC,319,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,22.8,141.9,4 RC,319,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,319,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,319,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,319,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,319,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,319,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,319,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,319,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,319,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,319,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,319,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,319,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,13.64,91.62,4 RC,319,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,13.64,91.62,4 RC,319,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,13.64,91.62,4 RC,319,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,36.17,224.54,4 RC,319,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,12.56,77.23,4 RC,319,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,13.64,91.62,4 RC,319,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,23.68,147.31,4 RC,319,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,20.59,127.56,4 RC,319,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,319,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,319,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,319,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,239.05,1478.42,4 RC,319,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,319,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,319,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,319,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,319,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,9.2,57.47,4 RC,319,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,9.68,59.26,4 RC,319,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,319,Dehydroepiandrosterone (DHEA) ,,,21.65,134.7,4 RC,319,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,19.04,118.58,4 RC,319,"Deoxycortisol, 11- ",,,25.09,154.51,4 RC,319,"Deoxyribonuclease, antibody ",,,11.35,70.08,4 RC,319,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,11.77,73.66,4 RC,319,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,10.37,64.67,4 RC,319,"Desoxycorticosterone, 11- ",,,26.54,163.49,4 RC,319,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,138.7,858.65,4 RC,319,Dibucaine number ,,,10.5,64.67,4 RC,319,Digoxin; free ,,,11.38,70.08,4 RC,319,Digoxin; total ,,,11.38,70.08,4 RC,319,Dihydrotestosterone (DHT) ,,,25.09,154.51,4 RC,319,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,319,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,319,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,319,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,1309.57,16 RC,319,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,328.72,4 RC,319,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,53.24,328.72,4 RC,319,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,10.79,66.46,4 RC,319,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,14.69,91.62,4 RC,319,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,18.45,127.56,4 RC,319,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,19.17,127.56,4 RC,319,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,6.66,127.56,4 RC,319,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,319,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,319,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,319,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,319,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,319,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,319,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,319,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,319,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,319,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,319,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,319,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,319,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,319,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,319,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,319,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,319,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,319,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,319,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,319,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,319,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,278.1,1720.93,4 RC,319,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,150.29,930.52,4 RC,319,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,319,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,9.88,61.1,4 RC,319,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,19.68,122.15,4 RC,319,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,8.24,37.72,4 RC,319,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,319,"Electrophoretic technique, not elsewhere specified ",,,52.69,325.15,4 RC,319,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,319,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,10.36,64.67,4 RC,319,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,18.99,116.79,4 RC,319,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,37.73,233.52,4 RC,319,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,319,Erythropoietin ,,,16.1,98.82,4 RC,319,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,23.94,147.31,4 RC,319,Estradiol; total ,,,23.94,147.31,4 RC,319,Estriol ,,,20.72,127.56,4 RC,319,Estrogens; fractionated ,,,27.67,170.64,4 RC,319,Estrogens; total ,,,18.59,114.95,4 RC,319,Estrone ,,,21.38,132.92,4 RC,319,Ethosuximide ,,,14.0,86.21,4 RC,319,Ethylene glycol ,,,12.77,79.01,4 RC,319,Etiocholanolone ,,,22.48,138.33,4 RC,319,Euglobulin lysis ,,,7.2,44.92,4 RC,319,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,84.06,520.95,4 RC,319,Everolimus ,,,11.76,73.66,4 RC,319,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,319,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,319,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,319,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,319,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,319,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,15.36,95.19,4 RC,319,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,56.28,348.47,4 RC,319,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,62.86,389.82,4 RC,319,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,514.08,3181.38,4 RC,319,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,31.38,194.02,4 RC,319,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,141.81,876.62,4 RC,319,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,71.11,440.09,4 RC,319,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,38.46,237.09,4 RC,319,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,48.87,301.77,4 RC,319,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,319,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,319,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,319,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,319,Factor inhibitor test ,,,11.03,68.24,4 RC,319,"Fat differential, feces, quantitative ",,,19.68,122.15,4 RC,319,"Fat or lipids, feces; qualitative ",,,4.37,26.95,4 RC,319,"Fat or lipids, feces; quantitative ",,,14.39,89.84,4 RC,319,"Fat stain, feces, urine, or respiratory secretions ",,,5.04,30.52,4 RC,319,"Fatty acids, nonesterified ",,,16.09,98.82,4 RC,319,Felbamate ,,,15.97,98.82,4 RC,319,Fentanyl ,,,13.07,127.56,4 RC,319,Fern test ,,,40.44,52.12,3 RC,319,Ferritin ,,,11.68,71.87,4 RC,319,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,681.16,4214.24,4 RC,319,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,650.35,4023.85,4 RC,319,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,319,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,319,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,319,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,319,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,319,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,319,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,55.18,341.33,4 RC,319,Fetal lung maturity assessment; fluorescence polarization ,,,16.2,100.61,4 RC,319,Fetal lung maturity assessment; foam stability test ,,,16.2,100.61,4 RC,319,Fetal lung maturity assessment; lamellar body density ,,,16.55,102.39,4 RC,319,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,18.84,116.79,4 RC,319,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,8.32,52.12,4 RC,319,"Fibrin degradation products, D-dimer; quantitative ",,,8.72,53.9,4 RC,319,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,8.72,53.9,4 RC,319,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,5.91,35.94,4 RC,319,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,68.94,425.75,4 RC,319,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,10.65,66.46,4 RC,319,Fibrinogen; activity ,,,8.32,52.12,4 RC,319,Fibrinogen; antigen ,,,12.39,77.23,4 RC,319,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,13.26,82.64,4 RC,319,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,6.61,41.29,4 RC,319,Fibrinolytic factors and inhibitors; plasmin ,,,6.61,41.29,4 RC,319,Fibrinolytic factors and inhibitors; plasminogen activator ,,,14.73,91.62,4 RC,319,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,8.72,53.9,4 RC,319,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,5.6,34.15,4 RC,319,Flecainide ,,,15.97,98.82,4 RC,319,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,319,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,319,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,319,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,319,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,319,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,319,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,10.32,64.67,4 RC,319,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,10.32,64.67,4 RC,319,Fluoride ,,,15.88,98.82,4 RC,319,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,319,Folic acid; RBC ,,,15.13,93.41,4 RC,319,Folic acid; serum ,,,12.6,77.23,4 RC,319,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,319,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,319,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,319,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,319,"Fructose, semen ",,,14.86,91.62,4 RC,319,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,50.11,310.75,4 RC,319,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,149.78,926.95,4 RC,319,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,319,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,321.51,1988.54,4 RC,319,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,40.48,249.71,4 RC,319,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,86.64,535.29,4 RC,319,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,52.71,326.93,4 RC,319,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,29.99,185.03,4 RC,319,"Gabapentin, non-blood ",,,7.86,127.56,4 RC,319,"Gabapentin, whole blood, serum, or plasma ",,,18.56,114.95,4 RC,319,"Galactokinase, RBC ",,,18.4,113.16,4 RC,319,Galactose ,,,9.6,59.26,4 RC,319,Galactose-1-phosphate uridyl transferase; quantitative ,,,18.05,111.38,4 RC,319,Galactose-1-phosphate uridyl transferase; screen ,,,10.06,62.89,4 RC,319,Galectin-3 ,,,182.6,235.31,3 RC,319,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,7.97,48.49,4 RC,319,Gammaglobulin (immunoglobulin); IgE ,,,14.11,88.0,4 RC,319,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,6.87,43.13,4 RC,319,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,8.37,52.12,4 RC,319,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,22.34,138.33,4 RC,319,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,67.49,416.77,4 RC,319,"Gases, blood, pH only ",,,9.42,57.47,4 RC,319,"Gastric acid analysis, includes pH if performed, each specimen ",,,5.75,35.94,4 RC,319,Gastrin ,,,15.11,93.41,4 RC,319,Gastrin after secretin stimulation ,,,15.16,93.41,4 RC,319,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,319,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,319,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,319,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,319,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,319,Gentamicin ,,,14.04,86.21,4 RC,319,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,9.88,64.67,4 RC,319,Glucagon ,,,12.24,75.44,4 RC,319,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,39.47,244.29,4 RC,319,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,43.27,267.67,4 RC,319,Glucagon tolerance test ,,,15.23,93.41,4 RC,319,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,319,"Glucose, body fluid, other than blood ",,,3.37,21.54,4 RC,319,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,8.31,52.12,4 RC,319,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,5.18,32.31,4 RC,319,"Glucose; blood, reagent strip ",,,4.31,26.95,4 RC,319,Glucose; post glucose dose (includes glucose) ,,,4.07,25.17,4 RC,319,"Glucose; quantitative, blood (except reagent strip) ",,,3.37,21.54,4 RC,319,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,11.03,68.24,4 RC,319,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,3.36,21.54,4 RC,319,"Glucosidase, beta ",,,18.4,113.16,4 RC,319,Glutamate dehydrogenase ,,,11.27,70.08,4 RC,319,"Glutamyltransferase, gamma (GGT) ",,,6.17,37.72,4 RC,319,Glutathione ,,,13.24,82.64,4 RC,319,"Glutathione reductase, RBC ",,,8.09,50.28,4 RC,319,Glycated protein ,,,14.36,88.0,4 RC,319,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,127.15,786.78,4 RC,319,"Gonadotropin, chorionic (hCG); free beta chain ",,,13.1,80.85,4 RC,319,"Gonadotropin, chorionic (hCG); qualitative ",,,6.45,39.51,4 RC,319,"Gonadotropin, chorionic (hCG); quantitative ",,,12.89,79.01,4 RC,319,Gonadotropin; follicle stimulating hormone (FSH) ,,,15.92,98.82,4 RC,319,Gonadotropin; luteinizing hormone (LH) ,,,15.87,98.82,4 RC,319,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,57.15,353.88,4 RC,319,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,110.81,686.23,4 RC,319,"Growth hormone, human (HGH) (somatotropin) ",,,14.28,88.0,4 RC,319,"Growth hormone, human (HGH), antibody ",,,13.48,82.64,4 RC,319,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,64.77,400.59,4 RC,319,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,87.62,542.49,4 RC,319,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,319,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,514.08,3181.38,4 RC,319,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,321.51,1988.54,4 RC,319,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,149.78,926.95,4 RC,319,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,173.42,1072.42,4 RC,319,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,278.1,1720.93,4 RC,319,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,321.51,1988.54,4 RC,319,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,44.08,273.03,4 RC,319,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,56.0,346.69,4 RC,319,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,296.09,1832.3,4 RC,319,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,344.54,2132.29,4 RC,319,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,346.6,2144.84,4 RC,319,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,287.35,1778.4,4 RC,319,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,145.57,900.0,4 RC,319,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,151.87,939.5,4 RC,319,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,345.8,2139.48,4 RC,319,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,63.69,393.39,4 RC,319,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,109.18,675.46,4 RC,319,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,93.5,578.42,4 RC,319,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,105.97,655.65,4 RC,319,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,189.13,1169.46,4 RC,319,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,81.17,502.98,4 RC,319,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,104.71,648.51,4 RC,319,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,22.11,136.54,4 RC,319,"HLA typing; A, B, or C, multiple antigens ",,,49.69,307.18,4 RC,319,"HLA typing; DR/DQ, multiple antigens ",,,90.94,562.24,4 RC,319,"HLA typing; DR/DQ, single antigen ",,,25.85,159.87,4 RC,319,"HLA typing; lymphocyte culture, mixed (MLC) ",,,31.32,194.02,4 RC,319,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,319,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,Haloperidol ,,,13.53,84.43,4 RC,319,Haptoglobin; phenotypes ,,,23.04,141.9,4 RC,319,Haptoglobin; quantitative ,,,10.78,66.46,4 RC,319,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,319,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,319,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,17.94,111.38,4 RC,319,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,18.82,116.79,4 RC,319,Heinz bodies; direct ,,,3.6,21.54,4 RC,319,"Heinz bodies; induced, acetyl phenylhydrazine ",,,5.84,35.94,4 RC,319,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,319,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,57.71,357.45,4 RC,319,Helicobacter pylori; drug administration ,,,6.73,41.29,4 RC,319,Hemagglutination inhibition test (HAI) ,,,7.02,43.13,4 RC,319,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,650.77,4025.64,8 RC,319,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,319,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,15.47,95.19,4 RC,319,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,11.03,68.24,4 RC,319,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,6.62,41.29,4 RC,319,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,8.02,50.28,4 RC,319,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,319,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,319,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,11.43,70.08,4 RC,319,"Hemoglobin; F (fetal), chemical ",,,9.2,57.47,4 RC,319,"Hemoglobin; F (fetal), qualitative ",,,6.85,43.13,4 RC,319,"Hemoglobin; by copper sulfate method, non-automated ",,,3.44,21.54,4 RC,319,Hemoglobin; glycosylated (A1C) ,,,8.32,52.12,4 RC,319,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,8.32,52.12,4 RC,319,"Hemoglobin; methemoglobin, qualitative ",,,5.56,34.15,4 RC,319,"Hemoglobin; methemoglobin, quantitative ",,,7.03,43.13,4 RC,319,Hemoglobin; plasma ,,,6.26,39.51,4 RC,319,"Hemoglobin; sulfhemoglobin, quantitative ",,,7.54,46.7,4 RC,319,Hemoglobin; thermolabile ,,,7.71,48.49,4 RC,319,"Hemoglobin; unstable, screen ",,,8.11,50.28,4 RC,319,Hemoglobin; urine ,,,3.39,21.54,4 RC,319,"Hemolysin, acid ",,,7.6,46.7,4 RC,319,"Hemolysins and agglutinins; auto, screen, each ",,,7.52,46.7,4 RC,319,Hemolysins and agglutinins; incubated ,,,10.37,64.67,4 RC,319,"Hemosiderin, qualitative ",,,4.07,25.17,4 RC,319,Heparin assay ,,,11.22,70.08,4 RC,319,Heparin neutralization ,,,10.15,62.89,4 RC,319,Heparin-protamine tolerance test ,,,11.22,70.08,4 RC,319,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,6.13,43.13,4 RC,319,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,319,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,319,Hepatitis A antibody (HAAb) ,,,10.62,66.46,4 RC,319,"Hepatitis A antibody (HAAb), IgM antibody ",,,9.65,59.26,4 RC,319,Hepatitis B core antibody (HBcAb); IgM antibody ,,,10.09,62.89,4 RC,319,Hepatitis B core antibody (HBcAb); total ,,,10.32,64.67,4 RC,319,Hepatitis B surface antibody (HBsAb) ,,,9.2,57.47,4 RC,319,Hepatitis Be antibody (HBeAb) ,,,9.91,61.1,4 RC,319,Hepatitis C antibody; ,,,12.23,75.44,4 RC,319,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,13.27,82.64,4 RC,319,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,149.1,4 RC,319,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,319,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,319,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,319,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,319,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,319,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,319,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,319,Heroin metabolite ,,,13.63,127.56,4 RC,319,Heterophile antibodies; screening ,,,4.44,26.95,4 RC,319,Heterophile antibodies; titer ,,,5.54,34.15,4 RC,319,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,6.31,39.51,4 RC,319,Histamine ,,,25.31,156.3,4 RC,319,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,319,Homocysteine ,,,15.35,95.19,4 RC,319,"Homogenization, tissue, for culture ",,,5.04,30.52,4 RC,319,Homovanillic acid (HVA) ,,,19.2,118.58,4 RC,319,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,104.71,648.51,4 RC,319,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,104.71,648.51,4 RC,319,Human epididymis protein 4 (HE4) ,,,17.83,109.59,4 RC,319,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,31.3,194.02,4 RC,319,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,93.81,580.21,4 RC,319,Hydroxychloroquine ,,,15.97,98.82,4 RC,319,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,15.34,95.19,4 RC,319,"Hydroxyindolacetic acid, 5-(HIAA) ",,,11.06,68.24,4 RC,319,"Hydroxyprogesterone, 17-d ",,,23.28,143.69,4 RC,319,Hydroxyproline; free ,,,19.41,120.36,4 RC,319,Hydroxyproline; total ,,,20.82,129.34,4 RC,319,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,319,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,165.58,1023.93,4 RC,319,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,253.43,1568.2,4 RC,319,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,319,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,252.35,1561.06,4 RC,319,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,169.64,1049.1,4 RC,319,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,58.73,362.87,4 RC,319,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,177.62,1099.37,4 RC,319,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,147.99,916.12,4 RC,319,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,33.68,208.36,4 RC,319,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,319,Immune complex assay ,,,20.88,129.34,4 RC,319,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,9.88,61.1,4 RC,319,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,8.26,50.28,4 RC,319,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,15.77,96.98,4 RC,319,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,14.8,91.62,4 RC,319,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,15.5,95.19,4 RC,319,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disea",,,46.19,46.19,1 RC,319,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,12.84,79.01,4 RC,319,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,17.83,109.59,4 RC,319,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,21.91,134.7,4 RC,319,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,17.83,109.59,4 RC,319,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,17.83,109.59,4 RC,319,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,17.83,109.59,4 RC,319,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,10.26,62.89,4 RC,319,Immunodiffusion; not elsewhere specified ,,,12.04,73.66,4 RC,319,Immunoelectrophoresis; crossed (2-dimensional assay) ,,,25.63,25.63,1 RC,319,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,19.82,122.15,4 RC,319,Immunoelectrophoresis; serum ,,,25.63,158.08,4 RC,319,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,25.14,156.3,4 RC,319,Immunofixation electrophoresis; serum ,,,19.15,118.58,4 RC,319,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,319,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,319,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,14.8,91.62,4 RC,319,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,319,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,319,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,319,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,319,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,319,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,319,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,319,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,96.98,4 RC,319,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,319,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,8.85,127.56,117 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,30.23,186.82,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,13.71,84.43,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,28.08,174.26,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,14.18,88.0,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,21.04,129.34,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,14.17,88.0,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,10.9,68.24,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,13.1,80.85,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,18.65,114.95,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,13.77,84.43,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,11.22,70.08,4 RC,319,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») ",,,42.21,42.21,1 RC,319,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,10.26,62.89,4 RC,319,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,319,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,11.5,71.87,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,13.36,82.64,4 RC,319,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,14.08,86.21,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,52.09,321.58,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,10.43,64.67,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,11.5,71.87,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,12.36,77.23,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,10.26,62.89,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,11.66,71.87,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,13.77,84.43,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,10.5,64.67,4 RC,319,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,13.79,86.21,4 RC,319,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,11.5,71.87,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,60.15,371.85,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,37.41,231.74,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,25.73,159.87,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,47.76,294.62,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,19.49,120.36,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,45.81,283.8,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,31.94,197.59,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,35.78,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,18.78,116.79,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,72.91,450.86,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,18.78,116.79,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,50.22,310.75,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,49.69,307.18,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,35.78,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,34.74,215.56,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,35.78,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,23.38,145.53,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,41.33,255.06,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,35.71,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,23.03,141.9,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,259.28,1604.14,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,23.03,141.9,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,35.78,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,17.18,105.96,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,43.96,271.24,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,25.73,159.87,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,109.92,2209.51,12 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,26.74,165.28,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,36.71,226.32,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed ",,,36.71,36.71,1 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,33.64,208.36,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,25.53,158.08,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,35.78,220.97,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,25.03,508.39,8 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,43.96,271.24,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,60.15,371.85,4 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,122.21,2209.51,12 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») and influenza virus types A and B, multiplex ampl",,,145.48,145.48,1 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique ",,,52.34,52.34,1 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), influenza virus types A and B, and respiratory s",,,145.48,145.48,1 RC,319,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,30.07,186.82,4 RC,319,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,319,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,111.68,691.59,4 RC,319,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,10.47,64.67,4 RC,319,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,110.29,682.6,4 RC,319,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,220.59,1365.26,4 RC,319,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,220.59,1365.26,4 RC,319,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,220.59,1365.26,4 RC,319,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,220.59,1365.26,4 RC,319,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), mutation identification in targeted regi",,,262.6,262.6,1 RC,319,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,22.34,138.33,4 RC,319,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,418.68,2590.35,4 RC,319,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,225.33,1394.0,4 RC,319,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,122.21,756.26,4 RC,319,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,319,Infliximab ,,,33.05,204.79,4 RC,319,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,319,Inhibin A ,,,13.36,82.64,4 RC,319,Insemination of oocytes ,,,442.57,570.33,3 RC,319,Insulin antibodies ,,,18.34,113.16,4 RC,319,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,244.22,1510.73,4 RC,319,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,88.25,546.11,4 RC,319,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,141.89,878.4,4 RC,319,Insulin; free ,,,11.1,68.24,4 RC,319,Insulin; total ,,,9.79,61.1,4 RC,319,Interleukin-6 (IL-6) ,,,14.8,91.62,4 RC,319,Intrinsic factor ,,,16.98,104.18,4 RC,319,Intrinsic factor antibodies ,,,12.92,80.85,4 RC,319,Iron ,,,5.54,34.15,4 RC,319,Iron binding capacity ,,,7.49,46.7,4 RC,319,"Iron stain, peripheral blood ",,,5.9,35.94,4 RC,319,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,319,Islet cell antibody ,,,20.2,125.72,4 RC,319,Isocitric dehydrogenase (IDH) ,,,7.58,46.7,4 RC,319,Itraconazole ,,,23.23,143.69,4 RC,319,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,78.53,485.01,4 RC,319,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,319,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,319,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,282.33,1746.04,4 RC,319,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,106.99,661.06,4 RC,319,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,165.58,1023.93,4 RC,319,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,165.58,1023.93,4 RC,319,Ketamine and norketamine ,,,10.54,127.56,4 RC,319,"Ketogenic steroids, fractionation ",,,13.25,82.64,4 RC,319,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,3.88,23.38,4 RC,319,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,7.0,43.13,4 RC,319,"Ketosteroids, 17- (17-KS); fractionation ",,,24.42,150.88,4 RC,319,"Ketosteroids, 17- (17-KS); total ",,,10.96,68.24,4 RC,319,Lacosamide ,,,23.23,143.69,4 RC,319,Lactate (lactic acid) ,,,9.91,61.1,4 RC,319,"Lactate dehydrogenase (LD), (LDH); ",,,5.17,32.31,4 RC,319,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,10.95,68.24,4 RC,319,"Lactoferrin, fecal; qualitative ",,,16.88,104.18,4 RC,319,"Lactoferrin, fecal; quantitative ",,,16.82,104.18,4 RC,319,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,17.32,107.81,4 RC,319,"Lactose, urine, qualitative ",,,9.64,59.26,4 RC,319,Lamotrigine ,,,11.35,70.08,4 RC,319,Lead ,,,10.37,64.67,4 RC,319,Leflunomide ,,,33.05,204.79,4 RC,319,Leucine aminopeptidase (LAP) ,,,8.4,52.12,4 RC,319,Leukocyte alkaline phosphatase with count ,,,7.36,44.92,4 RC,319,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,3.66,23.38,4 RC,319,Leukocyte histamine release test (LHR) ,,,10.68,66.46,4 RC,319,Leukocyte phagocytosis ,,,8.9,55.69,4 RC,319,Leukocyte transfusion ,,,305.26,393.39,3 RC,319,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,319,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,319,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,319,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,319,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,319,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,319,Levetiracetam ,,,11.35,70.08,4 RC,319,Lidocaine ,,,12.59,77.23,4 RC,319,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,319,Lipase ,,,5.91,35.94,4 RC,319,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,7.81,71.87,4 RC,319,Lipoprotein (a) ,,,12.27,75.44,4 RC,319,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,9.65,59.26,4 RC,319,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,29.01,179.62,4 RC,319,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,29.29,181.41,4 RC,319,"Lipoprotein, direct measurement; LDL cholesterol ",,,9.0,55.69,4 RC,319,"Lipoprotein, direct measurement; VLDL cholesterol ",,,10.92,68.24,4 RC,319,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,7.02,43.13,4 RC,319,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,29.29,181.41,4 RC,319,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,39.68,246.08,4 RC,319,Lithium ,,,5.66,35.94,4 RC,319,Luteinizing releasing factor (LRH) ,,,14.73,91.62,4 RC,319,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,319,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,319,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,319,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,319,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,42.01,260.47,4 RC,319,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,162.37,1004.18,4 RC,319,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,40.78,251.49,4 RC,319,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,33.68,208.36,4 RC,319,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,128.52,795.76,4 RC,319,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,452.28,2798.7,4 RC,319,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,102.82,635.9,4 RC,319,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,106.79,661.06,4 RC,319,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,173.42,1072.42,4 RC,319,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,578.69,3580.13,4 RC,319,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,319,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,164.78,1020.36,4 RC,319,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,319,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,319,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,182.75,1129.89,4 RC,319,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,327.04,2022.69,4 RC,319,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,289.36,1790.96,4 RC,319,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,203.92,1261.02,4 RC,319,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,549.93,3402.29,4 RC,319,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,263.89,1632.88,4 RC,319,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,55.99,346.69,4 RC,319,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,319,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,319,Macroscopic examination; arthropod ,,,3.66,23.38,4 RC,319,Macroscopic examination; parasite ,,,3.69,23.38,4 RC,319,Magnesium ,,,5.74,35.94,4 RC,319,Malate dehydrogenase ,,,6.31,39.51,4 RC,319,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,319,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,319,Manganese ,,,22.84,141.9,4 RC,319,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,319,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,20.66,127.56,4 RC,319,"Meat fibers, feces ",,,4.15,25.17,4 RC,319,"Mechanical fragility, RBC ",,,7.36,44.92,4 RC,319,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,319,"Mercury, quantitative ",,,13.93,86.21,4 RC,319,Metanephrines ,,,14.51,89.84,4 RC,319,Methadone ,,,11.24,127.56,4 RC,319,Methemalbumin ,,,9.2,57.47,4 RC,319,Methotrexate ,,,33.05,204.79,4 RC,319,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,8.67,127.56,4 RC,319,Methylphenidate ,,,9.29,127.56,4 RC,319,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,78.1,483.23,4 RC,319,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,319,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,319,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,19.26,118.58,4 RC,319,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,298.65,1848.43,4 RC,319,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,12.46,77.23,4 RC,319,"Mitochondrial antibody (eg, M2), each ",,,21.81,134.7,4 RC,319,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,18.35,113.16,4 RC,319,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,29.82,185.03,4 RC,319,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,34.87,215.56,4 RC,319,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,43.86,271.24,4 RC,319,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,36.31,224.54,4 RC,319,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,54.8,339.49,4 RC,319,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,117.38,725.73,4 RC,319,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,128.81,797.61,4 RC,319,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,158.68,982.58,4 RC,319,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,235.48,1456.83,4 RC,319,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,258.19,1596.94,4 RC,319,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,242.37,1499.96,4 RC,319,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,725.09,4485.54,4 RC,319,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,1713.6,10602.11,4 RC,319,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,319,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,22.95,141.9,4 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,319,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,319,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,319,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,319,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,319,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,319,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,319,"Mucin, synovial fluid (Ropes test) ",,,5.02,30.52,4 RC,319,"Mucopolysaccharides, acid, quantitative ",,,24.42,150.88,4 RC,319,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,319,Muramidase ,,,16.07,98.82,4 RC,319,Muscle-specific kinase (MuSK) antibody ,,,15.77,15.77,1 RC,319,Mycophenolate (mycophenolic acid) ,,,15.46,95.19,4 RC,319,"Myelin basic protein, cerebrospinal fluid ",,,14.74,91.62,4 RC,319,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,10.32,64.67,4 RC,319,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,10.32,199.37,4 RC,319,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,319,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,319,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,319,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,319,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,319,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,319,Myoglobin ,,,11.07,68.24,4 RC,319,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,211.22,1305.94,4 RC,319,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,319,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,319,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,319,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,319,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,319,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,319,Nasal smear for eosinophils ,,,4.96,30.52,4 RC,319,Natriuretic peptide ,,,33.64,208.36,4 RC,319,"Natural killer (NK) cells, total count ",,,32.32,199.37,4 RC,319,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,319,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,319,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,319,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,319,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,319,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,319,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,319,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,319,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,319,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,319,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,319,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,319,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,319,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,319,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,319,"Nephelometry, each analyte not elsewhere specified ",,,11.65,71.87,4 RC,319,Nerve teasing preparations ,,,499.29,643.43,3 RC,319,"Neutralization test, viral ",,,14.48,89.84,4 RC,319,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); screen ",,,42.97,42.97,1 RC,319,"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»); titer ",,,107.44,107.44,1 RC,319,Nickel ,,,21.0,129.34,4 RC,319,Nitroblue tetrazolium dye test (NTD) ,,,11.66,71.87,4 RC,319,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,319,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,319,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,18.67,114.95,4 RC,319,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,319,Nucleotidase 5'- ,,,9.56,59.26,4 RC,319,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,64.14,397.02,4 RC,319,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,319,Oligoclonal immune (oligoclonal bands) ,,,23.47,145.53,4 RC,319,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,2150.75,13307.46,4 RC,319,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,319,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,319,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,3318.39,20530.61,4 RC,319,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,319,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,319,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,319,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,436.0,2698.15,4 RC,319,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,319,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,319,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,319,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,319,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,319,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,319,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,319,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,319,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,319,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,319,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,319,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,319,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,319,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,319,Oncoprotein; HER-2/neu ,,,55.18,341.33,4 RC,319,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,55.18,341.33,4 RC,319,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,319,"Opiates, 1 or more ",,,14.57,127.56,4 RC,319,Opioids and Opiate analogs; 3 or 4 ,,,18.19,18.19,1 RC,319,Opioids and Opiate analogs; 5 or more ,,,13.65,13.65,1 RC,319,Opioids and opiate analogs; 1 or 2 ,,,11.82,127.56,4 RC,319,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,319,"Organic acid, single, quantitative ",,,18.18,113.16,4 RC,319,"Organic acids; qualitative, each specimen ",,,14.1,88.0,4 RC,319,"Organic acids; total, quantitative, each specimen ",,,20.22,125.72,4 RC,319,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,319,Osmolality; blood ,,,5.66,35.94,4 RC,319,Osmolality; urine ,,,5.84,35.94,4 RC,319,"Osmotic fragility, RBC; incubated ",,,11.44,70.08,4 RC,319,"Osmotic fragility, RBC; unincubated ",,,6.4,39.51,4 RC,319,Osteocalcin (bone g1a protein) ,,,25.57,158.08,4 RC,319,"Ova and parasites, direct smears, concentration and identification ",,,7.63,46.7,4 RC,319,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,319,Oxalate ,,,12.38,77.23,4 RC,319,Oxcarbazepine ,,,11.35,70.08,4 RC,319,Oxycodone ,,,12.15,127.56,4 RC,319,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,319,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,319,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,218.52,1352.65,4 RC,319,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,282.33,1746.04,4 RC,319,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,319,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,319,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,177.62,1099.37,4 RC,319,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,177.62,1099.37,4 RC,319,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,649.76,4020.28,4 RC,319,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,659.38,4079.54,4 RC,319,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,39.92,247.92,4 RC,319,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,174.36,1079.62,4 RC,319,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,579.63,3585.54,4 RC,319,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,283.6,1755.02,4 RC,319,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,257.04,1589.8,4 RC,319,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,514.08,3181.38,4 RC,319,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,39.92,247.92,4 RC,319,Parathormone (parathyroid hormone) ,,,35.37,219.18,4 RC,319,"Particle agglutination; screen, each antibody ",,,9.88,61.1,4 RC,319,"Particle agglutination; titer, each antibody ",,,9.12,55.69,4 RC,319,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,319,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,319,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,319,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,319,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,319,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,319,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,319,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,319,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,319,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,319,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,319,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,319,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,319,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,37.69,233.52,4 RC,319,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,319,Phencyclidine (PCP) ,,,14.39,195.8,4 RC,319,Phenobarbital ,,,13.11,80.85,4 RC,319,"Phenylalanine (PKU), blood ",,,4.71,28.74,4 RC,319,"Phenylketones, qualitative ",,,3.41,21.54,4 RC,319,Phenytoin; free ,,,11.79,73.66,4 RC,319,Phenytoin; total ,,,11.35,70.08,4 RC,319,"Phosphatase, acid; prostatic ",,,8.27,52.12,4 RC,319,"Phosphatase, acid; total ",,,6.55,41.29,4 RC,319,"Phosphatase, alkaline; ",,,4.44,26.95,4 RC,319,"Phosphatase, alkaline; heat stable (total not included) ",,,7.08,43.13,4 RC,319,"Phosphatase, alkaline; isoenzymes ",,,12.67,79.01,4 RC,319,Phosphatidylglycerol ,,,14.16,88.0,4 RC,319,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,8.09,50.28,4 RC,319,Phosphohexose isomerase ,,,9.19,57.47,4 RC,319,Phospholipid neutralization; hexagonal phospholipid ,,,15.4,95.19,4 RC,319,Phospholipid neutralization; platelet ,,,15.4,95.19,4 RC,319,Phosphorus inorganic (phosphate); ,,,4.06,25.17,4 RC,319,Phosphorus inorganic (phosphate); urine ,,,4.96,30.52,4 RC,319,"Pinworm exam (eg, cellophane tape prep) ",,,3.66,23.38,4 RC,319,Pinworm examinations ,,,18.14,23.38,3 RC,319,"Platelet, aggregation (in vitro), each agent ",,,21.34,132.92,4 RC,319,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,319,"Porphobilinogen, urine; qualitative ",,,4.99,30.52,4 RC,319,"Porphobilinogen, urine; quantitative ",,,7.23,44.92,4 RC,319,"Porphyrins, feces, quantitative ",,,33.51,206.57,4 RC,319,"Porphyrins, urine; qualitative ",,,11.44,70.08,4 RC,319,"Porphyrins, urine; quantitation and fractionation ",,,12.61,77.23,4 RC,319,Posaconazole ,,,23.23,143.69,4 RC,319,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,319,"Potassium; serum, plasma or whole blood ",,,4.08,25.17,4 RC,319,Potassium; urine ,,,4.05,25.17,4 RC,319,Prealbumin ,,,12.51,77.23,4 RC,319,Pregabalin ,,,7.07,127.56,4 RC,319,Pregnancy-associated plasma protein-A (PAPP-A) ,,,12.89,79.01,4 RC,319,Pregnanediol ,,,18.23,113.16,4 RC,319,Pregnanetriol ,,,18.03,111.38,4 RC,319,Pregnenolone ,,,17.71,109.59,4 RC,319,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,319,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,319,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,319,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,319,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,319,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,319,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,319,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,319,Primidone ,,,14.22,88.0,4 RC,319,Procainamide; ,,,51.41,317.95,4 RC,319,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,14.35,88.0,4 RC,319,Procalcitonin (PCT) ,,,23.32,143.69,4 RC,319,Progesterone ,,,17.87,111.38,4 RC,319,Proinsulin ,,,22.87,141.9,4 RC,319,Prolactin ,,,16.61,102.39,4 RC,319,Propoxyphene ,,,10.72,127.56,4 RC,319,"Prostaglandin, each ",,,35.79,220.97,4 RC,319,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,319,Prostate specific antigen (PSA); complexed (direct measurement) ,,,15.76,96.98,4 RC,319,Prostate specific antigen (PSA); free ,,,15.76,96.98,4 RC,319,Prostate specific antigen (PSA); total ,,,15.76,96.98,4 RC,319,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,19.04,118.58,4 RC,319,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,22.46,138.33,4 RC,319,"Protein, total, by refractometry, any source ",,,4.8,30.52,4 RC,319,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,3.43,21.54,4 RC,319,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,3.14,19.75,4 RC,319,"Protein, total, except by refractometry; urine ",,,3.14,19.75,4 RC,319,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,14.6,89.84,4 RC,319,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,25.03,154.51,4 RC,319,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,15.28,95.19,4 RC,319,"Protein; electrophoretic fractionation and quantitation, serum ",,,9.2,57.47,4 RC,319,Prothrombin time; ,,,3.67,23.38,4 RC,319,"Prothrombin time; substitution, plasma fractions, each ",,,3.38,21.54,4 RC,319,"Protoporphyrin, RBC; quantitative ",,,12.29,75.44,4 RC,319,"Protoporphyrin, RBC; screen ",,,8.34,52.12,4 RC,319,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,319,Pyridoxal phosphate (Vitamin B-6) ,,,24.07,149.1,4 RC,319,Pyruvate ,,,12.4,77.23,4 RC,319,Pyruvate kinase ,,,8.09,50.28,4 RC,319,"Quantitation of therapeutic drug, not elsewhere specified ",,,15.97,98.82,4 RC,319,Quinidine ,,,12.51,77.23,4 RC,319,Quinine ,,,9.97,61.1,4 RC,319,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,282.33,1746.04,4 RC,319,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,319,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,319,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,319,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,319,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,319,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,319,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,319,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,319,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,319,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,319,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,319,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,319,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,319,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,319,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,319,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,319,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,319,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,319,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,319,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,319,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,319,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,319,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,319,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,319,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,319,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,319,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,319,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,319,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,319,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,319,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,319,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,319,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,319,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,319,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,319,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,319,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,319,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,319,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,319,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,319,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,319,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,319,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,319,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,319,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,319,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,319,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,319,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,319,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,319,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,319,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,319,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,319,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,319,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,319,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,319,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,319,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,319,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,319,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,319,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,319,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,319,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,319,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,319,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,319,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,319,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,319,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,319,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,319,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,319,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,319,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,319,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,319,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,319,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,319,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,319,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,319,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,319,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,319,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,319,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,319,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,319,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,319,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,319,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,319,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,319,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,319,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,319,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,319,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,319,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,319,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,319,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,319,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,319,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,319,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,319,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,319,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,319,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,319,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,319,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,319,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,319,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,319,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,319,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,319,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,319,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,319,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,319,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,319,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,319,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,319,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,319,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,319,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,319,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,319,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,319,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,319,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,319,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,319,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,61.03,377.21,4 RC,319,Receptor assay; estrogen ,,,75.3,465.26,4 RC,319,Receptor assay; non-endocrine (specify receptor) ,,,31.33,194.02,4 RC,319,Receptor assay; progesterone ,,,55.59,343.11,4 RC,319,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,6.13,46.7,4 RC,319,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,179.35,1110.14,4 RC,319,Renin ,,,18.84,116.79,4 RC,319,Reptilase test ,,,8.44,52.12,4 RC,319,Reticulated platelet assay ,,,30.62,188.6,4 RC,319,Rheumatoid factor; qualitative ,,,5.26,32.31,4 RC,319,Rheumatoid factor; quantitative ,,,4.86,30.52,4 RC,319,Riboflavin (Vitamin B-2) ,,,17.34,107.81,4 RC,319,Rufinamide ,,,23.23,143.69,4 RC,319,Russell viper venom time (includes venom); diluted ,,,8.21,50.28,4 RC,319,Russell viper venom time (includes venom); undiluted ,,,14.98,93.41,4 RC,319,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,164.51,1018.52,4 RC,319,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,37.4,231.74,4 RC,319,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,319,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,319,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,117.38,725.73,4 RC,319,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,258.19,1596.94,4 RC,319,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,158.68,982.58,4 RC,319,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,40.27,249.71,4 RC,319,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,43.76,271.24,4 RC,319,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,319,Salicylate ,,,15.97,98.82,4 RC,319,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,319,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,319,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,319,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,319,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,319,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,319,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,319,Sedative hypnotics (non-benzodiazepines) ,,,9.0,127.56,4 RC,319,"Sedimentation rate, erythrocyte; automated ",,,2.32,14.4,4 RC,319,"Sedimentation rate, erythrocyte; non-automated ",,,3.66,23.38,4 RC,319,Selenium ,,,21.88,134.7,4 RC,319,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,319,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,319,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,319,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,319,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,319,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,319,Serotonin ,,,26.54,163.49,4 RC,319,Serum bactericidal titer (Schlichter test) ,,,12.87,79.01,4 RC,319,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,25.43,158.08,4 RC,319,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,67.39,416.77,4 RC,319,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») antibody, quantitative ",,,42.97,42.97,1 RC,319,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,319,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,319,Sex hormone binding globulin (SHBG) ,,,18.62,114.95,4 RC,319,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,319,Sialic acid ,,,11.52,71.87,4 RC,319,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,319,"Sickling of RBC, reduction ",,,4.72,28.74,4 RC,319,Silica ,,,21.6,132.92,4 RC,319,Sirolimus ,,,11.76,73.66,4 RC,319,Skeletal muscle relaxants; 1 or 2 ,,,11.43,127.56,4 RC,319,Skeletal muscle relaxants; 3 or more ,,,10.1,10.1,1 RC,319,Skin test; candida ,,,79.46,102.39,3 RC,319,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,319,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,319,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,319,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,3.66,23.38,4 RC,319,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,15.4,95.19,4 RC,319,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,4.62,28.74,4 RC,319,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,5.13,32.31,4 RC,319,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,4.99,30.52,4 RC,319,Sodium; other source ,,,4.16,25.17,4 RC,319,"Sodium; serum, plasma or whole blood ",,,4.12,25.17,4 RC,319,Sodium; urine ,,,4.33,26.95,4 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,512.28,3168.77,4 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants and",,,512.28,512.28,1 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, mi",,,512.28,512.28,1 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; DNA analysis, copy number variants, and microsatellite instability ",,,512.28,512.28,1 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis, copy number variants, microsatellite instability, tumor mutat",,,512.28,512.28,1 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, copy number variants and microsatellite instability ",,,512.28,512.28,1 RC,319,"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; DNA analysis, microsatellite instability ",,,512.28,512.28,1 RC,319,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,2501.51,15477.47,8 RC,319,Somatomedin ,,,18.22,113.16,4 RC,319,Somatostatin ,,,15.67,96.98,4 RC,319,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,319,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,319,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,319,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,319,Specific gravity (except urine) ,,,2.82,17.97,4 RC,319,"Spectrophotometry, analyte not elsewhere specified ",,,6.94,43.13,4 RC,319,Sperm antibodies ,,,43.21,55.69,3 RC,319,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,319,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,319,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,319,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,319,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,319,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,319,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,319,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,319,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,319,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,319,"Stem cells (ie, CD34), total count ",,,66.65,413.14,4 RC,319,"Stereoisomer (enantiomer) analysis, single drug class ",,,10.11,127.56,4 RC,319,"Stimulants, synthetic ",,,12.05,127.56,4 RC,319,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,319,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,319,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,319,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,319,"Streptokinase, antibody ",,,10.84,66.46,4 RC,319,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,4.71,28.74,4 RC,319,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,9.88,61.1,4 RC,319,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,4.71,28.74,4 RC,319,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,9.88,61.1,4 RC,319,"Sugars, chromatographic, TLC or paper chromatography ",,,33.42,206.57,4 RC,319,"Sulfate, urine ",,,4.7,28.74,4 RC,319,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,319,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,4.07,25.17,4 RC,319,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,6.41,39.51,4 RC,319,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,4.07,25.17,4 RC,319,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,5.69,35.94,4 RC,319,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,7.42,46.7,4 RC,319,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,34.41,213.77,4 RC,319,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,6.26,39.51,4 RC,319,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,319,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,3.66,23.38,4 RC,319,"Syphilis test, non-treponemal antibody; quantitative ",,,3.77,23.38,4 RC,319,"T cells; absolute CD4 and CD8 count, including ratio ",,,40.25,249.71,4 RC,319,T cells; absolute CD4 count ,,,22.95,141.9,4 RC,319,T cells; total count ,,,32.32,199.37,4 RC,319,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,319,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,319,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,319,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,549.93,3402.29,4 RC,319,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,263.89,1632.88,4 RC,319,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,282.33,1746.04,4 RC,319,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,319,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,179.0,1108.36,4 RC,319,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,42.49,262.26,4 RC,319,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,172.65,1068.85,4 RC,319,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,319,Tacrolimus ,,,11.76,73.66,4 RC,319,Tapentadol ,,,10.83,127.56,4 RC,319,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,319,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,319,Testosterone; free ,,,21.82,134.7,4 RC,319,Testosterone; total ,,,22.11,136.54,4 RC,319,"Thawing and expansion of frozen cells, each aliquot ",,,10.36,64.67,4 RC,319,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,319,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,319,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,319,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,319,Theophylline ,,,12.12,75.44,4 RC,319,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,319,Thiamine (Vitamin B-1) ,,,18.19,113.16,4 RC,319,Thiocyanate ,,,9.97,61.1,4 RC,319,Thiopurine S-methyltransferase (TPMT) ,,,90.63,200.49,4 RC,319,Thrombin time; plasma ,,,4.95,30.52,4 RC,319,Thrombin time; titer ,,,5.87,35.94,4 RC,319,Thrombomodulin ,,,14.8,91.62,4 RC,319,"Thromboplastin inhibition, tissue ",,,8.25,50.28,4 RC,319,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,5.15,32.31,4 RC,319,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,5.54,34.15,4 RC,319,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,30.08,186.82,4 RC,319,Thyroglobulin ,,,13.76,84.43,4 RC,319,Thyroglobulin antibody ,,,13.63,84.43,4 RC,319,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,5.54,34.15,4 RC,319,Thyroid stimulating hormone (TSH) ,,,14.39,89.84,4 RC,319,Thyroid stimulating immune globulins (TSI) ,,,43.57,269.46,4 RC,319,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,43.19,267.67,4 RC,319,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,57.59,355.67,4 RC,319,Thyroxine binding globulin (TBG) ,,,12.67,79.01,4 RC,319,Thyroxine; free ,,,7.73,48.49,4 RC,319,"Thyroxine; requiring elution (eg, neonatal) ",,,5.54,34.15,4 RC,319,Thyroxine; total ,,,5.89,35.94,4 RC,319,Tiagabine ,,,23.23,143.69,4 RC,319,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,123.17,761.67,4 RC,319,Tissue culture for neoplastic disorders; solid tumor ,,,126.4,781.42,4 RC,319,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,128.78,797.61,4 RC,319,Tissue culture for non-neoplastic disorders; lymphocyte ,,,99.81,617.93,4 RC,319,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,120.57,745.49,4 RC,319,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,3.66,23.38,4 RC,319,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,9.88,61.1,4 RC,319,Tobramycin ,,,13.82,86.21,4 RC,319,Tocopherol alpha (Vitamin E) ,,,12.15,75.44,4 RC,319,Topiramate ,,,10.21,62.89,4 RC,319,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,16.91,104.18,4 RC,319,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,319,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,319,Tramadol ,,,10.54,127.56,4 RC,319,Transcortin (cortisol binding globulin) ,,,15.42,95.19,4 RC,319,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,319,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,319,Transferase; alanine amino (ALT) (SGPT) ,,,4.54,28.74,4 RC,319,Transferase; aspartate amino (AST) (SGOT) ,,,4.44,26.95,4 RC,319,Transferrin ,,,10.93,68.24,4 RC,319,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,319,Triglycerides ,,,4.92,30.52,4 RC,319,Triiodothyronine T3; free ,,,14.51,89.84,4 RC,319,Triiodothyronine T3; reverse ,,,13.5,84.43,4 RC,319,Triiodothyronine T3; total (TT-3) ,,,12.15,75.44,4 RC,319,"Troponin, qualitative ",,,8.65,53.9,4 RC,319,"Troponin, quantitative ",,,10.68,66.46,4 RC,319,Trypsin; duodenal fluid ,,,6.17,37.72,4 RC,319,"Trypsin; feces, qualitative ",,,6.25,39.51,4 RC,319,"Trypsin; feces, quantitative, 24-hour collection ",,,8.51,52.12,4 RC,319,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,85.68,529.93,4 RC,319,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,53.1,328.72,4 RC,319,Tyrosine ,,,9.11,55.69,4 RC,319,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,319,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,200.49,1241.27,4 RC,319,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,319,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,319,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,319,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,319,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,319,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,319,Unlisted immunology procedure ,,,99.55,128.28,3 RC,319,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,319,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,319,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,319,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,319,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,319,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,319,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,319,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,319,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,319,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,319,"Urea breath test, C-14 (isotopic); acquisition for analysis ",,,9.48,9.48,1 RC,319,"Urea breath test, C-14 (isotopic); analysis ",,,80.89,80.89,1 RC,319,"Urea nitrogen, clearance ",,,6.17,37.72,4 RC,319,"Urea nitrogen, urine ",,,4.76,28.74,4 RC,319,Urea nitrogen; quantitative ,,,3.39,21.54,4 RC,319,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,4.4,26.95,4 RC,319,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,319,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,319,Uric acid; blood ,,,3.88,23.38,4 RC,319,Uric acid; other source ,,,4.36,26.95,4 RC,319,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,1.93,16.18,8 RC,319,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,2.98,21.54,8 RC,319,Urinalysis; 2 or 3 glass test ,,,4.03,25.17,4 RC,319,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,25.68,158.08,4 RC,319,Urinalysis; microscopic only ,,,2.61,16.18,4 RC,319,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,1.86,10.77,4 RC,319,"Urine pregnancy test, by visual color comparison methods ",,,7.37,44.92,4 RC,319,"Urobilinogen, feces, quantitative ",,,14.39,89.84,4 RC,319,"Urobilinogen, urine; qualitative ",,,3.83,23.38,4 RC,319,"Urobilinogen, urine; quantitative, timed specimen ",,,8.18,50.28,4 RC,319,"Urobilinogen, urine; semiquantitative ",,,5.18,32.31,4 RC,319,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,319,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,319,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,319,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,319,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,319,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,75.57,467.05,4 RC,319,Valproic acid (dipropylacetic acid); free ,,,11.6,71.87,4 RC,319,Valproic acid (dipropylacetic acid); total ,,,11.6,71.87,4 RC,319,Vancomycin ,,,11.6,71.87,4 RC,319,"Vanillylmandelic acid (VMA), urine ",,,13.28,82.64,4 RC,319,Vasoactive intestinal peptide (VIP) ,,,30.27,186.82,4 RC,319,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,319,"Vasopressin (antidiuretic hormone, ADH) ",,,29.08,179.62,4 RC,319,Vedolizumab ,,,33.05,204.79,4 RC,319,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,319,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,319,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,319,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,319,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,319,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,319,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,319,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,319,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,319,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,319,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,319,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,319,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,319,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,319,Very long chain fatty acids ,,,16.92,104.18,4 RC,319,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,16.76,104.18,4 RC,319,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,29.01,179.62,4 RC,319,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,16.76,104.18,4 RC,319,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,22.34,138.33,4 RC,319,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,17.31,107.81,4 RC,319,Viscosity ,,,10.0,61.1,4 RC,319,Vitamin A ,,,9.95,61.1,4 RC,319,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,32.99,204.79,4 RC,319,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,25.36,156.3,4 RC,319,Vitamin K ,,,11.75,71.87,4 RC,319,"Vitamin, not otherwise specified ",,,14.62,89.84,4 RC,319,"Volatiles (eg, acetic anhydride, diethylether) ",,,14.66,89.84,4 RC,319,"Voltage-gated calcium channel antibody, each ",,,15.77,64.67,4 RC,319,"Volume measurement for timed collection, each ",,,3.12,19.75,4 RC,319,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,319,Voriconazole ,,,23.23,143.69,4 RC,319,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,319,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,319,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,319,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,319,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,319,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,319,"Xylose absorption test, blood and/or urine ",,,11.06,68.24,4 RC,319,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,319,Zinc ,,,9.76,61.1,4 RC,319,Zonisamide ,,,11.35,70.08,4 RC,319,"b-Hexosaminidase, each assay ",,,14.45,89.84,4 RC,319,"pH; body fluid, not otherwise specified ",,,3.07,19.75,4 RC,319,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,320, Radiology - Diagnostic General Classification ,,,198.0,198.0,1 RC,320,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,320,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,320,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,320,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,320,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,320,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,320,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,320,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,320,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,320,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,320,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,320,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,320,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,320,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,320,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,320,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,320,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,Acetaminophen ,,,76.68,98.82,3 RC,320,Acetylcholinesterase ,,,50.18,64.67,3 RC,320,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,320,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,320,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,320,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,320,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,320,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,320,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,320,Adalimumab ,,,158.91,204.79,3 RC,320,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,320,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,320,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,320,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,320,Albumin; ischemia modified ,,,139.38,179.62,3 RC,320,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,320,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,320,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,320,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,320,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,320,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,320,Alcohols ,,,98.98,127.56,3 RC,320,Aldolase ,,,40.44,52.12,3 RC,320,Aldosterone ,,,167.27,215.56,3 RC,320,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,320,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,320,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,320,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,320,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,320,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,320,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,320,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,320,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,320,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,320,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,320,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,320,Aluminum ,,,104.53,134.7,3 RC,320,Amikacin ,,,62.74,80.85,3 RC,320,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,320,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,320,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,320,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,320,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,320,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,320,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,320,Amiodarone ,,,76.68,98.82,3 RC,320,Ammonia ,,,59.93,77.23,3 RC,320,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,320,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,320,Amylase ,,,26.5,34.15,3 RC,320,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,320,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,320,Androstanediol glucuronide ,,,118.47,152.67,3 RC,320,Androstenedione ,,,119.9,154.51,3 RC,320,Androsterone ,,,104.53,134.7,3 RC,320,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,320,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,320,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,320,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,320,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,320,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,320,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,320,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,320,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,320,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,320,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,320,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,320,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,320,Angiotensin II ,,,85.04,109.59,3 RC,320,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,320,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,320,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,320,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,320,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,320,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,320,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,320,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,320,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,320,Antibody; Aspergillus ,,,61.31,79.01,3 RC,320,Antibody; Bartonella ,,,41.83,53.9,3 RC,320,Antibody; Blastomyces ,,,52.96,68.24,3 RC,320,Antibody; Bordetella ,,,54.38,70.08,3 RC,320,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,320,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,320,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,320,Antibody; Brucella ,,,36.24,46.7,3 RC,320,Antibody; Campylobacter ,,,54.38,70.08,3 RC,320,Antibody; Candida ,,,48.8,62.89,3 RC,320,Antibody; Chlamydia ,,,48.8,62.89,3 RC,320,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,320,Antibody; Coccidioides ,,,47.41,61.1,3 RC,320,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,320,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,320,Antibody; Diphtheria ,,,62.74,80.85,3 RC,320,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,320,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,320,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,320,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,320,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,320,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,320,Antibody; HIV-1 ,,,36.24,46.7,3 RC,320,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,320,Antibody; HIV-2 ,,,55.77,71.87,3 RC,320,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,320,Antibody; HTLV-I ,,,37.63,48.49,3 RC,320,Antibody; HTLV-II ,,,57.16,73.66,3 RC,320,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,320,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,320,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,320,Antibody; Legionella ,,,62.74,80.85,3 RC,320,Antibody; Leishmania ,,,50.18,64.67,3 RC,320,Antibody; Leptospira ,,,66.9,86.21,3 RC,320,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,320,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,320,Antibody; Nocardia ,,,65.51,84.43,3 RC,320,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,320,Antibody; Rickettsia ,,,79.46,102.39,3 RC,320,Antibody; Salmonella ,,,54.38,70.08,3 RC,320,Antibody; Shigella ,,,100.37,129.34,3 RC,320,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,320,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,320,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,320,Antibody; Trichinella ,,,51.57,66.46,3 RC,320,Antibody; West Nile virus ,,,58.54,75.44,3 RC,320,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,320,Antibody; Yersinia ,,,54.38,70.08,3 RC,320,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,320,Antibody; actinomyces ,,,41.83,53.9,3 RC,320,Antibody; adenovirus ,,,52.96,68.24,3 RC,320,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,320,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,320,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,320,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,320,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,320,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,320,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,320,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,320,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,320,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,320,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,320,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,320,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,320,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,320,Antibody; histoplasma ,,,57.16,73.66,3 RC,320,Antibody; influenza virus ,,,55.77,71.87,3 RC,320,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,320,Antibody; mucormycosis ,,,61.31,79.01,3 RC,320,Antibody; mumps ,,,54.38,70.08,3 RC,320,Antibody; mycoplasma ,,,54.38,70.08,3 RC,320,Antibody; parvovirus ,,,61.31,79.01,3 RC,320,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,320,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,320,Antibody; rotavirus ,,,75.26,96.98,3 RC,320,Antibody; rubella ,,,58.54,75.44,3 RC,320,Antibody; rubeola ,,,52.96,68.24,3 RC,320,Antibody; tetanus ,,,61.31,79.01,3 RC,320,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,320,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,320,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,320,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,320,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,320,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,320,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,320,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,320,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,320,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,320,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,320,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,320,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,320,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,320,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,320,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,320,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,320,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,320,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,320,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,320,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,320,"Apolipoprotein, each ",,,86.43,111.38,3 RC,320,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,320,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,320,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,320,Arsenic ,,,78.07,100.61,3 RC,320,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,320,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,320,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,320,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,320,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,320,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,320,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,320,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,320,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,320,"B cells, total count ",,,154.71,199.37,3 RC,320,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,320,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,320,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,320,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,320,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,320,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,320,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,320,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,320,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,320,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,320,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,320,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,320,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,320,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,320,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,320,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,320,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,320,Barbiturates ,,,98.98,127.56,3 RC,320,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,320,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,320,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,320,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,320,Beta-2 microglobulin ,,,66.9,86.21,3 RC,320,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,320,Bile acids; total ,,,71.1,91.62,3 RC,320,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,320,Bilirubin; direct ,,,20.91,26.95,3 RC,320,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,320,Bilirubin; total ,,,20.91,26.95,3 RC,320,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,320,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,320,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,320,Bleeding time ,,,19.53,25.17,3 RC,320,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,320,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,320,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,320,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,320,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,320,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,320,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,320,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,320,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,320,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,320,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,320,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,320,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,320,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,320,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,320,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,320,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,320,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,320,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,320,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,320,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,320,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,320,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,320,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,320,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,320,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,320,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,320,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,320,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,320,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,320,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,320,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,320,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,320,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,320,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,320,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,320,"Bone length studies (orthoroentgenogram, scanogram) ",2628.6,2628.6,46.01,149.57,4 RC,320,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,320,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,320,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,320,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,320,Bradykinin ,,,20.91,26.95,3 RC,320,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,320,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,320,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,320,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,320,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,320,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,320,C-peptide ,,,85.04,109.59,3 RC,320,C-reactive protein; ,,,20.91,26.95,3 RC,320,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,320,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,320,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,320,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,320,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,320,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,320,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,320,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,320,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,320,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,320,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,320,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,320,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,320,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,320,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,320,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,320,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,320,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,320,Cadmium ,,,97.55,125.72,3 RC,320,Caffeine ,,,158.91,204.79,3 RC,320,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,320,Calcitonin ,,,110.11,141.9,3 RC,320,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,320,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,320,Calcium; ionized ,,,55.77,71.87,3 RC,320,Calcium; total ,,,20.91,26.95,3 RC,320,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,320,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,320,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,320,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,320,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,320,"Calprotectin, fecal ",,,80.84,104.18,3 RC,320,"Cannabinoids, natural ",,,98.98,127.56,3 RC,320,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,320,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,320,Carbamazepine; free ,,,54.38,70.08,3 RC,320,Carbamazepine; total ,,,59.93,77.23,3 RC,320,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,320,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,320,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,320,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,320,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,320,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,320,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,320,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,320,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,320,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,320,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,320,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,320,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,320,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,320,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,320,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,320,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,320,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,320,Cardiac shunt detection ,,,186.76,186.76,1 RC,320,Cardiokymography ,,,20.04,20.04,1 RC,320,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,320,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,320,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,320,Carotene ,,,37.63,48.49,3 RC,320,Catecholamines; blood ,,,119.9,154.51,3 RC,320,Catecholamines; fractionated ,,,104.53,134.7,3 RC,320,Catecholamines; total urine ,,,112.93,145.53,3 RC,320,Cathepsin-D ,,,73.87,95.19,3 RC,320,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,320,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,320,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,320,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,320,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,320,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,320,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,320,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,320,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,320,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,320,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,320,Ceruloplasmin ,,,44.6,57.47,3 RC,320,Chemiluminescent assay ,,,58.54,75.44,3 RC,320,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,320,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,320,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,320,Chloramphenicol ,,,51.57,66.46,3 RC,320,Chloride; blood ,,,19.53,25.17,3 RC,320,Chloride; other source ,,,20.91,26.95,3 RC,320,Chloride; urine ,,,23.69,30.52,3 RC,320,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,320,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,320,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,320,Cholinesterase; RBC ,,,40.44,52.12,3 RC,320,Cholinesterase; serum ,,,32.04,41.29,3 RC,320,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,320,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,320,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,320,Chromium ,,,83.66,107.81,3 RC,320,Chromogenic substrate assay ,,,48.8,62.89,3 RC,320,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,320,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,320,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,320,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,320,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,320,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,320,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,320,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,320,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,320,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,320,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,320,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,320,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,320,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,320,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,320,Citrate ,,,114.31,147.31,3 RC,320,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,320,Clot retraction ,,,66.9,86.21,3 RC,320,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,320,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,320,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,320,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,320,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,320,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,320,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,320,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,320,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,320,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,320,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,320,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,320,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,320,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,320,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,320,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,320,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,320,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,320,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,320,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,320,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,320,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,320,Clozapine ,,,82.23,105.96,3 RC,320,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,320,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,320,Coagulation time; activated ,,,18.14,23.38,3 RC,320,Coagulation time; other methods ,,,18.14,23.38,3 RC,320,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,320,Cocaine ,,,98.98,127.56,3 RC,320,Cold agglutinin; screen ,,,33.47,43.13,3 RC,320,Cold agglutinin; titer ,,,33.47,43.13,3 RC,320,"Collagen cross links, any method ",,,76.68,98.82,3 RC,320,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,320,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,320,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,320,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,320,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,320,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,320,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,320,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,320,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,320,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,320,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,320,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,320,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,320,"Complement; antigen, each component ",,,48.8,62.89,3 RC,320,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,320,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,320,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,320,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,320,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,320,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,320,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,320,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,320,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,320,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,320,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,320,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,320,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,320,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,320,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,320,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,320,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,320,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,320,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,320,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,320,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,320,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,320,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,320,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,320,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,320,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,320,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,320,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,320,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,320,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,320,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,320,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,320,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,320,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,320,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,320,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,320,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,320,Copper ,,,51.57,66.46,3 RC,320,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,320,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,320,Corticosterone ,,,92.01,118.58,3 RC,320,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,320,Cortisol; free ,,,68.28,88.0,3 RC,320,Cortisol; total ,,,66.9,86.21,3 RC,320,Creatine ,,,19.53,25.17,3 RC,320,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,320,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,320,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,320,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,320,Creatinine; blood ,,,20.91,26.95,3 RC,320,Creatinine; clearance ,,,39.01,50.28,3 RC,320,Creatinine; other source ,,,20.91,26.95,3 RC,320,Cryofibrinogen ,,,58.54,75.44,3 RC,320,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,320,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,320,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,320,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,320,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,320,Cryopreservation; sperm ,,,442.57,570.33,3 RC,320,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,320,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,320,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,320,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,320,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,320,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,320,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,320,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,320,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,320,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,320,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,320,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,320,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,320,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,320,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,320,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,320,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,320,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,320,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,320,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,320,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,320,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,320,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,320,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,320,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,320,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,320,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,320,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,320,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,320,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,320,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,320,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,320,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,320,"Culture, typing; other methods ",,,32.04,41.29,3 RC,320,Cyanide ,,,79.46,102.39,3 RC,320,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,320,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,320,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,320,Cyclosporine ,,,73.87,95.19,3 RC,320,Cystatin C ,,,76.68,98.82,3 RC,320,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,320,"Cystography, minimum of 3 views, radiological supervision and interpretation ",5539.48,5539.48,42.27,123.04,4 RC,320,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,320,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,320,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,320,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,320,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,320,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,320,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,320,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,320,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,320,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,320,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,320,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,320,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,320,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,320,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,320,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,320,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,320,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,320,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,320,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,320,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,320,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,320,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,320,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,320,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,320,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,320,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,320,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,320,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,320,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,320,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,320,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,320,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,320,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,320,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,320,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,320,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,320,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,320,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,320,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,320,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,320,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,320,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,320,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,320,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,320,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,320,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,320,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,320,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,320,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,320,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,320,Dibucaine number ,,,50.18,64.67,3 RC,320,Digoxin; free ,,,54.38,70.08,3 RC,320,Digoxin; total ,,,54.38,70.08,3 RC,320,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,320,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,320,"Discography, cervical or thoracic, radiological supervision and interpretation ",20775.94,20775.94,131.56,344.74,4 RC,320,"Discography, lumbar, radiological supervision and interpretation ",8109.33,8109.33,113.49,335.38,4 RC,320,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,320,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,320,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,320,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,320,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,320,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,320,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,320,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,320,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,320,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,320,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,320,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,320,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,320,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,320,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,320,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,320,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,320,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,320,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,320,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,320,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,320,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,320,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,320,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,320,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,320,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,320,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,320,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,320,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,320,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,320,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,320,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,320,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,320,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,320,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,320,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,320,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,320,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,320,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,320,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,320,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,320,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,320,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,320,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,320,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,320,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,320,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,320,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,320,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,320,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,320,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,320,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,320,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,320,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,320,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,320,Erythropoietin ,,,76.68,98.82,3 RC,320,Esophageal motility ,,,214.04,214.04,1 RC,320,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,320,Estradiol; total ,,,114.31,147.31,3 RC,320,Estriol ,,,98.98,127.56,3 RC,320,Estrogens; fractionated ,,,132.41,170.64,3 RC,320,Estrogens; total ,,,89.2,114.95,3 RC,320,Estrone ,,,103.14,132.92,3 RC,320,Ethosuximide ,,,66.9,86.21,3 RC,320,Ethylene glycol ,,,61.31,79.01,3 RC,320,Etiocholanolone ,,,107.34,138.33,3 RC,320,Euglobulin lysis ,,,34.86,44.92,3 RC,320,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,320,Everolimus ,,,57.16,73.66,3 RC,320,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,320,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,320,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,320,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,320,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,320,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,320,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,320,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,320,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,320,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,320,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,320,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,320,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,320,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,320,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,320,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,320,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,320,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,320,Factor inhibitor test ,,,52.96,68.24,3 RC,320,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,320,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,320,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,320,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,320,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,320,Felbamate ,,,76.68,98.82,3 RC,320,Fentanyl ,,,98.98,127.56,3 RC,320,Fern test ,,,40.44,52.12,3 RC,320,Ferritin ,,,55.77,71.87,3 RC,320,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,320,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,320,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,320,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,320,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,320,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,320,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,320,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,320,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,320,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,320,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,320,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,320,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,320,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,320,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,320,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,320,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,320,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,320,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,320,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,320,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,320,Fibrinogen; activity ,,,40.44,52.12,3 RC,320,Fibrinogen; antigen ,,,59.93,77.23,3 RC,320,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,320,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,320,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,320,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,320,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,320,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,320,Flecainide ,,,76.68,98.82,3 RC,320,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,320,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,320,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,320,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,320,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,320,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,320,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,320,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,320,Fluoride ,,,76.68,98.82,3 RC,320,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",3789.63,3789.63,44.31,130.85,4 RC,320,Folic acid; RBC ,,,72.48,93.41,3 RC,320,Folic acid; serum ,,,59.93,77.23,3 RC,320,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,320,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,320,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,320,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,320,"Fructose, semen ",,,71.1,91.62,3 RC,320,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,320,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,320,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,320,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,320,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,320,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,320,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,320,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,320,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,320,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,320,"Galactokinase, RBC ",,,87.81,113.16,3 RC,320,Galactose ,,,45.98,59.26,3 RC,320,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,320,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,320,Galectin-3 ,,,182.6,235.31,3 RC,320,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,320,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,320,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,320,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,320,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,320,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,320,"Gases, blood, pH only ",,,44.6,57.47,3 RC,320,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,320,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,320,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,320,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,320,Gastric mucosa imaging ,,,205.51,205.51,1 RC,320,Gastrin ,,,72.48,93.41,3 RC,320,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,320,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,320,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,320,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,320,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,320,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,320,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,320,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,320,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,320,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,320,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,320,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,320,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,320,Gentamicin ,,,66.9,86.21,3 RC,320,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,320,Glucagon ,,,58.54,75.44,3 RC,320,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,320,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,320,Glucagon tolerance test ,,,72.48,93.41,3 RC,320,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,320,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,320,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,320,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,320,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,320,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,320,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,320,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,320,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,320,"Glucosidase, beta ",,,87.81,113.16,3 RC,320,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,320,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,320,Glutathione ,,,64.13,82.64,3 RC,320,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,320,Glycated protein ,,,68.28,88.0,3 RC,320,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,320,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,320,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,320,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,320,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,320,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,320,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,320,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,320,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,320,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,320,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,320,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,320,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,320,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,320,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,320,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,320,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,320,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,320,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,320,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,320,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,320,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,320,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,320,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,320,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,320,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,320,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,320,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,320,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,320,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,320,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,320,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,320,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,320,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,320,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,320,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,320,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,320,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,320,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,320,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,320,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,320,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,Haloperidol ,,,65.51,84.43,3 RC,320,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,320,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,320,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,320,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,320,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,320,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,320,Heinz bodies; direct ,,,16.71,21.54,3 RC,320,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,320,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,320,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,320,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,320,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,320,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,320,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,320,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,320,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,320,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,320,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,320,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,320,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,320,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,320,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,320,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,320,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,320,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,320,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,320,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,320,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,320,Hemoglobin; plasma ,,,30.66,39.51,3 RC,320,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,320,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,320,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,320,Hemoglobin; urine ,,,16.71,21.54,3 RC,320,"Hemolysin, acid ",,,36.24,46.7,3 RC,320,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,320,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,320,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,320,Heparin assay ,,,54.38,70.08,3 RC,320,Heparin neutralization ,,,48.8,62.89,3 RC,320,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,320,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,320,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,320,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,320,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,320,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,320,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,320,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,320,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,320,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,320,Hepatitis C antibody; ,,,58.54,75.44,3 RC,320,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,320,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,320,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,320,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,320,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,320,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,320,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,320,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,320,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,320,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,320,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,320,Heroin metabolite ,,,98.98,127.56,3 RC,320,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,320,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,320,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,320,Histamine ,,,121.28,156.3,3 RC,320,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,320,Homocysteine ,,,73.87,95.19,3 RC,320,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,320,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,320,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,320,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,320,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,320,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,320,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,320,Hydroxychloroquine ,,,76.68,98.82,3 RC,320,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,320,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,320,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,320,Hydroxyproline; free ,,,93.4,120.36,3 RC,320,Hydroxyproline; total ,,,100.37,129.34,3 RC,320,"Hysterosalpingography, radiological supervision and interpretation ",4658.17,4658.17,68.17,365.06,4 RC,320,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,320,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,320,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,320,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,320,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,320,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,320,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,320,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,320,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,320,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,320,Immune complex assay ,,,100.37,129.34,3 RC,320,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,320,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,320,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,320,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,320,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,320,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,320,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,320,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,320,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,320,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,320,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,320,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,320,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,320,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,320,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,320,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,320,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,320,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,320,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,320,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,320,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,320,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,320,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,320,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,320,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,320,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,320,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,320,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,320,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,320,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,320,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,320,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,320,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,320,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,320,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,320,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,320,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,320,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,320,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,320,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,320,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,320,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,320,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,320,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,320,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,320,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,320,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,320,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,320,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,320,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,320,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,320,Infliximab ,,,158.91,204.79,3 RC,320,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,320,Inhibin A ,,,64.13,82.64,3 RC,320,Insemination of oocytes ,,,442.57,570.33,3 RC,320,Insulin antibodies ,,,87.81,113.16,3 RC,320,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,320,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,320,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,320,Insulin; free ,,,52.96,68.24,3 RC,320,Insulin; total ,,,47.41,61.1,3 RC,320,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,320,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,320,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,320,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,320,Intrinsic factor ,,,80.84,104.18,3 RC,320,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,320,Iron ,,,26.5,34.15,3 RC,320,Iron binding capacity ,,,36.24,46.7,3 RC,320,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,320,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,320,Islet cell antibody ,,,97.55,125.72,3 RC,320,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,320,Itraconazole ,,,111.5,143.69,3 RC,320,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,320,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,320,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,320,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,320,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,320,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,320,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,320,Ketamine and norketamine ,,,98.98,127.56,3 RC,320,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,320,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,320,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,320,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,320,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,320,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,320,Kidney imaging morphology; ,,,172.11,172.11,1 RC,320,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,320,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,320,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,320,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,320,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,320,Lacosamide ,,,111.5,143.69,3 RC,320,Lactate (lactic acid) ,,,47.41,61.1,3 RC,320,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,320,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,320,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,320,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,320,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,320,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,320,Lamotrigine ,,,54.38,70.08,3 RC,320,Lead ,,,50.18,64.67,3 RC,320,Leflunomide ,,,158.91,204.79,3 RC,320,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,320,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,320,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,320,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,320,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,320,Leukocyte transfusion ,,,305.26,393.39,3 RC,320,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,320,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,320,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,320,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,320,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,320,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,320,Levetiracetam ,,,54.38,70.08,3 RC,320,Lidocaine ,,,59.93,77.23,3 RC,320,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,320,Lipase ,,,27.89,35.94,3 RC,320,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,320,Lipoprotein (a) ,,,58.54,75.44,3 RC,320,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,320,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,320,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,320,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,320,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,320,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,320,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,320,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,320,Lithium ,,,27.89,35.94,3 RC,320,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,320,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,320,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,320,Liver imaging; static only ,,,191.2,191.2,1 RC,320,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,320,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,320,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,320,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,320,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,320,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,320,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,320,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,320,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,320,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,320,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,320,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,320,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,320,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,320,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,320,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,320,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,320,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,320,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,320,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,320,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,320,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,320,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,320,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,320,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,320,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,320,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,320,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,320,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,320,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,320,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,320,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,320,Magnesium ,,,27.89,35.94,3 RC,320,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,320,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,320,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,320,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,320,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,320,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,320,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,320,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,320,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,320,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,320,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,320,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,320,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,320,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,320,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,320,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,320,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,320,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,320,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,320,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,320,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,320,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,320,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,320,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,320,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,320,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,320,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,320,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,320,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,320,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,320,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,320,Malate dehydrogenase ,,,30.66,39.51,3 RC,320,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,320,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,320,Manganese ,,,110.11,141.9,3 RC,320,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,320,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,320,"Meat fibers, feces ",,,19.53,25.17,3 RC,320,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,320,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,320,"Mercury, quantitative ",,,66.9,86.21,3 RC,320,Metanephrines ,,,69.71,89.84,3 RC,320,Methadone ,,,98.98,127.56,3 RC,320,Methemalbumin ,,,44.6,57.47,3 RC,320,Methotrexate ,,,158.91,204.79,3 RC,320,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,320,Methylphenidate ,,,98.98,127.56,3 RC,320,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,320,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,320,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,320,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,320,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,320,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,320,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,320,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,320,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,320,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,320,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,320,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,320,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,320,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,320,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,320,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,320,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,320,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,320,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,320,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,320,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,320,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,320,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,320,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,320,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,320,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,320,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,320,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,320,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,320,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,320,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,320,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,320,Muramidase ,,,76.68,98.82,3 RC,320,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,320,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,320,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,320,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,320,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",14318.11,14318.11,168.36,464.97,4 RC,320,"Myelography, cervical, radiological supervision and interpretation ",9283.14,9283.14,117.59,332.27,4 RC,320,"Myelography, lumbosacral, radiological supervision and interpretation ",5479.46,5479.46,112.13,329.12,4 RC,320,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,320,"Myelography, thoracic, radiological supervision and interpretation ",6797.58,6797.58,123.04,346.29,4 RC,320,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,320,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,320,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,320,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,320,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,320,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,320,Myoglobin ,,,52.96,68.24,3 RC,320,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,320,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,320,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,320,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,320,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,320,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,320,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,320,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,320,Natriuretic peptide ,,,161.68,208.36,3 RC,320,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,320,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,320,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,320,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,320,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,320,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,320,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,320,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,320,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,320,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,320,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,320,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,320,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,320,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,320,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,320,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,320,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,320,Nerve teasing preparations ,,,499.29,643.43,3 RC,320,"Neutralization test, viral ",,,69.71,89.84,3 RC,320,Nickel ,,,100.37,129.34,3 RC,320,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,320,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,320,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,320,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,320,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,320,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,320,Nucleotidase 5'- ,,,45.98,59.26,3 RC,320,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,320,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,320,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,320,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,320,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,320,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,320,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,320,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,320,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,320,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,320,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,320,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,320,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,320,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,320,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,320,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,320,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,320,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,320,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,320,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,320,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,320,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,320,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,320,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,320,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,320,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,320,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,320,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,320,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,320,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,320,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,320,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,320,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,320,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,320,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,320,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,320,"Opiates, 1 or more ",,,98.98,127.56,3 RC,320,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,320,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,320,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,320,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,320,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,320,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,320,Osmolality; blood ,,,27.89,35.94,3 RC,320,Osmolality; urine ,,,27.89,35.94,3 RC,320,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,320,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,320,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,320,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,320,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,320,Oxalate ,,,59.93,77.23,3 RC,320,Oxcarbazepine ,,,54.38,70.08,3 RC,320,Oxycodone ,,,98.98,127.56,3 RC,320,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,320,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,320,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,320,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,320,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,320,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,320,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,320,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,320,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,320,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,320,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,320,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,320,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,320,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,320,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,320,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,320,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,320,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,320,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,320,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,320,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,320,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,320,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,320,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,320,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,320,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,320,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,320,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,320,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,320,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,320,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,320,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,320,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",2454.89,2454.89,139.39,338.19,4 RC,320,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,320,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,320,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,320,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,320,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,320,Phenobarbital ,,,62.74,80.85,3 RC,320,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,320,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,320,Phenytoin; free ,,,57.16,73.66,3 RC,320,Phenytoin; total ,,,54.38,70.08,3 RC,320,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,320,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,320,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,320,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,320,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,320,Phosphatidylglycerol ,,,68.28,88.0,3 RC,320,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,320,Phosphohexose isomerase ,,,44.6,57.47,3 RC,320,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,320,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,320,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,320,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,320,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,320,Pinworm examinations ,,,18.14,23.38,3 RC,320,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,320,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,320,Platelet survival study ,,,126.1,126.1,1 RC,320,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,320,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,320,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,320,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,320,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,320,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,320,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,320,Posaconazole ,,,111.5,143.69,3 RC,320,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,320,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,320,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,320,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,320,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,320,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,320,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,320,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,320,Potassium; urine ,,,19.53,25.17,3 RC,320,Prealbumin ,,,59.93,77.23,3 RC,320,Pregabalin ,,,98.98,127.56,3 RC,320,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,320,Pregnanediol ,,,87.81,113.16,3 RC,320,Pregnanetriol ,,,86.43,111.38,3 RC,320,Pregnenolone ,,,85.04,109.59,3 RC,320,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,320,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,320,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,320,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,320,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,320,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,320,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,320,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,320,Primidone ,,,68.28,88.0,3 RC,320,Procainamide; ,,,246.72,317.95,3 RC,320,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,320,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,320,Progesterone ,,,86.43,111.38,3 RC,320,Proinsulin ,,,110.11,141.9,3 RC,320,Prolactin ,,,79.46,102.39,3 RC,320,Propoxyphene ,,,98.98,127.56,3 RC,320,"Prostaglandin, each ",,,171.47,220.97,3 RC,320,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,320,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,320,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,320,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,320,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,320,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,320,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,320,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,320,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,320,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,320,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,320,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,320,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,320,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,320,Prothrombin time; ,,,18.14,23.38,3 RC,320,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,320,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,320,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,320,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,320,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,320,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,320,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,320,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,320,Pyruvate ,,,59.93,77.23,3 RC,320,Pyruvate kinase ,,,39.01,50.28,3 RC,320,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,320,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,320,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,320,Quinidine ,,,59.93,77.23,3 RC,320,Quinine ,,,47.41,61.1,3 RC,320,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,320,"Radiologic examination from nose to rectum for foreign body, single view, child ",2125.36,2125.36,77.44,99.62,4 RC,320,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,320,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,320,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,320,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",3820.29,3820.29,61.34,165.19,4 RC,320,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,320,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,320,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,320,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,320,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,320,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,320,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,320,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",6608.55,6608.55,183.95,772.27,4 RC,320,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5055.4,5055.4,159.16,500.86,4 RC,320,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,320,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,320,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,320,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,320,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,320,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",4121.72,4121.72,101.9,332.27,4 RC,320,"Radiologic examination, eye, for detection of foreign body ",1687.26,1687.26,33.41,112.08,4 RC,320,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,320,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,320,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,320,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,320,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,320,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,320,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,320,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,320,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,320,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,320,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,320,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,320,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,320,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,320,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,320,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,320,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,320,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,320,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,320,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,320,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,320,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,320,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,320,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,320,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,320,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,320,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,320,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,320,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",6065.71,6065.71,102.24,344.45,4 RC,320,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,320,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,320,"Radiologic examination, pelvis; complete, minimum of 3 views ",2585.17,2585.17,43.29,141.77,4 RC,320,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,320,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,320,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,320,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,320,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,320,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,320,"Radiologic examination, sacroiliac joints; 3 or more views ",2246.7,2246.7,40.22,133.96,4 RC,320,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,320,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,320,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,320,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,320,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,320,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,320,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,320,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,320,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,320,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,320,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,320,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,320,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",6404.19,6404.19,183.95,1493.9,4 RC,320,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",5600.79,5600.79,126.79,402.5,4 RC,320,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,320,"Radiologic examination, spine, cervical; 4 or 5 views ",4062.97,4062.97,54.53,188.62,4 RC,320,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,320,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,320,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",3523.96,3523.96,80.77,290.08,4 RC,320,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,320,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",931.12,931.12,43.64,141.77,4 RC,320,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,320,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,320,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,320,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,320,"Radiologic examination, spine, single view, specify level ",890.25,890.25,25.22,79.3,4 RC,320,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,320,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,320,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,320,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,320,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",3925.02,3925.02,130.19,477.48,4 RC,320,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,320,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,320,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,320,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",3263.4,3263.4,54.19,194.87,4 RC,320,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,320,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",6364.59,6364.59,144.51,464.97,4 RC,320,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",5225.28,5225.28,127.46,405.65,4 RC,320,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,320,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,320,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,320,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,320,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,320,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,320,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,320,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,320,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,320,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,320,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,320,"Radiologic examination; orbits, complete, minimum of 4 views ",2771.66,2771.66,49.07,162.09,4 RC,320,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,320,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,320,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",2290.13,2290.13,42.27,144.87,4 RC,320,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,320,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,320,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,320,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,320,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,320,"Radiological examination, surgical specimen ",1549.31,1549.31,42.94,126.15,4 RC,320,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,320,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,320,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,320,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,320,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,320,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,320,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,320,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,320,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,320,Receptor assay; estrogen ,,,361.04,465.26,3 RC,320,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,320,Receptor assay; progesterone ,,,266.25,343.11,3 RC,320,Red cell survival study ,,,126.1,126.1,1 RC,320,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,320,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,320,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,320,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,320,Renin ,,,90.63,116.79,3 RC,320,Reptilase test ,,,40.44,52.12,3 RC,320,Reticulated platelet assay ,,,146.35,188.6,3 RC,320,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,320,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,320,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,320,Rufinamide ,,,111.5,143.69,3 RC,320,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,320,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,320,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,320,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,320,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,320,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,320,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,320,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,320,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,320,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,320,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,320,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,320,Salicylate ,,,76.68,98.82,3 RC,320,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,320,Salivary gland function study ,,,104.3,104.3,1 RC,320,Salivary gland imaging; ,,,175.52,175.52,1 RC,320,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,320,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,320,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,320,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,320,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,320,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,320,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,320,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,320,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,320,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,320,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,320,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,320,Selenium ,,,104.53,134.7,3 RC,320,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,320,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,320,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,320,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,320,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,320,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,320,Serotonin ,,,126.87,163.49,3 RC,320,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,320,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,320,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,320,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,320,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,320,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,320,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",2550.69,2550.69,84.18,277.61,4 RC,320,Sialic acid ,,,55.77,71.87,3 RC,320,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,320,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,320,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,320,Silica ,,,103.14,132.92,3 RC,320,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,320,Sirolimus ,,,57.16,73.66,3 RC,320,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,320,Skin test; candida ,,,79.46,102.39,3 RC,320,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,320,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,320,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,320,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,320,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,320,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,320,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,320,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,320,Sodium; other source ,,,19.53,25.17,3 RC,320,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,320,Sodium; urine ,,,20.91,26.95,3 RC,320,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,320,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,320,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,320,Somatomedin ,,,87.81,113.16,3 RC,320,Somatostatin ,,,75.26,96.98,3 RC,320,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,320,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,320,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,320,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,320,Specific gravity (except urine) ,,,13.94,17.97,3 RC,320,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,320,Sperm antibodies ,,,43.21,55.69,3 RC,320,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,320,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,320,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,320,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,320,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,320,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,320,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,320,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,320,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,320,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,320,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,320,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,320,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,320,"Stimulants, synthetic ",,,98.98,127.56,3 RC,320,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,320,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,320,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,320,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,320,"Streptokinase, antibody ",,,51.57,66.46,3 RC,320,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,320,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,320,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,320,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,320,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,320,"Sulfate, urine ",,,22.3,28.74,3 RC,320,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,320,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,320,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,320,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,320,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,320,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,320,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,320,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,320,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,320,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,320,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,320,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,320,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,320,T cells; total count ,,,154.71,199.37,3 RC,320,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,320,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,320,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,320,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,320,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,320,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,320,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,320,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,320,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,320,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,320,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,320,Tacrolimus ,,,57.16,73.66,3 RC,320,Tapentadol ,,,98.98,127.56,3 RC,320,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,320,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,320,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,320,Testosterone; free ,,,104.53,134.7,3 RC,320,Testosterone; total ,,,105.96,136.54,3 RC,320,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,320,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,320,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,320,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,320,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,320,Theophylline ,,,58.54,75.44,3 RC,320,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,320,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,320,Thiocyanate ,,,47.41,61.1,3 RC,320,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,320,Thrombin time; plasma ,,,23.69,30.52,3 RC,320,Thrombin time; titer ,,,27.89,35.94,3 RC,320,Thrombomodulin ,,,71.1,91.62,3 RC,320,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,320,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,320,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,320,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,320,Thyroglobulin ,,,65.51,84.43,3 RC,320,Thyroglobulin antibody ,,,65.51,84.43,3 RC,320,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,320,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,320,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,320,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,320,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,320,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,320,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,320,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,320,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,320,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,320,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,320,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,320,Thyroxine; free ,,,37.63,48.49,3 RC,320,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,320,Thyroxine; total ,,,27.89,35.94,3 RC,320,Tiagabine ,,,111.5,143.69,3 RC,320,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,320,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,320,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,320,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,320,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,320,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,320,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,320,Tobramycin ,,,66.9,86.21,3 RC,320,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,320,Topiramate ,,,48.8,62.89,3 RC,320,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,320,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,320,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,320,Tramadol ,,,98.98,127.56,3 RC,320,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,320,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,320,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,320,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,320,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,320,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,320,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,320,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,320,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,320,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,320,Transferrin ,,,52.96,68.24,3 RC,320,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,320,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,320,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,320,Triglycerides ,,,23.69,30.52,3 RC,320,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,320,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,320,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,320,"Troponin, qualitative ",,,41.83,53.9,3 RC,320,"Troponin, quantitative ",,,51.57,66.46,3 RC,320,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,320,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,320,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,320,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,320,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,320,Tyrosine ,,,43.21,55.69,3 RC,320,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,320,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,320,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,320,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,320,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,320,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,320,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,320,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,320,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,320,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,320,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,320,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,320,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,320,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,320,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,320,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,320,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,320,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,320,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,320,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,320,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,320,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,320,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,320,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,320,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,320,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,320,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,320,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,320,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,320,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,320,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,320,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,320,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,320,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,320,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,320,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,320,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,320,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,320,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,320,Unlisted immunology procedure ,,,99.55,128.28,3 RC,320,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,320,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,320,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,320,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,320,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,320,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,320,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,320,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,320,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,320,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,320,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,320,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,320,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,320,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,320,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,320,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,320,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,320,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,320,"Urethrocystography, voiding, radiological supervision and interpretation ",5086.05,5086.05,107.36,419.67,4 RC,320,Uric acid; blood ,,,18.14,23.38,3 RC,320,Uric acid; other source ,,,20.91,26.95,3 RC,320,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,320,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,320,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,320,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,320,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,320,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,320,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,320,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,320,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,320,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,320,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,320,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,320,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,320,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,320,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,320,"Urography, retrograde, with or without KUB ",10289.62,10289.62,78.73,247.93,4 RC,320,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,320,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,320,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,320,Vancomycin ,,,55.77,71.87,3 RC,320,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,320,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,320,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,320,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,320,Vedolizumab ,,,158.91,204.79,3 RC,320,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,320,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,320,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,320,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,320,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,320,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,320,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,320,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,320,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,320,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",15144.49,15144.49,149.95,364.72,4 RC,320,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,320,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,320,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",7395.34,7395.34,128.83,341.29,4 RC,320,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,320,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,320,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,320,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,320,Very long chain fatty acids ,,,80.84,104.18,3 RC,320,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,320,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,320,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,320,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,320,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,320,Viscosity ,,,47.41,61.1,3 RC,320,Vitamin A ,,,47.41,61.1,3 RC,320,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,320,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,320,Vitamin K ,,,55.77,71.87,3 RC,320,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,320,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,320,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,320,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,320,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,320,Voriconazole ,,,111.5,143.69,3 RC,320,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,320,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,320,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,320,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,320,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,320,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,320,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,320,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,320,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,320,Zinc ,,,47.41,61.1,3 RC,320,Zonisamide ,,,54.38,70.08,3 RC,320,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,320,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,320,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,321, Radiology - Diagnostic Angiocardiology ,,,198.0,198.0,1 RC,321,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,321,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,321,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,321,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,321,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,321,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,321,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,321,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,321,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,321,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,321,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,321,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,321,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,321,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,321,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,321,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,321,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,Acetaminophen ,,,76.68,98.82,3 RC,321,Acetylcholinesterase ,,,50.18,64.67,3 RC,321,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,321,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,321,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,321,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,321,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,321,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,321,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,321,Adalimumab ,,,158.91,204.79,3 RC,321,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,321,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,321,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,321,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,321,Albumin; ischemia modified ,,,139.38,179.62,3 RC,321,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,321,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,321,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,321,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,321,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,321,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,321,Alcohols ,,,98.98,127.56,3 RC,321,Aldolase ,,,40.44,52.12,3 RC,321,Aldosterone ,,,167.27,215.56,3 RC,321,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,321,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,321,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,321,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,321,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,321,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,321,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,321,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,321,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,321,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,321,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,321,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,321,Aluminum ,,,104.53,134.7,3 RC,321,Amikacin ,,,62.74,80.85,3 RC,321,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,321,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,321,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,321,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,321,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,321,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,321,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,321,Amiodarone ,,,76.68,98.82,3 RC,321,Ammonia ,,,59.93,77.23,3 RC,321,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,321,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,321,Amylase ,,,26.5,34.15,3 RC,321,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,321,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,321,Androstanediol glucuronide ,,,118.47,152.67,3 RC,321,Androstenedione ,,,119.9,154.51,3 RC,321,Androsterone ,,,104.53,134.7,3 RC,321,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,321,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,321,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,321,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,321,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,321,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,321,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,321,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,321,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,321,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,321,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,321,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,321,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,321,Angiotensin II ,,,85.04,109.59,3 RC,321,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,321,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,321,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,321,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,321,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,321,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,321,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,321,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,321,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,321,Antibody; Aspergillus ,,,61.31,79.01,3 RC,321,Antibody; Bartonella ,,,41.83,53.9,3 RC,321,Antibody; Blastomyces ,,,52.96,68.24,3 RC,321,Antibody; Bordetella ,,,54.38,70.08,3 RC,321,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,321,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,321,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,321,Antibody; Brucella ,,,36.24,46.7,3 RC,321,Antibody; Campylobacter ,,,54.38,70.08,3 RC,321,Antibody; Candida ,,,48.8,62.89,3 RC,321,Antibody; Chlamydia ,,,48.8,62.89,3 RC,321,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,321,Antibody; Coccidioides ,,,47.41,61.1,3 RC,321,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,321,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,321,Antibody; Diphtheria ,,,62.74,80.85,3 RC,321,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,321,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,321,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,321,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,321,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,321,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,321,Antibody; HIV-1 ,,,36.24,46.7,3 RC,321,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,321,Antibody; HIV-2 ,,,55.77,71.87,3 RC,321,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,321,Antibody; HTLV-I ,,,37.63,48.49,3 RC,321,Antibody; HTLV-II ,,,57.16,73.66,3 RC,321,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,321,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,321,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,321,Antibody; Legionella ,,,62.74,80.85,3 RC,321,Antibody; Leishmania ,,,50.18,64.67,3 RC,321,Antibody; Leptospira ,,,66.9,86.21,3 RC,321,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,321,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,321,Antibody; Nocardia ,,,65.51,84.43,3 RC,321,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,321,Antibody; Rickettsia ,,,79.46,102.39,3 RC,321,Antibody; Salmonella ,,,54.38,70.08,3 RC,321,Antibody; Shigella ,,,100.37,129.34,3 RC,321,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,321,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,321,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,321,Antibody; Trichinella ,,,51.57,66.46,3 RC,321,Antibody; West Nile virus ,,,58.54,75.44,3 RC,321,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,321,Antibody; Yersinia ,,,54.38,70.08,3 RC,321,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,321,Antibody; actinomyces ,,,41.83,53.9,3 RC,321,Antibody; adenovirus ,,,52.96,68.24,3 RC,321,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,321,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,321,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,321,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,321,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,321,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,321,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,321,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,321,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,321,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,321,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,321,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,321,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,321,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,321,Antibody; histoplasma ,,,57.16,73.66,3 RC,321,Antibody; influenza virus ,,,55.77,71.87,3 RC,321,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,321,Antibody; mucormycosis ,,,61.31,79.01,3 RC,321,Antibody; mumps ,,,54.38,70.08,3 RC,321,Antibody; mycoplasma ,,,54.38,70.08,3 RC,321,Antibody; parvovirus ,,,61.31,79.01,3 RC,321,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,321,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,321,Antibody; rotavirus ,,,75.26,96.98,3 RC,321,Antibody; rubella ,,,58.54,75.44,3 RC,321,Antibody; rubeola ,,,52.96,68.24,3 RC,321,Antibody; tetanus ,,,61.31,79.01,3 RC,321,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,321,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,321,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,321,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,321,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,321,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,321,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,321,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,321,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,321,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,321,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,321,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,321,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,321,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,321,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,321,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,321,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,321,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,321,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,321,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,321,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,321,"Apolipoprotein, each ",,,86.43,111.38,3 RC,321,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,321,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,321,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,321,Arsenic ,,,78.07,100.61,3 RC,321,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,321,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,321,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,321,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,321,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,321,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,321,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,321,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,321,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,321,"B cells, total count ",,,154.71,199.37,3 RC,321,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,321,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,321,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,321,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,321,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,321,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,321,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,321,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,321,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,321,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,321,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,321,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,321,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,321,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,321,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,321,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,321,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,321,Barbiturates ,,,98.98,127.56,3 RC,321,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,321,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,321,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,321,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,321,Beta-2 microglobulin ,,,66.9,86.21,3 RC,321,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,321,Bile acids; total ,,,71.1,91.62,3 RC,321,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,321,Bilirubin; direct ,,,20.91,26.95,3 RC,321,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,321,Bilirubin; total ,,,20.91,26.95,3 RC,321,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,321,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,321,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,321,Bleeding time ,,,19.53,25.17,3 RC,321,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,321,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,321,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,321,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,321,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,321,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,321,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,321,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,321,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,321,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,321,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,321,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,321,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,321,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,321,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,321,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,321,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,321,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,321,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,321,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,321,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,321,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,321,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,321,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,321,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,321,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,321,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,321,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,321,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,321,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,321,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,321,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,321,Bone age studies ,,,26.58,79.3,4 RC,321,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,321,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,321,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,321,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,321,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,321,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,321,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,321,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,321,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,321,Bradykinin ,,,20.91,26.95,3 RC,321,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,321,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,321,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,321,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,321,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,321,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,321,C-peptide ,,,85.04,109.59,3 RC,321,C-reactive protein; ,,,20.91,26.95,3 RC,321,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,321,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,321,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,321,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,321,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,321,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,321,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,321,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,321,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,321,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,321,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,321,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,321,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,321,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,321,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,321,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,321,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,321,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,321,Cadmium ,,,97.55,125.72,3 RC,321,Caffeine ,,,158.91,204.79,3 RC,321,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,321,Calcitonin ,,,110.11,141.9,3 RC,321,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,321,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,321,Calcium; ionized ,,,55.77,71.87,3 RC,321,Calcium; total ,,,20.91,26.95,3 RC,321,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,321,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,321,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,321,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,321,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,321,"Calprotectin, fecal ",,,80.84,104.18,3 RC,321,"Cannabinoids, natural ",,,98.98,127.56,3 RC,321,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,321,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,321,Carbamazepine; free ,,,54.38,70.08,3 RC,321,Carbamazepine; total ,,,59.93,77.23,3 RC,321,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,321,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,321,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,321,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,321,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,321,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,321,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,321,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,321,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,321,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,321,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,321,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,321,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,321,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,321,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,321,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,321,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,321,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,321,Cardiac shunt detection ,,,186.76,186.76,1 RC,321,Cardiokymography ,,,20.04,20.04,1 RC,321,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,321,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,321,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,321,Carotene ,,,37.63,48.49,3 RC,321,Catecholamines; blood ,,,119.9,154.51,3 RC,321,Catecholamines; fractionated ,,,104.53,134.7,3 RC,321,Catecholamines; total urine ,,,112.93,145.53,3 RC,321,Cathepsin-D ,,,73.87,95.19,3 RC,321,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,321,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,321,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,321,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,321,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,321,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,321,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,321,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,321,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,321,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,321,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,321,Ceruloplasmin ,,,44.6,57.47,3 RC,321,Chemiluminescent assay ,,,58.54,75.44,3 RC,321,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,321,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,321,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,321,Chloramphenicol ,,,51.57,66.46,3 RC,321,Chloride; blood ,,,19.53,25.17,3 RC,321,Chloride; other source ,,,20.91,26.95,3 RC,321,Chloride; urine ,,,23.69,30.52,3 RC,321,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,321,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,321,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,321,Cholinesterase; RBC ,,,40.44,52.12,3 RC,321,Cholinesterase; serum ,,,32.04,41.29,3 RC,321,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,321,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,321,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,321,Chromium ,,,83.66,107.81,3 RC,321,Chromogenic substrate assay ,,,48.8,62.89,3 RC,321,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,321,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,321,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,321,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,321,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,321,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,321,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,321,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,321,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,321,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,321,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,321,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,321,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,321,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,321,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,321,Citrate ,,,114.31,147.31,3 RC,321,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,321,Clot retraction ,,,66.9,86.21,3 RC,321,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,321,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,321,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,321,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,321,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,321,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,321,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,321,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,321,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,321,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,321,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,321,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,321,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,321,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,321,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,321,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,321,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,321,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,321,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,321,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,321,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,321,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,321,Clozapine ,,,82.23,105.96,3 RC,321,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,321,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,321,Coagulation time; activated ,,,18.14,23.38,3 RC,321,Coagulation time; other methods ,,,18.14,23.38,3 RC,321,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,321,Cocaine ,,,98.98,127.56,3 RC,321,Cold agglutinin; screen ,,,33.47,43.13,3 RC,321,Cold agglutinin; titer ,,,33.47,43.13,3 RC,321,"Collagen cross links, any method ",,,76.68,98.82,3 RC,321,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,321,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,321,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,321,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,321,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,321,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,321,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,321,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,321,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,321,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,321,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,321,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,321,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,321,"Complement; antigen, each component ",,,48.8,62.89,3 RC,321,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,321,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,321,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,321,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,321,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,321,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,321,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,321,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,321,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,321,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,321,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,321,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,321,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,321,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,321,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,321,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,321,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,321,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,321,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,321,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,321,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,321,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,321,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,321,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,321,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,321,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,321,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,321,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,321,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,321,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,321,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,321,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,321,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,321,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,321,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,321,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,321,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,321,Copper ,,,51.57,66.46,3 RC,321,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,321,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,321,Corticosterone ,,,92.01,118.58,3 RC,321,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,321,Cortisol; free ,,,68.28,88.0,3 RC,321,Cortisol; total ,,,66.9,86.21,3 RC,321,Creatine ,,,19.53,25.17,3 RC,321,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,321,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,321,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,321,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,321,Creatinine; blood ,,,20.91,26.95,3 RC,321,Creatinine; clearance ,,,39.01,50.28,3 RC,321,Creatinine; other source ,,,20.91,26.95,3 RC,321,Cryofibrinogen ,,,58.54,75.44,3 RC,321,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,321,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,321,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,321,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,321,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,321,Cryopreservation; sperm ,,,442.57,570.33,3 RC,321,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,321,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,321,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,321,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,321,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,321,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,321,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,321,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,321,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,321,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,321,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,321,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,321,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,321,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,321,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,321,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,321,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,321,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,321,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,321,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,321,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,321,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,321,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,321,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,321,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,321,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,321,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,321,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,321,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,321,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,321,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,321,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,321,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,321,"Culture, typing; other methods ",,,32.04,41.29,3 RC,321,Cyanide ,,,79.46,102.39,3 RC,321,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,321,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,321,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,321,Cyclosporine ,,,73.87,95.19,3 RC,321,Cystatin C ,,,76.68,98.82,3 RC,321,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,321,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,321,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,321,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,321,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,321,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,321,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,321,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,321,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,321,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,321,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,321,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,321,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,321,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,321,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,321,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,321,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,321,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,321,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,321,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,321,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,321,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,321,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,321,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,321,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,321,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,321,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,321,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,321,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,321,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,321,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,321,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,321,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,321,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,321,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,321,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,321,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,321,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,321,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,321,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,321,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,321,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,321,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,321,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,321,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,321,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,321,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,321,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,321,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,321,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,321,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,321,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,321,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,321,Dibucaine number ,,,50.18,64.67,3 RC,321,Digoxin; free ,,,54.38,70.08,3 RC,321,Digoxin; total ,,,54.38,70.08,3 RC,321,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,321,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,321,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,321,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,321,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,321,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,321,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,321,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,321,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,321,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,321,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,321,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,321,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,321,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,321,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,321,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,321,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,321,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,321,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,321,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,321,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,321,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,321,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,321,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,321,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,321,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,321,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,321,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,321,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,321,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,321,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,321,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,321,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,321,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,321,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,321,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,321,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,321,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,321,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,321,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,321,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,321,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,321,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,321,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,321,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,321,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,321,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,321,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,321,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,321,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,321,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,321,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,321,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,321,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,321,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,321,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,321,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,321,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,321,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,321,Erythropoietin ,,,76.68,98.82,3 RC,321,Esophageal motility ,,,214.04,214.04,1 RC,321,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,321,Estradiol; total ,,,114.31,147.31,3 RC,321,Estriol ,,,98.98,127.56,3 RC,321,Estrogens; fractionated ,,,132.41,170.64,3 RC,321,Estrogens; total ,,,89.2,114.95,3 RC,321,Estrone ,,,103.14,132.92,3 RC,321,Ethosuximide ,,,66.9,86.21,3 RC,321,Ethylene glycol ,,,61.31,79.01,3 RC,321,Etiocholanolone ,,,107.34,138.33,3 RC,321,Euglobulin lysis ,,,34.86,44.92,3 RC,321,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,321,Everolimus ,,,57.16,73.66,3 RC,321,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,321,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,321,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,321,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,321,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,321,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,321,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,321,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,321,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,321,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,321,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,321,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,321,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,321,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,321,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,321,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,321,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,321,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,321,Factor inhibitor test ,,,52.96,68.24,3 RC,321,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,321,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,321,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,321,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,321,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,321,Felbamate ,,,76.68,98.82,3 RC,321,Fentanyl ,,,98.98,127.56,3 RC,321,Fern test ,,,40.44,52.12,3 RC,321,Ferritin ,,,55.77,71.87,3 RC,321,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,321,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,321,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,321,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,321,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,321,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,321,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,321,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,321,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,321,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,321,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,321,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,321,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,321,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,321,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,321,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,321,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,321,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,321,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,321,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,321,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,321,Fibrinogen; activity ,,,40.44,52.12,3 RC,321,Fibrinogen; antigen ,,,59.93,77.23,3 RC,321,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,321,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,321,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,321,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,321,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,321,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,321,Flecainide ,,,76.68,98.82,3 RC,321,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,321,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,321,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,321,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,321,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,321,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,321,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,321,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,321,Fluoride ,,,76.68,98.82,3 RC,321,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,321,Folic acid; RBC ,,,72.48,93.41,3 RC,321,Folic acid; serum ,,,59.93,77.23,3 RC,321,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,321,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,321,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,321,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,321,"Fructose, semen ",,,71.1,91.62,3 RC,321,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,321,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,321,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,321,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,321,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,321,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,321,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,321,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,321,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,321,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,321,"Galactokinase, RBC ",,,87.81,113.16,3 RC,321,Galactose ,,,45.98,59.26,3 RC,321,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,321,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,321,Galectin-3 ,,,182.6,235.31,3 RC,321,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,321,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,321,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,321,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,321,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,321,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,321,"Gases, blood, pH only ",,,44.6,57.47,3 RC,321,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,321,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,321,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,321,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,321,Gastric mucosa imaging ,,,205.51,205.51,1 RC,321,Gastrin ,,,72.48,93.41,3 RC,321,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,321,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,321,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,321,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,321,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,321,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,321,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,321,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,321,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,321,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,321,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,321,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,321,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,321,Gentamicin ,,,66.9,86.21,3 RC,321,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,321,Glucagon ,,,58.54,75.44,3 RC,321,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,321,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,321,Glucagon tolerance test ,,,72.48,93.41,3 RC,321,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,321,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,321,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,321,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,321,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,321,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,321,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,321,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,321,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,321,"Glucosidase, beta ",,,87.81,113.16,3 RC,321,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,321,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,321,Glutathione ,,,64.13,82.64,3 RC,321,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,321,Glycated protein ,,,68.28,88.0,3 RC,321,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,321,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,321,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,321,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,321,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,321,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,321,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,321,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,321,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,321,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,321,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,321,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,321,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,321,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,321,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,321,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,321,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,321,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,321,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,321,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,321,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,321,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,321,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,321,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,321,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,321,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,321,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,321,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,321,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,321,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,321,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,321,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,321,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,321,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,321,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,321,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,321,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,321,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,321,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,321,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,321,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,321,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,Haloperidol ,,,65.51,84.43,3 RC,321,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,321,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,321,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,321,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,321,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,321,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,321,Heinz bodies; direct ,,,16.71,21.54,3 RC,321,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,321,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,321,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,321,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,321,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,321,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,321,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,321,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,321,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,321,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,321,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,321,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,321,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,321,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,321,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,321,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,321,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,321,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,321,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,321,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,321,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,321,Hemoglobin; plasma ,,,30.66,39.51,3 RC,321,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,321,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,321,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,321,Hemoglobin; urine ,,,16.71,21.54,3 RC,321,"Hemolysin, acid ",,,36.24,46.7,3 RC,321,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,321,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,321,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,321,Heparin assay ,,,54.38,70.08,3 RC,321,Heparin neutralization ,,,48.8,62.89,3 RC,321,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,321,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,321,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,321,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,321,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,321,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,321,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,321,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,321,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,321,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,321,Hepatitis C antibody; ,,,58.54,75.44,3 RC,321,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,321,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,321,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,321,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,321,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,321,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,321,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,321,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,321,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,321,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,321,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,321,Heroin metabolite ,,,98.98,127.56,3 RC,321,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,321,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,321,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,321,Histamine ,,,121.28,156.3,3 RC,321,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,321,Homocysteine ,,,73.87,95.19,3 RC,321,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,321,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,321,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,321,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,321,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,321,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,321,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,321,Hydroxychloroquine ,,,76.68,98.82,3 RC,321,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,321,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,321,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,321,Hydroxyproline; free ,,,93.4,120.36,3 RC,321,Hydroxyproline; total ,,,100.37,129.34,3 RC,321,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,321,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,321,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,321,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,321,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,321,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,321,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,321,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,321,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,321,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,321,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,321,Immune complex assay ,,,100.37,129.34,3 RC,321,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,321,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,321,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,321,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,321,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,321,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,321,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,321,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,321,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,321,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,321,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,321,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,321,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,321,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,321,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,321,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,321,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,321,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,321,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,321,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,321,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,321,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,321,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,321,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,321,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,321,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,321,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,321,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,321,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,321,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,321,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,321,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,321,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,321,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,321,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,321,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,321,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,321,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,321,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,321,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,321,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,321,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,321,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,321,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,321,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,321,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,321,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,321,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,321,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,321,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,321,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,321,Infliximab ,,,158.91,204.79,3 RC,321,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,321,Inhibin A ,,,64.13,82.64,3 RC,321,Insemination of oocytes ,,,442.57,570.33,3 RC,321,Insulin antibodies ,,,87.81,113.16,3 RC,321,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,321,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,321,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,321,Insulin; free ,,,52.96,68.24,3 RC,321,Insulin; total ,,,47.41,61.1,3 RC,321,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,321,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,321,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,321,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,321,Intrinsic factor ,,,80.84,104.18,3 RC,321,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,321,Iron ,,,26.5,34.15,3 RC,321,Iron binding capacity ,,,36.24,46.7,3 RC,321,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,321,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,321,Islet cell antibody ,,,97.55,125.72,3 RC,321,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,321,Itraconazole ,,,111.5,143.69,3 RC,321,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,321,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,321,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,321,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,321,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,321,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,321,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,321,Ketamine and norketamine ,,,98.98,127.56,3 RC,321,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,321,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,321,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,321,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,321,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,321,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,321,Kidney imaging morphology; ,,,172.11,172.11,1 RC,321,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,321,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,321,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,321,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,321,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,321,Lacosamide ,,,111.5,143.69,3 RC,321,Lactate (lactic acid) ,,,47.41,61.1,3 RC,321,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,321,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,321,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,321,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,321,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,321,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,321,Lamotrigine ,,,54.38,70.08,3 RC,321,Lead ,,,50.18,64.67,3 RC,321,Leflunomide ,,,158.91,204.79,3 RC,321,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,321,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,321,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,321,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,321,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,321,Leukocyte transfusion ,,,305.26,393.39,3 RC,321,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,321,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,321,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,321,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,321,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,321,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,321,Levetiracetam ,,,54.38,70.08,3 RC,321,Lidocaine ,,,59.93,77.23,3 RC,321,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,321,Lipase ,,,27.89,35.94,3 RC,321,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,321,Lipoprotein (a) ,,,58.54,75.44,3 RC,321,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,321,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,321,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,321,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,321,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,321,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,321,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,321,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,321,Lithium ,,,27.89,35.94,3 RC,321,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,321,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,321,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,321,Liver imaging; static only ,,,191.2,191.2,1 RC,321,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,321,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,321,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,321,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,321,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,321,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,321,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,321,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,321,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,321,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,321,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,321,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,321,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,321,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,321,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,321,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,321,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,321,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,321,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,321,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,321,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,321,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,321,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,321,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,321,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,321,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,321,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,321,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,321,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,321,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,321,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,321,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,321,Magnesium ,,,27.89,35.94,3 RC,321,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,321,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,321,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,321,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,321,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,321,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,321,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,321,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,321,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,321,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,321,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,321,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,321,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,321,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,321,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,321,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,321,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,321,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,321,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,321,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,321,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,321,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,321,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,321,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,321,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,321,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,321,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,321,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,321,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,321,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,321,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,321,Malate dehydrogenase ,,,30.66,39.51,3 RC,321,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,321,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,321,Manganese ,,,110.11,141.9,3 RC,321,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,321,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,321,"Meat fibers, feces ",,,19.53,25.17,3 RC,321,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,321,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,321,"Mercury, quantitative ",,,66.9,86.21,3 RC,321,Metanephrines ,,,69.71,89.84,3 RC,321,Methadone ,,,98.98,127.56,3 RC,321,Methemalbumin ,,,44.6,57.47,3 RC,321,Methotrexate ,,,158.91,204.79,3 RC,321,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,321,Methylphenidate ,,,98.98,127.56,3 RC,321,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,321,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,321,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,321,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,321,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,321,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,321,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,321,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,321,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,321,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,321,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,321,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,321,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,321,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,321,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,321,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,321,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,321,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,321,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,321,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,321,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,321,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,321,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,321,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,321,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,321,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,321,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,321,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,321,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,321,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,321,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,321,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,321,Muramidase ,,,76.68,98.82,3 RC,321,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,321,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,321,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,321,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,321,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,321,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,321,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,321,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,321,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,321,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,321,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,321,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,321,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,321,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,321,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,321,Myoglobin ,,,52.96,68.24,3 RC,321,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,321,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,321,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,321,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,321,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,321,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,321,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,321,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,321,Natriuretic peptide ,,,161.68,208.36,3 RC,321,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,321,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,321,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,321,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,321,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,321,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,321,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,321,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,321,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,321,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,321,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,321,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,321,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,321,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,321,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,321,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,321,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,321,Nerve teasing preparations ,,,499.29,643.43,3 RC,321,"Neutralization test, viral ",,,69.71,89.84,3 RC,321,Nickel ,,,100.37,129.34,3 RC,321,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,321,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,321,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,321,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,321,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,321,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,321,Nucleotidase 5'- ,,,45.98,59.26,3 RC,321,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,321,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,321,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,321,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,321,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,321,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,321,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,321,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,321,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,321,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,321,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,321,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,321,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,321,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,321,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,321,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,321,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,321,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,321,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,321,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,321,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,321,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,321,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,321,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,321,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,321,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,321,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,321,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,321,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,321,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,321,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,321,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,321,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,321,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,321,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,321,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,321,"Opiates, 1 or more ",,,98.98,127.56,3 RC,321,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,321,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,321,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,321,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,321,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,321,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,321,Osmolality; blood ,,,27.89,35.94,3 RC,321,Osmolality; urine ,,,27.89,35.94,3 RC,321,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,321,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,321,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,321,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,321,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,321,Oxalate ,,,59.93,77.23,3 RC,321,Oxcarbazepine ,,,54.38,70.08,3 RC,321,Oxycodone ,,,98.98,127.56,3 RC,321,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,321,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,321,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,321,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,321,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,321,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,321,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,321,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,321,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,321,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,321,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,321,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,321,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,321,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,321,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,321,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,321,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,321,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,321,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,321,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,321,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,321,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,321,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,321,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,321,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,321,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,321,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,321,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,321,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,321,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,321,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,321,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,321,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,321,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,321,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,321,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,321,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,321,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,321,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,321,Phenobarbital ,,,62.74,80.85,3 RC,321,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,321,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,321,Phenytoin; free ,,,57.16,73.66,3 RC,321,Phenytoin; total ,,,54.38,70.08,3 RC,321,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,321,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,321,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,321,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,321,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,321,Phosphatidylglycerol ,,,68.28,88.0,3 RC,321,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,321,Phosphohexose isomerase ,,,44.6,57.47,3 RC,321,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,321,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,321,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,321,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,321,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,321,Pinworm examinations ,,,18.14,23.38,3 RC,321,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,321,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,321,Platelet survival study ,,,126.1,126.1,1 RC,321,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,321,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,321,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,321,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,321,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,321,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,321,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,321,Posaconazole ,,,111.5,143.69,3 RC,321,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,321,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,321,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,321,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,321,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,321,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,321,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,321,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,321,Potassium; urine ,,,19.53,25.17,3 RC,321,Prealbumin ,,,59.93,77.23,3 RC,321,Pregabalin ,,,98.98,127.56,3 RC,321,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,321,Pregnanediol ,,,87.81,113.16,3 RC,321,Pregnanetriol ,,,86.43,111.38,3 RC,321,Pregnenolone ,,,85.04,109.59,3 RC,321,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,321,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,321,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,321,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,321,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,321,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,321,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,321,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,321,Primidone ,,,68.28,88.0,3 RC,321,Procainamide; ,,,246.72,317.95,3 RC,321,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,321,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,321,Progesterone ,,,86.43,111.38,3 RC,321,Proinsulin ,,,110.11,141.9,3 RC,321,Prolactin ,,,79.46,102.39,3 RC,321,Propoxyphene ,,,98.98,127.56,3 RC,321,"Prostaglandin, each ",,,171.47,220.97,3 RC,321,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,321,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,321,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,321,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,321,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,321,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,321,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,321,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,321,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,321,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,321,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,321,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,321,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,321,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,321,Prothrombin time; ,,,18.14,23.38,3 RC,321,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,321,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,321,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,321,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,321,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,321,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,321,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,321,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,321,Pyruvate ,,,59.93,77.23,3 RC,321,Pyruvate kinase ,,,39.01,50.28,3 RC,321,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,321,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,321,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,321,Quinidine ,,,59.93,77.23,3 RC,321,Quinine ,,,47.41,61.1,3 RC,321,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,321,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,321,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,321,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,321,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,321,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,321,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,321,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,321,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,321,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,321,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,321,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,321,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,321,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,321,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,321,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,321,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,321,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,321,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,321,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,321,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,321,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,321,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,321,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,321,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,321,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,321,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,321,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,321,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,321,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,321,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,321,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,321,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,321,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,321,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,321,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,321,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,321,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,321,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,321,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,321,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,321,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,321,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,321,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,321,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,321,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,321,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,321,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,321,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,321,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,321,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,321,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,321,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,321,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,321,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,321,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,321,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,321,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,321,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,321,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,321,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,321,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,321,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,321,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,321,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,321,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,321,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,321,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,321,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,321,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,321,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,321,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,321,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,321,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,321,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,321,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,321,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,321,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,321,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,321,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,321,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,321,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,321,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,321,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,321,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,321,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,321,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,321,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,321,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,321,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,321,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,321,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,321,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,321,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,321,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,321,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,321,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,321,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,321,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,321,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,321,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,321,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,321,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,321,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,321,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,321,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,321,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,321,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,321,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,321,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,321,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,321,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,321,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,321,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,321,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,321,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,321,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,321,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,321,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,321,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,321,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,321,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,321,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,321,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,321,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,321,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,321,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,321,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,321,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,321,Receptor assay; estrogen ,,,361.04,465.26,3 RC,321,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,321,Receptor assay; progesterone ,,,266.25,343.11,3 RC,321,Red cell survival study ,,,126.1,126.1,1 RC,321,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,321,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,321,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,321,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,321,Renin ,,,90.63,116.79,3 RC,321,Reptilase test ,,,40.44,52.12,3 RC,321,Reticulated platelet assay ,,,146.35,188.6,3 RC,321,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,321,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,321,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,321,Rufinamide ,,,111.5,143.69,3 RC,321,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,321,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,321,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,321,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,321,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,321,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,321,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,321,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,321,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,321,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,321,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,321,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,321,Salicylate ,,,76.68,98.82,3 RC,321,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,321,Salivary gland function study ,,,104.3,104.3,1 RC,321,Salivary gland imaging; ,,,175.52,175.52,1 RC,321,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,321,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,321,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,321,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,321,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,321,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,321,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,321,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,321,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,321,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,321,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,321,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,321,Selenium ,,,104.53,134.7,3 RC,321,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,321,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,321,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,321,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,321,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,321,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,321,Serotonin ,,,126.87,163.49,3 RC,321,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,321,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,321,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,321,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,321,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,321,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,321,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,321,Sialic acid ,,,55.77,71.87,3 RC,321,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,321,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,321,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,321,Silica ,,,103.14,132.92,3 RC,321,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,321,Sirolimus ,,,57.16,73.66,3 RC,321,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,321,Skin test; candida ,,,79.46,102.39,3 RC,321,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,321,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,321,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,321,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,321,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,321,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,321,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,321,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,321,Sodium; other source ,,,19.53,25.17,3 RC,321,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,321,Sodium; urine ,,,20.91,26.95,3 RC,321,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,321,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,321,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,321,Somatomedin ,,,87.81,113.16,3 RC,321,Somatostatin ,,,75.26,96.98,3 RC,321,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,321,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,321,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,321,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,321,Specific gravity (except urine) ,,,13.94,17.97,3 RC,321,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,321,Sperm antibodies ,,,43.21,55.69,3 RC,321,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,321,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,321,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,321,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,321,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,321,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,321,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,321,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,321,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,321,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,321,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,321,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,321,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,321,"Stimulants, synthetic ",,,98.98,127.56,3 RC,321,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,321,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,321,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,321,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,321,"Streptokinase, antibody ",,,51.57,66.46,3 RC,321,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,321,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,321,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,321,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,321,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,321,"Sulfate, urine ",,,22.3,28.74,3 RC,321,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,321,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,321,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,321,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,321,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,321,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,321,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,321,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,321,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,321,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,321,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,321,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,321,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,321,T cells; total count ,,,154.71,199.37,3 RC,321,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,321,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,321,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,321,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,321,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,321,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,321,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,321,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,321,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,321,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,321,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,321,Tacrolimus ,,,57.16,73.66,3 RC,321,Tapentadol ,,,98.98,127.56,3 RC,321,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,321,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,321,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,321,Testosterone; free ,,,104.53,134.7,3 RC,321,Testosterone; total ,,,105.96,136.54,3 RC,321,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,321,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,321,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,321,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,321,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,321,Theophylline ,,,58.54,75.44,3 RC,321,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,321,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,321,Thiocyanate ,,,47.41,61.1,3 RC,321,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,321,Thrombin time; plasma ,,,23.69,30.52,3 RC,321,Thrombin time; titer ,,,27.89,35.94,3 RC,321,Thrombomodulin ,,,71.1,91.62,3 RC,321,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,321,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,321,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,321,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,321,Thyroglobulin ,,,65.51,84.43,3 RC,321,Thyroglobulin antibody ,,,65.51,84.43,3 RC,321,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,321,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,321,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,321,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,321,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,321,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,321,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,321,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,321,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,321,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,321,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,321,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,321,Thyroxine; free ,,,37.63,48.49,3 RC,321,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,321,Thyroxine; total ,,,27.89,35.94,3 RC,321,Tiagabine ,,,111.5,143.69,3 RC,321,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,321,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,321,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,321,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,321,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,321,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,321,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,321,Tobramycin ,,,66.9,86.21,3 RC,321,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,321,Topiramate ,,,48.8,62.89,3 RC,321,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,321,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,321,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,321,Tramadol ,,,98.98,127.56,3 RC,321,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,321,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,321,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,321,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,321,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,321,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,321,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,321,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,321,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,321,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,321,Transferrin ,,,52.96,68.24,3 RC,321,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,321,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,321,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,321,Triglycerides ,,,23.69,30.52,3 RC,321,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,321,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,321,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,321,"Troponin, qualitative ",,,41.83,53.9,3 RC,321,"Troponin, quantitative ",,,51.57,66.46,3 RC,321,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,321,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,321,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,321,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,321,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,321,Tyrosine ,,,43.21,55.69,3 RC,321,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,321,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,321,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,321,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,321,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,321,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,321,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,321,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,321,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,321,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,321,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,321,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,321,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,321,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,321,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,321,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,321,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,321,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,321,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,321,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,321,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,321,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,321,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,321,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,321,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,321,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,321,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,321,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,321,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,321,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,321,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,321,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,321,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,321,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,321,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,321,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,321,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,321,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,321,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,321,Unlisted immunology procedure ,,,99.55,128.28,3 RC,321,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,321,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,321,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,321,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,321,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,321,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,321,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,321,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,321,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,321,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,321,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,321,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,321,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,321,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,321,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,321,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,321,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,321,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,321,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,321,Uric acid; blood ,,,18.14,23.38,3 RC,321,Uric acid; other source ,,,20.91,26.95,3 RC,321,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,321,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,321,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,321,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,321,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,321,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,321,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,321,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,321,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,321,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,321,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,321,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,321,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,321,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,321,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,321,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,321,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,321,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,321,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,321,Vancomycin ,,,55.77,71.87,3 RC,321,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,321,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,321,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,321,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,321,Vedolizumab ,,,158.91,204.79,3 RC,321,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,321,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,321,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,321,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,321,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,321,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,321,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,321,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,321,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,321,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,321,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,321,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,321,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,321,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,321,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,321,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,321,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,321,Very long chain fatty acids ,,,80.84,104.18,3 RC,321,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,321,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,321,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,321,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,321,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,321,Viscosity ,,,47.41,61.1,3 RC,321,Vitamin A ,,,47.41,61.1,3 RC,321,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,321,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,321,Vitamin K ,,,55.77,71.87,3 RC,321,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,321,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,321,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,321,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,321,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,321,Voriconazole ,,,111.5,143.69,3 RC,321,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,321,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,321,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,321,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,321,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,321,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,321,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,321,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,321,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,321,Zinc ,,,47.41,61.1,3 RC,321,Zonisamide ,,,54.38,70.08,3 RC,321,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,321,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,321,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,322, Radiology - Diagnostic Arthrography ,,,198.0,198.0,1 RC,322,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,322,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,322,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,322,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,322,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,322,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,322,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,322,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,322,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,322,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,322,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,322,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,322,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,322,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,322,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,322,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,322,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,Acetaminophen ,,,76.68,98.82,3 RC,322,Acetylcholinesterase ,,,50.18,64.67,3 RC,322,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,322,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,322,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,322,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,322,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,322,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,322,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,322,Adalimumab ,,,158.91,204.79,3 RC,322,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,322,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,322,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,322,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,322,Albumin; ischemia modified ,,,139.38,179.62,3 RC,322,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,322,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,322,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,322,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,322,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,322,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,322,Alcohols ,,,98.98,127.56,3 RC,322,Aldolase ,,,40.44,52.12,3 RC,322,Aldosterone ,,,167.27,215.56,3 RC,322,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,322,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,322,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,322,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,322,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,322,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,322,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,322,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,322,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,322,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,322,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,322,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,322,Aluminum ,,,104.53,134.7,3 RC,322,Amikacin ,,,62.74,80.85,3 RC,322,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,322,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,322,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,322,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,322,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,322,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,322,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,322,Amiodarone ,,,76.68,98.82,3 RC,322,Ammonia ,,,59.93,77.23,3 RC,322,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,322,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,322,Amylase ,,,26.5,34.15,3 RC,322,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,322,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,322,Androstanediol glucuronide ,,,118.47,152.67,3 RC,322,Androstenedione ,,,119.9,154.51,3 RC,322,Androsterone ,,,104.53,134.7,3 RC,322,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,322,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,322,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,322,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,322,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,322,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,322,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,322,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,322,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,322,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,322,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,322,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,322,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,322,Angiotensin II ,,,85.04,109.59,3 RC,322,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,322,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,322,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,322,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,322,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,322,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,322,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,322,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,322,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,322,Antibody; Aspergillus ,,,61.31,79.01,3 RC,322,Antibody; Bartonella ,,,41.83,53.9,3 RC,322,Antibody; Blastomyces ,,,52.96,68.24,3 RC,322,Antibody; Bordetella ,,,54.38,70.08,3 RC,322,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,322,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,322,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,322,Antibody; Brucella ,,,36.24,46.7,3 RC,322,Antibody; Campylobacter ,,,54.38,70.08,3 RC,322,Antibody; Candida ,,,48.8,62.89,3 RC,322,Antibody; Chlamydia ,,,48.8,62.89,3 RC,322,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,322,Antibody; Coccidioides ,,,47.41,61.1,3 RC,322,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,322,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,322,Antibody; Diphtheria ,,,62.74,80.85,3 RC,322,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,322,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,322,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,322,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,322,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,322,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,322,Antibody; HIV-1 ,,,36.24,46.7,3 RC,322,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,322,Antibody; HIV-2 ,,,55.77,71.87,3 RC,322,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,322,Antibody; HTLV-I ,,,37.63,48.49,3 RC,322,Antibody; HTLV-II ,,,57.16,73.66,3 RC,322,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,322,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,322,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,322,Antibody; Legionella ,,,62.74,80.85,3 RC,322,Antibody; Leishmania ,,,50.18,64.67,3 RC,322,Antibody; Leptospira ,,,66.9,86.21,3 RC,322,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,322,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,322,Antibody; Nocardia ,,,65.51,84.43,3 RC,322,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,322,Antibody; Rickettsia ,,,79.46,102.39,3 RC,322,Antibody; Salmonella ,,,54.38,70.08,3 RC,322,Antibody; Shigella ,,,100.37,129.34,3 RC,322,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,322,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,322,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,322,Antibody; Trichinella ,,,51.57,66.46,3 RC,322,Antibody; West Nile virus ,,,58.54,75.44,3 RC,322,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,322,Antibody; Yersinia ,,,54.38,70.08,3 RC,322,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,322,Antibody; actinomyces ,,,41.83,53.9,3 RC,322,Antibody; adenovirus ,,,52.96,68.24,3 RC,322,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,322,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,322,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,322,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,322,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,322,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,322,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,322,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,322,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,322,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,322,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,322,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,322,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,322,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,322,Antibody; histoplasma ,,,57.16,73.66,3 RC,322,Antibody; influenza virus ,,,55.77,71.87,3 RC,322,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,322,Antibody; mucormycosis ,,,61.31,79.01,3 RC,322,Antibody; mumps ,,,54.38,70.08,3 RC,322,Antibody; mycoplasma ,,,54.38,70.08,3 RC,322,Antibody; parvovirus ,,,61.31,79.01,3 RC,322,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,322,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,322,Antibody; rotavirus ,,,75.26,96.98,3 RC,322,Antibody; rubella ,,,58.54,75.44,3 RC,322,Antibody; rubeola ,,,52.96,68.24,3 RC,322,Antibody; tetanus ,,,61.31,79.01,3 RC,322,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,322,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,322,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,322,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,322,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,322,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,322,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,322,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,322,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,322,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,322,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,322,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,322,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,322,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,322,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,322,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,322,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,322,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,322,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,322,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,322,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,322,"Apolipoprotein, each ",,,86.43,111.38,3 RC,322,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,322,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,322,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,322,Arsenic ,,,78.07,100.61,3 RC,322,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,322,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,322,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,322,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,322,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,322,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,322,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,322,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,322,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,322,"B cells, total count ",,,154.71,199.37,3 RC,322,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,322,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,322,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,322,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,322,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,322,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,322,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,322,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,322,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,322,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,322,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,322,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,322,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,322,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,322,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,322,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,322,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,322,Barbiturates ,,,98.98,127.56,3 RC,322,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,322,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,322,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,322,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,322,Beta-2 microglobulin ,,,66.9,86.21,3 RC,322,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,322,Bile acids; total ,,,71.1,91.62,3 RC,322,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,322,Bilirubin; direct ,,,20.91,26.95,3 RC,322,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,322,Bilirubin; total ,,,20.91,26.95,3 RC,322,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,322,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,322,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,322,Bleeding time ,,,19.53,25.17,3 RC,322,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,322,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,322,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,322,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,322,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,322,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,322,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,322,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,322,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,322,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,322,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,322,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,322,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,322,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,322,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,322,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,322,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,322,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,322,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,322,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,322,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,322,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,322,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,322,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,322,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,322,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,322,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,322,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,322,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,322,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,322,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,322,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,322,Bone age studies ,,,26.58,79.3,4 RC,322,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,322,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,322,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,322,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,322,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,322,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,322,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,322,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,322,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,322,Bradykinin ,,,20.91,26.95,3 RC,322,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,322,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,322,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,322,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,322,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,322,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,322,C-peptide ,,,85.04,109.59,3 RC,322,C-reactive protein; ,,,20.91,26.95,3 RC,322,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,322,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,322,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,322,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,322,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,322,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,322,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,322,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,322,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,322,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,322,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,322,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,322,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,322,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,322,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,322,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,322,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,322,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,322,Cadmium ,,,97.55,125.72,3 RC,322,Caffeine ,,,158.91,204.79,3 RC,322,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,322,Calcitonin ,,,110.11,141.9,3 RC,322,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,322,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,322,Calcium; ionized ,,,55.77,71.87,3 RC,322,Calcium; total ,,,20.91,26.95,3 RC,322,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,322,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,322,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,322,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,322,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,322,"Calprotectin, fecal ",,,80.84,104.18,3 RC,322,"Cannabinoids, natural ",,,98.98,127.56,3 RC,322,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,322,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,322,Carbamazepine; free ,,,54.38,70.08,3 RC,322,Carbamazepine; total ,,,59.93,77.23,3 RC,322,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,322,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,322,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,322,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,322,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,322,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,322,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,322,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,322,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,322,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,322,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,322,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,322,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,322,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,322,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,322,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,322,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,322,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,322,Cardiac shunt detection ,,,186.76,186.76,1 RC,322,Cardiokymography ,,,20.04,20.04,1 RC,322,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,322,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,322,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,322,Carotene ,,,37.63,48.49,3 RC,322,Catecholamines; blood ,,,119.9,154.51,3 RC,322,Catecholamines; fractionated ,,,104.53,134.7,3 RC,322,Catecholamines; total urine ,,,112.93,145.53,3 RC,322,Cathepsin-D ,,,73.87,95.19,3 RC,322,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,322,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,322,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,322,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,322,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,322,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,322,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,322,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,322,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,322,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,322,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,322,Ceruloplasmin ,,,44.6,57.47,3 RC,322,Chemiluminescent assay ,,,58.54,75.44,3 RC,322,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,322,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,322,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,322,Chloramphenicol ,,,51.57,66.46,3 RC,322,Chloride; blood ,,,19.53,25.17,3 RC,322,Chloride; other source ,,,20.91,26.95,3 RC,322,Chloride; urine ,,,23.69,30.52,3 RC,322,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,322,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,322,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,322,Cholinesterase; RBC ,,,40.44,52.12,3 RC,322,Cholinesterase; serum ,,,32.04,41.29,3 RC,322,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,322,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,322,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,322,Chromium ,,,83.66,107.81,3 RC,322,Chromogenic substrate assay ,,,48.8,62.89,3 RC,322,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,322,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,322,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,322,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,322,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,322,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,322,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,322,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,322,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,322,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,322,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,322,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,322,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,322,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,322,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,322,Citrate ,,,114.31,147.31,3 RC,322,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,322,Clot retraction ,,,66.9,86.21,3 RC,322,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,322,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,322,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,322,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,322,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,322,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,322,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,322,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,322,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,322,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,322,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,322,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,322,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,322,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,322,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,322,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,322,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,322,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,322,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,322,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,322,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,322,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,322,Clozapine ,,,82.23,105.96,3 RC,322,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,322,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,322,Coagulation time; activated ,,,18.14,23.38,3 RC,322,Coagulation time; other methods ,,,18.14,23.38,3 RC,322,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,322,Cocaine ,,,98.98,127.56,3 RC,322,Cold agglutinin; screen ,,,33.47,43.13,3 RC,322,Cold agglutinin; titer ,,,33.47,43.13,3 RC,322,"Collagen cross links, any method ",,,76.68,98.82,3 RC,322,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,322,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,322,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,322,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,322,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,322,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,322,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,322,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,322,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,322,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,322,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,322,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,322,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,322,"Complement; antigen, each component ",,,48.8,62.89,3 RC,322,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,322,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,322,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,322,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,322,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,322,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,322,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,322,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,322,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,322,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,322,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,322,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,322,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,322,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,322,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,322,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,322,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,322,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,322,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,322,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,322,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,322,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,322,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,322,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,322,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,322,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,322,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,322,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,322,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,322,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,322,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,322,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,322,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,322,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,322,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,322,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,322,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,322,Copper ,,,51.57,66.46,3 RC,322,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,322,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,322,Corticosterone ,,,92.01,118.58,3 RC,322,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,322,Cortisol; free ,,,68.28,88.0,3 RC,322,Cortisol; total ,,,66.9,86.21,3 RC,322,Creatine ,,,19.53,25.17,3 RC,322,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,322,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,322,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,322,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,322,Creatinine; blood ,,,20.91,26.95,3 RC,322,Creatinine; clearance ,,,39.01,50.28,3 RC,322,Creatinine; other source ,,,20.91,26.95,3 RC,322,Cryofibrinogen ,,,58.54,75.44,3 RC,322,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,322,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,322,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,322,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,322,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,322,Cryopreservation; sperm ,,,442.57,570.33,3 RC,322,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,322,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,322,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,322,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,322,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,322,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,322,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,322,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,322,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,322,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,322,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,322,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,322,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,322,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,322,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,322,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,322,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,322,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,322,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,322,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,322,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,322,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,322,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,322,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,322,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,322,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,322,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,322,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,322,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,322,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,322,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,322,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,322,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,322,"Culture, typing; other methods ",,,32.04,41.29,3 RC,322,Cyanide ,,,79.46,102.39,3 RC,322,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,322,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,322,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,322,Cyclosporine ,,,73.87,95.19,3 RC,322,Cystatin C ,,,76.68,98.82,3 RC,322,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,322,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,322,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,322,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,322,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,322,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,322,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,322,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,322,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,322,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,322,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,322,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,322,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,322,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,322,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,322,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,322,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,322,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,322,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,322,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,322,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,322,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,322,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,322,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,322,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,322,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,322,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,322,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,322,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,322,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,322,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,322,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,322,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,322,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,322,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,322,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,322,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,322,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,322,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,322,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,322,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,322,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,322,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,322,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,322,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,322,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,322,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,322,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,322,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,322,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,322,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,322,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,322,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,322,Dibucaine number ,,,50.18,64.67,3 RC,322,Digoxin; free ,,,54.38,70.08,3 RC,322,Digoxin; total ,,,54.38,70.08,3 RC,322,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,322,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,322,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,322,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,322,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,322,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,322,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,322,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,322,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,322,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,322,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,322,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,322,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,322,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,322,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,322,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,322,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,322,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,322,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,322,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,322,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,322,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,322,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,322,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,322,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,322,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,322,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,322,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,322,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,322,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,322,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,322,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,322,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,322,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,322,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,322,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,322,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,322,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,322,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,322,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,322,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,322,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,322,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,322,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,322,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,322,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,322,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,322,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,322,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,322,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,322,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,322,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,322,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,322,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,322,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,322,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,322,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,322,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,322,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,322,Erythropoietin ,,,76.68,98.82,3 RC,322,Esophageal motility ,,,214.04,214.04,1 RC,322,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,322,Estradiol; total ,,,114.31,147.31,3 RC,322,Estriol ,,,98.98,127.56,3 RC,322,Estrogens; fractionated ,,,132.41,170.64,3 RC,322,Estrogens; total ,,,89.2,114.95,3 RC,322,Estrone ,,,103.14,132.92,3 RC,322,Ethosuximide ,,,66.9,86.21,3 RC,322,Ethylene glycol ,,,61.31,79.01,3 RC,322,Etiocholanolone ,,,107.34,138.33,3 RC,322,Euglobulin lysis ,,,34.86,44.92,3 RC,322,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,322,Everolimus ,,,57.16,73.66,3 RC,322,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,322,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,322,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,322,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,322,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,322,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,322,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,322,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,322,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,322,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,322,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,322,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,322,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,322,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,322,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,322,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,322,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,322,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,322,Factor inhibitor test ,,,52.96,68.24,3 RC,322,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,322,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,322,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,322,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,322,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,322,Felbamate ,,,76.68,98.82,3 RC,322,Fentanyl ,,,98.98,127.56,3 RC,322,Fern test ,,,40.44,52.12,3 RC,322,Ferritin ,,,55.77,71.87,3 RC,322,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,322,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,322,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,322,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,322,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,322,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,322,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,322,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,322,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,322,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,322,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,322,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,322,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,322,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,322,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,322,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,322,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,322,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,322,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,322,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,322,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,322,Fibrinogen; activity ,,,40.44,52.12,3 RC,322,Fibrinogen; antigen ,,,59.93,77.23,3 RC,322,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,322,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,322,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,322,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,322,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,322,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,322,Flecainide ,,,76.68,98.82,3 RC,322,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,322,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,322,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,322,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,322,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,322,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,322,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,322,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,322,Fluoride ,,,76.68,98.82,3 RC,322,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,322,Folic acid; RBC ,,,72.48,93.41,3 RC,322,Folic acid; serum ,,,59.93,77.23,3 RC,322,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,322,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,322,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,322,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,322,"Fructose, semen ",,,71.1,91.62,3 RC,322,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,322,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,322,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,322,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,322,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,322,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,322,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,322,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,322,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,322,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,322,"Galactokinase, RBC ",,,87.81,113.16,3 RC,322,Galactose ,,,45.98,59.26,3 RC,322,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,322,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,322,Galectin-3 ,,,182.6,235.31,3 RC,322,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,322,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,322,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,322,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,322,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,322,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,322,"Gases, blood, pH only ",,,44.6,57.47,3 RC,322,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,322,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,322,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,322,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,322,Gastric mucosa imaging ,,,205.51,205.51,1 RC,322,Gastrin ,,,72.48,93.41,3 RC,322,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,322,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,322,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,322,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,322,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,322,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,322,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,322,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,322,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,322,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,322,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,322,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,322,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,322,Gentamicin ,,,66.9,86.21,3 RC,322,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,322,Glucagon ,,,58.54,75.44,3 RC,322,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,322,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,322,Glucagon tolerance test ,,,72.48,93.41,3 RC,322,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,322,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,322,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,322,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,322,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,322,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,322,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,322,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,322,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,322,"Glucosidase, beta ",,,87.81,113.16,3 RC,322,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,322,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,322,Glutathione ,,,64.13,82.64,3 RC,322,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,322,Glycated protein ,,,68.28,88.0,3 RC,322,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,322,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,322,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,322,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,322,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,322,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,322,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,322,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,322,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,322,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,322,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,322,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,322,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,322,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,322,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,322,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,322,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,322,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,322,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,322,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,322,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,322,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,322,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,322,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,322,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,322,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,322,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,322,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,322,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,322,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,322,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,322,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,322,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,322,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,322,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,322,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,322,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,322,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,322,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,322,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,322,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,322,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,Haloperidol ,,,65.51,84.43,3 RC,322,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,322,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,322,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,322,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,322,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,322,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,322,Heinz bodies; direct ,,,16.71,21.54,3 RC,322,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,322,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,322,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,322,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,322,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,322,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,322,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,322,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,322,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,322,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,322,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,322,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,322,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,322,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,322,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,322,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,322,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,322,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,322,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,322,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,322,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,322,Hemoglobin; plasma ,,,30.66,39.51,3 RC,322,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,322,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,322,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,322,Hemoglobin; urine ,,,16.71,21.54,3 RC,322,"Hemolysin, acid ",,,36.24,46.7,3 RC,322,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,322,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,322,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,322,Heparin assay ,,,54.38,70.08,3 RC,322,Heparin neutralization ,,,48.8,62.89,3 RC,322,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,322,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,322,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,322,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,322,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,322,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,322,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,322,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,322,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,322,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,322,Hepatitis C antibody; ,,,58.54,75.44,3 RC,322,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,322,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,322,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,322,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,322,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,322,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,322,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,322,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,322,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,322,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,322,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,322,Heroin metabolite ,,,98.98,127.56,3 RC,322,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,322,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,322,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,322,Histamine ,,,121.28,156.3,3 RC,322,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,322,Homocysteine ,,,73.87,95.19,3 RC,322,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,322,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,322,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,322,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,322,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,322,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,322,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,322,Hydroxychloroquine ,,,76.68,98.82,3 RC,322,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,322,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,322,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,322,Hydroxyproline; free ,,,93.4,120.36,3 RC,322,Hydroxyproline; total ,,,100.37,129.34,3 RC,322,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,322,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,322,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,322,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,322,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,322,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,322,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,322,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,322,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,322,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,322,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,322,Immune complex assay ,,,100.37,129.34,3 RC,322,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,322,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,322,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,322,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,322,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,322,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,322,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,322,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,322,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,322,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,322,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,322,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,322,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,322,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,322,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,322,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,322,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,322,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,322,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,322,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,322,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,322,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,322,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,322,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,322,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,322,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,322,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,322,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,322,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,322,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,322,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,322,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,322,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,322,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,322,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,322,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,322,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,322,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,322,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,322,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,322,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,322,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,322,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,322,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,322,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,322,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,322,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,322,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,322,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,322,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,322,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,322,Infliximab ,,,158.91,204.79,3 RC,322,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,322,Inhibin A ,,,64.13,82.64,3 RC,322,Insemination of oocytes ,,,442.57,570.33,3 RC,322,Insulin antibodies ,,,87.81,113.16,3 RC,322,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,322,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,322,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,322,Insulin; free ,,,52.96,68.24,3 RC,322,Insulin; total ,,,47.41,61.1,3 RC,322,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,322,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,322,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,322,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,322,Intrinsic factor ,,,80.84,104.18,3 RC,322,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,322,Iron ,,,26.5,34.15,3 RC,322,Iron binding capacity ,,,36.24,46.7,3 RC,322,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,322,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,322,Islet cell antibody ,,,97.55,125.72,3 RC,322,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,322,Itraconazole ,,,111.5,143.69,3 RC,322,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,322,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,322,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,322,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,322,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,322,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,322,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,322,Ketamine and norketamine ,,,98.98,127.56,3 RC,322,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,322,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,322,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,322,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,322,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,322,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,322,Kidney imaging morphology; ,,,172.11,172.11,1 RC,322,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,322,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,322,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,322,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,322,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,322,Lacosamide ,,,111.5,143.69,3 RC,322,Lactate (lactic acid) ,,,47.41,61.1,3 RC,322,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,322,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,322,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,322,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,322,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,322,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,322,Lamotrigine ,,,54.38,70.08,3 RC,322,Lead ,,,50.18,64.67,3 RC,322,Leflunomide ,,,158.91,204.79,3 RC,322,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,322,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,322,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,322,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,322,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,322,Leukocyte transfusion ,,,305.26,393.39,3 RC,322,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,322,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,322,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,322,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,322,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,322,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,322,Levetiracetam ,,,54.38,70.08,3 RC,322,Lidocaine ,,,59.93,77.23,3 RC,322,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,322,Lipase ,,,27.89,35.94,3 RC,322,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,322,Lipoprotein (a) ,,,58.54,75.44,3 RC,322,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,322,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,322,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,322,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,322,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,322,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,322,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,322,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,322,Lithium ,,,27.89,35.94,3 RC,322,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,322,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,322,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,322,Liver imaging; static only ,,,191.2,191.2,1 RC,322,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,322,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,322,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,322,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,322,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,322,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,322,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,322,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,322,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,322,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,322,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,322,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,322,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,322,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,322,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,322,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,322,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,322,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,322,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,322,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,322,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,322,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,322,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,322,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,322,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,322,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,322,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,322,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,322,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,322,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,322,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,322,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,322,Magnesium ,,,27.89,35.94,3 RC,322,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,322,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,322,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,322,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,322,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,322,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,322,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,322,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,322,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,322,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,322,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,322,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,322,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,322,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,322,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,322,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,322,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,322,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,322,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,322,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,322,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,322,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,322,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,322,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,322,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,322,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,322,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,322,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,322,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,322,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,322,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,322,Malate dehydrogenase ,,,30.66,39.51,3 RC,322,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,322,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,322,Manganese ,,,110.11,141.9,3 RC,322,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,322,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,322,"Meat fibers, feces ",,,19.53,25.17,3 RC,322,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,322,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,322,"Mercury, quantitative ",,,66.9,86.21,3 RC,322,Metanephrines ,,,69.71,89.84,3 RC,322,Methadone ,,,98.98,127.56,3 RC,322,Methemalbumin ,,,44.6,57.47,3 RC,322,Methotrexate ,,,158.91,204.79,3 RC,322,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,322,Methylphenidate ,,,98.98,127.56,3 RC,322,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,322,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,322,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,322,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,322,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,322,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,322,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,322,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,322,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,322,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,322,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,322,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,322,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,322,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,322,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,322,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,322,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,322,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,322,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,322,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,322,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,322,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,322,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,322,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,322,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,322,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,322,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,322,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,322,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,322,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,322,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,322,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,322,Muramidase ,,,76.68,98.82,3 RC,322,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,322,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,322,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,322,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,322,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,322,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,322,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,322,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,322,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,322,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,322,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,322,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,322,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,322,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,322,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,322,Myoglobin ,,,52.96,68.24,3 RC,322,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,322,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,322,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,322,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,322,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,322,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,322,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,322,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,322,Natriuretic peptide ,,,161.68,208.36,3 RC,322,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,322,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,322,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,322,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,322,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,322,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,322,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,322,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,322,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,322,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,322,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,322,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,322,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,322,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,322,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,322,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,322,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,322,Nerve teasing preparations ,,,499.29,643.43,3 RC,322,"Neutralization test, viral ",,,69.71,89.84,3 RC,322,Nickel ,,,100.37,129.34,3 RC,322,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,322,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,322,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,322,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,322,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,322,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,322,Nucleotidase 5'- ,,,45.98,59.26,3 RC,322,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,322,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,322,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,322,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,322,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,322,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,322,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,322,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,322,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,322,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,322,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,322,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,322,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,322,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,322,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,322,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,322,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,322,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,322,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,322,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,322,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,322,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,322,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,322,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,322,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,322,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,322,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,322,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,322,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,322,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,322,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,322,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,322,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,322,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,322,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,322,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,322,"Opiates, 1 or more ",,,98.98,127.56,3 RC,322,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,322,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,322,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,322,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,322,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,322,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,322,Osmolality; blood ,,,27.89,35.94,3 RC,322,Osmolality; urine ,,,27.89,35.94,3 RC,322,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,322,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,322,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,322,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,322,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,322,Oxalate ,,,59.93,77.23,3 RC,322,Oxcarbazepine ,,,54.38,70.08,3 RC,322,Oxycodone ,,,98.98,127.56,3 RC,322,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,322,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,322,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,322,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,322,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,322,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,322,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,322,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,322,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,322,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,322,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,322,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,322,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,322,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,322,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,322,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,322,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,322,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,322,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,322,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,322,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,322,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,322,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,322,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,322,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,322,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,322,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,322,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,322,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,322,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,322,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,322,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,322,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,322,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,322,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,322,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,322,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,322,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,322,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,322,Phenobarbital ,,,62.74,80.85,3 RC,322,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,322,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,322,Phenytoin; free ,,,57.16,73.66,3 RC,322,Phenytoin; total ,,,54.38,70.08,3 RC,322,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,322,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,322,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,322,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,322,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,322,Phosphatidylglycerol ,,,68.28,88.0,3 RC,322,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,322,Phosphohexose isomerase ,,,44.6,57.47,3 RC,322,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,322,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,322,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,322,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,322,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,322,Pinworm examinations ,,,18.14,23.38,3 RC,322,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,322,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,322,Platelet survival study ,,,126.1,126.1,1 RC,322,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,322,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,322,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,322,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,322,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,322,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,322,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,322,Posaconazole ,,,111.5,143.69,3 RC,322,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,322,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,322,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,322,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,322,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,322,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,322,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,322,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,322,Potassium; urine ,,,19.53,25.17,3 RC,322,Prealbumin ,,,59.93,77.23,3 RC,322,Pregabalin ,,,98.98,127.56,3 RC,322,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,322,Pregnanediol ,,,87.81,113.16,3 RC,322,Pregnanetriol ,,,86.43,111.38,3 RC,322,Pregnenolone ,,,85.04,109.59,3 RC,322,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,322,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,322,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,322,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,322,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,322,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,322,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,322,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,322,Primidone ,,,68.28,88.0,3 RC,322,Procainamide; ,,,246.72,317.95,3 RC,322,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,322,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,322,Progesterone ,,,86.43,111.38,3 RC,322,Proinsulin ,,,110.11,141.9,3 RC,322,Prolactin ,,,79.46,102.39,3 RC,322,Propoxyphene ,,,98.98,127.56,3 RC,322,"Prostaglandin, each ",,,171.47,220.97,3 RC,322,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,322,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,322,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,322,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,322,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,322,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,322,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,322,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,322,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,322,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,322,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,322,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,322,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,322,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,322,Prothrombin time; ,,,18.14,23.38,3 RC,322,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,322,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,322,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,322,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,322,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,322,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,322,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,322,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,322,Pyruvate ,,,59.93,77.23,3 RC,322,Pyruvate kinase ,,,39.01,50.28,3 RC,322,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,322,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,322,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,322,Quinidine ,,,59.93,77.23,3 RC,322,Quinine ,,,47.41,61.1,3 RC,322,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,322,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,322,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,322,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,322,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,322,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,322,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,322,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,322,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,322,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,322,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,322,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,322,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,322,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,322,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,322,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,322,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,322,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,322,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,322,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,322,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,322,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,322,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,322,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,322,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,322,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,322,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,322,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,322,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,322,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,322,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,322,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,322,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,322,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,322,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,322,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,322,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,322,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,322,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,322,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,322,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,322,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,322,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,322,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,322,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,322,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,322,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,322,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,322,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,322,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,322,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,322,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,322,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,322,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,322,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,322,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,322,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,322,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,322,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,322,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,322,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,322,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,322,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,322,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,322,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,322,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,322,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,322,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,322,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,322,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,322,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,322,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,322,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,322,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,322,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,322,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,322,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,322,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,322,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,322,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,322,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,322,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,322,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,322,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,322,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,322,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,322,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,322,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,322,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,322,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,322,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,322,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,322,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,322,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,322,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,322,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,322,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,322,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,322,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,322,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,322,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,322,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,322,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,322,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,322,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,322,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,322,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,322,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,322,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,322,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,322,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,322,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,322,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,322,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,322,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,322,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,322,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,322,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,322,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,322,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,322,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,322,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,322,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,322,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,322,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,322,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,322,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,322,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,322,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,322,Receptor assay; estrogen ,,,361.04,465.26,3 RC,322,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,322,Receptor assay; progesterone ,,,266.25,343.11,3 RC,322,Red cell survival study ,,,126.1,126.1,1 RC,322,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,322,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,322,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,322,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,322,Renin ,,,90.63,116.79,3 RC,322,Reptilase test ,,,40.44,52.12,3 RC,322,Reticulated platelet assay ,,,146.35,188.6,3 RC,322,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,322,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,322,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,322,Rufinamide ,,,111.5,143.69,3 RC,322,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,322,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,322,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,322,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,322,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,322,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,322,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,322,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,322,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,322,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,322,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,322,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,322,Salicylate ,,,76.68,98.82,3 RC,322,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,322,Salivary gland function study ,,,104.3,104.3,1 RC,322,Salivary gland imaging; ,,,175.52,175.52,1 RC,322,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,322,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,322,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,322,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,322,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,322,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,322,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,322,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,322,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,322,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,322,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,322,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,322,Selenium ,,,104.53,134.7,3 RC,322,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,322,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,322,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,322,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,322,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,322,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,322,Serotonin ,,,126.87,163.49,3 RC,322,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,322,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,322,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,322,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,322,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,322,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,322,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,322,Sialic acid ,,,55.77,71.87,3 RC,322,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,322,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,322,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,322,Silica ,,,103.14,132.92,3 RC,322,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,322,Sirolimus ,,,57.16,73.66,3 RC,322,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,322,Skin test; candida ,,,79.46,102.39,3 RC,322,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,322,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,322,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,322,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,322,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,322,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,322,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,322,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,322,Sodium; other source ,,,19.53,25.17,3 RC,322,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,322,Sodium; urine ,,,20.91,26.95,3 RC,322,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,322,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,322,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,322,Somatomedin ,,,87.81,113.16,3 RC,322,Somatostatin ,,,75.26,96.98,3 RC,322,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,322,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,322,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,322,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,322,Specific gravity (except urine) ,,,13.94,17.97,3 RC,322,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,322,Sperm antibodies ,,,43.21,55.69,3 RC,322,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,322,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,322,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,322,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,322,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,322,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,322,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,322,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,322,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,322,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,322,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,322,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,322,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,322,"Stimulants, synthetic ",,,98.98,127.56,3 RC,322,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,322,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,322,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,322,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,322,"Streptokinase, antibody ",,,51.57,66.46,3 RC,322,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,322,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,322,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,322,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,322,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,322,"Sulfate, urine ",,,22.3,28.74,3 RC,322,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,322,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,322,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,322,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,322,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,322,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,322,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,322,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,322,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,322,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,322,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,322,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,322,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,322,T cells; total count ,,,154.71,199.37,3 RC,322,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,322,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,322,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,322,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,322,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,322,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,322,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,322,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,322,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,322,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,322,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,322,Tacrolimus ,,,57.16,73.66,3 RC,322,Tapentadol ,,,98.98,127.56,3 RC,322,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,322,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,322,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,322,Testosterone; free ,,,104.53,134.7,3 RC,322,Testosterone; total ,,,105.96,136.54,3 RC,322,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,322,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,322,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,322,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,322,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,322,Theophylline ,,,58.54,75.44,3 RC,322,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,322,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,322,Thiocyanate ,,,47.41,61.1,3 RC,322,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,322,Thrombin time; plasma ,,,23.69,30.52,3 RC,322,Thrombin time; titer ,,,27.89,35.94,3 RC,322,Thrombomodulin ,,,71.1,91.62,3 RC,322,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,322,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,322,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,322,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,322,Thyroglobulin ,,,65.51,84.43,3 RC,322,Thyroglobulin antibody ,,,65.51,84.43,3 RC,322,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,322,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,322,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,322,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,322,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,322,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,322,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,322,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,322,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,322,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,322,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,322,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,322,Thyroxine; free ,,,37.63,48.49,3 RC,322,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,322,Thyroxine; total ,,,27.89,35.94,3 RC,322,Tiagabine ,,,111.5,143.69,3 RC,322,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,322,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,322,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,322,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,322,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,322,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,322,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,322,Tobramycin ,,,66.9,86.21,3 RC,322,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,322,Topiramate ,,,48.8,62.89,3 RC,322,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,322,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,322,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,322,Tramadol ,,,98.98,127.56,3 RC,322,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,322,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,322,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,322,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,322,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,322,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,322,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,322,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,322,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,322,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,322,Transferrin ,,,52.96,68.24,3 RC,322,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,322,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,322,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,322,Triglycerides ,,,23.69,30.52,3 RC,322,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,322,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,322,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,322,"Troponin, qualitative ",,,41.83,53.9,3 RC,322,"Troponin, quantitative ",,,51.57,66.46,3 RC,322,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,322,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,322,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,322,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,322,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,322,Tyrosine ,,,43.21,55.69,3 RC,322,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,322,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,322,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,322,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,322,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,322,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,322,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,322,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,322,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,322,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,322,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,322,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,322,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,322,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,322,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,322,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,322,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,322,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,322,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,322,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,322,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,322,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,322,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,322,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,322,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,322,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,322,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,322,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,322,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,322,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,322,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,322,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,322,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,322,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,322,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,322,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,322,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,322,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,322,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,322,Unlisted immunology procedure ,,,99.55,128.28,3 RC,322,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,322,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,322,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,322,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,322,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,322,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,322,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,322,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,322,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,322,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,322,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,322,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,322,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,322,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,322,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,322,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,322,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,322,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,322,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,322,Uric acid; blood ,,,18.14,23.38,3 RC,322,Uric acid; other source ,,,20.91,26.95,3 RC,322,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,322,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,322,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,322,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,322,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,322,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,322,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,322,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,322,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,322,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,322,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,322,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,322,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,322,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,322,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,322,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,322,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,322,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,322,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,322,Vancomycin ,,,55.77,71.87,3 RC,322,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,322,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,322,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,322,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,322,Vedolizumab ,,,158.91,204.79,3 RC,322,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,322,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,322,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,322,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,322,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,322,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,322,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,322,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,322,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,322,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,322,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,322,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,322,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,322,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,322,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,322,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,322,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,322,Very long chain fatty acids ,,,80.84,104.18,3 RC,322,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,322,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,322,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,322,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,322,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,322,Viscosity ,,,47.41,61.1,3 RC,322,Vitamin A ,,,47.41,61.1,3 RC,322,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,322,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,322,Vitamin K ,,,55.77,71.87,3 RC,322,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,322,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,322,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,322,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,322,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,322,Voriconazole ,,,111.5,143.69,3 RC,322,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,322,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,322,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,322,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,322,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,322,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,322,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,322,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,322,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,322,Zinc ,,,47.41,61.1,3 RC,322,Zonisamide ,,,54.38,70.08,3 RC,322,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,322,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,322,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,323, Radiology - Diagnostic Arteriography ,,,198.0,198.0,1 RC,323,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,323,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,323,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,323,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,323,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,323,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,323,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,323,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,323,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,323,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,323,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,323,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,323,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,323,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,323,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,323,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,323,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,Acetaminophen ,,,76.68,98.82,3 RC,323,Acetylcholinesterase ,,,50.18,64.67,3 RC,323,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,323,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,323,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,323,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,323,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,323,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,323,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,323,Adalimumab ,,,158.91,204.79,3 RC,323,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,323,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,323,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,323,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,323,Albumin; ischemia modified ,,,139.38,179.62,3 RC,323,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,323,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,323,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,323,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,323,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,323,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,323,Alcohols ,,,98.98,127.56,3 RC,323,Aldolase ,,,40.44,52.12,3 RC,323,Aldosterone ,,,167.27,215.56,3 RC,323,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,323,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,323,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,323,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,323,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,323,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,323,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,323,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,323,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,323,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,323,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,323,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,323,Aluminum ,,,104.53,134.7,3 RC,323,Amikacin ,,,62.74,80.85,3 RC,323,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,323,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,323,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,323,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,323,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,323,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,323,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,323,Amiodarone ,,,76.68,98.82,3 RC,323,Ammonia ,,,59.93,77.23,3 RC,323,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,323,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,323,Amylase ,,,26.5,34.15,3 RC,323,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,323,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,323,Androstanediol glucuronide ,,,118.47,152.67,3 RC,323,Androstenedione ,,,119.9,154.51,3 RC,323,Androsterone ,,,104.53,134.7,3 RC,323,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,323,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,323,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,323,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,323,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,323,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,323,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",10608.94,10608.94,145.87,425.01,4 RC,323,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,323,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,323,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,323,"Angiography, spinal, selective, radiological supervision and interpretation ",8922.95,8922.95,253.56,623.27,4 RC,323,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,323,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,323,Angiotensin II ,,,85.04,109.59,3 RC,323,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,323,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,323,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,323,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,323,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,323,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,323,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,323,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,323,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,323,Antibody; Aspergillus ,,,61.31,79.01,3 RC,323,Antibody; Bartonella ,,,41.83,53.9,3 RC,323,Antibody; Blastomyces ,,,52.96,68.24,3 RC,323,Antibody; Bordetella ,,,54.38,70.08,3 RC,323,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,323,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,323,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,323,Antibody; Brucella ,,,36.24,46.7,3 RC,323,Antibody; Campylobacter ,,,54.38,70.08,3 RC,323,Antibody; Candida ,,,48.8,62.89,3 RC,323,Antibody; Chlamydia ,,,48.8,62.89,3 RC,323,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,323,Antibody; Coccidioides ,,,47.41,61.1,3 RC,323,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,323,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,323,Antibody; Diphtheria ,,,62.74,80.85,3 RC,323,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,323,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,323,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,323,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,323,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,323,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,323,Antibody; HIV-1 ,,,36.24,46.7,3 RC,323,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,323,Antibody; HIV-2 ,,,55.77,71.87,3 RC,323,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,323,Antibody; HTLV-I ,,,37.63,48.49,3 RC,323,Antibody; HTLV-II ,,,57.16,73.66,3 RC,323,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,323,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,323,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,323,Antibody; Legionella ,,,62.74,80.85,3 RC,323,Antibody; Leishmania ,,,50.18,64.67,3 RC,323,Antibody; Leptospira ,,,66.9,86.21,3 RC,323,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,323,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,323,Antibody; Nocardia ,,,65.51,84.43,3 RC,323,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,323,Antibody; Rickettsia ,,,79.46,102.39,3 RC,323,Antibody; Salmonella ,,,54.38,70.08,3 RC,323,Antibody; Shigella ,,,100.37,129.34,3 RC,323,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,323,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,323,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,323,Antibody; Trichinella ,,,51.57,66.46,3 RC,323,Antibody; West Nile virus ,,,58.54,75.44,3 RC,323,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,323,Antibody; Yersinia ,,,54.38,70.08,3 RC,323,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,323,Antibody; actinomyces ,,,41.83,53.9,3 RC,323,Antibody; adenovirus ,,,52.96,68.24,3 RC,323,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,323,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,323,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,323,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,323,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,323,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,323,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,323,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,323,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,323,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,323,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,323,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,323,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,323,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,323,Antibody; histoplasma ,,,57.16,73.66,3 RC,323,Antibody; influenza virus ,,,55.77,71.87,3 RC,323,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,323,Antibody; mucormycosis ,,,61.31,79.01,3 RC,323,Antibody; mumps ,,,54.38,70.08,3 RC,323,Antibody; mycoplasma ,,,54.38,70.08,3 RC,323,Antibody; parvovirus ,,,61.31,79.01,3 RC,323,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,323,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,323,Antibody; rotavirus ,,,75.26,96.98,3 RC,323,Antibody; rubella ,,,58.54,75.44,3 RC,323,Antibody; rubeola ,,,52.96,68.24,3 RC,323,Antibody; tetanus ,,,61.31,79.01,3 RC,323,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,323,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,323,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,323,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,323,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,323,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,323,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,323,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,323,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,323,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,323,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,323,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,323,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,323,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,323,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,323,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,323,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,323,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,323,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,323,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,323,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,323,"Apolipoprotein, each ",,,86.43,111.38,3 RC,323,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,323,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,323,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,323,Arsenic ,,,78.07,100.61,3 RC,323,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,323,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,323,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,323,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,323,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,323,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,323,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,323,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,323,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,323,"B cells, total count ",,,154.71,199.37,3 RC,323,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,323,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,323,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,323,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,323,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,323,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,323,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,323,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,323,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,323,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,323,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,323,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,323,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,323,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,323,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,323,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,323,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,323,Barbiturates ,,,98.98,127.56,3 RC,323,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,323,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,323,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,323,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,323,Beta-2 microglobulin ,,,66.9,86.21,3 RC,323,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,323,Bile acids; total ,,,71.1,91.62,3 RC,323,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,323,Bilirubin; direct ,,,20.91,26.95,3 RC,323,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,323,Bilirubin; total ,,,20.91,26.95,3 RC,323,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,323,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,323,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,323,Bleeding time ,,,19.53,25.17,3 RC,323,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,323,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,323,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,323,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,323,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,323,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,323,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,323,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,323,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,323,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,323,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,323,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,323,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,323,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,323,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,323,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,323,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,323,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,323,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,323,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,323,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,323,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,323,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,323,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,323,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,323,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,323,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,323,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,323,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,323,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,323,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,323,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,323,Bone age studies ,,,26.58,79.3,4 RC,323,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,323,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,323,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,323,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,323,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,323,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,323,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,323,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,323,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,323,Bradykinin ,,,20.91,26.95,3 RC,323,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,323,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,323,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,323,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,323,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,323,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,323,C-peptide ,,,85.04,109.59,3 RC,323,C-reactive protein; ,,,20.91,26.95,3 RC,323,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,323,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,323,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,323,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,323,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,323,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,323,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,323,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,323,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,323,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,323,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,323,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,323,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,323,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,323,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,323,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,323,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,323,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,323,Cadmium ,,,97.55,125.72,3 RC,323,Caffeine ,,,158.91,204.79,3 RC,323,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,323,Calcitonin ,,,110.11,141.9,3 RC,323,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,323,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,323,Calcium; ionized ,,,55.77,71.87,3 RC,323,Calcium; total ,,,20.91,26.95,3 RC,323,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,323,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,323,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,323,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,323,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,323,"Calprotectin, fecal ",,,80.84,104.18,3 RC,323,"Cannabinoids, natural ",,,98.98,127.56,3 RC,323,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,323,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,323,Carbamazepine; free ,,,54.38,70.08,3 RC,323,Carbamazepine; total ,,,59.93,77.23,3 RC,323,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,323,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,323,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,323,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,323,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,323,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,323,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,323,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,323,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,323,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,323,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,323,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,323,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,323,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,323,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,323,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,323,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,323,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,323,Cardiac shunt detection ,,,186.76,186.76,1 RC,323,Cardiokymography ,,,20.04,20.04,1 RC,323,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,323,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,323,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,323,Carotene ,,,37.63,48.49,3 RC,323,Catecholamines; blood ,,,119.9,154.51,3 RC,323,Catecholamines; fractionated ,,,104.53,134.7,3 RC,323,Catecholamines; total urine ,,,112.93,145.53,3 RC,323,Cathepsin-D ,,,73.87,95.19,3 RC,323,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,323,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,323,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,323,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,323,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,323,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,323,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,323,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,323,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,323,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,323,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,323,Ceruloplasmin ,,,44.6,57.47,3 RC,323,Chemiluminescent assay ,,,58.54,75.44,3 RC,323,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,323,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,323,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,323,Chloramphenicol ,,,51.57,66.46,3 RC,323,Chloride; blood ,,,19.53,25.17,3 RC,323,Chloride; other source ,,,20.91,26.95,3 RC,323,Chloride; urine ,,,23.69,30.52,3 RC,323,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,323,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,323,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,323,Cholinesterase; RBC ,,,40.44,52.12,3 RC,323,Cholinesterase; serum ,,,32.04,41.29,3 RC,323,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,323,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,323,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,323,Chromium ,,,83.66,107.81,3 RC,323,Chromogenic substrate assay ,,,48.8,62.89,3 RC,323,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,323,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,323,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,323,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,323,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,323,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,323,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,323,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,323,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,323,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,323,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,323,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,323,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,323,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,323,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,323,Citrate ,,,114.31,147.31,3 RC,323,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,323,Clot retraction ,,,66.9,86.21,3 RC,323,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,323,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,323,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,323,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,323,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,323,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,323,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,323,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,323,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,323,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,323,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,323,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,323,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,323,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,323,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,323,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,323,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,323,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,323,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,323,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,323,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,323,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,323,Clozapine ,,,82.23,105.96,3 RC,323,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,323,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,323,Coagulation time; activated ,,,18.14,23.38,3 RC,323,Coagulation time; other methods ,,,18.14,23.38,3 RC,323,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,323,Cocaine ,,,98.98,127.56,3 RC,323,Cold agglutinin; screen ,,,33.47,43.13,3 RC,323,Cold agglutinin; titer ,,,33.47,43.13,3 RC,323,"Collagen cross links, any method ",,,76.68,98.82,3 RC,323,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,323,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,323,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,323,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,323,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,323,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,323,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,323,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,323,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,323,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,323,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,323,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,323,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,323,"Complement; antigen, each component ",,,48.8,62.89,3 RC,323,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,323,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,323,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,323,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,323,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,323,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,323,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,323,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,323,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,323,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,323,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,323,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,323,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,323,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,323,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,323,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,323,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,323,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,323,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,323,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,323,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,323,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,323,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,323,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,323,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,323,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,323,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,323,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,323,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,323,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,323,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,323,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,323,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,323,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,323,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,323,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,323,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,323,Copper ,,,51.57,66.46,3 RC,323,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,323,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,323,Corticosterone ,,,92.01,118.58,3 RC,323,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,323,Cortisol; free ,,,68.28,88.0,3 RC,323,Cortisol; total ,,,66.9,86.21,3 RC,323,Creatine ,,,19.53,25.17,3 RC,323,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,323,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,323,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,323,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,323,Creatinine; blood ,,,20.91,26.95,3 RC,323,Creatinine; clearance ,,,39.01,50.28,3 RC,323,Creatinine; other source ,,,20.91,26.95,3 RC,323,Cryofibrinogen ,,,58.54,75.44,3 RC,323,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,323,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,323,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,323,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,323,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,323,Cryopreservation; sperm ,,,442.57,570.33,3 RC,323,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,323,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,323,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,323,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,323,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,323,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,323,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,323,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,323,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,323,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,323,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,323,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,323,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,323,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,323,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,323,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,323,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,323,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,323,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,323,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,323,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,323,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,323,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,323,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,323,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,323,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,323,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,323,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,323,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,323,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,323,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,323,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,323,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,323,"Culture, typing; other methods ",,,32.04,41.29,3 RC,323,Cyanide ,,,79.46,102.39,3 RC,323,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,323,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,323,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,323,Cyclosporine ,,,73.87,95.19,3 RC,323,Cystatin C ,,,76.68,98.82,3 RC,323,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,323,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,323,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,323,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,323,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,323,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,323,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,323,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,323,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,323,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,323,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,323,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,323,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,323,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,323,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,323,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,323,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,323,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,323,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,323,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,323,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,323,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,323,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,323,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,323,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,323,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,323,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,323,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,323,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,323,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,323,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,323,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,323,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,323,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,323,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,323,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,323,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,323,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,323,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,323,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,323,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,323,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,323,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,323,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,323,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,323,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,323,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,323,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,323,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,323,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,323,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,323,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,323,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,323,Dibucaine number ,,,50.18,64.67,3 RC,323,Digoxin; free ,,,54.38,70.08,3 RC,323,Digoxin; total ,,,54.38,70.08,3 RC,323,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,323,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,323,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,323,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,323,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,323,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,323,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,323,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,323,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,323,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,323,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,323,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,323,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,323,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,323,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,323,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,323,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,323,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,323,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,323,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,323,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,323,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,323,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,323,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,323,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,323,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,323,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,323,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,323,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,323,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,323,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,323,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,323,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,323,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,323,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,323,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,323,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,323,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,323,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,323,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,323,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,323,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,323,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,323,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,323,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,323,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,323,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,323,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,323,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,323,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,323,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,323,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,323,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,323,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,323,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,323,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,323,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,323,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,323,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,323,Erythropoietin ,,,76.68,98.82,3 RC,323,Esophageal motility ,,,214.04,214.04,1 RC,323,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,323,Estradiol; total ,,,114.31,147.31,3 RC,323,Estriol ,,,98.98,127.56,3 RC,323,Estrogens; fractionated ,,,132.41,170.64,3 RC,323,Estrogens; total ,,,89.2,114.95,3 RC,323,Estrone ,,,103.14,132.92,3 RC,323,Ethosuximide ,,,66.9,86.21,3 RC,323,Ethylene glycol ,,,61.31,79.01,3 RC,323,Etiocholanolone ,,,107.34,138.33,3 RC,323,Euglobulin lysis ,,,34.86,44.92,3 RC,323,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,323,Everolimus ,,,57.16,73.66,3 RC,323,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,323,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,323,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,323,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,323,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,323,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,323,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,323,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,323,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,323,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,323,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,323,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,323,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,323,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,323,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,323,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,323,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,323,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,323,Factor inhibitor test ,,,52.96,68.24,3 RC,323,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,323,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,323,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,323,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,323,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,323,Felbamate ,,,76.68,98.82,3 RC,323,Fentanyl ,,,98.98,127.56,3 RC,323,Fern test ,,,40.44,52.12,3 RC,323,Ferritin ,,,55.77,71.87,3 RC,323,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,323,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,323,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,323,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,323,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,323,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,323,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,323,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,323,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,323,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,323,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,323,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,323,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,323,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,323,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,323,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,323,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,323,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,323,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,323,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,323,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,323,Fibrinogen; activity ,,,40.44,52.12,3 RC,323,Fibrinogen; antigen ,,,59.93,77.23,3 RC,323,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,323,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,323,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,323,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,323,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,323,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,323,Flecainide ,,,76.68,98.82,3 RC,323,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,323,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,323,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,323,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,323,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,323,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,323,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,323,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,323,Fluoride ,,,76.68,98.82,3 RC,323,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,323,Folic acid; RBC ,,,72.48,93.41,3 RC,323,Folic acid; serum ,,,59.93,77.23,3 RC,323,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,323,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,323,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,323,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,323,"Fructose, semen ",,,71.1,91.62,3 RC,323,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,323,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,323,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,323,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,323,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,323,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,323,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,323,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,323,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,323,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,323,"Galactokinase, RBC ",,,87.81,113.16,3 RC,323,Galactose ,,,45.98,59.26,3 RC,323,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,323,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,323,Galectin-3 ,,,182.6,235.31,3 RC,323,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,323,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,323,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,323,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,323,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,323,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,323,"Gases, blood, pH only ",,,44.6,57.47,3 RC,323,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,323,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,323,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,323,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,323,Gastric mucosa imaging ,,,205.51,205.51,1 RC,323,Gastrin ,,,72.48,93.41,3 RC,323,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,323,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,323,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,323,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,323,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,323,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,323,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,323,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,323,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,323,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,323,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,323,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,323,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,323,Gentamicin ,,,66.9,86.21,3 RC,323,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,323,Glucagon ,,,58.54,75.44,3 RC,323,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,323,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,323,Glucagon tolerance test ,,,72.48,93.41,3 RC,323,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,323,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,323,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,323,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,323,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,323,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,323,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,323,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,323,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,323,"Glucosidase, beta ",,,87.81,113.16,3 RC,323,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,323,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,323,Glutathione ,,,64.13,82.64,3 RC,323,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,323,Glycated protein ,,,68.28,88.0,3 RC,323,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,323,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,323,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,323,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,323,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,323,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,323,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,323,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,323,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,323,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,323,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,323,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,323,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,323,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,323,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,323,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,323,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,323,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,323,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,323,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,323,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,323,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,323,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,323,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,323,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,323,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,323,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,323,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,323,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,323,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,323,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,323,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,323,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,323,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,323,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,323,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,323,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,323,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,323,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,323,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,323,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,323,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,Haloperidol ,,,65.51,84.43,3 RC,323,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,323,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,323,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,323,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,323,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,323,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,323,Heinz bodies; direct ,,,16.71,21.54,3 RC,323,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,323,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,323,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,323,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,323,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,323,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,323,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,323,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,323,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,323,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,323,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,323,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,323,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,323,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,323,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,323,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,323,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,323,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,323,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,323,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,323,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,323,Hemoglobin; plasma ,,,30.66,39.51,3 RC,323,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,323,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,323,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,323,Hemoglobin; urine ,,,16.71,21.54,3 RC,323,"Hemolysin, acid ",,,36.24,46.7,3 RC,323,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,323,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,323,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,323,Heparin assay ,,,54.38,70.08,3 RC,323,Heparin neutralization ,,,48.8,62.89,3 RC,323,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,323,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,323,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,323,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,323,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,323,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,323,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,323,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,323,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,323,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,323,Hepatitis C antibody; ,,,58.54,75.44,3 RC,323,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,323,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,323,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,323,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,323,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,323,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,323,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,323,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,323,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,323,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,323,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,323,Heroin metabolite ,,,98.98,127.56,3 RC,323,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,323,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,323,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,323,Histamine ,,,121.28,156.3,3 RC,323,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,323,Homocysteine ,,,73.87,95.19,3 RC,323,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,323,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,323,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,323,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,323,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,323,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,323,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,323,Hydroxychloroquine ,,,76.68,98.82,3 RC,323,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,323,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,323,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,323,Hydroxyproline; free ,,,93.4,120.36,3 RC,323,Hydroxyproline; total ,,,100.37,129.34,3 RC,323,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,323,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,323,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,323,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,323,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,323,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,323,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,323,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,323,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,323,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,323,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,323,Immune complex assay ,,,100.37,129.34,3 RC,323,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,323,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,323,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,323,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,323,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,323,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,323,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,323,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,323,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,323,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,323,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,323,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,323,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,323,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,323,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,323,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,323,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,323,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,323,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,323,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,323,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,323,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,323,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,323,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,323,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,323,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,323,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,323,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,323,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,323,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,323,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,323,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,323,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,323,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,323,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,323,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,323,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,323,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,323,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,323,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,323,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,323,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,323,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,323,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,323,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,323,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,323,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,323,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,323,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,323,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,323,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,323,Infliximab ,,,158.91,204.79,3 RC,323,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,323,Inhibin A ,,,64.13,82.64,3 RC,323,Insemination of oocytes ,,,442.57,570.33,3 RC,323,Insulin antibodies ,,,87.81,113.16,3 RC,323,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,323,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,323,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,323,Insulin; free ,,,52.96,68.24,3 RC,323,Insulin; total ,,,47.41,61.1,3 RC,323,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,323,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,323,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,323,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,323,Intrinsic factor ,,,80.84,104.18,3 RC,323,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,323,Iron ,,,26.5,34.15,3 RC,323,Iron binding capacity ,,,36.24,46.7,3 RC,323,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,323,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,323,Islet cell antibody ,,,97.55,125.72,3 RC,323,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,323,Itraconazole ,,,111.5,143.69,3 RC,323,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,323,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,323,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,323,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,323,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,323,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,323,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,323,Ketamine and norketamine ,,,98.98,127.56,3 RC,323,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,323,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,323,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,323,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,323,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,323,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,323,Kidney imaging morphology; ,,,172.11,172.11,1 RC,323,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,323,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,323,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,323,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,323,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,323,Lacosamide ,,,111.5,143.69,3 RC,323,Lactate (lactic acid) ,,,47.41,61.1,3 RC,323,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,323,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,323,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,323,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,323,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,323,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,323,Lamotrigine ,,,54.38,70.08,3 RC,323,Lead ,,,50.18,64.67,3 RC,323,Leflunomide ,,,158.91,204.79,3 RC,323,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,323,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,323,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,323,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,323,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,323,Leukocyte transfusion ,,,305.26,393.39,3 RC,323,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,323,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,323,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,323,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,323,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,323,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,323,Levetiracetam ,,,54.38,70.08,3 RC,323,Lidocaine ,,,59.93,77.23,3 RC,323,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,323,Lipase ,,,27.89,35.94,3 RC,323,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,323,Lipoprotein (a) ,,,58.54,75.44,3 RC,323,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,323,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,323,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,323,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,323,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,323,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,323,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,323,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,323,Lithium ,,,27.89,35.94,3 RC,323,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,323,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,323,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,323,Liver imaging; static only ,,,191.2,191.2,1 RC,323,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,323,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,323,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,323,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,323,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,323,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,323,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,323,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,323,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,323,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,323,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,323,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,323,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,323,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,323,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,323,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,323,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,323,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,323,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,323,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,323,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,323,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,323,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,323,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,323,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,323,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,323,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,323,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,323,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,323,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,323,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,323,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,323,Magnesium ,,,27.89,35.94,3 RC,323,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,323,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,323,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,323,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,323,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,323,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,323,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,323,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,323,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,323,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,323,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,323,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,323,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,323,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,323,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,323,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,323,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,323,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,323,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,323,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,323,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,323,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,323,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,323,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,323,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,323,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,323,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,323,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,323,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,323,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,323,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,323,Malate dehydrogenase ,,,30.66,39.51,3 RC,323,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,323,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,323,Manganese ,,,110.11,141.9,3 RC,323,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,323,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,323,"Meat fibers, feces ",,,19.53,25.17,3 RC,323,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,323,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,323,"Mercury, quantitative ",,,66.9,86.21,3 RC,323,Metanephrines ,,,69.71,89.84,3 RC,323,Methadone ,,,98.98,127.56,3 RC,323,Methemalbumin ,,,44.6,57.47,3 RC,323,Methotrexate ,,,158.91,204.79,3 RC,323,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,323,Methylphenidate ,,,98.98,127.56,3 RC,323,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,323,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,323,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,323,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,323,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,323,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,323,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,323,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,323,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,323,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,323,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,323,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,323,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,323,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,323,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,323,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,323,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,323,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,323,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,323,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,323,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,323,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,323,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,323,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,323,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,323,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,323,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,323,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,323,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,323,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,323,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,323,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,323,Muramidase ,,,76.68,98.82,3 RC,323,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,323,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,323,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,323,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,323,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,323,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,323,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,323,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,323,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,323,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,323,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,323,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,323,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,323,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,323,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,323,Myoglobin ,,,52.96,68.24,3 RC,323,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,323,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,323,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,323,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,323,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,323,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,323,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,323,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,323,Natriuretic peptide ,,,161.68,208.36,3 RC,323,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,323,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,323,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,323,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,323,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,323,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,323,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,323,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,323,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,323,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,323,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,323,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,323,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,323,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,323,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,323,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,323,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,323,Nerve teasing preparations ,,,499.29,643.43,3 RC,323,"Neutralization test, viral ",,,69.71,89.84,3 RC,323,Nickel ,,,100.37,129.34,3 RC,323,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,323,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,323,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,323,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,323,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,323,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,323,Nucleotidase 5'- ,,,45.98,59.26,3 RC,323,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,323,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,323,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,323,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,323,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,323,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,323,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,323,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,323,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,323,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,323,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,323,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,323,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,323,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,323,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,323,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,323,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,323,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,323,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,323,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,323,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,323,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,323,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,323,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,323,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,323,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,323,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,323,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,323,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,323,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,323,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,323,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,323,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,323,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,323,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,323,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,323,"Opiates, 1 or more ",,,98.98,127.56,3 RC,323,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,323,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,323,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,323,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,323,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,323,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,323,Osmolality; blood ,,,27.89,35.94,3 RC,323,Osmolality; urine ,,,27.89,35.94,3 RC,323,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,323,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,323,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,323,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,323,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,323,Oxalate ,,,59.93,77.23,3 RC,323,Oxcarbazepine ,,,54.38,70.08,3 RC,323,Oxycodone ,,,98.98,127.56,3 RC,323,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,323,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,323,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,323,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,323,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,323,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,323,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,323,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,323,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,323,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,323,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,323,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,323,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,323,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,323,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,323,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,323,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,323,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,323,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,323,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,323,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,323,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,323,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,323,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,323,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,323,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,323,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,323,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,323,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,323,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,323,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,323,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,323,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,323,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,323,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,323,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,323,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,323,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,323,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,323,Phenobarbital ,,,62.74,80.85,3 RC,323,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,323,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,323,Phenytoin; free ,,,57.16,73.66,3 RC,323,Phenytoin; total ,,,54.38,70.08,3 RC,323,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,323,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,323,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,323,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,323,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,323,Phosphatidylglycerol ,,,68.28,88.0,3 RC,323,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,323,Phosphohexose isomerase ,,,44.6,57.47,3 RC,323,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,323,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,323,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,323,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,323,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,323,Pinworm examinations ,,,18.14,23.38,3 RC,323,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,323,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,323,Platelet survival study ,,,126.1,126.1,1 RC,323,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,323,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,323,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,323,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,323,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,323,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,323,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,323,Posaconazole ,,,111.5,143.69,3 RC,323,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,323,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,323,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,323,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,323,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,323,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,323,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,323,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,323,Potassium; urine ,,,19.53,25.17,3 RC,323,Prealbumin ,,,59.93,77.23,3 RC,323,Pregabalin ,,,98.98,127.56,3 RC,323,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,323,Pregnanediol ,,,87.81,113.16,3 RC,323,Pregnanetriol ,,,86.43,111.38,3 RC,323,Pregnenolone ,,,85.04,109.59,3 RC,323,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,323,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,323,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,323,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,323,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,323,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,323,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,323,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,323,Primidone ,,,68.28,88.0,3 RC,323,Procainamide; ,,,246.72,317.95,3 RC,323,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,323,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,323,Progesterone ,,,86.43,111.38,3 RC,323,Proinsulin ,,,110.11,141.9,3 RC,323,Prolactin ,,,79.46,102.39,3 RC,323,Propoxyphene ,,,98.98,127.56,3 RC,323,"Prostaglandin, each ",,,171.47,220.97,3 RC,323,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,323,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,323,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,323,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,323,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,323,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,323,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,323,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,323,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,323,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,323,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,323,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,323,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,323,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,323,Prothrombin time; ,,,18.14,23.38,3 RC,323,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,323,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,323,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,323,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,323,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,323,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,323,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,323,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,323,Pyruvate ,,,59.93,77.23,3 RC,323,Pyruvate kinase ,,,39.01,50.28,3 RC,323,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,323,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,323,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,323,Quinidine ,,,59.93,77.23,3 RC,323,Quinine ,,,47.41,61.1,3 RC,323,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,323,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,323,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,323,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,323,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,323,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,323,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,323,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,323,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,323,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,323,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,323,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,323,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,323,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,323,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,323,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,323,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,323,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,323,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,323,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,323,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,323,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,323,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,323,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,323,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,323,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,323,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,323,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,323,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,323,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,323,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,323,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,323,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,323,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,323,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,323,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,323,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,323,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,323,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,323,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,323,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,323,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,323,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,323,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,323,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,323,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,323,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,323,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,323,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,323,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,323,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,323,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,323,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,323,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,323,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,323,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,323,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,323,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,323,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,323,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,323,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,323,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,323,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,323,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,323,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,323,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,323,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,323,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,323,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,323,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,323,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,323,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,323,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,323,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,323,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,323,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,323,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,323,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,323,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,323,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,323,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,323,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,323,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,323,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,323,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,323,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,323,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,323,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,323,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,323,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,323,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,323,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,323,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,323,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,323,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,323,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,323,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,323,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,323,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,323,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,323,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,323,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,323,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,323,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,323,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,323,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,323,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,323,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,323,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,323,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,323,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,323,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,323,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,323,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,323,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,323,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,323,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,323,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,323,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,323,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,323,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,323,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,323,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,323,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,323,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,323,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,323,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,323,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,323,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,323,Receptor assay; estrogen ,,,361.04,465.26,3 RC,323,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,323,Receptor assay; progesterone ,,,266.25,343.11,3 RC,323,Red cell survival study ,,,126.1,126.1,1 RC,323,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,323,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,323,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,323,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,323,Renin ,,,90.63,116.79,3 RC,323,Reptilase test ,,,40.44,52.12,3 RC,323,Reticulated platelet assay ,,,146.35,188.6,3 RC,323,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,323,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,323,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,323,Rufinamide ,,,111.5,143.69,3 RC,323,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,323,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,323,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,323,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,323,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,323,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,323,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,323,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,323,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,323,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,323,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,323,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,323,Salicylate ,,,76.68,98.82,3 RC,323,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,323,Salivary gland function study ,,,104.3,104.3,1 RC,323,Salivary gland imaging; ,,,175.52,175.52,1 RC,323,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,323,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,323,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,323,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,323,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,323,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,323,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,323,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,323,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,323,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,323,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,323,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,323,Selenium ,,,104.53,134.7,3 RC,323,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,323,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,323,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,323,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,323,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,323,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,323,Serotonin ,,,126.87,163.49,3 RC,323,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,323,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,323,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,323,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,323,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,323,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,323,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,323,Sialic acid ,,,55.77,71.87,3 RC,323,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,323,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,323,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,323,Silica ,,,103.14,132.92,3 RC,323,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,323,Sirolimus ,,,57.16,73.66,3 RC,323,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,323,Skin test; candida ,,,79.46,102.39,3 RC,323,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,323,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,323,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,323,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,323,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,323,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,323,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,323,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,323,Sodium; other source ,,,19.53,25.17,3 RC,323,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,323,Sodium; urine ,,,20.91,26.95,3 RC,323,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,323,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,323,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,323,Somatomedin ,,,87.81,113.16,3 RC,323,Somatostatin ,,,75.26,96.98,3 RC,323,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,323,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,323,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,323,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,323,Specific gravity (except urine) ,,,13.94,17.97,3 RC,323,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,323,Sperm antibodies ,,,43.21,55.69,3 RC,323,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,323,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,323,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,323,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,323,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,323,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,323,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,323,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,323,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,323,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,323,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,323,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,323,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,323,"Stimulants, synthetic ",,,98.98,127.56,3 RC,323,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,323,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,323,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,323,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,323,"Streptokinase, antibody ",,,51.57,66.46,3 RC,323,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,323,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,323,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,323,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,323,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,323,"Sulfate, urine ",,,22.3,28.74,3 RC,323,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,323,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,323,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,323,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,323,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,323,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,323,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,323,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,323,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,323,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,323,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,323,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,323,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,323,T cells; total count ,,,154.71,199.37,3 RC,323,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,323,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,323,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,323,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,323,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,323,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,323,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,323,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,323,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,323,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,323,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,323,Tacrolimus ,,,57.16,73.66,3 RC,323,Tapentadol ,,,98.98,127.56,3 RC,323,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,323,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,323,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,323,Testosterone; free ,,,104.53,134.7,3 RC,323,Testosterone; total ,,,105.96,136.54,3 RC,323,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,323,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,323,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,323,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,323,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,323,Theophylline ,,,58.54,75.44,3 RC,323,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,323,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,323,Thiocyanate ,,,47.41,61.1,3 RC,323,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,323,Thrombin time; plasma ,,,23.69,30.52,3 RC,323,Thrombin time; titer ,,,27.89,35.94,3 RC,323,Thrombomodulin ,,,71.1,91.62,3 RC,323,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,323,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,323,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,323,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,323,Thyroglobulin ,,,65.51,84.43,3 RC,323,Thyroglobulin antibody ,,,65.51,84.43,3 RC,323,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,323,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,323,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,323,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,323,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,323,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,323,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,323,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,323,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,323,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,323,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,323,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,323,Thyroxine; free ,,,37.63,48.49,3 RC,323,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,323,Thyroxine; total ,,,27.89,35.94,3 RC,323,Tiagabine ,,,111.5,143.69,3 RC,323,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,323,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,323,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,323,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,323,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,323,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,323,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,323,Tobramycin ,,,66.9,86.21,3 RC,323,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,323,Topiramate ,,,48.8,62.89,3 RC,323,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,323,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,323,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,323,Tramadol ,,,98.98,127.56,3 RC,323,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,323,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,323,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,323,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,323,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,323,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,323,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,323,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,323,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,323,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,323,Transferrin ,,,52.96,68.24,3 RC,323,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,323,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,323,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,323,Triglycerides ,,,23.69,30.52,3 RC,323,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,323,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,323,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,323,"Troponin, qualitative ",,,41.83,53.9,3 RC,323,"Troponin, quantitative ",,,51.57,66.46,3 RC,323,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,323,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,323,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,323,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,323,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,323,Tyrosine ,,,43.21,55.69,3 RC,323,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,323,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,323,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,323,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,323,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,323,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,323,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,323,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,323,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,323,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,323,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,323,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,323,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,323,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,323,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,323,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,323,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,323,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,323,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,323,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,323,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,323,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,323,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,323,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,323,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,323,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,323,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,323,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,323,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,323,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,323,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,323,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,323,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,323,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,323,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,323,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,323,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,323,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,323,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,323,Unlisted immunology procedure ,,,99.55,128.28,3 RC,323,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,323,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,323,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,323,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,323,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,323,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,323,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,323,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,323,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,323,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,323,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,323,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,323,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,323,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,323,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,323,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,323,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,323,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,323,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,323,Uric acid; blood ,,,18.14,23.38,3 RC,323,Uric acid; other source ,,,20.91,26.95,3 RC,323,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,323,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,323,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,323,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,323,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,323,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,323,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,323,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,323,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,323,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,323,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,323,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,323,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,323,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,323,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,323,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,323,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,323,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,323,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,323,Vancomycin ,,,55.77,71.87,3 RC,323,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,323,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,323,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,323,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,323,Vedolizumab ,,,158.91,204.79,3 RC,323,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,323,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,323,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,323,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,323,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,323,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,323,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,323,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,323,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,323,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,323,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,323,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,323,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,323,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,323,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,323,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,323,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,323,Very long chain fatty acids ,,,80.84,104.18,3 RC,323,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,323,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,323,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,323,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,323,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,323,Viscosity ,,,47.41,61.1,3 RC,323,Vitamin A ,,,47.41,61.1,3 RC,323,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,323,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,323,Vitamin K ,,,55.77,71.87,3 RC,323,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,323,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,323,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,323,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,323,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,323,Voriconazole ,,,111.5,143.69,3 RC,323,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,323,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,323,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,323,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,323,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,323,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,323,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,323,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,323,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,323,Zinc ,,,47.41,61.1,3 RC,323,Zonisamide ,,,54.38,70.08,3 RC,323,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,323,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,323,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,324, Radiology - Diagnostic Chest X-Ray ,,,198.0,198.0,1 RC,324,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,324,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,324,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,324,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,324,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,324,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,324,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,324,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,324,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,324,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,324,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,324,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,324,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,324,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,324,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,324,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,324,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,Acetaminophen ,,,76.68,98.82,3 RC,324,Acetylcholinesterase ,,,50.18,64.67,3 RC,324,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,324,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,324,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,324,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,324,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,324,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,324,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,324,Adalimumab ,,,158.91,204.79,3 RC,324,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,324,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,324,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,324,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,324,Albumin; ischemia modified ,,,139.38,179.62,3 RC,324,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,324,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,324,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,324,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,324,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,324,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,324,Alcohols ,,,98.98,127.56,3 RC,324,Aldolase ,,,40.44,52.12,3 RC,324,Aldosterone ,,,167.27,215.56,3 RC,324,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,324,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,324,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,324,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,324,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,324,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,324,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,324,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,324,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,324,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,324,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,324,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,324,Aluminum ,,,104.53,134.7,3 RC,324,Amikacin ,,,62.74,80.85,3 RC,324,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,324,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,324,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,324,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,324,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,324,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,324,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,324,Amiodarone ,,,76.68,98.82,3 RC,324,Ammonia ,,,59.93,77.23,3 RC,324,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,324,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,324,Amylase ,,,26.5,34.15,3 RC,324,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,324,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,324,Androstanediol glucuronide ,,,118.47,152.67,3 RC,324,Androstenedione ,,,119.9,154.51,3 RC,324,Androsterone ,,,104.53,134.7,3 RC,324,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,324,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,324,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,324,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,324,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,324,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,324,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,324,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,324,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,324,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,324,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,324,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,324,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,324,Angiotensin II ,,,85.04,109.59,3 RC,324,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,324,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,324,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,324,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,324,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,324,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,324,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,324,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,324,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,324,Antibody; Aspergillus ,,,61.31,79.01,3 RC,324,Antibody; Bartonella ,,,41.83,53.9,3 RC,324,Antibody; Blastomyces ,,,52.96,68.24,3 RC,324,Antibody; Bordetella ,,,54.38,70.08,3 RC,324,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,324,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,324,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,324,Antibody; Brucella ,,,36.24,46.7,3 RC,324,Antibody; Campylobacter ,,,54.38,70.08,3 RC,324,Antibody; Candida ,,,48.8,62.89,3 RC,324,Antibody; Chlamydia ,,,48.8,62.89,3 RC,324,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,324,Antibody; Coccidioides ,,,47.41,61.1,3 RC,324,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,324,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,324,Antibody; Diphtheria ,,,62.74,80.85,3 RC,324,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,324,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,324,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,324,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,324,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,324,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,324,Antibody; HIV-1 ,,,36.24,46.7,3 RC,324,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,324,Antibody; HIV-2 ,,,55.77,71.87,3 RC,324,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,324,Antibody; HTLV-I ,,,37.63,48.49,3 RC,324,Antibody; HTLV-II ,,,57.16,73.66,3 RC,324,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,324,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,324,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,324,Antibody; Legionella ,,,62.74,80.85,3 RC,324,Antibody; Leishmania ,,,50.18,64.67,3 RC,324,Antibody; Leptospira ,,,66.9,86.21,3 RC,324,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,324,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,324,Antibody; Nocardia ,,,65.51,84.43,3 RC,324,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,324,Antibody; Rickettsia ,,,79.46,102.39,3 RC,324,Antibody; Salmonella ,,,54.38,70.08,3 RC,324,Antibody; Shigella ,,,100.37,129.34,3 RC,324,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,324,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,324,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,324,Antibody; Trichinella ,,,51.57,66.46,3 RC,324,Antibody; West Nile virus ,,,58.54,75.44,3 RC,324,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,324,Antibody; Yersinia ,,,54.38,70.08,3 RC,324,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,324,Antibody; actinomyces ,,,41.83,53.9,3 RC,324,Antibody; adenovirus ,,,52.96,68.24,3 RC,324,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,324,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,324,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,324,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,324,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,324,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,324,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,324,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,324,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,324,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,324,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,324,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,324,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,324,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,324,Antibody; histoplasma ,,,57.16,73.66,3 RC,324,Antibody; influenza virus ,,,55.77,71.87,3 RC,324,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,324,Antibody; mucormycosis ,,,61.31,79.01,3 RC,324,Antibody; mumps ,,,54.38,70.08,3 RC,324,Antibody; mycoplasma ,,,54.38,70.08,3 RC,324,Antibody; parvovirus ,,,61.31,79.01,3 RC,324,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,324,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,324,Antibody; rotavirus ,,,75.26,96.98,3 RC,324,Antibody; rubella ,,,58.54,75.44,3 RC,324,Antibody; rubeola ,,,52.96,68.24,3 RC,324,Antibody; tetanus ,,,61.31,79.01,3 RC,324,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,324,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,324,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,324,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,324,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,324,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,324,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,324,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,324,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,324,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,324,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,324,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,324,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,324,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,324,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,324,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,324,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,324,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,324,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,324,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,324,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,324,"Apolipoprotein, each ",,,86.43,111.38,3 RC,324,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,324,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,324,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,324,Arsenic ,,,78.07,100.61,3 RC,324,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,324,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,324,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,324,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,324,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,324,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,324,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,324,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,324,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,324,"B cells, total count ",,,154.71,199.37,3 RC,324,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,324,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,324,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,324,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,324,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,324,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,324,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,324,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,324,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,324,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,324,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,324,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,324,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,324,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,324,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,324,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,324,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,324,Barbiturates ,,,98.98,127.56,3 RC,324,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,324,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,324,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,324,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,324,Beta-2 microglobulin ,,,66.9,86.21,3 RC,324,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,324,Bile acids; total ,,,71.1,91.62,3 RC,324,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,324,Bilirubin; direct ,,,20.91,26.95,3 RC,324,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,324,Bilirubin; total ,,,20.91,26.95,3 RC,324,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,324,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,324,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,324,Bleeding time ,,,19.53,25.17,3 RC,324,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,324,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,324,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,324,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,324,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,324,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,324,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,324,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,324,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,324,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,324,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,324,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,324,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,324,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,324,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,324,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,324,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,324,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,324,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,324,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,324,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,324,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,324,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,324,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,324,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,324,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,324,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,324,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,324,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,324,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,324,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,324,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,324,Bone age studies ,,,26.58,79.3,4 RC,324,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,324,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,324,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,324,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,324,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,324,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,324,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,324,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,324,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,324,Bradykinin ,,,20.91,26.95,3 RC,324,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,324,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,324,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,324,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,324,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,324,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,324,C-peptide ,,,85.04,109.59,3 RC,324,C-reactive protein; ,,,20.91,26.95,3 RC,324,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,324,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,324,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,324,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,324,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,324,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,324,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,324,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,324,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,324,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,324,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,324,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,324,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,324,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,324,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,324,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,324,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,324,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,324,Cadmium ,,,97.55,125.72,3 RC,324,Caffeine ,,,158.91,204.79,3 RC,324,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,324,Calcitonin ,,,110.11,141.9,3 RC,324,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,324,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,324,Calcium; ionized ,,,55.77,71.87,3 RC,324,Calcium; total ,,,20.91,26.95,3 RC,324,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,324,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,324,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,324,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,324,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,324,"Calprotectin, fecal ",,,80.84,104.18,3 RC,324,"Cannabinoids, natural ",,,98.98,127.56,3 RC,324,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,324,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,324,Carbamazepine; free ,,,54.38,70.08,3 RC,324,Carbamazepine; total ,,,59.93,77.23,3 RC,324,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,324,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,324,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,324,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,324,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,324,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,324,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,324,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,324,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,324,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,324,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,324,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,324,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,324,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,324,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,324,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,324,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,324,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,324,Cardiac shunt detection ,,,186.76,186.76,1 RC,324,Cardiokymography ,,,20.04,20.04,1 RC,324,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,324,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,324,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,324,Carotene ,,,37.63,48.49,3 RC,324,Catecholamines; blood ,,,119.9,154.51,3 RC,324,Catecholamines; fractionated ,,,104.53,134.7,3 RC,324,Catecholamines; total urine ,,,112.93,145.53,3 RC,324,Cathepsin-D ,,,73.87,95.19,3 RC,324,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,324,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,324,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,324,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,324,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,324,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,324,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,324,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,324,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,324,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,324,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,324,Ceruloplasmin ,,,44.6,57.47,3 RC,324,Chemiluminescent assay ,,,58.54,75.44,3 RC,324,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,324,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,324,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,324,Chloramphenicol ,,,51.57,66.46,3 RC,324,Chloride; blood ,,,19.53,25.17,3 RC,324,Chloride; other source ,,,20.91,26.95,3 RC,324,Chloride; urine ,,,23.69,30.52,3 RC,324,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,324,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,324,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,324,Cholinesterase; RBC ,,,40.44,52.12,3 RC,324,Cholinesterase; serum ,,,32.04,41.29,3 RC,324,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,324,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,324,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,324,Chromium ,,,83.66,107.81,3 RC,324,Chromogenic substrate assay ,,,48.8,62.89,3 RC,324,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,324,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,324,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,324,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,324,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,324,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,324,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,324,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,324,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,324,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,324,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,324,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,324,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,324,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,324,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,324,Citrate ,,,114.31,147.31,3 RC,324,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,324,Clot retraction ,,,66.9,86.21,3 RC,324,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,324,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,324,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,324,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,324,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,324,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,324,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,324,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,324,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,324,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,324,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,324,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,324,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,324,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,324,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,324,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,324,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,324,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,324,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,324,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,324,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,324,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,324,Clozapine ,,,82.23,105.96,3 RC,324,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,324,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,324,Coagulation time; activated ,,,18.14,23.38,3 RC,324,Coagulation time; other methods ,,,18.14,23.38,3 RC,324,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,324,Cocaine ,,,98.98,127.56,3 RC,324,Cold agglutinin; screen ,,,33.47,43.13,3 RC,324,Cold agglutinin; titer ,,,33.47,43.13,3 RC,324,"Collagen cross links, any method ",,,76.68,98.82,3 RC,324,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,324,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,324,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,324,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,324,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,324,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,324,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,324,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,324,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,324,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,324,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,324,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,324,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,324,"Complement; antigen, each component ",,,48.8,62.89,3 RC,324,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,324,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,324,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,324,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,324,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,324,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,324,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,324,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,324,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,324,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,324,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,324,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,324,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,324,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,324,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,324,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,324,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,324,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,324,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,324,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,324,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,324,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,324,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,324,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,324,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,324,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,324,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,324,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,324,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,324,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,324,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,324,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,324,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,324,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,324,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,324,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,324,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,324,Copper ,,,51.57,66.46,3 RC,324,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,324,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,324,Corticosterone ,,,92.01,118.58,3 RC,324,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,324,Cortisol; free ,,,68.28,88.0,3 RC,324,Cortisol; total ,,,66.9,86.21,3 RC,324,Creatine ,,,19.53,25.17,3 RC,324,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,324,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,324,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,324,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,324,Creatinine; blood ,,,20.91,26.95,3 RC,324,Creatinine; clearance ,,,39.01,50.28,3 RC,324,Creatinine; other source ,,,20.91,26.95,3 RC,324,Cryofibrinogen ,,,58.54,75.44,3 RC,324,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,324,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,324,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,324,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,324,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,324,Cryopreservation; sperm ,,,442.57,570.33,3 RC,324,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,324,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,324,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,324,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,324,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,324,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,324,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,324,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,324,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,324,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,324,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,324,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,324,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,324,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,324,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,324,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,324,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,324,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,324,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,324,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,324,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,324,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,324,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,324,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,324,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,324,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,324,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,324,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,324,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,324,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,324,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,324,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,324,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,324,"Culture, typing; other methods ",,,32.04,41.29,3 RC,324,Cyanide ,,,79.46,102.39,3 RC,324,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,324,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,324,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,324,Cyclosporine ,,,73.87,95.19,3 RC,324,Cystatin C ,,,76.68,98.82,3 RC,324,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,324,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,324,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,324,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,324,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,324,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,324,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,324,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,324,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,324,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,324,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,324,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,324,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,324,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,324,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,324,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,324,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,324,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,324,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,324,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,324,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,324,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,324,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,324,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,324,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,324,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,324,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,324,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,324,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,324,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,324,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,324,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,324,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,324,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,324,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,324,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,324,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,324,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,324,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,324,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,324,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,324,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,324,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,324,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,324,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,324,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,324,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,324,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,324,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,324,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,324,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,324,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,324,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,324,Dibucaine number ,,,50.18,64.67,3 RC,324,Digoxin; free ,,,54.38,70.08,3 RC,324,Digoxin; total ,,,54.38,70.08,3 RC,324,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,324,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,324,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,324,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,324,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,324,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,324,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,324,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,324,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,324,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,324,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,324,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,324,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,324,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,324,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,324,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,324,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,324,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,324,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,324,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,324,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,324,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,324,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,324,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,324,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,324,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,324,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,324,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,324,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,324,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,324,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,324,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,324,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,324,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,324,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,324,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,324,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,324,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,324,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,324,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,324,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,324,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,324,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,324,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,324,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,324,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,324,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,324,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,324,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,324,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,324,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,324,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,324,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,324,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,324,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,324,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,324,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,324,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,324,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,324,Erythropoietin ,,,76.68,98.82,3 RC,324,Esophageal motility ,,,214.04,214.04,1 RC,324,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,324,Estradiol; total ,,,114.31,147.31,3 RC,324,Estriol ,,,98.98,127.56,3 RC,324,Estrogens; fractionated ,,,132.41,170.64,3 RC,324,Estrogens; total ,,,89.2,114.95,3 RC,324,Estrone ,,,103.14,132.92,3 RC,324,Ethosuximide ,,,66.9,86.21,3 RC,324,Ethylene glycol ,,,61.31,79.01,3 RC,324,Etiocholanolone ,,,107.34,138.33,3 RC,324,Euglobulin lysis ,,,34.86,44.92,3 RC,324,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,324,Everolimus ,,,57.16,73.66,3 RC,324,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,324,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,324,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,324,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,324,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,324,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,324,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,324,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,324,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,324,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,324,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,324,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,324,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,324,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,324,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,324,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,324,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,324,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,324,Factor inhibitor test ,,,52.96,68.24,3 RC,324,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,324,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,324,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,324,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,324,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,324,Felbamate ,,,76.68,98.82,3 RC,324,Fentanyl ,,,98.98,127.56,3 RC,324,Fern test ,,,40.44,52.12,3 RC,324,Ferritin ,,,55.77,71.87,3 RC,324,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,324,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,324,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,324,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,324,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,324,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,324,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,324,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,324,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,324,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,324,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,324,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,324,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,324,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,324,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,324,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,324,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,324,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,324,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,324,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,324,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,324,Fibrinogen; activity ,,,40.44,52.12,3 RC,324,Fibrinogen; antigen ,,,59.93,77.23,3 RC,324,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,324,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,324,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,324,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,324,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,324,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,324,Flecainide ,,,76.68,98.82,3 RC,324,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,324,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,324,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,324,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,324,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,324,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,324,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,324,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,324,Fluoride ,,,76.68,98.82,3 RC,324,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,324,Folic acid; RBC ,,,72.48,93.41,3 RC,324,Folic acid; serum ,,,59.93,77.23,3 RC,324,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,324,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,324,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,324,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,324,"Fructose, semen ",,,71.1,91.62,3 RC,324,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,324,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,324,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,324,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,324,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,324,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,324,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,324,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,324,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,324,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,324,"Galactokinase, RBC ",,,87.81,113.16,3 RC,324,Galactose ,,,45.98,59.26,3 RC,324,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,324,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,324,Galectin-3 ,,,182.6,235.31,3 RC,324,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,324,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,324,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,324,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,324,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,324,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,324,"Gases, blood, pH only ",,,44.6,57.47,3 RC,324,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,324,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,324,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,324,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,324,Gastric mucosa imaging ,,,205.51,205.51,1 RC,324,Gastrin ,,,72.48,93.41,3 RC,324,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,324,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,324,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,324,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,324,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,324,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,324,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,324,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,324,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,324,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,324,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,324,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,324,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,324,Gentamicin ,,,66.9,86.21,3 RC,324,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,324,Glucagon ,,,58.54,75.44,3 RC,324,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,324,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,324,Glucagon tolerance test ,,,72.48,93.41,3 RC,324,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,324,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,324,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,324,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,324,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,324,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,324,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,324,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,324,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,324,"Glucosidase, beta ",,,87.81,113.16,3 RC,324,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,324,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,324,Glutathione ,,,64.13,82.64,3 RC,324,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,324,Glycated protein ,,,68.28,88.0,3 RC,324,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,324,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,324,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,324,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,324,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,324,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,324,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,324,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,324,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,324,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,324,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,324,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,324,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,324,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,324,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,324,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,324,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,324,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,324,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,324,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,324,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,324,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,324,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,324,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,324,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,324,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,324,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,324,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,324,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,324,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,324,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,324,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,324,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,324,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,324,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,324,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,324,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,324,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,324,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,324,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,324,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,324,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,Haloperidol ,,,65.51,84.43,3 RC,324,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,324,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,324,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,324,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,324,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,324,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,324,Heinz bodies; direct ,,,16.71,21.54,3 RC,324,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,324,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,324,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,324,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,324,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,324,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,324,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,324,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,324,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,324,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,324,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,324,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,324,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,324,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,324,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,324,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,324,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,324,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,324,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,324,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,324,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,324,Hemoglobin; plasma ,,,30.66,39.51,3 RC,324,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,324,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,324,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,324,Hemoglobin; urine ,,,16.71,21.54,3 RC,324,"Hemolysin, acid ",,,36.24,46.7,3 RC,324,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,324,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,324,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,324,Heparin assay ,,,54.38,70.08,3 RC,324,Heparin neutralization ,,,48.8,62.89,3 RC,324,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,324,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,324,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,324,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,324,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,324,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,324,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,324,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,324,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,324,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,324,Hepatitis C antibody; ,,,58.54,75.44,3 RC,324,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,324,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,324,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,324,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,324,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,324,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,324,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,324,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,324,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,324,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,324,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,324,Heroin metabolite ,,,98.98,127.56,3 RC,324,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,324,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,324,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,324,Histamine ,,,121.28,156.3,3 RC,324,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,324,Homocysteine ,,,73.87,95.19,3 RC,324,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,324,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,324,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,324,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,324,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,324,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,324,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,324,Hydroxychloroquine ,,,76.68,98.82,3 RC,324,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,324,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,324,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,324,Hydroxyproline; free ,,,93.4,120.36,3 RC,324,Hydroxyproline; total ,,,100.37,129.34,3 RC,324,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,324,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,324,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,324,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,324,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,324,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,324,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,324,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,324,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,324,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,324,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,324,Immune complex assay ,,,100.37,129.34,3 RC,324,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,324,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,324,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,324,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,324,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,324,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,324,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,324,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,324,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,324,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,324,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,324,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,324,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,324,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,324,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,324,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,324,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,324,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,324,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,324,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,324,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,324,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,324,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,324,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,324,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,324,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,324,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,324,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,324,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,324,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,324,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,324,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,324,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,324,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,324,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,324,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,324,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,324,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,324,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,324,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,324,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,324,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,324,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,324,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,324,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,324,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,324,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,324,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,324,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,324,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,324,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,324,Infliximab ,,,158.91,204.79,3 RC,324,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,324,Inhibin A ,,,64.13,82.64,3 RC,324,Insemination of oocytes ,,,442.57,570.33,3 RC,324,Insulin antibodies ,,,87.81,113.16,3 RC,324,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,324,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,324,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,324,Insulin; free ,,,52.96,68.24,3 RC,324,Insulin; total ,,,47.41,61.1,3 RC,324,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,324,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,324,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,324,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,324,Intrinsic factor ,,,80.84,104.18,3 RC,324,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,324,Iron ,,,26.5,34.15,3 RC,324,Iron binding capacity ,,,36.24,46.7,3 RC,324,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,324,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,324,Islet cell antibody ,,,97.55,125.72,3 RC,324,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,324,Itraconazole ,,,111.5,143.69,3 RC,324,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,324,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,324,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,324,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,324,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,324,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,324,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,324,Ketamine and norketamine ,,,98.98,127.56,3 RC,324,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,324,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,324,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,324,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,324,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,324,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,324,Kidney imaging morphology; ,,,172.11,172.11,1 RC,324,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,324,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,324,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,324,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,324,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,324,Lacosamide ,,,111.5,143.69,3 RC,324,Lactate (lactic acid) ,,,47.41,61.1,3 RC,324,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,324,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,324,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,324,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,324,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,324,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,324,Lamotrigine ,,,54.38,70.08,3 RC,324,Lead ,,,50.18,64.67,3 RC,324,Leflunomide ,,,158.91,204.79,3 RC,324,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,324,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,324,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,324,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,324,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,324,Leukocyte transfusion ,,,305.26,393.39,3 RC,324,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,324,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,324,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,324,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,324,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,324,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,324,Levetiracetam ,,,54.38,70.08,3 RC,324,Lidocaine ,,,59.93,77.23,3 RC,324,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,324,Lipase ,,,27.89,35.94,3 RC,324,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,324,Lipoprotein (a) ,,,58.54,75.44,3 RC,324,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,324,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,324,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,324,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,324,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,324,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,324,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,324,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,324,Lithium ,,,27.89,35.94,3 RC,324,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,324,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,324,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,324,Liver imaging; static only ,,,191.2,191.2,1 RC,324,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,324,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,324,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,324,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,324,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,324,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,324,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,324,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,324,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,324,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,324,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,324,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,324,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,324,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,324,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,324,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,324,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,324,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,324,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,324,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,324,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,324,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,324,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,324,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,324,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,324,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,324,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,324,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,324,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,324,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,324,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,324,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,324,Magnesium ,,,27.89,35.94,3 RC,324,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,324,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,324,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,324,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,324,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,324,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,324,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,324,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,324,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,324,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,324,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,324,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,324,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,324,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,324,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,324,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,324,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,324,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,324,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,324,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,324,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,324,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,324,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,324,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,324,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,324,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,324,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,324,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,324,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,324,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,324,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,324,Malate dehydrogenase ,,,30.66,39.51,3 RC,324,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,324,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,324,Manganese ,,,110.11,141.9,3 RC,324,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,324,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,324,"Meat fibers, feces ",,,19.53,25.17,3 RC,324,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,324,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,324,"Mercury, quantitative ",,,66.9,86.21,3 RC,324,Metanephrines ,,,69.71,89.84,3 RC,324,Methadone ,,,98.98,127.56,3 RC,324,Methemalbumin ,,,44.6,57.47,3 RC,324,Methotrexate ,,,158.91,204.79,3 RC,324,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,324,Methylphenidate ,,,98.98,127.56,3 RC,324,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,324,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,324,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,324,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,324,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,324,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,324,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,324,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,324,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,324,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,324,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,324,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,324,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,324,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,324,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,324,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,324,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,324,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,324,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,324,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,324,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,324,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,324,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,324,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,324,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,324,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,324,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,324,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,324,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,324,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,324,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,324,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,324,Muramidase ,,,76.68,98.82,3 RC,324,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,324,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,324,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,324,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,324,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,324,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,324,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,324,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,324,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,324,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,324,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,324,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,324,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,324,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,324,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,324,Myoglobin ,,,52.96,68.24,3 RC,324,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,324,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,324,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,324,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,324,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,324,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,324,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,324,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,324,Natriuretic peptide ,,,161.68,208.36,3 RC,324,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,324,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,324,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,324,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,324,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,324,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,324,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,324,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,324,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,324,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,324,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,324,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,324,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,324,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,324,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,324,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,324,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,324,Nerve teasing preparations ,,,499.29,643.43,3 RC,324,"Neutralization test, viral ",,,69.71,89.84,3 RC,324,Nickel ,,,100.37,129.34,3 RC,324,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,324,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,324,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,324,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,324,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,324,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,324,Nucleotidase 5'- ,,,45.98,59.26,3 RC,324,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,324,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,324,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,324,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,324,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,324,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,324,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,324,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,324,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,324,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,324,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,324,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,324,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,324,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,324,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,324,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,324,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,324,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,324,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,324,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,324,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,324,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,324,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,324,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,324,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,324,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,324,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,324,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,324,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,324,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,324,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,324,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,324,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,324,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,324,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,324,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,324,"Opiates, 1 or more ",,,98.98,127.56,3 RC,324,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,324,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,324,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,324,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,324,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,324,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,324,Osmolality; blood ,,,27.89,35.94,3 RC,324,Osmolality; urine ,,,27.89,35.94,3 RC,324,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,324,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,324,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,324,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,324,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,324,Oxalate ,,,59.93,77.23,3 RC,324,Oxcarbazepine ,,,54.38,70.08,3 RC,324,Oxycodone ,,,98.98,127.56,3 RC,324,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,324,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,324,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,324,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,324,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,324,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,324,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,324,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,324,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,324,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,324,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,324,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,324,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,324,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,324,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,324,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,324,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,324,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,324,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,324,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,324,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,324,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,324,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,324,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,324,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,324,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,324,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,324,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,324,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,324,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,324,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,324,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,324,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,324,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,324,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,324,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,324,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,324,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,324,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,324,Phenobarbital ,,,62.74,80.85,3 RC,324,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,324,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,324,Phenytoin; free ,,,57.16,73.66,3 RC,324,Phenytoin; total ,,,54.38,70.08,3 RC,324,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,324,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,324,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,324,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,324,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,324,Phosphatidylglycerol ,,,68.28,88.0,3 RC,324,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,324,Phosphohexose isomerase ,,,44.6,57.47,3 RC,324,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,324,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,324,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,324,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,324,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,324,Pinworm examinations ,,,18.14,23.38,3 RC,324,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,324,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,324,Platelet survival study ,,,126.1,126.1,1 RC,324,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,324,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,324,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,324,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,324,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,324,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,324,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,324,Posaconazole ,,,111.5,143.69,3 RC,324,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,324,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,324,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,324,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,324,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,324,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,324,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,324,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,324,Potassium; urine ,,,19.53,25.17,3 RC,324,Prealbumin ,,,59.93,77.23,3 RC,324,Pregabalin ,,,98.98,127.56,3 RC,324,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,324,Pregnanediol ,,,87.81,113.16,3 RC,324,Pregnanetriol ,,,86.43,111.38,3 RC,324,Pregnenolone ,,,85.04,109.59,3 RC,324,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,324,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,324,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,324,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,324,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,324,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,324,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,324,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,324,Primidone ,,,68.28,88.0,3 RC,324,Procainamide; ,,,246.72,317.95,3 RC,324,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,324,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,324,Progesterone ,,,86.43,111.38,3 RC,324,Proinsulin ,,,110.11,141.9,3 RC,324,Prolactin ,,,79.46,102.39,3 RC,324,Propoxyphene ,,,98.98,127.56,3 RC,324,"Prostaglandin, each ",,,171.47,220.97,3 RC,324,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,324,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,324,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,324,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,324,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,324,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,324,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,324,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,324,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,324,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,324,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,324,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,324,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,324,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,324,Prothrombin time; ,,,18.14,23.38,3 RC,324,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,324,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,324,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,324,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,324,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,324,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,324,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,324,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,324,Pyruvate ,,,59.93,77.23,3 RC,324,Pyruvate kinase ,,,39.01,50.28,3 RC,324,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,324,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,324,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,324,Quinidine ,,,59.93,77.23,3 RC,324,Quinine ,,,47.41,61.1,3 RC,324,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,324,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,324,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,324,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,324,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,324,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,324,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,324,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,324,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,324,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,324,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,324,"Radiologic examination, chest; 4 or more views ",2209.66,2209.66,47.38,148.02,4 RC,324,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,324,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,324,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,324,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,324,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,324,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,324,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,324,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,324,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,324,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,324,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,324,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,324,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,324,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,324,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,324,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,324,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,324,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,324,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,324,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,324,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,324,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,324,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,324,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,324,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,324,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,324,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,324,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,324,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,324,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,324,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,324,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,324,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,324,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,324,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,324,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,324,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,324,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,324,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,324,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,324,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,324,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,324,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,324,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,324,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,324,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,324,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,324,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,324,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,324,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,324,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,324,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,324,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,324,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,324,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,324,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,324,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,324,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,324,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,324,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,324,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,324,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,324,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,324,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,324,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,324,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,324,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,324,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,324,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,324,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,324,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,324,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,324,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,324,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,324,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,324,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,324,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,324,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,324,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,324,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,324,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,324,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,324,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,324,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,324,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,324,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,324,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,324,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,324,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,324,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,324,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,324,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,324,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,324,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,324,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,324,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,324,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,324,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,324,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,324,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,324,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,324,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,324,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,324,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,324,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,324,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,324,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,324,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,324,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,324,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,324,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,324,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,324,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,324,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,324,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,324,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,324,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,324,Receptor assay; estrogen ,,,361.04,465.26,3 RC,324,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,324,Receptor assay; progesterone ,,,266.25,343.11,3 RC,324,Red cell survival study ,,,126.1,126.1,1 RC,324,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,324,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,324,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,324,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,324,Renin ,,,90.63,116.79,3 RC,324,Reptilase test ,,,40.44,52.12,3 RC,324,Reticulated platelet assay ,,,146.35,188.6,3 RC,324,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,324,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,324,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,324,Rufinamide ,,,111.5,143.69,3 RC,324,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,324,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,324,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,324,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,324,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,324,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,324,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,324,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,324,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,324,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,324,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,324,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,324,Salicylate ,,,76.68,98.82,3 RC,324,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,324,Salivary gland function study ,,,104.3,104.3,1 RC,324,Salivary gland imaging; ,,,175.52,175.52,1 RC,324,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,324,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,324,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,324,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,324,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,324,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,324,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,324,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,324,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,324,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,324,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,324,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,324,Selenium ,,,104.53,134.7,3 RC,324,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,324,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,324,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,324,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,324,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,324,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,324,Serotonin ,,,126.87,163.49,3 RC,324,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,324,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,324,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,324,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,324,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,324,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,324,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,324,Sialic acid ,,,55.77,71.87,3 RC,324,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,324,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,324,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,324,Silica ,,,103.14,132.92,3 RC,324,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,324,Sirolimus ,,,57.16,73.66,3 RC,324,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,324,Skin test; candida ,,,79.46,102.39,3 RC,324,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,324,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,324,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,324,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,324,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,324,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,324,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,324,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,324,Sodium; other source ,,,19.53,25.17,3 RC,324,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,324,Sodium; urine ,,,20.91,26.95,3 RC,324,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,324,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,324,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,324,Somatomedin ,,,87.81,113.16,3 RC,324,Somatostatin ,,,75.26,96.98,3 RC,324,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,324,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,324,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,324,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,324,Specific gravity (except urine) ,,,13.94,17.97,3 RC,324,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,324,Sperm antibodies ,,,43.21,55.69,3 RC,324,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,324,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,324,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,324,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,324,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,324,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,324,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,324,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,324,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,324,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,324,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,324,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,324,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,324,"Stimulants, synthetic ",,,98.98,127.56,3 RC,324,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,324,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,324,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,324,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,324,"Streptokinase, antibody ",,,51.57,66.46,3 RC,324,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,324,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,324,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,324,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,324,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,324,"Sulfate, urine ",,,22.3,28.74,3 RC,324,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,324,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,324,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,324,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,324,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,324,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,324,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,324,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,324,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,324,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,324,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,324,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,324,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,324,T cells; total count ,,,154.71,199.37,3 RC,324,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,324,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,324,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,324,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,324,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,324,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,324,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,324,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,324,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,324,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,324,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,324,Tacrolimus ,,,57.16,73.66,3 RC,324,Tapentadol ,,,98.98,127.56,3 RC,324,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,324,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,324,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,324,Testosterone; free ,,,104.53,134.7,3 RC,324,Testosterone; total ,,,105.96,136.54,3 RC,324,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,324,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,324,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,324,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,324,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,324,Theophylline ,,,58.54,75.44,3 RC,324,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,324,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,324,Thiocyanate ,,,47.41,61.1,3 RC,324,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,324,Thrombin time; plasma ,,,23.69,30.52,3 RC,324,Thrombin time; titer ,,,27.89,35.94,3 RC,324,Thrombomodulin ,,,71.1,91.62,3 RC,324,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,324,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,324,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,324,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,324,Thyroglobulin ,,,65.51,84.43,3 RC,324,Thyroglobulin antibody ,,,65.51,84.43,3 RC,324,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,324,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,324,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,324,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,324,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,324,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,324,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,324,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,324,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,324,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,324,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,324,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,324,Thyroxine; free ,,,37.63,48.49,3 RC,324,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,324,Thyroxine; total ,,,27.89,35.94,3 RC,324,Tiagabine ,,,111.5,143.69,3 RC,324,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,324,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,324,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,324,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,324,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,324,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,324,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,324,Tobramycin ,,,66.9,86.21,3 RC,324,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,324,Topiramate ,,,48.8,62.89,3 RC,324,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,324,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,324,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,324,Tramadol ,,,98.98,127.56,3 RC,324,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,324,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,324,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,324,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,324,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,324,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,324,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,324,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,324,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,324,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,324,Transferrin ,,,52.96,68.24,3 RC,324,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,324,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,324,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,324,Triglycerides ,,,23.69,30.52,3 RC,324,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,324,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,324,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,324,"Troponin, qualitative ",,,41.83,53.9,3 RC,324,"Troponin, quantitative ",,,51.57,66.46,3 RC,324,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,324,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,324,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,324,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,324,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,324,Tyrosine ,,,43.21,55.69,3 RC,324,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,324,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,324,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,324,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,324,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,324,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,324,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,324,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,324,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,324,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,324,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,324,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,324,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,324,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,324,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,324,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,324,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,324,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,324,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,324,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,324,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,324,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,324,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,324,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,324,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,324,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,324,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,324,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,324,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,324,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,324,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,324,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,324,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,324,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,324,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,324,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,324,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,324,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,324,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,324,Unlisted immunology procedure ,,,99.55,128.28,3 RC,324,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,324,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,324,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,324,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,324,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,324,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,324,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,324,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,324,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,324,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,324,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,324,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,324,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,324,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,324,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,324,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,324,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,324,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,324,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,324,Uric acid; blood ,,,18.14,23.38,3 RC,324,Uric acid; other source ,,,20.91,26.95,3 RC,324,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,324,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,324,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,324,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,324,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,324,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,324,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,324,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,324,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,324,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,324,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,324,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,324,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,324,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,324,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,324,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,324,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,324,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,324,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,324,Vancomycin ,,,55.77,71.87,3 RC,324,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,324,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,324,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,324,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,324,Vedolizumab ,,,158.91,204.79,3 RC,324,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,324,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,324,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,324,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,324,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,324,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,324,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,324,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,324,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,324,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,324,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,324,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,324,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,324,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,324,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,324,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,324,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,324,Very long chain fatty acids ,,,80.84,104.18,3 RC,324,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,324,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,324,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,324,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,324,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,324,Viscosity ,,,47.41,61.1,3 RC,324,Vitamin A ,,,47.41,61.1,3 RC,324,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,324,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,324,Vitamin K ,,,55.77,71.87,3 RC,324,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,324,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,324,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,324,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,324,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,324,Voriconazole ,,,111.5,143.69,3 RC,324,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,324,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,324,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,324,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,324,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,324,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,324,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,324,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,324,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,324,Zinc ,,,47.41,61.1,3 RC,324,Zonisamide ,,,54.38,70.08,3 RC,324,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,324,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,324,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,329, Radiology Diagnostic Other ,,,198.0,198.0,1 RC,329,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,329,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,329,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,329,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,329,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,329,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,329,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,329,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,329,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,329,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,329,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,329,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,329,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,329,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,329,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,329,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,329,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,Acetaminophen ,,,76.68,98.82,3 RC,329,Acetylcholinesterase ,,,50.18,64.67,3 RC,329,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,329,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,329,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,329,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,329,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,329,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,329,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,329,Adalimumab ,,,158.91,204.79,3 RC,329,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,329,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,329,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,329,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,329,Albumin; ischemia modified ,,,139.38,179.62,3 RC,329,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,329,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,329,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,329,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,329,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,329,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,329,Alcohols ,,,98.98,127.56,3 RC,329,Aldolase ,,,40.44,52.12,3 RC,329,Aldosterone ,,,167.27,215.56,3 RC,329,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,329,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,329,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,329,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,329,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,329,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,329,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,329,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,329,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,329,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,329,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,329,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,329,Aluminum ,,,104.53,134.7,3 RC,329,Amikacin ,,,62.74,80.85,3 RC,329,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,329,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,329,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,329,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,329,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,329,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,329,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,329,Amiodarone ,,,76.68,98.82,3 RC,329,Ammonia ,,,59.93,77.23,3 RC,329,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,329,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,329,Amylase ,,,26.5,34.15,3 RC,329,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,329,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,329,Androstanediol glucuronide ,,,118.47,152.67,3 RC,329,Androstenedione ,,,119.9,154.51,3 RC,329,Androsterone ,,,104.53,134.7,3 RC,329,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,329,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,329,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,329,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,329,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,329,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,329,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,329,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,329,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,329,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,329,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,329,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,329,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,329,Angiotensin II ,,,85.04,109.59,3 RC,329,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,329,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,329,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,329,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,329,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,329,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,329,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,329,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,329,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,329,Antibody; Aspergillus ,,,61.31,79.01,3 RC,329,Antibody; Bartonella ,,,41.83,53.9,3 RC,329,Antibody; Blastomyces ,,,52.96,68.24,3 RC,329,Antibody; Bordetella ,,,54.38,70.08,3 RC,329,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,329,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,329,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,329,Antibody; Brucella ,,,36.24,46.7,3 RC,329,Antibody; Campylobacter ,,,54.38,70.08,3 RC,329,Antibody; Candida ,,,48.8,62.89,3 RC,329,Antibody; Chlamydia ,,,48.8,62.89,3 RC,329,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,329,Antibody; Coccidioides ,,,47.41,61.1,3 RC,329,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,329,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,329,Antibody; Diphtheria ,,,62.74,80.85,3 RC,329,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,329,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,329,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,329,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,329,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,329,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,329,Antibody; HIV-1 ,,,36.24,46.7,3 RC,329,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,329,Antibody; HIV-2 ,,,55.77,71.87,3 RC,329,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,329,Antibody; HTLV-I ,,,37.63,48.49,3 RC,329,Antibody; HTLV-II ,,,57.16,73.66,3 RC,329,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,329,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,329,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,329,Antibody; Legionella ,,,62.74,80.85,3 RC,329,Antibody; Leishmania ,,,50.18,64.67,3 RC,329,Antibody; Leptospira ,,,66.9,86.21,3 RC,329,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,329,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,329,Antibody; Nocardia ,,,65.51,84.43,3 RC,329,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,329,Antibody; Rickettsia ,,,79.46,102.39,3 RC,329,Antibody; Salmonella ,,,54.38,70.08,3 RC,329,Antibody; Shigella ,,,100.37,129.34,3 RC,329,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,329,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,329,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,329,Antibody; Trichinella ,,,51.57,66.46,3 RC,329,Antibody; West Nile virus ,,,58.54,75.44,3 RC,329,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,329,Antibody; Yersinia ,,,54.38,70.08,3 RC,329,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,329,Antibody; actinomyces ,,,41.83,53.9,3 RC,329,Antibody; adenovirus ,,,52.96,68.24,3 RC,329,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,329,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,329,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,329,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,329,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,329,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,329,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,329,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,329,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,329,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,329,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,329,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,329,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,329,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,329,Antibody; histoplasma ,,,57.16,73.66,3 RC,329,Antibody; influenza virus ,,,55.77,71.87,3 RC,329,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,329,Antibody; mucormycosis ,,,61.31,79.01,3 RC,329,Antibody; mumps ,,,54.38,70.08,3 RC,329,Antibody; mycoplasma ,,,54.38,70.08,3 RC,329,Antibody; parvovirus ,,,61.31,79.01,3 RC,329,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,329,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,329,Antibody; rotavirus ,,,75.26,96.98,3 RC,329,Antibody; rubella ,,,58.54,75.44,3 RC,329,Antibody; rubeola ,,,52.96,68.24,3 RC,329,Antibody; tetanus ,,,61.31,79.01,3 RC,329,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,329,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,329,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,329,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,329,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,329,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,329,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,329,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,329,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,329,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,329,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,329,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,329,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,329,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,329,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,329,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,329,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,329,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,329,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,329,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,329,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,329,"Apolipoprotein, each ",,,86.43,111.38,3 RC,329,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,329,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,329,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,329,Arsenic ,,,78.07,100.61,3 RC,329,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,329,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,329,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,329,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,329,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,329,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,329,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,329,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,329,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,329,"B cells, total count ",,,154.71,199.37,3 RC,329,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,329,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,329,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,329,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,329,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,329,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,329,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,329,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,329,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,329,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,329,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,329,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,329,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,329,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,329,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,329,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,329,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,329,Barbiturates ,,,98.98,127.56,3 RC,329,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,329,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,329,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,329,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,329,Beta-2 microglobulin ,,,66.9,86.21,3 RC,329,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,329,Bile acids; total ,,,71.1,91.62,3 RC,329,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,329,Bilirubin; direct ,,,20.91,26.95,3 RC,329,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,329,Bilirubin; total ,,,20.91,26.95,3 RC,329,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,329,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,329,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,329,Bleeding time ,,,19.53,25.17,3 RC,329,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,329,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,329,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,329,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,329,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,329,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,329,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,329,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,329,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,329,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,329,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,329,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,329,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,329,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,329,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,329,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,329,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,329,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,329,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,329,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,329,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,329,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,329,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,329,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,329,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,329,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,329,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,329,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,329,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,329,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,329,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,329,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,329,Bone age studies ,,,26.58,79.3,4 RC,329,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,329,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,329,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,329,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,329,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,329,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,329,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,329,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,329,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,329,Bradykinin ,,,20.91,26.95,3 RC,329,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,329,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,329,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,329,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,329,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,329,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,329,C-peptide ,,,85.04,109.59,3 RC,329,C-reactive protein; ,,,20.91,26.95,3 RC,329,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,329,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,329,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,329,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,329,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,329,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,329,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,329,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,329,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,329,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,329,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,329,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,329,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,329,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,329,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,329,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,329,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,329,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,329,Cadmium ,,,97.55,125.72,3 RC,329,Caffeine ,,,158.91,204.79,3 RC,329,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,329,Calcitonin ,,,110.11,141.9,3 RC,329,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,329,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,329,Calcium; ionized ,,,55.77,71.87,3 RC,329,Calcium; total ,,,20.91,26.95,3 RC,329,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,329,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,329,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,329,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,329,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,329,"Calprotectin, fecal ",,,80.84,104.18,3 RC,329,"Cannabinoids, natural ",,,98.98,127.56,3 RC,329,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,329,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,329,Carbamazepine; free ,,,54.38,70.08,3 RC,329,Carbamazepine; total ,,,59.93,77.23,3 RC,329,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,329,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,329,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,329,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,329,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,329,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,329,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,329,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,329,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,329,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,329,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,329,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,329,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,329,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,329,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,329,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,329,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,329,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,329,Cardiac shunt detection ,,,186.76,186.76,1 RC,329,Cardiokymography ,,,20.04,20.04,1 RC,329,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,329,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,329,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,329,Carotene ,,,37.63,48.49,3 RC,329,Catecholamines; blood ,,,119.9,154.51,3 RC,329,Catecholamines; fractionated ,,,104.53,134.7,3 RC,329,Catecholamines; total urine ,,,112.93,145.53,3 RC,329,Cathepsin-D ,,,73.87,95.19,3 RC,329,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,329,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,329,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,329,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,329,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,329,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,329,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,329,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,329,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,329,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,329,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,329,Ceruloplasmin ,,,44.6,57.47,3 RC,329,Chemiluminescent assay ,,,58.54,75.44,3 RC,329,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,329,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,329,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,329,Chloramphenicol ,,,51.57,66.46,3 RC,329,Chloride; blood ,,,19.53,25.17,3 RC,329,Chloride; other source ,,,20.91,26.95,3 RC,329,Chloride; urine ,,,23.69,30.52,3 RC,329,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,329,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,329,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,329,Cholinesterase; RBC ,,,40.44,52.12,3 RC,329,Cholinesterase; serum ,,,32.04,41.29,3 RC,329,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,329,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,329,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,329,Chromium ,,,83.66,107.81,3 RC,329,Chromogenic substrate assay ,,,48.8,62.89,3 RC,329,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,329,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,329,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,329,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,329,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,329,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,329,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,329,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,329,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,329,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,329,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,329,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,329,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,329,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,329,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,329,Citrate ,,,114.31,147.31,3 RC,329,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,329,Clot retraction ,,,66.9,86.21,3 RC,329,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,329,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,329,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,329,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,329,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,329,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,329,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,329,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,329,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,329,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,329,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,329,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,329,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,329,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,329,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,329,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,329,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,329,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,329,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,329,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,329,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,329,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,329,Clozapine ,,,82.23,105.96,3 RC,329,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,329,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,329,Coagulation time; activated ,,,18.14,23.38,3 RC,329,Coagulation time; other methods ,,,18.14,23.38,3 RC,329,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,329,Cocaine ,,,98.98,127.56,3 RC,329,Cold agglutinin; screen ,,,33.47,43.13,3 RC,329,Cold agglutinin; titer ,,,33.47,43.13,3 RC,329,"Collagen cross links, any method ",,,76.68,98.82,3 RC,329,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,329,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,329,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,329,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,329,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,329,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,329,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,329,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,329,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,329,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,329,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,329,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,329,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,329,"Complement; antigen, each component ",,,48.8,62.89,3 RC,329,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,329,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,329,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,329,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,329,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,329,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,329,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,329,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,329,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,329,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,329,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,329,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,329,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,329,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,329,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,329,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,329,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,329,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,329,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,329,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,329,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,329,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,329,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,329,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,329,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,329,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,329,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,329,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,329,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,329,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,329,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,329,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,329,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,329,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,329,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,329,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,329,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,329,Copper ,,,51.57,66.46,3 RC,329,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,329,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,329,Corticosterone ,,,92.01,118.58,3 RC,329,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,329,Cortisol; free ,,,68.28,88.0,3 RC,329,Cortisol; total ,,,66.9,86.21,3 RC,329,Creatine ,,,19.53,25.17,3 RC,329,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,329,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,329,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,329,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,329,Creatinine; blood ,,,20.91,26.95,3 RC,329,Creatinine; clearance ,,,39.01,50.28,3 RC,329,Creatinine; other source ,,,20.91,26.95,3 RC,329,Cryofibrinogen ,,,58.54,75.44,3 RC,329,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,329,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,329,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,329,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,329,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,329,Cryopreservation; sperm ,,,442.57,570.33,3 RC,329,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,329,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,329,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,329,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,329,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,329,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,329,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,329,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,329,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,329,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,329,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,329,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,329,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,329,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,329,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,329,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,329,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,329,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,329,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,329,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,329,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,329,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,329,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,329,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,329,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,329,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,329,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,329,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,329,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,329,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,329,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,329,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,329,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,329,"Culture, typing; other methods ",,,32.04,41.29,3 RC,329,Cyanide ,,,79.46,102.39,3 RC,329,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,329,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,329,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,329,Cyclosporine ,,,73.87,95.19,3 RC,329,Cystatin C ,,,76.68,98.82,3 RC,329,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,329,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,329,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,329,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,329,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,329,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,329,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,329,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,329,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,329,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,329,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,329,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,329,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,329,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,329,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,329,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,329,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,329,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,329,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,329,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,329,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,329,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,329,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,329,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,329,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,329,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,329,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,329,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,329,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,329,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,329,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,329,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,329,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,329,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,329,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,329,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,329,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,329,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,329,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,329,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,329,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,329,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,329,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,329,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,329,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,329,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,329,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,329,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,329,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,329,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,329,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,329,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,329,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,329,Dibucaine number ,,,50.18,64.67,3 RC,329,Digoxin; free ,,,54.38,70.08,3 RC,329,Digoxin; total ,,,54.38,70.08,3 RC,329,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,329,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,329,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,329,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,329,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,329,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,329,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,329,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,329,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,329,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,329,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,329,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,329,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,329,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,329,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,329,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,329,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,329,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,329,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,329,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,329,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,329,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,329,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,329,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,329,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,329,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,329,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,329,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,329,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,329,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,329,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,329,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,329,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,329,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,329,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,329,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,329,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,329,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,329,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,329,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,329,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,329,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,329,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,329,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,329,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,329,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,329,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,329,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,329,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,329,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,329,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,329,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,329,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,329,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,329,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,329,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,329,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,329,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,329,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,329,Erythropoietin ,,,76.68,98.82,3 RC,329,Esophageal motility ,,,214.04,214.04,1 RC,329,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,329,Estradiol; total ,,,114.31,147.31,3 RC,329,Estriol ,,,98.98,127.56,3 RC,329,Estrogens; fractionated ,,,132.41,170.64,3 RC,329,Estrogens; total ,,,89.2,114.95,3 RC,329,Estrone ,,,103.14,132.92,3 RC,329,Ethosuximide ,,,66.9,86.21,3 RC,329,Ethylene glycol ,,,61.31,79.01,3 RC,329,Etiocholanolone ,,,107.34,138.33,3 RC,329,Euglobulin lysis ,,,34.86,44.92,3 RC,329,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,329,Everolimus ,,,57.16,73.66,3 RC,329,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,329,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,329,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,329,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,329,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,329,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,329,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,329,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,329,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,329,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,329,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,329,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,329,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,329,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,329,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,329,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,329,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,329,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,329,Factor inhibitor test ,,,52.96,68.24,3 RC,329,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,329,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,329,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,329,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,329,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,329,Felbamate ,,,76.68,98.82,3 RC,329,Fentanyl ,,,98.98,127.56,3 RC,329,Fern test ,,,40.44,52.12,3 RC,329,Ferritin ,,,55.77,71.87,3 RC,329,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,329,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,329,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,329,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,329,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,329,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,329,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,329,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,329,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,329,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,329,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,329,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,329,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,329,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,329,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,329,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,329,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,329,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,329,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,329,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,329,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,329,Fibrinogen; activity ,,,40.44,52.12,3 RC,329,Fibrinogen; antigen ,,,59.93,77.23,3 RC,329,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,329,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,329,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,329,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,329,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,329,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,329,Flecainide ,,,76.68,98.82,3 RC,329,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,329,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,329,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,329,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,329,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,329,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,329,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,329,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,329,Fluoride ,,,76.68,98.82,3 RC,329,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,329,Folic acid; RBC ,,,72.48,93.41,3 RC,329,Folic acid; serum ,,,59.93,77.23,3 RC,329,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,329,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,329,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,329,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,329,"Fructose, semen ",,,71.1,91.62,3 RC,329,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,329,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,329,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,329,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,329,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,329,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,329,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,329,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,329,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,329,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,329,"Galactokinase, RBC ",,,87.81,113.16,3 RC,329,Galactose ,,,45.98,59.26,3 RC,329,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,329,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,329,Galectin-3 ,,,182.6,235.31,3 RC,329,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,329,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,329,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,329,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,329,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,329,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,329,"Gases, blood, pH only ",,,44.6,57.47,3 RC,329,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,329,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,329,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,329,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,329,Gastric mucosa imaging ,,,205.51,205.51,1 RC,329,Gastrin ,,,72.48,93.41,3 RC,329,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,329,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,329,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,329,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,329,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,329,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,329,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,329,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,329,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,329,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,329,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,329,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,329,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,329,Gentamicin ,,,66.9,86.21,3 RC,329,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,329,Glucagon ,,,58.54,75.44,3 RC,329,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,329,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,329,Glucagon tolerance test ,,,72.48,93.41,3 RC,329,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,329,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,329,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,329,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,329,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,329,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,329,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,329,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,329,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,329,"Glucosidase, beta ",,,87.81,113.16,3 RC,329,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,329,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,329,Glutathione ,,,64.13,82.64,3 RC,329,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,329,Glycated protein ,,,68.28,88.0,3 RC,329,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,329,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,329,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,329,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,329,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,329,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,329,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,329,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,329,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,329,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,329,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,329,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,329,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,329,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,329,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,329,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,329,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,329,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,329,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,329,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,329,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,329,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,329,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,329,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,329,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,329,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,329,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,329,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,329,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,329,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,329,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,329,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,329,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,329,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,329,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,329,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,329,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,329,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,329,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,329,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,329,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,329,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,Haloperidol ,,,65.51,84.43,3 RC,329,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,329,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,329,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,329,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,329,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,329,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,329,Heinz bodies; direct ,,,16.71,21.54,3 RC,329,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,329,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,329,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,329,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,329,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,329,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,329,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,329,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,329,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,329,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,329,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,329,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,329,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,329,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,329,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,329,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,329,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,329,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,329,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,329,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,329,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,329,Hemoglobin; plasma ,,,30.66,39.51,3 RC,329,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,329,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,329,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,329,Hemoglobin; urine ,,,16.71,21.54,3 RC,329,"Hemolysin, acid ",,,36.24,46.7,3 RC,329,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,329,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,329,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,329,Heparin assay ,,,54.38,70.08,3 RC,329,Heparin neutralization ,,,48.8,62.89,3 RC,329,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,329,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,329,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,329,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,329,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,329,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,329,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,329,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,329,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,329,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,329,Hepatitis C antibody; ,,,58.54,75.44,3 RC,329,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,329,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,329,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,329,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,329,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,329,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,329,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,329,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,329,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,329,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,329,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,329,Heroin metabolite ,,,98.98,127.56,3 RC,329,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,329,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,329,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,329,Histamine ,,,121.28,156.3,3 RC,329,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,329,Homocysteine ,,,73.87,95.19,3 RC,329,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,329,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,329,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,329,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,329,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,329,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,329,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,329,Hydroxychloroquine ,,,76.68,98.82,3 RC,329,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,329,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,329,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,329,Hydroxyproline; free ,,,93.4,120.36,3 RC,329,Hydroxyproline; total ,,,100.37,129.34,3 RC,329,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,329,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,329,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,329,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,329,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,329,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,329,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,329,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,329,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,329,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,329,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,329,Immune complex assay ,,,100.37,129.34,3 RC,329,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,329,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,329,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,329,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,329,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,329,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,329,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,329,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,329,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,329,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,329,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,329,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,329,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,329,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,329,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,329,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,329,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,329,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,329,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,329,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,329,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,329,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,329,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,329,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,329,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,329,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,329,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,329,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,329,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,329,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,329,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,329,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,329,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,329,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,329,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,329,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,329,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,329,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,329,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,329,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,329,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,329,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,329,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,329,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,329,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,329,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,329,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,329,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,329,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,329,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,329,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,329,Infliximab ,,,158.91,204.79,3 RC,329,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,329,Inhibin A ,,,64.13,82.64,3 RC,329,Insemination of oocytes ,,,442.57,570.33,3 RC,329,Insulin antibodies ,,,87.81,113.16,3 RC,329,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,329,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,329,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,329,Insulin; free ,,,52.96,68.24,3 RC,329,Insulin; total ,,,47.41,61.1,3 RC,329,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,329,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,329,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,329,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,329,Intrinsic factor ,,,80.84,104.18,3 RC,329,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,329,Iron ,,,26.5,34.15,3 RC,329,Iron binding capacity ,,,36.24,46.7,3 RC,329,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,329,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,329,Islet cell antibody ,,,97.55,125.72,3 RC,329,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,329,Itraconazole ,,,111.5,143.69,3 RC,329,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,329,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,329,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,329,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,329,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,329,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,329,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,329,Ketamine and norketamine ,,,98.98,127.56,3 RC,329,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,329,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,329,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,329,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,329,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,329,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,329,Kidney imaging morphology; ,,,172.11,172.11,1 RC,329,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,329,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,329,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,329,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,329,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,329,Lacosamide ,,,111.5,143.69,3 RC,329,Lactate (lactic acid) ,,,47.41,61.1,3 RC,329,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,329,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,329,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,329,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,329,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,329,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,329,Lamotrigine ,,,54.38,70.08,3 RC,329,Lead ,,,50.18,64.67,3 RC,329,Leflunomide ,,,158.91,204.79,3 RC,329,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,329,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,329,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,329,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,329,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,329,Leukocyte transfusion ,,,305.26,393.39,3 RC,329,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,329,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,329,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,329,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,329,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,329,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,329,Levetiracetam ,,,54.38,70.08,3 RC,329,Lidocaine ,,,59.93,77.23,3 RC,329,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,329,Lipase ,,,27.89,35.94,3 RC,329,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,329,Lipoprotein (a) ,,,58.54,75.44,3 RC,329,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,329,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,329,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,329,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,329,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,329,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,329,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,329,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,329,Lithium ,,,27.89,35.94,3 RC,329,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,329,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,329,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,329,Liver imaging; static only ,,,191.2,191.2,1 RC,329,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,329,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,329,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,329,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,329,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,329,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,329,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,329,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,329,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,329,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,329,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,329,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,329,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,329,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,329,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,329,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,329,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,329,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,329,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,329,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,329,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,329,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,329,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,329,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,329,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,329,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,329,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,329,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,329,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,329,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,329,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,329,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,329,Magnesium ,,,27.89,35.94,3 RC,329,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,329,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,329,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,329,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,329,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,329,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,329,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,329,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,329,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,329,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,329,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,329,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,329,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,329,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,329,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,329,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,329,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,329,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,329,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,329,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,329,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,329,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,329,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,329,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,329,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,329,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,329,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,329,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,329,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,329,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,329,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,329,Malate dehydrogenase ,,,30.66,39.51,3 RC,329,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,329,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,329,Manganese ,,,110.11,141.9,3 RC,329,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,329,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,329,"Meat fibers, feces ",,,19.53,25.17,3 RC,329,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,329,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,329,"Mercury, quantitative ",,,66.9,86.21,3 RC,329,Metanephrines ,,,69.71,89.84,3 RC,329,Methadone ,,,98.98,127.56,3 RC,329,Methemalbumin ,,,44.6,57.47,3 RC,329,Methotrexate ,,,158.91,204.79,3 RC,329,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,329,Methylphenidate ,,,98.98,127.56,3 RC,329,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,329,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,329,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,329,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,329,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,329,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,329,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,329,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,329,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,329,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,329,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,329,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,329,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,329,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,329,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,329,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,329,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,329,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,329,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,329,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,329,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,329,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,329,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,329,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,329,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,329,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,329,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,329,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,329,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,329,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,329,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,329,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,329,Muramidase ,,,76.68,98.82,3 RC,329,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,329,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,329,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,329,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,329,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,329,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,329,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,329,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,329,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,329,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,329,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,329,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,329,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,329,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,329,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,329,Myoglobin ,,,52.96,68.24,3 RC,329,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,329,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,329,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,329,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,329,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,329,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,329,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,329,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,329,Natriuretic peptide ,,,161.68,208.36,3 RC,329,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,329,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,329,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,329,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,329,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,329,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,329,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,329,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,329,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,329,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,329,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,329,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,329,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,329,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,329,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,329,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,329,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,329,Nerve teasing preparations ,,,499.29,643.43,3 RC,329,"Neutralization test, viral ",,,69.71,89.84,3 RC,329,Nickel ,,,100.37,129.34,3 RC,329,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,329,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,329,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,329,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,329,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,329,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,329,Nucleotidase 5'- ,,,45.98,59.26,3 RC,329,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,329,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,329,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,329,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,329,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,329,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,329,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,329,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,329,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,329,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,329,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,329,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,329,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,329,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,329,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,329,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,329,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,329,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,329,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,329,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,329,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,329,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,329,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,329,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,329,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,329,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,329,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,329,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,329,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,329,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,329,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,329,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,329,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,329,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,329,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,329,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,329,"Opiates, 1 or more ",,,98.98,127.56,3 RC,329,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,329,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,329,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,329,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,329,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,329,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,329,Osmolality; blood ,,,27.89,35.94,3 RC,329,Osmolality; urine ,,,27.89,35.94,3 RC,329,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,329,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,329,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,329,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,329,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,329,Oxalate ,,,59.93,77.23,3 RC,329,Oxcarbazepine ,,,54.38,70.08,3 RC,329,Oxycodone ,,,98.98,127.56,3 RC,329,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,329,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,329,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,329,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,329,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,329,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,329,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,329,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,329,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,329,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,329,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,329,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,329,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,329,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,329,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,329,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,329,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,329,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,329,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,329,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,329,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,329,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,329,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,329,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,329,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,329,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,329,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,329,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,329,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,329,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,329,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,329,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,329,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,329,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,329,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,329,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,329,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,329,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,329,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,329,Phenobarbital ,,,62.74,80.85,3 RC,329,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,329,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,329,Phenytoin; free ,,,57.16,73.66,3 RC,329,Phenytoin; total ,,,54.38,70.08,3 RC,329,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,329,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,329,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,329,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,329,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,329,Phosphatidylglycerol ,,,68.28,88.0,3 RC,329,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,329,Phosphohexose isomerase ,,,44.6,57.47,3 RC,329,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,329,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,329,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,329,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,329,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,329,Pinworm examinations ,,,18.14,23.38,3 RC,329,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,329,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,329,Platelet survival study ,,,126.1,126.1,1 RC,329,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,329,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,329,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,329,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,329,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,329,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,329,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,329,Posaconazole ,,,111.5,143.69,3 RC,329,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,329,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,329,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,329,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,329,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,329,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,329,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,329,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,329,Potassium; urine ,,,19.53,25.17,3 RC,329,Prealbumin ,,,59.93,77.23,3 RC,329,Pregabalin ,,,98.98,127.56,3 RC,329,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,329,Pregnanediol ,,,87.81,113.16,3 RC,329,Pregnanetriol ,,,86.43,111.38,3 RC,329,Pregnenolone ,,,85.04,109.59,3 RC,329,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,329,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,329,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,329,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,329,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,329,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,329,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,329,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,329,Primidone ,,,68.28,88.0,3 RC,329,Procainamide; ,,,246.72,317.95,3 RC,329,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,329,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,329,Progesterone ,,,86.43,111.38,3 RC,329,Proinsulin ,,,110.11,141.9,3 RC,329,Prolactin ,,,79.46,102.39,3 RC,329,Propoxyphene ,,,98.98,127.56,3 RC,329,"Prostaglandin, each ",,,171.47,220.97,3 RC,329,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,329,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,329,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,329,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,329,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,329,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,329,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,329,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,329,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,329,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,329,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,329,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,329,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,329,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,329,Prothrombin time; ,,,18.14,23.38,3 RC,329,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,329,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,329,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,329,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,329,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,329,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,329,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,329,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,329,Pyruvate ,,,59.93,77.23,3 RC,329,Pyruvate kinase ,,,39.01,50.28,3 RC,329,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,329,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,329,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,329,Quinidine ,,,59.93,77.23,3 RC,329,Quinine ,,,47.41,61.1,3 RC,329,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,329,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,329,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,329,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,329,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,329,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,329,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,329,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,329,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,329,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,329,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,329,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,329,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,329,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,329,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,329,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,329,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,329,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,329,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,329,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,329,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,329,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,329,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,329,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,329,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,329,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,329,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,329,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,329,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,329,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,329,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,329,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,329,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,329,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,329,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,329,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,329,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,329,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,329,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,329,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,329,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,329,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,329,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,329,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,329,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,329,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,329,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,329,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,329,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,329,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,329,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,329,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,329,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,329,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,329,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,329,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,329,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,329,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,329,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,329,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,329,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,329,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,329,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,329,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,329,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,329,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,329,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,329,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,329,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,329,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,329,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,329,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,329,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,329,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,329,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,329,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,329,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,329,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,329,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,329,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,329,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,329,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,329,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,329,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,329,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,329,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,329,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,329,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,329,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,329,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,329,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,329,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,329,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,329,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,329,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,329,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,329,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,329,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,329,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,329,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,329,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,329,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,329,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,329,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,329,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,329,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,329,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,329,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,329,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,329,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,329,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,329,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,329,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,329,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,329,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,329,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,329,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,329,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,329,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,329,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,329,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,329,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,329,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,329,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,329,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,329,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,329,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,329,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,329,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,329,Receptor assay; estrogen ,,,361.04,465.26,3 RC,329,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,329,Receptor assay; progesterone ,,,266.25,343.11,3 RC,329,Red cell survival study ,,,126.1,126.1,1 RC,329,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,329,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,329,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,329,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,329,Renin ,,,90.63,116.79,3 RC,329,Reptilase test ,,,40.44,52.12,3 RC,329,Reticulated platelet assay ,,,146.35,188.6,3 RC,329,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,329,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,329,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,329,Rufinamide ,,,111.5,143.69,3 RC,329,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,329,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,329,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,329,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,329,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,329,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,329,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,329,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,329,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,329,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,329,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,329,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,329,Salicylate ,,,76.68,98.82,3 RC,329,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,329,Salivary gland function study ,,,104.3,104.3,1 RC,329,Salivary gland imaging; ,,,175.52,175.52,1 RC,329,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,329,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,329,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,329,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,329,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,329,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,329,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,329,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,329,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,329,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,329,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,329,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,329,Selenium ,,,104.53,134.7,3 RC,329,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,329,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,329,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,329,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,329,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,329,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,329,Serotonin ,,,126.87,163.49,3 RC,329,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,329,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,329,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,329,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,329,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,329,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,329,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,329,Sialic acid ,,,55.77,71.87,3 RC,329,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,329,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,329,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,329,Silica ,,,103.14,132.92,3 RC,329,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,329,Sirolimus ,,,57.16,73.66,3 RC,329,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,329,Skin test; candida ,,,79.46,102.39,3 RC,329,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,329,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,329,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,329,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,329,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,329,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,329,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,329,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,329,Sodium; other source ,,,19.53,25.17,3 RC,329,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,329,Sodium; urine ,,,20.91,26.95,3 RC,329,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,329,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,329,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,329,Somatomedin ,,,87.81,113.16,3 RC,329,Somatostatin ,,,75.26,96.98,3 RC,329,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,329,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,329,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,329,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,329,Specific gravity (except urine) ,,,13.94,17.97,3 RC,329,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,329,Sperm antibodies ,,,43.21,55.69,3 RC,329,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,329,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,329,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,329,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,329,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,329,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,329,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,329,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,329,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,329,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,329,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,329,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,329,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,329,"Stimulants, synthetic ",,,98.98,127.56,3 RC,329,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,329,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,329,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,329,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,329,"Streptokinase, antibody ",,,51.57,66.46,3 RC,329,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,329,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,329,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,329,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,329,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,329,"Sulfate, urine ",,,22.3,28.74,3 RC,329,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,329,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,329,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,329,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,329,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,329,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,329,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,329,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,329,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,329,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,329,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,329,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,329,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,329,T cells; total count ,,,154.71,199.37,3 RC,329,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,329,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,329,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,329,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,329,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,329,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,329,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,329,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,329,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,329,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,329,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,329,Tacrolimus ,,,57.16,73.66,3 RC,329,Tapentadol ,,,98.98,127.56,3 RC,329,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,329,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,329,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,329,Testosterone; free ,,,104.53,134.7,3 RC,329,Testosterone; total ,,,105.96,136.54,3 RC,329,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,329,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,329,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,329,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,329,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,329,Theophylline ,,,58.54,75.44,3 RC,329,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,329,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,329,Thiocyanate ,,,47.41,61.1,3 RC,329,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,329,Thrombin time; plasma ,,,23.69,30.52,3 RC,329,Thrombin time; titer ,,,27.89,35.94,3 RC,329,Thrombomodulin ,,,71.1,91.62,3 RC,329,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,329,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,329,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,329,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,329,Thyroglobulin ,,,65.51,84.43,3 RC,329,Thyroglobulin antibody ,,,65.51,84.43,3 RC,329,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,329,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,329,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,329,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,329,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,329,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,329,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,329,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,329,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,329,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,329,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,329,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,329,Thyroxine; free ,,,37.63,48.49,3 RC,329,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,329,Thyroxine; total ,,,27.89,35.94,3 RC,329,Tiagabine ,,,111.5,143.69,3 RC,329,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,329,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,329,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,329,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,329,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,329,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,329,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,329,Tobramycin ,,,66.9,86.21,3 RC,329,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,329,Topiramate ,,,48.8,62.89,3 RC,329,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,329,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,329,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,329,Tramadol ,,,98.98,127.56,3 RC,329,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,329,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,329,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,329,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,329,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,329,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,329,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,329,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,329,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,329,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,329,Transferrin ,,,52.96,68.24,3 RC,329,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,329,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,329,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,329,Triglycerides ,,,23.69,30.52,3 RC,329,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,329,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,329,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,329,"Troponin, qualitative ",,,41.83,53.9,3 RC,329,"Troponin, quantitative ",,,51.57,66.46,3 RC,329,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,329,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,329,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,329,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,329,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,329,Tyrosine ,,,43.21,55.69,3 RC,329,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,329,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,329,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,329,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,329,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,329,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,329,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,329,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,329,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,329,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,329,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,329,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,329,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,329,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,329,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,329,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,329,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,329,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,329,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,329,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,329,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,329,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,329,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,329,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,329,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,329,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,329,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,329,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,329,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,329,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,329,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,329,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,329,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,329,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,329,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,329,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,329,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,329,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,329,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,329,Unlisted immunology procedure ,,,99.55,128.28,3 RC,329,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,329,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,329,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,329,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,329,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,329,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,329,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,329,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,329,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,329,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,329,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,329,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,329,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,329,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,329,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,329,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,329,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,329,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,329,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,329,Uric acid; blood ,,,18.14,23.38,3 RC,329,Uric acid; other source ,,,20.91,26.95,3 RC,329,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,329,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,329,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,329,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,329,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,329,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,329,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,329,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,329,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,329,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,329,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,329,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,329,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,329,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,329,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,329,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,329,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,329,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,329,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,329,Vancomycin ,,,55.77,71.87,3 RC,329,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,329,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,329,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,329,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,329,Vedolizumab ,,,158.91,204.79,3 RC,329,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,329,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,329,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,329,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,329,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,329,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,329,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,329,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,329,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,329,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,329,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,329,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,329,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,329,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,329,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,329,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,329,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,329,Very long chain fatty acids ,,,80.84,104.18,3 RC,329,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,329,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,329,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,329,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,329,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,329,Viscosity ,,,47.41,61.1,3 RC,329,Vitamin A ,,,47.41,61.1,3 RC,329,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,329,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,329,Vitamin K ,,,55.77,71.87,3 RC,329,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,329,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,329,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,329,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,329,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,329,Voriconazole ,,,111.5,143.69,3 RC,329,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,329,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,329,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,329,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,329,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,329,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,329,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,329,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,329,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,329,Zinc ,,,47.41,61.1,3 RC,329,Zonisamide ,,,54.38,70.08,3 RC,329,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,329,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,329,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,330, Radiology - Therapeutic and/or Chemotherapy Administration General Classification ,,,1312.0,1873.0,2 RC,331, Radiology - Therapeutic and/or Chemotherapy Administration Chemotherapy Admin - Injected ,,,1173.0,2642.0,5 RC,332, Radiology - Therapeutic and/or Chemotherapy Administration Chemotherapy Admin - Oral ,,,1173.0,2642.0,5 RC,333, Radiology - Therapeutic and/or Chemotherapy Administration Radiation Therapy ,,,1312.0,32195.0,8 RC,333,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,10151.0,41580.0,6 RC,333,"Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based ",,,10151.0,41580.0,5 RC,333,"Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based ",,,10151.0,41580.0,6 RC,333,"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions ",,,7429.0,39710.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,10151.0,41580.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,10151.0,41580.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,10151.0,41580.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,10151.0,41580.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,10151.0,41580.0,6 RC,333,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,10151.0,41580.0,6 RC,335, Radiology - Therapeutic and/or Chemotherapy Administration Chemotherapy Admin - IV ,,,1173.0,2642.0,5 RC,339, Radiology - Therapeutic and/or Chemotherapy Administration Other ,,,1312.0,1873.0,2 RC,339,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,339,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,339,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,339,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,339,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,339,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,339,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,339,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,339,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,339,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,339,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,339,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,339,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,339,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,339,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,339,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,Acetaminophen ,,,76.68,98.82,3 RC,339,Acetylcholinesterase ,,,50.18,64.67,3 RC,339,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,339,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,339,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,339,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,339,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,339,Adalimumab ,,,158.91,204.79,3 RC,339,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,339,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,339,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,339,Albumin; ischemia modified ,,,139.38,179.62,3 RC,339,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,339,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,339,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,339,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,339,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,339,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,339,Alcohols ,,,98.98,127.56,3 RC,339,Aldolase ,,,40.44,52.12,3 RC,339,Aldosterone ,,,167.27,215.56,3 RC,339,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,339,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,339,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,339,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,339,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,339,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,339,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,339,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,339,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,339,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,339,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,339,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,339,Aluminum ,,,104.53,134.7,3 RC,339,Amikacin ,,,62.74,80.85,3 RC,339,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,339,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,339,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,339,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,339,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,339,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,339,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,339,Amiodarone ,,,76.68,98.82,3 RC,339,Ammonia ,,,59.93,77.23,3 RC,339,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,339,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,339,Amylase ,,,26.5,34.15,3 RC,339,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,339,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,339,Androstanediol glucuronide ,,,118.47,152.67,3 RC,339,Androstenedione ,,,119.9,154.51,3 RC,339,Androsterone ,,,104.53,134.7,3 RC,339,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,158.49,203.89,3 RC,339,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,394.68,507.75,3 RC,339,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,359.47,462.45,3 RC,339,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,260.47,335.09,3 RC,339,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,250.74,322.57,3 RC,339,"Angiography, internal mammary, radiological supervision and interpretation ",,,388.61,499.94,3 RC,339,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,330.37,425.01,3 RC,339,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,262.88,338.19,3 RC,339,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,299.3,385.04,3 RC,339,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,258.02,331.93,3 RC,339,"Angiography, spinal, selective, radiological supervision and interpretation ",,,484.48,623.27,3 RC,339,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,282.3,363.17,3 RC,339,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,339,Angiotensin II ,,,85.04,109.59,3 RC,339,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,339,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,339,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,339,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,339,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,339,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,339,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,339,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,339,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,339,Antibody; Aspergillus ,,,61.31,79.01,3 RC,339,Antibody; Bartonella ,,,41.83,53.9,3 RC,339,Antibody; Blastomyces ,,,52.96,68.24,3 RC,339,Antibody; Bordetella ,,,54.38,70.08,3 RC,339,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,339,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,339,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,339,Antibody; Brucella ,,,36.24,46.7,3 RC,339,Antibody; Campylobacter ,,,54.38,70.08,3 RC,339,Antibody; Candida ,,,48.8,62.89,3 RC,339,Antibody; Chlamydia ,,,48.8,62.89,3 RC,339,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,339,Antibody; Coccidioides ,,,47.41,61.1,3 RC,339,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,339,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,339,Antibody; Diphtheria ,,,62.74,80.85,3 RC,339,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,339,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,339,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,339,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,339,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,339,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,339,Antibody; HIV-1 ,,,36.24,46.7,3 RC,339,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,339,Antibody; HIV-2 ,,,55.77,71.87,3 RC,339,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,339,Antibody; HTLV-I ,,,37.63,48.49,3 RC,339,Antibody; HTLV-II ,,,57.16,73.66,3 RC,339,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,339,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,339,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,339,Antibody; Legionella ,,,62.74,80.85,3 RC,339,Antibody; Leishmania ,,,50.18,64.67,3 RC,339,Antibody; Leptospira ,,,66.9,86.21,3 RC,339,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,339,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,339,Antibody; Nocardia ,,,65.51,84.43,3 RC,339,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,339,Antibody; Rickettsia ,,,79.46,102.39,3 RC,339,Antibody; Salmonella ,,,54.38,70.08,3 RC,339,Antibody; Shigella ,,,100.37,129.34,3 RC,339,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,339,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,339,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,339,Antibody; Trichinella ,,,51.57,66.46,3 RC,339,Antibody; West Nile virus ,,,58.54,75.44,3 RC,339,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,339,Antibody; Yersinia ,,,54.38,70.08,3 RC,339,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,339,Antibody; actinomyces ,,,41.83,53.9,3 RC,339,Antibody; adenovirus ,,,52.96,68.24,3 RC,339,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,339,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,339,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,339,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,339,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,339,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,339,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,339,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,339,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,339,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,339,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,339,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,339,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,339,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,339,Antibody; histoplasma ,,,57.16,73.66,3 RC,339,Antibody; influenza virus ,,,55.77,71.87,3 RC,339,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,339,Antibody; mucormycosis ,,,61.31,79.01,3 RC,339,Antibody; mumps ,,,54.38,70.08,3 RC,339,Antibody; mycoplasma ,,,54.38,70.08,3 RC,339,Antibody; parvovirus ,,,61.31,79.01,3 RC,339,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,339,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,339,Antibody; rotavirus ,,,75.26,96.98,3 RC,339,Antibody; rubella ,,,58.54,75.44,3 RC,339,Antibody; rubeola ,,,52.96,68.24,3 RC,339,Antibody; tetanus ,,,61.31,79.01,3 RC,339,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,339,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,339,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,339,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,339,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,339,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,339,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,339,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,339,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,339,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,339,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,339,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,339,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,339,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,339,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,339,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,339,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,339,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,234.0,301.04,3 RC,339,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,218.21,280.72,3 RC,339,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,247.09,317.87,3 RC,339,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,586.91,755.05,3 RC,339,"Apolipoprotein, each ",,,86.43,111.38,3 RC,339,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,339,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,339,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,339,Arsenic ,,,78.07,100.61,3 RC,339,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,339,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,339,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,339,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,339,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,339,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,339,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,339,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,339,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,339,"B cells, total count ",,,154.71,199.37,3 RC,339,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,339,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,339,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,339,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,339,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,339,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,339,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,339,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,339,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,339,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,339,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,339,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,339,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,339,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,339,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,339,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,339,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,339,Barbiturates ,,,98.98,127.56,3 RC,339,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,339,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,339,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,339,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,339,Beta-2 microglobulin ,,,66.9,86.21,3 RC,339,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,339,Bile acids; total ,,,71.1,91.62,3 RC,339,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,339,Bilirubin; direct ,,,20.91,26.95,3 RC,339,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,339,Bilirubin; total ,,,20.91,26.95,3 RC,339,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,339,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,339,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,339,Bleeding time ,,,19.53,25.17,3 RC,339,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,339,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,339,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,339,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,339,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,339,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,339,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,339,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,339,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,339,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,339,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,339,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,339,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,339,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,339,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,339,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,339,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,339,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,339,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,339,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,339,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,339,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,339,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,339,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,339,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,339,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,339,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,339,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,339,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,339,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,339,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,339,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,339,Bone age studies ,,,61.64,79.3,3 RC,339,"Bone length studies (orthoroentgenogram, scanogram) ",,,116.27,149.57,3 RC,339,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,339,Bradykinin ,,,20.91,26.95,3 RC,339,C-peptide ,,,85.04,109.59,3 RC,339,C-reactive protein; ,,,20.91,26.95,3 RC,339,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,339,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,339,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,339,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,339,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,339,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,339,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,339,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,339,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,339,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,339,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,339,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,339,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,339,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,339,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,339,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,339,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,339,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,339,Cadmium ,,,97.55,125.72,3 RC,339,Caffeine ,,,158.91,204.79,3 RC,339,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,339,Calcitonin ,,,110.11,141.9,3 RC,339,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,339,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,339,Calcium; ionized ,,,55.77,71.87,3 RC,339,Calcium; total ,,,20.91,26.95,3 RC,339,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,339,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,339,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,339,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,339,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,339,"Calprotectin, fecal ",,,80.84,104.18,3 RC,339,"Cannabinoids, natural ",,,98.98,127.56,3 RC,339,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,339,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,339,Carbamazepine; free ,,,54.38,70.08,3 RC,339,Carbamazepine; total ,,,59.93,77.23,3 RC,339,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,339,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,339,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,339,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,339,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,339,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,339,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,339,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,339,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,339,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,339,Carotene ,,,37.63,48.49,3 RC,339,Catecholamines; blood ,,,119.9,154.51,3 RC,339,Catecholamines; fractionated ,,,104.53,134.7,3 RC,339,Catecholamines; total urine ,,,112.93,145.53,3 RC,339,Cathepsin-D ,,,73.87,95.19,3 RC,339,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,339,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,339,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,339,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,339,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,339,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,339,"Cephalogram, orthodontic ",,,28.88,37.15,3 RC,339,Ceruloplasmin ,,,44.6,57.47,3 RC,339,Chemiluminescent assay ,,,58.54,75.44,3 RC,339,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,339,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,339,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,339,Chloramphenicol ,,,51.57,66.46,3 RC,339,Chloride; blood ,,,19.53,25.17,3 RC,339,Chloride; other source ,,,20.91,26.95,3 RC,339,Chloride; urine ,,,23.69,30.52,3 RC,339,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,339,"Cholecystography, oral contrast ",,,261.9,336.93,3 RC,339,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,339,Cholinesterase; RBC ,,,40.44,52.12,3 RC,339,Cholinesterase; serum ,,,32.04,41.29,3 RC,339,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,339,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,339,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,339,Chromium ,,,83.66,107.81,3 RC,339,Chromogenic substrate assay ,,,48.8,62.89,3 RC,339,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,339,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,339,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,339,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,339,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,339,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,339,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,339,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,339,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,339,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,339,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,339,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,339,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,339,"Cineradiography/videoradiography, except where specifically included ",,,357.77,460.26,3 RC,339,"Cisternography, positive contrast, radiological supervision and interpretation ",,,408.78,525.89,3 RC,339,Citrate ,,,114.31,147.31,3 RC,339,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,339,Clot retraction ,,,66.9,86.21,3 RC,339,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,339,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,339,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,339,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,339,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,339,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,339,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,339,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,339,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,339,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,339,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,339,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,339,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,339,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,339,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,339,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,339,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,339,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,339,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,339,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,339,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,339,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,339,Clozapine ,,,82.23,105.96,3 RC,339,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,339,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,339,Coagulation time; activated ,,,18.14,23.38,3 RC,339,Coagulation time; other methods ,,,18.14,23.38,3 RC,339,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,339,Cocaine ,,,98.98,127.56,3 RC,339,Cold agglutinin; screen ,,,33.47,43.13,3 RC,339,Cold agglutinin; titer ,,,33.47,43.13,3 RC,339,"Collagen cross links, any method ",,,76.68,98.82,3 RC,339,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,339,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,339,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,339,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,339,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,339,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,339,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,339,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,339,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,339,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,339,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,339,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,339,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,339,"Complement; antigen, each component ",,,48.8,62.89,3 RC,339,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,339,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,339,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,339,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,387.9,499.02,3 RC,339,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,339,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,246.14,316.66,3 RC,339,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,339,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,339,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,339,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,339,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,339,Copper ,,,51.57,66.46,3 RC,339,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,339,"Corpora cavernosography, radiological supervision and interpretation ",,,141.75,182.36,3 RC,339,Corticosterone ,,,92.01,118.58,3 RC,339,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,339,Cortisol; free ,,,68.28,88.0,3 RC,339,Cortisol; total ,,,66.9,86.21,3 RC,339,Creatine ,,,19.53,25.17,3 RC,339,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,339,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,339,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,339,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,339,Creatinine; blood ,,,20.91,26.95,3 RC,339,Creatinine; clearance ,,,39.01,50.28,3 RC,339,Creatinine; other source ,,,20.91,26.95,3 RC,339,Cryofibrinogen ,,,58.54,75.44,3 RC,339,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,339,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,339,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,339,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,339,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,339,Cryopreservation; sperm ,,,442.57,570.33,3 RC,339,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,339,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,339,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,339,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,339,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,339,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,339,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,339,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,339,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,339,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,339,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,339,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,339,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,339,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,339,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,339,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,339,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,339,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,339,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,339,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,339,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,339,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,339,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,339,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,339,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,339,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,339,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,339,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,339,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,339,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,339,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,339,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,339,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,339,"Culture, typing; other methods ",,,32.04,41.29,3 RC,339,Cyanide ,,,79.46,102.39,3 RC,339,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,339,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,339,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,339,Cyclosporine ,,,73.87,95.19,3 RC,339,Cystatin C ,,,76.68,98.82,3 RC,339,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,339,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,95.64,123.04,3 RC,339,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,339,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,339,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,339,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,339,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,339,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,339,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,339,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,339,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,339,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,339,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,339,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,339,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,339,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,339,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,339,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,339,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,339,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,339,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,339,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,339,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,339,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,339,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,339,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,339,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,339,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,339,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,339,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,339,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,339,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,339,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,339,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,339,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,339,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,339,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,339,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,339,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,339,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,126.22,162.38,3 RC,339,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,339,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,339,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,339,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,339,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,339,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,339,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,339,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,339,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,339,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,339,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,339,Dibucaine number ,,,50.18,64.67,3 RC,339,Digoxin; free ,,,54.38,70.08,3 RC,339,Digoxin; total ,,,54.38,70.08,3 RC,339,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,339,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,293.46,377.52,3 RC,339,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,267.97,344.74,3 RC,339,"Discography, lumbar, radiological supervision and interpretation ",,,260.7,335.38,3 RC,339,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,339,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,339,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,339,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,339,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,339,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,339,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,339,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,339,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,78.64,101.17,3 RC,339,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,104.13,133.96,3 RC,339,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,135.68,174.55,3 RC,339,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,519.69,668.57,3 RC,339,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,342.99,441.25,3 RC,339,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,339,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,339,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,768.48,988.62,3 RC,339,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,440.07,566.14,3 RC,339,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,208.52,268.25,3 RC,339,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,178.17,229.21,3 RC,339,Duplex scan of extracranial arteries; complete bilateral study ,,,557.32,716.98,3 RC,339,Duplex scan of extracranial arteries; unilateral or limited study ,,,364.82,469.33,3 RC,339,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,565.8,727.89,3 RC,339,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,357.55,459.97,3 RC,339,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,448.55,577.05,3 RC,339,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,739.37,951.18,3 RC,339,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,437.66,563.04,3 RC,339,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,575.53,740.4,3 RC,339,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,366.03,470.89,3 RC,339,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,339,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,339,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,339,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,339,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,339,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,339,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,339,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,339,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,339,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,339,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,339,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,339,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,339,Erythropoietin ,,,76.68,98.82,3 RC,339,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,339,Estradiol; total ,,,114.31,147.31,3 RC,339,Estriol ,,,98.98,127.56,3 RC,339,Estrogens; fractionated ,,,132.41,170.64,3 RC,339,Estrogens; total ,,,89.2,114.95,3 RC,339,Estrone ,,,103.14,132.92,3 RC,339,Ethosuximide ,,,66.9,86.21,3 RC,339,Ethylene glycol ,,,61.31,79.01,3 RC,339,Etiocholanolone ,,,107.34,138.33,3 RC,339,Euglobulin lysis ,,,34.86,44.92,3 RC,339,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,339,Everolimus ,,,57.16,73.66,3 RC,339,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,339,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,339,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,339,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,339,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,339,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,339,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,339,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,339,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,339,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,339,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,339,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,339,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,339,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,339,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,339,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,339,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,339,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,339,Factor inhibitor test ,,,52.96,68.24,3 RC,339,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,339,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,339,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,339,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,339,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,339,Felbamate ,,,76.68,98.82,3 RC,339,Fentanyl ,,,98.98,127.56,3 RC,339,Fern test ,,,40.44,52.12,3 RC,339,Ferritin ,,,55.77,71.87,3 RC,339,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,339,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,339,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,339,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,339,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,339,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,339,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,339,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,339,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,339,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,339,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,339,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,339,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,339,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,339,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,339,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,339,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,339,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,339,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,339,Fibrinogen; activity ,,,40.44,52.12,3 RC,339,Fibrinogen; antigen ,,,59.93,77.23,3 RC,339,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,339,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,339,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,339,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,339,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,339,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,339,Flecainide ,,,76.68,98.82,3 RC,339,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,339,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,339,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,339,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,339,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,339,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,339,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,339,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,339,Fluoride ,,,76.68,98.82,3 RC,339,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,101.71,130.85,3 RC,339,Folic acid; RBC ,,,72.48,93.41,3 RC,339,Folic acid; serum ,,,59.93,77.23,3 RC,339,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,339,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,339,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,339,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,339,"Fructose, semen ",,,71.1,91.62,3 RC,339,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,339,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,339,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,339,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,339,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,339,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,339,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,339,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,339,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,339,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,339,"Galactokinase, RBC ",,,87.81,113.16,3 RC,339,Galactose ,,,45.98,59.26,3 RC,339,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,339,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,339,Galectin-3 ,,,182.6,235.31,3 RC,339,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,339,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,339,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,339,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,339,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,339,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,339,"Gases, blood, pH only ",,,44.6,57.47,3 RC,339,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,339,Gastrin ,,,72.48,93.41,3 RC,339,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,339,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,339,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,339,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,339,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,339,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,339,Gentamicin ,,,66.9,86.21,3 RC,339,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,339,Glucagon ,,,58.54,75.44,3 RC,339,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,339,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,339,Glucagon tolerance test ,,,72.48,93.41,3 RC,339,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,339,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,339,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,339,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,339,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,339,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,339,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,339,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,339,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,339,"Glucosidase, beta ",,,87.81,113.16,3 RC,339,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,339,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,339,Glutathione ,,,64.13,82.64,3 RC,339,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,339,Glycated protein ,,,68.28,88.0,3 RC,339,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,339,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,339,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,339,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,339,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,339,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,339,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,339,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,339,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,339,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,339,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,339,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,339,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,339,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,339,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,339,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,339,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,339,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,339,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,339,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,339,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,339,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,339,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,339,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,339,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,339,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,339,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,339,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,339,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,339,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,339,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,339,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,339,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,339,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,339,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,339,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,339,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,339,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,339,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,339,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,339,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,339,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,Haloperidol ,,,65.51,84.43,3 RC,339,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,339,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,339,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,339,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,339,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,339,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,339,Heinz bodies; direct ,,,16.71,21.54,3 RC,339,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,339,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,339,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,339,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,339,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,339,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,339,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,339,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,339,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,339,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,339,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,339,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,339,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,339,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,339,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,339,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,339,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,339,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,339,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,339,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,339,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,339,Hemoglobin; plasma ,,,30.66,39.51,3 RC,339,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,339,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,339,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,339,Hemoglobin; urine ,,,16.71,21.54,3 RC,339,"Hemolysin, acid ",,,36.24,46.7,3 RC,339,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,339,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,339,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,339,Heparin assay ,,,54.38,70.08,3 RC,339,Heparin neutralization ,,,48.8,62.89,3 RC,339,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,339,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,339,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,264.09,339.74,3 RC,339,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,265.29,341.29,3 RC,339,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,339,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,339,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,339,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,339,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,339,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,339,Hepatitis C antibody; ,,,58.54,75.44,3 RC,339,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,339,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,339,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,339,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,339,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,339,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,339,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,339,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,339,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,339,Heroin metabolite ,,,98.98,127.56,3 RC,339,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,339,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,339,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,339,Histamine ,,,121.28,156.3,3 RC,339,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,339,Homocysteine ,,,73.87,95.19,3 RC,339,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,339,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,339,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,339,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,339,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,339,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,339,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,339,Hydroxychloroquine ,,,76.68,98.82,3 RC,339,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,339,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,339,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,339,Hydroxyproline; free ,,,93.4,120.36,3 RC,339,Hydroxyproline; total ,,,100.37,129.34,3 RC,339,"Hysterosalpingography, radiological supervision and interpretation ",,,283.77,365.06,3 RC,339,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,339,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,339,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,339,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,339,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,339,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,339,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,339,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,339,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,339,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,339,Immune complex assay ,,,100.37,129.34,3 RC,339,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,339,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,339,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,339,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,339,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,339,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,339,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,339,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,339,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,339,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,339,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,339,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,339,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,339,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,339,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,339,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,339,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,339,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,339,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,339,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,339,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,339,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,339,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,339,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,339,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,339,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,339,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,339,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,339,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,339,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,339,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,339,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,339,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,339,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,339,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,339,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,339,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,339,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,339,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,339,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,339,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,339,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,339,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,339,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,339,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,339,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,339,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,339,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,339,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,339,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,339,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,339,Infliximab ,,,158.91,204.79,3 RC,339,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,339,Inhibin A ,,,64.13,82.64,3 RC,339,Insemination of oocytes ,,,442.57,570.33,3 RC,339,Insulin antibodies ,,,87.81,113.16,3 RC,339,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,339,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,339,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,339,Insulin; free ,,,52.96,68.24,3 RC,339,Insulin; total ,,,47.41,61.1,3 RC,339,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,339,Intrinsic factor ,,,80.84,104.18,3 RC,339,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,339,Iron ,,,26.5,34.15,3 RC,339,Iron binding capacity ,,,36.24,46.7,3 RC,339,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,339,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,339,Islet cell antibody ,,,97.55,125.72,3 RC,339,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,339,Itraconazole ,,,111.5,143.69,3 RC,339,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,339,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,339,"Joint survey, single view, 2 or more joints (specify) ",,,111.4,143.32,3 RC,339,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,339,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,339,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,339,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,339,Ketamine and norketamine ,,,98.98,127.56,3 RC,339,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,339,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,339,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,339,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,339,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,339,Lacosamide ,,,111.5,143.69,3 RC,339,Lactate (lactic acid) ,,,47.41,61.1,3 RC,339,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,339,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,339,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,339,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,339,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,339,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,339,Lamotrigine ,,,54.38,70.08,3 RC,339,Lead ,,,50.18,64.67,3 RC,339,Leflunomide ,,,158.91,204.79,3 RC,339,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,339,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,339,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,339,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,339,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,339,Leukocyte transfusion ,,,305.26,393.39,3 RC,339,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,339,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,339,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,339,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,339,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,339,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,339,Levetiracetam ,,,54.38,70.08,3 RC,339,Lidocaine ,,,59.93,77.23,3 RC,339,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,339,Lipase ,,,27.89,35.94,3 RC,339,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,339,Lipoprotein (a) ,,,58.54,75.44,3 RC,339,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,339,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,339,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,339,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,339,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,339,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,339,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,339,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,339,Lithium ,,,27.89,35.94,3 RC,339,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,339,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,707.78,910.54,3 RC,339,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,733.98,944.25,3 RC,339,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,749.78,964.57,3 RC,339,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,783.26,1007.64,3 RC,339,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,339,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,339,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,339,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,339,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,339,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,339,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,339,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,339,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,339,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,339,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,339,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,339,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,339,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,339,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,339,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,339,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,339,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,339,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,339,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,339,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,339,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,339,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,339,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,339,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,339,Magnesium ,,,27.89,35.94,3 RC,339,Malate dehydrogenase ,,,30.66,39.51,3 RC,339,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,174.51,224.51,3 RC,339,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,132.06,169.9,3 RC,339,Manganese ,,,110.11,141.9,3 RC,339,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,297.19,382.33,3 RC,339,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,339,"Meat fibers, feces ",,,19.53,25.17,3 RC,339,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,339,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,339,"Mercury, quantitative ",,,66.9,86.21,3 RC,339,Metanephrines ,,,69.71,89.84,3 RC,339,Methadone ,,,98.98,127.56,3 RC,339,Methemalbumin ,,,44.6,57.47,3 RC,339,Methotrexate ,,,158.91,204.79,3 RC,339,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,339,Methylphenidate ,,,98.98,127.56,3 RC,339,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,339,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,339,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,339,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,339,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,339,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,339,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,339,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,339,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,339,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,339,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,339,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,339,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,339,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,339,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,339,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,339,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,339,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,339,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,339,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,339,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,339,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,339,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,339,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,339,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,339,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,339,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,339,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,339,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,339,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,339,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,339,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,339,Muramidase ,,,76.68,98.82,3 RC,339,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,339,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,339,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,339,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,339,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,361.43,464.97,3 RC,339,"Myelography, cervical, radiological supervision and interpretation ",,,258.28,332.27,3 RC,339,"Myelography, lumbosacral, radiological supervision and interpretation ",,,255.83,329.12,3 RC,339,"Myelography, posterior fossa, radiological supervision and interpretation ",,,160.22,206.12,3 RC,339,"Myelography, thoracic, radiological supervision and interpretation ",,,269.18,346.29,3 RC,339,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,339,Myoglobin ,,,52.96,68.24,3 RC,339,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,339,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,339,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,339,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,339,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,339,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,339,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,339,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,339,Natriuretic peptide ,,,161.68,208.36,3 RC,339,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,339,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,339,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,339,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,339,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,339,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,339,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,339,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,339,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,339,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,339,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,339,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,339,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,339,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,339,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,339,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,339,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,339,Nerve teasing preparations ,,,499.29,643.43,3 RC,339,"Neutralization test, viral ",,,69.71,89.84,3 RC,339,Nickel ,,,100.37,129.34,3 RC,339,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,339,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,485.69,624.83,3 RC,339,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,339,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,339,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,339,Nucleotidase 5'- ,,,45.98,59.26,3 RC,339,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,339,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,339,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,339,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,339,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,339,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,339,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,339,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,339,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,339,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,339,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,339,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,339,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,339,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,339,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,339,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,339,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,339,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,339,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,339,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,339,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,339,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,339,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,339,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,339,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,339,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,339,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,339,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,339,"Opiates, 1 or more ",,,98.98,127.56,3 RC,339,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,339,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,339,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,339,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,339,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,339,"Orthopantogram (eg, panoramic x-ray) ",,,30.08,38.7,3 RC,339,Osmolality; blood ,,,27.89,35.94,3 RC,339,Osmolality; urine ,,,27.89,35.94,3 RC,339,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,339,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,339,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,339,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,339,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,339,Oxalate ,,,59.93,77.23,3 RC,339,Oxcarbazepine ,,,54.38,70.08,3 RC,339,Oxycodone ,,,98.98,127.56,3 RC,339,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,339,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,339,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,339,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,339,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,339,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,339,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,339,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,339,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,339,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,339,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,339,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,339,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,339,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,339,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,339,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,339,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,339,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,339,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,339,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,339,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,339,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,339,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,339,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,339,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,339,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,339,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,339,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,339,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,339,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,339,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,262.88,338.19,3 RC,339,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,266.5,342.85,3 RC,339,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,3 RC,339,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,339,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,118.94,153.02,3 RC,339,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,339,Phenobarbital ,,,62.74,80.85,3 RC,339,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,339,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,339,Phenytoin; free ,,,57.16,73.66,3 RC,339,Phenytoin; total ,,,54.38,70.08,3 RC,339,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,339,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,339,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,339,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,339,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,339,Phosphatidylglycerol ,,,68.28,88.0,3 RC,339,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,339,Phosphohexose isomerase ,,,44.6,57.47,3 RC,339,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,339,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,339,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,339,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,339,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,339,Pinworm examinations ,,,18.14,23.38,3 RC,339,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,339,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,339,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,339,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,339,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,339,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,339,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,339,Posaconazole ,,,111.5,143.69,3 RC,339,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,339,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,339,Potassium; urine ,,,19.53,25.17,3 RC,339,Prealbumin ,,,59.93,77.23,3 RC,339,Pregabalin ,,,98.98,127.56,3 RC,339,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,339,Pregnanediol ,,,87.81,113.16,3 RC,339,Pregnanetriol ,,,86.43,111.38,3 RC,339,Pregnenolone ,,,85.04,109.59,3 RC,339,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,339,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,339,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,339,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,339,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,339,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,339,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,339,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,339,Primidone ,,,68.28,88.0,3 RC,339,Procainamide; ,,,246.72,317.95,3 RC,339,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,339,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,339,Progesterone ,,,86.43,111.38,3 RC,339,Proinsulin ,,,110.11,141.9,3 RC,339,Prolactin ,,,79.46,102.39,3 RC,339,Propoxyphene ,,,98.98,127.56,3 RC,339,"Prostaglandin, each ",,,171.47,220.97,3 RC,339,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,339,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,339,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,339,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,339,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,339,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,339,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,339,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,339,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,339,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,339,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,339,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,339,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,339,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,339,Prothrombin time; ,,,18.14,23.38,3 RC,339,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,339,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,339,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,339,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,339,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,339,Pyruvate ,,,59.93,77.23,3 RC,339,Pyruvate kinase ,,,39.01,50.28,3 RC,339,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,339,Quinidine ,,,59.93,77.23,3 RC,339,Quinine ,,,47.41,61.1,3 RC,339,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,339,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,3 RC,339,"Radiologic examination, abdomen; 1 view ",,,77.44,99.62,3 RC,339,"Radiologic examination, abdomen; 2 views ",,,94.44,121.49,3 RC,339,"Radiologic examination, abdomen; 3 or more views ",,,110.2,141.77,3 RC,339,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,128.41,165.19,3 RC,339,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,374.78,482.14,3 RC,339,"Radiologic examination, ankle; 2 views ",,,89.58,115.24,3 RC,339,"Radiologic examination, ankle; complete, minimum of 3 views ",,,104.13,133.96,3 RC,339,"Radiologic examination, chest; 2 views ",,,84.71,108.98,3 RC,339,"Radiologic examination, chest; 3 views ",,,106.54,137.06,3 RC,339,"Radiologic examination, chest; 4 or more views ",,,115.06,148.02,3 RC,339,"Radiologic examination, chest; single view ",,,62.88,80.9,3 RC,339,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,600.3,772.27,3 RC,339,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,389.33,500.86,3 RC,339,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,125.99,162.09,3 RC,339,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,309.25,397.85,3 RC,339,"Radiologic examination, elbow; 2 views ",,,77.44,99.62,3 RC,339,"Radiologic examination, elbow; complete, minimum of 3 views ",,,88.37,113.68,3 RC,339,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,287.39,369.72,3 RC,339,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,258.28,332.27,3 RC,339,"Radiologic examination, eye, for detection of foreign body ",,,87.12,112.08,3 RC,339,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,125.99,162.09,3 RC,339,"Radiologic examination, facial bones; less than 3 views ",,,82.3,105.88,3 RC,339,"Radiologic examination, femur; 1 view ",,,77.44,99.62,3 RC,339,"Radiologic examination, femur; minimum 2 views ",,,98.06,126.15,3 RC,339,"Radiologic examination, finger(s), minimum of 2 views ",,,113.85,146.47,3 RC,339,"Radiologic examination, foot; 2 views ",,,76.23,98.07,3 RC,339,"Radiologic examination, foot; complete, minimum of 3 views ",,,95.64,123.04,3 RC,339,"Radiologic examination, hand; 2 views ",,,84.71,108.98,3 RC,339,"Radiologic examination, hand; minimum of 3 views ",,,104.13,133.96,3 RC,339,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,375.98,483.69,3 RC,339,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,87.12,112.08,3 RC,339,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,132.06,169.9,3 RC,339,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,168.44,216.7,3 RC,339,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,111.4,143.32,3 RC,339,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,144.16,185.46,3 RC,339,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,170.89,219.85,3 RC,339,"Radiologic examination, internal auditory meati, complete ",,,162.37,208.89,3 RC,339,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,356.57,458.71,3 RC,339,"Radiologic examination, knee; 1 or 2 views ",,,95.64,123.04,3 RC,339,"Radiologic examination, knee; 3 views ",,,115.06,148.02,3 RC,339,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,115.06,148.02,3 RC,339,"Radiologic examination, knee; complete, 4 or more views ",,,129.61,166.74,3 RC,339,"Radiologic examination, mandible; complete, minimum of 4 views ",,,115.06,148.02,3 RC,339,"Radiologic examination, mandible; partial, less than 4 views ",,,108.99,140.21,3 RC,339,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,168.44,216.7,3 RC,339,"Radiologic examination, mastoids; less than 3 views per side ",,,108.99,140.21,3 RC,339,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,108.99,140.21,3 RC,339,"Radiologic examination, osseous survey, infant ",,,270.16,347.55,3 RC,339,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,267.75,344.45,3 RC,339,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,161.17,207.34,3 RC,339,"Radiologic examination, pelvis; 1 or 2 views ",,,71.37,91.81,3 RC,339,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,110.2,141.77,3 RC,339,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,252.21,324.47,3 RC,339,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,159.7,205.45,3 RC,339,"Radiologic examination, ribs, bilateral; 3 views ",,,110.2,141.77,3 RC,339,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,135.68,174.55,3 RC,339,"Radiologic examination, ribs, unilateral; 2 views ",,,95.64,123.04,3 RC,339,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,107.78,138.66,3 RC,339,"Radiologic examination, sacroiliac joints; 3 or more views ",,,104.13,133.96,3 RC,339,"Radiologic examination, sacroiliac joints; less than 3 views ",,,90.78,116.79,3 RC,339,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,88.37,113.68,3 RC,339,"Radiologic examination, salivary gland for calculus ",,,107.78,138.66,3 RC,339,"Radiologic examination, sella turcica ",,,87.12,112.08,3 RC,339,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,383.26,493.05,3 RC,339,"Radiologic examination, shoulder; 1 view ",,,51.95,66.83,3 RC,339,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,93.19,119.89,3 RC,339,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,225.48,290.08,3 RC,339,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,99.26,127.7,3 RC,339,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,87.12,112.08,3 RC,339,"Radiologic examination, skull; complete, minimum of 4 views ",,,113.85,146.47,3 RC,339,"Radiologic examination, skull; less than 4 views ",,,99.26,127.7,3 RC,339,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,1161.24,1493.9,3 RC,339,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,312.87,402.5,3 RC,339,"Radiologic examination, spine, cervical; 2 or 3 views ",,,105.33,135.51,3 RC,339,"Radiologic examination, spine, cervical; 4 or 5 views ",,,146.62,188.62,3 RC,339,"Radiologic examination, spine, cervical; 6 or more views ",,,174.51,224.51,3 RC,339,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,201.24,258.89,3 RC,339,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,225.48,290.08,3 RC,339,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,288.37,370.98,3 RC,339,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,110.2,141.77,3 RC,339,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,106.54,137.06,3 RC,339,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,108.99,140.21,3 RC,339,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,172.1,221.4,3 RC,339,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,141.75,182.36,3 RC,339,"Radiologic examination, spine, single view, specify level ",,,61.64,79.3,3 RC,339,"Radiologic examination, spine; thoracic, 2 views ",,,84.71,108.98,3 RC,339,"Radiologic examination, spine; thoracic, 3 views ",,,104.13,133.96,3 RC,339,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,118.68,152.68,3 RC,339,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,89.58,115.24,3 RC,339,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,371.16,477.48,3 RC,339,"Radiologic examination, teeth; complete, full mouth ",,,152.69,196.42,3 RC,339,"Radiologic examination, teeth; partial examination, less than full mouth ",,,115.06,148.02,3 RC,339,"Radiologic examination, teeth; single view ",,,28.88,37.15,3 RC,339,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,151.48,194.87,3 RC,339,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,94.44,121.49,3 RC,339,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,361.43,464.97,3 RC,339,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,315.32,405.65,3 RC,339,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,396.64,510.27,3 RC,339,"Radiologic examination, wrist; 2 views ",,,94.44,121.49,3 RC,339,"Radiologic examination, wrist; complete, minimum of 3 views ",,,118.68,152.68,3 RC,339,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,71.37,91.81,3 RC,339,"Radiologic examination; calcaneus, minimum of 2 views ",,,76.23,98.07,3 RC,339,"Radiologic examination; clavicle, complete ",,,88.37,113.68,3 RC,339,"Radiologic examination; forearm, 2 views ",,,78.64,101.17,3 RC,339,"Radiologic examination; humerus, minimum of 2 views ",,,88.37,113.68,3 RC,339,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,339,"Radiologic examination; neck, soft tissue ",,,83.51,107.43,3 RC,339,Radiologic examination; optic foramina ,,,98.06,126.15,3 RC,339,"Radiologic examination; orbits, complete, minimum of 4 views ",,,125.99,162.09,3 RC,339,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,317.74,408.76,3 RC,339,"Radiologic examination; scapula, complete ",,,54.36,69.94,3 RC,339,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,112.61,144.87,3 RC,339,"Radiologic examination; sternum, minimum of 2 views ",,,88.37,113.68,3 RC,339,"Radiologic examination; tibia and fibula, 2 views ",,,87.12,112.08,3 RC,339,"Radiologic examination; toe(s), minimum of 2 views ",,,83.51,107.43,3 RC,339,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,3 RC,339,"Radiological examination, surgical specimen ",,,98.06,126.15,3 RC,339,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,339,Receptor assay; estrogen ,,,361.04,465.26,3 RC,339,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,339,Receptor assay; progesterone ,,,266.25,343.11,3 RC,339,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,339,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,339,Renin ,,,90.63,116.79,3 RC,339,Reptilase test ,,,40.44,52.12,3 RC,339,Reticulated platelet assay ,,,146.35,188.6,3 RC,339,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,339,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,339,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,339,Rufinamide ,,,111.5,143.69,3 RC,339,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,339,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,339,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,339,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,339,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,339,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,339,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,339,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,339,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,339,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,339,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,339,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,339,Salicylate ,,,76.68,98.82,3 RC,339,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,339,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,339,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,339,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,339,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,339,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,339,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,339,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,339,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,339,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,339,Selenium ,,,104.53,134.7,3 RC,339,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,339,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,339,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,339,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,339,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,339,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,339,Serotonin ,,,126.87,163.49,3 RC,339,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,339,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,339,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,339,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,339,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,339,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,339,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,215.79,277.61,3 RC,339,Sialic acid ,,,55.77,71.87,3 RC,339,"Sialography, radiological supervision and interpretation ",,,365.09,469.67,3 RC,339,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,339,Silica ,,,103.14,132.92,3 RC,339,Sirolimus ,,,57.16,73.66,3 RC,339,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,339,Skin test; candida ,,,79.46,102.39,3 RC,339,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,339,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,339,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,339,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,339,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,339,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,339,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,339,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,339,Sodium; other source ,,,19.53,25.17,3 RC,339,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,339,Sodium; urine ,,,20.91,26.95,3 RC,339,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,339,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,339,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,339,Somatomedin ,,,87.81,113.16,3 RC,339,Somatostatin ,,,75.26,96.98,3 RC,339,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,339,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,339,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,339,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,339,Specific gravity (except urine) ,,,13.94,17.97,3 RC,339,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,339,Sperm antibodies ,,,43.21,55.69,3 RC,339,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,339,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,339,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,339,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,339,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,339,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,339,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,339,"Splenoportography, radiological supervision and interpretation ",,,1390.07,1788.29,3 RC,339,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,339,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,339,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,339,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,339,"Stimulants, synthetic ",,,98.98,127.56,3 RC,339,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,339,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,339,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,339,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,339,"Streptokinase, antibody ",,,51.57,66.46,3 RC,339,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,339,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,339,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,339,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,339,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,339,"Sulfate, urine ",,,22.3,28.74,3 RC,339,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,339,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,339,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,339,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,339,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,339,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,339,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,339,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,339,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,339,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,339,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,339,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,339,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,339,T cells; total count ,,,154.71,199.37,3 RC,339,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,339,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,339,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,339,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,339,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,339,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,339,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,339,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,339,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,339,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,339,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,339,Tacrolimus ,,,57.16,73.66,3 RC,339,Tapentadol ,,,98.98,127.56,3 RC,339,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,214.59,276.06,3 RC,339,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,339,Testosterone; free ,,,104.53,134.7,3 RC,339,Testosterone; total ,,,105.96,136.54,3 RC,339,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,339,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,339,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,339,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,339,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,339,Theophylline ,,,58.54,75.44,3 RC,339,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,575.04,739.77,3 RC,339,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,339,Thiocyanate ,,,47.41,61.1,3 RC,339,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,339,Thrombin time; plasma ,,,23.69,30.52,3 RC,339,Thrombin time; titer ,,,27.89,35.94,3 RC,339,Thrombomodulin ,,,71.1,91.62,3 RC,339,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,339,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,339,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,339,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,339,Thyroglobulin ,,,65.51,84.43,3 RC,339,Thyroglobulin antibody ,,,65.51,84.43,3 RC,339,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,339,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,339,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,339,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,339,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,339,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,339,Thyroxine; free ,,,37.63,48.49,3 RC,339,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,339,Thyroxine; total ,,,27.89,35.94,3 RC,339,Tiagabine ,,,111.5,143.69,3 RC,339,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,339,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,339,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,339,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,339,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,339,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,339,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,339,Tobramycin ,,,66.9,86.21,3 RC,339,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,339,Topiramate ,,,48.8,62.89,3 RC,339,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,339,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,339,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,339,Tramadol ,,,98.98,127.56,3 RC,339,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,339,Transcranial Doppler study of the intracranial arteries; complete study ,,,818.24,1052.64,3 RC,339,Transcranial Doppler study of the intracranial arteries; limited study ,,,488.63,628.61,3 RC,339,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,339,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,339,Transferrin ,,,52.96,68.24,3 RC,339,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,339,Triglycerides ,,,23.69,30.52,3 RC,339,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,339,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,339,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,339,"Troponin, qualitative ",,,41.83,53.9,3 RC,339,"Troponin, quantitative ",,,51.57,66.46,3 RC,339,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,339,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,339,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,339,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,339,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,339,Tyrosine ,,,43.21,55.69,3 RC,339,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,339,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,339,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,339,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,339,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,339,Unlisted diagnostic radiographic procedure ,,,297.19,382.33,3 RC,339,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,161.43,207.68,3 RC,339,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,339,Unlisted immunology procedure ,,,99.55,128.28,3 RC,339,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,339,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,339,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,339,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,339,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,339,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,339,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,339,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,339,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,339,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,339,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,339,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,339,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,339,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,339,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,188.58,242.6,3 RC,339,"Urethrocystography, voiding, radiological supervision and interpretation ",,,326.22,419.67,3 RC,339,Uric acid; blood ,,,18.14,23.38,3 RC,339,Uric acid; other source ,,,20.91,26.95,3 RC,339,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,339,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,339,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,339,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,339,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,339,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,339,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,339,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,339,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,339,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,339,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,339,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,412.17,530.25,3 RC,339,"Urography, antegrade, radiological supervision and interpretation ",,,413.61,532.09,3 RC,339,"Urography, infusion, drip technique and/or bolus technique; ",,,432.8,556.78,3 RC,339,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,482.56,620.8,3 RC,339,"Urography, retrograde, with or without KUB ",,,192.72,247.93,3 RC,339,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,339,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,339,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,339,Vancomycin ,,,55.77,71.87,3 RC,339,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,339,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,339,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,291.04,374.42,3 RC,339,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,339,Vedolizumab ,,,158.91,204.79,3 RC,339,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,339,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,273.82,352.26,3 RC,339,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,224.28,288.53,3 RC,339,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,241.28,310.4,3 RC,339,"Venography, epidural, radiological supervision and interpretation ",,,273.82,352.26,3 RC,339,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,237.62,305.7,3 RC,339,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,219.41,282.27,3 RC,339,"Venography, orbital, radiological supervision and interpretation ",,,272.57,350.65,3 RC,339,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,283.5,364.72,3 RC,339,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,250.74,322.57,3 RC,339,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,357.55,459.97,3 RC,339,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,265.29,341.29,3 RC,339,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,287.16,369.42,3 RC,339,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,90.78,116.79,3 RC,339,Very long chain fatty acids ,,,80.84,104.18,3 RC,339,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,339,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,339,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,339,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,339,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,339,Viscosity ,,,47.41,61.1,3 RC,339,Vitamin A ,,,47.41,61.1,3 RC,339,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,339,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,339,Vitamin K ,,,55.77,71.87,3 RC,339,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,339,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,339,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,339,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,339,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,339,Voriconazole ,,,111.5,143.69,3 RC,339,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,339,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,339,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,339,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,339,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,339,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,339,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,339,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,339,Zinc ,,,47.41,61.1,3 RC,339,Zonisamide ,,,54.38,70.08,3 RC,339,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,339,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,339,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,340, Nuclear Medicine General Classification ,,,1179.0,1529.0,4 RC,340,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,340,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,340,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,340,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,340,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,340,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,340,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,340,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,340,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,340,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,340,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,340,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,340,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,340,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,340,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,340,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,340,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,Acetaminophen ,,,76.68,98.82,3 RC,340,Acetylcholinesterase ,,,50.18,64.67,3 RC,340,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,340,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,340,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,340,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,340,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,340,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,340,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,340,Adalimumab ,,,158.91,204.79,3 RC,340,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,340,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,340,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,340,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,340,Albumin; ischemia modified ,,,139.38,179.62,3 RC,340,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,340,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,340,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,340,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,340,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,340,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,340,Alcohols ,,,98.98,127.56,3 RC,340,Aldolase ,,,40.44,52.12,3 RC,340,Aldosterone ,,,167.27,215.56,3 RC,340,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,340,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,340,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,340,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,340,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,340,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,340,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,340,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,340,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,340,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,340,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,340,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,340,Aluminum ,,,104.53,134.7,3 RC,340,Amikacin ,,,62.74,80.85,3 RC,340,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,340,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,340,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,340,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,340,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,340,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,340,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,340,Amiodarone ,,,76.68,98.82,3 RC,340,Ammonia ,,,59.93,77.23,3 RC,340,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,340,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,340,Amylase ,,,26.5,34.15,3 RC,340,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,340,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,340,Androstanediol glucuronide ,,,118.47,152.67,3 RC,340,Androstenedione ,,,119.9,154.51,3 RC,340,Androsterone ,,,104.53,134.7,3 RC,340,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,340,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,340,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,340,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,340,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,340,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,340,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,340,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,340,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,340,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,340,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,340,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,340,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,340,Angiotensin II ,,,85.04,109.59,3 RC,340,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,340,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,340,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,340,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,340,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,340,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,340,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,340,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,340,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,340,Antibody; Aspergillus ,,,61.31,79.01,3 RC,340,Antibody; Bartonella ,,,41.83,53.9,3 RC,340,Antibody; Blastomyces ,,,52.96,68.24,3 RC,340,Antibody; Bordetella ,,,54.38,70.08,3 RC,340,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,340,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,340,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,340,Antibody; Brucella ,,,36.24,46.7,3 RC,340,Antibody; Campylobacter ,,,54.38,70.08,3 RC,340,Antibody; Candida ,,,48.8,62.89,3 RC,340,Antibody; Chlamydia ,,,48.8,62.89,3 RC,340,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,340,Antibody; Coccidioides ,,,47.41,61.1,3 RC,340,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,340,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,340,Antibody; Diphtheria ,,,62.74,80.85,3 RC,340,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,340,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,340,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,340,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,340,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,340,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,340,Antibody; HIV-1 ,,,36.24,46.7,3 RC,340,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,340,Antibody; HIV-2 ,,,55.77,71.87,3 RC,340,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,340,Antibody; HTLV-I ,,,37.63,48.49,3 RC,340,Antibody; HTLV-II ,,,57.16,73.66,3 RC,340,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,340,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,340,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,340,Antibody; Legionella ,,,62.74,80.85,3 RC,340,Antibody; Leishmania ,,,50.18,64.67,3 RC,340,Antibody; Leptospira ,,,66.9,86.21,3 RC,340,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,340,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,340,Antibody; Nocardia ,,,65.51,84.43,3 RC,340,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,340,Antibody; Rickettsia ,,,79.46,102.39,3 RC,340,Antibody; Salmonella ,,,54.38,70.08,3 RC,340,Antibody; Shigella ,,,100.37,129.34,3 RC,340,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,340,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,340,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,340,Antibody; Trichinella ,,,51.57,66.46,3 RC,340,Antibody; West Nile virus ,,,58.54,75.44,3 RC,340,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,340,Antibody; Yersinia ,,,54.38,70.08,3 RC,340,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,340,Antibody; actinomyces ,,,41.83,53.9,3 RC,340,Antibody; adenovirus ,,,52.96,68.24,3 RC,340,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,340,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,340,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,340,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,340,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,340,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,340,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,340,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,340,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,340,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,340,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,340,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,340,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,340,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,340,Antibody; histoplasma ,,,57.16,73.66,3 RC,340,Antibody; influenza virus ,,,55.77,71.87,3 RC,340,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,340,Antibody; mucormycosis ,,,61.31,79.01,3 RC,340,Antibody; mumps ,,,54.38,70.08,3 RC,340,Antibody; mycoplasma ,,,54.38,70.08,3 RC,340,Antibody; parvovirus ,,,61.31,79.01,3 RC,340,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,340,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,340,Antibody; rotavirus ,,,75.26,96.98,3 RC,340,Antibody; rubella ,,,58.54,75.44,3 RC,340,Antibody; rubeola ,,,52.96,68.24,3 RC,340,Antibody; tetanus ,,,61.31,79.01,3 RC,340,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,340,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,340,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,340,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,340,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,340,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,340,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,340,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,340,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,340,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,340,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,340,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,340,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,340,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,340,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,340,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,340,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,340,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,340,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,340,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,340,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,340,"Apolipoprotein, each ",,,86.43,111.38,3 RC,340,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,340,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,340,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,340,Arsenic ,,,78.07,100.61,3 RC,340,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,340,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,340,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,340,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,340,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,340,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,340,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,340,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,340,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,340,"B cells, total count ",,,154.71,199.37,3 RC,340,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,340,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,340,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,340,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,340,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,340,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,340,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,340,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,340,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,340,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,340,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,340,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,340,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,340,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,340,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,340,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,340,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,340,Barbiturates ,,,98.98,127.56,3 RC,340,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,340,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,340,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,340,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,340,Beta-2 microglobulin ,,,66.9,86.21,3 RC,340,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,340,Bile acids; total ,,,71.1,91.62,3 RC,340,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,340,Bilirubin; direct ,,,20.91,26.95,3 RC,340,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,340,Bilirubin; total ,,,20.91,26.95,3 RC,340,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,340,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,340,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,340,Bleeding time ,,,19.53,25.17,3 RC,340,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,340,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,340,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,340,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,340,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,340,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,340,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,340,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,340,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,340,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,340,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,340,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,340,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,340,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,340,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,340,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,340,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,340,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,340,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,340,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,340,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,340,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,340,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,340,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,340,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,340,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,340,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,340,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,340,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,340,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,340,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,340,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,340,Bone age studies ,,,26.58,79.3,4 RC,340,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,340,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,340,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,340,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,340,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,340,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,340,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,340,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,340,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,340,Bradykinin ,,,20.91,26.95,3 RC,340,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,340,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,340,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,340,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,340,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,340,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,340,C-peptide ,,,85.04,109.59,3 RC,340,C-reactive protein; ,,,20.91,26.95,3 RC,340,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,340,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,340,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,340,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,340,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,340,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,340,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,340,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,340,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,340,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,340,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,340,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,340,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,340,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,340,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,340,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,340,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,340,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,340,Cadmium ,,,97.55,125.72,3 RC,340,Caffeine ,,,158.91,204.79,3 RC,340,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,340,Calcitonin ,,,110.11,141.9,3 RC,340,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,340,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,340,Calcium; ionized ,,,55.77,71.87,3 RC,340,Calcium; total ,,,20.91,26.95,3 RC,340,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,340,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,340,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,340,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,340,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,340,"Calprotectin, fecal ",,,80.84,104.18,3 RC,340,"Cannabinoids, natural ",,,98.98,127.56,3 RC,340,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,340,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,340,Carbamazepine; free ,,,54.38,70.08,3 RC,340,Carbamazepine; total ,,,59.93,77.23,3 RC,340,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,340,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,340,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,340,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,340,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,340,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,340,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,340,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,340,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,340,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,340,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,340,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,340,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,340,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,340,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,340,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,340,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,340,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,340,Cardiac shunt detection ,,,186.76,186.76,1 RC,340,Cardiokymography ,,,20.04,20.04,1 RC,340,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,340,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,340,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,340,Carotene ,,,37.63,48.49,3 RC,340,Catecholamines; blood ,,,119.9,154.51,3 RC,340,Catecholamines; fractionated ,,,104.53,134.7,3 RC,340,Catecholamines; total urine ,,,112.93,145.53,3 RC,340,Cathepsin-D ,,,73.87,95.19,3 RC,340,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,340,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,340,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,340,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,340,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,340,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,340,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,340,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,340,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,340,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,340,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,340,Ceruloplasmin ,,,44.6,57.47,3 RC,340,Chemiluminescent assay ,,,58.54,75.44,3 RC,340,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,340,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,340,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,340,Chloramphenicol ,,,51.57,66.46,3 RC,340,Chloride; blood ,,,19.53,25.17,3 RC,340,Chloride; other source ,,,20.91,26.95,3 RC,340,Chloride; urine ,,,23.69,30.52,3 RC,340,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,340,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,340,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,340,Cholinesterase; RBC ,,,40.44,52.12,3 RC,340,Cholinesterase; serum ,,,32.04,41.29,3 RC,340,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,340,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,340,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,340,Chromium ,,,83.66,107.81,3 RC,340,Chromogenic substrate assay ,,,48.8,62.89,3 RC,340,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,340,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,340,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,340,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,340,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,340,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,340,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,340,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,340,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,340,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,340,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,340,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,340,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,340,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,340,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,340,Citrate ,,,114.31,147.31,3 RC,340,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,340,Clot retraction ,,,66.9,86.21,3 RC,340,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,340,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,340,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,340,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,340,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,340,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,340,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,340,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,340,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,340,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,340,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,340,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,340,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,340,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,340,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,340,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,340,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,340,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,340,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,340,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,340,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,340,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,340,Clozapine ,,,82.23,105.96,3 RC,340,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,340,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,340,Coagulation time; activated ,,,18.14,23.38,3 RC,340,Coagulation time; other methods ,,,18.14,23.38,3 RC,340,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,340,Cocaine ,,,98.98,127.56,3 RC,340,Cold agglutinin; screen ,,,33.47,43.13,3 RC,340,Cold agglutinin; titer ,,,33.47,43.13,3 RC,340,"Collagen cross links, any method ",,,76.68,98.82,3 RC,340,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,340,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,340,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,340,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,340,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,340,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,340,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,340,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,340,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,340,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,340,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,340,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,340,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,340,"Complement; antigen, each component ",,,48.8,62.89,3 RC,340,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,340,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,340,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,340,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,340,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,340,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,340,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,340,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,340,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,340,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,340,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,340,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,340,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,340,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,340,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,340,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,340,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,340,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,340,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,340,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,340,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,340,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,340,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,340,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,340,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,340,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,340,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,340,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,340,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,340,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,340,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,340,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,340,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,340,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,340,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,340,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,340,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,340,Copper ,,,51.57,66.46,3 RC,340,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,340,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,340,Corticosterone ,,,92.01,118.58,3 RC,340,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,340,Cortisol; free ,,,68.28,88.0,3 RC,340,Cortisol; total ,,,66.9,86.21,3 RC,340,Creatine ,,,19.53,25.17,3 RC,340,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,340,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,340,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,340,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,340,Creatinine; blood ,,,20.91,26.95,3 RC,340,Creatinine; clearance ,,,39.01,50.28,3 RC,340,Creatinine; other source ,,,20.91,26.95,3 RC,340,Cryofibrinogen ,,,58.54,75.44,3 RC,340,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,340,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,340,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,340,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,340,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,340,Cryopreservation; sperm ,,,442.57,570.33,3 RC,340,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,340,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,340,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,340,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,340,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,340,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,340,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,340,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,340,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,340,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,340,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,340,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,340,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,340,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,340,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,340,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,340,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,340,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,340,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,340,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,340,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,340,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,340,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,340,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,340,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,340,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,340,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,340,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,340,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,340,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,340,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,340,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,340,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,340,"Culture, typing; other methods ",,,32.04,41.29,3 RC,340,Cyanide ,,,79.46,102.39,3 RC,340,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,340,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,340,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,340,Cyclosporine ,,,73.87,95.19,3 RC,340,Cystatin C ,,,76.68,98.82,3 RC,340,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,340,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,340,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,340,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,340,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,340,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,340,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,340,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,340,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,340,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,340,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,340,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,340,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,340,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,340,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,340,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,340,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,340,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,340,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,340,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,340,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,340,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,340,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,340,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,340,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,340,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,340,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,340,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,340,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,340,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,340,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,340,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,340,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,340,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,340,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,340,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,340,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,340,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,340,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,340,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,340,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,340,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,340,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,340,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,340,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,340,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,340,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,340,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,340,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,340,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,340,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,340,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,340,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,340,Dibucaine number ,,,50.18,64.67,3 RC,340,Digoxin; free ,,,54.38,70.08,3 RC,340,Digoxin; total ,,,54.38,70.08,3 RC,340,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,340,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,340,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,340,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,340,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,340,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,340,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,340,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,340,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,340,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,340,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,340,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,340,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,340,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,340,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,340,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,340,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,340,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,340,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,340,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,340,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,340,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,340,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,340,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,340,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,340,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,340,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,340,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,340,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,340,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,340,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,340,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,340,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,340,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,340,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,340,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,340,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,340,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,340,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,340,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,340,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,340,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,340,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,340,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,340,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,340,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,340,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,340,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,340,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,340,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,340,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,340,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,340,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,340,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,340,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,340,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,340,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,340,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,340,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,340,Erythropoietin ,,,76.68,98.82,3 RC,340,Esophageal motility ,,,214.04,214.04,1 RC,340,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,340,Estradiol; total ,,,114.31,147.31,3 RC,340,Estriol ,,,98.98,127.56,3 RC,340,Estrogens; fractionated ,,,132.41,170.64,3 RC,340,Estrogens; total ,,,89.2,114.95,3 RC,340,Estrone ,,,103.14,132.92,3 RC,340,Ethosuximide ,,,66.9,86.21,3 RC,340,Ethylene glycol ,,,61.31,79.01,3 RC,340,Etiocholanolone ,,,107.34,138.33,3 RC,340,Euglobulin lysis ,,,34.86,44.92,3 RC,340,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,340,Everolimus ,,,57.16,73.66,3 RC,340,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,340,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,340,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,340,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,340,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,340,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,340,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,340,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,340,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,340,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,340,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,340,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,340,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,340,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,340,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,340,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,340,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,340,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,340,Factor inhibitor test ,,,52.96,68.24,3 RC,340,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,340,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,340,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,340,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,340,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,340,Felbamate ,,,76.68,98.82,3 RC,340,Fentanyl ,,,98.98,127.56,3 RC,340,Fern test ,,,40.44,52.12,3 RC,340,Ferritin ,,,55.77,71.87,3 RC,340,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,340,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,340,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,340,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,340,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,340,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,340,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,340,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,340,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,340,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,340,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,340,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,340,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,340,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,340,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,340,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,340,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,340,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,340,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,340,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,340,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,340,Fibrinogen; activity ,,,40.44,52.12,3 RC,340,Fibrinogen; antigen ,,,59.93,77.23,3 RC,340,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,340,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,340,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,340,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,340,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,340,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,340,Flecainide ,,,76.68,98.82,3 RC,340,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,340,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,340,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,340,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,340,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,340,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,340,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,340,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,340,Fluoride ,,,76.68,98.82,3 RC,340,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,340,Folic acid; RBC ,,,72.48,93.41,3 RC,340,Folic acid; serum ,,,59.93,77.23,3 RC,340,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,340,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,340,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,340,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,340,"Fructose, semen ",,,71.1,91.62,3 RC,340,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,340,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,340,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,340,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,340,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,340,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,340,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,340,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,340,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,340,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,340,"Galactokinase, RBC ",,,87.81,113.16,3 RC,340,Galactose ,,,45.98,59.26,3 RC,340,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,340,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,340,Galectin-3 ,,,182.6,235.31,3 RC,340,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,340,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,340,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,340,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,340,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,340,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,340,"Gases, blood, pH only ",,,44.6,57.47,3 RC,340,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,340,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,340,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,340,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,340,Gastric mucosa imaging ,,,205.51,205.51,1 RC,340,Gastrin ,,,72.48,93.41,3 RC,340,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,340,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,340,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,340,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,340,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,340,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,340,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,340,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,340,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,340,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,340,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,340,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,340,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,340,Gentamicin ,,,66.9,86.21,3 RC,340,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,340,Glucagon ,,,58.54,75.44,3 RC,340,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,340,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,340,Glucagon tolerance test ,,,72.48,93.41,3 RC,340,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,340,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,340,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,340,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,340,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,340,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,340,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,340,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,340,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,340,"Glucosidase, beta ",,,87.81,113.16,3 RC,340,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,340,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,340,Glutathione ,,,64.13,82.64,3 RC,340,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,340,Glycated protein ,,,68.28,88.0,3 RC,340,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,340,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,340,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,340,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,340,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,340,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,340,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,340,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,340,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,340,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,340,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,340,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,340,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,340,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,340,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,340,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,340,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,340,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,340,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,340,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,340,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,340,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,340,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,340,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,340,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,340,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,340,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,340,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,340,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,340,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,340,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,340,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,340,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,340,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,340,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,340,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,340,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,340,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,340,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,340,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,340,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,340,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,Haloperidol ,,,65.51,84.43,3 RC,340,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,340,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,340,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,340,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,340,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,340,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,340,Heinz bodies; direct ,,,16.71,21.54,3 RC,340,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,340,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,340,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,340,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,340,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,340,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,340,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,340,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,340,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,340,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,340,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,340,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,340,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,340,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,340,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,340,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,340,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,340,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,340,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,340,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,340,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,340,Hemoglobin; plasma ,,,30.66,39.51,3 RC,340,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,340,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,340,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,340,Hemoglobin; urine ,,,16.71,21.54,3 RC,340,"Hemolysin, acid ",,,36.24,46.7,3 RC,340,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,340,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,340,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,340,Heparin assay ,,,54.38,70.08,3 RC,340,Heparin neutralization ,,,48.8,62.89,3 RC,340,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,340,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,340,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,340,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,340,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,340,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,340,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,340,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,340,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,340,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,340,Hepatitis C antibody; ,,,58.54,75.44,3 RC,340,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,340,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,340,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,340,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,340,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,340,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,340,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,340,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,340,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,340,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,340,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,340,Heroin metabolite ,,,98.98,127.56,3 RC,340,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,340,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,340,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,340,Histamine ,,,121.28,156.3,3 RC,340,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,340,Homocysteine ,,,73.87,95.19,3 RC,340,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,340,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,340,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,340,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,340,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,340,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,340,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,340,Hydroxychloroquine ,,,76.68,98.82,3 RC,340,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,340,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,340,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,340,Hydroxyproline; free ,,,93.4,120.36,3 RC,340,Hydroxyproline; total ,,,100.37,129.34,3 RC,340,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,340,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,340,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,340,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,340,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,340,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,340,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,340,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,340,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,340,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,340,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,340,Immune complex assay ,,,100.37,129.34,3 RC,340,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,340,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,340,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,340,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,340,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,340,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,340,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,340,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,340,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,340,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,340,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,340,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,340,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,340,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,340,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,340,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,340,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,340,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,340,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,340,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,340,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,340,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,340,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,340,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,340,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,340,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,340,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,340,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,340,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,340,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,340,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,340,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,340,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,340,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,340,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,340,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,340,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,340,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,340,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,340,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,340,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,340,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,340,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,340,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,340,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,340,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,340,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,340,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,340,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,340,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,340,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,340,Infliximab ,,,158.91,204.79,3 RC,340,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,340,Inhibin A ,,,64.13,82.64,3 RC,340,Insemination of oocytes ,,,442.57,570.33,3 RC,340,Insulin antibodies ,,,87.81,113.16,3 RC,340,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,340,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,340,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,340,Insulin; free ,,,52.96,68.24,3 RC,340,Insulin; total ,,,47.41,61.1,3 RC,340,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,340,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,340,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,340,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,340,Intrinsic factor ,,,80.84,104.18,3 RC,340,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,340,Iron ,,,26.5,34.15,3 RC,340,Iron binding capacity ,,,36.24,46.7,3 RC,340,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,340,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,340,Islet cell antibody ,,,97.55,125.72,3 RC,340,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,340,Itraconazole ,,,111.5,143.69,3 RC,340,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,340,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,340,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,340,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,340,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,340,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,340,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,340,Ketamine and norketamine ,,,98.98,127.56,3 RC,340,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,340,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,340,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,340,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,340,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,340,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,340,Kidney imaging morphology; ,,,172.11,172.11,1 RC,340,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,340,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,340,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,340,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,340,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,340,Lacosamide ,,,111.5,143.69,3 RC,340,Lactate (lactic acid) ,,,47.41,61.1,3 RC,340,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,340,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,340,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,340,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,340,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,340,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,340,Lamotrigine ,,,54.38,70.08,3 RC,340,Lead ,,,50.18,64.67,3 RC,340,Leflunomide ,,,158.91,204.79,3 RC,340,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,340,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,340,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,340,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,340,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,340,Leukocyte transfusion ,,,305.26,393.39,3 RC,340,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,340,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,340,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,340,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,340,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,340,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,340,Levetiracetam ,,,54.38,70.08,3 RC,340,Lidocaine ,,,59.93,77.23,3 RC,340,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,340,Lipase ,,,27.89,35.94,3 RC,340,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,340,Lipoprotein (a) ,,,58.54,75.44,3 RC,340,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,340,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,340,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,340,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,340,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,340,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,340,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,340,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,340,Lithium ,,,27.89,35.94,3 RC,340,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,340,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,340,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,340,Liver imaging; static only ,,,191.2,191.2,1 RC,340,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,340,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,340,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,340,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,340,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,340,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,340,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,340,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,340,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,340,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,340,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,340,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,340,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,340,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,340,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,340,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,340,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,340,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,340,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,340,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,340,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,340,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,340,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,340,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,340,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,340,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,340,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,340,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,340,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,340,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,340,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,340,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,340,Magnesium ,,,27.89,35.94,3 RC,340,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,340,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,340,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,340,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,340,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,340,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,340,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,340,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,340,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,340,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,340,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,340,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,340,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,340,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,340,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,340,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,340,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,340,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,340,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,340,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,340,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,340,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,340,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,340,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,340,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,340,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,340,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,340,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,340,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,340,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,340,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,340,Malate dehydrogenase ,,,30.66,39.51,3 RC,340,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,340,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,340,Manganese ,,,110.11,141.9,3 RC,340,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,340,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,340,"Meat fibers, feces ",,,19.53,25.17,3 RC,340,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,340,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,340,"Mercury, quantitative ",,,66.9,86.21,3 RC,340,Metanephrines ,,,69.71,89.84,3 RC,340,Methadone ,,,98.98,127.56,3 RC,340,Methemalbumin ,,,44.6,57.47,3 RC,340,Methotrexate ,,,158.91,204.79,3 RC,340,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,340,Methylphenidate ,,,98.98,127.56,3 RC,340,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,340,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,340,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,340,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,340,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,340,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,340,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,340,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,340,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,340,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,340,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,340,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,340,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,340,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,340,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,340,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,340,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,340,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,340,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,340,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,340,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,340,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,340,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,340,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,340,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,340,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,340,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,340,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,340,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,340,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,340,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,340,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,340,Muramidase ,,,76.68,98.82,3 RC,340,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,340,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,340,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,340,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,340,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,340,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,340,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,340,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,340,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,340,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,340,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,340,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,340,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,340,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,340,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,340,Myoglobin ,,,52.96,68.24,3 RC,340,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,340,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,340,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,340,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,340,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,340,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,340,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,340,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,340,Natriuretic peptide ,,,161.68,208.36,3 RC,340,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,340,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,340,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,340,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,340,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,340,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,340,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,340,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,340,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,340,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,340,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,340,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,340,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,340,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,340,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,340,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,340,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,340,Nerve teasing preparations ,,,499.29,643.43,3 RC,340,"Neutralization test, viral ",,,69.71,89.84,3 RC,340,Nickel ,,,100.37,129.34,3 RC,340,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,340,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,340,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,340,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,340,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,340,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,340,Nucleotidase 5'- ,,,45.98,59.26,3 RC,340,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,340,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,340,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,340,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,340,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,340,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,340,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,340,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,340,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,340,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,340,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,340,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,340,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,340,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,340,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,340,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,340,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,340,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,340,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,340,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,340,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,340,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,340,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,340,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,340,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,340,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,340,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,340,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,340,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,340,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,340,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,340,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,340,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,340,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,340,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,340,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,340,"Opiates, 1 or more ",,,98.98,127.56,3 RC,340,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,340,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,340,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,340,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,340,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,340,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,340,Osmolality; blood ,,,27.89,35.94,3 RC,340,Osmolality; urine ,,,27.89,35.94,3 RC,340,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,340,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,340,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,340,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,340,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,340,Oxalate ,,,59.93,77.23,3 RC,340,Oxcarbazepine ,,,54.38,70.08,3 RC,340,Oxycodone ,,,98.98,127.56,3 RC,340,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,340,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,340,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,340,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,340,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,340,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,340,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,340,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,340,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,340,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,340,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,340,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,340,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,340,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,340,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,340,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,340,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,340,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,340,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,340,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,340,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,340,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,340,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,340,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,340,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,340,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,340,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,340,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,340,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,340,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,340,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,340,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,340,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,340,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,340,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,340,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,340,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,340,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,340,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,340,Phenobarbital ,,,62.74,80.85,3 RC,340,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,340,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,340,Phenytoin; free ,,,57.16,73.66,3 RC,340,Phenytoin; total ,,,54.38,70.08,3 RC,340,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,340,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,340,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,340,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,340,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,340,Phosphatidylglycerol ,,,68.28,88.0,3 RC,340,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,340,Phosphohexose isomerase ,,,44.6,57.47,3 RC,340,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,340,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,340,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,340,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,340,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,340,Pinworm examinations ,,,18.14,23.38,3 RC,340,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,340,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,340,Platelet survival study ,,,126.1,126.1,1 RC,340,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,340,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,340,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,340,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,340,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,340,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,340,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,340,Posaconazole ,,,111.5,143.69,3 RC,340,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,340,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,340,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,340,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,340,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,340,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,340,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,340,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,340,Potassium; urine ,,,19.53,25.17,3 RC,340,Prealbumin ,,,59.93,77.23,3 RC,340,Pregabalin ,,,98.98,127.56,3 RC,340,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,340,Pregnanediol ,,,87.81,113.16,3 RC,340,Pregnanetriol ,,,86.43,111.38,3 RC,340,Pregnenolone ,,,85.04,109.59,3 RC,340,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,340,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,340,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,340,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,340,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,340,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,340,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,340,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,340,Primidone ,,,68.28,88.0,3 RC,340,Procainamide; ,,,246.72,317.95,3 RC,340,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,340,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,340,Progesterone ,,,86.43,111.38,3 RC,340,Proinsulin ,,,110.11,141.9,3 RC,340,Prolactin ,,,79.46,102.39,3 RC,340,Propoxyphene ,,,98.98,127.56,3 RC,340,"Prostaglandin, each ",,,171.47,220.97,3 RC,340,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,340,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,340,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,340,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,340,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,340,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,340,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,340,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,340,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,340,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,340,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,340,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,340,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,340,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,340,Prothrombin time; ,,,18.14,23.38,3 RC,340,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,340,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,340,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,340,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,340,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,340,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,340,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,340,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,340,Pyruvate ,,,59.93,77.23,3 RC,340,Pyruvate kinase ,,,39.01,50.28,3 RC,340,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,340,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,340,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,340,Quinidine ,,,59.93,77.23,3 RC,340,Quinine ,,,47.41,61.1,3 RC,340,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,340,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,340,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,340,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,340,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,340,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,340,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,340,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,340,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,340,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,340,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,340,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,340,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,340,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,340,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,340,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,340,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,340,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,340,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,340,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,340,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,340,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,340,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,340,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,340,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,340,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,340,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,340,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,340,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,340,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,340,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,340,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,340,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,340,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,340,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,340,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,340,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,340,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,340,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,340,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,340,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,340,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,340,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,340,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,340,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,340,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,340,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,340,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,340,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,340,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,340,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,340,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,340,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,340,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,340,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,340,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,340,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,340,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,340,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,340,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,340,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,340,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,340,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,340,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,340,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,340,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,340,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,340,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,340,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,340,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,340,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,340,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,340,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,340,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,340,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,340,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,340,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,340,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,340,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,340,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,340,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,340,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,340,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,340,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,340,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,340,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,340,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,340,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,340,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,340,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,340,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,340,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,340,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,340,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,340,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,340,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,340,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,340,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,340,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,340,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,340,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,340,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,340,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,340,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,340,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,340,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,340,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,340,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,340,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,340,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,340,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,340,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,340,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,340,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,340,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,340,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,340,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,340,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,340,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,340,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,340,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,340,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,340,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,340,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,340,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,340,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,340,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,340,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,340,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,340,Receptor assay; estrogen ,,,361.04,465.26,3 RC,340,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,340,Receptor assay; progesterone ,,,266.25,343.11,3 RC,340,Red cell survival study ,,,126.1,126.1,1 RC,340,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,340,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,340,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,340,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,340,Renin ,,,90.63,116.79,3 RC,340,Reptilase test ,,,40.44,52.12,3 RC,340,Reticulated platelet assay ,,,146.35,188.6,3 RC,340,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,340,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,340,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,340,Rufinamide ,,,111.5,143.69,3 RC,340,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,340,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,340,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,340,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,340,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,340,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,340,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,340,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,340,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,340,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,340,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,340,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,340,Salicylate ,,,76.68,98.82,3 RC,340,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,340,Salivary gland function study ,,,104.3,104.3,1 RC,340,Salivary gland imaging; ,,,175.52,175.52,1 RC,340,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,340,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,340,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,340,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,340,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,340,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,340,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,340,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,340,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,340,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,340,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,340,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,340,Selenium ,,,104.53,134.7,3 RC,340,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,340,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,340,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,340,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,340,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,340,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,340,Serotonin ,,,126.87,163.49,3 RC,340,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,340,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,340,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,340,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,340,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,340,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,340,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,340,Sialic acid ,,,55.77,71.87,3 RC,340,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,340,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,340,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,340,Silica ,,,103.14,132.92,3 RC,340,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,340,Sirolimus ,,,57.16,73.66,3 RC,340,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,340,Skin test; candida ,,,79.46,102.39,3 RC,340,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,340,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,340,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,340,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,340,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,340,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,340,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,340,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,340,Sodium; other source ,,,19.53,25.17,3 RC,340,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,340,Sodium; urine ,,,20.91,26.95,3 RC,340,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,340,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,340,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,340,Somatomedin ,,,87.81,113.16,3 RC,340,Somatostatin ,,,75.26,96.98,3 RC,340,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,340,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,340,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,340,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,340,Specific gravity (except urine) ,,,13.94,17.97,3 RC,340,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,340,Sperm antibodies ,,,43.21,55.69,3 RC,340,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,340,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,340,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,340,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,340,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,340,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,340,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,340,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,340,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,340,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,340,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,340,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,340,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,340,"Stimulants, synthetic ",,,98.98,127.56,3 RC,340,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,340,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,340,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,340,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,340,"Streptokinase, antibody ",,,51.57,66.46,3 RC,340,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,340,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,340,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,340,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,340,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,340,"Sulfate, urine ",,,22.3,28.74,3 RC,340,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,340,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,340,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,340,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,340,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,340,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,340,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,340,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,340,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,340,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,340,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,340,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,340,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,340,T cells; total count ,,,154.71,199.37,3 RC,340,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,340,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,340,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,340,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,340,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,340,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,340,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,340,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,340,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,340,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,340,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,340,Tacrolimus ,,,57.16,73.66,3 RC,340,Tapentadol ,,,98.98,127.56,3 RC,340,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,340,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,340,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,340,Testosterone; free ,,,104.53,134.7,3 RC,340,Testosterone; total ,,,105.96,136.54,3 RC,340,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,340,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,340,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,340,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,340,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,340,Theophylline ,,,58.54,75.44,3 RC,340,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,340,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,340,Thiocyanate ,,,47.41,61.1,3 RC,340,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,340,Thrombin time; plasma ,,,23.69,30.52,3 RC,340,Thrombin time; titer ,,,27.89,35.94,3 RC,340,Thrombomodulin ,,,71.1,91.62,3 RC,340,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,340,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,340,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,340,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,340,Thyroglobulin ,,,65.51,84.43,3 RC,340,Thyroglobulin antibody ,,,65.51,84.43,3 RC,340,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,340,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,340,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,340,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,340,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,340,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,340,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,340,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,340,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,340,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,340,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,340,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,340,Thyroxine; free ,,,37.63,48.49,3 RC,340,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,340,Thyroxine; total ,,,27.89,35.94,3 RC,340,Tiagabine ,,,111.5,143.69,3 RC,340,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,340,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,340,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,340,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,340,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,340,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,340,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,340,Tobramycin ,,,66.9,86.21,3 RC,340,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,340,Topiramate ,,,48.8,62.89,3 RC,340,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,340,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,340,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,340,Tramadol ,,,98.98,127.56,3 RC,340,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,340,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,340,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,340,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,340,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,340,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,340,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,340,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,340,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,340,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,340,Transferrin ,,,52.96,68.24,3 RC,340,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,340,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,340,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,340,Triglycerides ,,,23.69,30.52,3 RC,340,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,340,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,340,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,340,"Troponin, qualitative ",,,41.83,53.9,3 RC,340,"Troponin, quantitative ",,,51.57,66.46,3 RC,340,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,340,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,340,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,340,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,340,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,340,Tyrosine ,,,43.21,55.69,3 RC,340,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,340,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,340,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,340,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,340,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,340,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,340,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,340,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,340,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,340,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,340,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,340,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,340,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,340,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,340,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,340,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,340,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,340,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,340,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,340,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,340,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,340,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,340,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,340,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,340,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,340,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,340,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,340,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,340,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,340,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,340,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,340,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,340,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,340,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,340,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,340,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,340,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,340,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,340,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,340,Unlisted immunology procedure ,,,99.55,128.28,3 RC,340,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,340,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,340,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,340,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,340,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,340,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,340,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,340,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,340,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,340,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,340,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,340,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,340,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,340,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,340,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,340,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,340,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,340,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,340,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,340,Uric acid; blood ,,,18.14,23.38,3 RC,340,Uric acid; other source ,,,20.91,26.95,3 RC,340,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,340,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,340,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,340,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,340,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,340,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,340,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,340,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,340,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,340,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,340,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,340,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,340,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,340,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,340,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,340,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,340,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,340,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,340,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,340,Vancomycin ,,,55.77,71.87,3 RC,340,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,340,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,340,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,340,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,340,Vedolizumab ,,,158.91,204.79,3 RC,340,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,340,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,340,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,340,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,340,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,340,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,340,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,340,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,340,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,340,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,340,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,340,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,340,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,340,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,340,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,340,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,340,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,340,Very long chain fatty acids ,,,80.84,104.18,3 RC,340,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,340,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,340,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,340,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,340,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,340,Viscosity ,,,47.41,61.1,3 RC,340,Vitamin A ,,,47.41,61.1,3 RC,340,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,340,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,340,Vitamin K ,,,55.77,71.87,3 RC,340,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,340,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,340,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,340,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,340,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,340,Voriconazole ,,,111.5,143.69,3 RC,340,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,340,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,340,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,340,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,340,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,340,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,340,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,340,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,340,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,340,Zinc ,,,47.41,61.1,3 RC,340,Zonisamide ,,,54.38,70.08,3 RC,340,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,340,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,340,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,341, Nuclear Medicine Diagnostic ,,,1179.0,1529.0,4 RC,341,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,341,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,341,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,341,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,341,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,341,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,341,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,341,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,341,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,341,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,341,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,341,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,341,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,341,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,341,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,341,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,341,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,Acetaminophen ,,,76.68,98.82,3 RC,341,Acetylcholinesterase ,,,50.18,64.67,3 RC,341,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,341,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,341,Acute gastrointestinal blood loss imaging ,3376.98,3376.98,348.99,348.99,1 RC,341,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,341,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,341,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,341,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,341,Adalimumab ,,,158.91,204.79,3 RC,341,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,341,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,341,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,341,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,341,Albumin; ischemia modified ,,,139.38,179.62,3 RC,341,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,341,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,341,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,341,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,341,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,341,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,341,Alcohols ,,,98.98,127.56,3 RC,341,Aldolase ,,,40.44,52.12,3 RC,341,Aldosterone ,,,167.27,215.56,3 RC,341,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,341,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,341,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,341,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,341,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,341,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,341,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,341,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,341,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,341,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,341,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,341,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,341,Aluminum ,,,104.53,134.7,3 RC,341,Amikacin ,,,62.74,80.85,3 RC,341,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,341,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,341,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,341,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,341,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,341,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,341,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,341,Amiodarone ,,,76.68,98.82,3 RC,341,Ammonia ,,,59.93,77.23,3 RC,341,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,341,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,341,Amylase ,,,26.5,34.15,3 RC,341,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,341,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,341,Androstanediol glucuronide ,,,118.47,152.67,3 RC,341,Androstenedione ,,,119.9,154.51,3 RC,341,Androsterone ,,,104.53,134.7,3 RC,341,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,341,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,341,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,341,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,341,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,341,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,341,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,341,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,341,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,341,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,341,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,341,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,341,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,341,Angiotensin II ,,,85.04,109.59,3 RC,341,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,341,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,341,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,341,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,341,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,341,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,341,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,341,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,341,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,341,Antibody; Aspergillus ,,,61.31,79.01,3 RC,341,Antibody; Bartonella ,,,41.83,53.9,3 RC,341,Antibody; Blastomyces ,,,52.96,68.24,3 RC,341,Antibody; Bordetella ,,,54.38,70.08,3 RC,341,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,341,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,341,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,341,Antibody; Brucella ,,,36.24,46.7,3 RC,341,Antibody; Campylobacter ,,,54.38,70.08,3 RC,341,Antibody; Candida ,,,48.8,62.89,3 RC,341,Antibody; Chlamydia ,,,48.8,62.89,3 RC,341,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,341,Antibody; Coccidioides ,,,47.41,61.1,3 RC,341,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,341,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,341,Antibody; Diphtheria ,,,62.74,80.85,3 RC,341,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,341,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,341,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,341,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,341,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,341,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,341,Antibody; HIV-1 ,,,36.24,46.7,3 RC,341,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,341,Antibody; HIV-2 ,,,55.77,71.87,3 RC,341,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,341,Antibody; HTLV-I ,,,37.63,48.49,3 RC,341,Antibody; HTLV-II ,,,57.16,73.66,3 RC,341,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,341,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,341,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,341,Antibody; Legionella ,,,62.74,80.85,3 RC,341,Antibody; Leishmania ,,,50.18,64.67,3 RC,341,Antibody; Leptospira ,,,66.9,86.21,3 RC,341,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,341,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,341,Antibody; Nocardia ,,,65.51,84.43,3 RC,341,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,341,Antibody; Rickettsia ,,,79.46,102.39,3 RC,341,Antibody; Salmonella ,,,54.38,70.08,3 RC,341,Antibody; Shigella ,,,100.37,129.34,3 RC,341,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,341,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,341,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,341,Antibody; Trichinella ,,,51.57,66.46,3 RC,341,Antibody; West Nile virus ,,,58.54,75.44,3 RC,341,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,341,Antibody; Yersinia ,,,54.38,70.08,3 RC,341,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,341,Antibody; actinomyces ,,,41.83,53.9,3 RC,341,Antibody; adenovirus ,,,52.96,68.24,3 RC,341,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,341,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,341,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,341,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,341,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,341,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,341,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,341,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,341,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,341,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,341,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,341,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,341,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,341,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,341,Antibody; histoplasma ,,,57.16,73.66,3 RC,341,Antibody; influenza virus ,,,55.77,71.87,3 RC,341,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,341,Antibody; mucormycosis ,,,61.31,79.01,3 RC,341,Antibody; mumps ,,,54.38,70.08,3 RC,341,Antibody; mycoplasma ,,,54.38,70.08,3 RC,341,Antibody; parvovirus ,,,61.31,79.01,3 RC,341,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,341,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,341,Antibody; rotavirus ,,,75.26,96.98,3 RC,341,Antibody; rubella ,,,58.54,75.44,3 RC,341,Antibody; rubeola ,,,52.96,68.24,3 RC,341,Antibody; tetanus ,,,61.31,79.01,3 RC,341,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,341,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,341,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,341,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,341,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,341,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,341,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,341,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,341,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,341,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,341,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,341,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,341,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,341,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,341,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,341,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,341,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,341,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,341,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,341,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,341,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,341,"Apolipoprotein, each ",,,86.43,111.38,3 RC,341,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,341,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,341,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,341,Arsenic ,,,78.07,100.61,3 RC,341,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,341,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,341,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,341,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,341,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,341,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,341,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,341,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,341,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,341,"B cells, total count ",,,154.71,199.37,3 RC,341,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,341,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,341,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,341,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,341,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,341,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,341,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,341,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,341,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,341,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,341,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,341,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,341,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,341,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,341,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,341,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,341,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,341,Barbiturates ,,,98.98,127.56,3 RC,341,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,341,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,341,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,341,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,341,Beta-2 microglobulin ,,,66.9,86.21,3 RC,341,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,341,Bile acids; total ,,,71.1,91.62,3 RC,341,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,341,Bilirubin; direct ,,,20.91,26.95,3 RC,341,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,341,Bilirubin; total ,,,20.91,26.95,3 RC,341,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,341,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,341,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,341,Bleeding time ,,,19.53,25.17,3 RC,341,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,341,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,341,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,341,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,341,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,341,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,341,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,341,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,341,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,341,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,341,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,341,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,341,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,341,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,341,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,341,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,341,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,341,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,341,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,341,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,341,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,341,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,341,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,341,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,341,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,341,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,341,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,341,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,341,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,341,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,341,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,341,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,341,Bone age studies ,,,26.58,79.3,4 RC,341,Bone and/or joint imaging; 3 phase study ,7657.19,7657.19,346.95,346.95,1 RC,341,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,341,Bone and/or joint imaging; whole body ,8663.7,8663.7,299.92,299.92,1 RC,341,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,341,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,341,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,341,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,341,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,341,Bradykinin ,,,20.91,26.95,3 RC,341,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,341,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,341,"Brain imaging, minimum 4 static views; ",9961.84,9961.84,200.06,200.06,1 RC,341,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,341,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,341,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,341,C-peptide ,,,85.04,109.59,3 RC,341,C-reactive protein; ,,,20.91,26.95,3 RC,341,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,341,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,341,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,341,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,341,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,341,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,341,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,341,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,341,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,341,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,341,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,341,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,341,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,341,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,341,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,341,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,341,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,341,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,341,Cadmium ,,,97.55,125.72,3 RC,341,Caffeine ,,,158.91,204.79,3 RC,341,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,341,Calcitonin ,,,110.11,141.9,3 RC,341,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,341,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,341,Calcium; ionized ,,,55.77,71.87,3 RC,341,Calcium; total ,,,20.91,26.95,3 RC,341,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,341,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,341,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,341,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,341,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,341,"Calprotectin, fecal ",,,80.84,104.18,3 RC,341,"Cannabinoids, natural ",,,98.98,127.56,3 RC,341,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,341,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,341,Carbamazepine; free ,,,54.38,70.08,3 RC,341,Carbamazepine; total ,,,59.93,77.23,3 RC,341,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,341,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,341,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,341,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,341,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,341,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,341,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,341,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,341,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,341,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",7418.89,7418.89,228.34,228.34,1 RC,341,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,341,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,341,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,341,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,341,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,341,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,341,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,341,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,341,Cardiac shunt detection ,,,186.76,186.76,1 RC,341,Cardiokymography ,,,20.04,20.04,1 RC,341,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,341,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,341,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,341,Carotene ,,,37.63,48.49,3 RC,341,Catecholamines; blood ,,,119.9,154.51,3 RC,341,Catecholamines; fractionated ,,,104.53,134.7,3 RC,341,Catecholamines; total urine ,,,112.93,145.53,3 RC,341,Cathepsin-D ,,,73.87,95.19,3 RC,341,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,341,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,341,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,341,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,341,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,341,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,341,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,341,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",6225.16,6225.16,338.43,338.43,1 RC,341,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,341,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,341,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,341,Ceruloplasmin ,,,44.6,57.47,3 RC,341,Chemiluminescent assay ,,,58.54,75.44,3 RC,341,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,341,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,341,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,341,Chloramphenicol ,,,51.57,66.46,3 RC,341,Chloride; blood ,,,19.53,25.17,3 RC,341,Chloride; other source ,,,20.91,26.95,3 RC,341,Chloride; urine ,,,23.69,30.52,3 RC,341,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,341,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,341,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,341,Cholinesterase; RBC ,,,40.44,52.12,3 RC,341,Cholinesterase; serum ,,,32.04,41.29,3 RC,341,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,341,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,341,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,341,Chromium ,,,83.66,107.81,3 RC,341,Chromogenic substrate assay ,,,48.8,62.89,3 RC,341,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,341,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,341,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,341,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,341,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,341,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,341,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,341,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,341,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,341,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,341,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,341,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,341,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,341,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,341,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,341,Citrate ,,,114.31,147.31,3 RC,341,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,341,Clot retraction ,,,66.9,86.21,3 RC,341,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,341,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,341,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,341,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,341,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,341,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,341,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,341,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,341,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,341,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,341,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,341,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,341,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,341,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,341,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,341,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,341,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,341,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,341,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,341,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,341,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,341,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,341,Clozapine ,,,82.23,105.96,3 RC,341,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,341,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,341,Coagulation time; activated ,,,18.14,23.38,3 RC,341,Coagulation time; other methods ,,,18.14,23.38,3 RC,341,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,341,Cocaine ,,,98.98,127.56,3 RC,341,Cold agglutinin; screen ,,,33.47,43.13,3 RC,341,Cold agglutinin; titer ,,,33.47,43.13,3 RC,341,"Collagen cross links, any method ",,,76.68,98.82,3 RC,341,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,341,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,341,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,341,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,341,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,341,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,341,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,341,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,341,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,341,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,341,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,341,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,341,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,341,"Complement; antigen, each component ",,,48.8,62.89,3 RC,341,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,341,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,341,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,341,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,341,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,341,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,341,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,341,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,341,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,341,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,341,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,341,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,341,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,341,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,341,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,341,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,341,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,341,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,341,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,341,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,341,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,341,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,341,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,341,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,341,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,341,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,341,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,341,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,341,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,341,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,341,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,341,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,341,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,341,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,341,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,341,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,341,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,341,Copper ,,,51.57,66.46,3 RC,341,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,341,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,341,Corticosterone ,,,92.01,118.58,3 RC,341,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,341,Cortisol; free ,,,68.28,88.0,3 RC,341,Cortisol; total ,,,66.9,86.21,3 RC,341,Creatine ,,,19.53,25.17,3 RC,341,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,341,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,341,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,341,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,341,Creatinine; blood ,,,20.91,26.95,3 RC,341,Creatinine; clearance ,,,39.01,50.28,3 RC,341,Creatinine; other source ,,,20.91,26.95,3 RC,341,Cryofibrinogen ,,,58.54,75.44,3 RC,341,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,341,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,341,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,341,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,341,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,341,Cryopreservation; sperm ,,,442.57,570.33,3 RC,341,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,341,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,341,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,341,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,341,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,341,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,341,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,341,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,341,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,341,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,341,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,341,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,341,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,341,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,341,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,341,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,341,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,341,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,341,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,341,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,341,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,341,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,341,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,341,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,341,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,341,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,341,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,341,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,341,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,341,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,341,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,341,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,341,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,341,"Culture, typing; other methods ",,,32.04,41.29,3 RC,341,Cyanide ,,,79.46,102.39,3 RC,341,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,341,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,341,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,341,Cyclosporine ,,,73.87,95.19,3 RC,341,Cystatin C ,,,76.68,98.82,3 RC,341,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,341,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,341,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,341,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,341,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,341,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,341,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,341,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,341,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,341,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,341,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,341,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,341,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,341,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,341,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,341,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,341,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,341,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,341,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,341,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,341,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,341,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,341,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,341,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,341,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,341,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,341,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,341,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,341,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,341,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,341,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,341,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,341,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,341,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,341,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,341,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,341,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,341,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,341,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,341,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,341,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,341,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,341,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,341,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,341,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,341,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,341,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,341,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,341,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,341,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,341,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,341,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,341,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,341,Dibucaine number ,,,50.18,64.67,3 RC,341,Digoxin; free ,,,54.38,70.08,3 RC,341,Digoxin; total ,,,54.38,70.08,3 RC,341,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,341,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,341,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,341,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,341,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,341,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,341,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,341,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,341,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,341,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,341,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,341,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,341,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,341,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,341,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,341,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,341,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,341,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,341,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,341,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,341,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,341,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,341,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,341,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,341,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,341,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,341,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,341,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,341,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,341,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,341,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,341,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,341,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,341,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,341,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,341,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,341,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,341,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,341,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,341,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,341,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,341,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,341,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,341,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,341,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,341,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,341,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,341,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,341,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,341,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,341,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,341,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,341,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,341,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,341,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,341,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,341,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,341,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,341,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,341,Erythropoietin ,,,76.68,98.82,3 RC,341,Esophageal motility ,,,214.04,214.04,1 RC,341,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,341,Estradiol; total ,,,114.31,147.31,3 RC,341,Estriol ,,,98.98,127.56,3 RC,341,Estrogens; fractionated ,,,132.41,170.64,3 RC,341,Estrogens; total ,,,89.2,114.95,3 RC,341,Estrone ,,,103.14,132.92,3 RC,341,Ethosuximide ,,,66.9,86.21,3 RC,341,Ethylene glycol ,,,61.31,79.01,3 RC,341,Etiocholanolone ,,,107.34,138.33,3 RC,341,Euglobulin lysis ,,,34.86,44.92,3 RC,341,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,341,Everolimus ,,,57.16,73.66,3 RC,341,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,341,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,341,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,341,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,341,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,341,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,341,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,341,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,341,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,341,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,341,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,341,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,341,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,341,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,341,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,341,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,341,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,341,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,341,Factor inhibitor test ,,,52.96,68.24,3 RC,341,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,341,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,341,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,341,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,341,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,341,Felbamate ,,,76.68,98.82,3 RC,341,Fentanyl ,,,98.98,127.56,3 RC,341,Fern test ,,,40.44,52.12,3 RC,341,Ferritin ,,,55.77,71.87,3 RC,341,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,341,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,341,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,341,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,341,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,341,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,341,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,341,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,341,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,341,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,341,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,341,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,341,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,341,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,341,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,341,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,341,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,341,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,341,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,341,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,341,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,341,Fibrinogen; activity ,,,40.44,52.12,3 RC,341,Fibrinogen; antigen ,,,59.93,77.23,3 RC,341,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,341,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,341,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,341,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,341,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,341,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,341,Flecainide ,,,76.68,98.82,3 RC,341,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,341,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,341,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,341,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,341,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,341,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,341,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,341,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,341,Fluoride ,,,76.68,98.82,3 RC,341,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,341,Folic acid; RBC ,,,72.48,93.41,3 RC,341,Folic acid; serum ,,,59.93,77.23,3 RC,341,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,341,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,341,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,341,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,341,"Fructose, semen ",,,71.1,91.62,3 RC,341,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,341,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,341,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,341,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,341,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,341,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,341,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,341,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,341,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,341,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,341,"Galactokinase, RBC ",,,87.81,113.16,3 RC,341,Galactose ,,,45.98,59.26,3 RC,341,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,341,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,341,Galectin-3 ,,,182.6,235.31,3 RC,341,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,341,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,341,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,341,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,341,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,341,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,341,"Gases, blood, pH only ",,,44.6,57.47,3 RC,341,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,341,"Gastric emptying imaging study (eg, solid, liquid, or both); ",5239.07,5239.07,332.98,332.98,1 RC,341,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",6798.2,6798.2,436.24,436.24,1 RC,341,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,341,Gastric mucosa imaging ,,,205.51,205.51,1 RC,341,Gastrin ,,,72.48,93.41,3 RC,341,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,341,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,341,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,341,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,341,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,341,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,341,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,341,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,341,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,341,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,341,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,341,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,341,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,341,Gentamicin ,,,66.9,86.21,3 RC,341,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,341,Glucagon ,,,58.54,75.44,3 RC,341,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,341,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,341,Glucagon tolerance test ,,,72.48,93.41,3 RC,341,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,341,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,341,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,341,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,341,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,341,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,341,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,341,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,341,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,341,"Glucosidase, beta ",,,87.81,113.16,3 RC,341,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,341,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,341,Glutathione ,,,64.13,82.64,3 RC,341,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,341,Glycated protein ,,,68.28,88.0,3 RC,341,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,341,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,341,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,341,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,341,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,341,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,341,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,341,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,341,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,341,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,341,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,341,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,341,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,341,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,341,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,341,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,341,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,341,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,341,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,341,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,341,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,341,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,341,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,341,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,341,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,341,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,341,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,341,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,341,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,341,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,341,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,341,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,341,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,341,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,341,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,341,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,341,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,341,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,341,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,341,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,341,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,341,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,Haloperidol ,,,65.51,84.43,3 RC,341,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,341,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,341,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,341,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,341,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,341,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,341,Heinz bodies; direct ,,,16.71,21.54,3 RC,341,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,341,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,341,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,341,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,341,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,341,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,341,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,341,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,341,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,341,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,341,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,341,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,341,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,341,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,341,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,341,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,341,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,341,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,341,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,341,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,341,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,341,Hemoglobin; plasma ,,,30.66,39.51,3 RC,341,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,341,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,341,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,341,Hemoglobin; urine ,,,16.71,21.54,3 RC,341,"Hemolysin, acid ",,,36.24,46.7,3 RC,341,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,341,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,341,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,341,Heparin assay ,,,54.38,70.08,3 RC,341,Heparin neutralization ,,,48.8,62.89,3 RC,341,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,341,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,341,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,341,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,341,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,341,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,341,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,341,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,341,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,341,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,341,Hepatitis C antibody; ,,,58.54,75.44,3 RC,341,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,341,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,341,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,341,"Hepatobiliary system imaging, including gallbladder when present; ",9898.29,9898.29,328.2,328.2,1 RC,341,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",12147.34,12147.34,441.7,441.7,1 RC,341,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,341,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,341,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,341,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,341,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,341,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,341,Heroin metabolite ,,,98.98,127.56,3 RC,341,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,341,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,341,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,341,Histamine ,,,121.28,156.3,3 RC,341,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,341,Homocysteine ,,,73.87,95.19,3 RC,341,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,341,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,341,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,341,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,341,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,341,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,341,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,341,Hydroxychloroquine ,,,76.68,98.82,3 RC,341,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,341,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,341,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,341,Hydroxyproline; free ,,,93.4,120.36,3 RC,341,Hydroxyproline; total ,,,100.37,129.34,3 RC,341,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,341,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,341,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,341,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,341,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,341,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,341,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,341,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,341,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,341,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,341,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,341,Immune complex assay ,,,100.37,129.34,3 RC,341,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,341,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,341,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,341,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,341,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,341,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,341,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,341,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,341,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,341,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,341,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,341,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,341,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,341,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,341,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,341,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,341,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,341,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,341,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,341,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,341,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,341,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,341,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,341,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,341,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,341,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,341,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,341,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,341,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,341,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,341,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,341,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,341,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,341,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,341,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,341,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,341,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,341,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,341,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,341,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,341,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,341,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,341,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,341,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,341,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,341,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,341,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,341,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,341,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,341,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,341,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,341,Infliximab ,,,158.91,204.79,3 RC,341,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,341,Inhibin A ,,,64.13,82.64,3 RC,341,Insemination of oocytes ,,,442.57,570.33,3 RC,341,Insulin antibodies ,,,87.81,113.16,3 RC,341,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,341,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,341,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,341,Insulin; free ,,,52.96,68.24,3 RC,341,Insulin; total ,,,47.41,61.1,3 RC,341,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,341,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",6689.26,6689.26,331.28,331.28,1 RC,341,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,341,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,341,Intrinsic factor ,,,80.84,104.18,3 RC,341,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,341,Iron ,,,26.5,34.15,3 RC,341,Iron binding capacity ,,,36.24,46.7,3 RC,341,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,341,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,341,Islet cell antibody ,,,97.55,125.72,3 RC,341,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,341,Itraconazole ,,,111.5,143.69,3 RC,341,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,341,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,341,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,341,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,341,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,341,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,341,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,341,Ketamine and norketamine ,,,98.98,127.56,3 RC,341,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,341,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,341,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,341,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,341,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,341,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,341,Kidney imaging morphology; ,,,172.11,172.11,1 RC,341,Kidney imaging morphology; with vascular flow ,8305.13,8305.13,220.84,220.84,1 RC,341,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,341,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",5060.92,5060.92,231.75,231.75,1 RC,341,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",12267.62,12267.62,176.88,176.88,1 RC,341,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,341,Lacosamide ,,,111.5,143.69,3 RC,341,Lactate (lactic acid) ,,,47.41,61.1,3 RC,341,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,341,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,341,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,341,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,341,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,341,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,341,Lamotrigine ,,,54.38,70.08,3 RC,341,Lead ,,,50.18,64.67,3 RC,341,Leflunomide ,,,158.91,204.79,3 RC,341,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,341,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,341,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,341,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,341,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,341,Leukocyte transfusion ,,,305.26,393.39,3 RC,341,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,341,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,341,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,341,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,341,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,341,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,341,Levetiracetam ,,,54.38,70.08,3 RC,341,Lidocaine ,,,59.93,77.23,3 RC,341,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,341,Lipase ,,,27.89,35.94,3 RC,341,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,341,Lipoprotein (a) ,,,58.54,75.44,3 RC,341,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,341,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,341,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,341,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,341,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,341,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,341,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,341,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,341,Lithium ,,,27.89,35.94,3 RC,341,Liver and spleen imaging; static only ,6742.6,6742.6,196.31,196.31,1 RC,341,Liver and spleen imaging; with vascular flow ,5721.34,5721.34,129.52,129.52,1 RC,341,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,341,Liver imaging; static only ,,,191.2,191.2,1 RC,341,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,341,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,341,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,341,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,341,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,341,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,341,Lymphatics and lymph nodes imaging ,6123.03,6123.03,355.12,355.12,1 RC,341,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,341,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,341,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,341,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,341,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,341,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,341,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,341,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,341,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,341,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,341,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,341,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,341,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,341,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,341,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,341,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,341,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,341,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,341,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,341,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,341,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,341,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,341,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,341,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,341,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,341,Magnesium ,,,27.89,35.94,3 RC,341,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,341,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,341,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,341,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,341,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,341,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,341,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,341,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,341,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,341,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,341,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,341,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,341,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,341,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,341,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,341,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,341,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,341,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,341,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,341,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,341,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,341,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,341,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,341,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,341,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,341,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,341,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,341,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,341,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,341,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,341,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,341,Malate dehydrogenase ,,,30.66,39.51,3 RC,341,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,341,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,341,Manganese ,,,110.11,141.9,3 RC,341,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,341,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,341,"Meat fibers, feces ",,,19.53,25.17,3 RC,341,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,341,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,341,"Mercury, quantitative ",,,66.9,86.21,3 RC,341,Metanephrines ,,,69.71,89.84,3 RC,341,Methadone ,,,98.98,127.56,3 RC,341,Methemalbumin ,,,44.6,57.47,3 RC,341,Methotrexate ,,,158.91,204.79,3 RC,341,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,341,Methylphenidate ,,,98.98,127.56,3 RC,341,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,341,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,341,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,341,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,341,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,341,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,341,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,341,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,341,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,341,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,341,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,341,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,341,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,341,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,341,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,341,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,341,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,341,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,341,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,341,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,341,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,341,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,341,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,341,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,341,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,341,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,341,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,341,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,341,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,341,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,341,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,341,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,341,Muramidase ,,,76.68,98.82,3 RC,341,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,341,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,341,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,341,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,341,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,341,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,341,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,341,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,341,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,341,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,341,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,341,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,341,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",17522.58,17522.58,433.86,433.86,1 RC,341,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",16883.73,16883.73,299.92,299.92,1 RC,341,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",16395.22,16395.22,341.15,475.1,2 RC,341,Myoglobin ,,,52.96,68.24,3 RC,341,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,341,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,341,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,341,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,341,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,341,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,341,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,341,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,341,Natriuretic peptide ,,,161.68,208.36,3 RC,341,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,341,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,341,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,341,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,341,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,341,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,341,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,341,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,341,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,341,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,341,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,341,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,341,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,341,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,341,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,341,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,341,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,341,Nerve teasing preparations ,,,499.29,643.43,3 RC,341,"Neutralization test, viral ",,,69.71,89.84,3 RC,341,Nickel ,,,100.37,129.34,3 RC,341,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,341,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,341,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,341,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,341,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,341,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,341,Nucleotidase 5'- ,,,45.98,59.26,3 RC,341,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,341,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,341,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,341,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,341,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,341,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,341,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,341,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,341,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,341,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,341,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,341,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,341,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,341,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,341,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,341,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,341,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,341,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,341,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,341,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,341,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,341,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,341,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,341,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,341,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,341,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,341,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,341,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,341,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,341,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,341,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,341,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,341,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,341,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,341,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,341,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,341,"Opiates, 1 or more ",,,98.98,127.56,3 RC,341,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,341,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,341,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,341,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,341,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,341,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,341,Osmolality; blood ,,,27.89,35.94,3 RC,341,Osmolality; urine ,,,27.89,35.94,3 RC,341,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,341,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,341,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,341,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,341,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,341,Oxalate ,,,59.93,77.23,3 RC,341,Oxcarbazepine ,,,54.38,70.08,3 RC,341,Oxycodone ,,,98.98,127.56,3 RC,341,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,341,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,341,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,341,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,341,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,341,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,341,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,341,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,341,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,341,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,341,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,341,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,341,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,341,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,341,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,341,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,341,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,341,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,341,"Parathyroid planar imaging (including subtraction, when performed); ",7185.14,7185.14,295.83,295.83,1 RC,341,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,341,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,341,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,341,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,341,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,341,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,341,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,341,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,341,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,341,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,341,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,341,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,341,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,341,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,341,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,341,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,341,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,341,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,341,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,341,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,341,Phenobarbital ,,,62.74,80.85,3 RC,341,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,341,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,341,Phenytoin; free ,,,57.16,73.66,3 RC,341,Phenytoin; total ,,,54.38,70.08,3 RC,341,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,341,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,341,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,341,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,341,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,341,Phosphatidylglycerol ,,,68.28,88.0,3 RC,341,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,341,Phosphohexose isomerase ,,,44.6,57.47,3 RC,341,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,341,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,341,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,341,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,341,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,341,Pinworm examinations ,,,18.14,23.38,3 RC,341,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,341,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,341,Platelet survival study ,,,126.1,126.1,1 RC,341,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,341,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,341,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,341,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,341,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,341,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,341,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,341,Posaconazole ,,,111.5,143.69,3 RC,341,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,341,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,341,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,341,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,341,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,341,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,341,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,341,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,341,Potassium; urine ,,,19.53,25.17,3 RC,341,Prealbumin ,,,59.93,77.23,3 RC,341,Pregabalin ,,,98.98,127.56,3 RC,341,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,341,Pregnanediol ,,,87.81,113.16,3 RC,341,Pregnanetriol ,,,86.43,111.38,3 RC,341,Pregnenolone ,,,85.04,109.59,3 RC,341,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,341,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,341,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,341,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,341,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,341,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,341,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,341,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,341,Primidone ,,,68.28,88.0,3 RC,341,Procainamide; ,,,246.72,317.95,3 RC,341,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,341,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,341,Progesterone ,,,86.43,111.38,3 RC,341,Proinsulin ,,,110.11,141.9,3 RC,341,Prolactin ,,,79.46,102.39,3 RC,341,Propoxyphene ,,,98.98,127.56,3 RC,341,"Prostaglandin, each ",,,171.47,220.97,3 RC,341,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,341,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,341,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,341,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,341,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,341,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,341,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,341,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,341,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,341,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,341,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,341,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,341,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,341,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,341,Prothrombin time; ,,,18.14,23.38,3 RC,341,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,341,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,341,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,341,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,341,"Pulmonary perfusion imaging (eg, particulate) ",4474.26,4474.26,237.2,237.2,1 RC,341,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",6864.01,6864.01,333.65,333.65,1 RC,341,"Pulmonary ventilation imaging (eg, aerosol or gas) ",8596.76,8596.76,187.46,187.46,1 RC,341,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,341,Pyruvate ,,,59.93,77.23,3 RC,341,Pyruvate kinase ,,,39.01,50.28,3 RC,341,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,341,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,341,"Quantitative differential pulmonary perfusion, including imaging when performed ",15331.41,15331.41,202.79,202.79,1 RC,341,Quinidine ,,,59.93,77.23,3 RC,341,Quinine ,,,47.41,61.1,3 RC,341,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,341,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,341,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,341,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,341,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,341,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,341,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,341,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,341,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,341,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,341,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,341,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,341,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,341,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,341,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,341,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,341,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,341,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,341,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,341,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,341,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,341,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,341,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,341,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,341,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,341,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,341,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,341,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,341,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,341,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,341,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,341,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,341,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,341,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,341,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,341,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,341,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,341,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,341,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,341,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,341,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,341,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,341,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,341,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,341,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,341,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,341,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,341,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,341,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,341,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,341,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,341,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,341,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,341,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,341,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,341,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,341,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,341,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,341,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,341,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,341,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,341,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,341,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,341,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,341,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,341,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,341,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,341,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,341,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,341,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,341,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,341,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,341,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,341,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,341,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,341,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,341,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,341,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,341,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,341,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,341,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,341,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,341,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,341,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,341,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,341,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,341,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,341,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,341,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,341,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,341,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,341,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,341,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,341,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,341,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,341,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,341,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,341,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,341,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,341,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,341,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,341,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,341,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,341,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,341,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,341,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,341,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,341,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,341,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,341,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,341,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,341,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,341,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,341,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,341,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,341,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,341,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,341,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,341,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,341,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,341,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,341,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,341,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,341,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,341,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,341,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,341,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,341,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,341,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,341,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,341,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,341,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,341,Receptor assay; estrogen ,,,361.04,465.26,3 RC,341,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,341,Receptor assay; progesterone ,,,266.25,343.11,3 RC,341,Red cell survival study ,,,126.1,126.1,1 RC,341,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,341,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,341,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,341,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,341,Renin ,,,90.63,116.79,3 RC,341,Reptilase test ,,,40.44,52.12,3 RC,341,Reticulated platelet assay ,,,146.35,188.6,3 RC,341,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,341,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,341,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,341,Rufinamide ,,,111.5,143.69,3 RC,341,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,341,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,341,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,341,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,341,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,341,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,341,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,341,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,341,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,341,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,341,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,341,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,341,Salicylate ,,,76.68,98.82,3 RC,341,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,341,Salivary gland function study ,,,104.3,104.3,1 RC,341,Salivary gland imaging; ,,,175.52,175.52,1 RC,341,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,341,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,341,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,341,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,341,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,341,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,341,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,341,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,341,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,341,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,341,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,341,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,341,Selenium ,,,104.53,134.7,3 RC,341,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,341,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,341,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,341,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,341,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,341,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,341,Serotonin ,,,126.87,163.49,3 RC,341,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,341,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,341,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,341,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,341,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,341,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,341,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,341,Sialic acid ,,,55.77,71.87,3 RC,341,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,341,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,341,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,341,Silica ,,,103.14,132.92,3 RC,341,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,341,Sirolimus ,,,57.16,73.66,3 RC,341,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,341,Skin test; candida ,,,79.46,102.39,3 RC,341,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,341,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,341,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,341,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,341,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,341,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,341,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,341,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,341,Sodium; other source ,,,19.53,25.17,3 RC,341,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,341,Sodium; urine ,,,20.91,26.95,3 RC,341,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,341,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,341,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,341,Somatomedin ,,,87.81,113.16,3 RC,341,Somatostatin ,,,75.26,96.98,3 RC,341,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,341,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,341,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,341,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,341,Specific gravity (except urine) ,,,13.94,17.97,3 RC,341,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,341,Sperm antibodies ,,,43.21,55.69,3 RC,341,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,341,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,341,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,341,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,341,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,341,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,341,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,341,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,341,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,341,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,341,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,341,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,341,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,341,"Stimulants, synthetic ",,,98.98,127.56,3 RC,341,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,341,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,341,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,341,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,341,"Streptokinase, antibody ",,,51.57,66.46,3 RC,341,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,341,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,341,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,341,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,341,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,341,"Sulfate, urine ",,,22.3,28.74,3 RC,341,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,341,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,341,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,341,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,341,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,341,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,341,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,341,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,341,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,341,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,341,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,341,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,341,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,341,T cells; total count ,,,154.71,199.37,3 RC,341,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,341,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,341,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,341,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,341,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,341,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,341,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,341,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,341,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,341,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,341,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,341,Tacrolimus ,,,57.16,73.66,3 RC,341,Tapentadol ,,,98.98,127.56,3 RC,341,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,341,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,341,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,341,Testosterone; free ,,,104.53,134.7,3 RC,341,Testosterone; total ,,,105.96,136.54,3 RC,341,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,341,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,341,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,341,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,341,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,341,Theophylline ,,,58.54,75.44,3 RC,341,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,341,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,341,Thiocyanate ,,,47.41,61.1,3 RC,341,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,341,Thrombin time; plasma ,,,23.69,30.52,3 RC,341,Thrombin time; titer ,,,27.89,35.94,3 RC,341,Thrombomodulin ,,,71.1,91.62,3 RC,341,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,341,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,341,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,341,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,341,Thyroglobulin ,,,65.51,84.43,3 RC,341,Thyroglobulin antibody ,,,65.51,84.43,3 RC,341,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,341,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,341,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,341,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,341,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,341,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",7601.59,7601.59,226.99,226.99,1 RC,341,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,341,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,341,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,341,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,341,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,341,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,341,Thyroxine; free ,,,37.63,48.49,3 RC,341,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,341,Thyroxine; total ,,,27.89,35.94,3 RC,341,Tiagabine ,,,111.5,143.69,3 RC,341,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,341,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,341,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,341,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,341,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,341,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,341,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,341,Tobramycin ,,,66.9,86.21,3 RC,341,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,341,Topiramate ,,,48.8,62.89,3 RC,341,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,341,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,341,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,341,Tramadol ,,,98.98,127.56,3 RC,341,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,341,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,341,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,341,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,341,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,341,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,341,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,341,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,341,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,341,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,341,Transferrin ,,,52.96,68.24,3 RC,341,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,341,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,341,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,341,Triglycerides ,,,23.69,30.52,3 RC,341,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,341,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,341,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,341,"Troponin, qualitative ",,,41.83,53.9,3 RC,341,"Troponin, quantitative ",,,51.57,66.46,3 RC,341,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,341,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,341,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,341,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,341,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,341,Tyrosine ,,,43.21,55.69,3 RC,341,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,341,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,341,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,341,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,341,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,341,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,341,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,341,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,341,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,341,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,341,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,341,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,341,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,341,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,341,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,341,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,341,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,341,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,341,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,341,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,341,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,341,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,341,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,341,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,341,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,341,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,341,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,341,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,341,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,341,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,341,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,341,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,341,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,341,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,341,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,341,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,341,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,341,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,341,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,341,Unlisted immunology procedure ,,,99.55,128.28,3 RC,341,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,341,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,341,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,341,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,341,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,341,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,341,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,341,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,341,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,341,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,341,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,341,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,341,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,341,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,341,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,341,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,341,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,341,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,341,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,341,Uric acid; blood ,,,18.14,23.38,3 RC,341,Uric acid; other source ,,,20.91,26.95,3 RC,341,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,341,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,341,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,341,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,341,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,341,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,341,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,341,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,341,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,341,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,341,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,341,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,341,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,341,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,341,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,341,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,341,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,341,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,341,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,341,Vancomycin ,,,55.77,71.87,3 RC,341,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,341,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,341,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,341,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,341,Vedolizumab ,,,158.91,204.79,3 RC,341,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,341,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,341,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,341,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,341,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,341,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,341,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,341,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,341,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,341,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,341,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,341,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,341,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,341,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,341,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,341,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,341,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,341,Very long chain fatty acids ,,,80.84,104.18,3 RC,341,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,341,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,341,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,341,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,341,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,341,Viscosity ,,,47.41,61.1,3 RC,341,Vitamin A ,,,47.41,61.1,3 RC,341,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,341,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,341,Vitamin K ,,,55.77,71.87,3 RC,341,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,341,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,341,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,341,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,341,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,341,Voriconazole ,,,111.5,143.69,3 RC,341,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,341,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,341,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,341,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,341,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,341,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,341,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,341,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,341,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,341,Zinc ,,,47.41,61.1,3 RC,341,Zonisamide ,,,54.38,70.08,3 RC,341,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,341,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,341,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,342, Nuclear Medicine Therapeutic ,,,1179.0,1529.0,4 RC,342,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,342,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,342,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,342,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,342,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,342,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,342,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,342,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,342,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,342,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,342,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,342,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,342,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,342,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,342,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,342,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,342,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,Acetaminophen ,,,76.68,98.82,3 RC,342,Acetylcholinesterase ,,,50.18,64.67,3 RC,342,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,342,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,342,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,342,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,342,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,342,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,342,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,342,Adalimumab ,,,158.91,204.79,3 RC,342,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,342,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,342,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,342,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,342,Albumin; ischemia modified ,,,139.38,179.62,3 RC,342,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,342,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,342,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,342,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,342,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,342,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,342,Alcohols ,,,98.98,127.56,3 RC,342,Aldolase ,,,40.44,52.12,3 RC,342,Aldosterone ,,,167.27,215.56,3 RC,342,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,342,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,342,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,342,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,342,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,342,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,342,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,342,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,342,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,342,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,342,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,342,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,342,Aluminum ,,,104.53,134.7,3 RC,342,Amikacin ,,,62.74,80.85,3 RC,342,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,342,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,342,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,342,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,342,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,342,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,342,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,342,Amiodarone ,,,76.68,98.82,3 RC,342,Ammonia ,,,59.93,77.23,3 RC,342,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,342,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,342,Amylase ,,,26.5,34.15,3 RC,342,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,342,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,342,Androstanediol glucuronide ,,,118.47,152.67,3 RC,342,Androstenedione ,,,119.9,154.51,3 RC,342,Androsterone ,,,104.53,134.7,3 RC,342,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,342,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,342,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,342,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,342,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,342,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,342,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,342,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,342,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,342,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,342,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,342,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,342,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,342,Angiotensin II ,,,85.04,109.59,3 RC,342,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,342,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,342,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,342,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,342,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,342,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,342,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,342,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,342,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,342,Antibody; Aspergillus ,,,61.31,79.01,3 RC,342,Antibody; Bartonella ,,,41.83,53.9,3 RC,342,Antibody; Blastomyces ,,,52.96,68.24,3 RC,342,Antibody; Bordetella ,,,54.38,70.08,3 RC,342,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,342,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,342,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,342,Antibody; Brucella ,,,36.24,46.7,3 RC,342,Antibody; Campylobacter ,,,54.38,70.08,3 RC,342,Antibody; Candida ,,,48.8,62.89,3 RC,342,Antibody; Chlamydia ,,,48.8,62.89,3 RC,342,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,342,Antibody; Coccidioides ,,,47.41,61.1,3 RC,342,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,342,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,342,Antibody; Diphtheria ,,,62.74,80.85,3 RC,342,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,342,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,342,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,342,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,342,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,342,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,342,Antibody; HIV-1 ,,,36.24,46.7,3 RC,342,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,342,Antibody; HIV-2 ,,,55.77,71.87,3 RC,342,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,342,Antibody; HTLV-I ,,,37.63,48.49,3 RC,342,Antibody; HTLV-II ,,,57.16,73.66,3 RC,342,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,342,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,342,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,342,Antibody; Legionella ,,,62.74,80.85,3 RC,342,Antibody; Leishmania ,,,50.18,64.67,3 RC,342,Antibody; Leptospira ,,,66.9,86.21,3 RC,342,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,342,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,342,Antibody; Nocardia ,,,65.51,84.43,3 RC,342,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,342,Antibody; Rickettsia ,,,79.46,102.39,3 RC,342,Antibody; Salmonella ,,,54.38,70.08,3 RC,342,Antibody; Shigella ,,,100.37,129.34,3 RC,342,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,342,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,342,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,342,Antibody; Trichinella ,,,51.57,66.46,3 RC,342,Antibody; West Nile virus ,,,58.54,75.44,3 RC,342,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,342,Antibody; Yersinia ,,,54.38,70.08,3 RC,342,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,342,Antibody; actinomyces ,,,41.83,53.9,3 RC,342,Antibody; adenovirus ,,,52.96,68.24,3 RC,342,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,342,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,342,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,342,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,342,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,342,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,342,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,342,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,342,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,342,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,342,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,342,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,342,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,342,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,342,Antibody; histoplasma ,,,57.16,73.66,3 RC,342,Antibody; influenza virus ,,,55.77,71.87,3 RC,342,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,342,Antibody; mucormycosis ,,,61.31,79.01,3 RC,342,Antibody; mumps ,,,54.38,70.08,3 RC,342,Antibody; mycoplasma ,,,54.38,70.08,3 RC,342,Antibody; parvovirus ,,,61.31,79.01,3 RC,342,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,342,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,342,Antibody; rotavirus ,,,75.26,96.98,3 RC,342,Antibody; rubella ,,,58.54,75.44,3 RC,342,Antibody; rubeola ,,,52.96,68.24,3 RC,342,Antibody; tetanus ,,,61.31,79.01,3 RC,342,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,342,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,342,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,342,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,342,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,342,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,342,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,342,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,342,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,342,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,342,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,342,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,342,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,342,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,342,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,342,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,342,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,342,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,342,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,342,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,342,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,342,"Apolipoprotein, each ",,,86.43,111.38,3 RC,342,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,342,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,342,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,342,Arsenic ,,,78.07,100.61,3 RC,342,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,342,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,342,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,342,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,342,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,342,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,342,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,342,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,342,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,342,"B cells, total count ",,,154.71,199.37,3 RC,342,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,342,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,342,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,342,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,342,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,342,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,342,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,342,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,342,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,342,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,342,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,342,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,342,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,342,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,342,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,342,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,342,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,342,Barbiturates ,,,98.98,127.56,3 RC,342,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,342,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,342,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,342,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,342,Beta-2 microglobulin ,,,66.9,86.21,3 RC,342,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,342,Bile acids; total ,,,71.1,91.62,3 RC,342,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,342,Bilirubin; direct ,,,20.91,26.95,3 RC,342,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,342,Bilirubin; total ,,,20.91,26.95,3 RC,342,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,342,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,342,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,342,Bleeding time ,,,19.53,25.17,3 RC,342,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,342,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,342,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,342,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,342,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,342,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,342,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,342,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,342,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,342,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,342,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,342,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,342,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,342,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,342,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,342,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,342,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,342,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,342,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,342,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,342,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,342,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,342,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,342,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,342,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,342,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,342,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,342,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,342,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,342,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,342,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,342,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,342,Bone age studies ,,,26.58,79.3,4 RC,342,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,342,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,342,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,342,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,342,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,342,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,342,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,342,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,342,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,342,Bradykinin ,,,20.91,26.95,3 RC,342,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,342,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,342,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,342,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,342,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,342,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,342,C-peptide ,,,85.04,109.59,3 RC,342,C-reactive protein; ,,,20.91,26.95,3 RC,342,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,342,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,342,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,342,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,342,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,342,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,342,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,342,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,342,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,342,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,342,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,342,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,342,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,342,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,342,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,342,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,342,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,342,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,342,Cadmium ,,,97.55,125.72,3 RC,342,Caffeine ,,,158.91,204.79,3 RC,342,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,342,Calcitonin ,,,110.11,141.9,3 RC,342,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,342,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,342,Calcium; ionized ,,,55.77,71.87,3 RC,342,Calcium; total ,,,20.91,26.95,3 RC,342,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,342,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,342,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,342,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,342,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,342,"Calprotectin, fecal ",,,80.84,104.18,3 RC,342,"Cannabinoids, natural ",,,98.98,127.56,3 RC,342,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,342,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,342,Carbamazepine; free ,,,54.38,70.08,3 RC,342,Carbamazepine; total ,,,59.93,77.23,3 RC,342,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,342,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,342,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,342,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,342,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,342,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,342,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,342,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,342,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,342,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,342,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,342,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,342,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,342,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,342,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,342,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,342,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,342,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,342,Cardiac shunt detection ,,,186.76,186.76,1 RC,342,Cardiokymography ,,,20.04,20.04,1 RC,342,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,342,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,342,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,342,Carotene ,,,37.63,48.49,3 RC,342,Catecholamines; blood ,,,119.9,154.51,3 RC,342,Catecholamines; fractionated ,,,104.53,134.7,3 RC,342,Catecholamines; total urine ,,,112.93,145.53,3 RC,342,Cathepsin-D ,,,73.87,95.19,3 RC,342,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,342,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,342,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,342,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,342,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,342,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,342,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,342,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,342,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,342,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,342,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,342,Ceruloplasmin ,,,44.6,57.47,3 RC,342,Chemiluminescent assay ,,,58.54,75.44,3 RC,342,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,342,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,342,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,342,Chloramphenicol ,,,51.57,66.46,3 RC,342,Chloride; blood ,,,19.53,25.17,3 RC,342,Chloride; other source ,,,20.91,26.95,3 RC,342,Chloride; urine ,,,23.69,30.52,3 RC,342,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,342,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,342,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,342,Cholinesterase; RBC ,,,40.44,52.12,3 RC,342,Cholinesterase; serum ,,,32.04,41.29,3 RC,342,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,342,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,342,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,342,Chromium ,,,83.66,107.81,3 RC,342,Chromogenic substrate assay ,,,48.8,62.89,3 RC,342,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,342,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,342,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,342,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,342,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,342,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,342,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,342,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,342,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,342,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,342,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,342,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,342,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,342,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,342,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,342,Citrate ,,,114.31,147.31,3 RC,342,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,342,Clot retraction ,,,66.9,86.21,3 RC,342,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,342,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,342,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,342,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,342,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,342,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,342,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,342,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,342,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,342,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,342,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,342,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,342,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,342,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,342,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,342,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,342,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,342,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,342,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,342,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,342,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,342,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,342,Clozapine ,,,82.23,105.96,3 RC,342,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,342,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,342,Coagulation time; activated ,,,18.14,23.38,3 RC,342,Coagulation time; other methods ,,,18.14,23.38,3 RC,342,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,342,Cocaine ,,,98.98,127.56,3 RC,342,Cold agglutinin; screen ,,,33.47,43.13,3 RC,342,Cold agglutinin; titer ,,,33.47,43.13,3 RC,342,"Collagen cross links, any method ",,,76.68,98.82,3 RC,342,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,342,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,342,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,342,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,342,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,342,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,342,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,342,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,342,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,342,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,342,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,342,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,342,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,342,"Complement; antigen, each component ",,,48.8,62.89,3 RC,342,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,342,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,342,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,342,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,342,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,342,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,342,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,342,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,342,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,342,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,342,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,342,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,342,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,342,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,342,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,342,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,342,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,342,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,342,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,342,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,342,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,342,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,342,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,342,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,342,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,342,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,342,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,342,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,342,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,342,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,342,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,342,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,342,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,342,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,342,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,342,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,342,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,342,Copper ,,,51.57,66.46,3 RC,342,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,342,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,342,Corticosterone ,,,92.01,118.58,3 RC,342,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,342,Cortisol; free ,,,68.28,88.0,3 RC,342,Cortisol; total ,,,66.9,86.21,3 RC,342,Creatine ,,,19.53,25.17,3 RC,342,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,342,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,342,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,342,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,342,Creatinine; blood ,,,20.91,26.95,3 RC,342,Creatinine; clearance ,,,39.01,50.28,3 RC,342,Creatinine; other source ,,,20.91,26.95,3 RC,342,Cryofibrinogen ,,,58.54,75.44,3 RC,342,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,342,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,342,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,342,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,342,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,342,Cryopreservation; sperm ,,,442.57,570.33,3 RC,342,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,342,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,342,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,342,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,342,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,342,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,342,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,342,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,342,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,342,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,342,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,342,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,342,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,342,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,342,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,342,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,342,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,342,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,342,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,342,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,342,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,342,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,342,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,342,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,342,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,342,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,342,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,342,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,342,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,342,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,342,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,342,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,342,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,342,"Culture, typing; other methods ",,,32.04,41.29,3 RC,342,Cyanide ,,,79.46,102.39,3 RC,342,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,342,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,342,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,342,Cyclosporine ,,,73.87,95.19,3 RC,342,Cystatin C ,,,76.68,98.82,3 RC,342,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,342,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,342,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,342,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,342,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,342,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,342,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,342,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,342,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,342,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,342,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,342,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,342,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,342,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,342,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,342,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,342,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,342,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,342,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,342,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,342,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,342,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,342,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,342,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,342,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,342,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,342,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,342,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,342,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,342,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,342,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,342,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,342,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,342,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,342,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,342,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,342,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,342,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,342,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,342,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,342,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,342,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,342,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,342,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,342,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,342,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,342,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,342,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,342,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,342,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,342,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,342,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,342,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,342,Dibucaine number ,,,50.18,64.67,3 RC,342,Digoxin; free ,,,54.38,70.08,3 RC,342,Digoxin; total ,,,54.38,70.08,3 RC,342,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,342,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,342,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,342,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,342,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,342,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,342,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,342,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,342,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,342,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,342,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,342,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,342,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,342,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,342,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,342,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,342,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,342,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,342,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,342,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,342,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,342,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,342,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,342,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,342,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,342,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,342,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,342,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,342,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,342,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,342,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,342,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,342,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,342,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,342,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,342,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,342,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,342,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,342,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,342,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,342,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,342,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,342,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,342,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,342,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,342,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,342,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,342,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,342,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,342,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,342,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,342,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,342,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,342,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,342,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,342,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,342,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,342,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,342,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,342,Erythropoietin ,,,76.68,98.82,3 RC,342,Esophageal motility ,,,214.04,214.04,1 RC,342,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,342,Estradiol; total ,,,114.31,147.31,3 RC,342,Estriol ,,,98.98,127.56,3 RC,342,Estrogens; fractionated ,,,132.41,170.64,3 RC,342,Estrogens; total ,,,89.2,114.95,3 RC,342,Estrone ,,,103.14,132.92,3 RC,342,Ethosuximide ,,,66.9,86.21,3 RC,342,Ethylene glycol ,,,61.31,79.01,3 RC,342,Etiocholanolone ,,,107.34,138.33,3 RC,342,Euglobulin lysis ,,,34.86,44.92,3 RC,342,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,342,Everolimus ,,,57.16,73.66,3 RC,342,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,342,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,342,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,342,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,342,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,342,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,342,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,342,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,342,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,342,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,342,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,342,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,342,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,342,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,342,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,342,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,342,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,342,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,342,Factor inhibitor test ,,,52.96,68.24,3 RC,342,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,342,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,342,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,342,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,342,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,342,Felbamate ,,,76.68,98.82,3 RC,342,Fentanyl ,,,98.98,127.56,3 RC,342,Fern test ,,,40.44,52.12,3 RC,342,Ferritin ,,,55.77,71.87,3 RC,342,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,342,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,342,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,342,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,342,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,342,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,342,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,342,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,342,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,342,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,342,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,342,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,342,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,342,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,342,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,342,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,342,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,342,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,342,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,342,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,342,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,342,Fibrinogen; activity ,,,40.44,52.12,3 RC,342,Fibrinogen; antigen ,,,59.93,77.23,3 RC,342,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,342,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,342,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,342,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,342,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,342,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,342,Flecainide ,,,76.68,98.82,3 RC,342,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,342,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,342,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,342,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,342,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,342,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,342,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,342,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,342,Fluoride ,,,76.68,98.82,3 RC,342,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,342,Folic acid; RBC ,,,72.48,93.41,3 RC,342,Folic acid; serum ,,,59.93,77.23,3 RC,342,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,342,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,342,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,342,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,342,"Fructose, semen ",,,71.1,91.62,3 RC,342,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,342,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,342,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,342,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,342,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,342,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,342,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,342,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,342,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,342,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,342,"Galactokinase, RBC ",,,87.81,113.16,3 RC,342,Galactose ,,,45.98,59.26,3 RC,342,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,342,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,342,Galectin-3 ,,,182.6,235.31,3 RC,342,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,342,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,342,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,342,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,342,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,342,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,342,"Gases, blood, pH only ",,,44.6,57.47,3 RC,342,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,342,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,342,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,342,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,342,Gastric mucosa imaging ,,,205.51,205.51,1 RC,342,Gastrin ,,,72.48,93.41,3 RC,342,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,342,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,342,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,342,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,342,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,342,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,342,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,342,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,342,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,342,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,342,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,342,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,342,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,342,Gentamicin ,,,66.9,86.21,3 RC,342,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,342,Glucagon ,,,58.54,75.44,3 RC,342,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,342,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,342,Glucagon tolerance test ,,,72.48,93.41,3 RC,342,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,342,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,342,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,342,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,342,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,342,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,342,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,342,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,342,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,342,"Glucosidase, beta ",,,87.81,113.16,3 RC,342,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,342,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,342,Glutathione ,,,64.13,82.64,3 RC,342,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,342,Glycated protein ,,,68.28,88.0,3 RC,342,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,342,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,342,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,342,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,342,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,342,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,342,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,342,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,342,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,342,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,342,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,342,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,342,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,342,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,342,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,342,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,342,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,342,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,342,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,342,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,342,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,342,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,342,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,342,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,342,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,342,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,342,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,342,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,342,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,342,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,342,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,342,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,342,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,342,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,342,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,342,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,342,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,342,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,342,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,342,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,342,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,342,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,Haloperidol ,,,65.51,84.43,3 RC,342,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,342,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,342,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,342,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,342,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,342,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,342,Heinz bodies; direct ,,,16.71,21.54,3 RC,342,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,342,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,342,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,342,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,342,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,342,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,342,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,342,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,342,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,342,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,342,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,342,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,342,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,342,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,342,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,342,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,342,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,342,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,342,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,342,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,342,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,342,Hemoglobin; plasma ,,,30.66,39.51,3 RC,342,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,342,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,342,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,342,Hemoglobin; urine ,,,16.71,21.54,3 RC,342,"Hemolysin, acid ",,,36.24,46.7,3 RC,342,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,342,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,342,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,342,Heparin assay ,,,54.38,70.08,3 RC,342,Heparin neutralization ,,,48.8,62.89,3 RC,342,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,342,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,342,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,342,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,342,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,342,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,342,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,342,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,342,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,342,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,342,Hepatitis C antibody; ,,,58.54,75.44,3 RC,342,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,342,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,342,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,342,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,342,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,342,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,342,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,342,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,342,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,342,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,342,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,342,Heroin metabolite ,,,98.98,127.56,3 RC,342,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,342,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,342,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,342,Histamine ,,,121.28,156.3,3 RC,342,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,342,Homocysteine ,,,73.87,95.19,3 RC,342,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,342,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,342,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,342,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,342,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,342,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,342,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,342,Hydroxychloroquine ,,,76.68,98.82,3 RC,342,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,342,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,342,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,342,Hydroxyproline; free ,,,93.4,120.36,3 RC,342,Hydroxyproline; total ,,,100.37,129.34,3 RC,342,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,342,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,342,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,342,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,342,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,342,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,342,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,342,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,342,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,342,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,342,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,342,Immune complex assay ,,,100.37,129.34,3 RC,342,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,342,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,342,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,342,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,342,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,342,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,342,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,342,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,342,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,342,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,342,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,342,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,342,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,342,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,342,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,342,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,342,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,342,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,342,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,342,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,342,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,342,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,342,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,342,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,342,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,342,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,342,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,342,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,342,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,342,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,342,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,342,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,342,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,342,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,342,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,342,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,342,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,342,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,342,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,342,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,342,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,342,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,342,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,342,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,342,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,342,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,342,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,342,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,342,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,342,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,342,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,342,Infliximab ,,,158.91,204.79,3 RC,342,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,342,Inhibin A ,,,64.13,82.64,3 RC,342,Insemination of oocytes ,,,442.57,570.33,3 RC,342,Insulin antibodies ,,,87.81,113.16,3 RC,342,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,342,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,342,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,342,Insulin; free ,,,52.96,68.24,3 RC,342,Insulin; total ,,,47.41,61.1,3 RC,342,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,342,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,342,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,342,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,342,Intrinsic factor ,,,80.84,104.18,3 RC,342,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,342,Iron ,,,26.5,34.15,3 RC,342,Iron binding capacity ,,,36.24,46.7,3 RC,342,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,342,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,342,Islet cell antibody ,,,97.55,125.72,3 RC,342,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,342,Itraconazole ,,,111.5,143.69,3 RC,342,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,342,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,342,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,342,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,342,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,342,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,342,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,342,Ketamine and norketamine ,,,98.98,127.56,3 RC,342,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,342,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,342,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,342,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,342,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,342,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,342,Kidney imaging morphology; ,,,172.11,172.11,1 RC,342,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,342,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,342,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,342,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,342,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,342,Lacosamide ,,,111.5,143.69,3 RC,342,Lactate (lactic acid) ,,,47.41,61.1,3 RC,342,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,342,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,342,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,342,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,342,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,342,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,342,Lamotrigine ,,,54.38,70.08,3 RC,342,Lead ,,,50.18,64.67,3 RC,342,Leflunomide ,,,158.91,204.79,3 RC,342,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,342,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,342,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,342,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,342,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,342,Leukocyte transfusion ,,,305.26,393.39,3 RC,342,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,342,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,342,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,342,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,342,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,342,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,342,Levetiracetam ,,,54.38,70.08,3 RC,342,Lidocaine ,,,59.93,77.23,3 RC,342,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,342,Lipase ,,,27.89,35.94,3 RC,342,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,342,Lipoprotein (a) ,,,58.54,75.44,3 RC,342,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,342,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,342,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,342,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,342,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,342,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,342,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,342,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,342,Lithium ,,,27.89,35.94,3 RC,342,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,342,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,342,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,342,Liver imaging; static only ,,,191.2,191.2,1 RC,342,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,342,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,342,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,342,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,342,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,342,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,342,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,342,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,342,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,342,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,342,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,342,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,342,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,342,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,342,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,342,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,342,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,342,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,342,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,342,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,342,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,342,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,342,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,342,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,342,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,342,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,342,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,342,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,342,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,342,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,342,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,342,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,342,Magnesium ,,,27.89,35.94,3 RC,342,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,342,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,342,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,342,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,342,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,342,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,342,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,342,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,342,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,342,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,342,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,342,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,342,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,342,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,342,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,342,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,342,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,342,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,342,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,342,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,342,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,342,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,342,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,342,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,342,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,342,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,342,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,342,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,342,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,342,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,342,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,342,Malate dehydrogenase ,,,30.66,39.51,3 RC,342,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,342,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,342,Manganese ,,,110.11,141.9,3 RC,342,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,342,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,342,"Meat fibers, feces ",,,19.53,25.17,3 RC,342,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,342,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,342,"Mercury, quantitative ",,,66.9,86.21,3 RC,342,Metanephrines ,,,69.71,89.84,3 RC,342,Methadone ,,,98.98,127.56,3 RC,342,Methemalbumin ,,,44.6,57.47,3 RC,342,Methotrexate ,,,158.91,204.79,3 RC,342,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,342,Methylphenidate ,,,98.98,127.56,3 RC,342,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,342,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,342,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,342,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,342,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,342,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,342,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,342,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,342,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,342,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,342,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,342,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,342,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,342,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,342,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,342,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,342,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,342,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,342,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,342,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,342,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,342,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,342,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,342,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,342,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,342,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,342,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,342,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,342,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,342,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,342,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,342,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,342,Muramidase ,,,76.68,98.82,3 RC,342,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,342,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,342,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,342,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,342,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,342,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,342,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,342,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,342,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,342,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,342,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,342,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,342,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,342,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,342,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,342,Myoglobin ,,,52.96,68.24,3 RC,342,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,342,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,342,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,342,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,342,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,342,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,342,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,342,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,342,Natriuretic peptide ,,,161.68,208.36,3 RC,342,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,342,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,342,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,342,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,342,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,342,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,342,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,342,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,342,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,342,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,342,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,342,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,342,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,342,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,342,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,342,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,342,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,342,Nerve teasing preparations ,,,499.29,643.43,3 RC,342,"Neutralization test, viral ",,,69.71,89.84,3 RC,342,Nickel ,,,100.37,129.34,3 RC,342,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,342,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,342,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,342,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,342,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,342,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,342,Nucleotidase 5'- ,,,45.98,59.26,3 RC,342,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,342,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,342,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,342,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,342,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,342,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,342,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,342,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,342,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,342,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,342,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,342,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,342,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,342,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,342,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,342,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,342,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,342,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,342,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,342,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,342,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,342,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,342,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,342,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,342,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,342,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,342,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,342,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,342,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,342,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,342,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,342,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,342,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,342,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,342,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,342,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,342,"Opiates, 1 or more ",,,98.98,127.56,3 RC,342,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,342,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,342,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,342,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,342,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,342,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,342,Osmolality; blood ,,,27.89,35.94,3 RC,342,Osmolality; urine ,,,27.89,35.94,3 RC,342,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,342,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,342,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,342,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,342,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,342,Oxalate ,,,59.93,77.23,3 RC,342,Oxcarbazepine ,,,54.38,70.08,3 RC,342,Oxycodone ,,,98.98,127.56,3 RC,342,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,342,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,342,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,342,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,342,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,342,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,342,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,342,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,342,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,342,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,342,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,342,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,342,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,342,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,342,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,342,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,342,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,342,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,342,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,342,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,342,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,342,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,342,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,342,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,342,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,342,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,342,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,342,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,342,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,342,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,342,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,342,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,342,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,342,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,342,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,342,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,342,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,342,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,342,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,342,Phenobarbital ,,,62.74,80.85,3 RC,342,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,342,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,342,Phenytoin; free ,,,57.16,73.66,3 RC,342,Phenytoin; total ,,,54.38,70.08,3 RC,342,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,342,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,342,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,342,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,342,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,342,Phosphatidylglycerol ,,,68.28,88.0,3 RC,342,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,342,Phosphohexose isomerase ,,,44.6,57.47,3 RC,342,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,342,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,342,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,342,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,342,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,342,Pinworm examinations ,,,18.14,23.38,3 RC,342,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,342,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,342,Platelet survival study ,,,126.1,126.1,1 RC,342,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,342,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,342,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,342,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,342,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,342,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,342,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,342,Posaconazole ,,,111.5,143.69,3 RC,342,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,342,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,342,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,342,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,342,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,342,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,342,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,342,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,342,Potassium; urine ,,,19.53,25.17,3 RC,342,Prealbumin ,,,59.93,77.23,3 RC,342,Pregabalin ,,,98.98,127.56,3 RC,342,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,342,Pregnanediol ,,,87.81,113.16,3 RC,342,Pregnanetriol ,,,86.43,111.38,3 RC,342,Pregnenolone ,,,85.04,109.59,3 RC,342,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,342,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,342,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,342,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,342,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,342,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,342,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,342,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,342,Primidone ,,,68.28,88.0,3 RC,342,Procainamide; ,,,246.72,317.95,3 RC,342,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,342,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,342,Progesterone ,,,86.43,111.38,3 RC,342,Proinsulin ,,,110.11,141.9,3 RC,342,Prolactin ,,,79.46,102.39,3 RC,342,Propoxyphene ,,,98.98,127.56,3 RC,342,"Prostaglandin, each ",,,171.47,220.97,3 RC,342,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,342,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,342,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,342,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,342,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,342,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,342,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,342,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,342,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,342,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,342,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,342,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,342,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,342,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,342,Prothrombin time; ,,,18.14,23.38,3 RC,342,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,342,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,342,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,342,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,342,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,342,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,342,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,342,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,342,Pyruvate ,,,59.93,77.23,3 RC,342,Pyruvate kinase ,,,39.01,50.28,3 RC,342,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,342,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,342,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,342,Quinidine ,,,59.93,77.23,3 RC,342,Quinine ,,,47.41,61.1,3 RC,342,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,342,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,342,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,342,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,342,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,342,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,342,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,342,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,342,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,342,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,342,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,342,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,342,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,342,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,342,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,342,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,342,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,342,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,342,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,342,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,342,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,342,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,342,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,342,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,342,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,342,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,342,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,342,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,342,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,342,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,342,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,342,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,342,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,342,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,342,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,342,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,342,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,342,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,342,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,342,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,342,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,342,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,342,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,342,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,342,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,342,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,342,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,342,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,342,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,342,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,342,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,342,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,342,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,342,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,342,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,342,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,342,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,342,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,342,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,342,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,342,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,342,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,342,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,342,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,342,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,342,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,342,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,342,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,342,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,342,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,342,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,342,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,342,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,342,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,342,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,342,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,342,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,342,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,342,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,342,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,342,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,342,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,342,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,342,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,342,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,342,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,342,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,342,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,342,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,342,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,342,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,342,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,342,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,342,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,342,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,342,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,342,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,342,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,342,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,342,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,342,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,342,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,342,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,342,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,342,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,342,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,342,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,342,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,342,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,342,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,342,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,342,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,342,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,342,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,342,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,342,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,342,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,342,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,342,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,342,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,342,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,342,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,342,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,342,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,342,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,342,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,342,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,342,"Radiopharmaceutical therapy, by oral administration ",1373.03,1373.03,135.65,135.65,1 RC,342,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,342,Receptor assay; estrogen ,,,361.04,465.26,3 RC,342,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,342,Receptor assay; progesterone ,,,266.25,343.11,3 RC,342,Red cell survival study ,,,126.1,126.1,1 RC,342,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,342,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,342,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,342,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,342,Renin ,,,90.63,116.79,3 RC,342,Reptilase test ,,,40.44,52.12,3 RC,342,Reticulated platelet assay ,,,146.35,188.6,3 RC,342,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,342,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,342,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,342,Rufinamide ,,,111.5,143.69,3 RC,342,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,342,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,342,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,342,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,342,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,342,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,342,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,342,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,342,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,342,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,342,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,342,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,342,Salicylate ,,,76.68,98.82,3 RC,342,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,342,Salivary gland function study ,,,104.3,104.3,1 RC,342,Salivary gland imaging; ,,,175.52,175.52,1 RC,342,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,342,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,342,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,342,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,342,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,342,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,342,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,342,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,342,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,342,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,342,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,342,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,342,Selenium ,,,104.53,134.7,3 RC,342,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,342,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,342,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,342,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,342,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,342,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,342,Serotonin ,,,126.87,163.49,3 RC,342,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,342,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,342,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,342,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,342,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,342,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,342,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,342,Sialic acid ,,,55.77,71.87,3 RC,342,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,342,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,342,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,342,Silica ,,,103.14,132.92,3 RC,342,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,342,Sirolimus ,,,57.16,73.66,3 RC,342,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,342,Skin test; candida ,,,79.46,102.39,3 RC,342,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,342,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,342,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,342,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,342,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,342,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,342,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,342,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,342,Sodium; other source ,,,19.53,25.17,3 RC,342,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,342,Sodium; urine ,,,20.91,26.95,3 RC,342,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,342,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,342,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,342,Somatomedin ,,,87.81,113.16,3 RC,342,Somatostatin ,,,75.26,96.98,3 RC,342,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,342,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,342,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,342,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,342,Specific gravity (except urine) ,,,13.94,17.97,3 RC,342,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,342,Sperm antibodies ,,,43.21,55.69,3 RC,342,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,342,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,342,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,342,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,342,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,342,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,342,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,342,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,342,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,342,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,342,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,342,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,342,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,342,"Stimulants, synthetic ",,,98.98,127.56,3 RC,342,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,342,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,342,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,342,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,342,"Streptokinase, antibody ",,,51.57,66.46,3 RC,342,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,342,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,342,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,342,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,342,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,342,"Sulfate, urine ",,,22.3,28.74,3 RC,342,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,342,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,342,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,342,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,342,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,342,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,342,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,342,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,342,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,342,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,342,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,342,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,342,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,342,T cells; total count ,,,154.71,199.37,3 RC,342,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,342,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,342,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,342,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,342,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,342,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,342,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,342,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,342,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,342,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,342,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,342,Tacrolimus ,,,57.16,73.66,3 RC,342,Tapentadol ,,,98.98,127.56,3 RC,342,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,342,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,342,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,342,Testosterone; free ,,,104.53,134.7,3 RC,342,Testosterone; total ,,,105.96,136.54,3 RC,342,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,342,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,342,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,342,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,342,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,342,Theophylline ,,,58.54,75.44,3 RC,342,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,342,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,342,Thiocyanate ,,,47.41,61.1,3 RC,342,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,342,Thrombin time; plasma ,,,23.69,30.52,3 RC,342,Thrombin time; titer ,,,27.89,35.94,3 RC,342,Thrombomodulin ,,,71.1,91.62,3 RC,342,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,342,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,342,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,342,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,342,Thyroglobulin ,,,65.51,84.43,3 RC,342,Thyroglobulin antibody ,,,65.51,84.43,3 RC,342,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,342,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,342,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,342,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,342,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,342,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,342,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,342,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,342,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,342,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,342,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,342,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,342,Thyroxine; free ,,,37.63,48.49,3 RC,342,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,342,Thyroxine; total ,,,27.89,35.94,3 RC,342,Tiagabine ,,,111.5,143.69,3 RC,342,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,342,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,342,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,342,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,342,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,342,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,342,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,342,Tobramycin ,,,66.9,86.21,3 RC,342,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,342,Topiramate ,,,48.8,62.89,3 RC,342,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,342,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,342,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,342,Tramadol ,,,98.98,127.56,3 RC,342,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,342,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,342,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,342,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,342,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,342,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,342,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,342,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,342,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,342,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,342,Transferrin ,,,52.96,68.24,3 RC,342,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,342,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,342,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,342,Triglycerides ,,,23.69,30.52,3 RC,342,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,342,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,342,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,342,"Troponin, qualitative ",,,41.83,53.9,3 RC,342,"Troponin, quantitative ",,,51.57,66.46,3 RC,342,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,342,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,342,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,342,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,342,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,342,Tyrosine ,,,43.21,55.69,3 RC,342,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,342,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,342,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,342,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,342,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,342,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,342,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,342,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,342,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,342,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,342,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,342,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,342,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,342,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,342,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,342,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,342,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,342,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,342,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,342,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,342,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,342,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,342,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,342,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,342,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,342,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,342,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,342,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,342,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,342,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,342,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,342,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,342,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,342,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,342,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,342,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,342,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,342,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,342,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,342,Unlisted immunology procedure ,,,99.55,128.28,3 RC,342,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,342,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,342,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,342,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,342,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,342,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,342,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,342,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,342,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,342,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,342,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,342,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,342,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,342,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,342,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,342,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,342,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,342,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,342,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,342,Uric acid; blood ,,,18.14,23.38,3 RC,342,Uric acid; other source ,,,20.91,26.95,3 RC,342,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,342,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,342,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,342,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,342,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,342,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,342,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,342,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,342,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,342,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,342,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,342,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,342,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,342,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,342,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,342,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,342,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,342,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,342,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,342,Vancomycin ,,,55.77,71.87,3 RC,342,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,342,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,342,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,342,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,342,Vedolizumab ,,,158.91,204.79,3 RC,342,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,342,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,342,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,342,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,342,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,342,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,342,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,342,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,342,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,342,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,342,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,342,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,342,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,342,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,342,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,342,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,342,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,342,Very long chain fatty acids ,,,80.84,104.18,3 RC,342,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,342,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,342,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,342,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,342,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,342,Viscosity ,,,47.41,61.1,3 RC,342,Vitamin A ,,,47.41,61.1,3 RC,342,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,342,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,342,Vitamin K ,,,55.77,71.87,3 RC,342,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,342,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,342,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,342,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,342,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,342,Voriconazole ,,,111.5,143.69,3 RC,342,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,342,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,342,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,342,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,342,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,342,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,342,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,342,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,342,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,342,Zinc ,,,47.41,61.1,3 RC,342,Zonisamide ,,,54.38,70.08,3 RC,342,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,342,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,342,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,343, Nuclear Medicine Diagnostic Radiopharmaceuticals ,,,,,0 RC,343,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,343,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,343,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,343,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,343,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,343,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,343,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,343,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,343,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,343,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,343,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,343,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,343,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,343,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,343,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,343,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,343,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,343,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,343,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,343,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,343,Bone age studies ,,,26.58,26.58,1 RC,343,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,343,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,343,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,343,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,343,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,343,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,343,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,343,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,343,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,343,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,343,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,343,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,343,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,343,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,343,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,343,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,343,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,343,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,343,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,343,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,343,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,343,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,343,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,343,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,343,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,343,Cardiac shunt detection ,,,186.76,186.76,1 RC,343,Cardiokymography ,,,20.04,20.04,1 RC,343,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,343,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,343,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,343,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,343,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,343,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,343,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,343,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,343,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,343,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,343,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,343,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,343,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,343,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,343,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,343,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,343,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,343,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,343,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,343,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,343,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,343,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,343,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,343,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,343,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,343,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,343,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,343,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,343,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,343,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,343,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,343,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,343,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,343,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,343,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,343,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,343,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,343,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,343,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,343,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,343,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,343,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,343,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,343,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,343,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,343,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,343,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,343,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,343,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,343,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,343,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,343,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,343,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,343,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,343,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,343,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,343,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,343,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,343,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,343,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,343,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,343,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,343,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,343,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,343,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,343,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,343,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,343,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,343,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,343,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,343,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,343,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,343,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,343,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,343,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,343,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,343,Esophageal motility ,,,214.04,214.04,1 RC,343,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,343,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,343,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,343,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,343,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,343,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,343,Gastric mucosa imaging ,,,205.51,205.51,1 RC,343,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,343,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,343,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,343,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,343,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,343,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,343,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,343,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,343,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,343,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,343,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,343,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,343,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,343,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,343,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,343,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,343,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,343,Kidney imaging morphology; ,,,172.11,172.11,1 RC,343,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,343,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,343,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,343,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,343,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,343,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,343,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,343,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,343,Liver imaging; static only ,,,191.2,191.2,1 RC,343,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,343,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,343,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,343,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,343,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,343,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,343,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,343,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,343,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,343,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,343,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,343,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,343,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,343,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,343,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,343,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,343,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,343,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,343,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,343,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,343,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,343,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,343,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,343,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,343,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,343,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,343,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,343,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,343,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,343,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,343,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,343,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,343,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,343,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,343,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,343,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,343,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,343,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,343,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,343,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,343,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,343,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,343,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,343,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,343,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,343,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,343,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,343,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,343,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,343,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,343,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,343,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,343,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,343,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,343,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,343,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,343,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,343,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,343,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,343,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,343,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,343,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,343,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,343,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,343,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,343,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,343,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,343,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,343,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,343,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,343,Platelet survival study ,,,126.1,126.1,1 RC,343,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,343,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,343,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,343,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,343,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,343,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,343,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,343,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,343,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,343,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,343,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,343,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,343,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,343,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,343,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,343,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,343,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,343,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,343,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,343,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,343,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,343,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,343,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,343,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,343,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,343,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,343,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,343,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,343,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,343,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,343,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,343,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,343,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,343,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,343,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,343,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,343,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,343,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,343,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,343,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,343,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,343,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,343,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,343,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,343,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,343,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,343,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,343,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,343,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,343,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,343,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,343,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,343,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,343,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,343,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,343,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,343,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,343,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,343,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,343,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,343,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,343,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,343,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,343,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,343,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,343,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,343,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,343,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,343,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,343,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,343,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,343,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,343,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,343,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,343,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,343,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,343,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,343,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,343,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,343,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,343,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,343,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,343,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,343,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,343,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,343,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,343,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,343,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,343,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,343,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,343,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,343,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,343,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,343,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,343,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,343,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,343,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,343,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,343,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,343,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,343,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,343,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,343,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,343,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,343,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,343,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,343,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,343,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,343,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,343,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,343,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,343,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,343,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,343,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,343,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,343,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,343,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,343,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,343,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,343,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,343,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,343,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,343,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,343,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,343,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,343,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,343,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,343,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,343,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,343,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,343,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,343,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,343,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,343,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,343,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,343,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,343,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,343,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,343,Red cell survival study ,,,126.1,126.1,1 RC,343,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,343,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,343,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,343,Salivary gland function study ,,,104.3,104.3,1 RC,343,Salivary gland imaging; ,,,175.52,175.52,1 RC,343,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,343,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,343,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,343,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,343,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,343,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,343,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,343,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,343,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,343,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,343,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,343,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,343,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,343,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,343,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,343,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,343,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,343,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,343,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,343,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,343,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,343,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,343,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,343,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,343,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,343,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,343,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,343,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,343,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,343,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,343,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,343,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,343,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,343,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,343,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,343,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,343,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,343,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,343,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,343,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,343,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,343,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,343,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,343,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,343,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,343,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,343,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,343,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,343,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,343,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,343,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,343,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,343,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,343,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,343,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,343,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,343,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,343,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,343,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,343,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,343,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,343,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,343,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,343,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,343,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,343,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,343,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,343,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,343,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,343,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,343,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,343,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,343,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,343,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,343,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,343,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,343,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,343,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,343,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,343,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,343,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,343,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,343,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,343,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,343,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,343,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,343,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,344, Nuclear Medicine Therapeutic Radiopharmaceuticals ,,,,,0 RC,344,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,344,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,344,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,344,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,344,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,344,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,344,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,344,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,344,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,344,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,344,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,344,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,344,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,344,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,344,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,344,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,344,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,344,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,344,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,344,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,344,Bone age studies ,,,26.58,26.58,1 RC,344,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,344,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,344,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,344,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,344,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,344,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,344,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,344,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,344,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,344,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,344,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,344,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,344,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,344,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,344,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,344,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,344,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,344,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,344,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,344,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,344,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,344,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,344,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,344,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,344,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,344,Cardiac shunt detection ,,,186.76,186.76,1 RC,344,Cardiokymography ,,,20.04,20.04,1 RC,344,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,344,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,344,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,344,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,344,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,344,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,344,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,344,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,344,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,344,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,344,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,344,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,344,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,344,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,344,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,344,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,344,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,344,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,344,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,344,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,344,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,344,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,344,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,344,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,344,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,344,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,344,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,344,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,344,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,344,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,344,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,344,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,344,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,344,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,344,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,344,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,344,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,344,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,344,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,344,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,344,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,344,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,344,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,344,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,344,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,344,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,344,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,344,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,344,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,344,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,344,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,344,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,344,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,344,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,344,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,344,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,344,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,344,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,344,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,344,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,344,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,344,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,344,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,344,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,344,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,344,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,344,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,344,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,344,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,344,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,344,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,344,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,344,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,344,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,344,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,344,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,344,Esophageal motility ,,,214.04,214.04,1 RC,344,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,344,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,344,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,344,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,344,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,344,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,344,Gastric mucosa imaging ,,,205.51,205.51,1 RC,344,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,344,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,344,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,344,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,344,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,344,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,344,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,344,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,344,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,344,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,344,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,344,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,344,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,344,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,344,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,344,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,344,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,344,Kidney imaging morphology; ,,,172.11,172.11,1 RC,344,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,344,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,344,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,344,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,344,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,344,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,344,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,344,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,344,Liver imaging; static only ,,,191.2,191.2,1 RC,344,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,344,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,344,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,344,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,344,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,344,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,344,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,344,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,344,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,344,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,344,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,344,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,344,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,344,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,344,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,344,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,344,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,344,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,344,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,344,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,344,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,344,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,344,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,344,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,344,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,344,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,344,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,344,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,344,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,344,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,344,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,344,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,344,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,344,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,344,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,344,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,344,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,344,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,344,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,344,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,344,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,344,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,344,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,344,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,344,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,344,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,344,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,344,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,344,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,344,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,344,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,344,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,344,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,344,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,344,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,344,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,344,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,344,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,344,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,344,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,344,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,344,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,344,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,344,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,344,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,344,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,344,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,344,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,344,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,344,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,344,Platelet survival study ,,,126.1,126.1,1 RC,344,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,344,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,344,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,344,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,344,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,344,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,344,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,344,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,344,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,344,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,344,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,344,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,344,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,344,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,344,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,344,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,344,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,344,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,344,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,344,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,344,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,344,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,344,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,344,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,344,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,344,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,344,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,344,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,344,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,344,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,344,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,344,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,344,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,344,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,344,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,344,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,344,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,344,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,344,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,344,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,344,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,344,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,344,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,344,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,344,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,344,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,344,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,344,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,344,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,344,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,344,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,344,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,344,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,344,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,344,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,344,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,344,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,344,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,344,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,344,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,344,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,344,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,344,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,344,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,344,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,344,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,344,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,344,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,344,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,344,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,344,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,344,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,344,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,344,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,344,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,344,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,344,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,344,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,344,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,344,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,344,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,344,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,344,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,344,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,344,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,344,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,344,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,344,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,344,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,344,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,344,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,344,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,344,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,344,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,344,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,344,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,344,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,344,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,344,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,344,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,344,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,344,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,344,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,344,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,344,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,344,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,344,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,344,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,344,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,344,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,344,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,344,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,344,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,344,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,344,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,344,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,344,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,344,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,344,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,344,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,344,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,344,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,344,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,344,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,344,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,344,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,344,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,344,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,344,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,344,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,344,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,344,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,344,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,344,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,344,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,344,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,344,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,344,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,344,Red cell survival study ,,,126.1,126.1,1 RC,344,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,344,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,344,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,344,Salivary gland function study ,,,104.3,104.3,1 RC,344,Salivary gland imaging; ,,,175.52,175.52,1 RC,344,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,344,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,344,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,344,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,344,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,344,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,344,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,344,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,344,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,344,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,344,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,344,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,344,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,344,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,344,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,344,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,344,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,344,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,344,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,344,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,344,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,344,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,344,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,344,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,344,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,344,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,344,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,344,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,344,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,344,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,344,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,344,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,344,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,344,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,344,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,344,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,344,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,344,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,344,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,344,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,344,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,344,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,344,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,344,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,344,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,344,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,344,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,344,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,344,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,344,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,344,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,344,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,344,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,344,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,344,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,344,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,344,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,344,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,344,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,344,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,344,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,344,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,344,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,344,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,344,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,344,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,344,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,344,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,344,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,344,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,344,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,344,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,344,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,344,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,344,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,344,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,344,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,344,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,344,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,344,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,344,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,344,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,344,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,344,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,344,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,344,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,344,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,349, Nuclear Medicine Other ,,,1179.0,1529.0,4 RC,349,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,349,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,349,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,349,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,349,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,349,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,349,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,349,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,349,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,349,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,349,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,349,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,349,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,349,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,349,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,349,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,349,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,Acetaminophen ,,,76.68,98.82,3 RC,349,Acetylcholinesterase ,,,50.18,64.67,3 RC,349,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,349,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,349,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,349,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,349,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,349,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,349,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,349,Adalimumab ,,,158.91,204.79,3 RC,349,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,349,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,349,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,349,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,349,Albumin; ischemia modified ,,,139.38,179.62,3 RC,349,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,349,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,349,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,349,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,349,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,349,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,349,Alcohols ,,,98.98,127.56,3 RC,349,Aldolase ,,,40.44,52.12,3 RC,349,Aldosterone ,,,167.27,215.56,3 RC,349,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,349,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,349,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,349,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,349,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,349,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,349,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,349,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,349,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,349,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,349,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,349,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,349,Aluminum ,,,104.53,134.7,3 RC,349,Amikacin ,,,62.74,80.85,3 RC,349,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,349,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,349,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,349,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,349,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,349,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,349,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,349,Amiodarone ,,,76.68,98.82,3 RC,349,Ammonia ,,,59.93,77.23,3 RC,349,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,349,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,349,Amylase ,,,26.5,34.15,3 RC,349,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,349,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,349,Androstanediol glucuronide ,,,118.47,152.67,3 RC,349,Androstenedione ,,,119.9,154.51,3 RC,349,Androsterone ,,,104.53,134.7,3 RC,349,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,349,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,349,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,349,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,349,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,349,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,349,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,349,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,349,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,349,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,349,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,349,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,349,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,349,Angiotensin II ,,,85.04,109.59,3 RC,349,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,349,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,349,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,349,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,349,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,349,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,349,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,349,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,349,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,349,Antibody; Aspergillus ,,,61.31,79.01,3 RC,349,Antibody; Bartonella ,,,41.83,53.9,3 RC,349,Antibody; Blastomyces ,,,52.96,68.24,3 RC,349,Antibody; Bordetella ,,,54.38,70.08,3 RC,349,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,349,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,349,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,349,Antibody; Brucella ,,,36.24,46.7,3 RC,349,Antibody; Campylobacter ,,,54.38,70.08,3 RC,349,Antibody; Candida ,,,48.8,62.89,3 RC,349,Antibody; Chlamydia ,,,48.8,62.89,3 RC,349,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,349,Antibody; Coccidioides ,,,47.41,61.1,3 RC,349,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,349,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,349,Antibody; Diphtheria ,,,62.74,80.85,3 RC,349,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,349,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,349,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,349,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,349,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,349,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,349,Antibody; HIV-1 ,,,36.24,46.7,3 RC,349,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,349,Antibody; HIV-2 ,,,55.77,71.87,3 RC,349,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,349,Antibody; HTLV-I ,,,37.63,48.49,3 RC,349,Antibody; HTLV-II ,,,57.16,73.66,3 RC,349,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,349,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,349,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,349,Antibody; Legionella ,,,62.74,80.85,3 RC,349,Antibody; Leishmania ,,,50.18,64.67,3 RC,349,Antibody; Leptospira ,,,66.9,86.21,3 RC,349,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,349,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,349,Antibody; Nocardia ,,,65.51,84.43,3 RC,349,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,349,Antibody; Rickettsia ,,,79.46,102.39,3 RC,349,Antibody; Salmonella ,,,54.38,70.08,3 RC,349,Antibody; Shigella ,,,100.37,129.34,3 RC,349,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,349,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,349,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,349,Antibody; Trichinella ,,,51.57,66.46,3 RC,349,Antibody; West Nile virus ,,,58.54,75.44,3 RC,349,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,349,Antibody; Yersinia ,,,54.38,70.08,3 RC,349,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,349,Antibody; actinomyces ,,,41.83,53.9,3 RC,349,Antibody; adenovirus ,,,52.96,68.24,3 RC,349,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,349,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,349,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,349,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,349,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,349,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,349,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,349,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,349,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,349,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,349,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,349,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,349,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,349,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,349,Antibody; histoplasma ,,,57.16,73.66,3 RC,349,Antibody; influenza virus ,,,55.77,71.87,3 RC,349,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,349,Antibody; mucormycosis ,,,61.31,79.01,3 RC,349,Antibody; mumps ,,,54.38,70.08,3 RC,349,Antibody; mycoplasma ,,,54.38,70.08,3 RC,349,Antibody; parvovirus ,,,61.31,79.01,3 RC,349,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,349,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,349,Antibody; rotavirus ,,,75.26,96.98,3 RC,349,Antibody; rubella ,,,58.54,75.44,3 RC,349,Antibody; rubeola ,,,52.96,68.24,3 RC,349,Antibody; tetanus ,,,61.31,79.01,3 RC,349,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,349,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,349,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,349,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,349,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,349,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,349,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,349,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,349,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,349,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,349,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,349,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,349,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,349,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,349,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,349,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,349,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,349,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,349,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,349,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,349,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,349,"Apolipoprotein, each ",,,86.43,111.38,3 RC,349,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,349,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,349,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,349,Arsenic ,,,78.07,100.61,3 RC,349,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,349,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,349,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,349,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,349,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,349,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,349,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,349,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,349,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,349,"B cells, total count ",,,154.71,199.37,3 RC,349,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,349,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,349,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,349,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,349,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,349,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,349,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,349,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,349,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,349,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,349,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,349,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,349,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,349,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,349,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,349,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,349,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,349,Barbiturates ,,,98.98,127.56,3 RC,349,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,349,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,349,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,349,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,349,Beta-2 microglobulin ,,,66.9,86.21,3 RC,349,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,349,Bile acids; total ,,,71.1,91.62,3 RC,349,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,349,Bilirubin; direct ,,,20.91,26.95,3 RC,349,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,349,Bilirubin; total ,,,20.91,26.95,3 RC,349,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,349,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,349,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,349,Bleeding time ,,,19.53,25.17,3 RC,349,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,349,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,349,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,349,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,349,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,349,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,349,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,349,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,349,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,349,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,349,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,349,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,349,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,349,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,349,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,349,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,349,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,349,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,349,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,349,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,349,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,349,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,349,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,349,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,349,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,349,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,349,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,349,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,349,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,349,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,349,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,349,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,349,Bone age studies ,,,26.58,79.3,4 RC,349,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,349,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,349,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,349,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,349,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,349,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,349,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,349,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,349,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,349,Bradykinin ,,,20.91,26.95,3 RC,349,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,349,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,349,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,349,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,349,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,349,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,349,C-peptide ,,,85.04,109.59,3 RC,349,C-reactive protein; ,,,20.91,26.95,3 RC,349,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,349,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,349,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,349,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,349,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,349,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,349,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,349,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,349,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,349,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,349,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,349,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,349,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,349,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,349,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,349,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,349,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,349,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,349,Cadmium ,,,97.55,125.72,3 RC,349,Caffeine ,,,158.91,204.79,3 RC,349,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,349,Calcitonin ,,,110.11,141.9,3 RC,349,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,349,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,349,Calcium; ionized ,,,55.77,71.87,3 RC,349,Calcium; total ,,,20.91,26.95,3 RC,349,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,349,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,349,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,349,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,349,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,349,"Calprotectin, fecal ",,,80.84,104.18,3 RC,349,"Cannabinoids, natural ",,,98.98,127.56,3 RC,349,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,349,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,349,Carbamazepine; free ,,,54.38,70.08,3 RC,349,Carbamazepine; total ,,,59.93,77.23,3 RC,349,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,349,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,349,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,349,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,349,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,349,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,349,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,349,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,349,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,349,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,349,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,349,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,349,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,349,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,349,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,349,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,349,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,349,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,349,Cardiac shunt detection ,,,186.76,186.76,1 RC,349,Cardiokymography ,,,20.04,20.04,1 RC,349,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,349,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,349,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,349,Carotene ,,,37.63,48.49,3 RC,349,Catecholamines; blood ,,,119.9,154.51,3 RC,349,Catecholamines; fractionated ,,,104.53,134.7,3 RC,349,Catecholamines; total urine ,,,112.93,145.53,3 RC,349,Cathepsin-D ,,,73.87,95.19,3 RC,349,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,349,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,349,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,349,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,349,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,349,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,349,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,349,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,349,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,349,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,349,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,349,Ceruloplasmin ,,,44.6,57.47,3 RC,349,Chemiluminescent assay ,,,58.54,75.44,3 RC,349,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,349,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,349,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,349,Chloramphenicol ,,,51.57,66.46,3 RC,349,Chloride; blood ,,,19.53,25.17,3 RC,349,Chloride; other source ,,,20.91,26.95,3 RC,349,Chloride; urine ,,,23.69,30.52,3 RC,349,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,349,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,349,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,349,Cholinesterase; RBC ,,,40.44,52.12,3 RC,349,Cholinesterase; serum ,,,32.04,41.29,3 RC,349,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,349,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,349,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,349,Chromium ,,,83.66,107.81,3 RC,349,Chromogenic substrate assay ,,,48.8,62.89,3 RC,349,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,349,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,349,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,349,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,349,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,349,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,349,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,349,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,349,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,349,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,349,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,349,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,349,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,349,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,349,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,349,Citrate ,,,114.31,147.31,3 RC,349,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,349,Clot retraction ,,,66.9,86.21,3 RC,349,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,349,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,349,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,349,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,349,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,349,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,349,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,349,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,349,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,349,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,349,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,349,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,349,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,349,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,349,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,349,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,349,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,349,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,349,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,349,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,349,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,349,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,349,Clozapine ,,,82.23,105.96,3 RC,349,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,349,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,349,Coagulation time; activated ,,,18.14,23.38,3 RC,349,Coagulation time; other methods ,,,18.14,23.38,3 RC,349,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,349,Cocaine ,,,98.98,127.56,3 RC,349,Cold agglutinin; screen ,,,33.47,43.13,3 RC,349,Cold agglutinin; titer ,,,33.47,43.13,3 RC,349,"Collagen cross links, any method ",,,76.68,98.82,3 RC,349,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,0.26,0.33,3 RC,349,Collection of venous blood by venipuncture ,,,24.12,31.08,3 RC,349,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,349,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,349,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,349,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,349,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,349,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,349,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,349,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,349,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,349,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,349,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,349,"Complement; antigen, each component ",,,48.8,62.89,3 RC,349,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,349,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,349,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,349,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,349,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,349,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,349,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,349,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,349,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,349,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,349,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,349,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,349,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,349,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,349,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,349,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,349,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,349,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,349,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,349,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,349,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,349,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,349,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,349,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,349,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,349,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,349,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,349,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,349,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,349,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,349,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,349,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,349,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,349,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,349,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,349,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,349,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,349,Copper ,,,51.57,66.46,3 RC,349,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,349,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,349,Corticosterone ,,,92.01,118.58,3 RC,349,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,349,Cortisol; free ,,,68.28,88.0,3 RC,349,Cortisol; total ,,,66.9,86.21,3 RC,349,Creatine ,,,19.53,25.17,3 RC,349,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,349,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,349,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,349,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,349,Creatinine; blood ,,,20.91,26.95,3 RC,349,Creatinine; clearance ,,,39.01,50.28,3 RC,349,Creatinine; other source ,,,20.91,26.95,3 RC,349,Cryofibrinogen ,,,58.54,75.44,3 RC,349,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,349,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,349,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,349,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,349,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,349,Cryopreservation; sperm ,,,442.57,570.33,3 RC,349,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,349,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,349,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,349,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,349,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,349,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,349,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,349,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,349,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,349,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,349,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,349,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,349,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,349,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,349,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,349,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,349,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,349,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,349,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,349,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,349,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,349,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,349,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,349,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,349,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,349,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,349,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,349,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,349,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,349,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,349,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,349,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,349,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,349,"Culture, typing; other methods ",,,32.04,41.29,3 RC,349,Cyanide ,,,79.46,102.39,3 RC,349,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,349,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,349,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,349,Cyclosporine ,,,73.87,95.19,3 RC,349,Cystatin C ,,,76.68,98.82,3 RC,349,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,349,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,349,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,349,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,349,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,349,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,349,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,349,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,349,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,349,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,349,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,349,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,349,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,349,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,349,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,349,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,349,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,349,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,349,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,349,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,349,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,349,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,349,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,349,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,349,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,349,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,349,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,349,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,349,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,349,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,349,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,349,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,349,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,349,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,349,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,349,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,349,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,349,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,349,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,349,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,349,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,349,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,349,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,349,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,349,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,349,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,349,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,349,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,349,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,349,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,349,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,349,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,349,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,349,Dibucaine number ,,,50.18,64.67,3 RC,349,Digoxin; free ,,,54.38,70.08,3 RC,349,Digoxin; total ,,,54.38,70.08,3 RC,349,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,349,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,349,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,349,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,349,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,349,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,349,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,349,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,349,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,349,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,349,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,349,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,349,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,349,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,349,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,349,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,349,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,349,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,349,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,349,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,349,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,349,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,349,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,349,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,349,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,349,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,349,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,349,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,349,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,349,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,349,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,349,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,349,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,349,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,349,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,349,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,349,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,349,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,349,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,349,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,349,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,349,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,349,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,349,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,349,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,349,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,349,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,349,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,349,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,349,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,349,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,349,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,349,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,349,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,349,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,349,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,349,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,349,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,349,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,349,Erythropoietin ,,,76.68,98.82,3 RC,349,Esophageal motility ,,,214.04,214.04,1 RC,349,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,349,Estradiol; total ,,,114.31,147.31,3 RC,349,Estriol ,,,98.98,127.56,3 RC,349,Estrogens; fractionated ,,,132.41,170.64,3 RC,349,Estrogens; total ,,,89.2,114.95,3 RC,349,Estrone ,,,103.14,132.92,3 RC,349,Ethosuximide ,,,66.9,86.21,3 RC,349,Ethylene glycol ,,,61.31,79.01,3 RC,349,Etiocholanolone ,,,107.34,138.33,3 RC,349,Euglobulin lysis ,,,34.86,44.92,3 RC,349,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,349,Everolimus ,,,57.16,73.66,3 RC,349,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,349,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,349,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,349,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,349,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,349,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,349,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,349,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,349,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,349,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,349,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,349,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,349,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,349,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,349,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,349,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,349,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,349,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,349,Factor inhibitor test ,,,52.96,68.24,3 RC,349,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,349,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,349,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,349,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,349,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,349,Felbamate ,,,76.68,98.82,3 RC,349,Fentanyl ,,,98.98,127.56,3 RC,349,Fern test ,,,40.44,52.12,3 RC,349,Ferritin ,,,55.77,71.87,3 RC,349,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,349,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,349,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,349,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,349,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,349,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,349,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,349,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,349,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,349,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,349,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,349,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,349,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,349,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,349,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,349,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,349,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,349,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,349,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,349,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,349,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,349,Fibrinogen; activity ,,,40.44,52.12,3 RC,349,Fibrinogen; antigen ,,,59.93,77.23,3 RC,349,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,349,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,349,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,349,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,349,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,349,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,349,Flecainide ,,,76.68,98.82,3 RC,349,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,349,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,349,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,349,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,349,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,349,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,349,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,349,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,349,Fluoride ,,,76.68,98.82,3 RC,349,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,349,Folic acid; RBC ,,,72.48,93.41,3 RC,349,Folic acid; serum ,,,59.93,77.23,3 RC,349,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,349,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,349,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,349,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,349,"Fructose, semen ",,,71.1,91.62,3 RC,349,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,349,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,349,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,349,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,349,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,349,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,349,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,349,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,349,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,349,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,349,"Galactokinase, RBC ",,,87.81,113.16,3 RC,349,Galactose ,,,45.98,59.26,3 RC,349,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,349,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,349,Galectin-3 ,,,182.6,235.31,3 RC,349,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,349,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,349,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,349,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,349,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,349,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,349,"Gases, blood, pH only ",,,44.6,57.47,3 RC,349,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,349,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,349,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,349,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,349,Gastric mucosa imaging ,,,205.51,205.51,1 RC,349,Gastrin ,,,72.48,93.41,3 RC,349,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,349,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,349,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,349,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,349,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,349,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,349,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,349,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,349,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,349,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,349,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,349,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,349,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,349,Gentamicin ,,,66.9,86.21,3 RC,349,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,349,Glucagon ,,,58.54,75.44,3 RC,349,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,349,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,349,Glucagon tolerance test ,,,72.48,93.41,3 RC,349,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,349,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,349,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,349,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,349,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,349,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,349,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,349,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,349,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,349,"Glucosidase, beta ",,,87.81,113.16,3 RC,349,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,349,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,349,Glutathione ,,,64.13,82.64,3 RC,349,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,349,Glycated protein ,,,68.28,88.0,3 RC,349,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,349,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,349,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,349,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,349,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,349,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,349,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,349,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,349,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,349,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,349,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,349,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,349,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,349,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,349,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,349,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,349,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,349,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,349,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,349,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,349,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,349,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,349,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,349,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,349,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,349,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,349,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,349,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,349,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,349,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,349,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,349,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,349,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,349,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,349,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,349,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,349,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,349,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,349,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,349,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,349,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,349,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,Haloperidol ,,,65.51,84.43,3 RC,349,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,349,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,349,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,349,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,349,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,349,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,349,Heinz bodies; direct ,,,16.71,21.54,3 RC,349,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,349,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,349,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,349,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,349,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,349,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,349,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,349,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,349,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,349,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,349,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,349,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,349,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,349,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,349,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,349,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,349,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,349,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,349,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,349,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,349,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,349,Hemoglobin; plasma ,,,30.66,39.51,3 RC,349,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,349,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,349,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,349,Hemoglobin; urine ,,,16.71,21.54,3 RC,349,"Hemolysin, acid ",,,36.24,46.7,3 RC,349,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,349,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,349,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,349,Heparin assay ,,,54.38,70.08,3 RC,349,Heparin neutralization ,,,48.8,62.89,3 RC,349,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,349,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,349,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,349,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,349,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,349,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,349,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,349,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,349,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,349,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,349,Hepatitis C antibody; ,,,58.54,75.44,3 RC,349,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,349,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,349,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,349,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,349,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,349,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,349,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,349,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,349,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,349,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,349,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,349,Heroin metabolite ,,,98.98,127.56,3 RC,349,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,349,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,349,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,349,Histamine ,,,121.28,156.3,3 RC,349,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,349,Homocysteine ,,,73.87,95.19,3 RC,349,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,349,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,349,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,349,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,349,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,349,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,349,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,349,Hydroxychloroquine ,,,76.68,98.82,3 RC,349,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,349,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,349,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,349,Hydroxyproline; free ,,,93.4,120.36,3 RC,349,Hydroxyproline; total ,,,100.37,129.34,3 RC,349,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,349,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,349,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,349,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,349,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,349,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,349,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,349,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,349,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,349,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,349,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,349,Immune complex assay ,,,100.37,129.34,3 RC,349,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,349,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,349,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,349,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,349,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,349,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,349,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,349,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,349,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,349,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,349,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,349,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,349,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,349,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,349,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,349,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,349,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,349,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,349,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,349,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,349,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,349,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,349,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,349,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,349,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,349,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,349,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,349,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,349,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,349,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,349,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,349,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,349,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,349,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,349,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,349,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,349,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,349,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,349,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,349,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,349,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,349,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,349,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,349,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,349,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,349,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,349,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,349,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,349,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,349,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,349,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,349,Infliximab ,,,158.91,204.79,3 RC,349,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,349,Inhibin A ,,,64.13,82.64,3 RC,349,Insemination of oocytes ,,,442.57,570.33,3 RC,349,Insulin antibodies ,,,87.81,113.16,3 RC,349,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,349,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,349,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,349,Insulin; free ,,,52.96,68.24,3 RC,349,Insulin; total ,,,47.41,61.1,3 RC,349,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,349,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,349,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,349,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,349,Intrinsic factor ,,,80.84,104.18,3 RC,349,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,349,Iron ,,,26.5,34.15,3 RC,349,Iron binding capacity ,,,36.24,46.7,3 RC,349,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,349,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,349,Islet cell antibody ,,,97.55,125.72,3 RC,349,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,349,Itraconazole ,,,111.5,143.69,3 RC,349,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,349,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,349,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,349,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,349,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,349,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,349,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,349,Ketamine and norketamine ,,,98.98,127.56,3 RC,349,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,349,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,349,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,349,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,349,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,349,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,349,Kidney imaging morphology; ,,,172.11,172.11,1 RC,349,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,349,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,349,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,349,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,349,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,349,Lacosamide ,,,111.5,143.69,3 RC,349,Lactate (lactic acid) ,,,47.41,61.1,3 RC,349,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,349,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,349,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,349,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,349,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,349,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,349,Lamotrigine ,,,54.38,70.08,3 RC,349,Lead ,,,50.18,64.67,3 RC,349,Leflunomide ,,,158.91,204.79,3 RC,349,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,349,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,349,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,349,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,349,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,349,Leukocyte transfusion ,,,305.26,393.39,3 RC,349,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,349,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,349,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,349,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,349,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,349,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,349,Levetiracetam ,,,54.38,70.08,3 RC,349,Lidocaine ,,,59.93,77.23,3 RC,349,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,349,Lipase ,,,27.89,35.94,3 RC,349,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,349,Lipoprotein (a) ,,,58.54,75.44,3 RC,349,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,349,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,349,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,349,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,349,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,349,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,349,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,349,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,349,Lithium ,,,27.89,35.94,3 RC,349,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,349,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,349,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,349,Liver imaging; static only ,,,191.2,191.2,1 RC,349,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,349,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,349,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,349,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,349,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,349,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,349,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,349,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,349,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,349,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,349,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,349,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,349,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,349,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,349,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,349,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,349,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,349,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,349,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,349,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,349,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,349,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,349,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,349,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,349,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,349,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,349,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,349,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,349,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,349,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,349,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,349,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,349,Magnesium ,,,27.89,35.94,3 RC,349,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,349,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,349,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,349,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,349,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,349,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,349,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,349,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,349,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,349,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,349,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,349,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,349,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,349,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,349,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,349,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,349,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,349,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,349,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,349,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,349,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,349,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,349,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,349,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,349,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,349,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,349,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,349,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,349,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,349,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,349,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,349,Malate dehydrogenase ,,,30.66,39.51,3 RC,349,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,349,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,349,Manganese ,,,110.11,141.9,3 RC,349,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,349,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,349,"Meat fibers, feces ",,,19.53,25.17,3 RC,349,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,349,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,349,"Mercury, quantitative ",,,66.9,86.21,3 RC,349,Metanephrines ,,,69.71,89.84,3 RC,349,Methadone ,,,98.98,127.56,3 RC,349,Methemalbumin ,,,44.6,57.47,3 RC,349,Methotrexate ,,,158.91,204.79,3 RC,349,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,349,Methylphenidate ,,,98.98,127.56,3 RC,349,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,349,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,349,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,349,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,349,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,349,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,349,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,349,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,349,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,349,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,349,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,349,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,349,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,349,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,349,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,349,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,349,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,349,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,349,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,349,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,349,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,349,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,349,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,349,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,349,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,349,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,349,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,349,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,349,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,349,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,349,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,349,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,349,Muramidase ,,,76.68,98.82,3 RC,349,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,349,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,349,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,349,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,349,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,349,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,349,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,349,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,349,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,349,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,349,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,349,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,349,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,349,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,349,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,349,Myoglobin ,,,52.96,68.24,3 RC,349,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,349,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,349,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,349,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,349,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,349,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,349,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,349,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,349,Natriuretic peptide ,,,161.68,208.36,3 RC,349,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,349,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,349,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,349,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,349,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,349,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,349,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,349,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,349,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,349,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,349,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,349,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,349,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,349,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,349,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,349,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,349,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,349,Nerve teasing preparations ,,,499.29,643.43,3 RC,349,"Neutralization test, viral ",,,69.71,89.84,3 RC,349,Nickel ,,,100.37,129.34,3 RC,349,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,349,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,349,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,349,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,349,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,349,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,349,Nucleotidase 5'- ,,,45.98,59.26,3 RC,349,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,349,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,349,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,349,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,349,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,349,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,349,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,349,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,349,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,349,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,349,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,349,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,349,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,349,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,349,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,349,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,349,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,349,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,349,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,349,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,349,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,349,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,349,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,349,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,349,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,349,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,349,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,349,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,349,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,349,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,349,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,349,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,349,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,349,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,349,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,349,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,349,"Opiates, 1 or more ",,,98.98,127.56,3 RC,349,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,349,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,349,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,349,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,349,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,349,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,349,Osmolality; blood ,,,27.89,35.94,3 RC,349,Osmolality; urine ,,,27.89,35.94,3 RC,349,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,349,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,349,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,349,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,349,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,349,Oxalate ,,,59.93,77.23,3 RC,349,Oxcarbazepine ,,,54.38,70.08,3 RC,349,Oxycodone ,,,98.98,127.56,3 RC,349,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,349,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,349,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,349,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,349,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,349,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,349,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,349,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,349,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,349,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,349,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,349,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,349,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,349,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,349,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,349,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,349,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,349,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,349,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,349,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,349,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,349,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,349,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,349,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,349,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,349,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,349,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,349,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,349,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,349,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,349,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,349,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,349,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,349,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,349,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,349,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,349,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,349,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,349,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,349,Phenobarbital ,,,62.74,80.85,3 RC,349,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,349,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,349,Phenytoin; free ,,,57.16,73.66,3 RC,349,Phenytoin; total ,,,54.38,70.08,3 RC,349,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,349,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,349,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,349,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,349,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,349,Phosphatidylglycerol ,,,68.28,88.0,3 RC,349,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,349,Phosphohexose isomerase ,,,44.6,57.47,3 RC,349,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,349,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,349,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,349,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,349,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,349,Pinworm examinations ,,,18.14,23.38,3 RC,349,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,349,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,349,Platelet survival study ,,,126.1,126.1,1 RC,349,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,349,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,349,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,349,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,349,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,349,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,349,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,349,Posaconazole ,,,111.5,143.69,3 RC,349,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,349,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,349,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,349,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,349,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,349,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,349,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,349,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,349,Potassium; urine ,,,19.53,25.17,3 RC,349,Prealbumin ,,,59.93,77.23,3 RC,349,Pregabalin ,,,98.98,127.56,3 RC,349,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,349,Pregnanediol ,,,87.81,113.16,3 RC,349,Pregnanetriol ,,,86.43,111.38,3 RC,349,Pregnenolone ,,,85.04,109.59,3 RC,349,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,349,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,349,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,349,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,349,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,349,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,349,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,349,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,349,Primidone ,,,68.28,88.0,3 RC,349,Procainamide; ,,,246.72,317.95,3 RC,349,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,349,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,349,Progesterone ,,,86.43,111.38,3 RC,349,Proinsulin ,,,110.11,141.9,3 RC,349,Prolactin ,,,79.46,102.39,3 RC,349,Propoxyphene ,,,98.98,127.56,3 RC,349,"Prostaglandin, each ",,,171.47,220.97,3 RC,349,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,349,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,349,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,349,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,349,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,349,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,349,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,349,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,349,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,349,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,349,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,349,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,349,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,349,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,349,Prothrombin time; ,,,18.14,23.38,3 RC,349,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,349,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,349,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,349,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,349,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,349,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,349,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,349,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,349,Pyruvate ,,,59.93,77.23,3 RC,349,Pyruvate kinase ,,,39.01,50.28,3 RC,349,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,349,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,349,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,349,Quinidine ,,,59.93,77.23,3 RC,349,Quinine ,,,47.41,61.1,3 RC,349,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,349,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,349,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,349,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,349,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,349,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,349,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,349,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,349,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,349,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,349,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,349,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,349,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,349,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,349,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,349,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,349,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,349,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,349,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,349,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,349,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,349,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,349,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,349,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,349,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,349,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,349,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,349,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,349,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,349,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,349,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,349,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,349,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,349,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,349,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,349,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,349,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,349,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,349,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,349,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,349,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,349,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,349,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,349,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,349,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,349,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,349,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,349,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,349,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,349,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,349,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,349,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,349,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,349,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,349,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,349,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,349,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,349,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,349,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,349,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,349,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,349,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,349,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,349,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,349,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,349,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,349,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,349,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,349,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,349,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,349,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,349,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,349,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,349,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,349,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,349,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,349,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,349,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,349,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,349,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,349,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,349,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,349,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,349,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,349,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,349,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,349,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,349,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,349,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,349,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,349,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,349,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,349,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,349,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,349,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,349,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,349,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,349,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,349,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,349,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,349,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,349,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,349,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,349,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,349,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,349,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,349,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,349,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,349,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,349,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,349,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,349,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,349,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,349,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,349,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,349,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,349,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,349,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,349,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,349,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,349,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,349,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,349,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,349,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,349,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,349,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,349,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,349,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,349,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,349,Receptor assay; estrogen ,,,361.04,465.26,3 RC,349,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,349,Receptor assay; progesterone ,,,266.25,343.11,3 RC,349,Red cell survival study ,,,126.1,126.1,1 RC,349,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,349,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,349,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,349,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,349,Renin ,,,90.63,116.79,3 RC,349,Reptilase test ,,,40.44,52.12,3 RC,349,Reticulated platelet assay ,,,146.35,188.6,3 RC,349,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,349,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,349,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,349,Rufinamide ,,,111.5,143.69,3 RC,349,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,349,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,349,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,349,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,349,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,349,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,349,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,349,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,349,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,349,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,349,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,349,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,349,Salicylate ,,,76.68,98.82,3 RC,349,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,349,Salivary gland function study ,,,104.3,104.3,1 RC,349,Salivary gland imaging; ,,,175.52,175.52,1 RC,349,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,349,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,349,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,349,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,349,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,349,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,349,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,349,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,349,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,349,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,349,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,349,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,349,Selenium ,,,104.53,134.7,3 RC,349,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,349,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,349,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,349,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,349,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,349,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,349,Serotonin ,,,126.87,163.49,3 RC,349,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,349,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,349,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,349,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,349,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,349,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,349,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,349,Sialic acid ,,,55.77,71.87,3 RC,349,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,349,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,349,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,349,Silica ,,,103.14,132.92,3 RC,349,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,349,Sirolimus ,,,57.16,73.66,3 RC,349,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,349,Skin test; candida ,,,79.46,102.39,3 RC,349,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,349,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,349,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,349,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,349,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,349,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,349,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,349,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,349,Sodium; other source ,,,19.53,25.17,3 RC,349,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,349,Sodium; urine ,,,20.91,26.95,3 RC,349,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,349,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,349,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,349,Somatomedin ,,,87.81,113.16,3 RC,349,Somatostatin ,,,75.26,96.98,3 RC,349,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,349,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,349,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,349,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,349,Specific gravity (except urine) ,,,13.94,17.97,3 RC,349,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,349,Sperm antibodies ,,,43.21,55.69,3 RC,349,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,349,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,349,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,349,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,349,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,349,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,349,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,349,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,349,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,349,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,349,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,349,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,349,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,349,"Stimulants, synthetic ",,,98.98,127.56,3 RC,349,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,349,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,349,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,349,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,349,"Streptokinase, antibody ",,,51.57,66.46,3 RC,349,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,349,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,349,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,349,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,349,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,349,"Sulfate, urine ",,,22.3,28.74,3 RC,349,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,349,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,349,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,349,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,349,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,349,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,349,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,349,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,349,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,349,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,349,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,349,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,349,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,349,T cells; total count ,,,154.71,199.37,3 RC,349,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,349,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,349,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,349,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,349,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,349,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,349,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,349,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,349,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,349,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,349,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,349,Tacrolimus ,,,57.16,73.66,3 RC,349,Tapentadol ,,,98.98,127.56,3 RC,349,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,349,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,349,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,349,Testosterone; free ,,,104.53,134.7,3 RC,349,Testosterone; total ,,,105.96,136.54,3 RC,349,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,349,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,349,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,349,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,349,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,349,Theophylline ,,,58.54,75.44,3 RC,349,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,349,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,349,Thiocyanate ,,,47.41,61.1,3 RC,349,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,349,Thrombin time; plasma ,,,23.69,30.52,3 RC,349,Thrombin time; titer ,,,27.89,35.94,3 RC,349,Thrombomodulin ,,,71.1,91.62,3 RC,349,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,349,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,349,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,349,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,349,Thyroglobulin ,,,65.51,84.43,3 RC,349,Thyroglobulin antibody ,,,65.51,84.43,3 RC,349,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,349,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,349,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,349,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,349,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,349,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,349,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,349,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,349,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,349,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,349,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,349,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,349,Thyroxine; free ,,,37.63,48.49,3 RC,349,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,349,Thyroxine; total ,,,27.89,35.94,3 RC,349,Tiagabine ,,,111.5,143.69,3 RC,349,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,349,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,349,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,349,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,349,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,349,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,349,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,349,Tobramycin ,,,66.9,86.21,3 RC,349,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,349,Topiramate ,,,48.8,62.89,3 RC,349,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,349,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,349,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,349,Tramadol ,,,98.98,127.56,3 RC,349,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,349,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,349,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,349,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,349,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,349,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,349,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,349,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,349,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,349,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,349,Transferrin ,,,52.96,68.24,3 RC,349,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,349,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,349,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,349,Triglycerides ,,,23.69,30.52,3 RC,349,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,349,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,349,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,349,"Troponin, qualitative ",,,41.83,53.9,3 RC,349,"Troponin, quantitative ",,,51.57,66.46,3 RC,349,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,349,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,349,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,349,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,349,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,349,Tyrosine ,,,43.21,55.69,3 RC,349,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,349,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,349,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,349,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,349,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,349,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,349,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,349,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,349,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,349,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,349,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,349,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,349,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,349,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,349,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,349,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,349,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,349,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,349,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,349,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,349,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,349,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,349,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,349,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,349,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,349,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,349,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,349,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,349,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,349,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,349,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,349,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,349,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,349,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,349,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,349,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,349,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,349,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,349,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,349,Unlisted immunology procedure ,,,99.55,128.28,3 RC,349,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,349,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,349,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,349,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,349,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,349,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,349,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,349,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,349,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,349,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,349,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,349,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,349,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,349,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,349,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,349,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,349,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,349,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,349,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,349,Uric acid; blood ,,,18.14,23.38,3 RC,349,Uric acid; other source ,,,20.91,26.95,3 RC,349,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,349,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,349,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,349,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,349,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,349,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,349,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,349,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,349,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,349,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,349,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,349,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,349,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,349,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,349,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,349,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,349,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,349,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,349,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,349,Vancomycin ,,,55.77,71.87,3 RC,349,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,349,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,349,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,349,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,349,Vedolizumab ,,,158.91,204.79,3 RC,349,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,25.76,33.2,3 RC,349,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,349,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,349,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,349,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,349,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,349,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,349,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,349,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,349,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,349,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,349,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,349,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,349,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,349,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,349,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,349,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,349,Very long chain fatty acids ,,,80.84,104.18,3 RC,349,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,349,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,349,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,349,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,349,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,349,Viscosity ,,,47.41,61.1,3 RC,349,Vitamin A ,,,47.41,61.1,3 RC,349,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,349,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,349,Vitamin K ,,,55.77,71.87,3 RC,349,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,349,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,349,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,349,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,349,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,349,Voriconazole ,,,111.5,143.69,3 RC,349,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,349,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,349,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,349,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,349,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,349,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,349,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,349,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,349,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,349,Zinc ,,,47.41,61.1,3 RC,349,Zonisamide ,,,54.38,70.08,3 RC,349,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,349,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,349,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,350, CT Scan General Classification ,,,332.0,1138.0,4 RC,350,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,350,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,350,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,350,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,350,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,350,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,350,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,350,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,350,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,350,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,350,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,350,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,350,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,350,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,350,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,350,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,350,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,350,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,350,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,350,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,350,Bone age studies ,,,26.58,26.58,1 RC,350,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,350,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,350,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,350,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,350,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,350,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,350,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,350,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,350,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,350,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,350,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,350,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,350,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,350,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,350,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,350,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,350,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,350,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,350,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,350,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,350,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,350,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,350,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,350,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,350,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,350,Cardiac shunt detection ,,,186.76,186.76,1 RC,350,Cardiokymography ,,,20.04,20.04,1 RC,350,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,350,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,350,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,350,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,350,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,350,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,350,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,350,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,350,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,350,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,350,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,2106.0,4 RC,350,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomographic (CT) colonography, screening, including image postprocessing ",,,1635.0,2106.0,3 RC,350,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,2106.0,4 RC,350,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",1603.66,1603.66,183.95,2106.0,4 RC,350,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,350,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,2106.0,4 RC,350,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,2106.0,4 RC,350,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,2106.0,4 RC,350,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,2106.0,4 RC,350,"Computed tomography, abdomen; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,2106.0,4 RC,350,"Computed tomography, cervical spine; with contrast material ",,,178.59,2106.0,4 RC,350,"Computed tomography, cervical spine; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,2106.0,4 RC,350,"Computed tomography, head or brain; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",24558.62,24558.62,183.95,2106.0,4 RC,350,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",24558.62,24558.62,183.95,2106.0,4 RC,350,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",818.66,818.66,88.62,2106.0,4 RC,350,"Computed tomography, limited or localized follow-up study ",,,88.62,2106.0,4 RC,350,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,2106.0,4 RC,350,"Computed tomography, lower extremity; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, lumbar spine; with contrast material ",,,178.94,2106.0,4 RC,350,"Computed tomography, lumbar spine; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,2106.0,4 RC,350,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,2106.0,4 RC,350,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,2106.0,4 RC,350,"Computed tomography, pelvis; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,2106.0,4 RC,350,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, thoracic spine; with contrast material ",,,179.96,2106.0,4 RC,350,"Computed tomography, thoracic spine; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,2106.0,4 RC,350,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,350,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,2106.0,4 RC,350,"Computed tomography, upper extremity; without contrast material ",,,109.02,2106.0,4 RC,350,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,350,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,350,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,350,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,350,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,350,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,350,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,350,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,350,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,350,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,350,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,350,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,350,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,350,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,350,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,350,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,350,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,350,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,350,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,350,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,350,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,350,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,350,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,350,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,350,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,350,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,350,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,350,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,350,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,350,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,350,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,350,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,350,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,350,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,350,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,350,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,350,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,350,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,350,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,350,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,350,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,350,Esophageal motility ,,,214.04,214.04,1 RC,350,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,350,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,350,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,350,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,350,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,350,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,350,Gastric mucosa imaging ,,,205.51,205.51,1 RC,350,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,350,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,350,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,350,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,350,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,350,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,350,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,350,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,350,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,350,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,350,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,350,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,350,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,350,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,350,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,350,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,350,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,350,Kidney imaging morphology; ,,,172.11,172.11,1 RC,350,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,350,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,350,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,350,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,350,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,350,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,350,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,350,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,350,Liver imaging; static only ,,,191.2,191.2,1 RC,350,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,350,Low dose ct scan (ldct) for lung cancer screening ,,,1635.0,2106.0,3 RC,350,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,350,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,350,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,350,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,350,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,350,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,350,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,350,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,350,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,350,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,350,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,350,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,350,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,350,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,350,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,350,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,350,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,350,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,350,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,350,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,350,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,350,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,350,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,350,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,350,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,350,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,350,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,350,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,350,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,350,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,350,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,350,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,350,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,350,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,350,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,350,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,350,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,350,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,350,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,350,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,350,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,350,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,350,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,350,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,350,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,350,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,350,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,350,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,350,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,350,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,350,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,350,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,350,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,350,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,350,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,350,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,350,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,350,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,350,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,350,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,350,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,350,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,350,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,350,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,350,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,350,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,350,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,350,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,350,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,350,Platelet survival study ,,,126.1,126.1,1 RC,350,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,350,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,350,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,350,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,350,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,350,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,350,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,350,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,350,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,350,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,350,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,350,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,350,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,350,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,350,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,350,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,350,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,350,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,350,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,350,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,350,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,350,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,350,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,350,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,350,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,350,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,350,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,350,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,350,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,350,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,350,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,350,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,350,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,350,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,350,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,350,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,350,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,350,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,350,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,350,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,350,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,350,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,350,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,350,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,350,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,350,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,350,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,350,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,350,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,350,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,350,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,350,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,350,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,350,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,350,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,350,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,350,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,350,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,350,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,350,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,350,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,350,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,350,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,350,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,350,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,350,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,350,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,350,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,350,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,350,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,350,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,350,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,350,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,350,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,350,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,350,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,350,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,350,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,350,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,350,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,350,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,350,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,350,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,350,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,350,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,350,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,350,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,350,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,350,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,350,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,350,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,350,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,350,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,350,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,350,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,350,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,350,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,350,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,350,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,350,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,350,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,350,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,350,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,350,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,350,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,350,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,350,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,350,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,350,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,350,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,350,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,350,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,350,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,350,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,350,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,350,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,350,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,350,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,350,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,350,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,350,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,350,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,350,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,350,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,350,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,350,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,350,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,350,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,350,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,350,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,350,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,350,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,350,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,350,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,350,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,350,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,350,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,350,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,350,Red cell survival study ,,,126.1,126.1,1 RC,350,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,350,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,350,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,350,Salivary gland function study ,,,104.3,104.3,1 RC,350,Salivary gland imaging; ,,,175.52,175.52,1 RC,350,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,350,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,350,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,350,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,350,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,350,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,350,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,350,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,350,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,350,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,350,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,350,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,350,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,350,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,350,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,350,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,350,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,350,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,350,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,350,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,350,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,350,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,350,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,350,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,350,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,350,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,350,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,350,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,350,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,350,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,350,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,350,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,350,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,350,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,350,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,350,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,350,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,350,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,350,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,350,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,350,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,350,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,350,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,350,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,350,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,350,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,350,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,350,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,350,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,350,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,350,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,350,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,350,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,350,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,350,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,350,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,350,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,2106.0,4 RC,350,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,350,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,350,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,350,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,350,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,350,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,350,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,350,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,350,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,350,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,350,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,350,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,350,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,350,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,350,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,350,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,350,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,350,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,350,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,350,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,350,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,350,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,350,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,350,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,350,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,350,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,350,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,350,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,350,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,350,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,351, CT Scan - Head Scan ,,,332.0,1138.0,4 RC,351,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,351,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,351,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,351,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,351,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,351,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,351,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,351,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,351,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,351,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,351,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,351,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,351,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,351,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,351,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,351,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,351,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,351,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,351,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,351,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,351,Bone age studies ,,,26.58,26.58,1 RC,351,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,351,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,351,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,351,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,351,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,351,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,351,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,351,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,351,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,351,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,351,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,351,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,351,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,351,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,351,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,351,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,351,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,351,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,351,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,351,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,351,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,351,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,351,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,351,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,351,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,351,Cardiac shunt detection ,,,186.76,186.76,1 RC,351,Cardiokymography ,,,20.04,20.04,1 RC,351,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,351,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,351,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,351,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,351,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,351,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,351,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,351,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,351,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,351,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,351,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,2106.0,4 RC,351,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomographic (CT) colonography, screening, including image postprocessing ",,,1635.0,2106.0,3 RC,351,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,2106.0,4 RC,351,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,351,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,2106.0,4 RC,351,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,2106.0,4 RC,351,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,2106.0,4 RC,351,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,2106.0,4 RC,351,"Computed tomography, abdomen; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,2106.0,4 RC,351,"Computed tomography, cervical spine; with contrast material ",,,178.59,2106.0,4 RC,351,"Computed tomography, cervical spine; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,2106.0,4 RC,351,"Computed tomography, head or brain; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,2106.0,4 RC,351,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,2106.0,4 RC,351,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,2106.0,4 RC,351,"Computed tomography, limited or localized follow-up study ",,,88.62,2106.0,4 RC,351,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,2106.0,4 RC,351,"Computed tomography, lower extremity; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, lumbar spine; with contrast material ",,,178.94,2106.0,4 RC,351,"Computed tomography, lumbar spine; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,2106.0,4 RC,351,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,2106.0,4 RC,351,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",15775.75,15775.75,109.02,2106.0,4 RC,351,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,2106.0,4 RC,351,"Computed tomography, pelvis; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,2106.0,4 RC,351,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, thoracic spine; with contrast material ",,,179.96,2106.0,4 RC,351,"Computed tomography, thoracic spine; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,2106.0,4 RC,351,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,351,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,2106.0,4 RC,351,"Computed tomography, upper extremity; without contrast material ",,,109.02,2106.0,4 RC,351,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,351,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,351,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,351,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,351,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,351,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,351,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,351,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,351,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,351,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,351,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,351,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,351,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,351,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,351,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,351,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,351,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,351,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,351,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,351,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,351,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,351,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,351,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,351,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,351,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,351,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,351,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,351,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,351,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,351,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,351,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,351,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,351,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,351,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,351,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,351,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,351,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,351,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,351,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,351,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,351,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,351,Esophageal motility ,,,214.04,214.04,1 RC,351,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,351,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,351,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,351,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,351,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,351,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,351,Gastric mucosa imaging ,,,205.51,205.51,1 RC,351,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,351,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,351,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,351,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,351,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,351,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,351,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,351,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,351,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,351,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,351,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,351,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,351,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,351,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,351,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,351,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,351,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,351,Kidney imaging morphology; ,,,172.11,172.11,1 RC,351,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,351,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,351,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,351,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,351,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,351,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,351,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,351,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,351,Liver imaging; static only ,,,191.2,191.2,1 RC,351,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,351,Low dose ct scan (ldct) for lung cancer screening ,,,1635.0,2106.0,3 RC,351,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,351,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,351,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,351,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,351,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,351,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,351,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,351,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,351,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,351,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,351,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,351,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,351,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,351,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,351,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,351,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,351,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,351,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,351,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,351,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,351,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,351,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,351,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,351,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,351,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,351,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,351,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,351,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,351,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,351,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,351,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,351,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,351,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,351,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,351,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,351,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,351,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,351,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,351,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,351,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,351,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,351,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,351,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,351,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,351,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,351,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,351,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,351,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,351,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,351,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,351,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,351,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,351,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,351,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,351,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,351,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,351,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,351,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,351,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,351,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,351,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,351,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,351,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,351,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,351,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,351,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,351,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,351,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,351,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,351,Platelet survival study ,,,126.1,126.1,1 RC,351,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,351,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,351,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,351,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,351,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,351,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,351,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,351,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,351,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,351,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,351,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,351,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,351,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,351,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,351,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,351,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,351,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,351,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,351,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,351,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,351,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,351,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,351,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,351,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,351,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,351,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,351,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,351,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,351,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,351,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,351,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,351,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,351,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,351,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,351,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,351,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,351,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,351,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,351,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,351,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,351,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,351,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,351,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,351,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,351,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,351,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,351,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,351,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,351,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,351,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,351,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,351,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,351,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,351,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,351,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,351,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,351,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,351,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,351,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,351,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,351,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,351,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,351,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,351,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,351,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,351,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,351,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,351,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,351,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,351,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,351,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,351,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,351,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,351,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,351,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,351,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,351,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,351,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,351,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,351,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,351,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,351,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,351,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,351,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,351,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,351,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,351,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,351,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,351,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,351,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,351,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,351,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,351,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,351,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,351,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,351,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,351,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,351,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,351,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,351,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,351,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,351,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,351,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,351,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,351,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,351,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,351,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,351,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,351,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,351,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,351,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,351,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,351,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,351,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,351,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,351,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,351,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,351,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,351,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,351,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,351,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,351,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,351,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,351,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,351,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,351,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,351,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,351,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,351,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,351,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,351,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,351,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,351,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,351,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,351,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,351,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,351,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,351,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,351,Red cell survival study ,,,126.1,126.1,1 RC,351,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,351,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,351,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,351,Salivary gland function study ,,,104.3,104.3,1 RC,351,Salivary gland imaging; ,,,175.52,175.52,1 RC,351,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,351,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,351,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,351,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,351,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,351,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,351,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,351,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,351,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,351,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,351,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,351,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,351,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,351,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,351,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,351,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,351,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,351,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,351,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,351,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,351,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,351,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,351,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,351,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,351,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,351,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,351,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,351,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,351,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,351,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,351,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,351,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,351,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,351,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,351,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,351,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,351,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,351,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,351,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,351,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,351,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,351,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,351,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,351,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,351,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,351,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,351,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,351,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,351,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,351,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,351,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,351,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,351,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,351,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,351,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,351,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,351,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,2106.0,4 RC,351,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,351,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,351,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,351,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,351,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,351,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,351,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,351,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,351,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,351,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,351,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,351,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,351,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,351,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,351,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,351,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,351,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,351,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,351,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,351,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,351,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,351,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,351,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,351,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,351,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,351,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,351,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,351,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,351,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,351,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,352, CT Scan - Body Scan ,,,332.0,1138.0,4 RC,352,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,352,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,352,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,352,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,352,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,352,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,352,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,352,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,352,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,352,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,352,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,352,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,352,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,352,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,352,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,352,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,352,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,352,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,352,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,352,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,352,Bone age studies ,,,26.58,26.58,1 RC,352,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,352,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,352,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,352,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,352,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,352,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,352,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,352,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,352,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,352,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,352,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,352,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,352,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,352,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,352,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,352,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,352,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,352,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,352,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,352,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,352,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,352,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,352,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,352,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,352,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,352,Cardiac shunt detection ,,,186.76,186.76,1 RC,352,Cardiokymography ,,,20.04,20.04,1 RC,352,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,352,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,352,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,352,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,352,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,352,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,352,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,352,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,352,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,352,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,352,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,2106.0,4 RC,352,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomographic (CT) colonography, screening, including image postprocessing ",,,1635.0,2106.0,3 RC,352,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,2106.0,4 RC,352,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,352,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,2106.0,4 RC,352,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,2106.0,4 RC,352,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,2106.0,4 RC,352,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,2106.0,4 RC,352,"Computed tomography, abdomen; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,2106.0,4 RC,352,"Computed tomography, cervical spine; with contrast material ",,,178.59,2106.0,4 RC,352,"Computed tomography, cervical spine; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,2106.0,4 RC,352,"Computed tomography, head or brain; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,2106.0,4 RC,352,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,2106.0,4 RC,352,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,2106.0,4 RC,352,"Computed tomography, limited or localized follow-up study ",,,88.62,2106.0,4 RC,352,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,2106.0,4 RC,352,"Computed tomography, lower extremity; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, lumbar spine; with contrast material ",,,178.94,2106.0,4 RC,352,"Computed tomography, lumbar spine; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,2106.0,4 RC,352,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,2106.0,4 RC,352,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,2106.0,4 RC,352,"Computed tomography, pelvis; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,2106.0,4 RC,352,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, thoracic spine; with contrast material ",15868.31,15868.31,179.96,2106.0,4 RC,352,"Computed tomography, thoracic spine; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,2106.0,4 RC,352,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,352,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,2106.0,4 RC,352,"Computed tomography, upper extremity; without contrast material ",,,109.02,2106.0,4 RC,352,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,352,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,352,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,352,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,352,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,352,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,352,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,352,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,352,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,352,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,352,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,352,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,352,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,352,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,352,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,352,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,352,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,352,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,352,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,352,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,352,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,352,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,352,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,352,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,352,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,352,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,352,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,352,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,352,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,352,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,352,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,352,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,352,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,352,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,352,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,352,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,352,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,352,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,352,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,352,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,352,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,352,Esophageal motility ,,,214.04,214.04,1 RC,352,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,352,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,352,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,352,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,352,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,352,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,352,Gastric mucosa imaging ,,,205.51,205.51,1 RC,352,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,352,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,352,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,352,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,352,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,352,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,352,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,352,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,352,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,352,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,352,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,352,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,352,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,352,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,352,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,352,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,352,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,352,Kidney imaging morphology; ,,,172.11,172.11,1 RC,352,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,352,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,352,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,352,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,352,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,352,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,352,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,352,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,352,Liver imaging; static only ,,,191.2,191.2,1 RC,352,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,352,Low dose ct scan (ldct) for lung cancer screening ,,,1635.0,2106.0,3 RC,352,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,352,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,352,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,352,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,352,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,352,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,352,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,352,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,352,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,352,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,352,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,352,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,352,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,352,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,352,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,352,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,352,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,352,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,352,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,352,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,352,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,352,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,352,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,352,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,352,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,352,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,352,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,352,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,352,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,352,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,352,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,352,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,352,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,352,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,352,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,352,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,352,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,352,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,352,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,352,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,352,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,352,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,352,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,352,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,352,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,352,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,352,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,352,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,352,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,352,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,352,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,352,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,352,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,352,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,352,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,352,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,352,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,352,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,352,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,352,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,352,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,352,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,352,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,352,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,352,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,352,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,352,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,352,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,352,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,352,Platelet survival study ,,,126.1,126.1,1 RC,352,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,352,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,352,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,352,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,352,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,352,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,352,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,352,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,352,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,352,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,352,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,352,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,352,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,352,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,352,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,352,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,352,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,352,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,352,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,352,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,352,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,352,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,352,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,352,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,352,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,352,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,352,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,352,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,352,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,352,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,352,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,352,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,352,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,352,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,352,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,352,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,352,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,352,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,352,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,352,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,352,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,352,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,352,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,352,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,352,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,352,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,352,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,352,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,352,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,352,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,352,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,352,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,352,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,352,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,352,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,352,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,352,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,352,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,352,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,352,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,352,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,352,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,352,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,352,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,352,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,352,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,352,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,352,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,352,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,352,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,352,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,352,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,352,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,352,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,352,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,352,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,352,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,352,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,352,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,352,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,352,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,352,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,352,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,352,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,352,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,352,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,352,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,352,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,352,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,352,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,352,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,352,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,352,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,352,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,352,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,352,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,352,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,352,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,352,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,352,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,352,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,352,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,352,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,352,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,352,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,352,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,352,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,352,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,352,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,352,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,352,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,352,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,352,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,352,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,352,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,352,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,352,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,352,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,352,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,352,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,352,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,352,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,352,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,352,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,352,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,352,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,352,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,352,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,352,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,352,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,352,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,352,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,352,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,352,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,352,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,352,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,352,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,352,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,352,Red cell survival study ,,,126.1,126.1,1 RC,352,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,352,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,352,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,352,Salivary gland function study ,,,104.3,104.3,1 RC,352,Salivary gland imaging; ,,,175.52,175.52,1 RC,352,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,352,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,352,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,352,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,352,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,352,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,352,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,352,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,352,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,352,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,352,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,352,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,352,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,352,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,352,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,352,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,352,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,352,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,352,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,352,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,352,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,352,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,352,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,352,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,352,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,352,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,352,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,352,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,352,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,352,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,352,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,352,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,352,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,352,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,352,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,352,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,352,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,352,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,352,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,352,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,352,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,352,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,352,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,352,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,352,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,352,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,352,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,352,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,352,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,352,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,352,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,352,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,352,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,352,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,352,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,352,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,352,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,2106.0,4 RC,352,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,352,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,352,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,352,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,352,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,352,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,352,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,352,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,352,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,352,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,352,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,352,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,352,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,352,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,352,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,352,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,352,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,352,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,352,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,352,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,352,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,352,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,352,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,352,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,352,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,352,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,352,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,352,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,352,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,352,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,359, CT Scan - Other ,,,332.0,1138.0,4 RC,359,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,359,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,359,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,359,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,359,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,359,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,359,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,359,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,359,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,359,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,359,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,359,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,359,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,359,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,359,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,359,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,359,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,359,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,359,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,359,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,359,Bone age studies ,,,26.58,26.58,1 RC,359,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,359,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,359,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,359,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,359,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,359,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,359,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,359,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,359,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,359,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,359,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,359,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,359,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,359,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,359,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,359,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,359,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,359,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,359,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,359,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,359,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,359,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,359,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,359,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,359,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,359,Cardiac shunt detection ,,,186.76,186.76,1 RC,359,Cardiokymography ,,,20.04,20.04,1 RC,359,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,359,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,359,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,359,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,359,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,359,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,359,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,359,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,359,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,359,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,359,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,2106.0,4 RC,359,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomographic (CT) colonography, screening, including image postprocessing ",,,1635.0,2106.0,3 RC,359,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,2106.0,4 RC,359,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,2106.0,4 RC,359,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,2106.0,4 RC,359,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,2106.0,4 RC,359,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,2106.0,4 RC,359,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,2106.0,4 RC,359,"Computed tomography, abdomen; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,2106.0,4 RC,359,"Computed tomography, cervical spine; with contrast material ",,,178.59,2106.0,4 RC,359,"Computed tomography, cervical spine; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,2106.0,4 RC,359,"Computed tomography, head or brain; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,2106.0,4 RC,359,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,2106.0,4 RC,359,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,2106.0,4 RC,359,"Computed tomography, limited or localized follow-up study ",,,88.62,2106.0,4 RC,359,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,2106.0,4 RC,359,"Computed tomography, lower extremity; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, lumbar spine; with contrast material ",,,178.94,2106.0,4 RC,359,"Computed tomography, lumbar spine; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,2106.0,4 RC,359,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,2106.0,4 RC,359,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,2106.0,4 RC,359,"Computed tomography, pelvis; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,2106.0,4 RC,359,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, thoracic spine; with contrast material ",,,179.96,2106.0,4 RC,359,"Computed tomography, thoracic spine; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,2106.0,4 RC,359,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,359,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,2106.0,4 RC,359,"Computed tomography, upper extremity; without contrast material ",,,109.02,2106.0,4 RC,359,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,2106.0,4 RC,359,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,359,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,359,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,359,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,359,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,359,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,359,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,359,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,359,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,359,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,359,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,359,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,359,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,359,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,359,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,359,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,359,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,359,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,359,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,359,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,359,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,359,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,359,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,359,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,359,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,359,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,359,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,359,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,359,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,359,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,359,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,359,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,359,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,359,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,359,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,359,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,359,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,359,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,359,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,359,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,359,Esophageal motility ,,,214.04,214.04,1 RC,359,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,359,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,359,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,359,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,359,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,359,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,359,Gastric mucosa imaging ,,,205.51,205.51,1 RC,359,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,359,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,359,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,359,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,359,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,359,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,359,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,359,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,359,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,359,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,359,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,359,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,359,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,359,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,359,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,359,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,359,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,359,Kidney imaging morphology; ,,,172.11,172.11,1 RC,359,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,359,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,359,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,359,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,359,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,359,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,359,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,359,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,359,Liver imaging; static only ,,,191.2,191.2,1 RC,359,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,359,Low dose ct scan (ldct) for lung cancer screening ,,,1635.0,2106.0,3 RC,359,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,359,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,359,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,359,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,359,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,359,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,359,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,359,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,359,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,359,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,359,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,359,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,359,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,359,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,359,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,359,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,359,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,359,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,359,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,359,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,359,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,359,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,359,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,359,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,359,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,359,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,359,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,359,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,359,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,359,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,359,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,359,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,359,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,359,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,359,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,359,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,359,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,359,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,359,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,359,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,359,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,359,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,359,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,359,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,359,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,359,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,359,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,359,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,359,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,359,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,359,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,359,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,359,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,359,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,359,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,359,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,359,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,359,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,359,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,359,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,359,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,359,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,359,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,359,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,359,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,359,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,359,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,359,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,359,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,359,Platelet survival study ,,,126.1,126.1,1 RC,359,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,359,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,359,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,359,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,359,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,359,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,359,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,359,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,359,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,359,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,359,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,359,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,359,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,359,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,359,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,359,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,359,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,359,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,359,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,359,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,359,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,359,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,359,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,359,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,359,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,359,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,359,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,359,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,359,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,359,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,359,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,359,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,359,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,359,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,359,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,359,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,359,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,359,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,359,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,359,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,359,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,359,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,359,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,359,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,359,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,359,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,359,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,359,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,359,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,359,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,359,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,359,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,359,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,359,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,359,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,359,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,359,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,359,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,359,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,359,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,359,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,359,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,359,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,359,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,359,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,359,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,359,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,359,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,359,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,359,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,359,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,359,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,359,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,359,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,359,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,359,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,359,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,359,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,359,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,359,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,359,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,359,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,359,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,359,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,359,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,359,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,359,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,359,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,359,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,359,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,359,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,359,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,359,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,359,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,359,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,359,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,359,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,359,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,359,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,359,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,359,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,359,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,359,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,359,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,359,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,359,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,359,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,359,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,359,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,359,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,359,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,359,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,359,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,359,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,359,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,359,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,359,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,359,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,359,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,359,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,359,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,359,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,359,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,359,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,359,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,359,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,359,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,359,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,359,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,359,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,359,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,359,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,359,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,359,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,359,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,359,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,359,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,359,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,359,Red cell survival study ,,,126.1,126.1,1 RC,359,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,359,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,359,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,359,Salivary gland function study ,,,104.3,104.3,1 RC,359,Salivary gland imaging; ,,,175.52,175.52,1 RC,359,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,359,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,359,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,359,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,359,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,359,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,359,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,359,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,359,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,359,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,359,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,359,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,359,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,359,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,359,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,359,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,359,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,359,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,359,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,359,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,359,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,359,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,359,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,359,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,359,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,359,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,359,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,359,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,359,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,359,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,359,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,359,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,359,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,359,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,359,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,359,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,359,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,359,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,359,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,359,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,359,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,359,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,359,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,359,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,359,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,359,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,359,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,359,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,359,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,359,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,359,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,359,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,359,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,359,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,359,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,359,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,359,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,2106.0,4 RC,359,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,359,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,359,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,359,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,359,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,359,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,359,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,359,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,359,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,359,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,359,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,359,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,359,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,359,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,359,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,359,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,359,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,359,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,359,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,359,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,359,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,359,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,359,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,359,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,359,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,359,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,359,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,359,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,359,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,359,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,360, Operating Room Services General Classification ,,,3673.0,5356.0,12 RC,360,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,360,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,360,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,360,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,360,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,360,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,948.0,12562.0,32 RC,360,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,948.0,12562.0,32 RC,360,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,948.0,12562.0,32 RC,360,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,948.0,12562.0,32 RC,360,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,360,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,360,ACCESS AV DIAL GRFT FOR EVAL ,,,2431.0,2979.0,3 RC,360,ACCESS AV DIAL GRFT FOR PROC ,,,2358.0,5841.0,2 RC,360,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,360,ARTERY TO VEIN SHUNT ,,,3390.0,5841.0,2 RC,360,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,360,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,360,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,360,"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,351.7,3249.0,32 RC,360,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,3249.0,32 RC,360,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,948.0,13835.0,29 RC,360,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,948.0,3390.0,18 RC,360,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,948.0,4423.26,23 RC,360,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,948.0,15059.0,28 RC,360,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,948.0,5802.38,23 RC,360,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,948.0,35469.31,23 RC,360,"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation ",,,948.0,15059.0,32 RC,360,"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency ",,,948.0,13835.0,32 RC,360,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,948.0,13196.03,32 RC,360,"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,22 RC,360,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,22 RC,360,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,948.0,16207.0,29 RC,360,"Ablation, open, of 1 or more liver tumor(s); cryosurgical ",,,948.0,17999.62,29 RC,360,"Ablation, open, of 1 or more liver tumor(s); radiofrequency ",,,948.0,17732.67,29 RC,360,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,948.0,22967.79,32 RC,360,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,360,"Adenoidectomy, primary; age 12 or over ",,,930.95,8234.0,32 RC,360,"Adenoidectomy, primary; younger than age 12 ",,,930.95,8234.0,32 RC,360,"Adenoidectomy, secondary; age 12 or over ",,,930.95,8234.0,32 RC,360,"Adenoidectomy, secondary; younger than age 12 ",,,930.95,8234.0,32 RC,360,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,360,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,360,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,360,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,948.0,16207.0,29 RC,360,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,948.0,16207.0,17 RC,360,Allogeneic lymphocyte infusions ,,,592.85,13835.0,20 RC,360,"Alveolectomy, including curettage of osteitis or sequestrectomy ",,,289.82,13835.0,32 RC,360,"Alveoloplasty, each quadrant (specify) ",,,234.0,13835.0,32 RC,360,Amniocentesis; diagnostic ,,,52.04,3083.0,29 RC,360,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,28 RC,360,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,18546.34,17 RC,360,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,948.0,16207.0,17 RC,360,Amputation of penis; complete ,,,948.0,13835.0,29 RC,360,Amputation of penis; partial ,,,948.0,8240.61,32 RC,360,"Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,30468.4,17 RC,360,"Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract ",,,948.0,40025.51,17 RC,360,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,948.0,32129.73,17 RC,360,"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,27747.48,17 RC,360,"Anastomosis, of intrahepatic ducts and gastrointestinal tract ",,,948.0,37283.43,17 RC,360,Anastomosis; facial-hypoglossal ,,,948.0,16207.0,17 RC,360,Anastomosis; facial-spinal accessory ,,,948.0,16207.0,17 RC,360,"Anoplasty, plastic operation for stricture; adult ",,,948.0,12562.0,32 RC,360,"Anoplasty, plastic operation for stricture; infant ",,,948.0,16207.0,17 RC,360,"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic ",,,948.0,6399.61,32 RC,360,Anorectal manometry ,,,1672.0,2358.0,4 RC,360,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,360,Anorectal myomectomy ,,,948.0,6399.61,32 RC,360,"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,223.51,5841.0,28 RC,360,"Anoscopy; diagnostic, with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when p",,,223.51,5841.0,28 RC,360,"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,32 RC,360,"Anoscopy; with biopsy, single or multiple ",,,211.33,13835.0,32 RC,360,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,115.98,13835.0,32 RC,360,"Anoscopy; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,13835.0,32 RC,360,"Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple ",,,948.0,8234.0,29 RC,360,Anoscopy; with removal of foreign body ,,,344.93,3128.0,32 RC,360,"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,32 RC,360,"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,32 RC,360,"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique ",,,344.93,3128.0,32 RC,360,Antepartum care only; 4-6 visits ,,,948.0,5841.0,12 RC,360,Antepartum care only; 7 or more visits ,,,948.0,7624.48,12 RC,360,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,948.0,13394.0,32 RC,360,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,948.0,13835.0,29 RC,360,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,948.0,13835.0,29 RC,360,Apheresis w/ adsorp/reinfuse ,,,3390.0,5841.0,2 RC,360,Appendectomy; ,,,948.0,13835.0,29 RC,360,Appendectomy; for ruptured appendix with abscess or generalized peritonitis ,,,948.0,16207.0,17 RC,360,Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,360,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,360,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,360,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,360,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,360,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,360,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,360,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,360,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,360,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,360,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,360,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,948.0,1915.7,10 RC,360,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,948.0,13394.0,32 RC,360,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,948.0,15059.0,32 RC,360,"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown ",,,948.0,7565.59,33 RC,360,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown ",,,948.0,6212.0,9 RC,360,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous ",,,948.0,6212.0,21 RC,360,"Arterial puncture, withdrawal of blood for diagnosis ",,,223.51,6212.0,16 RC,360,"Arteriovenous anastomosis, open; by forearm vein transposition ",,,2036.11,12562.0,28 RC,360,"Arteriovenous anastomosis, open; by forearm vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition ",,,2036.11,12562.0,28 RC,360,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition ",,,2036.11,12562.0,28 RC,360,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) ",,,1174.13,12562.0,28 RC,360,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,360,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,360,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,360,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,360,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,360,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,360,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,360,Artificial insemination; intra-cervical ,,,315.3,5841.0,16 RC,360,Artificial insemination; intra-uterine ,,,333.49,5841.0,16 RC,360,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,32 RC,360,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,32 RC,360,Aspiration of bladder; by needle ,,,38.37,3244.0,32 RC,360,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,32 RC,360,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,32 RC,360,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,27 RC,360,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,360,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,360,Axillary lymphadenectomy; complete ,,,948.0,13196.03,32 RC,360,Axillary lymphadenectomy; superficial ,,,948.0,13196.03,32 RC,360,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,360,BIOPSY OF STOMACH ,,,3390.0,5841.0,2 RC,360,BIOPSY OF THROAT ,,,3390.0,5841.0,2 RC,360,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,360,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,360,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,948.0,13835.0,15 RC,360,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,360,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,948.0,22352.23,15 RC,360,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,948.0,17385.04,17 RC,360,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,948.0,28561.16,51 RC,360,"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein ",,,948.0,16207.0,17 RC,360,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,948.0,18626.9,17 RC,360,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,948.0,17224.05,17 RC,360,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,948.0,16207.0,17 RC,360,"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each d",,,948.0,5841.0,20 RC,360,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,948.0,5841.0,20 RC,360,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,948.0,29900.51,17 RC,360,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,948.0,24971.42,17 RC,360,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,948.0,27115.97,17 RC,360,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,948.0,16944.28,17 RC,360,"Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure) ",,,948.0,13835.0,17 RC,360,"Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) ",,,948.0,8488.5,32 RC,360,"Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple ",,,948.0,12562.0,32 RC,360,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent ",,,948.0,15059.0,32 RC,360,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent ",,,948.0,12562.0,32 RC,360,"Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi ",,,948.0,13196.03,32 RC,360,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,948.0,12562.0,32 RC,360,Biopsy external auditory canal ,,,99.71,13835.0,20 RC,360,Biopsy external ear ,,,57.56,5841.0,19 RC,360,"Biopsy of anorectal wall, anal approach (eg, congenital megacolon) ",,,948.0,6399.61,32 RC,360,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,32 RC,360,Biopsy of conjunctiva ,,,113.96,12562.0,32 RC,360,Biopsy of cornea ,,,733.22,5283.1,32 RC,360,"Biopsy of epididymis, needle ",,,510.77,3747.2,32 RC,360,Biopsy of extraocular muscle ,,,948.0,8536.87,32 RC,360,Biopsy of floor of mouth ,,,110.18,3128.0,32 RC,360,"Biopsy of intestine by capsule, tube, peroral (1 or more specimens) ",,,351.7,3128.0,32 RC,360,Biopsy of lacrimal gland ,,,733.22,5571.0,32 RC,360,Biopsy of lacrimal sac ,,,733.22,5571.0,32 RC,360,Biopsy of lip ,,,67.44,5841.0,19 RC,360,"Biopsy of liver, needle; percutaneous ",,,510.77,3747.2,32 RC,360,"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Biopsy of liver, wedge ",,,948.0,16207.0,17 RC,360,Biopsy of nerve ,,,692.94,5571.0,32 RC,360,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,948.0,12562.0,32 RC,360,"Biopsy of palate, uvula ",,,703.52,3128.0,29 RC,360,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,948.0,16207.0,17 RC,360,"Biopsy of pancreas, percutaneous needle ",,,510.77,3747.2,32 RC,360,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,32 RC,360,Biopsy of penis; deep structures ,,,855.96,6330.57,32 RC,360,Biopsy of salivary gland; incisional ,,,441.67,5571.0,32 RC,360,Biopsy of salivary gland; needle ,,,60.46,3128.0,32 RC,360,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,32 RC,360,"Biopsy of stomach, by laparotomy ",,,948.0,13835.0,17 RC,360,"Biopsy of testis, incisional (separate procedure) ",,,948.0,8240.61,32 RC,360,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,32 RC,360,Biopsy of tongue; anterior two-thirds ,,,116.86,3128.0,32 RC,360,Biopsy of tongue; posterior one-third ,,,115.11,3755.0,32 RC,360,Biopsy of urethra ,,,685.44,5571.0,32 RC,360,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,948.0,6819.81,32 RC,360,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,32 RC,360,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,31 RC,360,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary) ",,,510.77,3747.2,32 RC,360,"Biopsy or excision of lymph node(s); open, deep axillary node(s) ",,,1011.84,8270.67,27 RC,360,"Biopsy or excision of lymph node(s); open, deep axillary node(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s) ",,,1011.84,8270.67,27 RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad ",,,1011.84,8270.67,27 RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s) ",,,948.0,13835.0,28 RC,360,"Biopsy or excision of lymph node(s); open, internal mammary node(s) ",,,948.0,8270.67,32 RC,360,"Biopsy or excision of lymph node(s); open, superficial ",,,948.0,8270.67,32 RC,360,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,32 RC,360,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,3747.2,32 RC,360,"Biopsy, prostate, any approach, nonimaging-guided ",,,948.0,4836.33,32 RC,360,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,948.0,3083.0,17 RC,360,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,948.0,14954.75,22 RC,360,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,948.0,14954.75,22 RC,360,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,360,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,9 RC,360,"Biopsy, vestibule of mouth ",,,113.09,5841.0,31 RC,360,"Biopsy; nasopharynx, survey for unknown primary lesion ",,,930.95,7150.66,32 RC,360,"Biopsy; nasopharynx, visible lesion, simple ",,,930.95,7150.66,32 RC,360,Biopsy; oropharynx ,,,89.82,13835.0,32 RC,360,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,19 RC,360,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,31 RC,360,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,31 RC,360,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,360,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,360,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,360,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,360,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,360,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic ",,,786.51,13835.0,16 RC,360,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous ",,,592.85,13835.0,20 RC,360,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,360,Bone marrow harvesting for transplantation; allogeneic ,,,592.85,13835.0,32 RC,360,Bone marrow harvesting for transplantation; autologous ,,,948.0,15059.0,32 RC,360,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,360,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,360,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,360,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,360,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,360,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,360,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,360,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,360,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,360,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,360,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,360,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,360,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,360,Bundle of His recording ,,,3673.0,43890.0,22 RC,360,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,948.0,16207.0,17 RC,360,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,948.0,16207.0,17 RC,360,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,948.0,16207.0,17 RC,360,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,948.0,16207.0,17 RC,360,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,948.0,16868.07,17 RC,360,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,948.0,16207.0,17 RC,360,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,948.0,16207.0,17 RC,360,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,948.0,16207.0,17 RC,360,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,948.0,16207.0,17 RC,360,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,360,CHANGE BILE DUCT CATHETER ,,,3390.0,5841.0,2 RC,360,CHANGE IV CATH AT THROMB TX ,,,3390.0,5841.0,2 RC,360,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,360,"CHANGE OF GASTROSTOMY TUBE, PERCUTANEOUS, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE ",,,2358.0,5841.0,2 RC,360,CIRCUMCISION ,,,3390.0,5841.0,2 RC,360,COLLECT BLOOD VENOUS DEVICE ,,,3390.0,5841.0,2 RC,360,COLONOSCOPY LESION REMOVAL ,,,3390.0,5841.0,2 RC,360,COLONOSCOPY W/STENT ,,,3390.0,5841.0,4 RC,360,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,360,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,360,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,360,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,360,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,360,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,360,CREATE SALIVARY CYST DRAIN ,,,3390.0,5841.0,4 RC,360,CRYOTHERAPY OF RECTAL LESION ,,,3390.0,5841.0,4 RC,360,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,360,"Cannulation, thoracic duct ",,,948.0,5841.0,8 RC,360,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,32 RC,360,Canthotomy (separate procedure) ,,,733.22,5571.0,32 RC,360,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,360,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,360,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,360,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,360,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,360,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,360,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,360,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,360,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,948.0,5841.0,20 RC,360,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,360,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,360,"Catheterization of umbilical vein for diagnosis or therapy, newborn ",,,948.0,5841.0,8 RC,360,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,600.2,3390.0,23 RC,360,"Catheterization, umbilical artery, newborn, for diagnosis or therapy ",,,654.37,16207.0,18 RC,360,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,31 RC,360,Cautery of cervix; electro or thermal ,,,83.14,13835.0,32 RC,360,Cautery of cervix; laser ablation ,,,948.0,6819.81,32 RC,360,"Cerclage of cervix, during pregnancy; abdominal ",,,948.0,16207.0,29 RC,360,"Cerclage of cervix, during pregnancy; vaginal ",,,948.0,6819.81,32 RC,360,"Cerclage of uterine cervix, nonobstetrical ",,,948.0,6819.81,29 RC,360,Cervical lymphadenectomy (complete) ,,,948.0,22210.08,29 RC,360,Cervical lymphadenectomy (modified radical neck dissection) ,,,948.0,17660.58,29 RC,360,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,948.0,13835.0,15 RC,360,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,948.0,15889.05,12 RC,360,Cesarean delivery only; ,,,948.0,13835.0,15 RC,360,Cesarean delivery only; including postpartum care ,,,948.0,15427.0,24 RC,360,Change of cystostomy tube; complicated ,,,250.06,3390.0,32 RC,360,Change of cystostomy tube; simple ,,,54.36,5841.0,31 RC,360,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,685.44,4836.33,32 RC,360,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,360,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,360,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,360,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,31 RC,360,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,31 RC,360,Chemodenervation of extraocular muscle ,,,107.27,5841.0,31 RC,360,Chemodenervation of internal anal sphincter ,,,450.72,3128.0,32 RC,360,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,32 RC,360,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,31 RC,360,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,31 RC,360,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,32 RC,360,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,32 RC,360,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,32 RC,360,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,31 RC,360,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,32 RC,360,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,32 RC,360,"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous ",,,948.0,3390.0,6 RC,360,"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day ",,,948.0,3390.0,6 RC,360,"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage) ",,,948.0,3390.0,6 RC,360,Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration ,,,948.0,3390.0,6 RC,360,Cholecystectomy with exploration of common duct; ,,,948.0,16207.0,29 RC,360,Cholecystectomy with exploration of common duct; with choledochoenterostomy ,,,948.0,16207.0,29 RC,360,"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography ",,,948.0,16774.82,29 RC,360,Cholecystectomy; ,,,2996.0,16207.0,24 RC,360,Cholecystectomy; High Cost Surgery,,,2369.0,2369.0,5 RC,360,Cholecystectomy; with cholangiography ,,,3293.0,16207.0,24 RC,360,Cholecystectomy; with cholangiography High Cost Surgery,,,2369.0,2369.0,5 RC,360,Cholecystoenterostomy; Roux-en-Y ,,,948.0,16207.0,17 RC,360,Cholecystoenterostomy; Roux-en-Y with gastroenterostomy ,,,948.0,18126.75,17 RC,360,Cholecystoenterostomy; direct ,,,948.0,16207.0,17 RC,360,Cholecystoenterostomy; with gastroenterostomy ,,,948.0,16677.33,17 RC,360,"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation ",,,948.0,13835.0,17 RC,360,"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure) ",,,948.0,16207.0,17 RC,360,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16829.85,17 RC,360,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16486.58,17 RC,360,"Chorionic villus sampling, any method ",,,52.32,3244.0,20 RC,360,"Chromotubation of oviduct, including materials ",,,948.0,12562.0,29 RC,360,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,32 RC,360,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,32 RC,360,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,32 RC,360,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,32 RC,360,Ciliary body destruction; diathermy ,,,892.44,5519.68,32 RC,360,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,32 RC,360,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,32 RC,360,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,32 RC,360,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,32 RC,360,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,32 RC,360,Clitoroplasty for intersex state ,,,948.0,13835.0,20 RC,360,Closure of anal fistula with rectal advancement flap ,,,948.0,8234.0,32 RC,360,Closure of cystostomy (separate procedure) ,,,948.0,8240.61,32 RC,360,Closure of enteroenteric or enterocolic fistula ,,,948.0,17745.37,17 RC,360,"Closure of enterostomy, large or small intestine; ",,,948.0,16207.0,17 RC,360,"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal ",,,948.0,16207.0,17 RC,360,"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure) ",,,948.0,19678.01,17 RC,360,Closure of enterovesical fistula; with intestine and/or bladder resection ,,,948.0,19063.43,17 RC,360,Closure of enterovesical fistula; without intestinal or bladder resection ,,,948.0,16401.79,17 RC,360,Closure of esophagostomy or fistula; cervical approach ,,,948.0,13835.0,29 RC,360,Closure of esophagostomy or fistula; transthoracic or transabdominal approach ,,,948.0,17647.88,17 RC,360,Closure of gastrocolic fistula ,,,948.0,19572.05,17 RC,360,"Closure of gastrostomy, surgical ",,,948.0,8187.49,32 RC,360,Closure of intestinal cutaneous fistula ,,,948.0,17228.28,17 RC,360,"Closure of laceration, vestibule of mouth; 2.5 cm or less ",,,91.96,5841.0,19 RC,360,"Closure of laceration, vestibule of mouth; over 2.5 cm or complex ",,,196.58,3128.0,32 RC,360,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,32 RC,360,Closure of nephrocutaneous or pyelocutaneous fistula ,,,948.0,14240.3,29 RC,360,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,948.0,18071.71,17 RC,360,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,948.0,19372.84,17 RC,360,Closure of rectourethral fistula; ,,,948.0,16207.0,17 RC,360,Closure of rectourethral fistula; with colostomy ,,,948.0,18834.58,17 RC,360,Closure of rectovaginal fistula; abdominal approach ,,,948.0,16207.0,29 RC,360,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,948.0,16207.0,17 RC,360,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,948.0,13835.0,17 RC,360,Closure of rectovaginal fistula; vaginal or transanal approach ,,,948.0,12562.0,32 RC,360,Closure of rectovesical fistula; ,,,948.0,16207.0,17 RC,360,Closure of rectovesical fistula; with colostomy ,,,948.0,18037.72,17 RC,360,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,31 RC,360,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,31 RC,360,Closure of ureterocutaneous fistula ,,,948.0,16207.0,17 RC,360,Closure of ureterovisceral fistula (including visceral repair) ,,,948.0,16207.0,17 RC,360,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,948.0,11552.32,32 RC,360,Closure of urethrovaginal fistula; ,,,948.0,18300.83,32 RC,360,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,948.0,13835.0,29 RC,360,Closure of vesicouterine fistula; ,,,948.0,13835.0,29 RC,360,Closure of vesicouterine fistula; with hysterectomy ,,,948.0,16207.0,17 RC,360,"Closure of vesicovaginal fistula, abdominal approach ",,,948.0,13835.0,29 RC,360,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,948.0,18300.83,17 RC,360,Closure of vesicovaginal fistula; vaginal approach ,,,948.0,12562.0,32 RC,360,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,32 RC,360,Closure salivary fistula ,,,930.95,7150.66,32 RC,360,"Closure, exstrophy of bladder ",,,948.0,20139.94,17 RC,360,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,28 RC,360,"Cochlear device implantation, with or without mastoidectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,948.0,16207.0,17 RC,360,"Colectomy, partial; abdominal and transanal approach ",,,948.0,23882.21,17 RC,360,"Colectomy, partial; with anastomosis ",,,948.0,16495.05,17 RC,360,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis) ",,,948.0,20364.56,17 RC,360,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy ",,,948.0,26005.59,17 RC,360,"Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) ",,,948.0,20457.81,17 RC,360,"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula ",,,948.0,21758.94,17 RC,360,"Colectomy, partial; with skin level cecostomy or colostomy ",,,948.0,22428.55,17 RC,360,"Colectomy, total, abdominal, with proctectomy; with continent ileostomy ",,,948.0,28196.72,17 RC,360,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,27671.16,17 RC,360,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,26954.98,17 RC,360,"Colectomy, total, abdominal, with proctectomy; with ileostomy ",,,948.0,25492.74,17 RC,360,"Colectomy, total, abdominal, without proctectomy; with continent ileostomy ",,,948.0,26556.55,17 RC,360,"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy ",,,948.0,22924.36,17 RC,360,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,360,Collection of blood specimen from a completely implantable venous access device ,,,948.0,6212.0,11 RC,360,"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified ",,,948.0,6212.0,11 RC,360,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,948.0,948.0,5 RC,360,Collection of venous blood by venipuncture ,,,948.0,948.0,5 RC,360,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,360,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,32 RC,360,"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,29 RC,360,"Colonoscopy through stoma; with biopsy, single or multiple ",,,450.72,3128.0,32 RC,360,"Colonoscopy through stoma; with control of bleeding, any method ",,,450.72,3128.0,32 RC,360,"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,8234.0,32 RC,360,"Colonoscopy through stoma; with directed submucosal injection(s), any substance ",,,450.72,8234.0,32 RC,360,Colonoscopy through stoma; with endoscopic mucosal resection ,,,450.72,8234.0,32 RC,360,"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,29 RC,360,"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures ",,,450.72,8234.0,32 RC,360,Colonoscopy through stoma; with removal of foreign body(s) ,,,344.93,3128.0,32 RC,360,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3128.0,32 RC,360,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,32 RC,360,Colonoscopy through stoma; with transendoscopic balloon dilation ,,,450.72,8234.0,32 RC,360,"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descendi",,,450.72,8234.0,32 RC,360,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3755.0,32 RC,360,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,32 RC,360,"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,32 RC,360,"Colonoscopy, flexible; with biopsy, single or multiple ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with control of bleeding, any method ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,450.72,8234.0,32 RC,360,"Colonoscopy, flexible; with directed submucosal injection(s), any substance ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,32 RC,360,"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,32 RC,360,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with removal of foreign body(s) ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3755.0,32 RC,360,"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, desc",,,450.72,3755.0,32 RC,360,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,26 RC,360,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,26 RC,360,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,23 RC,360,Colostomy or skin level cecostomy; ,,,948.0,16207.0,17 RC,360,"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure) ",,,948.0,16207.0,17 RC,360,"Colotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,360,Colpocentesis (separate procedure) ,,,948.0,11661.3,32 RC,360,Colpocleisis (Le Fort type) ,,,948.0,13835.0,32 RC,360,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,948.0,6819.81,32 RC,360,"Colpopexy, abdominal approach ",,,948.0,13835.0,29 RC,360,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,948.0,18300.83,29 RC,360,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,948.0,18300.83,29 RC,360,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,360,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,948.0,6819.81,32 RC,360,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,31 RC,360,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,31 RC,360,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,31 RC,360,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,31 RC,360,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,32 RC,360,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,32 RC,360,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,31 RC,360,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,32 RC,360,Colposcopy of the vulva; ,,,57.86,5841.0,31 RC,360,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,31 RC,360,Colpotomy; with drainage of pelvic abscess ,,,948.0,6819.81,32 RC,360,Colpotomy; with exploration ,,,948.0,6819.81,32 RC,360,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,948.0,13394.0,32 RC,360,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,948.0,12909.0,32 RC,360,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,360,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,360,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,360,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,360,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,32 RC,360,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,32 RC,360,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,32 RC,360,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,32 RC,360,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,283.62,5841.0,16 RC,360,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,360,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,360,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,360,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,360,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,360,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,360,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,948.0,5841.0,8 RC,360,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,948.0,6819.81,32 RC,360,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,948.0,6819.81,32 RC,360,Conjunctival flap; bridge or partial (separate procedure) ,,,948.0,8536.87,32 RC,360,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,32 RC,360,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,32 RC,360,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,948.0,8536.87,32 RC,360,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,948.0,8536.87,32 RC,360,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,32 RC,360,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,948.0,8536.87,32 RC,360,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,948.0,8536.87,32 RC,360,Construction of artificial vagina; with graft ,,,948.0,13835.0,29 RC,360,Construction of artificial vagina; without graft ,,,948.0,13394.0,32 RC,360,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,32 RC,360,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,32 RC,360,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,360,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,948.0,20377.26,17 RC,360,Continent ileostomy (Kock procedure) (separate procedure) ,,,948.0,17410.56,17 RC,360,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,360,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,,,948.0,5841.0,20 RC,360,"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report ",,,83.43,6212.0,32 RC,360,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",,,477.73,5841.0,28 RC,360,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization ",,,948.0,16207.0,17 RC,360,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery ",,,91.96,5841.0,31 RC,360,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention ",,,930.95,12562.0,32 RC,360,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization ",,,948.0,16207.0,17 RC,360,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple ",,,196.58,5841.0,31 RC,360,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention ",,,930.95,7150.66,32 RC,360,"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), ",,,948.0,15059.0,32 RC,360,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,32 RC,360,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,360,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,32 RC,360,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,360,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,360,"Cordocentesis (intrauterine), any method ",,,554.98,5841.0,16 RC,360,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,32 RC,360,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,32 RC,360,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,948.0,16207.0,17 RC,360,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,948.0,8240.61,32 RC,360,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,948.0,8234.0,32 RC,360,"Correction of everted punctum, cautery ",,,113.7,5841.0,31 RC,360,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,32 RC,360,Correction of lid retraction ,,,733.22,12562.0,32 RC,360,"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure) ",,,948.0,18393.82,29 RC,360,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,19 RC,360,"Correction of trichiasis; epilation, by forceps only ",,,223.51,5841.0,16 RC,360,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,32 RC,360,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,32 RC,360,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,948.0,5841.0,8 RC,360,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,948.0,16330.72,17 RC,360,Craniectomy for craniosynostosis; multiple cranial sutures ,,,948.0,18444.62,17 RC,360,Craniectomy for craniosynostosis; single cranial suture ,,,948.0,16207.0,17 RC,360,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,948.0,46759.99,17 RC,360,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,948.0,34350.61,17 RC,360,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,948.0,36766.35,17 RC,360,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,948.0,39720.34,17 RC,360,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,948.0,22576.85,17 RC,360,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,948.0,25611.4,17 RC,360,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,948.0,25806.38,17 RC,360,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,948.0,24598.51,17 RC,360,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,948.0,19402.47,17 RC,360,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,948.0,29586.87,17 RC,360,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,948.0,29561.46,17 RC,360,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,948.0,26149.65,17 RC,360,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,948.0,23547.4,17 RC,360,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,948.0,24861.23,17 RC,360,"Craniectomy or craniotomy, exploratory; supratentorial ",,,948.0,20406.89,17 RC,360,Craniectomy or craniotomy; with excision of foreign body from brain ,,,948.0,23106.64,17 RC,360,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,948.0,24297.57,17 RC,360,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,948.0,41508.92,17 RC,360,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,948.0,38601.49,17 RC,360,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,948.0,26679.44,17 RC,360,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,948.0,25797.91,17 RC,360,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,948.0,27154.19,17 RC,360,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,948.0,24954.48,17 RC,360,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,948.0,26158.12,17 RC,360,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,948.0,23733.91,17 RC,360,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,948.0,23716.98,17 RC,360,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,948.0,27162.66,17 RC,360,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,948.0,31706.02,17 RC,360,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,948.0,23081.23,17 RC,360,Craniectomy; for osteomyelitis ,,,948.0,16207.0,17 RC,360,Craniectomy; with excision of tumor or other bone lesion of skull ,,,948.0,16194.11,29 RC,360,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,948.0,29832.65,17 RC,360,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,948.0,32278.14,17 RC,360,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,948.0,37546.15,17 RC,360,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,948.0,35702.54,17 RC,360,Cranioplasty for skull defect with reparative brain surgery ,,,948.0,17389.28,17 RC,360,Cranioplasty for skull defect; larger than 5 cm diameter ,,,948.0,16207.0,17 RC,360,Cranioplasty for skull defect; up to 5 cm diameter ,,,948.0,16207.0,17 RC,360,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,948.0,17787.71,17 RC,360,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,948.0,16207.0,17 RC,360,Craniotomy for craniosynostosis; bifrontal bone flap ,,,948.0,20945.15,17 RC,360,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,948.0,21263.02,17 RC,360,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,948.0,28586.68,17 RC,360,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,948.0,19673.77,17 RC,360,"Craniotomy for repair of encephalocele, skull base ",,,948.0,19381.3,17 RC,360,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,948.0,31883.95,17 RC,360,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,948.0,39423.75,17 RC,360,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,948.0,20105.95,17 RC,360,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,948.0,23733.91,17 RC,360,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,948.0,29514.78,17 RC,360,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,948.0,26730.36,17 RC,360,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,948.0,33180.84,17 RC,360,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,948.0,30709.95,17 RC,360,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,948.0,30913.39,17 RC,360,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,948.0,26158.12,17 RC,360,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,948.0,16207.0,17 RC,360,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,948.0,27493.23,17 RC,360,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,948.0,18843.05,17 RC,360,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,948.0,26577.72,17 RC,360,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft ,,,2036.11,12547.6,28 RC,360,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) ",,,2036.11,12547.6,28 RC,360,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,948.0,15039.6,17 RC,360,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,948.0,19834.77,17 RC,360,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,32 RC,360,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,32 RC,360,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,32 RC,360,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,948.0,16207.0,17 RC,360,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,948.0,15039.6,29 RC,360,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,360,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,360,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,360,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,360,Cricopharyngeal myotomy ,,,948.0,13835.0,20 RC,360,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,360,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,948.0,24948.0,31 RC,360,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial ",,,154.64,13835.0,32 RC,360,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent ",,,948.0,3128.0,29 RC,360,"Curettage, postpartum ",,,948.0,12562.0,32 RC,360,Cutaneous appendico-vesicostomy ,,,948.0,16207.0,17 RC,360,Cutaneous vesicostomy ,,,948.0,13835.0,17 RC,360,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,948.0,28891.85,17 RC,360,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,948.0,23721.21,17 RC,360,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,26849.02,17 RC,360,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,948.0,23212.59,17 RC,360,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,25874.23,17 RC,360,"Cystectomy, complete; (separate procedure) ",,,948.0,18071.71,17 RC,360,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,22360.7,17 RC,360,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,948.0,16207.0,17 RC,360,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,948.0,16207.0,17 RC,360,"Cystectomy, partial; simple ",,,948.0,16207.0,17 RC,360,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,360,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,360,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,360,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,360,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,948.0,11552.32,32 RC,360,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,948.0,16207.0,29 RC,360,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,948.0,13835.0,29 RC,360,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,948.0,13835.0,29 RC,360,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,32 RC,360,"Cystotomy for excision, incision, or repair of ureterocele ",,,948.0,13835.0,17 RC,360,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,948.0,8240.61,32 RC,360,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,8 RC,360,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,948.0,8240.61,32 RC,360,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,32 RC,360,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,948.0,13835.0,17 RC,360,Cystotomy; for excision of bladder tumor ,,,948.0,13835.0,17 RC,360,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,948.0,8240.61,32 RC,360,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,948.0,16207.0,29 RC,360,Cystourethroscopy ,,,3390.0,5841.0,2 RC,360,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,27 RC,360,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,27 RC,360,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus High Cost Surgery",,,2369.0,2369.0,5 RC,360,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,27 RC,360,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus High Cost Surgery,,,2369.0,2369.0,5 RC,360,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,27 RC,360,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material High Cost Surgery,,,2369.0,2369.0,5 RC,360,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,32 RC,360,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,32 RC,360,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,360,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,32 RC,360,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,948.0,12562.0,32 RC,360,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,948.0,26403.19,22 RC,360,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,948.0,25988.0,34 RC,360,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,948.0,25244.72,23 RC,360,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde High Cost Surgery",,,2369.0,2369.0,5 RC,360,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,948.0,8240.61,32 RC,360,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,948.0,12562.0,29 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,27 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,360,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,32 RC,360,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,32 RC,360,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,32 RC,360,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,32 RC,360,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,32 RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,948.0,12562.0,32 RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,948.0,12562.0,32 RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,948.0,8240.61,32 RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,948.0,5571.0,32 RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,948.0,5571.0,32 RC,360,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,32 RC,360,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,27 RC,360,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,25 RC,360,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,948.0,5841.0,25 RC,360,"Cystourethroscopy, with insertion of permanent urethral stent ",,,948.0,15059.0,32 RC,360,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,360,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,26 RC,360,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,26 RC,360,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,32 RC,360,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,32 RC,360,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,948.0,15059.0,27 RC,360,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,32 RC,360,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,32 RC,360,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,948.0,8240.61,32 RC,360,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,32 RC,360,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,32 RC,360,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,948.0,8240.61,32 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,27 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,11552.32,24 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) Lithotripsy",,,2843.0,2843.0,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,948.0,15059.0,32 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,27 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,27 RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,948.0,11552.32,32 RC,360,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,948.0,12562.0,32 RC,360,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,948.0,8240.61,32 RC,360,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,360,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,32 RC,360,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,360,DECLOT VASCULAR DEVICE ,,,3390.0,5841.0,2 RC,360,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,360,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,360,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,360,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,360,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,360,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,6 RC,360,DILATE ESOPHAGUS ,,,3390.0,5841.0,4 RC,360,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,360,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,2 RC,360,DRAIN APP ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,360,DRAIN PANCREATIC PSEUDOCYST ,,,3390.0,5841.0,2 RC,360,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,360,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,2 RC,360,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,2 RC,360,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,360,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,360,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,948.0,8536.87,32 RC,360,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,360,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,360,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,360,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,32 RC,360,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,358.2,5841.0,16 RC,360,Declotting by thrombolytic agent of implanted vascular access device or catheter ,,,27.62,6212.0,32 RC,360,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,948.0,13835.0,29 RC,360,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,948.0,13394.0,32 RC,360,Decompression internal auditory canal ,,,948.0,13835.0,17 RC,360,"Decompression of orbit only, transcranial approach ",,,948.0,13835.0,17 RC,360,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,360,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,692.94,15059.0,32 RC,360,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,948.0,3083.0,17 RC,360,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,948.0,20238.53,22 RC,360,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,948.0,5446.4,22 RC,360,Decompression; plantar digital nerve ,,,692.94,5571.0,32 RC,360,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,32 RC,360,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,360,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,12562.0,32 RC,360,Deligation of ureter ,,,948.0,16207.0,17 RC,360,Delivery of placenta (separate procedure) ,,,948.0,13835.0,20 RC,360,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,360,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,31 RC,360,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,32 RC,360,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,948.0,5841.0,20 RC,360,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,32 RC,360,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,948.0,5841.0,20 RC,360,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,32 RC,360,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,32 RC,360,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,32 RC,360,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,32 RC,360,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,32 RC,360,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,32 RC,360,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,32 RC,360,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,31 RC,360,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,32 RC,360,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,32 RC,360,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,27 RC,360,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) ",,,137.5,13394.0,32 RC,360,"Destruction of lesion (except excision), dentoalveolar structures ",,,441.67,13835.0,32 RC,360,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,31 RC,360,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,32 RC,360,"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) ",,,187.2,3128.0,32 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6399.61,32 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,144.76,5841.0,31 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,78.06,5841.0,31 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,168.02,13835.0,32 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,948.0,6399.61,32 RC,360,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,948.0,6399.61,32 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,32 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,655.0,5841.0,16 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,358.2,5841.0,16 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,20 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,32 RC,360,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,32 RC,360,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,32 RC,360,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,32 RC,360,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,32 RC,360,"Destruction of lesion, palate or uvula (thermal, cryo or chemical) ",,,142.44,3128.0,32 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,27 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,27 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,360,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) High ",,,2369.0,2369.0,5 RC,360,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,26 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,27 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,27 RC,360,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ",,,948.0,15059.0,32 RC,360,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6819.81,32 RC,360,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,32 RC,360,Diagnostic bone marrow; aspiration(s) ,,,97.38,3128.0,32 RC,360,Diagnostic bone marrow; biopsy(ies) ,,,100.58,3128.0,32 RC,360,Diagnostic bone marrow; biopsy(ies) and aspiration(s) ,,,855.96,6330.57,31 RC,360,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,360,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,360,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,360,"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation neces",,,948.0,5841.0,20 RC,360,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,360,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,19 RC,360,"Dilation and catheterization of salivary duct, with or without injection ",,,59.88,5841.0,31 RC,360,Dilation and curettage of cervical stump ,,,948.0,12562.0,32 RC,360,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,948.0,6819.81,32 RC,360,Dilation of anal sphincter (separate procedure) under anesthesia other than local ,,,450.72,3128.0,32 RC,360,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,32 RC,360,"Dilation of esophagus, by unguided sound or bougie, single or multiple passes ",,,351.7,3128.0,32 RC,360,"Dilation of esophagus, over guide wire ",,,593.22,4251.7,32 RC,360,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,948.0,15059.0,62 RC,360,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,31 RC,360,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,19 RC,360,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,32 RC,360,"Dilation of lacrimal punctum, with or without irrigation ",,,745.36,5841.0,16 RC,360,Dilation of rectal stricture (separate procedure) under anesthesia other than local ,,,450.72,3128.0,32 RC,360,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,32 RC,360,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,31 RC,360,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,31 RC,360,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,31 RC,360,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,948.0,4836.33,32 RC,360,Dilation of vagina under anesthesia (other than local) ,,,948.0,6819.81,32 RC,360,Dilation salivary duct ,,,39.25,3128.0,32 RC,360,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,948.0,5841.0,20 RC,360,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,948.0,16330.72,29 RC,360,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,948.0,16207.0,17 RC,360,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,948.0,18749.79,17 RC,360,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,32 RC,360,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,31 RC,360,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,27 RC,360,"Discission of vitreous strands (without removal), pars plana approach High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,360,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,360,"Dissection, deep jugular node(s) ",,,948.0,13196.03,32 RC,360,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) ",,,2996.0,13835.0,25 RC,360,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach ",,,948.0,13835.0,32 RC,360,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach ",,,948.0,18033.49,17 RC,360,Division of stricture of rectum ,,,450.72,5571.0,32 RC,360,"Donor enterectomy (including cold preservation), open; from cadaver donor ",,,948.0,16207.0,17 RC,360,"Donor enterectomy (including cold preservation), open; partial, from living donor ",,,948.0,23742.38,17 RC,360,"Donor hepatectomy (including cold preservation), from cadaver donor ",,,948.0,22555.68,17 RC,360,"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) ",,,948.0,43933.13,17 RC,360,"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV) ",,,948.0,52591.78,17 RC,360,"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII) ",,,948.0,57868.37,17 RC,360,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,360,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,948.0,16207.0,17 RC,360,"Donor nephrectomy (including cold preservation); open, from living donor ",,,948.0,18414.98,17 RC,360,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,948.0,16028.88,15 RC,360,"Drainage external auditory canal, abscess ",,,154.94,5841.0,31 RC,360,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,32 RC,360,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,31 RC,360,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,29 RC,360,"Drainage of abscess of palate, uvula ",,,91.96,5841.0,31 RC,360,"Drainage of abscess, cyst, hematoma from dentoalveolar structures ",,,223.51,5841.0,28 RC,360,"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated ",,,196.58,3755.0,32 RC,360,"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple ",,,138.37,5841.0,19 RC,360,"Drainage of abscess; parotid, complicated ",,,930.95,7150.66,32 RC,360,"Drainage of abscess; parotid, simple ",,,441.67,3683.7,32 RC,360,"Drainage of abscess; submaxillary or sublingual, intraoral ",,,196.58,5841.0,31 RC,360,"Drainage of abscess; submaxillary, external ",,,196.58,5841.0,31 RC,360,Drainage of deep periurethral abscess ,,,948.0,5571.0,32 RC,360,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,948.0,16207.0,17 RC,360,Drainage of lymph node abscess or lymphadenitis; extensive ,,,855.96,6330.57,32 RC,360,Drainage of lymph node abscess or lymphadenitis; simple ,,,855.96,6330.57,32 RC,360,Drainage of ovarian abscess; abdominal approach ,,,948.0,13835.0,29 RC,360,"Drainage of ovarian abscess; vaginal approach, open ",,,948.0,12562.0,32 RC,360,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,948.0,13835.0,32 RC,360,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,948.0,12562.0,32 RC,360,Drainage of perineal urinary extravasation; complicated ,,,948.0,13835.0,17 RC,360,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,32 RC,360,"Drainage of perirenal or renal abscess, open ",,,948.0,13835.0,29 RC,360,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,948.0,19550.76,17 RC,360,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,32 RC,360,"Drainage of retroperitoneal abscess, open ",,,948.0,16207.0,17 RC,360,Drainage of scrotal wall abscess ,,,510.77,3747.2,32 RC,360,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,948.0,16207.0,17 RC,360,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic ",,,71.55,5841.0,31 RC,360,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,948.0,21996.26,17 RC,360,"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes d",,,351.7,3128.0,32 RC,360,"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture) ",,,948.0,5841.0,28 RC,360,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,360,"Duodenotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,360,"Dural graft, spinal ",,,948.0,16207.0,17 RC,360,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,466.41,13835.0,17 RC,360,EMBOLIZATION UTERINE FIBROID ,,,3390.0,5841.0,2 RC,360,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,10 RC,360,ESOPH ENDOSCOPY ABLATION ,,,3390.0,5841.0,2 RC,360,ESOPHAGUS ENDOSCOPY ,,,3390.0,5841.0,2 RC,360,EXCISION OF RECTAL LESION ,,,3390.0,5841.0,2 RC,360,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,360,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,360,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,360,Ear piercing ,,,370.1,16207.0,14 RC,360,Electroejaculation ,,,560.2,3128.0,29 RC,360,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,360,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,360,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,360,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,19 RC,360,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,360,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,948.0,5841.0,23 RC,360,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,479.41,5841.0,44 RC,360,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,948.0,5841.0,23 RC,360,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,360,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,360,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,360,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,360,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,948.0,16207.0,17 RC,360,"Elevation of depressed skull fracture; simple, extradural ",,,948.0,13835.0,17 RC,360,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,948.0,18957.47,17 RC,360,"Embryo transfer, intrauterine ",,,948.0,5841.0,28 RC,360,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,32 RC,360,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,948.0,5841.0,20 RC,360,"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and ",,,948.0,5841.0,20 RC,360,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,360,Endolymphatic sac operation; with shunt ,,,948.0,13241.95,32 RC,360,Endolymphatic sac operation; without shunt ,,,948.0,13241.95,32 RC,360,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,29 RC,360,"Endometrial ablation, thermal, without hysteroscopic guidance High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,948.0,23059.78,34 RC,360,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,31 RC,360,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,360,Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (List separately in addition to code(s) for primary procedure) ,,,948.0,15059.0,23 RC,360,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,948.0,16330.72,31 RC,360,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,360,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,32 RC,360,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); with biopsy, single or multiple ",,,344.93,3128.0,32 RC,360,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,948.0,12562.0,32 RC,360,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,948.0,8187.49,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed ",,,948.0,15059.0,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple ",,,948.0,8187.49,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) ",,,948.0,13051.67,29 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,948.0,15059.0,32 RC,360,Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi ,,,948.0,8187.49,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,948.0,15059.0,32 RC,360,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) ,,,948.0,8187.49,32 RC,360,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) ,,,948.0,15059.0,32 RC,360,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy ,,,948.0,8187.49,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, ",,,948.0,15059.0,32 RC,360,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,360,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,360,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,360,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,360,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,360,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,360,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,948.0,16207.0,19 RC,360,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,948.0,16207.0,19 RC,360,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,948.0,27050.15,29 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and moni",,,948.0,25767.84,48 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated ",,,948.0,15059.0,32 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separa",,,948.0,5841.0,20 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated ",,,948.0,18734.14,31 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each thro",,,948.0,5841.0,20 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated ",,,948.0,15059.0,32 RC,360,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each throu",,,948.0,5841.0,20 RC,360,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (List separately in addit",,,948.0,16207.0,17 RC,360,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering ",,,948.0,35172.75,17 RC,360,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering ",,,948.0,30231.08,17 RC,360,"Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Enterectomy, resection of small intestine; single resection and anastomosis ",,,948.0,16207.0,17 RC,360,"Enterectomy, resection of small intestine; with enterostomy ",,,948.0,16207.0,17 RC,360,"Enterocystoplasty, including intestinal anastomosis ",,,948.0,16974.03,17 RC,360,"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure) ",,,948.0,16207.0,17 RC,360,Enterolysis (freeing of intestinal adhesion) (separate procedure) ,,,948.0,16207.0,29 RC,360,"Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube) ",,,948.0,16207.0,17 RC,360,"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,360,"Enucleation of eye; with implant, muscles attached to implant ",,,948.0,8536.87,32 RC,360,"Enucleation of eye; with implant, muscles not attached to implant ",,,948.0,12562.0,32 RC,360,Enucleation of eye; without implant ,,,948.0,12562.0,32 RC,360,Epididymectomy; bilateral ,,,948.0,8240.61,32 RC,360,Epididymectomy; unilateral ,,,948.0,12562.0,32 RC,360,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,948.0,8240.61,29 RC,360,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,948.0,8234.0,29 RC,360,Epikeratoplasty ,,,948.0,15664.44,29 RC,360,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,29 RC,360,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,360,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,360,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,360,"Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,360,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,360,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,360,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,360,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,360,"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, w",,,2369.0,44136.57,16 RC,360,"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with ",,,2369.0,38563.39,16 RC,360,"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric dr",,,2369.0,45963.25,16 RC,360,Esophagogastric fundoplasty partial or complete; laparotomy ,,,948.0,16207.0,17 RC,360,Esophagogastric fundoplasty partial or complete; thoracotomy ,,,948.0,16207.0,17 RC,360,"Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) ",,,948.0,16681.56,17 RC,360,"Esophagogastric tamponade, with balloon (Sengstaken type) ",,,948.0,16207.0,17 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,593.22,13394.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple ",,,351.7,3755.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease ",,,948.0,12562.0,29 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon ",,,948.0,12909.0,28 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie) ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube ",,,593.22,4251.7,29 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,351.7,3755.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,593.22,12562.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed ",,,948.0,22967.79,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire ",,,351.7,3755.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy ",,,948.0,13394.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) ",,,351.7,3755.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s) ",,,948.0,13394.0,28 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) ",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,593.22,4251.7,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial ma",,,593.22,13394.0,32 RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterºs»/stentºs», when performed, and endoscopic ultrasound, when",,,948.0,8187.49,32 RC,360,"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach ",,,948.0,17147.73,17 RC,360,Esophagojejunostomy (without total gastrectomy); abdominal approach ,,,948.0,16897.71,17 RC,360,Esophagojejunostomy (without total gastrectomy); thoracic approach ,,,948.0,17207.11,17 RC,360,Esophagomyotomy (Heller type); abdominal approach ,,,948.0,16401.79,17 RC,360,Esophagomyotomy (Heller type); thoracic approach ,,,948.0,16414.49,17 RC,360,"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula ",,,948.0,16207.0,17 RC,360,"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula ",,,948.0,16207.0,17 RC,360,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula ",,,948.0,19555.0,17 RC,360,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula ",,,948.0,18190.37,17 RC,360,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula ",,,948.0,34948.13,17 RC,360,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula ",,,948.0,33617.37,17 RC,360,"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,117.44,12562.0,32 RC,360,"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple ",,,125.86,12562.0,32 RC,360,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,360,"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,360,"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,360,"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,360,"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,32 RC,360,"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with optical endomicroscopy ",,,593.22,13394.0,32 RC,360,"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,360,"Esophagoscopy, flexible, transoral; with removal of foreign body(s) ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,5571.0,32 RC,360,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) ",,,593.22,4251.7,32 RC,360,"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope ",,,948.0,15059.0,32 RC,360,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) ",,,593.22,12562.0,32 RC,360,"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter) ",,,948.0,13394.0,32 RC,360,"Esophagoscopy, rigid, transoral; with biopsy, single or multiple ",,,593.22,13394.0,32 RC,360,"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance ",,,593.22,13394.0,32 RC,360,"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire ",,,948.0,13394.0,32 RC,360,"Esophagoscopy, rigid, transoral; with removal of foreign body(s) ",,,593.22,13394.0,32 RC,360,"Esophagostomy, fistulization of esophagus, external; cervical approach ",,,948.0,16207.0,17 RC,360,"Esophagostomy, fistulization of esophagus, external; thoracic approach ",,,948.0,16207.0,17 RC,360,"Esophagotomy, cervical approach, with removal of foreign body ",,,948.0,3683.7,17 RC,360,"Esophagotomy, thoracic approach, with removal of foreign body ",,,948.0,16207.0,17 RC,360,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,360,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,360,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,360,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,360,Evisceration of ocular contents; with implant ,,,948.0,12562.0,32 RC,360,Evisceration of ocular contents; without implant ,,,948.0,12562.0,32 RC,360,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,32 RC,360,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,360,"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging",,,948.0,15059.0,32 RC,360,Exchange of intraocular lens ,,,892.44,5571.0,32 RC,360,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,593.22,13835.0,32 RC,360,"Exchange transfusion, blood; newborn ",,,172.52,5841.0,31 RC,360,"Exchange transfusion, blood; other than newborn ",,,172.52,5841.0,31 RC,360,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,360,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,360,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,360,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,64 RC,360,Excision aural glomus tumor; extended (extratemporal) ,,,948.0,30451.46,17 RC,360,Excision aural glomus tumor; transcanal ,,,948.0,13394.0,32 RC,360,Excision aural glomus tumor; transmastoid ,,,948.0,13241.95,32 RC,360,Excision aural polyp ,,,143.6,13835.0,32 RC,360,"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ",,,930.95,12562.0,32 RC,360,"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx ",,,948.0,13394.0,32 RC,360,"Excision exostosis(es), external auditory canal ",,,948.0,13241.95,32 RC,360,Excision external ear; complete amputation ,,,948.0,13241.95,32 RC,360,"Excision external ear; partial, simple repair ",,,855.96,6330.57,32 RC,360,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies ",,,948.0,16207.0,17 RC,360,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy ",,,948.0,16207.0,17 RC,360,Excision of Bartholin's gland or cyst ,,,948.0,12562.0,32 RC,360,Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct ,,,948.0,16207.0,17 RC,360,Excision of Mullerian duct cyst ,,,948.0,8240.61,32 RC,360,Excision of ampulla of Vater ,,,948.0,16207.0,17 RC,360,"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic ",,,948.0,19126.93,17 RC,360,"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic ",,,948.0,24530.65,17 RC,360,Excision of bulbourethral gland (Cowper's gland) ,,,948.0,8240.61,32 RC,360,Excision of carotid body tumor; with excision of carotid artery ,,,948.0,20326.45,17 RC,360,Excision of carotid body tumor; without excision of carotid artery ,,,948.0,16795.98,17 RC,360,"Excision of cervical stump, abdominal approach; ",,,948.0,16207.0,17 RC,360,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,948.0,16207.0,17 RC,360,"Excision of cervical stump, vaginal approach; ",,,948.0,12562.0,32 RC,360,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,948.0,13835.0,17 RC,360,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,948.0,13394.0,32 RC,360,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,31 RC,360,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,32 RC,360,Excision of chalazion; single ,,,65.12,5841.0,31 RC,360,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,32 RC,360,Excision of choledochal cyst ,,,948.0,16300.07,17 RC,360,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,948.0,13196.03,32 RC,360,"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection ",,,948.0,14297.8,32 RC,360,"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection ",,,948.0,12562.0,32 RC,360,Excision of extraparenchymal lesion of testis ,,,948.0,8240.61,32 RC,360,"Excision of fibrous tuberosities, dentoalveolar structures ",,,948.0,13835.0,29 RC,360,"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) ",,,441.67,3683.7,32 RC,360,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,948.0,12562.0,32 RC,360,Excision of hydrocele; bilateral ,,,948.0,13394.0,32 RC,360,Excision of hydrocele; unilateral ,,,948.0,12562.0,32 RC,360,"Excision of hyperplastic alveolar mucosa, each quadrant (specify) ",,,198.25,13835.0,32 RC,360,Excision of ileoanal reservoir with ileostomy ,,,948.0,22623.54,17 RC,360,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,948.0,12562.0,32 RC,360,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,948.0,12562.0,32 RC,360,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,32 RC,360,Excision of lacrimal gland tumor; involving osteotomy ,,,948.0,12562.0,32 RC,360,Excision of lacrimal sac (dacryocystectomy) ,,,948.0,12562.0,32 RC,360,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,32 RC,360,Excision of lesion of mesentery (separate procedure) ,,,948.0,16207.0,17 RC,360,"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle ",,,930.95,7150.66,32 RC,360,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair ",,,930.95,7150.66,32 RC,360,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair ",,,172.67,13835.0,32 RC,360,"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair ",,,144.47,13835.0,32 RC,360,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,948.0,16207.0,17 RC,360,Excision of lesion of spermatic cord (separate procedure) ,,,948.0,8240.61,32 RC,360,Excision of lesion of tongue with closure; anterior two-thirds ,,,930.95,7150.66,32 RC,360,Excision of lesion of tongue with closure; posterior one-third ,,,930.95,7150.66,32 RC,360,Excision of lesion of tongue with closure; with local tongue flap ,,,930.95,7150.66,32 RC,360,Excision of lesion of tongue without closure ,,,149.42,3128.0,32 RC,360,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair ",,,948.0,13241.95,32 RC,360,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair ",,,188.37,13835.0,32 RC,360,"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair ",,,146.52,13835.0,32 RC,360,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,32 RC,360,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,32 RC,360,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,32 RC,360,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,32 RC,360,"Excision of lesion, esophagus, with primary repair; cervical approach ",,,948.0,16207.0,17 RC,360,"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach ",,,948.0,16207.0,17 RC,360,"Excision of lesion, sclera ",,,733.22,12909.0,32 RC,360,Excision of lingual frenum (frenectomy) ,,,170.34,3128.0,32 RC,360,Excision of lip; V-excision with primary direct linear closure ,,,930.95,7150.66,32 RC,360,"Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) ",,,948.0,13241.95,32 RC,360,"Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) ",,,930.95,7150.66,32 RC,360,Excision of lip; transverse wedge excision with primary closure ,,,930.95,7150.66,32 RC,360,Excision of local lesion of epididymis ,,,948.0,12562.0,32 RC,360,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,360,Excision of mucosa of vestibule of mouth as donor graft ,,,196.58,5841.0,31 RC,360,"Excision of multiple external papillae or tags, anus ",,,948.0,6399.61,32 RC,360,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,32 RC,360,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,948.0,15039.6,32 RC,360,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,32 RC,360,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,32 RC,360,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,32 RC,360,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,32 RC,360,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,32 RC,360,Excision of neuroma; sciatic nerve ,,,948.0,15039.6,32 RC,360,"Excision of osseous tuberosities, dentoalveolar structures ",,,948.0,13835.0,29 RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve ",,,948.0,13241.95,32 RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection ",,,948.0,13241.95,32 RC,360,"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve ",,,948.0,13241.95,32 RC,360,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve ",,,948.0,13241.95,32 RC,360,"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection ",,,948.0,16448.48,17 RC,360,Excision of penile plaque (Peyronie disease); ,,,948.0,9653.0,32 RC,360,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,948.0,22025.45,32 RC,360,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,948.0,11552.32,32 RC,360,Excision of perinephric cyst ,,,948.0,16207.0,17 RC,360,Excision of presacral or sacrococcygeal tumor ,,,948.0,27243.1,17 RC,360,"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach ",,,948.0,16207.0,17 RC,360,"Excision of rectal procidentia, with anastomosis; perineal approach ",,,948.0,16207.0,17 RC,360,"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach ",,,948.0,6399.61,32 RC,360,"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) ",,,948.0,15059.0,32 RC,360,"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) ",,,948.0,13394.0,32 RC,360,"Excision of single external papilla or tag, anus ",,,450.72,3128.0,32 RC,360,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,32 RC,360,Excision of sublingual gland ,,,948.0,13241.95,32 RC,360,Excision of sublingual salivary cyst (ranula) ,,,930.95,12562.0,32 RC,360,Excision of submandibular (submaxillary) gland ,,,948.0,13241.95,32 RC,360,"Excision of thrombosed hemorrhoid, external ",,,131.97,3128.0,32 RC,360,Excision of thyroglossal duct cyst or sinus; ,,,948.0,13196.03,32 RC,360,Excision of thyroglossal duct cyst or sinus; recurrent ,,,948.0,13196.03,32 RC,360,Excision of tonsil tags ,,,930.95,12562.0,32 RC,360,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,948.0,13196.03,32 RC,360,Excision of urethral diverticulum (separate procedure); female ,,,948.0,11552.32,32 RC,360,Excision of urethral diverticulum (separate procedure); male ,,,948.0,12562.0,32 RC,360,Excision of vaginal cyst or tumor ,,,948.0,6819.81,32 RC,360,Excision of vaginal septum ,,,948.0,6819.81,32 RC,360,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,948.0,8240.61,32 RC,360,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,948.0,8488.5,32 RC,360,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,948.0,13394.0,32 RC,360,"Excision or destruction lingual tonsil, any method (separate procedure) ",,,948.0,13241.95,32 RC,360,"Excision or destruction of lesion of pharynx, any method ",,,930.95,7150.66,32 RC,360,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,948.0,24038.38,11 RC,360,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,948.0,27963.63,11 RC,360,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,948.0,15741.23,11 RC,360,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,948.0,20117.01,11 RC,360,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,948.0,34471.38,11 RC,360,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,3 RC,360,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,3 RC,360,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,3 RC,360,Excision or fulguration of carcinoma of urethra ,,,948.0,8240.61,32 RC,360,Excision or fulguration; Skene's glands ,,,948.0,5571.0,32 RC,360,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,32 RC,360,"Excision or fulguration; urethral polyp(s), distal urethra ",,,948.0,5571.0,32 RC,360,Excision or fulguration; urethral prolapse ,,,948.0,5571.0,32 RC,360,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,32 RC,360,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,32 RC,360,Excision or unroofing of cyst(s) of kidney ,,,948.0,16207.0,17 RC,360,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,32 RC,360,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,948.0,30069.97,17 RC,360,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,948.0,24382.36,17 RC,360,"Excision, lesion of floor of mouth ",,,930.95,7150.66,32 RC,360,"Excision, lesion of palate, uvula; with local flap closure ",,,948.0,13241.95,32 RC,360,"Excision, lesion of palate, uvula; with simple primary closure ",,,155.23,3755.0,32 RC,360,"Excision, lesion of palate, uvula; without closure ",,,133.14,3755.0,32 RC,360,"Excision, local; malignant tumor of stomach ",,,948.0,16207.0,17 RC,360,"Excision, local; ulcer or benign tumor of stomach ",,,948.0,16207.0,17 RC,360,"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum) ",,,948.0,16207.0,17 RC,360,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,948.0,13394.0,32 RC,360,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,948.0,12909.0,32 RC,360,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,948.0,12909.0,32 RC,360,"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography ",,,948.0,16207.0,17 RC,360,Exploration for undescended testis (inguinal or scrotal area) ,,,948.0,8488.5,32 RC,360,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,32 RC,360,"Exploration of epididymis, with or without biopsy ",,,948.0,8240.61,32 RC,360,"Exploration of orbit (transcranial approach), with removal of lesion ",,,948.0,25276.59,17 RC,360,"Exploration, repair, and presacral drainage for rectal injury; ",,,948.0,16207.0,17 RC,360,"Exploration, repair, and presacral drainage for rectal injury; with colostomy ",,,948.0,20228.96,17 RC,360,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,948.0,16207.0,29 RC,360,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,948.0,13835.0,29 RC,360,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,948.0,25988.0,34 RC,360,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,25988.0,19 RC,360,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,25988.0,19 RC,360,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,19 RC,360,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,948.0,23428.74,17 RC,360,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,948.0,28192.48,17 RC,360,External cannula declotting (separate procedure); with balloon catheter ,,,2699.0,12562.0,28 RC,360,External cannula declotting (separate procedure); with balloon catheter High Cost Surgery,,,2369.0,2369.0,5 RC,360,External cannula declotting (separate procedure); without balloon catheter ,,,468.58,6212.0,28 RC,360,External cannula declotting (separate procedure); without balloon catheter High Cost Surgery,,,2369.0,2369.0,5 RC,360,"External cephalic version, with or without tocolysis ",,,948.0,6819.81,17 RC,360,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,360,"External drainage, pseudocyst of pancreas, open ",,,948.0,16207.0,17 RC,360,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,948.0,15059.0,31 RC,360,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,948.0,11603.86,31 RC,360,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,32 RC,360,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,15059.0,94 RC,360,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,360,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space ",,,441.67,3683.7,32 RC,360,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual ",,,196.58,5841.0,31 RC,360,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular ",,,930.95,7150.66,32 RC,360,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental ",,,948.0,13241.95,32 RC,360,"FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE) ",,,2431.0,2979.0,3 RC,360,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,360,FUSE PANCREAS AND BOWEL ,,,3390.0,5841.0,2 RC,360,FUSION OF BILE DUCT CYST ,,,3390.0,5841.0,4 RC,360,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,360,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,360,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,360,Fetal contraction stress test ,,,28.49,5841.0,14 RC,360,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,31 RC,360,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,399.9,16207.0,14 RC,360,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,482.53,5841.0,13 RC,360,Fetal non-stress test ,,,16.57,5841.0,11 RC,360,Fetal scalp blood sampling ,,,554.98,5841.0,16 RC,360,"Fetal shunt placement, including ultrasound guidance ",,,554.98,5841.0,28 RC,360,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,360,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,360,Fimbrioplasty ,,,948.0,13835.0,29 RC,360,Fine needle aspiration of orbital contents ,,,733.22,5571.0,32 RC,360,"Fissurectomy, including sphincterotomy, when performed ",,,948.0,6399.61,32 RC,360,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,32 RC,360,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,948.0,10424.04,32 RC,360,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,32 RC,360,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,32 RC,360,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,948.0,10424.04,32 RC,360,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,19 RC,360,Fixation of contralateral testis (separate procedure) ,,,948.0,12562.0,32 RC,360,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,360,"Follicle puncture for oocyte retrieval, any method ",,,948.0,3128.0,29 RC,360,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,31 RC,360,Free jejunum transfer with microvascular anastomosis ,,,948.0,26721.9,17 RC,360,Free omental flap with microvascular anastomosis ,,,948.0,19868.64,17 RC,360,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty) ",,,930.95,9653.0,32 RC,360,Frenulotomy of penis ,,,685.44,5571.0,32 RC,360,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,360,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,554.98,5841.0,28 RC,360,"Gastrectomy, partial, distal; with Roux-en-Y reconstruction ",,,948.0,23653.36,17 RC,360,"Gastrectomy, partial, distal; with formation of intestinal pouch ",,,948.0,26056.4,17 RC,360,"Gastrectomy, partial, distal; with gastroduodenostomy ",,,948.0,17838.63,17 RC,360,"Gastrectomy, partial, distal; with gastrojejunostomy ",,,948.0,25039.27,17 RC,360,"Gastrectomy, total; with Roux-en-Y reconstruction ",,,948.0,27967.87,17 RC,360,"Gastrectomy, total; with esophagoenterostomy ",,,948.0,24157.74,17 RC,360,"Gastrectomy, total; with formation of intestinal pouch, any type ",,,948.0,28395.93,17 RC,360,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed ",,,518.85,5841.0,28 RC,360,"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pent",,,283.62,5841.0,28 RC,360,"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) ",,,518.85,5841.0,28 RC,360,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,360,"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal",,,948.0,23945.83,14 RC,360,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,360,"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ",,,948.0,8128.0,29 RC,360,"Gastric restrictive procedure, open; removal of subcutaneous port component only ",,,744.46,4430.08,29 RC,360,"Gastric restrictive procedure, open; revision of subcutaneous port component only ",,,948.0,8128.0,29 RC,360,"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed ",,,948.0,29647.99,22 RC,360,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy ",,,948.0,19923.79,14 RC,360,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption ",,,948.0,22081.05,14 RC,360,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty ",,,948.0,15511.79,11 RC,360,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty ",,,948.0,16207.0,14 RC,360,Gastroduodenostomy ,,,948.0,16207.0,17 RC,360,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstructi",,,948.0,33197.77,17 RC,360,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty ",,,948.0,27645.76,17 RC,360,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,360,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,360,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,360,"Gastrojejunostomy; with vagotomy, any type ",,,948.0,16207.0,17 RC,360,Gastrojejunostomy; without vagotomy ,,,948.0,16516.21,17 RC,360,"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury ",,,948.0,16715.43,17 RC,360,"Gastrostomy, open; neonatal, for feeding ",,,948.0,13835.0,17 RC,360,"Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) ",,,948.0,16207.0,17 RC,360,"Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,948.0,13835.0,17 RC,360,"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin) ",,,948.0,13835.0,17 RC,360,Gastrotomy; with exploration or foreign body removal ,,,948.0,16207.0,17 RC,360,Gastrotomy; with suture repair of bleeding ulcer ,,,948.0,16545.97,17 RC,360,"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) ",,,948.0,18648.07,17 RC,360,"Gingivectomy, excision gingiva, each quadrant ",,,930.95,15108.46,32 RC,360,"Gingivoplasty, each quadrant (specify) ",,,304.35,13835.0,20 RC,360,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,360,"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection ",,,948.0,33829.29,17 RC,360,"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection ",,,948.0,26704.84,17 RC,360,"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection ",,,948.0,26920.99,17 RC,360,"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type) ",,,948.0,36969.79,17 RC,360,"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection ",,,948.0,29179.97,17 RC,360,Glossectomy; hemiglossectomy ,,,948.0,16207.0,17 RC,360,Glossectomy; less than one-half tongue ,,,948.0,13394.0,32 RC,360,"Glossectomy; partial, with unilateral radical neck dissection ",,,948.0,26666.74,17 RC,360,Goniotomy ,,,948.0,10424.04,32 RC,360,Graft (Thiersch operation) for rectal incontinence and/or prolapse ,,,948.0,12562.0,32 RC,360,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,360,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,360,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,360,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,360,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,360,HIntroduction of needle or intracatheter; retrograde brachial artery ,,,2358.0,5841.0,2 RC,360,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,360,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,360,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,360,HTherapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion ,,,6326.0,8104.0,3 RC,360,"Harvesting conjunctival allograft, living donor ",,,948.0,5571.0,29 RC,360,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,360,Hematopoietic progenitor cell (HPC); HPC boost ,,,592.85,9577.36,32 RC,360,Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor ,,,948.0,102199.95,29 RC,360,Hematopoietic progenitor cell (HPC); autologous transplantation ,,,592.85,13835.0,32 RC,360,"Hemorrhoidectomy, external, 2 or more columns/groups ",,,948.0,12562.0,32 RC,360,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; ",,,948.0,12562.0,32 RC,360,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy ",,,948.0,8234.0,32 RC,360,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed ",,,948.0,8234.0,32 RC,360,"Hemorrhoidectomy, internal and external, single column/group; ",,,948.0,12562.0,32 RC,360,"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy ",,,948.0,12562.0,32 RC,360,"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed ",,,948.0,12562.0,32 RC,360,"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance ",,,948.0,6399.61,32 RC,360,"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance ",,,948.0,15754.86,32 RC,360,"Hemorrhoidectomy, internal, by rubber band ligation(s) ",,,171.8,3128.0,32 RC,360,"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed ",,,948.0,12909.0,31 RC,360,"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling ",,,948.0,12909.0,29 RC,360,"Hepatectomy, resection of liver; partial lobectomy ",,,948.0,28730.74,17 RC,360,"Hepatectomy, resection of liver; total left lobectomy ",,,948.0,37948.81,17 RC,360,"Hepatectomy, resection of liver; total right lobectomy ",,,948.0,40771.45,17 RC,360,"Hepatectomy, resection of liver; trisegmentectomy ",,,948.0,42242.16,17 RC,360,"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus ",,,948.0,26539.62,17 RC,360,"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages ",,,948.0,16207.0,17 RC,360,Hip core decompression ,,,9913.14,12713.03,5 RC,360,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,360,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,360,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,360,"Hymenotomy, simple incision ",,,948.0,6819.81,32 RC,360,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,948.0,19432.11,17 RC,360,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,948.0,16207.0,29 RC,360,Hysterorrhaphy of ruptured uterus ,,,948.0,13835.0,15 RC,360,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,948.0,16207.0,29 RC,360,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,6819.81,15 RC,360,"Hysteroscopy, diagnostic (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,15 RC,360,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,15 RC,360,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,15 RC,360,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,15 RC,360,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,15 RC,360,"Hysteroscopy, surgical; with removal of impacted foreign body High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,15 RC,360,"Hysteroscopy, surgical; with removal of leiomyomata High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,15 RC,360,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,948.0,26010.28,17 RC,360,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,360,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,360,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,360,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,360,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,360,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,360,ILEOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,360,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,360,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,360,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,2 RC,360,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,360,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,360,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,360,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,360,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,360,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,360,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,360,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,360,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,360,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,360,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,360,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,360,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,360,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,360,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,360,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,360,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,360,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,360,INJECTION FOR LIVER X-RAYS ,,,3390.0,5841.0,4 RC,360,INJECTION(S) SPIDER VEINS ,,,3390.0,5841.0,2 RC,360,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,360,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,360,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,360,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,360,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,2 RC,360,INSERT BILE DUCT DRAIN ,,,3390.0,5841.0,2 RC,360,INSERT CATHETER BILE DUCT ,,,3390.0,5841.0,2 RC,360,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,360,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,360,INSERTION OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,360,INSERTION OF CANNULA(S) ,,,5841.0,5841.0,1 RC,360,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,8 RC,360,INSERTION OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,360,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,360,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,360,IV US EACH ADD VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,360,IV US FIRST VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,360,"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,360,"Ileoscopy, through stoma; with biopsy, single or multiple ",,,351.7,3128.0,32 RC,360,"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,29 RC,360,"Ileoscopy, through stoma; with transendoscopic balloon dilation ",,,593.22,8234.0,32 RC,360,"Ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,17 RC,360,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,510.77,15059.0,32 RC,360,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,510.77,12562.0,32 RC,360,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",,,948.0,15059.0,29 RC,360,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,360,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,360,"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic ",,,948.0,16207.0,17 RC,360,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,360,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,360,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,360,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,17 RC,360,Implantation of intrastromal corneal ring segments ,,,948.0,26289.23,32 RC,360,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,27 RC,360,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,948.0,44816.88,23 RC,360,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,360,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,360,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,948.0,5841.0,20 RC,360,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,948.0,45089.88,33 RC,360,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,28 RC,360,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming High Cost Surgery",,,2369.0,2369.0,5 RC,360,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,948.0,45089.88,34 RC,360,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,948.0,12562.0,29 RC,360,"Implantation or replacement of gastric neurostimulator electrodes, antrum, open ",,,948.0,20491.68,17 RC,360,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,948.0,35621.26,31 RC,360,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,948.0,34379.68,31 RC,360,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,32488.94,32 RC,360,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,948.0,16330.72,29 RC,360,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,948.0,15039.6,32 RC,360,Incision and drainage abscess; peritonsillar ,,,91.96,5841.0,31 RC,360,"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach ",,,948.0,13241.95,32 RC,360,"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach ",,,930.95,7150.66,32 RC,360,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,31 RC,360,"Incision and drainage of appendiceal abscess, open ",,,948.0,16207.0,17 RC,360,"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess ",,,948.0,6399.61,32 RC,360,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,32 RC,360,"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia ",,,948.0,6399.61,32 RC,360,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) ,,,450.72,12562.0,32 RC,360,"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton ",,,948.0,6399.61,32 RC,360,"Incision and drainage of penis, deep ",,,510.77,8234.0,32 RC,360,"Incision and drainage of submucosal abscess, rectum ",,,450.72,3755.0,32 RC,360,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,32 RC,360,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,32 RC,360,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,32 RC,360,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,31 RC,360,"Incision and drainage, perianal abscess, superficial ",,,344.93,3128.0,32 RC,360,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,948.0,16207.0,17 RC,360,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,29 RC,360,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,32 RC,360,Incision of labial frenum (frenotomy) ,,,76.45,5841.0,31 RC,360,Incision of lingual frenum (frenotomy) ,,,441.67,3683.7,32 RC,360,"Incision of thrombosed hemorrhoid, external ",,,115.66,5841.0,31 RC,360,"Incision, anal septum (infant) ",,,948.0,13835.0,32 RC,360,"Incision, drainage of lacrimal gland ",,,948.0,3323.1,29 RC,360,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,32 RC,360,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,31 RC,360,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,360,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,360,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,360,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,360,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,29 RC,360,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,948.0,16207.0,29 RC,360,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,948.0,16207.0,29 RC,360,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,17 RC,360,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,948.0,16207.0,58 RC,360,"Induced abortion, by dilation and curettage ",,,948.0,13394.0,32 RC,360,"Induced abortion, by dilation and evacuation ",,,948.0,13394.0,32 RC,360,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,360,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,948.0,37783.59,17 RC,360,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,948.0,37372.46,17 RC,360,"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,17 RC,360,"Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) ",,,948.0,14297.8,32 RC,360,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,948.0,122851.37,22 RC,360,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,360,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,360,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,360,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,360,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,360,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,948.0,5841.0,20 RC,360,Injection of contrast medium for dacryocystography ,,,948.0,5841.0,20 RC,360,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,19 RC,360,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,31 RC,360,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal v",,,744.46,15059.0,31 RC,360,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity t",,,744.46,15059.0,31 RC,360,"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg ",,,122.09,5841.0,31 RC,360,Injection of sclerosant; single incompetent vein (other than telangiectasia) ,,,74.13,5841.0,31 RC,360,"Injection of sclerosing solution, hemorrhoids ",,,220.64,13835.0,20 RC,360,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,27 RC,360,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,948.0,5841.0,20 RC,360,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,948.0,5841.0,8 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,360,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,360,Injection procedure for Peyronie disease; ,,,63.08,5841.0,19 RC,360,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,948.0,11552.32,32 RC,360,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,948.0,12562.0,58 RC,360,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,948.0,11410.03,29 RC,360,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",,,948.0,15059.0,57 RC,360,Injection procedure for corpora cavernosography ,,,948.0,5841.0,20 RC,360,Injection procedure for cystography or voiding urethrocystography ,,,948.0,5841.0,8 RC,360,"Injection procedure for discography, each level; cervical or thoracic ",,,948.0,5841.0,20 RC,360,"Injection procedure for discography, each level; lumbar ",,,948.0,5841.0,20 RC,360,Injection procedure for extremity venography (including introduction of needle or intracatheter) ,,,948.0,5841.0,20 RC,360,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,948.0,16207.0,17 RC,360,"Injection procedure for myelography and/or computed tomography, lumbar ",,,948.0,5841.0,20 RC,360,Injection procedure for retrograde urethrocystography ,,,948.0,5841.0,8 RC,360,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,360,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,360,Injection procedure for sialography ,,,948.0,5841.0,20 RC,360,Injection procedure for splenoportography ,,,948.0,5841.0,20 RC,360,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,948.0,5841.0,20 RC,360,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,948.0,5841.0,20 RC,360,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,948.0,12562.0,29 RC,360,Injection procedure; lymphangiography ,,,948.0,5841.0,20 RC,360,Injection procedure; radioactive tracer for identification of sentinel node ,,,754.67,5841.0,28 RC,360,"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm ",,,234.94,5841.0,31 RC,360,"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk ",,,358.2,5841.0,28 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,20 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,20 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,31 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,31 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,31 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,20 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,948.0,5841.0,20 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,948.0,5841.0,20 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,32 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,31 RC,360,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,28 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,948.0,5841.0,20 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,32 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,948.0,5841.0,20 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,948.0,5841.0,20 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,32 RC,360,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,948.0,5841.0,20 RC,360,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,124 RC,360,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,124 RC,360,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,32 RC,360,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,32 RC,360,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,31 RC,360,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,32 RC,360,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,32 RC,360,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,32 RC,360,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,32 RC,360,"Injection, epidural, of blood or clot patch ",,,276.0,3128.0,32 RC,360,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,360,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,32 RC,360,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,32 RC,360,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,32 RC,360,Insert urinary catheter ,,,3390.0,5841.0,4 RC,360,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,360,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,360,Insertion of Heyman capsules for clinical brachytherapy ,,,948.0,11661.3,32 RC,360,Insertion of Thomas shunt (separate procedure) ,,,1747.39,8234.0,28 RC,360,Insertion of Thomas shunt (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,32 RC,360,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,31 RC,360,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,948.0,15059.0,32 RC,360,"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) ",,,2369.0,17122.32,18 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) ",,,1174.13,12562.0,28 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure ",,,2036.11,12562.0,28 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein ",,,2036.11,12562.0,28 RC,360,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,450.72,13394.0,32 RC,360,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,360,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,406.49,5841.0,28 RC,360,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,28 RC,360,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,32 RC,360,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,32 RC,360,"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver) ",,,948.0,41580.0,34 RC,360,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,360,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,948.0,47976.91,34 RC,360,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,32 RC,360,Insertion of intrauterine device (IUD) ,,,508.94,5841.0,28 RC,360,"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imagin",,,948.0,13835.0,29 RC,360,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,360,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,26 RC,360,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,360,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,360,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,360,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,360,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,223.51,5841.0,28 RC,360,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older ,,,948.0,6212.0,33 RC,360,Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age ,,,948.0,6212.0,33 RC,360,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,948.0,12562.0,32 RC,360,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,948.0,8536.87,32 RC,360,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,948.0,12562.0,32 RC,360,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,26 RC,360,Insertion of penile prosthesis; inflatable (self-contained) High Cost Surgery,,,2369.0,2369.0,5 RC,360,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,948.0,51975.0,31 RC,360,"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,948.0,12562.0,33 RC,360,"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,33 RC,360,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",,,234.94,12562.0,64 RC,360,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older ",,,468.58,6212.0,33 RC,360,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age ",,,468.58,6212.0,33 RC,360,Insertion of peritoneal-venous shunt ,,,948.0,13835.0,29 RC,360,Insertion of pin-retained palatal prosthesis ,,,948.0,13241.95,32 RC,360,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,360,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,948.0,15111.6,15 RC,360,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,948.0,3083.0,21 RC,360,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,948.0,41580.0,34 RC,360,Insertion of tandem cuff (dual cuff) ,,,948.0,47976.91,34 RC,360,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,31 RC,360,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,223.51,5841.0,28 RC,360,Insertion of testicular prosthesis (separate procedure) ,,,948.0,11552.32,32 RC,360,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,948.0,3390.0,23 RC,360,"Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract format",,,948.0,16207.0,29 RC,360,Insertion of tunneled centrally inserted central venous access device with subcutaneous pump ,,,948.0,12562.0,33 RC,360,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s) ",,,948.0,12909.0,33 RC,360,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter) ",,,948.0,12562.0,33 RC,360,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,948.0,12562.0,33 RC,360,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,33 RC,360,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older ",,,948.0,7565.59,33 RC,360,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age ",,,948.0,12547.6,33 RC,360,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,948.0,15059.0,32 RC,360,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,948.0,8488.5,32 RC,360,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,948.0,12547.6,32 RC,360,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,948.0,25988.0,34 RC,360,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,360,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,948.0,87318.0,33 RC,360,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,948.0,87318.0,33 RC,360,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,948.0,5841.0,19 RC,360,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,948.0,35432.53,27 RC,360,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,948.0,87318.0,33 RC,360,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,948.0,87318.0,33 RC,360,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,360,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,31 RC,360,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,948.0,16207.0,17 RC,360,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,948.0,16207.0,17 RC,360,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,948.0,5841.0,20 RC,360,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,360,Intersex surgery; female to male ,,,948.0,13835.0,15 RC,360,Intersex surgery; male to female ,,,948.0,13835.0,15 RC,360,Intestinal allotransplantation; from cadaver donor ,,,948.0,37588.61,17 RC,360,Intestinal allotransplantation; from living donor ,,,948.0,42394.68,17 RC,360,Intestinal plication (separate procedure) ,,,948.0,16207.0,17 RC,360,"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction ",,,948.0,16207.0,17 RC,360,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,360,Intra-atrial recording ,,,12065.71,43890.0,10 RC,360,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,360,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,32 RC,360,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,360,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,360,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,360,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,360,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,360,Intraoperative colonic lavage (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,360,"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,360,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual ",,,87.5,3128.0,32 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space ",,,196.58,5841.0,31 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid ",,,441.67,5571.0,32 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial ",,,91.96,5841.0,31 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space ",,,930.95,7150.66,32 RC,360,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space ",,,441.67,5571.0,32 RC,360,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,360,"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotri",,,1986.0,3083.0,17 RC,360,"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within ",,,1986.0,3083.0,17 RC,360,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (L",,,1672.0,5841.0,20 RC,360,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List sepa",,,1672.0,5841.0,20 RC,360,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,360,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,360,Intraventricular pacing ,,,12065.71,43890.0,10 RC,360,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,360,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,26 RC,360,Intravitreal injection of a pharmacologic agent (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,360,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,19 RC,360,"Introduction of catheter, aorta ",,,948.0,5841.0,20 RC,360,"Introduction of catheter, right heart or main pulmonary artery ",,,948.0,5841.0,20 RC,360,"Introduction of catheter, superior or inferior vena cava ",,,948.0,5841.0,20 RC,360,"Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) ",,,351.7,3128.0,20 RC,360,"Introduction of needle or intracatheter, aortic, translumbar ",,,948.0,5841.0,20 RC,360,"Introduction of needle or intracatheter, carotid or vertebral artery ",,,948.0,5841.0,20 RC,360,"Introduction of needle or intracatheter, upper or lower extremity artery ",,,948.0,5841.0,20 RC,360,"Introduction of needle or intracatheter, vein ",,,948.0,1672.0,6 RC,360,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,468.58,27050.15,88 RC,360,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,948.0,12562.0,32 RC,360,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,32 RC,360,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,32 RC,360,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,32 RC,360,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,32 RC,360,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,32 RC,360,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,31 RC,360,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,32 RC,360,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,32 RC,360,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,31 RC,360,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,112.77,5841.0,16 RC,360,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,360,Keratomileusis ,,,948.0,17897.9,29 RC,360,Keratophakia ,,,948.0,19576.28,29 RC,360,Keratoplasty (corneal transplant); anterior lamellar ,,,948.0,12909.0,32 RC,360,Keratoplasty (corneal transplant); endothelial ,,,948.0,15059.0,32 RC,360,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,948.0,12909.0,32 RC,360,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,948.0,12909.0,32 RC,360,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,948.0,12909.0,32 RC,360,Keratoprosthesis ,,,948.0,16924.12,29 RC,360,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,360,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,360,LAPARO W/CHOLANGIO/BIOPSY ,,,3390.0,5841.0,2 RC,360,"LAPAROSCOPE PROC, RECTUM ",,,3390.0,5841.0,2 RC,360,LAPAROSCOPY W/CHOLANGIO ,,,3390.0,5841.0,2 RC,360,"LAPAROSCOPY, ENTEROLYSIS ",,,3390.0,5841.0,2 RC,360,"LAPAROSCOPY, JEJUNOSTOMY ",,,3390.0,5841.0,2 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,360,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,360,LAVH ,,,3390.0,5841.0,2 RC,360,LESION REMOVAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,360,Labyrinthectomy; transcanal ,,,948.0,13241.95,32 RC,360,Labyrinthectomy; with mastoidectomy ,,,948.0,13241.95,32 RC,360,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,32 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,948.0,34473.5,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,948.0,22297.2,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,948.0,19224.42,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,948.0,19618.62,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,948.0,22153.02,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,948.0,26255.61,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,948.0,24454.45,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,948.0,25950.44,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,948.0,32557.8,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,948.0,32066.23,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,948.0,33960.65,14 RC,360,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,948.0,23454.14,14 RC,360,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,948.0,25611.4,14 RC,360,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,948.0,23386.41,14 RC,360,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,948.0,23085.47,14 RC,360,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,948.0,25611.4,14 RC,360,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,948.0,16330.72,26 RC,360,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,948.0,16330.72,26 RC,360,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,948.0,16330.72,26 RC,360,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,948.0,16330.72,26 RC,360,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,948.0,36291.71,14 RC,360,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,948.0,37902.24,14 RC,360,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,948.0,37686.1,14 RC,360,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,948.0,87318.0,31 RC,360,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,948.0,19563.47,14 RC,360,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,948.0,21237.62,14 RC,360,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,948.0,17147.73,14 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,948.0,16330.72,29 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,948.0,16330.72,29 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,948.0,16330.72,26 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,948.0,16330.72,29 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,948.0,16330.72,26 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,948.0,16330.72,26 RC,360,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,948.0,16330.72,26 RC,360,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,948.0,19678.01,14 RC,360,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,948.0,16330.72,26 RC,360,Laminectomy with rhizotomy; 1 or 2 segments ,,,948.0,14087.77,14 RC,360,Laminectomy with rhizotomy; more than 2 segments ,,,948.0,15253.31,14 RC,360,Laminectomy with section of spinal accessory nerve ,,,948.0,17173.13,14 RC,360,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,107 RC,360,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,948.0,5841.0,40 RC,360,"Laminectomy, with release of tethered spinal cord, lumbar ",,,948.0,18949.01,14 RC,360,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,948.0,18436.15,17 RC,360,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,948.0,21068.04,17 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,948.0,16330.72,26 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,948.0,7014.0,42 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,948.0,16330.72,29 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,948.0,16330.72,29 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,24 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,948.0,5841.0,20 RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,948.0,3083.0,22 RC,360,"Laparoscope proc, intestine ",,,3390.0,5841.0,2 RC,360,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,360,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,360,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,360,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,360,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,360,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,360,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,360,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,360,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,360,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,360,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,360,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,360,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,360,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,360,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,360,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,360,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,360,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,360,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,360,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,948.0,22967.79,11 RC,360,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,948.0,29647.99,22 RC,360,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,948.0,29647.99,22 RC,360,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,948.0,24808.33,28 RC,360,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical ",,,948.0,22967.79,17 RC,360,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency ",,,948.0,22967.79,17 RC,360,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,14 RC,360,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, appendectomy ",,,8778.0,13196.03,9 RC,360,"Laparoscopy, surgical, appendectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis ",,,948.0,20457.81,17 RC,360,"Laparoscopy, surgical, colostomy or skin level cecostomy ",,,948.0,16207.0,17 RC,360,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,948.0,22967.79,17 RC,360,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) ",,,948.0,13394.0,17 RC,360,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,1520.2,16207.0,12 RC,360,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed ",,,5841.0,22967.79,11 RC,360,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed ",,,948.0,15846.6,17 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) ",,,948.0,16425.0,17 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) ",,,948.0,22967.79,13 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components ",,,948.0,22869.0,13 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) ",,,948.0,21292.66,11 RC,360,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption ",,,948.0,22788.76,11 RC,360,"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ",,,948.0,16207.0,17 RC,360,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,15 RC,360,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, splenectomy ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical, splenectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,948.0,13196.03,14 RC,360,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,14 RC,360,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,948.0,22967.79,11 RC,360,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,11 RC,360,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,8 RC,360,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14626.03,12 RC,360,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,23335.49,6 RC,360,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed High Cost",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,9 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13394.0,12 RC,360,"Laparoscopy, surgical; ablation of renal cysts High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,12 RC,360,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; cholecystectomy ",,,1983.29,13196.03,12 RC,360,"Laparoscopy, surgical; cholecystectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; cholecystectomy with cholangiography ",,,1983.29,13196.03,12 RC,360,"Laparoscopy, surgical; cholecystectomy with cholangiography High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; cholecystectomy with exploration of common duct ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; cholecystectomy with exploration of common duct High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; cholecystoenterostomy ",,,3390.0,16207.0,12 RC,360,"Laparoscopy, surgical; cholecystoenterostomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis ",,,6326.0,18906.55,12 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) ",,,3390.0,22326.83,12 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy ",,,3390.0,24331.44,12 RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) ",,,3390.0,21483.4,12 RC,360,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,3390.0,16427.31,12 RC,360,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed ",,,948.0,26679.44,17 RC,360,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy ",,,948.0,25073.14,17 RC,360,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy ",,,3390.0,21826.68,12 RC,360,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,12 RC,360,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) ",,,2300.11,13835.0,12 RC,360,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis ",,,6326.0,17007.9,12 RC,360,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,17 RC,360,"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum ",,,948.0,16890.86,17 RC,360,"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) ",,,948.0,13394.0,17 RC,360,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,12 RC,360,"Laparoscopy, surgical; nephrectomy with total ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,12 RC,360,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; orchiectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical; partial nephrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when per",,,948.0,26340.4,17 RC,360,"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy ",,,948.0,24212.78,17 RC,360,"Laparoscopy, surgical; proctopexy (for prolapse) ",,,948.0,16207.0,17 RC,360,"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection ",,,948.0,18575.98,17 RC,360,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,12 RC,360,"Laparoscopy, surgical; pyeloplasty High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,12 RC,360,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; repair initial inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; repair recurrent inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum ",,,948.0,15059.0,17 RC,360,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,17 RC,360,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective ",,,8778.0,13394.0,12 RC,360,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; transection of vagus nerves, truncal ",,,8778.0,13394.0,12 RC,360,"Laparoscopy, surgical; transection of vagus nerves, truncal High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13394.0,12 RC,360,"Laparoscopy, surgical; ureterolithotomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,15 RC,360,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13394.0,12 RC,360,"Laparoscopy, surgical; urethral suspension for stress incontinence High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy ",,,3265.51,22967.79,15 RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple ",,,3265.51,22967.79,15 RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including ",,,2369.0,22967.79,19 RC,360,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; with biopsy (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,13196.03,12 RC,360,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; with fimbrioplasty High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,15 RC,360,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,15059.0,6 RC,360,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,15059.0,11 RC,360,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,15059.0,15 RC,360,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,15 RC,360,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,360,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,948.0,13835.0,29 RC,360,"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es) ",,,948.0,14320.86,17 RC,360,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,360,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,360,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,360,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,360,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,360,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,360,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,360,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,360,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,360,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,360,Lapscp intest resect ,,,3390.0,5841.0,2 RC,360,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,360,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,360,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,360,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,360,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,360,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,360,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,360,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,360,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,360,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,360,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,9 RC,360,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,948.0,15059.0,32 RC,360,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,360,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,948.0,13835.0,16 RC,360,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,948.0,13835.0,16 RC,360,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,32 RC,360,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,360,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,360,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,360,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,360,"Lengthening of palate, and pharyngeal flap ",,,948.0,13394.0,32 RC,360,"Lengthening of palate, with island flap ",,,948.0,13835.0,20 RC,360,"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of de",,,1174.13,12562.0,32 RC,360,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions ",,,1174.13,7565.59,27 RC,360,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions High Cost Surgery",,,2369.0,2369.0,5 RC,360,Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure) ,,,948.0,12562.0,32 RC,360,Ligation of common iliac vein ,,,948.0,16207.0,17 RC,360,Ligation of femoral vein ,,,948.0,7565.59,32 RC,360,Ligation of inferior vena cava ,,,948.0,13835.0,29 RC,360,"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg ",,,948.0,8304.31,32 RC,360,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg ",,,1174.13,12562.0,27 RC,360,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg High Cost Surgery",,,2369.0,2369.0,5 RC,360,Ligation of peritoneal-venous shunt ,,,948.0,13835.0,17 RC,360,Ligation or banding of angioaccess arteriovenous fistula ,,,948.0,12562.0,32 RC,360,"Ligation or biopsy, temporal artery ",,,510.77,3755.0,32 RC,360,Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation ,,,948.0,17796.17,17 RC,360,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,29 RC,360,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,948.0,13835.0,29 RC,360,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,948.0,13394.0,32 RC,360,"Ligation salivary duct, intraoral ",,,930.95,12909.0,32 RC,360,"Ligation, direct, esophageal varices ",,,948.0,18749.79,17 RC,360,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below ",,,1174.13,12562.0,27 RC,360,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Ligation, division, and stripping, short saphenous vein ",,,1174.13,12562.0,27 RC,360,"Ligation, division, and stripping, short saphenous vein High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg ",,,948.0,12562.0,32 RC,360,"Ligation, internal jugular vein ",,,948.0,13835.0,17 RC,360,"Ligation, major artery (eg, post-traumatic, rupture); abdomen ",,,948.0,16461.18,17 RC,360,"Ligation, major artery (eg, post-traumatic, rupture); chest ",,,948.0,16207.0,17 RC,360,"Ligation, major artery (eg, post-traumatic, rupture); extremity ",,,948.0,16207.0,17 RC,360,"Ligation, major artery (eg, post-traumatic, rupture); neck ",,,948.0,13835.0,17 RC,360,Ligation; external carotid artery ,,,948.0,13835.0,17 RC,360,Ligation; internal or common carotid artery ,,,948.0,13835.0,17 RC,360,"Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield clamp ",,,948.0,13835.0,17 RC,360,Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic ,,,948.0,16207.0,17 RC,360,Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) ,,,948.0,16207.0,17 RC,360,Limited pharyngectomy ,,,948.0,13241.95,32 RC,360,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,360,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,948.0,8240.61,32 RC,360,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,948.0,8240.61,32 RC,360,"Lithotripsy, extracorporeal shock wave ",,,1200.05,10342.0,9 RC,360,"Lithotripsy, extracorporeal shock wave Lithotripsy",,,2843.0,2843.0,5 RC,360,"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age ",,,948.0,66243.02,17 RC,360,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,360,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,360,"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy ºPOEM») ",,,948.0,15059.0,28 RC,360,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,360,Lymphangiotomy or other operations on lymphatic channels ,,,948.0,8270.67,32 RC,360,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,948.0,13835.0,29 RC,360,Lysis of labial adhesions ,,,948.0,6819.81,32 RC,360,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,32 RC,360,MEDIASTINOSCOPY INCL BIOPSY ,,,3390.0,5841.0,2 RC,360,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,948.0,4220.0,18 RC,360,"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation ",,,948.0,23089.7,17 RC,360,"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver ",,,948.0,37296.13,17 RC,360,Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing ,,,948.0,17851.33,17 RC,360,Management of liver hemorrhage; simple suture of liver wound or injury ,,,948.0,16825.62,17 RC,360,Management of recipient hematopoietic progenitor cell donor search and cell acquisition ,,,948.0,5841.0,7 RC,360,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,32 RC,360,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,19 RC,360,Marsupialization of Bartholin's gland cyst ,,,948.0,6819.81,32 RC,360,Marsupialization of cyst or abscess of liver ,,,948.0,16207.0,17 RC,360,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,360,Marsupialization of pancreatic cyst ,,,948.0,16207.0,17 RC,360,Marsupialization of sublingual salivary cyst (ranula) ,,,930.95,12562.0,32 RC,360,"Marsupialization of urethral diverticulum, male or female ",,,948.0,8240.61,32 RC,360,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,27 RC,360,Mastoid obliteration (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,360,Mastoidectomy; complete ,,,948.0,13241.95,32 RC,360,Mastoidectomy; modified radical ,,,948.0,13241.95,32 RC,360,Mastoidectomy; radical ,,,948.0,13241.95,32 RC,360,Maxillary impression for palatal prosthesis ,,,875.5,5841.0,28 RC,360,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,112.77,5841.0,16 RC,360,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,32 RC,360,"Meatotomy, cutting of meatus (separate procedure); infant ",,,948.0,13835.0,29 RC,360,Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen ,,,468.58,6212.0,33 RC,360,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,3128.0,32 RC,360,"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access ",,,948.0,7565.59,33 RC,360,"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed ",,,948.0,13835.0,29 RC,360,"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging) ",,,948.0,13835.0,29 RC,360,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach ",,,948.0,16207.0,17 RC,360,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy ",,,948.0,16207.0,17 RC,360,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,360,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,360,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,32 RC,360,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,360,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,360,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,360,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,360,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,360,Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ,,,948.0,16207.0,17 RC,360,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,20 RC,360,Multifetal pregnancy reduction(s) (MPR) ,,,554.98,5841.0,16 RC,360,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,32 RC,360,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,948.0,8234.0,29 RC,360,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,948.0,8234.0,29 RC,360,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,948.0,8234.0,29 RC,360,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,948.0,8234.0,29 RC,360,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,948.0,13835.0,29 RC,360,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,948.0,13394.0,32 RC,360,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,948.0,13835.0,17 RC,360,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,32 RC,360,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,31 RC,360,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,32 RC,360,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,360,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,360,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,360,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,360,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,360,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) ",,,117.96,5841.0,31 RC,360,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,360,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,948.0,15059.0,31 RC,360,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,948.0,15059.0,31 RC,360,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,31 RC,360,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,948.0,16207.0,17 RC,360,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,948.0,17974.22,17 RC,360,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,948.0,16207.0,17 RC,360,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,948.0,16207.0,17 RC,360,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,948.0,16207.0,17 RC,360,"Nephrectomy, partial ",,,948.0,16253.5,17 RC,360,Nephrolithotomy; complicated by congenital kidney abnormality ,,,948.0,16207.0,17 RC,360,Nephrolithotomy; removal of calculus ,,,948.0,16207.0,17 RC,360,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,948.0,17855.56,17 RC,360,Nephrolithotomy; secondary surgical operation for calculus ,,,948.0,16207.0,17 RC,360,"Nephrorrhaphy, suture of kidney wound or injury ",,,948.0,16207.0,17 RC,360,"Nephrostomy, nephrotomy with drainage ",,,948.0,13835.0,29 RC,360,"Nephrotomy, with exploration ",,,948.0,16207.0,17 RC,360,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,948.0,15039.6,32 RC,360,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Nerve pedicle transfer; first stage ,,,948.0,15039.6,32 RC,360,Nerve pedicle transfer; second stage ,,,948.0,15039.6,32 RC,360,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,948.0,15039.6,29 RC,360,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,948.0,15039.6,31 RC,360,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,948.0,15039.6,32 RC,360,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,948.0,18707.46,17 RC,360,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,948.0,25882.7,17 RC,360,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,948.0,18906.55,17 RC,360,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,948.0,23458.38,17 RC,360,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,32 RC,360,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,27 RC,360,Neuroplasty and/or transposition; median nerve at carpal tunnel High Cost Surgery,,,2369.0,2369.0,5 RC,360,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,32 RC,360,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,32 RC,360,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,32 RC,360,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,32 RC,360,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,32 RC,360,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,32 RC,360,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,32 RC,360,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,32 RC,360,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,28 RC,360,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,360,"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervi",,,948.0,13835.0,29 RC,360,OPERATIVE UPPER GI ENDOSCOPY ,,,3390.0,5841.0,2 RC,360,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,948.0,41102.02,17 RC,360,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,948.0,13835.0,32 RC,360,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,948.0,13394.0,32 RC,360,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,948.0,13394.0,29 RC,360,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,948.0,13394.0,29 RC,360,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,948.0,17359.64,17 RC,360,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,948.0,16207.0,29 RC,360,"Oophorectomy, partial or total, unilateral or bilateral; ",,,948.0,13835.0,29 RC,360,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,948.0,14490.44,17 RC,360,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,360,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,87318.0,33 RC,360,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,360,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,82073.3,30 RC,360,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,360,Open implantation of neurostimulator electrode array; neuromuscular ,,,948.0,87318.0,34 RC,360,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,34 RC,360,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,948.0,16890.86,32 RC,360,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,360,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,360,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,360,"Operculectomy, excision pericoronal tissues ",,,948.0,3683.7,29 RC,360,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,360,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,360,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,948.0,8536.87,32 RC,360,Orbital implant (implant outside muscle cone); insertion ,,,948.0,8536.87,32 RC,360,Orbital implant (implant outside muscle cone); removal or revision ,,,948.0,8536.87,32 RC,360,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,948.0,40347.62,17 RC,360,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,948.0,35482.15,17 RC,360,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,948.0,39228.77,17 RC,360,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,948.0,13394.0,32 RC,360,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,948.0,13394.0,32 RC,360,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,948.0,13394.0,32 RC,360,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,948.0,13394.0,32 RC,360,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,948.0,13394.0,32 RC,360,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,948.0,12562.0,32 RC,360,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,32 RC,360,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,948.0,13835.0,32 RC,360,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,32 RC,360,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,32 RC,360,"Orchiectomy, partial ",,,948.0,12562.0,32 RC,360,"Orchiectomy, radical, for tumor; inguinal approach ",,,948.0,8488.5,32 RC,360,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,948.0,13835.0,17 RC,360,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,948.0,12562.0,32 RC,360,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,948.0,13835.0,29 RC,360,"Orchiopexy, inguinal or scrotal approach ",,,948.0,8488.5,32 RC,360,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,948.0,16207.0,14 RC,360,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,360,"Other cranial decompression, posterior fossa ",,,948.0,25285.06,17 RC,360,Other spinal injection ,,,3390.0,5841.0,2 RC,360,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,360,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,32 RC,360,"Ovarian cystectomy, unilateral or bilateral ",,,948.0,13835.0,29 RC,360,PAROTID DUCT DIVERSION ,,,3390.0,5841.0,2 RC,360,"PARTIAL REMOVAL, DONOR LIVER ",,,3390.0,5841.0,2 RC,360,PERCUT DRAIN LIVER LESION ,,,3390.0,5841.0,2 RC,360,PERCUT THROMBECT AV FISTULA ,,,6326.0,8104.0,2 RC,360,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,360,PLACE GASTROSTOMY TUBE ,,,3390.0,5841.0,2 RC,360,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,360,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,360,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,360,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,2 RC,360,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) ",,,2051.93,13394.0,27 RC,360,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Palatoplasty for cleft palate, soft and/or hard palate only ",,,948.0,13394.0,32 RC,360,"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only ",,,930.95,13394.0,32 RC,360,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft) ",,,948.0,13394.0,32 RC,360,Palatoplasty for cleft palate; attachment pharyngeal flap ,,,948.0,13394.0,32 RC,360,Palatoplasty for cleft palate; major revision ,,,948.0,13241.95,32 RC,360,Palatoplasty for cleft palate; secondary lengthening procedure ,,,948.0,13394.0,32 RC,360,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,948.0,20063.62,17 RC,360,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,948.0,19262.64,17 RC,360,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,948.0,23102.4,17 RC,360,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38220.12,17 RC,360,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35766.16,17 RC,360,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38398.05,17 RC,360,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35550.01,17 RC,360,"Pancreatectomy, total ",,,948.0,22322.6,17 RC,360,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,948.0,16207.0,14 RC,360,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,948.0,20436.65,17 RC,360,Pancreatorrhaphy for injury ,,,948.0,16490.81,17 RC,360,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,31 RC,360,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,32 RC,360,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,32 RC,360,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,Parathyroidectomy or exploration of parathyroid(s); ,,,948.0,13835.0,32 RC,360,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,948.0,15059.0,29 RC,360,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,948.0,17020.6,17 RC,360,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,948.0,22967.79,29 RC,360,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,948.0,13835.0,29 RC,360,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,948.0,18300.83,29 RC,360,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,32 RC,360,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,948.0,5841.0,20 RC,360,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,32 RC,360,"Parotid duct diversion, bilateral (Wilke type procedure); ",,,948.0,13241.95,32 RC,360,"Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands ",,,948.0,13241.95,32 RC,360,"Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts ",,,930.95,9653.0,32 RC,360,"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction ",,,948.0,61720.83,17 RC,360,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including ",,,948.0,44797.72,17 RC,360,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor ",,,948.0,40004.34,17 RC,360,"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty ",,,948.0,34880.4,17 RC,360,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, prepa",,,948.0,55100.77,17 RC,360,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty ",,,948.0,31409.31,17 RC,360,"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn ",,,795.48,5841.0,28 RC,360,Partial hymenectomy or revision of hymenal ring ,,,948.0,6819.81,32 RC,360,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13835.0,32 RC,360,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13835.0,32 RC,360,Pelvic examination under anesthesia (other than local) ,,,948.0,6819.81,32 RC,360,"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or withou",,,948.0,34142.93,17 RC,360,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,2369.0,35948.44,17 RC,360,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,948.0,28124.63,17 RC,360,"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,17 RC,360,Penile plethysmography ,,,273.57,5841.0,28 RC,360,"Penile revascularization, artery, with or without vein graft ",,,948.0,16207.0,17 RC,360,Penile venous occlusive procedure ,,,948.0,12562.0,29 RC,360,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,948.0,16207.0,29 RC,360,"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angi",,,2036.11,46894.85,32 RC,360,"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angiopl",,,2036.11,46894.85,32 RC,360,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,32 RC,360,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,32 RC,360,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,360,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,360,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,360,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,360,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,360,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,948.0,3083.0,22 RC,360,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,360,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,948.0,87318.0,34 RC,360,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,948.0,87318.0,34 RC,360,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,34 RC,360,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,948.0,87318.0,34 RC,360,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,360,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,64 RC,360,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,948.0,22025.45,58 RC,360,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,360,Percutaneous portal vein catheterization by any method ,,,948.0,5841.0,20 RC,360,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,360,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,360,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,360,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,360,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,8 RC,360,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,8 RC,360,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,360,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,360,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,360,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,360,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,360,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,360,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,360,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,360,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,360,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,360,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,360,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,360,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,360,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,360,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,360,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,360,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,360,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,360,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,360,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",,,948.0,43516.12,93 RC,360,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance ",,,948.0,15059.0,32 RC,360,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,360,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during cours",,,948.0,15059.0,32 RC,360,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,360,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,360,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,360,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,360,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,360,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,360,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,360,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,360,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,360,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,360,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,360,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,360,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,360,"Pereyra procedure, including anterior colporrhaphy ",,,948.0,18300.83,32 RC,360,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,360,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,360,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,948.0,13394.0,32 RC,360,Periodontal mucosal grafting ,,,441.67,13835.0,32 RC,360,Perirectal injection of sclerosing solution for prolapse ,,,948.0,5841.0,28 RC,360,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,3249.0,32 RC,360,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,32022.79,28 RC,360,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,948.0,5841.0,28 RC,360,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,948.0,13835.0,28 RC,360,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,13835.0,28 RC,360,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,360,Petrous apicectomy including radical mastoidectomy ,,,948.0,13241.95,32 RC,360,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,360,Pharyngoesophageal repair ,,,948.0,16207.0,17 RC,360,Pharyngoplasty (plastic or reconstructive operation on pharynx) ,,,948.0,13241.95,32 RC,360,"Pharyngostomy (fistulization of pharynx, external for feeding) ",,,441.67,5571.0,32 RC,360,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,360,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,360,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,360,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,360,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,360,"Photopheresis, extracorporeal ",,,948.0,13835.0,32 RC,360,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,360,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,360,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,360,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,360,"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when per",,,948.0,15059.0,32 RC,360,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,948.0,5841.0,20 RC,360,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,948.0,8536.87,29 RC,360,Placement of amniotic membrane on the ocular surface; without sutures ,,,948.0,3755.0,29 RC,360,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",,,948.0,15059.0,64 RC,360,Placement of choledochal stent ,,,948.0,16207.0,17 RC,360,"Placement of drains, peripancreatic, for acute pancreatitis; ",,,948.0,23178.72,17 RC,360,"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy ",,,948.0,28256.1,17 RC,360,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,360,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,796.41,16207.0,17 RC,360,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,5193.86,32 RC,360,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,32 RC,360,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,360,Placement of needle for intraosseous infusion ,,,745.36,6212.0,29 RC,360,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,948.0,15059.0,29 RC,360,"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application ",,,948.0,13241.95,29 RC,360,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,32 RC,360,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,948.0,12909.0,32 RC,360,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,360,Placement of seton ,,,948.0,12562.0,32 RC,360,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,948.0,15059.0,96 RC,360,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,96 RC,360,"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure) ",,,948.0,16207.0,29 RC,360,Plasma and/or cell exchange ,,,3390.0,5841.0,2 RC,360,Plastic operation of penis for injury ,,,948.0,8240.61,32 RC,360,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,948.0,12562.0,32 RC,360,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,948.0,12562.0,32 RC,360,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,32 RC,360,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,948.0,15227.79,17 RC,360,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,32 RC,360,Plastic operation on penis to correct angulation ,,,948.0,12562.0,32 RC,360,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,948.0,12562.0,32 RC,360,Plastic repair of canaliculi ,,,733.22,5571.0,32 RC,360,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages ",,,948.0,32170.6,32 RC,360,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure ",,,948.0,13241.95,32 RC,360,"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral ",,,948.0,13241.95,32 RC,360,"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure ",,,930.95,12909.0,32 RC,360,"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle ",,,948.0,13241.95,32 RC,360,Plastic repair of introitus ,,,948.0,12562.0,32 RC,360,"Plastic repair of salivary duct, sialodochoplasty; primary or simple ",,,948.0,13241.95,32 RC,360,"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated ",,,948.0,13241.95,32 RC,360,Plastic repair of urethrocele ,,,948.0,12562.0,32 RC,360,"Portoenterostomy (eg, Kasai procedure) ",,,948.0,21004.54,17 RC,360,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,948.0,13394.0,32 RC,360,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,755.65,5841.0,28 RC,360,Postpartum care only (separate procedure) ,,,948.0,5841.0,24 RC,360,"Preparation of fecal microbiota for instillation, including assessment of donor specimen ",,,713.79,5841.0,24 RC,360,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,360,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,948.0,13835.0,16 RC,360,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",,,948.0,27050.15,52 RC,360,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,31 RC,360,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,31 RC,360,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,32 RC,360,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,32 RC,360,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,32 RC,360,"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed ",,,948.0,23712.75,17 RC,360,"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) ",,,948.0,22894.72,17 RC,360,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation) ",,,948.0,19512.66,17 RC,360,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies ",,,948.0,21178.23,17 RC,360,"Proctectomy, partial, with anastomosis; abdominal and transsacral approach ",,,948.0,22297.2,17 RC,360,"Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) ",,,948.0,19122.7,17 RC,360,"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy ",,,948.0,23178.72,17 RC,360,"Proctectomy, partial, without anastomosis, perineal approach ",,,948.0,13835.0,17 RC,360,"Proctectomy; complete, combined abdominoperineal, with colostomy ",,,948.0,22602.37,17 RC,360,"Proctectomy; partial resection of rectum, transabdominal approach ",,,948.0,16207.0,17 RC,360,"Proctopexy (eg, for prolapse); abdominal approach ",,,948.0,16207.0,17 RC,360,"Proctopexy (eg, for prolapse); perineal approach ",,,948.0,13835.0,32 RC,360,"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach ",,,948.0,17974.22,17 RC,360,Proctoplasty; for prolapse of mucous membrane ,,,948.0,7014.0,32 RC,360,Proctoplasty; for stenosis ,,,948.0,6399.61,32 RC,360,"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,86.63,3128.0,32 RC,360,"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser) ",,,948.0,6399.61,32 RC,360,"Proctosigmoidoscopy, rigid; with biopsy, single or multiple ",,,450.72,3128.0,32 RC,360,"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,450.72,3390.0,32 RC,360,"Proctosigmoidoscopy, rigid; with decompression of volvulus ",,,948.0,6399.61,32 RC,360,"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,7266.25,32 RC,360,"Proctosigmoidoscopy, rigid; with removal of foreign body ",,,948.0,6399.61,32 RC,360,"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,450.72,3128.0,32 RC,360,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,32 RC,360,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ",,,450.72,3128.0,32 RC,360,"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation) ",,,948.0,13051.67,32 RC,360,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,360,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,360,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,27 RC,360,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,948.0,16207.0,17 RC,360,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,948.0,16207.0,17 RC,360,"Prostatectomy, perineal radical; ",,,948.0,16207.0,17 RC,360,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,21559.73,17 RC,360,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,19741.51,17 RC,360,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,948.0,16207.0,17 RC,360,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,948.0,16207.0,17 RC,360,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,16732.36,29 RC,360,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,16207.0,17 RC,360,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,948.0,8240.61,32 RC,360,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,948.0,5571.0,32 RC,360,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,20 RC,360,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,32 RC,360,"Push transfusion, blood, 2 years or younger ",,,948.0,5841.0,28 RC,360,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,948.0,17109.62,17 RC,360,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,948.0,16207.0,17 RC,360,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,360,"Pyelotomy; with drainage, pyelostomy ",,,948.0,16207.0,17 RC,360,Pyelotomy; with exploration ,,,948.0,16207.0,17 RC,360,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,948.0,16207.0,17 RC,360,"Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) ",,,948.0,16207.0,17 RC,360,Pyloroplasty ,,,948.0,16207.0,17 RC,360,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,360,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,360,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,2 RC,360,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,2 RC,360,REMOVAL OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,360,REMOVAL OF ANAL CRYPT ,,,3390.0,5841.0,2 RC,360,REMOVAL OF ANAL CRYPTS ,,,3390.0,5841.0,2 RC,360,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,360,REMOVAL OF COLON/ILEOSTOMY ,,,3390.0,5841.0,4 RC,360,REMOVAL OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,360,REMOVAL OF LEG VEIN ,,,3390.0,5841.0,2 RC,360,REMOVAL OF LEG VEINS ,,,3390.0,5841.0,2 RC,360,"REMOVAL OF STOMACH, PARTIAL ",,,3390.0,5841.0,4 RC,360,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,360,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,2 RC,360,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,2 RC,360,REMOVE BILE DUCT STONE ,,,3390.0,5841.0,2 RC,360,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,360,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,360,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,360,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,360,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,360,REPAIR A-V ANEURYSM ,,,5841.0,5841.0,1 RC,360,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,360,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,3 RC,360,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,360,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,360,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,6 RC,360,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,360,REPAIR PARAESOPHAGEAL HERNIA ,,,3390.0,5841.0,2 RC,360,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,360,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,360,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,3 RC,360,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,360,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,3 RC,360,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,360,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,3 RC,360,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,360,REPOSITIONING OF CVC ,,,3390.0,5841.0,2 RC,360,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,360,RESECT/DEBRIDE PANCREAS ,,,3390.0,5841.0,2 RC,360,REVISE ESOPHAGUS & STOMACH ,,,3390.0,5841.0,4 RC,360,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,360,REVISE/REINSERT BILE TUBE ,,,3390.0,5841.0,2 RC,360,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,360,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,360,REVISION OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,360,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITH VAGOTOMY ,,,3390.0,16207.0,3 RC,360,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITHOUT VAGOTOMY ,,,3390.0,16207.0,3 RC,360,REVISION OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,360,REVISION OF MAJOR VEIN ,,,3390.0,5841.0,2 RC,360,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,360,Radial keratotomy ,,,948.0,7836.39,29 RC,360,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,24 RC,360,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) High C",,,2369.0,2369.0,5 RC,360,Radical excision external auditory canal lesion; with neck dissection ,,,948.0,19932.26,17 RC,360,Radical excision external auditory canal lesion; without neck dissection ,,,948.0,13241.95,32 RC,360,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal) ",,,948.0,13835.0,17 RC,360,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap ",,,948.0,27260.03,17 RC,360,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure ",,,948.0,13835.0,17 RC,360,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,948.0,20288.23,17 RC,360,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,31 RC,360,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,948.0,13835.0,16 RC,360,Recipient nephrectomy (separate procedure) ,,,948.0,16207.0,17 RC,360,"Reconstruction external auditory canal for congenital atresia, single stage ",,,948.0,13241.95,32 RC,360,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,948.0,13241.95,32 RC,360,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,32 RC,360,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,32 RC,360,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,948.0,12562.0,32 RC,360,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,32 RC,360,"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis ",,,948.0,19304.98,17 RC,360,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,360,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,360,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,948.0,20856.12,17 RC,360,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,948.0,24513.72,17 RC,360,Reduction of overcorrection of ptosis ,,,733.22,8234.0,32 RC,360,Reduction of procidentia (separate procedure) under anesthesia ,,,344.93,3128.0,32 RC,360,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,948.0,8240.61,32 RC,360,"Reduction of volvulus, intussusception, internal hernia, by laparotomy ",,,948.0,16207.0,29 RC,360,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,360,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,360,Reinsertion of ocular implant; with or without conjunctival graft ,,,948.0,8536.87,32 RC,360,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,948.0,12562.0,32 RC,360,Release of encircling material (posterior segment) ,,,1610.16,10424.04,27 RC,360,Release of encircling material (posterior segment) High Cost Surgery,,,2369.0,2369.0,5 RC,360,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,32 RC,360,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,32 RC,360,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,32 RC,360,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,32 RC,360,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,32 RC,360,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,26 RC,360,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,948.0,51975.0,30 RC,360,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,685.44,4836.33,32 RC,360,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,360,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,948.0,47976.91,32 RC,360,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,948.0,15672.9,17 RC,360,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,948.0,51975.0,31 RC,360,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,948.0,51975.0,31 RC,360,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,32 RC,360,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,32 RC,360,Removal foreign body from external auditory canal; without general anesthesia ,,,223.51,5841.0,16 RC,360,"Removal impacted cerumen requiring instrumentation, unilateral ",,,112.77,5841.0,28 RC,360,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,112.77,5841.0,28 RC,360,"Removal of Thiersch wire or suture, anal canal ",,,948.0,6399.61,32 RC,360,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,27 RC,360,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Removal of anal seton, other marker ",,,450.72,3128.0,32 RC,360,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,948.0,9751.1,22 RC,360,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,948.0,9751.1,22 RC,360,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,948.0,9528.08,22 RC,360,"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidan",,,351.7,3128.0,32 RC,360,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,32 RC,360,Removal of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,360,"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging ",,,948.0,5841.0,20 RC,360,Removal of cerclage suture under anesthesia (other than local) ,,,948.0,13394.0,32 RC,360,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,948.0,16207.0,17 RC,360,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,948.0,13835.0,29 RC,360,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,32 RC,360,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,32 RC,360,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,15059.0,32 RC,360,Removal of embedded foreign body from dentoalveolar structures; bone ,,,272.38,4335.95,32 RC,360,Removal of embedded foreign body from dentoalveolar structures; soft tissues ,,,231.98,5571.0,32 RC,360,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,31 RC,360,"Removal of embedded foreign body, vestibule of mouth; complicated ",,,158.14,5571.0,32 RC,360,"Removal of embedded foreign body, vestibule of mouth; simple ",,,948.0,5841.0,16 RC,360,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,32 RC,360,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,32 RC,360,Removal of esophageal sphincter augmentation device ,,,2996.0,13835.0,23 RC,360,Removal of esophageal sphincter augmentation device High Cost Surgery,,,2369.0,2369.0,5 RC,360,Removal of fecal impaction or foreign body (separate procedure) under anesthesia ,,,450.72,3128.0,32 RC,360,Removal of foreign body from pharynx ,,,745.36,5841.0,28 RC,360,Removal of foreign body in scrotum ,,,685.44,5571.0,32 RC,360,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,31 RC,360,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,745.36,5841.0,16 RC,360,"Removal of foreign body, external eye; conjunctival superficial ",,,223.51,5841.0,16 RC,360,"Removal of foreign body, external eye; corneal, with slit lamp ",,,223.51,5841.0,16 RC,360,"Removal of foreign body, external eye; corneal, without slit lamp ",,,745.36,5841.0,16 RC,360,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,32 RC,360,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,31 RC,360,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,32 RC,360,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,360,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,15899.38,31 RC,360,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,360,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,360,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,948.0,6819.81,32 RC,360,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,360,Removal of implanted intra-arterial infusion pump ,,,948.0,8146.35,32 RC,360,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,32 RC,360,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,27 RC,360,"Removal of implanted material, posterior segment; extraocular High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,27 RC,360,"Removal of implanted material, posterior segment; intraocular High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,32 RC,360,Removal of intrauterine device (IUD) ,,,53.78,5841.0,31 RC,360,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,32 RC,360,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,32 RC,360,Removal of lens material; intracapsular ,,,892.44,8234.0,32 RC,360,"Removal of lens material; intracapsular, for dislocated lens ",,,948.0,13394.0,32 RC,360,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,948.0,10424.04,32 RC,360,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,32 RC,360,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,250.06,3128.0,32 RC,360,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,360,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,948.0,12562.0,32 RC,360,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,360,Removal of ocular implant ,,,948.0,8536.87,32 RC,360,Removal of pancreatic calculus ,,,948.0,16207.0,17 RC,360,Removal of peritoneal foreign body from peritoneal cavity ,,,948.0,8488.5,32 RC,360,Removal of peritoneal-venous shunt ,,,948.0,13835.0,32 RC,360,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,360,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,32 RC,360,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,32 RC,360,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,948.0,15059.0,27 RC,360,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,32 RC,360,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,12909.0,32 RC,360,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,948.0,15039.6,32 RC,360,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,360,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,360,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,360,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,360,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,948.0,5841.0,20 RC,360,"Removal of transplanted intestinal allograft, complete ",,,948.0,19220.19,17 RC,360,Removal of transplanted pancreatic allograft ,,,948.0,15660.09,15 RC,360,Removal of transplanted renal allograft ,,,948.0,16207.0,17 RC,360,"Removal of tumor, temporal bone ",,,948.0,13835.0,29 RC,360,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion ",,,468.58,6212.0,33 RC,360,"Removal of tunneled central venous catheter, without subcutaneous port or pump ",,,234.94,6212.0,33 RC,360,Removal of tunneled intraperitoneal catheter ,,,948.0,7565.59,32 RC,360,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,27 RC,360,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,27 RC,360,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,32 RC,360,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,948.0,11552.32,32 RC,360,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,948.0,13835.0,32 RC,360,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,360,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,948.0,13835.0,31 RC,360,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,948.0,7895.92,31 RC,360,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,7895.92,31 RC,360,Remove interim implant component ,,,12018.0,12018.0,1 RC,360,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,948.0,35181.33,17 RC,360,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,948.0,29697.06,17 RC,360,"Renal autotransplantation, reimplantation of kidney ",,,948.0,24517.95,17 RC,360,Renal biopsy; by surgical exposure of kidney ,,,948.0,16207.0,17 RC,360,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,11552.32,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,22025.45,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,948.0,22025.45,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,948.0,11552.32,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,948.0,22025.45,32 RC,360,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,948.0,11552.32,32 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,4836.33,32 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,948.0,13835.0,20 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,948.0,13835.0,32 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,13835.0,32 RC,360,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,32 RC,360,"Renal exploration, not necessitating other specific procedures ",,,948.0,16207.0,17 RC,360,Reopening of recent laparotomy ,,,948.0,16207.0,17 RC,360,Repair incomplete circumcision ,,,685.44,5571.0,32 RC,360,"Repair inguinal hernia, sliding, any age ",,,1209.12,8488.5,27 RC,360,"Repair inguinal hernia, sliding, any age High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,360,"Repair initial femoral hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair initial femoral hernia, any age; reducible ",,,1209.12,13394.0,27 RC,360,"Repair initial femoral hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,360,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,8488.5,27 RC,360,"Repair initial inguinal hernia, age 5 years or older; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,948.0,15059.0,32 RC,360,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,948.0,8488.5,32 RC,360,"Repair lip, full thickness; over one-half vertical height, or complex ",,,441.67,12562.0,32 RC,360,"Repair lip, full thickness; up to half vertical height ",,,196.58,12562.0,32 RC,360,"Repair lip, full thickness; vermilion only ",,,196.58,12562.0,32 RC,360,Repair lumbar hernia ,,,1983.29,13196.03,27 RC,360,Repair lumbar hernia High Cost Surgery,,,2369.0,2369.0,5 RC,360,Repair of anal fistula with fibrin glue ,,,948.0,6399.61,32 RC,360,"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa ºSIS») ",,,948.0,15059.0,20 RC,360,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,360,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,183 RC,360,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15664.44,177 RC,360,"Repair of anterior palate, including vomer flap ",,,948.0,13394.0,32 RC,360,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,32 RC,360,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,32 RC,360,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,32 RC,360,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,948.0,13394.0,32 RC,360,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,32 RC,360,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,948.0,13394.0,32 RC,360,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,32 RC,360,"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,468.58,6212.0,33 RC,360,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; ",,,948.0,47921.29,17 RC,360,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps ",,,948.0,52015.42,17 RC,360,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach ",,,948.0,42911.77,17 RC,360,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,32 RC,360,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,24 RC,360,"Repair of component(s) of a multi-component, inflatable penile prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,360,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,360,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,948.0,16207.0,17 RC,360,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,948.0,16207.0,17 RC,360,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,32 RC,360,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,32 RC,360,Repair of ectropion; suture ,,,733.22,12562.0,32 RC,360,Repair of ectropion; thermocauterization ,,,210.46,5571.0,32 RC,360,"Repair of encephalocele, skull vault, including cranioplasty ",,,948.0,26255.61,17 RC,360,"Repair of enterocele, abdominal approach (separate procedure) ",,,948.0,13835.0,17 RC,360,"Repair of enterocele, vaginal approach (separate procedure) ",,,948.0,12562.0,32 RC,360,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,360,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,32 RC,360,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,32 RC,360,Repair of entropion; suture ,,,733.22,12562.0,32 RC,360,Repair of entropion; thermocauterization ,,,201.75,13835.0,32 RC,360,Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches ,,,948.0,30612.46,17 RC,360,Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach ,,,948.0,26425.19,17 RC,360,Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches ,,,948.0,27904.25,17 RC,360,Repair of high imperforate anus without fistula; perineal or sacroperineal approach ,,,948.0,24178.91,17 RC,360,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,948.0,12562.0,32 RC,360,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,948.0,12562.0,32 RC,360,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,948.0,12562.0,32 RC,360,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach ",,,948.0,27438.08,29 RC,360,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach ",,,948.0,16207.0,29 RC,360,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,32 RC,360,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,32 RC,360,Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue ,,,223.51,5841.0,28 RC,360,Repair of laceration 2.5 cm or less; posterior one-third of tongue ,,,91.96,5841.0,31 RC,360,"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex ",,,91.96,3755.0,32 RC,360,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,32 RC,360,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,948.0,16207.0,29 RC,360,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,32 RC,360,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,32 RC,360,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,948.0,10424.04,32 RC,360,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,948.0,10424.04,32 RC,360,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,948.0,8536.87,32 RC,360,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,948.0,60402.77,29 RC,360,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,948.0,16207.0,17 RC,360,Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) ,,,948.0,16207.0,17 RC,360,Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula ,,,948.0,16207.0,17 RC,360,Repair of meningocele; larger than 5 cm diameter ,,,948.0,17728.44,17 RC,360,Repair of meningocele; less than 5 cm diameter ,,,948.0,16207.0,17 RC,360,Repair of myelomeningocele; larger than 5 cm diameter ,,,948.0,21911.47,17 RC,360,Repair of myelomeningocele; less than 5 cm diameter ,,,948.0,19758.45,17 RC,360,Repair of nasolabial fistula ,,,948.0,13241.95,32 RC,360,Repair of omphalocele (Gross type operation); first stage ,,,948.0,16207.0,17 RC,360,Repair of omphalocele (Gross type operation); second stage ,,,948.0,16207.0,17 RC,360,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,948.0,15059.0,28 RC,360,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,948.0,9370.6,28 RC,360,Repair of rectocele (separate procedure) ,,,948.0,7014.0,32 RC,360,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,27 RC,360,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,27 RC,360,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,15 RC,360,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,32 RC,360,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,32 RC,360,Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy ,,,948.0,16207.0,17 RC,360,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,Repair of scleral staphyloma with graft ,,,948.0,10424.04,32 RC,360,"Repair of small omphalocele, with primary closure ",,,948.0,8488.5,32 RC,360,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,32 RC,360,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,32 RC,360,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,948.0,8536.87,32 RC,360,Repair of traumatic corporeal tear(s) ,,,948.0,12909.0,32 RC,360,Repair of tunica vaginalis hydrocele (Bottle type) ,,,948.0,8240.61,32 RC,360,"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site ",,,234.94,6212.0,33 RC,360,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,948.0,12562.0,32 RC,360,Repair oval window fistula ,,,930.95,8234.0,27 RC,360,Repair oval window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,360,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,15059.0,27 RC,360,Repair recurrent femoral hernia; incarcerated or strangulated High Cost Surgery,,,2369.0,2369.0,5 RC,360,Repair recurrent femoral hernia; reducible ,,,1209.12,13394.0,27 RC,360,Repair recurrent femoral hernia; reducible High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,360,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,12909.0,27 RC,360,"Repair recurrent inguinal hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,360,Repair round window fistula ,,,930.95,8234.0,27 RC,360,Repair round window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,360,"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute ",,,948.0,16207.0,17 RC,360,"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic ",,,948.0,16207.0,17 RC,360,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,948.0,8488.5,64 RC,360,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,948.0,13835.0,29 RC,360,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,948.0,13835.0,29 RC,360,"Repair, laceration of diaphragm, any approach ",,,948.0,16207.0,17 RC,360,"Repair, laceration of palate; over 2 cm or complex ",,,948.0,13241.95,32 RC,360,"Repair, laceration of palate; up to 2 cm ",,,196.58,5841.0,31 RC,360,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia ",,,948.0,73655.7,17 RC,360,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,360,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,360,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16418.72,17 RC,360,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,360,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,18898.08,17 RC,360,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,18571.74,17 RC,360,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,360,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,948.0,35621.26,31 RC,360,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,948.0,34379.68,31 RC,360,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,16330.72,32 RC,360,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,948.0,16207.0,17 RC,360,Replacement of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,360,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,32 RC,360,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,32 RC,360,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,32 RC,360,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract ",,,115.66,5841.0,31 RC,360,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract ",,,115.66,5841.0,31 RC,360,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,360,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,32 RC,360,"Replacement or irrigation, ventricular catheter ",,,948.0,15039.6,32 RC,360,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,948.0,15039.6,32 RC,360,"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,948.0,7565.59,33 RC,360,"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",,,635.9,6212.0,33 RC,360,"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,33 RC,360,"Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, an",,,468.58,6212.0,33 RC,360,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,33 RC,360,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access ",,,948.0,12562.0,33 RC,360,"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",,,948.0,7565.59,33 RC,360,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,948.0,15039.6,32 RC,360,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,360,"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition ",,,115.66,3128.0,32 RC,360,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,32 RC,360,"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and im",,,948.0,13835.0,29 RC,360,Repositioning of previously placed central venous catheter under fluoroscopic guidance ,,,468.58,6212.0,33 RC,360,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,19 RC,360,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,948.0,13973.35,17 RC,360,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,948.0,20267.07,17 RC,360,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,948.0,17864.03,17 RC,360,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,948.0,21716.49,17 RC,360,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,360,"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls ",,,948.0,13241.95,32 RC,360,"Resection of lip, more than one-fourth, without reconstruction ",,,930.95,7150.66,32 RC,360,Resection of mediastinal cyst ,,,948.0,16207.0,17 RC,360,Resection of mediastinal tumor ,,,948.0,16207.0,17 RC,360,Resection of palate or extensive resection of lesion ,,,948.0,13241.95,32 RC,360,"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis ",,,948.0,29052.84,17 RC,360,Resection of scrotum ,,,948.0,8240.61,32 RC,360,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,948.0,34939.67,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,948.0,26098.85,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,948.0,29709.76,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,948.0,34719.28,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,948.0,41237.62,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,948.0,26340.4,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,948.0,36321.35,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,948.0,32985.86,17 RC,360,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,948.0,40559.53,17 RC,360,"Resection temporal bone, external approach ",,,948.0,32511.23,17 RC,360,"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap) ",,,948.0,16207.0,17 RC,360,"Resection, diaphragm; with simple repair (eg, primary suture) ",,,948.0,16207.0,17 RC,360,"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, ",,,948.0,13835.0,29 RC,360,Retrobulbar injection; alcohol ,,,36.62,5841.0,31 RC,360,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,19 RC,360,"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) ",,,948.0,16207.0,17 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,23 RC,360,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,1986.0,15874.51,78 RC,360,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,1986.0,51129.32,78 RC,360,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,1986.0,32198.25,78 RC,360,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,1986.0,51129.32,78 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed ",,,5796.69,11113.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty ",,,2638.63,9653.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when",,,8579.0,13313.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5604.99,11113.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)",,,9124.0,9653.0,3 RC,360,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when p",,,9124.0,9653.0,3 RC,360,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty ",,,2454.04,9653.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5352.25,11113.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,1986.0,15874.51,78 RC,360,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,1986.0,32198.25,78 RC,360,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,1986.0,32198.25,78 RC,360,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,360,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,360,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,360,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,360,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,1986.0,32198.25,78 RC,360,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,1986.0,51129.32,78 RC,360,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,1986.0,51129.32,78 RC,360,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,1986.0,51129.32,78 RC,360,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed ",,,9049.29,11113.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty ",,,4988.47,9653.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same v",,,8579.0,13313.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf",,,8922.21,11113.0,6 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,23 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,23 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,23 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List s",,,10586.0,11113.0,3 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary proced",,,9124.0,9653.0,3 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the",,,9124.0,9653.0,3 RC,360,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, wh",,,9124.0,9653.0,3 RC,360,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,948.0,18300.83,20 RC,360,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,948.0,16207.0,17 RC,360,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,948.0,12562.0,32 RC,360,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,948.0,54750.0,32 RC,360,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,54750.0,32 RC,360,Revision mastoidectomy; resulting in complete mastoidectomy ,,,948.0,13241.95,32 RC,360,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,948.0,13241.95,32 RC,360,Revision mastoidectomy; resulting in radical mastoidectomy ,,,948.0,13241.95,32 RC,360,Revision mastoidectomy; resulting in tympanoplasty ,,,948.0,13241.95,32 RC,360,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,32 RC,360,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,32 RC,360,Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,13835.0,29 RC,360,Revision of colostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,12562.0,32 RC,360,Revision of colostomy; with repair of paracolostomy hernia (separate procedure) ,,,948.0,14524.31,29 RC,360,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy ",,,948.0,20945.15,17 RC,360,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy ",,,948.0,20101.72,17 RC,360,Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,16207.0,29 RC,360,Revision of ileostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,8128.0,32 RC,360,Revision of implanted intra-arterial infusion pump ,,,948.0,8146.35,32 RC,360,Revision of peritoneal-venous shunt ,,,948.0,8488.5,32 RC,360,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,948.0,12562.0,32 RC,360,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,27 RC,360,Revision of stapedectomy or stapedotomy High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannu",,,948.0,13835.0,29 RC,360,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,948.0,13835.0,20 RC,360,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,948.0,16207.0,17 RC,360,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,948.0,16890.86,32 RC,360,"Revision or removal of gastric neurostimulator electrodes, antrum, open ",,,948.0,21907.23,17 RC,360,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,32 RC,360,Revision or removal of intracranial neurostimulator electrodes ,,,948.0,13835.0,20 RC,360,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,948.0,27181.65,27 RC,360,Revision or removal of peripheral neurostimulator electrode array ,,,948.0,8595.41,32 RC,360,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,32 RC,360,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,32 RC,360,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,948.0,9751.1,22 RC,360,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,948.0,86066.14,22 RC,360,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,948.0,16890.86,32 RC,360,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,948.0,31349.63,31 RC,360,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,360,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,360,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,948.0,56900.95,27 RC,360,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,28 RC,360,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,28 RC,360,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) ",,,948.0,23695.81,11 RC,360,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,360,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,360,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,360,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,360,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,360,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,360,Right ventricular recording ,,,2024.5,43890.0,10 RC,360,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,360,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,360,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,948.0,28395.93,12 RC,360,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,948.0,28768.84,12 RC,360,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,948.0,25611.4,12 RC,360,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,948.0,26874.42,12 RC,360,SIGMOIDOSCOPY W/ABLATE TUMR ,,,3390.0,5841.0,2 RC,360,SIGMOIDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,360,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER ",,,4988.0,7014.0,3 RC,360,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,3 RC,360,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,360,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,360,SURGICAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,360,SURGICAL OPENING ESOPHAGUS ,,,3390.0,5841.0,2 RC,360,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,360,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,360,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,360,Salpingostomy (salpingoneostomy) ,,,948.0,13835.0,29 RC,360,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,360,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,32 RC,360,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,32 RC,360,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,948.0,12909.0,29 RC,360,"Scraping of cornea, diagnostic, for smear and/or culture ",,,745.36,5841.0,16 RC,360,Screening proctoscopy ,,,343.69,440.76,5 RC,360,Scrotal exploration ,,,948.0,8240.61,32 RC,360,Scrotoplasty; complicated ,,,948.0,11552.32,32 RC,360,Scrotoplasty; simple ,,,948.0,8240.61,32 RC,360,"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic ",,,948.0,5841.0,20 RC,360,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,948.0,16207.0,17 RC,360,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,948.0,17546.16,17 RC,360,"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast inje",,,948.0,13835.0,58 RC,360,"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial seco",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,29 RC,360,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,29 RC,360,"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological su",,,948.0,13835.0,23 RC,360,"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List",,,948.0,13835.0,23 RC,360,"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, ",,,948.0,13835.0,29 RC,360,"Selective catheter placement, left or right pulmonary artery ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, segmental or subsegmental pulmonary artery ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, inc",,,948.0,13835.0,29 RC,360,"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein) ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus) ",,,948.0,5841.0,20 RC,360,"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiograp",,,948.0,13835.0,29 RC,360,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,360,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,360,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,32 RC,360,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,948.0,10424.04,32 RC,360,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,32 RC,360,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,32 RC,360,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,32 RC,360,Severing of tarsorrhaphy ,,,179.07,3128.0,32 RC,360,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,27 RC,360,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Sialolithotomy; parotid, extraoral or complicated intraoral ",,,930.95,7150.66,32 RC,360,"Sialolithotomy; submandibular (submaxillary), complicated, intraoral ",,,265.4,12562.0,32 RC,360,"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral ",,,127.91,13835.0,32 RC,360,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,137.2,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,32 RC,360,"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,32 RC,360,"Sigmoidoscopy, flexible; with biopsy, single or multiple ",,,344.93,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with control of bleeding, any method ",,,450.72,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance ",,,344.93,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,32 RC,360,"Sigmoidoscopy, flexible; with endoscopic ultrasound examination ",,,344.93,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,32 RC,360,"Sigmoidoscopy, flexible; with removal of foreign body(s) ",,,450.72,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,344.93,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3128.0,32 RC,360,"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) ",,,450.72,3128.0,32 RC,360,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,31 RC,360,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,223.51,5841.0,16 RC,360,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,360,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,360,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,948.0,22025.45,34 RC,360,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,948.0,16632.0,34 RC,360,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,32 RC,360,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,948.0,8240.61,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, pl",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedu",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s) ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,360,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,32 RC,360,Snip incision of lacrimal punctum ,,,56.97,5841.0,31 RC,360,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,360,Sperm washing for artificial insemination ,,,44.33,5841.0,16 RC,360,"Sphincteroplasty, anal, for incontinence or prolapse; adult ",,,948.0,12562.0,32 RC,360,"Sphincteroplasty, anal, for incontinence or prolapse; child ",,,948.0,16207.0,17 RC,360,"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) ",,,948.0,12562.0,32 RC,360,"Sphincteroplasty, anal, for incontinence, adult; muscle transplant ",,,948.0,7014.0,32 RC,360,"Sphincterotomy, anal, division of sphincter (separate procedure) ",,,948.0,12562.0,32 RC,360,"Spinal puncture, lumbar, diagnostic; ",,,276.0,3128.0,32 RC,360,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,31 RC,360,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,32 RC,360,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,31 RC,360,Splenectomy; partial (separate procedure) ,,,948.0,16207.0,17 RC,360,Splenectomy; total (separate procedure) ,,,948.0,16207.0,17 RC,360,"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions ",,,204.65,12562.0,32 RC,360,"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions ",,,223.55,12562.0,32 RC,360,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,27 RC,360,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,27 RC,360,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out High Cost Surgery",,,2369.0,2369.0,5 RC,360,Stapes mobilization ,,,930.95,12909.0,27 RC,360,Stapes mobilization High Cost Surgery,,,2369.0,2369.0,5 RC,360,Stem cell collection ,,,3390.0,5841.0,2 RC,360,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,948.0,17554.62,17 RC,360,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,948.0,17156.19,17 RC,360,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,948.0,19516.9,17 RC,360,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,948.0,15059.0,17 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,948.0,29069.0,10 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,19113.0,29069.0,5 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,948.0,29069.0,10 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,360,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,360,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,948.0,12562.0,32 RC,360,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,360,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,112.77,5841.0,16 RC,360,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,948.0,5841.0,20 RC,360,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,32 RC,360,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,32 RC,360,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,32 RC,360,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,948.0,8536.87,32 RC,360,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,32 RC,360,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,360,Subconjunctival injection ,,,223.51,5841.0,16 RC,360,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,948.0,14948.14,17 RC,360,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,32 RC,360,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,32 RC,360,"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session ",,,948.0,12909.0,29 RC,360,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,948.0,17554.62,17 RC,360,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,948.0,13835.0,15 RC,360,"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheter",,,948.0,13835.0,58 RC,360,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,24 RC,360,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,456.3,5841.0,15 RC,360,Suprahyoid lymphadenectomy ,,,948.0,14297.8,32 RC,360,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,948.0,26865.96,17 RC,360,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,948.0,31193.16,17 RC,360,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,948.0,31862.78,17 RC,360,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,53176.72,17 RC,360,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,59338.96,17 RC,360,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,948.0,16537.5,17 RC,360,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,948.0,46115.78,17 RC,360,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,948.0,26984.61,17 RC,360,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,948.0,57821.69,17 RC,360,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,948.0,35240.6,17 RC,360,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,948.0,52341.76,17 RC,360,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,948.0,28014.44,17 RC,360,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,42699.85,17 RC,360,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,50133.7,17 RC,360,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,360,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,360,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,360,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,360,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,360,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,360,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,360,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,360,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,360,Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric ,,,948.0,12562.0,32 RC,360,Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage ,,,948.0,6399.61,32 RC,360,Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous ,,,948.0,12562.0,32 RC,360,"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed ",,,948.0,8234.0,32 RC,360,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,948.0,16207.0,17 RC,360,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,948.0,16207.0,17 RC,360,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,948.0,16207.0,17 RC,360,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,948.0,13835.0,29 RC,360,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,948.0,13835.0,29 RC,360,Suture and/or ligation of thoracic duct; abdominal approach ,,,948.0,16207.0,17 RC,360,Suture and/or ligation of thoracic duct; cervical approach ,,,948.0,16207.0,17 RC,360,Suture and/or ligation of thoracic duct; thoracic approach ,,,948.0,16207.0,17 RC,360,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,948.0,13394.0,32 RC,360,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,948.0,13394.0,32 RC,360,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,948.0,15039.6,32 RC,360,Suture of 1 nerve; median motor thenar ,,,948.0,15039.6,32 RC,360,Suture of 1 nerve; ulnar motor ,,,948.0,15039.6,32 RC,360,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,32 RC,360,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Suture of esophageal wound or injury; cervical approach ,,,948.0,16207.0,17 RC,360,Suture of esophageal wound or injury; transthoracic or transabdominal approach ,,,948.0,31642.4,17 RC,360,Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) ,,,948.0,16846.79,17 RC,360,Suture of facial nerve; extracranial ,,,948.0,15039.6,32 RC,360,"Suture of facial nerve; infratemporal, with or without grafting ",,,948.0,15039.6,32 RC,360,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,32 RC,360,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy ",,,948.0,16207.0,17 RC,360,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy ",,,948.0,16207.0,17 RC,360,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,948.0,15039.6,32 RC,360,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,948.0,15039.6,32 RC,360,Suture of mesentery (separate procedure) ,,,948.0,16207.0,17 RC,360,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,948.0,5841.0,20 RC,360,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,948.0,5841.0,20 RC,360,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,948.0,5841.0,20 RC,360,Suture of posterior tibial nerve ,,,948.0,15039.6,32 RC,360,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,32 RC,360,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,32 RC,360,Suture of sciatic nerve ,,,948.0,8104.0,32 RC,360,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations ",,,948.0,19923.79,17 RC,360,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation ",,,948.0,17359.64,17 RC,360,Suture of tongue to lip for micrognathia (Douglas type procedure) ,,,930.95,7150.66,32 RC,360,Suture of; brachial plexus ,,,692.94,12562.0,32 RC,360,Suture of; lumbar plexus ,,,948.0,15039.6,32 RC,360,Suture or repair of testicular injury ,,,948.0,12562.0,32 RC,360,Suture pharynx for wound or injury ,,,783.57,5571.0,32 RC,360,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,948.0,16207.0,17 RC,360,"Sympathectomy, cervical ",,,692.94,4693.83,32 RC,360,"Sympathectomy, cervicothoracic ",,,948.0,13835.0,17 RC,360,"Sympathectomy, lumbar ",,,948.0,16207.0,17 RC,360,"Sympathectomy, thoracolumbar ",,,948.0,16207.0,17 RC,360,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,20 RC,360,Sympathectomy; radial artery ,,,948.0,8234.0,32 RC,360,Sympathectomy; superficial palmar arch ,,,948.0,7473.24,32 RC,360,Sympathectomy; ulnar artery ,,,948.0,12562.0,32 RC,360,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,948.0,16207.0,17 RC,360,TRANSCATH IV STENT OPEN ,,,5841.0,5841.0,1 RC,360,TRANSCATH IV STENT PERCUT ,,,5841.0,5841.0,1 RC,360,TRANSCATH IV STENT/OPEN ADDL ,,,5841.0,5841.0,1 RC,360,TRANSCATH IV STENT/PERC ADDL ,,,5841.0,5841.0,1 RC,360,TRANSCATHETER OCCLUSION ,,,5841.0,5841.0,1 RC,360,TRANSCATHETER RETRIEVAL ,,,5841.0,5841.0,1 RC,360,TRANSCATHETER THERAPY INFUSE ,,,3390.0,5841.0,3 RC,360,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,360,"TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGEAL VARICES ",,,3390.0,16207.0,3 RC,360,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,360,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,360,TRANSPLANTATION OF LIVER ,,,3390.0,5841.0,2 RC,360,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,360,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,32 RC,360,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,360,Therapeutic apheresis; for plasma pheresis ,,,592.85,13835.0,32 RC,360,Therapeutic apheresis; for platelets ,,,172.52,13835.0,32 RC,360,Therapeutic apheresis; for red blood cells ,,,592.85,13835.0,32 RC,360,Therapeutic apheresis; for white blood cells ,,,592.85,13835.0,32 RC,360,"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion ",,,948.0,27628.58,32 RC,360,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,948.0,34379.68,31 RC,360,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,360,"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,15059.0,28 RC,360,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Thrombolysis, cerebral, by intravenous infusion ",,,634.68,5841.0,16 RC,360,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,360,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,360,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,948.0,16745.06,17 RC,360,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,948.0,16207.0,17 RC,360,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,948.0,13835.0,29 RC,360,"Thyroidectomy, including substernal thyroid; cervical approach ",,,948.0,13835.0,29 RC,360,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,948.0,16715.43,17 RC,360,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,948.0,13835.0,29 RC,360,"Thyroidectomy, total or complete ",,,948.0,13835.0,32 RC,360,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,360,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,948.0,13835.0,29 RC,360,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,948.0,20402.66,29 RC,360,"Tongue base suspension, permanent suture technique ",,,948.0,13241.95,29 RC,360,Tonsillectomy and adenoidectomy; age 12 or over ,,,930.95,13394.0,32 RC,360,Tonsillectomy and adenoidectomy; younger than age 12 ,,,948.0,13241.95,32 RC,360,"Tonsillectomy, primary or secondary; age 12 or over ",,,930.95,8234.0,32 RC,360,"Tonsillectomy, primary or secondary; younger than age 12 ",,,948.0,13241.95,32 RC,360,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,948.0,16207.0,29 RC,360,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,948.0,16207.0,29 RC,360,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,24 RC,360,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,360,Total facial nerve decompression and/or repair (may include graft) ,,,948.0,13835.0,29 RC,360,"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es) ",,,948.0,53753.08,17 RC,360,"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy) ",,,948.0,43081.23,17 RC,360,"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es) ",,,948.0,55066.91,17 RC,360,"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) ",,,948.0,36660.39,17 RC,360,"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy ",,,948.0,46819.38,17 RC,360,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13196.03,32 RC,360,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13196.03,32 RC,360,Trabeculoplasty by laser surgery ,,,114.82,3249.0,32 RC,360,Trabeculotomy ab externo ,,,892.44,8234.0,32 RC,360,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,948.0,12562.0,32 RC,360,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,948.0,12562.0,32 RC,360,"Transabdominal amnioinfusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,360,Transcatheter biopsy ,,,948.0,12547.6,32 RC,360,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,360,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,360,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,948.0,27050.15,58 RC,360,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,1986.0,43890.0,57 RC,360,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each",,,1986.0,43890.0,23 RC,360,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; init",,,2369.0,43890.0,34 RC,360,"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perfo",,,948.0,5841.0,20 RC,360,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal em",,,2369.0,43890.0,30 RC,360,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal",,,2369.0,43890.0,30 RC,360,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,948.0,18059.01,17 RC,360,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angiop",,,2369.0,43890.0,29 RC,360,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiolo",,,2369.0,43890.0,29 RC,360,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,360,"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound",,,948.0,15059.0,32 RC,360,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day ",,,1986.0,12547.6,28 RC,360,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day High Cost Surger",,,2369.0,2369.0,5 RC,360,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",,,2012.0,15059.0,60 RC,360,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day ",,,1594.88,8234.0,28 RC,360,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,948.0,19655.45,27 RC,360,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,948.0,17689.64,29 RC,360,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,948.0,29709.76,17 RC,360,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,948.0,36245.03,17 RC,360,"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure) ",,,948.0,16207.0,17 RC,360,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,20 RC,360,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,948.0,12562.0,17 RC,360,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,32 RC,360,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,32 RC,360,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,32 RC,360,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,32 RC,360,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,32 RC,360,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,32 RC,360,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,32 RC,360,Transection or avulsion of; mental nerve ,,,692.94,4693.83,32 RC,360,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,32 RC,360,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,32 RC,360,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,948.0,16207.0,17 RC,360,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,948.0,16207.0,17 RC,360,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,360,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,948.0,16207.0,17 RC,360,"Transfusion, blood or blood components ",,,32.27,5841.0,31 RC,360,"Transfusion, intrauterine, fetal ",,,795.48,5841.0,28 RC,360,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1672.0,13835.0,51 RC,360,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,360,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,1672.0,22539.28,68 RC,360,"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplast",,,1672.0,5841.0,15 RC,360,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,948.0,13394.0,29 RC,360,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,948.0,13394.0,29 RC,360,Transmastoid antrotomy (simple mastoidectomy) ,,,948.0,13241.95,32 RC,360,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,948.0,31201.63,17 RC,360,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,948.0,51345.81,17 RC,360,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,948.0,5841.0,20 RC,360,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,948.0,16330.72,32 RC,360,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,948.0,16330.72,32 RC,360,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,948.0,15059.0,31 RC,360,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,29 RC,360,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,948.0,35134.65,17 RC,360,"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer ",,,795.48,3128.0,17 RC,360,Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage ,,,795.48,5841.0,16 RC,360,Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion ,,,795.48,3128.0,17 RC,360,Transplant preparation of hematopoietic progenitor cells; platelet depletion ,,,795.48,3128.0,17 RC,360,Transplant preparation of hematopoietic progenitor cells; red blood cell removal ,,,795.48,3128.0,17 RC,360,"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion ",,,795.48,3128.0,17 RC,360,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor ",,,795.48,5841.0,16 RC,360,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor ",,,795.48,5841.0,16 RC,360,Transplant preparation of hematopoietic progenitor cells; tumor cell depletion ,,,795.48,3128.0,17 RC,360,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,360,Transplantation of pancreatic allograft ,,,948.0,31320.29,15 RC,360,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,360,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,948.0,12562.0,32 RC,360,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,"Transposition, ovary(s) ",,,948.0,13835.0,29 RC,360,Transrectal drainage of pelvic abscess ,,,450.72,5571.0,32 RC,360,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,948.0,28879.03,17 RC,360,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,948.0,16207.0,17 RC,360,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,948.0,19718.21,32 RC,360,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,948.0,15059.0,31 RC,360,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,948.0,18816.77,32 RC,360,Transurethral drainage of prostatic abscess ,,,948.0,8240.61,32 RC,360,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,32 RC,360,Transurethral incision of prostate ,,,948.0,12562.0,32 RC,360,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,948.0,12909.0,29 RC,360,Transurethral resection of bladder neck (separate procedure) ,,,948.0,12562.0,32 RC,360,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,27 RC,360,Transurethral resection; of postoperative bladder neck contracture High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,32 RC,360,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,948.0,26403.19,22 RC,360,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,23 RC,360,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,23 RC,360,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,23 RC,360,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,23 RC,360,Transvesical ureterolithotomy ,,,948.0,13835.0,17 RC,360,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,27 RC,360,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,32 RC,360,"Treatment of incomplete abortion, any trimester, completed surgically ",,,948.0,13394.0,32 RC,360,"Treatment of missed abortion, completed surgically; first trimester ",,,948.0,13394.0,32 RC,360,"Treatment of missed abortion, completed surgically; second trimester ",,,948.0,13394.0,32 RC,360,"Treatment of septic abortion, completed surgically ",,,948.0,16207.0,29 RC,360,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,360,"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure) ",,,948.0,16207.0,17 RC,360,Tubotubal anastomosis ,,,948.0,13835.0,29 RC,360,Tubouterine implantation ,,,948.0,13835.0,29 RC,360,Twist drill hole for subdural or ventricular puncture ,,,948.0,16207.0,17 RC,360,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,948.0,16207.0,17 RC,360,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,948.0,16207.0,17 RC,360,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,948.0,16207.0,17 RC,360,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,28345.13,68 RC,360,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,32 RC,360,Tympanic neurectomy ,,,930.95,12562.0,27 RC,360,Tympanic neurectomy High Cost Surgery,,,2369.0,2369.0,5 RC,360,"Tympanolysis, transcanal ",,,930.95,9653.0,32 RC,360,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,32 RC,360,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,360,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,27 RC,360,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,32 RC,360,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,27 RC,360,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,32 RC,360,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,31 RC,360,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,360,U-tube hepaticoenterostomy ,,,3390.0,16207.0,3 RC,360,UPPER GI ENDOSCOPY EXAM ,,,3390.0,5841.0,2 RC,360,UPPR GI ENDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,360,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,360,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,360,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,360,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,948.0,8488.5,32 RC,360,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,360,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,360,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,360,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,340.4,13835.0,28 RC,360,"Unlisted hysteroscopy procedure, uterus ",,,340.4,13835.0,11 RC,360,"Unlisted hysteroscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopic procedure, liver ",,,948.0,13835.0,17 RC,360,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, appendix ",,,6326.0,13196.03,9 RC,360,"Unlisted laparoscopy procedure, appendix High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, biliary tract ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, biliary tract High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, bladder ",,,948.0,13835.0,17 RC,360,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, endocrine system High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, esophagus ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, esophagus High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, intestine (except rectum) ",,,948.0,13835.0,17 RC,360,"Unlisted laparoscopy procedure, lymphatic system ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, lymphatic system High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,24 RC,360,"Unlisted laparoscopy procedure, maternity care and delivery High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, oviduct, ovary High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, rectum ",,,948.0,13835.0,17 RC,360,"Unlisted laparoscopy procedure, renal ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, renal High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, spermatic cord High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, spleen ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, spleen High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, stomach ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, stomach High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, testis ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, testis High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, ureter High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13835.0,12 RC,360,"Unlisted laparoscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Unlisted procedure, Meckel's diverticulum and the mesentery ",,,948.0,16207.0,17 RC,360,"Unlisted procedure, abdomen, peritoneum and omentum ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, anterior segment of eye ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, anus ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, biliary tract ",,,948.0,13835.0,17 RC,360,"Unlisted procedure, colon ",,,948.0,13394.0,29 RC,360,"Unlisted procedure, conjunctiva ",,,554.5,13835.0,16 RC,360,"Unlisted procedure, dentoalveolar structures ",,,417.46,13835.0,31 RC,360,"Unlisted procedure, diaphragm ",,,948.0,16207.0,17 RC,360,"Unlisted procedure, endocrine system ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, esophagus ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, external ear ",,,417.46,5841.0,16 RC,360,"Unlisted procedure, extraocular muscle ",,,554.5,13835.0,16 RC,360,"Unlisted procedure, eyelids ",,,554.5,13835.0,16 RC,360,"Unlisted procedure, female genital system (nonobstetrical) ",,,340.4,13835.0,28 RC,360,"Unlisted procedure, hemic or lymphatic system ",,,795.48,13835.0,28 RC,360,"Unlisted procedure, inner ear ",,,417.46,13835.0,28 RC,360,"Unlisted procedure, lacrimal system ",,,554.5,13835.0,16 RC,360,"Unlisted procedure, lips ",,,417.46,13835.0,16 RC,360,"Unlisted procedure, liver ",,,948.0,13835.0,16 RC,360,"Unlisted procedure, male genital system ",,,481.54,13835.0,28 RC,360,"Unlisted procedure, maternity care and delivery ",,,340.4,13835.0,28 RC,360,"Unlisted procedure, mediastinum ",,,948.0,16207.0,17 RC,360,"Unlisted procedure, middle ear ",,,417.46,13835.0,28 RC,360,"Unlisted procedure, nervous system ",,,536.63,13835.0,28 RC,360,"Unlisted procedure, orbit ",,,554.5,13835.0,16 RC,360,"Unlisted procedure, palate, uvula ",,,417.46,13835.0,16 RC,360,"Unlisted procedure, pancreas ",,,948.0,13835.0,16 RC,360,"Unlisted procedure, pharynx, adenoids, or tonsils ",,,417.46,13835.0,28 RC,360,"Unlisted procedure, posterior segment ",,,948.0,13835.0,17 RC,360,"Unlisted procedure, rectum ",,,948.0,13835.0,17 RC,360,"Unlisted procedure, salivary glands or ducts ",,,417.46,13835.0,28 RC,360,"Unlisted procedure, small intestine ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, stomach ",,,948.0,13835.0,26 RC,360,"Unlisted procedure, temporal bone, middle fossa approach ",,,417.46,13835.0,28 RC,360,"Unlisted procedure, tongue, floor of mouth ",,,417.46,13835.0,16 RC,360,"Unlisted procedure, urinary system ",,,481.54,13835.0,28 RC,360,"Unlisted procedure, vascular injection ",,,948.0,5841.0,8 RC,360,"Unlisted procedure, vascular surgery ",,,948.0,13835.0,29 RC,360,"Unlisted procedure, vestibule of mouth ",,,417.46,13835.0,28 RC,360,Unlisted vascular endoscopy procedure ,,,948.0,13835.0,17 RC,360,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,948.0,5841.0,20 RC,360,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,360,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,948.0,8240.61,32 RC,360,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,360,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,32 RC,360,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,948.0,8240.61,32 RC,360,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,948.0,16207.0,29 RC,360,"Ureterectomy, with bladder cuff (separate procedure) ",,,948.0,16207.0,29 RC,360,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,948.0,16207.0,17 RC,360,"Ureterocolon conduit, including intestine anastomosis ",,,948.0,16207.0,17 RC,360,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,948.0,16207.0,17 RC,360,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,948.0,16207.0,17 RC,360,Ureterolithotomy; lower one-third of ureter ,,,948.0,16207.0,29 RC,360,Ureterolithotomy; middle one-third of ureter ,,,948.0,16207.0,29 RC,360,Ureterolithotomy; upper one-third of ureter ,,,948.0,16207.0,29 RC,360,Ureterolysis for ovarian vein syndrome ,,,948.0,16207.0,17 RC,360,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,948.0,16207.0,17 RC,360,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,948.0,16207.0,17 RC,360,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,948.0,16207.0,17 RC,360,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,948.0,16207.0,17 RC,360,Ureteroneocystostomy; with extensive ureteral tailoring ,,,948.0,16207.0,17 RC,360,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,948.0,16207.0,17 RC,360,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,948.0,16207.0,17 RC,360,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,948.0,16207.0,17 RC,360,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,948.0,16207.0,17 RC,360,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,948.0,17194.41,17 RC,360,"Ureterostomy, transplantation of ureter to skin ",,,948.0,16207.0,17 RC,360,"Ureterotomy for insertion of indwelling stent, all types ",,,948.0,16207.0,29 RC,360,Ureterotomy with exploration or drainage (separate procedure) ,,,948.0,16207.0,29 RC,360,Ureteroureterostomy ,,,948.0,16207.0,17 RC,360,"Urethrectomy, total, including cystostomy; female ",,,948.0,13394.0,32 RC,360,"Urethrectomy, total, including cystostomy; male ",,,948.0,13394.0,32 RC,360,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,948.0,13835.0,29 RC,360,"Urethromeatoplasty, with mucosal advancement ",,,948.0,8240.61,32 RC,360,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,948.0,8240.61,32 RC,360,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,948.0,12562.0,32 RC,360,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,948.0,12562.0,32 RC,360,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,948.0,12562.0,32 RC,360,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,948.0,12562.0,32 RC,360,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,948.0,11552.32,32 RC,360,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,948.0,11552.32,32 RC,360,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,948.0,12562.0,32 RC,360,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,948.0,11552.32,32 RC,360,"Urethroplasty, reconstruction of female urethra ",,,948.0,11552.32,32 RC,360,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,948.0,13858.92,17 RC,360,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,948.0,12562.0,32 RC,360,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,948.0,11552.32,32 RC,360,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,948.0,8240.61,32 RC,360,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,948.0,11552.32,32 RC,360,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,948.0,11552.32,32 RC,360,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,948.0,11552.32,32 RC,360,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,32 RC,360,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,948.0,11552.32,32 RC,360,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,948.0,22102.21,17 RC,360,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,360,Uterine evacuation and curettage for hydatidiform mole ,,,948.0,13394.0,32 RC,360,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,948.0,16207.0,29 RC,360,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,948.0,16207.0,17 RC,360,"Uvulectomy, excision of uvula ",,,930.95,7150.66,32 RC,360,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,360,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,360,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,948.0,13835.0,29 RC,360,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,948.0,12689.16,24 RC,360,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,948.0,13835.0,29 RC,360,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,948.0,13841.99,12 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,27 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,948.0,13835.0,17 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,948.0,15059.0,32 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,948.0,15059.0,29 RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,948.0,15059.0,29 RC,360,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,948.0,18300.83,29 RC,360,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,13835.0,29 RC,360,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,948.0,18300.83,29 RC,360,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,948.0,13835.0,29 RC,360,"Vaginal hysterectomy, radical (Schauta type operation) ",,,948.0,17741.14,17 RC,360,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,948.0,13835.0,17 RC,360,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,948.0,13835.0,17 RC,360,"Vaginectomy, complete removal of vaginal wall; ",,,948.0,16207.0,29 RC,360,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,21606.3,29 RC,360,"Vaginectomy, partial removal of vaginal wall; ",,,948.0,13835.0,29 RC,360,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,13835.0,29 RC,360,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,948.0,13835.0,29 RC,360,Vaginoplasty for intersex state ,,,948.0,13835.0,29 RC,360,"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective) ",,,948.0,16207.0,17 RC,360,"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective ",,,948.0,16207.0,17 RC,360,Vagotomy when performed with partial distal gastrectomy (List separately in addition to codeºs» for primary procedure) ,,,948.0,16207.0,17 RC,360,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,360,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, ot",,,2369.0,27050.15,34 RC,360,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial",,,2369.0,27050.15,31 RC,360,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, ",,,2369.0,27050.15,34 RC,360,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, othe",,,2369.0,59899.7,34 RC,360,"Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) ",,,2036.11,12562.0,9 RC,360,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,32 RC,360,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,948.0,5841.0,20 RC,360,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,948.0,8240.61,29 RC,360,"Vasovasostomy, vasovasorrhaphy ",,,948.0,8240.61,29 RC,360,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",,,948.0,948.0,5 RC,360,"Venipuncture, cutdown; age 1 or over ",,,745.36,3244.0,26 RC,360,"Venipuncture, cutdown; younger than age 1 year ",,,112.77,3244.0,26 RC,360,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein ",,,948.0,948.0,5 RC,360,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein ",,,948.0,948.0,5 RC,360,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein ",,,948.0,948.0,5 RC,360,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,360,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,360,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,360,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,360,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,360,"Venous anastomosis, open; caval-mesenteric ",,,948.0,27217.7,17 RC,360,"Venous anastomosis, open; portocaval ",,,948.0,28565.51,17 RC,360,"Venous anastomosis, open; renoportal ",,,948.0,26488.69,17 RC,360,"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique) ",,,948.0,28565.51,17 RC,360,"Venous anastomosis, open; splenorenal, proximal ",,,948.0,26162.35,17 RC,360,Venous catheterization for selective organ blood sampling ,,,948.0,5841.0,20 RC,360,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,32 RC,360,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,32 RC,360,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,32 RC,360,Ventriculocisternostomy (Torkildsen type operation) ,,,948.0,19949.19,17 RC,360,"Ventriculocisternostomy, third ventricle; ",,,948.0,17075.76,17 RC,360,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,948.0,16207.0,17 RC,360,"Vermilionectomy (lip shave), with mucosal advancement ",,,930.95,7150.66,32 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,948.0,16207.0,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,948.0,21674.15,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,948.0,16207.0,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,948.0,29803.02,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,948.0,16207.0,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,948.0,22725.26,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,26781.17,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,948.0,26832.09,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,948.0,27196.53,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,948.0,28616.31,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,30091.25,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,948.0,29773.38,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,948.0,31277.95,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,28743.44,51 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,948.0,24149.28,34 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,948.0,16207.0,17 RC,360,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,948.0,23729.68,17 RC,360,"Vesiculectomy, any approach ",,,948.0,13835.0,29 RC,360,Vesiculotomy; ,,,685.44,11308.65,32 RC,360,Vesiculotomy; complicated ,,,948.0,13835.0,29 RC,360,"Vestibular nerve section, transcranial approach ",,,948.0,21449.53,17 RC,360,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,32 RC,360,Vestibuloplasty; anterior ,,,948.0,13241.95,32 RC,360,"Vestibuloplasty; complex (including ridge extension, muscle repositioning) ",,,948.0,13394.0,32 RC,360,Vestibuloplasty; entire arch ,,,948.0,13394.0,32 RC,360,"Vestibuloplasty; posterior, bilateral ",,,948.0,13241.95,32 RC,360,"Vestibuloplasty; posterior, unilateral ",,,948.0,13241.95,32 RC,360,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,360,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,27 RC,360,"Vitrectomy, mechanical, pars plana approach; High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,27 RC,360,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,27 RC,360,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,32 RC,360,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,27 RC,360,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) High Cost Surgery",,,2369.0,2369.0,5 RC,360,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,32 RC,360,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,360,Vulvectomy simple; complete ,,,948.0,12909.0,32 RC,360,Vulvectomy simple; partial ,,,948.0,13394.0,32 RC,360,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,948.0,18478.49,17 RC,360,"Vulvectomy, radical, complete; ",,,948.0,14986.24,17 RC,360,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,948.0,18618.43,17 RC,360,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,948.0,16058.52,17 RC,360,"Vulvectomy, radical, partial; ",,,948.0,16207.0,29 RC,360,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,948.0,17240.98,17 RC,360,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,948.0,14609.1,17 RC,360,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,948.0,18300.83,29 RC,360,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,361, Operating Room Services Minor Surgery ,,,3673.0,5356.0,12 RC,361,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,361,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,361,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,361,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,361,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,361,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,948.0,12562.0,32 RC,361,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,948.0,12562.0,32 RC,361,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,948.0,12562.0,32 RC,361,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,948.0,12562.0,32 RC,361,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,361,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,361,ACCESS AV DIAL GRFT FOR EVAL ,,,2431.0,2979.0,3 RC,361,ACCESS AV DIAL GRFT FOR PROC ,,,2358.0,5841.0,2 RC,361,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,361,ARTERY TO VEIN SHUNT ,,,3390.0,5841.0,2 RC,361,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,361,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,361,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,361,"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,3249.0,32 RC,361,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,948.0,13835.0,29 RC,361,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,948.0,3390.0,18 RC,361,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,948.0,4423.26,23 RC,361,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,948.0,15059.0,28 RC,361,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,948.0,5802.38,23 RC,361,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,948.0,35469.31,23 RC,361,"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation ",,,948.0,15059.0,32 RC,361,"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency ",,,948.0,13835.0,32 RC,361,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,948.0,13196.03,32 RC,361,"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,22 RC,361,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,22 RC,361,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,948.0,16207.0,29 RC,361,"Ablation, open, of 1 or more liver tumor(s); cryosurgical ",,,948.0,17999.62,29 RC,361,"Ablation, open, of 1 or more liver tumor(s); radiofrequency ",,,948.0,17732.67,29 RC,361,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,948.0,22967.79,32 RC,361,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,361,"Adenoidectomy, primary; age 12 or over ",,,930.95,8234.0,32 RC,361,"Adenoidectomy, primary; younger than age 12 ",,,930.95,8234.0,32 RC,361,"Adenoidectomy, secondary; age 12 or over ",,,930.95,8234.0,32 RC,361,"Adenoidectomy, secondary; younger than age 12 ",,,930.95,8234.0,32 RC,361,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,361,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,361,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,361,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,948.0,16207.0,29 RC,361,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,948.0,16207.0,17 RC,361,Allogeneic lymphocyte infusions ,,,592.85,13835.0,20 RC,361,"Alveolectomy, including curettage of osteitis or sequestrectomy ",,,289.82,13835.0,32 RC,361,"Alveoloplasty, each quadrant (specify) ",,,234.0,13835.0,32 RC,361,Amniocentesis; diagnostic ,,,52.04,3083.0,29 RC,361,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,28 RC,361,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,18546.34,17 RC,361,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,948.0,16207.0,17 RC,361,Amputation of penis; complete ,,,948.0,13835.0,29 RC,361,Amputation of penis; partial ,,,948.0,8240.61,32 RC,361,"Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,30468.4,17 RC,361,"Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract ",,,948.0,40025.51,17 RC,361,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,948.0,32129.73,17 RC,361,"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract ",,,948.0,27747.48,17 RC,361,"Anastomosis, of intrahepatic ducts and gastrointestinal tract ",,,948.0,37283.43,17 RC,361,Anastomosis; facial-hypoglossal ,,,948.0,16207.0,17 RC,361,Anastomosis; facial-spinal accessory ,,,948.0,16207.0,17 RC,361,"Anoplasty, plastic operation for stricture; adult ",,,948.0,12562.0,32 RC,361,"Anoplasty, plastic operation for stricture; infant ",,,948.0,16207.0,17 RC,361,"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic ",,,948.0,6399.61,32 RC,361,Anorectal manometry ,,,1672.0,2358.0,4 RC,361,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,361,Anorectal myomectomy ,,,948.0,6399.61,32 RC,361,"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,223.51,5841.0,28 RC,361,"Anoscopy; diagnostic, with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when p",,,223.51,5841.0,28 RC,361,"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,32 RC,361,"Anoscopy; with biopsy, single or multiple ",,,211.33,13835.0,32 RC,361,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,115.98,13835.0,32 RC,361,"Anoscopy; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,13835.0,32 RC,361,"Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple ",,,948.0,8234.0,29 RC,361,Anoscopy; with removal of foreign body ,,,344.93,3128.0,32 RC,361,"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,948.0,6399.61,32 RC,361,"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,32 RC,361,"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique ",,,344.93,3128.0,32 RC,361,Antepartum care only; 4-6 visits ,,,948.0,5841.0,12 RC,361,Antepartum care only; 7 or more visits ,,,948.0,7624.48,12 RC,361,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,948.0,13394.0,32 RC,361,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,948.0,13835.0,29 RC,361,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,948.0,13835.0,29 RC,361,Apheresis w/ adsorp/reinfuse ,,,3390.0,5841.0,2 RC,361,Appendectomy; ,,,948.0,13835.0,29 RC,361,Appendectomy; for ruptured appendix with abscess or generalized peritonitis ,,,948.0,16207.0,17 RC,361,Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,361,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,361,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,361,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,361,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,361,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,361,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,361,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,361,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,361,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,361,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,361,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,948.0,1915.7,10 RC,361,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,948.0,13394.0,32 RC,361,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,948.0,15059.0,32 RC,361,"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown ",,,948.0,7565.59,33 RC,361,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown ",,,948.0,6212.0,9 RC,361,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous ",,,948.0,6212.0,21 RC,361,"Arterial puncture, withdrawal of blood for diagnosis ",,,223.51,6212.0,16 RC,361,"Arteriovenous anastomosis, open; by forearm vein transposition ",,,2036.11,12562.0,28 RC,361,"Arteriovenous anastomosis, open; by forearm vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition ",,,2036.11,12562.0,28 RC,361,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition ",,,2036.11,12562.0,28 RC,361,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) ",,,1174.13,12562.0,28 RC,361,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,361,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,361,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,361,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,361,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,361,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,361,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,361,Artificial insemination; intra-cervical ,,,315.3,5841.0,16 RC,361,Artificial insemination; intra-uterine ,,,333.49,5841.0,16 RC,361,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,32 RC,361,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,32 RC,361,Aspiration of bladder; by needle ,,,38.37,3244.0,32 RC,361,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,32 RC,361,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,32 RC,361,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,27 RC,361,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,361,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,361,Axillary lymphadenectomy; complete ,,,948.0,13196.03,32 RC,361,Axillary lymphadenectomy; superficial ,,,948.0,13196.03,32 RC,361,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,361,BIOPSY OF STOMACH ,,,3390.0,5841.0,2 RC,361,BIOPSY OF THROAT ,,,3390.0,5841.0,2 RC,361,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,361,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,361,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,948.0,13835.0,15 RC,361,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,361,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,948.0,22352.23,15 RC,361,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,948.0,17385.04,17 RC,361,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,948.0,28561.16,51 RC,361,"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein ",,,948.0,16207.0,17 RC,361,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,948.0,18626.9,17 RC,361,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,948.0,17224.05,17 RC,361,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,948.0,16207.0,17 RC,361,"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each d",,,948.0,5841.0,20 RC,361,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,948.0,5841.0,20 RC,361,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,948.0,29900.51,17 RC,361,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,948.0,24971.42,17 RC,361,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,948.0,27115.97,17 RC,361,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,948.0,16944.28,17 RC,361,"Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure) ",,,948.0,13835.0,17 RC,361,"Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) ",,,948.0,8488.5,32 RC,361,"Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple ",,,948.0,12562.0,32 RC,361,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent ",,,948.0,15059.0,32 RC,361,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent ",,,948.0,12562.0,32 RC,361,"Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi ",,,948.0,13196.03,32 RC,361,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,948.0,12562.0,32 RC,361,Biopsy external auditory canal ,,,99.71,13835.0,20 RC,361,Biopsy external ear ,,,57.56,5841.0,19 RC,361,"Biopsy of anorectal wall, anal approach (eg, congenital megacolon) ",,,948.0,6399.61,32 RC,361,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,32 RC,361,Biopsy of conjunctiva ,,,113.96,12562.0,32 RC,361,Biopsy of cornea ,,,733.22,5283.1,32 RC,361,"Biopsy of epididymis, needle ",,,510.77,3747.2,32 RC,361,Biopsy of extraocular muscle ,,,948.0,8536.87,32 RC,361,Biopsy of floor of mouth ,,,110.18,3128.0,32 RC,361,"Biopsy of intestine by capsule, tube, peroral (1 or more specimens) ",,,351.7,3128.0,32 RC,361,Biopsy of lacrimal gland ,,,733.22,5571.0,32 RC,361,Biopsy of lacrimal sac ,,,733.22,5571.0,32 RC,361,Biopsy of lip ,,,67.44,5841.0,19 RC,361,"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Biopsy of liver, wedge ",,,948.0,16207.0,17 RC,361,Biopsy of nerve ,,,692.94,5571.0,32 RC,361,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,948.0,12562.0,32 RC,361,"Biopsy of palate, uvula ",,,703.52,3128.0,29 RC,361,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,948.0,16207.0,17 RC,361,"Biopsy of pancreas, percutaneous needle ",,,510.77,3747.2,32 RC,361,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,32 RC,361,Biopsy of penis; deep structures ,,,855.96,6330.57,32 RC,361,Biopsy of salivary gland; incisional ,,,441.67,5571.0,32 RC,361,Biopsy of salivary gland; needle ,,,60.46,3128.0,32 RC,361,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,32 RC,361,"Biopsy of stomach, by laparotomy ",,,948.0,13835.0,17 RC,361,"Biopsy of testis, incisional (separate procedure) ",,,948.0,8240.61,32 RC,361,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,32 RC,361,Biopsy of tongue; anterior two-thirds ,,,116.86,3128.0,32 RC,361,Biopsy of tongue; posterior one-third ,,,115.11,3755.0,32 RC,361,Biopsy of urethra ,,,685.44,5571.0,32 RC,361,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,948.0,6819.81,32 RC,361,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,32 RC,361,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,31 RC,361,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary) ",,,510.77,3747.2,32 RC,361,"Biopsy or excision of lymph node(s); open, deep axillary node(s) ",,,1011.84,8270.67,27 RC,361,"Biopsy or excision of lymph node(s); open, deep axillary node(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Biopsy or excision of lymph node(s); open, deep cervical node(s) ",,,1011.84,8270.67,27 RC,361,"Biopsy or excision of lymph node(s); open, deep cervical node(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad ",,,1011.84,8270.67,27 RC,361,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s) ",,,948.0,13835.0,28 RC,361,"Biopsy or excision of lymph node(s); open, internal mammary node(s) ",,,948.0,8270.67,32 RC,361,"Biopsy or excision of lymph node(s); open, superficial ",,,948.0,8270.67,32 RC,361,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,32 RC,361,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,3747.2,32 RC,361,"Biopsy, prostate, any approach, nonimaging-guided ",,,948.0,4836.33,32 RC,361,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,948.0,3083.0,17 RC,361,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,948.0,14954.75,22 RC,361,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,948.0,14954.75,22 RC,361,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,361,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,9 RC,361,"Biopsy, vestibule of mouth ",,,113.09,5841.0,31 RC,361,"Biopsy; nasopharynx, survey for unknown primary lesion ",,,930.95,7150.66,32 RC,361,"Biopsy; nasopharynx, visible lesion, simple ",,,930.95,7150.66,32 RC,361,Biopsy; oropharynx ,,,89.82,13835.0,32 RC,361,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,19 RC,361,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,31 RC,361,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,31 RC,361,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,361,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,361,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,361,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,361,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,361,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic ",,,786.51,13835.0,16 RC,361,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous ",,,592.85,13835.0,20 RC,361,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,361,Bone marrow harvesting for transplantation; allogeneic ,,,592.85,13835.0,32 RC,361,Bone marrow harvesting for transplantation; autologous ,,,948.0,15059.0,32 RC,361,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,361,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,361,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,361,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,361,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,361,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,361,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,361,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,361,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,361,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,361,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,361,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,361,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,361,Bundle of His recording ,,,3673.0,43890.0,22 RC,361,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,948.0,16207.0,17 RC,361,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,948.0,16207.0,17 RC,361,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,948.0,16207.0,17 RC,361,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,948.0,16207.0,17 RC,361,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,948.0,16868.07,17 RC,361,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,948.0,16207.0,17 RC,361,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,948.0,16207.0,17 RC,361,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,948.0,16207.0,17 RC,361,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,948.0,16207.0,17 RC,361,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,361,CHANGE BILE DUCT CATHETER ,,,3390.0,5841.0,2 RC,361,CHANGE IV CATH AT THROMB TX ,,,3390.0,5841.0,2 RC,361,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,361,"CHANGE OF GASTROSTOMY TUBE, PERCUTANEOUS, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE ",,,2358.0,5841.0,2 RC,361,CIRCUMCISION ,,,3390.0,5841.0,2 RC,361,COLLECT BLOOD VENOUS DEVICE ,,,3390.0,5841.0,2 RC,361,COLONOSCOPY LESION REMOVAL ,,,3390.0,5841.0,2 RC,361,COLONOSCOPY W/STENT ,,,3390.0,5841.0,4 RC,361,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,361,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,361,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,361,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,361,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,361,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,361,CREATE SALIVARY CYST DRAIN ,,,3390.0,5841.0,4 RC,361,CRYOTHERAPY OF RECTAL LESION ,,,3390.0,5841.0,4 RC,361,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,361,"Cannulation, thoracic duct ",,,948.0,5841.0,8 RC,361,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,32 RC,361,Canthotomy (separate procedure) ,,,733.22,5571.0,32 RC,361,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,361,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,361,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,361,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,361,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,361,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,361,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,361,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,361,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,948.0,5841.0,20 RC,361,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,361,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,361,"Catheterization of umbilical vein for diagnosis or therapy, newborn ",,,948.0,5841.0,8 RC,361,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,600.2,3390.0,23 RC,361,"Catheterization, umbilical artery, newborn, for diagnosis or therapy ",,,654.37,16207.0,18 RC,361,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,31 RC,361,Cautery of cervix; electro or thermal ,,,83.14,13835.0,32 RC,361,Cautery of cervix; laser ablation ,,,948.0,6819.81,32 RC,361,"Cerclage of cervix, during pregnancy; abdominal ",,,948.0,16207.0,29 RC,361,"Cerclage of cervix, during pregnancy; vaginal ",,,948.0,6819.81,32 RC,361,"Cerclage of uterine cervix, nonobstetrical ",,,948.0,6819.81,29 RC,361,Cervical lymphadenectomy (complete) ,,,948.0,22210.08,29 RC,361,Cervical lymphadenectomy (modified radical neck dissection) ,,,948.0,17660.58,29 RC,361,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,948.0,13835.0,15 RC,361,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,948.0,15889.05,12 RC,361,Cesarean delivery only; ,,,948.0,13835.0,15 RC,361,Cesarean delivery only; including postpartum care ,,,948.0,15427.0,24 RC,361,Change of cystostomy tube; complicated ,,,250.06,3390.0,32 RC,361,Change of cystostomy tube; simple ,,,54.36,5841.0,31 RC,361,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,361,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,361,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,361,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,31 RC,361,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,31 RC,361,Chemodenervation of extraocular muscle ,,,107.27,5841.0,31 RC,361,Chemodenervation of internal anal sphincter ,,,450.72,3128.0,32 RC,361,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,32 RC,361,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,31 RC,361,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,31 RC,361,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,32 RC,361,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,32 RC,361,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,32 RC,361,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,31 RC,361,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,32 RC,361,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,32 RC,361,"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous ",,,948.0,3390.0,6 RC,361,"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day ",,,948.0,3390.0,6 RC,361,"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage) ",,,948.0,3390.0,6 RC,361,Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration ,,,948.0,3390.0,6 RC,361,Cholecystectomy with exploration of common duct; ,,,948.0,16207.0,29 RC,361,Cholecystectomy with exploration of common duct; with choledochoenterostomy ,,,948.0,16207.0,29 RC,361,"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography ",,,948.0,16774.82,29 RC,361,Cholecystectomy; ,,,2996.0,16207.0,24 RC,361,Cholecystectomy; High Cost Surgery,,,2369.0,2369.0,5 RC,361,Cholecystectomy; with cholangiography ,,,3293.0,16207.0,24 RC,361,Cholecystectomy; with cholangiography High Cost Surgery,,,2369.0,2369.0,5 RC,361,Cholecystoenterostomy; Roux-en-Y ,,,948.0,16207.0,17 RC,361,Cholecystoenterostomy; Roux-en-Y with gastroenterostomy ,,,948.0,18126.75,17 RC,361,Cholecystoenterostomy; direct ,,,948.0,16207.0,17 RC,361,Cholecystoenterostomy; with gastroenterostomy ,,,948.0,16677.33,17 RC,361,"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure) ",,,948.0,16207.0,17 RC,361,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16829.85,17 RC,361,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty ",,,948.0,16486.58,17 RC,361,"Chorionic villus sampling, any method ",,,52.32,3244.0,20 RC,361,"Chromotubation of oviduct, including materials ",,,948.0,12562.0,29 RC,361,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,32 RC,361,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,32 RC,361,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,32 RC,361,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,32 RC,361,Ciliary body destruction; diathermy ,,,892.44,5519.68,32 RC,361,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,32 RC,361,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,32 RC,361,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,32 RC,361,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,32 RC,361,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,32 RC,361,Clitoroplasty for intersex state ,,,948.0,13835.0,20 RC,361,Closure of anal fistula with rectal advancement flap ,,,948.0,8234.0,32 RC,361,Closure of cystostomy (separate procedure) ,,,948.0,8240.61,32 RC,361,Closure of enteroenteric or enterocolic fistula ,,,948.0,17745.37,17 RC,361,"Closure of enterostomy, large or small intestine; ",,,948.0,16207.0,17 RC,361,"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal ",,,948.0,16207.0,17 RC,361,"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure) ",,,948.0,19678.01,17 RC,361,Closure of enterovesical fistula; with intestine and/or bladder resection ,,,948.0,19063.43,17 RC,361,Closure of enterovesical fistula; without intestinal or bladder resection ,,,948.0,16401.79,17 RC,361,Closure of esophagostomy or fistula; cervical approach ,,,948.0,13835.0,29 RC,361,Closure of esophagostomy or fistula; transthoracic or transabdominal approach ,,,948.0,17647.88,17 RC,361,Closure of gastrocolic fistula ,,,948.0,19572.05,17 RC,361,"Closure of gastrostomy, surgical ",,,948.0,8187.49,32 RC,361,Closure of intestinal cutaneous fistula ,,,948.0,17228.28,17 RC,361,"Closure of laceration, vestibule of mouth; 2.5 cm or less ",,,91.96,5841.0,19 RC,361,"Closure of laceration, vestibule of mouth; over 2.5 cm or complex ",,,196.58,3128.0,32 RC,361,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,32 RC,361,Closure of nephrocutaneous or pyelocutaneous fistula ,,,948.0,14240.3,29 RC,361,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,948.0,18071.71,17 RC,361,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,948.0,19372.84,17 RC,361,Closure of rectourethral fistula; ,,,948.0,16207.0,17 RC,361,Closure of rectourethral fistula; with colostomy ,,,948.0,18834.58,17 RC,361,Closure of rectovaginal fistula; abdominal approach ,,,948.0,16207.0,29 RC,361,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,948.0,16207.0,17 RC,361,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,948.0,13835.0,17 RC,361,Closure of rectovaginal fistula; vaginal or transanal approach ,,,948.0,12562.0,32 RC,361,Closure of rectovesical fistula; ,,,948.0,16207.0,17 RC,361,Closure of rectovesical fistula; with colostomy ,,,948.0,18037.72,17 RC,361,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,31 RC,361,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,31 RC,361,Closure of ureterocutaneous fistula ,,,948.0,16207.0,17 RC,361,Closure of ureterovisceral fistula (including visceral repair) ,,,948.0,16207.0,17 RC,361,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,948.0,11552.32,32 RC,361,Closure of urethrovaginal fistula; ,,,948.0,18300.83,32 RC,361,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,948.0,13835.0,29 RC,361,Closure of vesicouterine fistula; ,,,948.0,13835.0,29 RC,361,Closure of vesicouterine fistula; with hysterectomy ,,,948.0,16207.0,17 RC,361,"Closure of vesicovaginal fistula, abdominal approach ",,,948.0,13835.0,29 RC,361,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,948.0,18300.83,17 RC,361,Closure of vesicovaginal fistula; vaginal approach ,,,948.0,12562.0,32 RC,361,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,32 RC,361,Closure salivary fistula ,,,930.95,7150.66,32 RC,361,"Closure, exstrophy of bladder ",,,948.0,20139.94,17 RC,361,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,28 RC,361,"Cochlear device implantation, with or without mastoidectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,948.0,16207.0,17 RC,361,"Colectomy, partial; abdominal and transanal approach ",,,948.0,23882.21,17 RC,361,"Colectomy, partial; with anastomosis ",,,948.0,16495.05,17 RC,361,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis) ",,,948.0,20364.56,17 RC,361,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy ",,,948.0,26005.59,17 RC,361,"Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) ",,,948.0,20457.81,17 RC,361,"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula ",,,948.0,21758.94,17 RC,361,"Colectomy, partial; with skin level cecostomy or colostomy ",,,948.0,22428.55,17 RC,361,"Colectomy, total, abdominal, with proctectomy; with continent ileostomy ",,,948.0,28196.72,17 RC,361,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,27671.16,17 RC,361,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed ",,,948.0,26954.98,17 RC,361,"Colectomy, total, abdominal, with proctectomy; with ileostomy ",,,948.0,25492.74,17 RC,361,"Colectomy, total, abdominal, without proctectomy; with continent ileostomy ",,,948.0,26556.55,17 RC,361,"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy ",,,948.0,22924.36,17 RC,361,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,361,Collection of blood specimen from a completely implantable venous access device ,,,948.0,6212.0,11 RC,361,"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified ",,,948.0,6212.0,11 RC,361,"Collection of capillary blood specimen (eg, finger, heel, ear stick) ",,,948.0,948.0,5 RC,361,Collection of venous blood by venipuncture ,,,948.0,948.0,5 RC,361,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,361,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,32 RC,361,"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,29 RC,361,"Colonoscopy through stoma; with biopsy, single or multiple ",,,450.72,3128.0,32 RC,361,"Colonoscopy through stoma; with control of bleeding, any method ",,,450.72,3128.0,32 RC,361,"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,8234.0,32 RC,361,"Colonoscopy through stoma; with directed submucosal injection(s), any substance ",,,450.72,8234.0,32 RC,361,Colonoscopy through stoma; with endoscopic mucosal resection ,,,450.72,8234.0,32 RC,361,"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,29 RC,361,"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures ",,,450.72,8234.0,32 RC,361,Colonoscopy through stoma; with removal of foreign body(s) ,,,344.93,3128.0,32 RC,361,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3128.0,32 RC,361,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,32 RC,361,Colonoscopy through stoma; with transendoscopic balloon dilation ,,,450.72,8234.0,32 RC,361,"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descendi",,,450.72,8234.0,32 RC,361,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3755.0,32 RC,361,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,32 RC,361,"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,32 RC,361,"Colonoscopy, flexible; with biopsy, single or multiple ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with control of bleeding, any method ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,450.72,8234.0,32 RC,361,"Colonoscopy, flexible; with directed submucosal injection(s), any substance ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,32 RC,361,"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,32 RC,361,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with removal of foreign body(s) ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3755.0,32 RC,361,"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, desc",,,450.72,3755.0,32 RC,361,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,26 RC,361,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,26 RC,361,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,23 RC,361,Colostomy or skin level cecostomy; ,,,948.0,16207.0,17 RC,361,"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure) ",,,948.0,16207.0,17 RC,361,"Colotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,361,Colpocentesis (separate procedure) ,,,948.0,11661.3,32 RC,361,Colpocleisis (Le Fort type) ,,,948.0,13835.0,32 RC,361,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,948.0,6819.81,32 RC,361,"Colpopexy, abdominal approach ",,,948.0,13835.0,29 RC,361,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,948.0,18300.83,29 RC,361,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,948.0,18300.83,29 RC,361,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,361,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,948.0,6819.81,32 RC,361,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,31 RC,361,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,31 RC,361,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,31 RC,361,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,31 RC,361,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,32 RC,361,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,32 RC,361,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,31 RC,361,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,32 RC,361,Colposcopy of the vulva; ,,,57.86,5841.0,31 RC,361,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,31 RC,361,Colpotomy; with drainage of pelvic abscess ,,,948.0,6819.81,32 RC,361,Colpotomy; with exploration ,,,948.0,6819.81,32 RC,361,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,948.0,13394.0,32 RC,361,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,948.0,12909.0,32 RC,361,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,361,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,361,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,361,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,361,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,32 RC,361,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,32 RC,361,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,32 RC,361,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,32 RC,361,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,283.62,5841.0,16 RC,361,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,361,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,361,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,361,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,361,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,361,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,361,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,948.0,5841.0,8 RC,361,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,948.0,6819.81,32 RC,361,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,948.0,6819.81,32 RC,361,Conjunctival flap; bridge or partial (separate procedure) ,,,948.0,8536.87,32 RC,361,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,32 RC,361,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,32 RC,361,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,948.0,8536.87,32 RC,361,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,948.0,8536.87,32 RC,361,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,32 RC,361,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,948.0,8536.87,32 RC,361,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,948.0,8536.87,32 RC,361,Construction of artificial vagina; with graft ,,,948.0,13835.0,29 RC,361,Construction of artificial vagina; without graft ,,,948.0,13394.0,32 RC,361,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,32 RC,361,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,32 RC,361,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,361,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,948.0,20377.26,17 RC,361,Continent ileostomy (Kock procedure) (separate procedure) ,,,948.0,17410.56,17 RC,361,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,361,"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report ",,,83.43,6212.0,32 RC,361,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization ",,,948.0,16207.0,17 RC,361,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery ",,,91.96,5841.0,31 RC,361,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention ",,,930.95,12562.0,32 RC,361,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization ",,,948.0,16207.0,17 RC,361,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple ",,,196.58,5841.0,31 RC,361,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention ",,,930.95,7150.66,32 RC,361,"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), ",,,948.0,15059.0,32 RC,361,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,361,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,32 RC,361,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,361,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,361,"Cordocentesis (intrauterine), any method ",,,554.98,5841.0,16 RC,361,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,32 RC,361,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,32 RC,361,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,948.0,16207.0,17 RC,361,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,948.0,8240.61,32 RC,361,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,948.0,8234.0,32 RC,361,"Correction of everted punctum, cautery ",,,113.7,5841.0,31 RC,361,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,32 RC,361,Correction of lid retraction ,,,733.22,12562.0,32 RC,361,"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure) ",,,948.0,18393.82,29 RC,361,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,19 RC,361,"Correction of trichiasis; epilation, by forceps only ",,,223.51,5841.0,16 RC,361,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,32 RC,361,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,32 RC,361,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,948.0,5841.0,8 RC,361,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,948.0,16330.72,17 RC,361,Craniectomy for craniosynostosis; multiple cranial sutures ,,,948.0,18444.62,17 RC,361,Craniectomy for craniosynostosis; single cranial suture ,,,948.0,16207.0,17 RC,361,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,948.0,46759.99,17 RC,361,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,948.0,34350.61,17 RC,361,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,948.0,36766.35,17 RC,361,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,948.0,39720.34,17 RC,361,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,948.0,22576.85,17 RC,361,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,948.0,25611.4,17 RC,361,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,948.0,25806.38,17 RC,361,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,948.0,24598.51,17 RC,361,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,948.0,19402.47,17 RC,361,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,948.0,29586.87,17 RC,361,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,948.0,29561.46,17 RC,361,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,948.0,26149.65,17 RC,361,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,948.0,23547.4,17 RC,361,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,948.0,24861.23,17 RC,361,"Craniectomy or craniotomy, exploratory; supratentorial ",,,948.0,20406.89,17 RC,361,Craniectomy or craniotomy; with excision of foreign body from brain ,,,948.0,23106.64,17 RC,361,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,948.0,24297.57,17 RC,361,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,948.0,41508.92,17 RC,361,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,948.0,38601.49,17 RC,361,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,948.0,26679.44,17 RC,361,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,948.0,25797.91,17 RC,361,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,948.0,27154.19,17 RC,361,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,948.0,24954.48,17 RC,361,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,948.0,26158.12,17 RC,361,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,948.0,23733.91,17 RC,361,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,948.0,23716.98,17 RC,361,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,948.0,27162.66,17 RC,361,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,948.0,31706.02,17 RC,361,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,948.0,23081.23,17 RC,361,Craniectomy; for osteomyelitis ,,,948.0,16207.0,17 RC,361,Craniectomy; with excision of tumor or other bone lesion of skull ,,,948.0,16194.11,29 RC,361,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,948.0,29832.65,17 RC,361,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,948.0,32278.14,17 RC,361,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,948.0,37546.15,17 RC,361,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,948.0,35702.54,17 RC,361,Cranioplasty for skull defect with reparative brain surgery ,,,948.0,17389.28,17 RC,361,Cranioplasty for skull defect; larger than 5 cm diameter ,,,948.0,16207.0,17 RC,361,Cranioplasty for skull defect; up to 5 cm diameter ,,,948.0,16207.0,17 RC,361,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,948.0,17787.71,17 RC,361,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,948.0,16207.0,17 RC,361,Craniotomy for craniosynostosis; bifrontal bone flap ,,,948.0,20945.15,17 RC,361,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,948.0,21263.02,17 RC,361,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,948.0,28586.68,17 RC,361,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,948.0,19673.77,17 RC,361,"Craniotomy for repair of encephalocele, skull base ",,,948.0,19381.3,17 RC,361,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,948.0,31883.95,17 RC,361,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,948.0,39423.75,17 RC,361,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,948.0,20105.95,17 RC,361,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,948.0,23733.91,17 RC,361,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,948.0,29514.78,17 RC,361,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,948.0,26730.36,17 RC,361,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,948.0,33180.84,17 RC,361,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,948.0,30709.95,17 RC,361,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,948.0,30913.39,17 RC,361,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,948.0,26158.12,17 RC,361,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,948.0,16207.0,17 RC,361,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,948.0,27493.23,17 RC,361,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,948.0,18843.05,17 RC,361,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,948.0,26577.72,17 RC,361,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft ,,,2036.11,12547.6,28 RC,361,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) ",,,2036.11,12547.6,28 RC,361,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,948.0,15039.6,17 RC,361,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,948.0,19834.77,17 RC,361,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,32 RC,361,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,32 RC,361,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,32 RC,361,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,948.0,16207.0,17 RC,361,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,948.0,15039.6,29 RC,361,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,361,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,361,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,361,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,361,Cricopharyngeal myotomy ,,,948.0,13835.0,20 RC,361,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,361,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,948.0,24948.0,31 RC,361,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial ",,,154.64,13835.0,32 RC,361,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent ",,,948.0,3128.0,29 RC,361,"Curettage, postpartum ",,,948.0,12562.0,32 RC,361,Cutaneous appendico-vesicostomy ,,,948.0,16207.0,17 RC,361,Cutaneous vesicostomy ,,,948.0,13835.0,17 RC,361,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,948.0,28891.85,17 RC,361,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,948.0,23721.21,17 RC,361,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,26849.02,17 RC,361,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,948.0,23212.59,17 RC,361,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,25874.23,17 RC,361,"Cystectomy, complete; (separate procedure) ",,,948.0,18071.71,17 RC,361,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,22360.7,17 RC,361,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,948.0,16207.0,17 RC,361,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,948.0,16207.0,17 RC,361,"Cystectomy, partial; simple ",,,948.0,16207.0,17 RC,361,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,361,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,361,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,361,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,361,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,948.0,11552.32,32 RC,361,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,948.0,16207.0,29 RC,361,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,948.0,13835.0,29 RC,361,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,948.0,13835.0,29 RC,361,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,32 RC,361,"Cystotomy for excision, incision, or repair of ureterocele ",,,948.0,13835.0,17 RC,361,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,948.0,8240.61,32 RC,361,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,8 RC,361,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,948.0,8240.61,32 RC,361,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,32 RC,361,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,948.0,13835.0,17 RC,361,Cystotomy; for excision of bladder tumor ,,,948.0,13835.0,17 RC,361,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,948.0,8240.61,32 RC,361,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,948.0,16207.0,29 RC,361,Cystourethroscopy ,,,3390.0,5841.0,2 RC,361,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,27 RC,361,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,27 RC,361,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus High Cost Surgery",,,2369.0,2369.0,5 RC,361,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,27 RC,361,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus High Cost Surgery,,,2369.0,2369.0,5 RC,361,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,27 RC,361,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material High Cost Surgery,,,2369.0,2369.0,5 RC,361,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,32 RC,361,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,32 RC,361,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,361,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,32 RC,361,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,948.0,12562.0,32 RC,361,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,948.0,26403.19,22 RC,361,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,948.0,25988.0,34 RC,361,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,948.0,25244.72,23 RC,361,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde High Cost Surgery",,,2369.0,2369.0,5 RC,361,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,948.0,8240.61,32 RC,361,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,948.0,12562.0,29 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,27 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,361,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,32 RC,361,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,32 RC,361,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,32 RC,361,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,32 RC,361,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,32 RC,361,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,948.0,12562.0,32 RC,361,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,948.0,12562.0,32 RC,361,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,948.0,8240.61,32 RC,361,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,948.0,5571.0,32 RC,361,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,948.0,5571.0,32 RC,361,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,32 RC,361,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,27 RC,361,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,25 RC,361,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,948.0,5841.0,25 RC,361,"Cystourethroscopy, with insertion of permanent urethral stent ",,,948.0,15059.0,32 RC,361,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,361,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,26 RC,361,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,26 RC,361,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,32 RC,361,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,32 RC,361,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,948.0,15059.0,27 RC,361,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,32 RC,361,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,32 RC,361,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,948.0,8240.61,32 RC,361,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,32 RC,361,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,32 RC,361,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,948.0,8240.61,32 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,27 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,11552.32,24 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,948.0,15059.0,32 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,27 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,27 RC,361,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,948.0,11552.32,32 RC,361,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,948.0,12562.0,32 RC,361,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,948.0,8240.61,32 RC,361,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,361,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,32 RC,361,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,361,DECLOT VASCULAR DEVICE ,,,3390.0,5841.0,2 RC,361,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,361,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,361,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,361,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,361,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,361,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,6 RC,361,DILATE ESOPHAGUS ,,,3390.0,5841.0,4 RC,361,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,361,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,2 RC,361,DRAIN APP ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,361,DRAIN PANCREATIC PSEUDOCYST ,,,3390.0,5841.0,2 RC,361,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,361,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,2 RC,361,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,2 RC,361,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,361,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,361,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,948.0,8536.87,32 RC,361,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,361,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,361,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,361,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,32 RC,361,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,358.2,5841.0,16 RC,361,Declotting by thrombolytic agent of implanted vascular access device or catheter ,,,27.62,6212.0,32 RC,361,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,948.0,13835.0,29 RC,361,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,948.0,13394.0,32 RC,361,Decompression internal auditory canal ,,,948.0,13835.0,17 RC,361,"Decompression of orbit only, transcranial approach ",,,948.0,13835.0,17 RC,361,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,361,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,948.0,3083.0,17 RC,361,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,948.0,20238.53,22 RC,361,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,948.0,5446.4,22 RC,361,Decompression; plantar digital nerve ,,,692.94,5571.0,32 RC,361,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,32 RC,361,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,361,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,12562.0,32 RC,361,Deligation of ureter ,,,948.0,16207.0,17 RC,361,Delivery of placenta (separate procedure) ,,,948.0,13835.0,20 RC,361,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,361,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,31 RC,361,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,32 RC,361,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,948.0,5841.0,20 RC,361,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,32 RC,361,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,948.0,5841.0,20 RC,361,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,32 RC,361,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,32 RC,361,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,32 RC,361,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,32 RC,361,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,32 RC,361,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,32 RC,361,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,32 RC,361,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,31 RC,361,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,32 RC,361,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,32 RC,361,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,27 RC,361,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) ",,,137.5,13394.0,32 RC,361,"Destruction of lesion (except excision), dentoalveolar structures ",,,441.67,13835.0,32 RC,361,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,31 RC,361,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,32 RC,361,"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) ",,,187.2,3128.0,32 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6399.61,32 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,144.76,5841.0,31 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,78.06,5841.0,31 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,168.02,13835.0,32 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,948.0,6399.61,32 RC,361,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,948.0,6399.61,32 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,32 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,655.0,5841.0,16 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,358.2,5841.0,16 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,20 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,32 RC,361,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,32 RC,361,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,32 RC,361,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,32 RC,361,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,32 RC,361,"Destruction of lesion, palate or uvula (thermal, cryo or chemical) ",,,142.44,3128.0,32 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,27 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,27 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,361,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) High ",,,2369.0,2369.0,5 RC,361,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,26 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,27 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,27 RC,361,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ",,,948.0,15059.0,32 RC,361,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6819.81,32 RC,361,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,32 RC,361,Diagnostic bone marrow; aspiration(s) ,,,97.38,3128.0,32 RC,361,Diagnostic bone marrow; biopsy(ies) ,,,100.58,3128.0,32 RC,361,Diagnostic bone marrow; biopsy(ies) and aspiration(s) ,,,855.96,6330.57,31 RC,361,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,361,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,361,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,361,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,361,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,19 RC,361,"Dilation and catheterization of salivary duct, with or without injection ",,,59.88,5841.0,31 RC,361,Dilation and curettage of cervical stump ,,,948.0,12562.0,32 RC,361,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,948.0,6819.81,32 RC,361,Dilation of anal sphincter (separate procedure) under anesthesia other than local ,,,450.72,3128.0,32 RC,361,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,32 RC,361,"Dilation of esophagus, by unguided sound or bougie, single or multiple passes ",,,351.7,3128.0,32 RC,361,"Dilation of esophagus, over guide wire ",,,593.22,4251.7,32 RC,361,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,948.0,15059.0,62 RC,361,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,31 RC,361,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,19 RC,361,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,32 RC,361,"Dilation of lacrimal punctum, with or without irrigation ",,,745.36,5841.0,16 RC,361,Dilation of rectal stricture (separate procedure) under anesthesia other than local ,,,450.72,3128.0,32 RC,361,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,32 RC,361,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,31 RC,361,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,31 RC,361,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,31 RC,361,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,948.0,4836.33,32 RC,361,Dilation of vagina under anesthesia (other than local) ,,,948.0,6819.81,32 RC,361,Dilation salivary duct ,,,39.25,3128.0,32 RC,361,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,948.0,5841.0,20 RC,361,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,948.0,16330.72,29 RC,361,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,948.0,16207.0,17 RC,361,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,948.0,18749.79,17 RC,361,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,32 RC,361,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,31 RC,361,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,27 RC,361,"Discission of vitreous strands (without removal), pars plana approach High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,361,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,361,"Dissection, deep jugular node(s) ",,,948.0,13196.03,32 RC,361,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) ",,,2996.0,13835.0,25 RC,361,"Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach ",,,948.0,13835.0,32 RC,361,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach ",,,948.0,18033.49,17 RC,361,Division of stricture of rectum ,,,450.72,5571.0,32 RC,361,"Donor enterectomy (including cold preservation), open; from cadaver donor ",,,948.0,16207.0,17 RC,361,"Donor enterectomy (including cold preservation), open; partial, from living donor ",,,948.0,23742.38,17 RC,361,"Donor hepatectomy (including cold preservation), from cadaver donor ",,,948.0,22555.68,17 RC,361,"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) ",,,948.0,43933.13,17 RC,361,"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV) ",,,948.0,52591.78,17 RC,361,"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII) ",,,948.0,57868.37,17 RC,361,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,361,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,948.0,16207.0,17 RC,361,"Donor nephrectomy (including cold preservation); open, from living donor ",,,948.0,18414.98,17 RC,361,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,948.0,16028.88,15 RC,361,"Drainage external auditory canal, abscess ",,,154.94,5841.0,31 RC,361,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,32 RC,361,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,31 RC,361,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,29 RC,361,"Drainage of abscess of palate, uvula ",,,91.96,5841.0,31 RC,361,"Drainage of abscess, cyst, hematoma from dentoalveolar structures ",,,223.51,5841.0,28 RC,361,"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated ",,,196.58,3755.0,32 RC,361,"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple ",,,138.37,5841.0,19 RC,361,"Drainage of abscess; parotid, complicated ",,,930.95,7150.66,32 RC,361,"Drainage of abscess; parotid, simple ",,,441.67,3683.7,32 RC,361,"Drainage of abscess; submaxillary or sublingual, intraoral ",,,196.58,5841.0,31 RC,361,"Drainage of abscess; submaxillary, external ",,,196.58,5841.0,31 RC,361,Drainage of deep periurethral abscess ,,,948.0,5571.0,32 RC,361,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,948.0,16207.0,17 RC,361,Drainage of lymph node abscess or lymphadenitis; extensive ,,,855.96,6330.57,32 RC,361,Drainage of lymph node abscess or lymphadenitis; simple ,,,855.96,6330.57,32 RC,361,Drainage of ovarian abscess; abdominal approach ,,,948.0,13835.0,29 RC,361,"Drainage of ovarian abscess; vaginal approach, open ",,,948.0,12562.0,32 RC,361,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,948.0,13835.0,32 RC,361,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,948.0,12562.0,32 RC,361,Drainage of perineal urinary extravasation; complicated ,,,948.0,13835.0,17 RC,361,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,32 RC,361,"Drainage of perirenal or renal abscess, open ",,,948.0,13835.0,29 RC,361,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,948.0,19550.76,17 RC,361,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,32 RC,361,"Drainage of retroperitoneal abscess, open ",,,948.0,16207.0,17 RC,361,Drainage of scrotal wall abscess ,,,510.77,3747.2,32 RC,361,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,948.0,16207.0,17 RC,361,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic ",,,71.55,5841.0,31 RC,361,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,948.0,21996.26,17 RC,361,"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes d",,,351.7,3128.0,32 RC,361,"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture) ",,,948.0,5841.0,28 RC,361,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,361,"Duodenotomy, for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,361,"Dural graft, spinal ",,,948.0,16207.0,17 RC,361,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,466.41,13835.0,17 RC,361,EMBOLIZATION UTERINE FIBROID ,,,3390.0,5841.0,2 RC,361,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,10 RC,361,ESOPH ENDOSCOPY ABLATION ,,,3390.0,5841.0,2 RC,361,ESOPHAGUS ENDOSCOPY ,,,3390.0,5841.0,2 RC,361,EXCISION OF RECTAL LESION ,,,3390.0,5841.0,2 RC,361,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,361,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,361,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,361,Ear piercing ,,,370.1,16207.0,14 RC,361,Electroejaculation ,,,560.2,3128.0,29 RC,361,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,361,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,361,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,361,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,19 RC,361,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,361,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,948.0,5841.0,23 RC,361,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,479.41,5841.0,44 RC,361,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,948.0,5841.0,23 RC,361,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,361,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,361,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,361,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,361,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,948.0,16207.0,17 RC,361,"Elevation of depressed skull fracture; simple, extradural ",,,948.0,13835.0,17 RC,361,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,948.0,18957.47,17 RC,361,"Embryo transfer, intrauterine ",,,948.0,5841.0,28 RC,361,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,32 RC,361,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,948.0,5841.0,20 RC,361,"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and ",,,948.0,5841.0,20 RC,361,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,361,Endolymphatic sac operation; with shunt ,,,948.0,13241.95,32 RC,361,Endolymphatic sac operation; without shunt ,,,948.0,13241.95,32 RC,361,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,29 RC,361,"Endometrial ablation, thermal, without hysteroscopic guidance High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,948.0,23059.78,34 RC,361,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,31 RC,361,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,361,Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (List separately in addition to code(s) for primary procedure) ,,,948.0,15059.0,23 RC,361,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,948.0,16330.72,31 RC,361,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,361,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,32 RC,361,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); with biopsy, single or multiple ",,,344.93,3128.0,32 RC,361,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,948.0,12562.0,32 RC,361,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,948.0,8187.49,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed ",,,948.0,15059.0,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple ",,,948.0,8187.49,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) ",,,948.0,13051.67,29 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,948.0,15059.0,32 RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi ,,,948.0,8187.49,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,948.0,15059.0,32 RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) ,,,948.0,8187.49,32 RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) ,,,948.0,15059.0,32 RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy ,,,948.0,8187.49,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, ",,,948.0,15059.0,32 RC,361,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,361,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,361,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,361,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,361,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,361,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and moni",,,948.0,25767.84,48 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated ",,,948.0,15059.0,32 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separa",,,948.0,5841.0,20 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated ",,,948.0,18734.14,31 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each thro",,,948.0,5841.0,20 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated ",,,948.0,15059.0,32 RC,361,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each throu",,,948.0,5841.0,20 RC,361,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (List separately in addit",,,948.0,16207.0,17 RC,361,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering ",,,948.0,35172.75,17 RC,361,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering ",,,948.0,30231.08,17 RC,361,"Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Enterectomy, resection of small intestine; single resection and anastomosis ",,,948.0,16207.0,17 RC,361,"Enterectomy, resection of small intestine; with enterostomy ",,,948.0,16207.0,17 RC,361,"Enterocystoplasty, including intestinal anastomosis ",,,948.0,16974.03,17 RC,361,"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure) ",,,948.0,16207.0,17 RC,361,Enterolysis (freeing of intestinal adhesion) (separate procedure) ,,,948.0,16207.0,29 RC,361,"Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube) ",,,948.0,16207.0,17 RC,361,"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal ",,,948.0,16207.0,29 RC,361,"Enucleation of eye; with implant, muscles attached to implant ",,,948.0,8536.87,32 RC,361,"Enucleation of eye; with implant, muscles not attached to implant ",,,948.0,12562.0,32 RC,361,Enucleation of eye; without implant ,,,948.0,12562.0,32 RC,361,Epididymectomy; bilateral ,,,948.0,8240.61,32 RC,361,Epididymectomy; unilateral ,,,948.0,12562.0,32 RC,361,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,948.0,8240.61,29 RC,361,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,948.0,8234.0,29 RC,361,Epikeratoplasty ,,,948.0,15664.44,29 RC,361,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,29 RC,361,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,361,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,361,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,361,"Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,361,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,361,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,361,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,361,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,361,"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, w",,,2369.0,44136.57,16 RC,361,"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with ",,,2369.0,38563.39,16 RC,361,"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric dr",,,2369.0,45963.25,16 RC,361,Esophagogastric fundoplasty partial or complete; laparotomy ,,,948.0,16207.0,17 RC,361,Esophagogastric fundoplasty partial or complete; thoracotomy ,,,948.0,16207.0,17 RC,361,"Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) ",,,948.0,16681.56,17 RC,361,"Esophagogastric tamponade, with balloon (Sengstaken type) ",,,948.0,16207.0,17 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,593.22,13394.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple ",,,351.7,3755.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease ",,,948.0,12562.0,29 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon ",,,948.0,12909.0,28 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie) ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube ",,,593.22,4251.7,29 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,351.7,3755.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,593.22,12562.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed ",,,948.0,22967.79,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire ",,,351.7,3755.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy ",,,948.0,13394.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) ",,,351.7,3755.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s) ",,,948.0,13394.0,28 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) ",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,593.22,4251.7,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial ma",,,593.22,13394.0,32 RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterºs»/stentºs», when performed, and endoscopic ultrasound, when",,,948.0,8187.49,32 RC,361,"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach ",,,948.0,17147.73,17 RC,361,Esophagojejunostomy (without total gastrectomy); abdominal approach ,,,948.0,16897.71,17 RC,361,Esophagojejunostomy (without total gastrectomy); thoracic approach ,,,948.0,17207.11,17 RC,361,Esophagomyotomy (Heller type); abdominal approach ,,,948.0,16401.79,17 RC,361,Esophagomyotomy (Heller type); thoracic approach ,,,948.0,16414.49,17 RC,361,"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula ",,,948.0,16207.0,17 RC,361,"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula ",,,948.0,16207.0,17 RC,361,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula ",,,948.0,19555.0,17 RC,361,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula ",,,948.0,18190.37,17 RC,361,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula ",,,948.0,34948.13,17 RC,361,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula ",,,948.0,33617.37,17 RC,361,"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,117.44,12562.0,32 RC,361,"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple ",,,125.86,12562.0,32 RC,361,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,361,"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,361,"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,361,"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,32 RC,361,"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,32 RC,361,"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with optical endomicroscopy ",,,593.22,13394.0,32 RC,361,"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,15059.0,32 RC,361,"Esophagoscopy, flexible, transoral; with removal of foreign body(s) ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,5571.0,32 RC,361,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) ",,,593.22,4251.7,32 RC,361,"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope ",,,948.0,15059.0,32 RC,361,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) ",,,593.22,12562.0,32 RC,361,"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter) ",,,948.0,13394.0,32 RC,361,"Esophagoscopy, rigid, transoral; with biopsy, single or multiple ",,,593.22,13394.0,32 RC,361,"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance ",,,593.22,13394.0,32 RC,361,"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire ",,,948.0,13394.0,32 RC,361,"Esophagoscopy, rigid, transoral; with removal of foreign body(s) ",,,593.22,13394.0,32 RC,361,"Esophagostomy, fistulization of esophagus, external; cervical approach ",,,948.0,16207.0,17 RC,361,"Esophagostomy, fistulization of esophagus, external; thoracic approach ",,,948.0,16207.0,17 RC,361,"Esophagotomy, cervical approach, with removal of foreign body ",,,948.0,3683.7,17 RC,361,"Esophagotomy, thoracic approach, with removal of foreign body ",,,948.0,16207.0,17 RC,361,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,361,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,361,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,361,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,361,Evisceration of ocular contents; with implant ,,,948.0,12562.0,32 RC,361,Evisceration of ocular contents; without implant ,,,948.0,12562.0,32 RC,361,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,32 RC,361,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,361,"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging",,,948.0,15059.0,32 RC,361,Exchange of intraocular lens ,,,892.44,5571.0,32 RC,361,"Exchange transfusion, blood; newborn ",,,172.52,5841.0,31 RC,361,"Exchange transfusion, blood; other than newborn ",,,172.52,5841.0,31 RC,361,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,361,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,361,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,361,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,64 RC,361,Excision aural glomus tumor; extended (extratemporal) ,,,948.0,30451.46,17 RC,361,Excision aural glomus tumor; transcanal ,,,948.0,13394.0,32 RC,361,Excision aural glomus tumor; transmastoid ,,,948.0,13241.95,32 RC,361,Excision aural polyp ,,,143.6,13835.0,32 RC,361,"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ",,,930.95,12562.0,32 RC,361,"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx ",,,948.0,13394.0,32 RC,361,"Excision exostosis(es), external auditory canal ",,,948.0,13241.95,32 RC,361,Excision external ear; complete amputation ,,,948.0,13241.95,32 RC,361,"Excision external ear; partial, simple repair ",,,855.96,6330.57,32 RC,361,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies ",,,948.0,16207.0,17 RC,361,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy ",,,948.0,16207.0,17 RC,361,Excision of Bartholin's gland or cyst ,,,948.0,12562.0,32 RC,361,Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct ,,,948.0,16207.0,17 RC,361,Excision of Mullerian duct cyst ,,,948.0,8240.61,32 RC,361,Excision of ampulla of Vater ,,,948.0,16207.0,17 RC,361,"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic ",,,948.0,19126.93,17 RC,361,"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic ",,,948.0,24530.65,17 RC,361,Excision of bulbourethral gland (Cowper's gland) ,,,948.0,8240.61,32 RC,361,Excision of carotid body tumor; with excision of carotid artery ,,,948.0,20326.45,17 RC,361,Excision of carotid body tumor; without excision of carotid artery ,,,948.0,16795.98,17 RC,361,"Excision of cervical stump, abdominal approach; ",,,948.0,16207.0,17 RC,361,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,948.0,16207.0,17 RC,361,"Excision of cervical stump, vaginal approach; ",,,948.0,12562.0,32 RC,361,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,948.0,13835.0,17 RC,361,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,948.0,13394.0,32 RC,361,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,31 RC,361,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,32 RC,361,Excision of chalazion; single ,,,65.12,5841.0,31 RC,361,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,32 RC,361,Excision of choledochal cyst ,,,948.0,16300.07,17 RC,361,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,948.0,13196.03,32 RC,361,"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection ",,,948.0,14297.8,32 RC,361,"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection ",,,948.0,12562.0,32 RC,361,Excision of extraparenchymal lesion of testis ,,,948.0,8240.61,32 RC,361,"Excision of fibrous tuberosities, dentoalveolar structures ",,,948.0,13835.0,29 RC,361,"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) ",,,441.67,3683.7,32 RC,361,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,948.0,12562.0,32 RC,361,Excision of hydrocele; bilateral ,,,948.0,13394.0,32 RC,361,Excision of hydrocele; unilateral ,,,948.0,12562.0,32 RC,361,"Excision of hyperplastic alveolar mucosa, each quadrant (specify) ",,,198.25,13835.0,32 RC,361,Excision of ileoanal reservoir with ileostomy ,,,948.0,22623.54,17 RC,361,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,948.0,12562.0,32 RC,361,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,948.0,12562.0,32 RC,361,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,32 RC,361,Excision of lacrimal gland tumor; involving osteotomy ,,,948.0,12562.0,32 RC,361,Excision of lacrimal sac (dacryocystectomy) ,,,948.0,12562.0,32 RC,361,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,32 RC,361,Excision of lesion of mesentery (separate procedure) ,,,948.0,16207.0,17 RC,361,"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle ",,,930.95,7150.66,32 RC,361,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair ",,,930.95,7150.66,32 RC,361,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair ",,,172.67,13835.0,32 RC,361,"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair ",,,144.47,13835.0,32 RC,361,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,948.0,16207.0,17 RC,361,Excision of lesion of spermatic cord (separate procedure) ,,,948.0,8240.61,32 RC,361,Excision of lesion of tongue with closure; anterior two-thirds ,,,930.95,7150.66,32 RC,361,Excision of lesion of tongue with closure; posterior one-third ,,,930.95,7150.66,32 RC,361,Excision of lesion of tongue with closure; with local tongue flap ,,,930.95,7150.66,32 RC,361,Excision of lesion of tongue without closure ,,,149.42,3128.0,32 RC,361,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair ",,,948.0,13241.95,32 RC,361,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair ",,,188.37,13835.0,32 RC,361,"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair ",,,146.52,13835.0,32 RC,361,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,32 RC,361,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,32 RC,361,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,32 RC,361,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,32 RC,361,"Excision of lesion, esophagus, with primary repair; cervical approach ",,,948.0,16207.0,17 RC,361,"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach ",,,948.0,16207.0,17 RC,361,"Excision of lesion, sclera ",,,733.22,12909.0,32 RC,361,Excision of lingual frenum (frenectomy) ,,,170.34,3128.0,32 RC,361,Excision of lip; V-excision with primary direct linear closure ,,,930.95,7150.66,32 RC,361,"Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) ",,,948.0,13241.95,32 RC,361,"Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) ",,,930.95,7150.66,32 RC,361,Excision of lip; transverse wedge excision with primary closure ,,,930.95,7150.66,32 RC,361,Excision of local lesion of epididymis ,,,948.0,12562.0,32 RC,361,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,361,Excision of mucosa of vestibule of mouth as donor graft ,,,196.58,5841.0,31 RC,361,"Excision of multiple external papillae or tags, anus ",,,948.0,6399.61,32 RC,361,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,32 RC,361,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,948.0,15039.6,32 RC,361,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,32 RC,361,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,32 RC,361,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,32 RC,361,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,32 RC,361,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,32 RC,361,Excision of neuroma; sciatic nerve ,,,948.0,15039.6,32 RC,361,"Excision of osseous tuberosities, dentoalveolar structures ",,,948.0,13835.0,29 RC,361,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve ",,,948.0,13241.95,32 RC,361,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection ",,,948.0,13241.95,32 RC,361,"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve ",,,948.0,13241.95,32 RC,361,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve ",,,948.0,13241.95,32 RC,361,"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection ",,,948.0,16448.48,17 RC,361,Excision of penile plaque (Peyronie disease); ,,,948.0,9653.0,32 RC,361,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,948.0,22025.45,32 RC,361,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,948.0,11552.32,32 RC,361,Excision of perinephric cyst ,,,948.0,16207.0,17 RC,361,Excision of presacral or sacrococcygeal tumor ,,,948.0,27243.1,17 RC,361,"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach ",,,948.0,16207.0,17 RC,361,"Excision of rectal procidentia, with anastomosis; perineal approach ",,,948.0,16207.0,17 RC,361,"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach ",,,948.0,6399.61,32 RC,361,"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) ",,,948.0,15059.0,32 RC,361,"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) ",,,948.0,13394.0,32 RC,361,"Excision of single external papilla or tag, anus ",,,450.72,3128.0,32 RC,361,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,32 RC,361,Excision of sublingual gland ,,,948.0,13241.95,32 RC,361,Excision of sublingual salivary cyst (ranula) ,,,930.95,12562.0,32 RC,361,Excision of submandibular (submaxillary) gland ,,,948.0,13241.95,32 RC,361,"Excision of thrombosed hemorrhoid, external ",,,131.97,3128.0,32 RC,361,Excision of thyroglossal duct cyst or sinus; ,,,948.0,13196.03,32 RC,361,Excision of thyroglossal duct cyst or sinus; recurrent ,,,948.0,13196.03,32 RC,361,Excision of tonsil tags ,,,930.95,12562.0,32 RC,361,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,948.0,13196.03,32 RC,361,Excision of urethral diverticulum (separate procedure); female ,,,948.0,11552.32,32 RC,361,Excision of urethral diverticulum (separate procedure); male ,,,948.0,12562.0,32 RC,361,Excision of vaginal cyst or tumor ,,,948.0,6819.81,32 RC,361,Excision of vaginal septum ,,,948.0,6819.81,32 RC,361,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,948.0,8240.61,32 RC,361,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,948.0,8488.5,32 RC,361,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,948.0,13394.0,32 RC,361,"Excision or destruction lingual tonsil, any method (separate procedure) ",,,948.0,13241.95,32 RC,361,"Excision or destruction of lesion of pharynx, any method ",,,930.95,7150.66,32 RC,361,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,948.0,24038.38,11 RC,361,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,948.0,27963.63,11 RC,361,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,948.0,15741.23,11 RC,361,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,948.0,20117.01,11 RC,361,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,948.0,34471.38,11 RC,361,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,3 RC,361,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,3 RC,361,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,3 RC,361,Excision or fulguration of carcinoma of urethra ,,,948.0,8240.61,32 RC,361,Excision or fulguration; Skene's glands ,,,948.0,5571.0,32 RC,361,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,32 RC,361,"Excision or fulguration; urethral polyp(s), distal urethra ",,,948.0,5571.0,32 RC,361,Excision or fulguration; urethral prolapse ,,,948.0,5571.0,32 RC,361,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,32 RC,361,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,32 RC,361,Excision or unroofing of cyst(s) of kidney ,,,948.0,16207.0,17 RC,361,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,32 RC,361,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,948.0,30069.97,17 RC,361,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,948.0,24382.36,17 RC,361,"Excision, lesion of floor of mouth ",,,930.95,7150.66,32 RC,361,"Excision, lesion of palate, uvula; with local flap closure ",,,948.0,13241.95,32 RC,361,"Excision, lesion of palate, uvula; with simple primary closure ",,,155.23,3755.0,32 RC,361,"Excision, lesion of palate, uvula; without closure ",,,133.14,3755.0,32 RC,361,"Excision, local; malignant tumor of stomach ",,,948.0,16207.0,17 RC,361,"Excision, local; ulcer or benign tumor of stomach ",,,948.0,16207.0,17 RC,361,"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum) ",,,948.0,16207.0,17 RC,361,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,948.0,13394.0,32 RC,361,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,948.0,12909.0,32 RC,361,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,948.0,12909.0,32 RC,361,"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography ",,,948.0,16207.0,17 RC,361,Exploration for undescended testis (inguinal or scrotal area) ,,,948.0,8488.5,32 RC,361,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,32 RC,361,"Exploration of epididymis, with or without biopsy ",,,948.0,8240.61,32 RC,361,"Exploration of orbit (transcranial approach), with removal of lesion ",,,948.0,25276.59,17 RC,361,"Exploration, repair, and presacral drainage for rectal injury; ",,,948.0,16207.0,17 RC,361,"Exploration, repair, and presacral drainage for rectal injury; with colostomy ",,,948.0,20228.96,17 RC,361,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,948.0,16207.0,29 RC,361,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,948.0,13835.0,29 RC,361,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,948.0,25988.0,34 RC,361,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,25988.0,19 RC,361,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,25988.0,19 RC,361,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,19 RC,361,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,948.0,23428.74,17 RC,361,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,948.0,28192.48,17 RC,361,External cannula declotting (separate procedure); with balloon catheter ,,,2699.0,12562.0,28 RC,361,External cannula declotting (separate procedure); with balloon catheter High Cost Surgery,,,2369.0,2369.0,5 RC,361,External cannula declotting (separate procedure); without balloon catheter ,,,468.58,6212.0,28 RC,361,External cannula declotting (separate procedure); without balloon catheter High Cost Surgery,,,2369.0,2369.0,5 RC,361,"External cephalic version, with or without tocolysis ",,,948.0,6819.81,17 RC,361,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,361,"External drainage, pseudocyst of pancreas, open ",,,948.0,16207.0,17 RC,361,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,948.0,15059.0,31 RC,361,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,948.0,11603.86,31 RC,361,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,32 RC,361,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,15059.0,94 RC,361,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,361,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space ",,,441.67,3683.7,32 RC,361,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual ",,,196.58,5841.0,31 RC,361,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular ",,,930.95,7150.66,32 RC,361,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental ",,,948.0,13241.95,32 RC,361,"FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE) ",,,2431.0,2979.0,3 RC,361,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,361,FUSE PANCREAS AND BOWEL ,,,3390.0,5841.0,2 RC,361,FUSION OF BILE DUCT CYST ,,,3390.0,5841.0,4 RC,361,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,361,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,361,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,361,Fetal contraction stress test ,,,28.49,5841.0,14 RC,361,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,31 RC,361,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,399.9,16207.0,14 RC,361,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,482.53,5841.0,13 RC,361,Fetal non-stress test ,,,16.57,5841.0,11 RC,361,Fetal scalp blood sampling ,,,554.98,5841.0,16 RC,361,"Fetal shunt placement, including ultrasound guidance ",,,554.98,5841.0,28 RC,361,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,361,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,361,Fimbrioplasty ,,,948.0,13835.0,29 RC,361,Fine needle aspiration of orbital contents ,,,733.22,5571.0,32 RC,361,"Fissurectomy, including sphincterotomy, when performed ",,,948.0,6399.61,32 RC,361,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,32 RC,361,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,948.0,10424.04,32 RC,361,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,32 RC,361,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,32 RC,361,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,948.0,10424.04,32 RC,361,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,19 RC,361,Fixation of contralateral testis (separate procedure) ,,,948.0,12562.0,32 RC,361,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,361,"Follicle puncture for oocyte retrieval, any method ",,,948.0,3128.0,29 RC,361,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,31 RC,361,Free jejunum transfer with microvascular anastomosis ,,,948.0,26721.9,17 RC,361,Free omental flap with microvascular anastomosis ,,,948.0,19868.64,17 RC,361,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty) ",,,930.95,9653.0,32 RC,361,Frenulotomy of penis ,,,685.44,5571.0,32 RC,361,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,361,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,554.98,5841.0,28 RC,361,"Gastrectomy, partial, distal; with Roux-en-Y reconstruction ",,,948.0,23653.36,17 RC,361,"Gastrectomy, partial, distal; with formation of intestinal pouch ",,,948.0,26056.4,17 RC,361,"Gastrectomy, partial, distal; with gastroduodenostomy ",,,948.0,17838.63,17 RC,361,"Gastrectomy, partial, distal; with gastrojejunostomy ",,,948.0,25039.27,17 RC,361,"Gastrectomy, total; with Roux-en-Y reconstruction ",,,948.0,27967.87,17 RC,361,"Gastrectomy, total; with esophagoenterostomy ",,,948.0,24157.74,17 RC,361,"Gastrectomy, total; with formation of intestinal pouch, any type ",,,948.0,28395.93,17 RC,361,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed ",,,518.85,5841.0,28 RC,361,"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pent",,,283.62,5841.0,28 RC,361,"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) ",,,518.85,5841.0,28 RC,361,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,361,"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal",,,948.0,23945.83,14 RC,361,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,361,"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ",,,948.0,8128.0,29 RC,361,"Gastric restrictive procedure, open; removal of subcutaneous port component only ",,,744.46,4430.08,29 RC,361,"Gastric restrictive procedure, open; revision of subcutaneous port component only ",,,948.0,8128.0,29 RC,361,"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed ",,,948.0,29647.99,22 RC,361,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy ",,,948.0,19923.79,14 RC,361,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption ",,,948.0,22081.05,14 RC,361,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty ",,,948.0,15511.79,11 RC,361,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty ",,,948.0,16207.0,14 RC,361,Gastroduodenostomy ,,,948.0,16207.0,17 RC,361,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstructi",,,948.0,33197.77,17 RC,361,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty ",,,948.0,27645.76,17 RC,361,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,361,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,361,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,361,"Gastrojejunostomy; with vagotomy, any type ",,,948.0,16207.0,17 RC,361,Gastrojejunostomy; without vagotomy ,,,948.0,16516.21,17 RC,361,"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury ",,,948.0,16715.43,17 RC,361,"Gastrostomy, open; neonatal, for feeding ",,,948.0,13835.0,17 RC,361,"Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) ",,,948.0,16207.0,17 RC,361,"Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,948.0,13835.0,17 RC,361,"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin) ",,,948.0,13835.0,17 RC,361,Gastrotomy; with exploration or foreign body removal ,,,948.0,16207.0,17 RC,361,Gastrotomy; with suture repair of bleeding ulcer ,,,948.0,16545.97,17 RC,361,"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) ",,,948.0,18648.07,17 RC,361,"Gingivectomy, excision gingiva, each quadrant ",,,930.95,15108.46,32 RC,361,"Gingivoplasty, each quadrant (specify) ",,,304.35,13835.0,20 RC,361,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,361,"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection ",,,948.0,33829.29,17 RC,361,"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection ",,,948.0,26704.84,17 RC,361,"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection ",,,948.0,26920.99,17 RC,361,"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type) ",,,948.0,36969.79,17 RC,361,"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection ",,,948.0,29179.97,17 RC,361,Glossectomy; hemiglossectomy ,,,948.0,16207.0,17 RC,361,Glossectomy; less than one-half tongue ,,,948.0,13394.0,32 RC,361,"Glossectomy; partial, with unilateral radical neck dissection ",,,948.0,26666.74,17 RC,361,Goniotomy ,,,948.0,10424.04,32 RC,361,Graft (Thiersch operation) for rectal incontinence and/or prolapse ,,,948.0,12562.0,32 RC,361,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,361,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,361,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,361,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,361,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,361,HIntroduction of needle or intracatheter; retrograde brachial artery ,,,2358.0,5841.0,2 RC,361,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,361,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,361,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,361,HTherapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion ,,,6326.0,8104.0,3 RC,361,"Harvesting conjunctival allograft, living donor ",,,948.0,5571.0,29 RC,361,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,361,Hematopoietic progenitor cell (HPC); HPC boost ,,,592.85,9577.36,32 RC,361,Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor ,,,948.0,102199.95,29 RC,361,Hematopoietic progenitor cell (HPC); autologous transplantation ,,,592.85,13835.0,32 RC,361,"Hemorrhoidectomy, external, 2 or more columns/groups ",,,948.0,12562.0,32 RC,361,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; ",,,948.0,12562.0,32 RC,361,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy ",,,948.0,8234.0,32 RC,361,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed ",,,948.0,8234.0,32 RC,361,"Hemorrhoidectomy, internal and external, single column/group; ",,,948.0,12562.0,32 RC,361,"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy ",,,948.0,12562.0,32 RC,361,"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed ",,,948.0,12562.0,32 RC,361,"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance ",,,948.0,6399.61,32 RC,361,"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance ",,,948.0,15754.86,32 RC,361,"Hemorrhoidectomy, internal, by rubber band ligation(s) ",,,171.8,3128.0,32 RC,361,"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed ",,,948.0,12909.0,31 RC,361,"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling ",,,948.0,12909.0,29 RC,361,"Hepatectomy, resection of liver; partial lobectomy ",,,948.0,28730.74,17 RC,361,"Hepatectomy, resection of liver; total left lobectomy ",,,948.0,37948.81,17 RC,361,"Hepatectomy, resection of liver; total right lobectomy ",,,948.0,40771.45,17 RC,361,"Hepatectomy, resection of liver; trisegmentectomy ",,,948.0,42242.16,17 RC,361,"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus ",,,948.0,26539.62,17 RC,361,"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages ",,,948.0,16207.0,17 RC,361,Hip core decompression ,,,9913.14,12713.03,5 RC,361,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,361,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,361,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,361,"Hymenotomy, simple incision ",,,948.0,6819.81,32 RC,361,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,948.0,19432.11,17 RC,361,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,948.0,16207.0,29 RC,361,Hysterorrhaphy of ruptured uterus ,,,948.0,13835.0,15 RC,361,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,948.0,16207.0,29 RC,361,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,6819.81,15 RC,361,"Hysteroscopy, diagnostic (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,15 RC,361,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,15 RC,361,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,15 RC,361,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,15 RC,361,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,15 RC,361,"Hysteroscopy, surgical; with removal of impacted foreign body High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,15 RC,361,"Hysteroscopy, surgical; with removal of leiomyomata High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,15 RC,361,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,948.0,26010.28,17 RC,361,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,361,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,361,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,361,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,361,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,361,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,361,ILEOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,361,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,361,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,361,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,2 RC,361,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,361,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,361,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,361,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,361,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,361,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,361,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,361,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,361,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,361,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,361,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,361,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,361,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,361,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,361,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,361,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,361,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,361,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,361,INJECTION FOR LIVER X-RAYS ,,,3390.0,5841.0,4 RC,361,INJECTION(S) SPIDER VEINS ,,,3390.0,5841.0,2 RC,361,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,361,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,361,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,361,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,361,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,2 RC,361,INSERT BILE DUCT DRAIN ,,,3390.0,5841.0,2 RC,361,INSERT CATHETER BILE DUCT ,,,3390.0,5841.0,2 RC,361,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,361,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,361,INSERTION OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,361,INSERTION OF CANNULA(S) ,,,5841.0,5841.0,1 RC,361,"INSERTION OF CATHETER, VEIN ",,,3390.0,5841.0,8 RC,361,INSERTION OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,361,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,361,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,361,IV US EACH ADD VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,361,IV US FIRST VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,361,"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,32 RC,361,"Ileoscopy, through stoma; with biopsy, single or multiple ",,,351.7,3128.0,32 RC,361,"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,8234.0,29 RC,361,"Ileoscopy, through stoma; with transendoscopic balloon dilation ",,,593.22,8234.0,32 RC,361,"Ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,17 RC,361,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,361,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,361,"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic ",,,948.0,16207.0,17 RC,361,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,361,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,361,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,361,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,17 RC,361,Implantation of intrastromal corneal ring segments ,,,948.0,26289.23,32 RC,361,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,27 RC,361,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,948.0,44816.88,23 RC,361,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,361,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,361,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,948.0,5841.0,20 RC,361,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,948.0,45089.88,33 RC,361,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,28 RC,361,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming High Cost Surgery",,,2369.0,2369.0,5 RC,361,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,948.0,45089.88,34 RC,361,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,948.0,12562.0,29 RC,361,"Implantation or replacement of gastric neurostimulator electrodes, antrum, open ",,,948.0,20491.68,17 RC,361,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,948.0,35621.26,31 RC,361,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,948.0,34379.68,31 RC,361,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,32488.94,32 RC,361,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,948.0,16330.72,29 RC,361,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,948.0,15039.6,32 RC,361,Incision and drainage abscess; peritonsillar ,,,91.96,5841.0,31 RC,361,"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach ",,,948.0,13241.95,32 RC,361,"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach ",,,930.95,7150.66,32 RC,361,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,31 RC,361,"Incision and drainage of appendiceal abscess, open ",,,948.0,16207.0,17 RC,361,"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess ",,,948.0,6399.61,32 RC,361,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,32 RC,361,"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia ",,,948.0,6399.61,32 RC,361,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) ,,,450.72,12562.0,32 RC,361,"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton ",,,948.0,6399.61,32 RC,361,"Incision and drainage of penis, deep ",,,510.77,8234.0,32 RC,361,"Incision and drainage of submucosal abscess, rectum ",,,450.72,3755.0,32 RC,361,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,32 RC,361,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,32 RC,361,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,32 RC,361,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,31 RC,361,"Incision and drainage, perianal abscess, superficial ",,,344.93,3128.0,32 RC,361,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,948.0,16207.0,17 RC,361,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,29 RC,361,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,32 RC,361,Incision of labial frenum (frenotomy) ,,,76.45,5841.0,31 RC,361,Incision of lingual frenum (frenotomy) ,,,441.67,3683.7,32 RC,361,"Incision of thrombosed hemorrhoid, external ",,,115.66,5841.0,31 RC,361,"Incision, anal septum (infant) ",,,948.0,13835.0,32 RC,361,"Incision, drainage of lacrimal gland ",,,948.0,3323.1,29 RC,361,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,32 RC,361,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,31 RC,361,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,361,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,361,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,361,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,361,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,29 RC,361,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,948.0,16207.0,29 RC,361,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,948.0,16207.0,29 RC,361,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,17 RC,361,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,948.0,16207.0,58 RC,361,"Induced abortion, by dilation and curettage ",,,948.0,13394.0,32 RC,361,"Induced abortion, by dilation and evacuation ",,,948.0,13394.0,32 RC,361,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,361,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,948.0,37783.59,17 RC,361,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,948.0,37372.46,17 RC,361,"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,17 RC,361,"Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) ",,,948.0,14297.8,32 RC,361,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,948.0,122851.37,22 RC,361,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,361,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,361,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,361,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,361,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,361,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,948.0,5841.0,20 RC,361,Injection of contrast medium for dacryocystography ,,,948.0,5841.0,20 RC,361,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,19 RC,361,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,31 RC,361,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal v",,,744.46,15059.0,31 RC,361,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity t",,,744.46,15059.0,31 RC,361,"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg ",,,122.09,5841.0,31 RC,361,"Injection of sclerosing solution, hemorrhoids ",,,220.64,13835.0,20 RC,361,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,27 RC,361,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,948.0,5841.0,20 RC,361,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,948.0,5841.0,8 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,361,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,361,Injection procedure for Peyronie disease; ,,,63.08,5841.0,19 RC,361,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,948.0,11552.32,32 RC,361,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,948.0,12562.0,58 RC,361,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,948.0,11410.03,29 RC,361,Injection procedure for corpora cavernosography ,,,948.0,5841.0,20 RC,361,Injection procedure for cystography or voiding urethrocystography ,,,948.0,5841.0,8 RC,361,"Injection procedure for discography, each level; cervical or thoracic ",,,948.0,5841.0,20 RC,361,"Injection procedure for discography, each level; lumbar ",,,948.0,5841.0,20 RC,361,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,948.0,16207.0,17 RC,361,"Injection procedure for myelography and/or computed tomography, lumbar ",,,948.0,5841.0,20 RC,361,Injection procedure for retrograde urethrocystography ,,,948.0,5841.0,8 RC,361,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,361,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,361,Injection procedure for sialography ,,,948.0,5841.0,20 RC,361,Injection procedure for splenoportography ,,,948.0,5841.0,20 RC,361,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,948.0,5841.0,20 RC,361,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,948.0,5841.0,20 RC,361,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,948.0,12562.0,29 RC,361,Injection procedure; lymphangiography ,,,948.0,5841.0,20 RC,361,Injection procedure; radioactive tracer for identification of sentinel node ,,,754.67,5841.0,28 RC,361,"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk ",,,358.2,5841.0,28 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,20 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,20 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,31 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,31 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,31 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,20 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,948.0,5841.0,20 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,948.0,5841.0,20 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,32 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,31 RC,361,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,28 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,948.0,5841.0,20 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,32 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,948.0,5841.0,20 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,948.0,5841.0,20 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,32 RC,361,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,948.0,5841.0,20 RC,361,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,124 RC,361,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,62 RC,361,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,32 RC,361,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,32 RC,361,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,31 RC,361,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,32 RC,361,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,32 RC,361,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,32 RC,361,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,32 RC,361,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,361,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,32 RC,361,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,32 RC,361,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,32 RC,361,Insert urinary catheter ,,,3390.0,5841.0,4 RC,361,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,361,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,361,Insertion of Heyman capsules for clinical brachytherapy ,,,948.0,11661.3,32 RC,361,Insertion of Thomas shunt (separate procedure) ,,,1747.39,8234.0,28 RC,361,Insertion of Thomas shunt (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,32 RC,361,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,31 RC,361,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,948.0,15059.0,32 RC,361,"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) ",,,2369.0,17122.32,18 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) ",,,1174.13,12562.0,28 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure ",,,2036.11,12562.0,28 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein ",,,2036.11,12562.0,28 RC,361,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,361,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,406.49,5841.0,28 RC,361,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,28 RC,361,"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver) ",,,948.0,41580.0,34 RC,361,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,361,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,948.0,47976.91,34 RC,361,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,32 RC,361,Insertion of intrauterine device (IUD) ,,,508.94,5841.0,28 RC,361,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,361,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,26 RC,361,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,361,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,361,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,361,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,361,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,223.51,5841.0,28 RC,361,Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age ,,,948.0,6212.0,33 RC,361,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,948.0,12562.0,32 RC,361,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,948.0,8536.87,32 RC,361,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,948.0,12562.0,32 RC,361,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,26 RC,361,Insertion of penile prosthesis; inflatable (self-contained) High Cost Surgery,,,2369.0,2369.0,5 RC,361,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,948.0,51975.0,31 RC,361,"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,948.0,12562.0,33 RC,361,"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,33 RC,361,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",,,234.94,12562.0,32 RC,361,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age ",,,468.58,6212.0,33 RC,361,Insertion of peritoneal-venous shunt ,,,948.0,13835.0,29 RC,361,Insertion of pin-retained palatal prosthesis ,,,948.0,13241.95,32 RC,361,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,361,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,948.0,15111.6,15 RC,361,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,948.0,3083.0,21 RC,361,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,948.0,41580.0,34 RC,361,Insertion of tandem cuff (dual cuff) ,,,948.0,47976.91,34 RC,361,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,31 RC,361,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,223.51,5841.0,28 RC,361,Insertion of testicular prosthesis (separate procedure) ,,,948.0,11552.32,32 RC,361,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,948.0,3390.0,23 RC,361,Insertion of tunneled centrally inserted central venous access device with subcutaneous pump ,,,948.0,12562.0,33 RC,361,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s) ",,,948.0,12909.0,33 RC,361,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter) ",,,948.0,12562.0,33 RC,361,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,948.0,12562.0,33 RC,361,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age ",,,948.0,12547.6,33 RC,361,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,948.0,15059.0,32 RC,361,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,948.0,12547.6,32 RC,361,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,948.0,25988.0,34 RC,361,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,361,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,948.0,87318.0,33 RC,361,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,948.0,87318.0,33 RC,361,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,948.0,5841.0,19 RC,361,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,948.0,35432.53,27 RC,361,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,948.0,87318.0,33 RC,361,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,948.0,87318.0,33 RC,361,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,361,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,31 RC,361,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,948.0,16207.0,17 RC,361,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,948.0,16207.0,17 RC,361,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,948.0,5841.0,20 RC,361,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,361,Intersex surgery; female to male ,,,948.0,13835.0,15 RC,361,Intersex surgery; male to female ,,,948.0,13835.0,15 RC,361,Intestinal allotransplantation; from cadaver donor ,,,948.0,37588.61,17 RC,361,Intestinal allotransplantation; from living donor ,,,948.0,42394.68,17 RC,361,Intestinal plication (separate procedure) ,,,948.0,16207.0,17 RC,361,"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction ",,,948.0,16207.0,17 RC,361,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,361,Intra-atrial recording ,,,12065.71,43890.0,10 RC,361,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,361,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,32 RC,361,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,361,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,361,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,361,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,361,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,361,Intraoperative colonic lavage (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,361,"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,361,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual ",,,87.5,3128.0,32 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space ",,,196.58,5841.0,31 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid ",,,441.67,5571.0,32 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial ",,,91.96,5841.0,31 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space ",,,930.95,7150.66,32 RC,361,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space ",,,441.67,5571.0,32 RC,361,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,361,"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotri",,,1986.0,3083.0,17 RC,361,"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within ",,,1986.0,3083.0,17 RC,361,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,361,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,361,Intraventricular pacing ,,,12065.71,43890.0,10 RC,361,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,361,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,26 RC,361,Intravitreal injection of a pharmacologic agent (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,361,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,19 RC,361,"Introduction of catheter, aorta ",,,948.0,5841.0,20 RC,361,"Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) ",,,351.7,3128.0,20 RC,361,"Introduction of needle or intracatheter, aortic, translumbar ",,,948.0,5841.0,20 RC,361,"Introduction of needle or intracatheter, carotid or vertebral artery ",,,948.0,5841.0,20 RC,361,"Introduction of needle or intracatheter, upper or lower extremity artery ",,,948.0,5841.0,20 RC,361,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,948.0,12562.0,32 RC,361,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,32 RC,361,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,32 RC,361,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,32 RC,361,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,32 RC,361,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,32 RC,361,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,31 RC,361,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,32 RC,361,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,32 RC,361,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,31 RC,361,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,112.77,5841.0,16 RC,361,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,361,Keratomileusis ,,,948.0,17897.9,29 RC,361,Keratophakia ,,,948.0,19576.28,29 RC,361,Keratoplasty (corneal transplant); anterior lamellar ,,,948.0,12909.0,32 RC,361,Keratoplasty (corneal transplant); endothelial ,,,948.0,15059.0,32 RC,361,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,948.0,12909.0,32 RC,361,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,948.0,12909.0,32 RC,361,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,948.0,12909.0,32 RC,361,Keratoprosthesis ,,,948.0,16924.12,29 RC,361,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,361,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,361,LAPARO W/CHOLANGIO/BIOPSY ,,,3390.0,5841.0,2 RC,361,"LAPAROSCOPE PROC, RECTUM ",,,3390.0,5841.0,2 RC,361,LAPAROSCOPY W/CHOLANGIO ,,,3390.0,5841.0,2 RC,361,"LAPAROSCOPY, ENTEROLYSIS ",,,3390.0,5841.0,2 RC,361,"LAPAROSCOPY, JEJUNOSTOMY ",,,3390.0,5841.0,2 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,361,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,361,LAVH ,,,3390.0,5841.0,2 RC,361,LESION REMOVAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,361,Labyrinthectomy; transcanal ,,,948.0,13241.95,32 RC,361,Labyrinthectomy; with mastoidectomy ,,,948.0,13241.95,32 RC,361,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,32 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,948.0,34473.5,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,948.0,22297.2,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,948.0,19224.42,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,948.0,19618.62,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,948.0,22153.02,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,948.0,26255.61,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,948.0,24454.45,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,948.0,25950.44,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,948.0,32557.8,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,948.0,32066.23,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,948.0,33960.65,14 RC,361,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,948.0,23454.14,14 RC,361,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,948.0,25611.4,14 RC,361,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,948.0,23386.41,14 RC,361,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,948.0,23085.47,14 RC,361,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,948.0,25611.4,14 RC,361,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,948.0,16330.72,26 RC,361,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,948.0,16330.72,26 RC,361,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,948.0,16330.72,26 RC,361,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,948.0,16330.72,26 RC,361,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,948.0,36291.71,14 RC,361,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,948.0,37902.24,14 RC,361,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,948.0,37686.1,14 RC,361,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,948.0,87318.0,31 RC,361,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,948.0,19563.47,14 RC,361,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,948.0,21237.62,14 RC,361,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,948.0,17147.73,14 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,948.0,16330.72,29 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,948.0,16330.72,29 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,948.0,16330.72,26 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,948.0,16330.72,29 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,948.0,16330.72,26 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,948.0,16330.72,26 RC,361,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,948.0,16330.72,26 RC,361,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,948.0,19678.01,14 RC,361,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,948.0,16330.72,26 RC,361,Laminectomy with rhizotomy; 1 or 2 segments ,,,948.0,14087.77,14 RC,361,Laminectomy with rhizotomy; more than 2 segments ,,,948.0,15253.31,14 RC,361,Laminectomy with section of spinal accessory nerve ,,,948.0,17173.13,14 RC,361,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,107 RC,361,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,948.0,5841.0,40 RC,361,"Laminectomy, with release of tethered spinal cord, lumbar ",,,948.0,18949.01,14 RC,361,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,948.0,18436.15,17 RC,361,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,948.0,21068.04,17 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,948.0,16330.72,26 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,948.0,7014.0,42 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,948.0,16330.72,29 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,948.0,16330.72,29 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,24 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,948.0,5841.0,20 RC,361,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,948.0,3083.0,22 RC,361,"Laparoscope proc, intestine ",,,3390.0,5841.0,2 RC,361,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,361,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,361,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,361,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,361,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,361,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,361,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,361,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,361,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,361,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,361,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,361,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,361,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,361,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,361,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,361,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,361,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,361,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,361,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,361,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,948.0,22967.79,11 RC,361,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,948.0,29647.99,22 RC,361,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,948.0,29647.99,22 RC,361,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,948.0,24808.33,28 RC,361,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical ",,,948.0,22967.79,17 RC,361,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency ",,,948.0,22967.79,17 RC,361,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,14 RC,361,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, appendectomy ",,,8778.0,13196.03,9 RC,361,"Laparoscopy, surgical, appendectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis ",,,948.0,20457.81,17 RC,361,"Laparoscopy, surgical, colostomy or skin level cecostomy ",,,948.0,16207.0,17 RC,361,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,948.0,22967.79,17 RC,361,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) ",,,948.0,13394.0,17 RC,361,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,1520.2,16207.0,12 RC,361,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed ",,,5841.0,22967.79,11 RC,361,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed ",,,948.0,15846.6,17 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) ",,,948.0,16425.0,17 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) ",,,948.0,22967.79,13 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components ",,,948.0,22869.0,13 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only ",,,948.0,22869.0,13 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) ",,,948.0,21292.66,11 RC,361,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption ",,,948.0,22788.76,11 RC,361,"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ",,,948.0,16207.0,17 RC,361,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,15 RC,361,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, splenectomy ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical, splenectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,948.0,13196.03,14 RC,361,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,14 RC,361,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,948.0,22967.79,11 RC,361,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,11 RC,361,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,8 RC,361,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14626.03,12 RC,361,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,23335.49,6 RC,361,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed High Cost",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,9 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,361,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13394.0,12 RC,361,"Laparoscopy, surgical; ablation of renal cysts High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,12 RC,361,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; cholecystectomy ",,,1983.29,13196.03,12 RC,361,"Laparoscopy, surgical; cholecystectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; cholecystectomy with cholangiography ",,,1983.29,13196.03,12 RC,361,"Laparoscopy, surgical; cholecystectomy with cholangiography High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; cholecystectomy with exploration of common duct ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; cholecystectomy with exploration of common duct High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; cholecystoenterostomy ",,,3390.0,16207.0,12 RC,361,"Laparoscopy, surgical; cholecystoenterostomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis ",,,6326.0,18906.55,12 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) ",,,3390.0,22326.83,12 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy ",,,3390.0,24331.44,12 RC,361,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) ",,,3390.0,21483.4,12 RC,361,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,3390.0,16427.31,12 RC,361,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed ",,,948.0,26679.44,17 RC,361,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy ",,,948.0,25073.14,17 RC,361,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy ",,,3390.0,21826.68,12 RC,361,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,12 RC,361,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) ",,,2300.11,13835.0,12 RC,361,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis ",,,6326.0,17007.9,12 RC,361,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube ",,,948.0,16207.0,17 RC,361,"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum ",,,948.0,16890.86,17 RC,361,"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) ",,,948.0,13394.0,17 RC,361,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,12 RC,361,"Laparoscopy, surgical; nephrectomy with total ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,12 RC,361,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; orchiectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical; partial nephrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when per",,,948.0,26340.4,17 RC,361,"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy ",,,948.0,24212.78,17 RC,361,"Laparoscopy, surgical; proctopexy (for prolapse) ",,,948.0,16207.0,17 RC,361,"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection ",,,948.0,18575.98,17 RC,361,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,12 RC,361,"Laparoscopy, surgical; pyeloplasty High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,12 RC,361,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; repair initial inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; repair recurrent inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum ",,,948.0,15059.0,17 RC,361,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,17 RC,361,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective ",,,8778.0,13394.0,12 RC,361,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; transection of vagus nerves, truncal ",,,8778.0,13394.0,12 RC,361,"Laparoscopy, surgical; transection of vagus nerves, truncal High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13394.0,12 RC,361,"Laparoscopy, surgical; ureterolithotomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,15 RC,361,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13394.0,12 RC,361,"Laparoscopy, surgical; urethral suspension for stress incontinence High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy ",,,3265.51,22967.79,15 RC,361,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple ",,,3265.51,22967.79,15 RC,361,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including ",,,2369.0,22967.79,19 RC,361,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; with biopsy (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,13196.03,12 RC,361,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; with fimbrioplasty High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,15 RC,361,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,15059.0,6 RC,361,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,15059.0,11 RC,361,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,15059.0,15 RC,361,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,15 RC,361,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,361,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,948.0,13835.0,29 RC,361,"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es) ",,,948.0,14320.86,17 RC,361,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,361,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,361,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,361,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,361,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,361,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,361,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,361,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,361,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,361,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,361,Lapscp intest resect ,,,3390.0,5841.0,2 RC,361,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,361,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,361,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,361,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,361,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,361,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,361,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,361,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,361,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,361,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,361,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,9 RC,361,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,948.0,15059.0,32 RC,361,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,361,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,948.0,13835.0,16 RC,361,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,948.0,13835.0,16 RC,361,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,32 RC,361,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,361,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,361,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,361,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,361,"Lengthening of palate, and pharyngeal flap ",,,948.0,13394.0,32 RC,361,"Lengthening of palate, with island flap ",,,948.0,13835.0,20 RC,361,"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of de",,,1174.13,12562.0,32 RC,361,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions ",,,1174.13,7565.59,27 RC,361,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions High Cost Surgery",,,2369.0,2369.0,5 RC,361,Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure) ,,,948.0,12562.0,32 RC,361,Ligation of common iliac vein ,,,948.0,16207.0,17 RC,361,Ligation of femoral vein ,,,948.0,7565.59,32 RC,361,Ligation of inferior vena cava ,,,948.0,13835.0,29 RC,361,"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg ",,,948.0,8304.31,32 RC,361,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg ",,,1174.13,12562.0,27 RC,361,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg High Cost Surgery",,,2369.0,2369.0,5 RC,361,Ligation of peritoneal-venous shunt ,,,948.0,13835.0,17 RC,361,Ligation or banding of angioaccess arteriovenous fistula ,,,948.0,12562.0,32 RC,361,"Ligation or biopsy, temporal artery ",,,510.77,3755.0,32 RC,361,Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation ,,,948.0,17796.17,17 RC,361,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,29 RC,361,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,948.0,13835.0,29 RC,361,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,948.0,13394.0,32 RC,361,"Ligation salivary duct, intraoral ",,,930.95,12909.0,32 RC,361,"Ligation, direct, esophageal varices ",,,948.0,18749.79,17 RC,361,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below ",,,1174.13,12562.0,27 RC,361,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Ligation, division, and stripping, short saphenous vein ",,,1174.13,12562.0,27 RC,361,"Ligation, division, and stripping, short saphenous vein High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg ",,,948.0,12562.0,32 RC,361,"Ligation, internal jugular vein ",,,948.0,13835.0,17 RC,361,"Ligation, major artery (eg, post-traumatic, rupture); abdomen ",,,948.0,16461.18,17 RC,361,"Ligation, major artery (eg, post-traumatic, rupture); chest ",,,948.0,16207.0,17 RC,361,"Ligation, major artery (eg, post-traumatic, rupture); extremity ",,,948.0,16207.0,17 RC,361,"Ligation, major artery (eg, post-traumatic, rupture); neck ",,,948.0,13835.0,17 RC,361,Ligation; external carotid artery ,,,948.0,13835.0,17 RC,361,Ligation; internal or common carotid artery ,,,948.0,13835.0,17 RC,361,"Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield clamp ",,,948.0,13835.0,17 RC,361,Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic ,,,948.0,16207.0,17 RC,361,Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) ,,,948.0,16207.0,17 RC,361,Limited pharyngectomy ,,,948.0,13241.95,32 RC,361,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,361,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,948.0,8240.61,32 RC,361,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,948.0,8240.61,32 RC,361,"Lithotripsy, extracorporeal shock wave ",,,1200.05,10342.0,9 RC,361,"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age ",,,948.0,66243.02,17 RC,361,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,361,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,361,"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy ºPOEM») ",,,948.0,15059.0,28 RC,361,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,361,Lymphangiotomy or other operations on lymphatic channels ,,,948.0,8270.67,32 RC,361,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,948.0,13835.0,29 RC,361,Lysis of labial adhesions ,,,948.0,6819.81,32 RC,361,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,32 RC,361,MEDIASTINOSCOPY INCL BIOPSY ,,,3390.0,5841.0,2 RC,361,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,948.0,4220.0,18 RC,361,"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation ",,,948.0,23089.7,17 RC,361,"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver ",,,948.0,37296.13,17 RC,361,Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing ,,,948.0,17851.33,17 RC,361,Management of liver hemorrhage; simple suture of liver wound or injury ,,,948.0,16825.62,17 RC,361,Management of recipient hematopoietic progenitor cell donor search and cell acquisition ,,,948.0,5841.0,7 RC,361,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,32 RC,361,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,19 RC,361,Marsupialization of Bartholin's gland cyst ,,,948.0,6819.81,32 RC,361,Marsupialization of cyst or abscess of liver ,,,948.0,16207.0,17 RC,361,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,361,Marsupialization of pancreatic cyst ,,,948.0,16207.0,17 RC,361,Marsupialization of sublingual salivary cyst (ranula) ,,,930.95,12562.0,32 RC,361,"Marsupialization of urethral diverticulum, male or female ",,,948.0,8240.61,32 RC,361,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,27 RC,361,Mastoid obliteration (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,361,Mastoidectomy; complete ,,,948.0,13241.95,32 RC,361,Mastoidectomy; modified radical ,,,948.0,13241.95,32 RC,361,Mastoidectomy; radical ,,,948.0,13241.95,32 RC,361,Maxillary impression for palatal prosthesis ,,,875.5,5841.0,28 RC,361,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,112.77,5841.0,16 RC,361,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,32 RC,361,"Meatotomy, cutting of meatus (separate procedure); infant ",,,948.0,13835.0,29 RC,361,Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen ,,,468.58,6212.0,33 RC,361,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,3128.0,32 RC,361,"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access ",,,948.0,7565.59,33 RC,361,"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed ",,,948.0,13835.0,29 RC,361,"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging) ",,,948.0,13835.0,29 RC,361,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach ",,,948.0,16207.0,17 RC,361,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy ",,,948.0,16207.0,17 RC,361,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,361,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,361,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,32 RC,361,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,361,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,361,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,361,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,361,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,361,Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ,,,948.0,16207.0,17 RC,361,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,20 RC,361,Multifetal pregnancy reduction(s) (MPR) ,,,554.98,5841.0,16 RC,361,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,32 RC,361,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,948.0,8234.0,29 RC,361,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,948.0,8234.0,29 RC,361,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,948.0,8234.0,29 RC,361,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,948.0,8234.0,29 RC,361,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,948.0,13835.0,29 RC,361,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,948.0,13394.0,32 RC,361,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,948.0,13835.0,17 RC,361,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,32 RC,361,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,31 RC,361,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,32 RC,361,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,361,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,361,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,361,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,361,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,361,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,361,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,948.0,15059.0,31 RC,361,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,948.0,15059.0,31 RC,361,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,31 RC,361,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,948.0,16207.0,17 RC,361,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,948.0,17974.22,17 RC,361,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,948.0,16207.0,17 RC,361,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,948.0,16207.0,17 RC,361,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,948.0,16207.0,17 RC,361,"Nephrectomy, partial ",,,948.0,16253.5,17 RC,361,Nephrolithotomy; complicated by congenital kidney abnormality ,,,948.0,16207.0,17 RC,361,Nephrolithotomy; removal of calculus ,,,948.0,16207.0,17 RC,361,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,948.0,17855.56,17 RC,361,Nephrolithotomy; secondary surgical operation for calculus ,,,948.0,16207.0,17 RC,361,"Nephrorrhaphy, suture of kidney wound or injury ",,,948.0,16207.0,17 RC,361,"Nephrostomy, nephrotomy with drainage ",,,948.0,13835.0,29 RC,361,"Nephrotomy, with exploration ",,,948.0,16207.0,17 RC,361,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,948.0,15039.6,32 RC,361,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Nerve pedicle transfer; first stage ,,,948.0,15039.6,32 RC,361,Nerve pedicle transfer; second stage ,,,948.0,15039.6,32 RC,361,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,948.0,15039.6,29 RC,361,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,948.0,15039.6,31 RC,361,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,948.0,15039.6,32 RC,361,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,948.0,18707.46,17 RC,361,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,948.0,25882.7,17 RC,361,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,948.0,18906.55,17 RC,361,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,948.0,23458.38,17 RC,361,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,32 RC,361,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,27 RC,361,Neuroplasty and/or transposition; median nerve at carpal tunnel High Cost Surgery,,,2369.0,2369.0,5 RC,361,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,32 RC,361,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,32 RC,361,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,32 RC,361,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,32 RC,361,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,32 RC,361,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,32 RC,361,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,32 RC,361,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,32 RC,361,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,28 RC,361,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,361,OPERATIVE UPPER GI ENDOSCOPY ,,,3390.0,5841.0,2 RC,361,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,948.0,41102.02,17 RC,361,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,948.0,13835.0,32 RC,361,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,948.0,13394.0,32 RC,361,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,948.0,13394.0,29 RC,361,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,948.0,13394.0,29 RC,361,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,948.0,17359.64,17 RC,361,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,948.0,16207.0,29 RC,361,"Oophorectomy, partial or total, unilateral or bilateral; ",,,948.0,13835.0,29 RC,361,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,948.0,14490.44,17 RC,361,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,361,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,87318.0,33 RC,361,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,361,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,82073.3,30 RC,361,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,361,Open implantation of neurostimulator electrode array; neuromuscular ,,,948.0,87318.0,34 RC,361,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,34 RC,361,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,948.0,16890.86,32 RC,361,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,361,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,361,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,361,"Operculectomy, excision pericoronal tissues ",,,948.0,3683.7,29 RC,361,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,361,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,361,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,948.0,8536.87,32 RC,361,Orbital implant (implant outside muscle cone); insertion ,,,948.0,8536.87,32 RC,361,Orbital implant (implant outside muscle cone); removal or revision ,,,948.0,8536.87,32 RC,361,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,948.0,40347.62,17 RC,361,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,948.0,35482.15,17 RC,361,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,948.0,39228.77,17 RC,361,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,948.0,13394.0,32 RC,361,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,948.0,13394.0,32 RC,361,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,948.0,13394.0,32 RC,361,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,948.0,13394.0,32 RC,361,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,948.0,13394.0,32 RC,361,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,948.0,12562.0,32 RC,361,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,32 RC,361,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,948.0,13835.0,32 RC,361,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,32 RC,361,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,32 RC,361,"Orchiectomy, partial ",,,948.0,12562.0,32 RC,361,"Orchiectomy, radical, for tumor; inguinal approach ",,,948.0,8488.5,32 RC,361,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,948.0,13835.0,17 RC,361,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,948.0,12562.0,32 RC,361,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,948.0,13835.0,29 RC,361,"Orchiopexy, inguinal or scrotal approach ",,,948.0,8488.5,32 RC,361,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,948.0,16207.0,14 RC,361,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,361,"Other cranial decompression, posterior fossa ",,,948.0,25285.06,17 RC,361,Other spinal injection ,,,3390.0,5841.0,2 RC,361,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,361,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,32 RC,361,"Ovarian cystectomy, unilateral or bilateral ",,,948.0,13835.0,29 RC,361,PAROTID DUCT DIVERSION ,,,3390.0,5841.0,2 RC,361,"PARTIAL REMOVAL, DONOR LIVER ",,,3390.0,5841.0,2 RC,361,PERCUT DRAIN LIVER LESION ,,,3390.0,5841.0,2 RC,361,PERCUT THROMBECT AV FISTULA ,,,6326.0,8104.0,2 RC,361,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,361,PLACE GASTROSTOMY TUBE ,,,3390.0,5841.0,2 RC,361,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,361,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,361,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,361,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,2 RC,361,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) ",,,2051.93,13394.0,27 RC,361,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Palatoplasty for cleft palate, soft and/or hard palate only ",,,948.0,13394.0,32 RC,361,"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only ",,,930.95,13394.0,32 RC,361,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft) ",,,948.0,13394.0,32 RC,361,Palatoplasty for cleft palate; attachment pharyngeal flap ,,,948.0,13394.0,32 RC,361,Palatoplasty for cleft palate; major revision ,,,948.0,13241.95,32 RC,361,Palatoplasty for cleft palate; secondary lengthening procedure ,,,948.0,13394.0,32 RC,361,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,948.0,20063.62,17 RC,361,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,948.0,19262.64,17 RC,361,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,948.0,23102.4,17 RC,361,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38220.12,17 RC,361,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35766.16,17 RC,361,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,948.0,38398.05,17 RC,361,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,948.0,35550.01,17 RC,361,"Pancreatectomy, total ",,,948.0,22322.6,17 RC,361,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,948.0,16207.0,14 RC,361,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,948.0,20436.65,17 RC,361,Pancreatorrhaphy for injury ,,,948.0,16490.81,17 RC,361,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,31 RC,361,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,32 RC,361,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,32 RC,361,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,Parathyroidectomy or exploration of parathyroid(s); ,,,948.0,13835.0,32 RC,361,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,948.0,15059.0,29 RC,361,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,948.0,17020.6,17 RC,361,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,948.0,22967.79,29 RC,361,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,948.0,13835.0,29 RC,361,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,948.0,18300.83,29 RC,361,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,32 RC,361,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,948.0,5841.0,20 RC,361,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,32 RC,361,"Parotid duct diversion, bilateral (Wilke type procedure); ",,,948.0,13241.95,32 RC,361,"Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands ",,,948.0,13241.95,32 RC,361,"Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts ",,,930.95,9653.0,32 RC,361,"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction ",,,948.0,61720.83,17 RC,361,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including ",,,948.0,44797.72,17 RC,361,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor ",,,948.0,40004.34,17 RC,361,"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty ",,,948.0,34880.4,17 RC,361,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, prepa",,,948.0,55100.77,17 RC,361,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty ",,,948.0,31409.31,17 RC,361,"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn ",,,795.48,5841.0,28 RC,361,Partial hymenectomy or revision of hymenal ring ,,,948.0,6819.81,32 RC,361,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13835.0,32 RC,361,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13835.0,32 RC,361,Pelvic examination under anesthesia (other than local) ,,,948.0,6819.81,32 RC,361,"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or withou",,,948.0,34142.93,17 RC,361,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,2369.0,35948.44,17 RC,361,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,948.0,28124.63,17 RC,361,"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,948.0,16207.0,17 RC,361,Penile plethysmography ,,,273.57,5841.0,28 RC,361,"Penile revascularization, artery, with or without vein graft ",,,948.0,16207.0,17 RC,361,Penile venous occlusive procedure ,,,948.0,12562.0,29 RC,361,"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angi",,,2036.11,46894.85,32 RC,361,"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angiopl",,,2036.11,46894.85,32 RC,361,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,32 RC,361,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,32 RC,361,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,361,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,361,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,361,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,361,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,361,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,948.0,3083.0,22 RC,361,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,361,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,948.0,87318.0,34 RC,361,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,948.0,87318.0,34 RC,361,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,34 RC,361,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,948.0,87318.0,34 RC,361,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,361,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,64 RC,361,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,948.0,22025.45,58 RC,361,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,361,Percutaneous portal vein catheterization by any method ,,,948.0,5841.0,20 RC,361,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,361,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,361,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,361,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,361,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,8 RC,361,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,8 RC,361,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,361,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,361,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,361,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,361,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,361,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,361,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,361,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,361,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,361,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,361,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,361,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,361,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,361,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,361,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,361,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,361,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,361,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,361,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,361,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,361,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance ",,,948.0,15059.0,32 RC,361,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,361,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,361,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,361,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,361,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,361,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,361,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,361,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,361,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,361,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,361,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,361,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,361,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,361,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,361,"Pereyra procedure, including anterior colporrhaphy ",,,948.0,18300.83,32 RC,361,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,361,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,361,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,948.0,13394.0,32 RC,361,Periodontal mucosal grafting ,,,441.67,13835.0,32 RC,361,Perirectal injection of sclerosing solution for prolapse ,,,948.0,5841.0,28 RC,361,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,3249.0,32 RC,361,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,32022.79,28 RC,361,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,948.0,5841.0,28 RC,361,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,948.0,13835.0,28 RC,361,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,13835.0,28 RC,361,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,361,Petrous apicectomy including radical mastoidectomy ,,,948.0,13241.95,32 RC,361,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,361,Pharyngoesophageal repair ,,,948.0,16207.0,17 RC,361,Pharyngoplasty (plastic or reconstructive operation on pharynx) ,,,948.0,13241.95,32 RC,361,"Pharyngostomy (fistulization of pharynx, external for feeding) ",,,441.67,5571.0,32 RC,361,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,361,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,361,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,361,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,361,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,361,"Photopheresis, extracorporeal ",,,948.0,13835.0,32 RC,361,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,361,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,361,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,361,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,361,"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when per",,,948.0,15059.0,32 RC,361,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,948.0,5841.0,20 RC,361,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,948.0,8536.87,29 RC,361,Placement of amniotic membrane on the ocular surface; without sutures ,,,948.0,3755.0,29 RC,361,Placement of choledochal stent ,,,948.0,16207.0,17 RC,361,"Placement of drains, peripancreatic, for acute pancreatitis; ",,,948.0,23178.72,17 RC,361,"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy ",,,948.0,28256.1,17 RC,361,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,361,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,796.41,16207.0,17 RC,361,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,5193.86,32 RC,361,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,32 RC,361,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,361,Placement of needle for intraosseous infusion ,,,745.36,6212.0,29 RC,361,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,948.0,15059.0,29 RC,361,"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application ",,,948.0,13241.95,29 RC,361,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,32 RC,361,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,948.0,12909.0,32 RC,361,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,361,Placement of seton ,,,948.0,12562.0,32 RC,361,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,948.0,15059.0,96 RC,361,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,96 RC,361,"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure) ",,,948.0,16207.0,29 RC,361,Plasma and/or cell exchange ,,,3390.0,5841.0,2 RC,361,Plastic operation of penis for injury ,,,948.0,8240.61,32 RC,361,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,948.0,12562.0,32 RC,361,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,948.0,12562.0,32 RC,361,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,32 RC,361,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,948.0,15227.79,17 RC,361,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,32 RC,361,Plastic operation on penis to correct angulation ,,,948.0,12562.0,32 RC,361,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,948.0,12562.0,32 RC,361,Plastic repair of canaliculi ,,,733.22,5571.0,32 RC,361,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages ",,,948.0,32170.6,32 RC,361,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure ",,,948.0,13241.95,32 RC,361,"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral ",,,948.0,13241.95,32 RC,361,"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure ",,,930.95,12909.0,32 RC,361,"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle ",,,948.0,13241.95,32 RC,361,Plastic repair of introitus ,,,948.0,12562.0,32 RC,361,"Plastic repair of salivary duct, sialodochoplasty; primary or simple ",,,948.0,13241.95,32 RC,361,"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated ",,,948.0,13241.95,32 RC,361,Plastic repair of urethrocele ,,,948.0,12562.0,32 RC,361,"Portoenterostomy (eg, Kasai procedure) ",,,948.0,21004.54,17 RC,361,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,948.0,13394.0,32 RC,361,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,755.65,5841.0,28 RC,361,Postpartum care only (separate procedure) ,,,948.0,5841.0,24 RC,361,"Preparation of fecal microbiota for instillation, including assessment of donor specimen ",,,713.79,5841.0,24 RC,361,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,361,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,948.0,13835.0,16 RC,361,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",,,948.0,27050.15,32 RC,361,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,31 RC,361,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,31 RC,361,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,32 RC,361,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,32 RC,361,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,32 RC,361,"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed ",,,948.0,23712.75,17 RC,361,"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) ",,,948.0,22894.72,17 RC,361,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation) ",,,948.0,19512.66,17 RC,361,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies ",,,948.0,21178.23,17 RC,361,"Proctectomy, partial, with anastomosis; abdominal and transsacral approach ",,,948.0,22297.2,17 RC,361,"Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) ",,,948.0,19122.7,17 RC,361,"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy ",,,948.0,23178.72,17 RC,361,"Proctectomy, partial, without anastomosis, perineal approach ",,,948.0,13835.0,17 RC,361,"Proctectomy; complete, combined abdominoperineal, with colostomy ",,,948.0,22602.37,17 RC,361,"Proctectomy; partial resection of rectum, transabdominal approach ",,,948.0,16207.0,17 RC,361,"Proctopexy (eg, for prolapse); abdominal approach ",,,948.0,16207.0,17 RC,361,"Proctopexy (eg, for prolapse); perineal approach ",,,948.0,13835.0,32 RC,361,"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach ",,,948.0,17974.22,17 RC,361,Proctoplasty; for prolapse of mucous membrane ,,,948.0,7014.0,32 RC,361,Proctoplasty; for stenosis ,,,948.0,6399.61,32 RC,361,"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,86.63,3128.0,32 RC,361,"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser) ",,,948.0,6399.61,32 RC,361,"Proctosigmoidoscopy, rigid; with biopsy, single or multiple ",,,450.72,3128.0,32 RC,361,"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,450.72,3390.0,32 RC,361,"Proctosigmoidoscopy, rigid; with decompression of volvulus ",,,948.0,6399.61,32 RC,361,"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,7266.25,32 RC,361,"Proctosigmoidoscopy, rigid; with removal of foreign body ",,,948.0,6399.61,32 RC,361,"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,450.72,3128.0,32 RC,361,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,948.0,6399.61,32 RC,361,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ",,,450.72,3128.0,32 RC,361,"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation) ",,,948.0,13051.67,32 RC,361,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,361,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,361,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,27 RC,361,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,948.0,16207.0,17 RC,361,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,948.0,16207.0,17 RC,361,"Prostatectomy, perineal radical; ",,,948.0,16207.0,17 RC,361,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,21559.73,17 RC,361,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,19741.51,17 RC,361,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,948.0,16207.0,17 RC,361,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,948.0,16207.0,17 RC,361,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,16732.36,29 RC,361,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,16207.0,17 RC,361,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,948.0,8240.61,32 RC,361,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,948.0,5571.0,32 RC,361,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,20 RC,361,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,32 RC,361,"Push transfusion, blood, 2 years or younger ",,,948.0,5841.0,28 RC,361,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,948.0,17109.62,17 RC,361,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,948.0,16207.0,17 RC,361,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,361,"Pyelotomy; with drainage, pyelostomy ",,,948.0,16207.0,17 RC,361,Pyelotomy; with exploration ,,,948.0,16207.0,17 RC,361,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,948.0,16207.0,17 RC,361,"Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) ",,,948.0,16207.0,17 RC,361,Pyloroplasty ,,,948.0,16207.0,17 RC,361,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,361,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,361,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,2 RC,361,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,2 RC,361,REMOVAL OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,361,REMOVAL OF ANAL CRYPT ,,,3390.0,5841.0,2 RC,361,REMOVAL OF ANAL CRYPTS ,,,3390.0,5841.0,2 RC,361,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,361,REMOVAL OF COLON/ILEOSTOMY ,,,3390.0,5841.0,4 RC,361,REMOVAL OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,361,REMOVAL OF LEG VEIN ,,,3390.0,5841.0,2 RC,361,REMOVAL OF LEG VEINS ,,,3390.0,5841.0,2 RC,361,"REMOVAL OF STOMACH, PARTIAL ",,,3390.0,5841.0,4 RC,361,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,361,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,2 RC,361,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,2 RC,361,REMOVE BILE DUCT STONE ,,,3390.0,5841.0,2 RC,361,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,361,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,361,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,361,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,361,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,361,REPAIR A-V ANEURYSM ,,,5841.0,5841.0,1 RC,361,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,361,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,3 RC,361,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,361,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,361,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,6 RC,361,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,361,REPAIR PARAESOPHAGEAL HERNIA ,,,3390.0,5841.0,2 RC,361,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,361,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,361,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,3 RC,361,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,361,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,3 RC,361,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,361,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,3 RC,361,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,361,REPOSITIONING OF CVC ,,,3390.0,5841.0,2 RC,361,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,361,RESECT/DEBRIDE PANCREAS ,,,3390.0,5841.0,2 RC,361,REVISE ESOPHAGUS & STOMACH ,,,3390.0,5841.0,4 RC,361,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,361,REVISE/REINSERT BILE TUBE ,,,3390.0,5841.0,2 RC,361,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,361,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,361,REVISION OF ACCESS DEVICE ,,,3390.0,5841.0,2 RC,361,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITH VAGOTOMY ,,,3390.0,16207.0,3 RC,361,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITHOUT VAGOTOMY ,,,3390.0,16207.0,3 RC,361,REVISION OF INFUSION PUMP ,,,3390.0,5841.0,2 RC,361,REVISION OF MAJOR VEIN ,,,3390.0,5841.0,2 RC,361,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,361,Radial keratotomy ,,,948.0,7836.39,29 RC,361,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,24 RC,361,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) High C",,,2369.0,2369.0,5 RC,361,Radical excision external auditory canal lesion; with neck dissection ,,,948.0,19932.26,17 RC,361,Radical excision external auditory canal lesion; without neck dissection ,,,948.0,13241.95,32 RC,361,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal) ",,,948.0,13835.0,17 RC,361,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap ",,,948.0,27260.03,17 RC,361,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure ",,,948.0,13835.0,17 RC,361,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,948.0,20288.23,17 RC,361,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,31 RC,361,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,948.0,13835.0,16 RC,361,Recipient nephrectomy (separate procedure) ,,,948.0,16207.0,17 RC,361,"Reconstruction external auditory canal for congenital atresia, single stage ",,,948.0,13241.95,32 RC,361,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,948.0,13241.95,32 RC,361,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,32 RC,361,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,32 RC,361,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,948.0,12562.0,32 RC,361,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,32 RC,361,"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis ",,,948.0,19304.98,17 RC,361,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,361,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,361,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,948.0,20856.12,17 RC,361,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,948.0,24513.72,17 RC,361,Reduction of overcorrection of ptosis ,,,733.22,8234.0,32 RC,361,Reduction of procidentia (separate procedure) under anesthesia ,,,344.93,3128.0,32 RC,361,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,948.0,8240.61,32 RC,361,"Reduction of volvulus, intussusception, internal hernia, by laparotomy ",,,948.0,16207.0,29 RC,361,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,361,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,361,Reinsertion of ocular implant; with or without conjunctival graft ,,,948.0,8536.87,32 RC,361,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,948.0,12562.0,32 RC,361,Release of encircling material (posterior segment) ,,,1610.16,10424.04,27 RC,361,Release of encircling material (posterior segment) High Cost Surgery,,,2369.0,2369.0,5 RC,361,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,32 RC,361,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,32 RC,361,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,32 RC,361,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,32 RC,361,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,32 RC,361,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,26 RC,361,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,948.0,51975.0,30 RC,361,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,361,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,948.0,47976.91,32 RC,361,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,948.0,15672.9,17 RC,361,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,948.0,51975.0,31 RC,361,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,948.0,51975.0,31 RC,361,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,32 RC,361,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,32 RC,361,Removal foreign body from external auditory canal; without general anesthesia ,,,223.51,5841.0,16 RC,361,"Removal impacted cerumen requiring instrumentation, unilateral ",,,112.77,5841.0,28 RC,361,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,112.77,5841.0,28 RC,361,"Removal of Thiersch wire or suture, anal canal ",,,948.0,6399.61,32 RC,361,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,27 RC,361,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Removal of anal seton, other marker ",,,450.72,3128.0,32 RC,361,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,948.0,9751.1,22 RC,361,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,948.0,9751.1,22 RC,361,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,948.0,9528.08,22 RC,361,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,32 RC,361,Removal of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,361,"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging ",,,948.0,5841.0,20 RC,361,Removal of cerclage suture under anesthesia (other than local) ,,,948.0,13394.0,32 RC,361,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,948.0,16207.0,17 RC,361,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,948.0,13835.0,29 RC,361,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,32 RC,361,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,32 RC,361,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,15059.0,32 RC,361,Removal of embedded foreign body from dentoalveolar structures; bone ,,,272.38,4335.95,32 RC,361,Removal of embedded foreign body from dentoalveolar structures; soft tissues ,,,231.98,5571.0,32 RC,361,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,31 RC,361,"Removal of embedded foreign body, vestibule of mouth; complicated ",,,158.14,5571.0,32 RC,361,"Removal of embedded foreign body, vestibule of mouth; simple ",,,948.0,5841.0,16 RC,361,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,32 RC,361,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,32 RC,361,Removal of esophageal sphincter augmentation device ,,,2996.0,13835.0,23 RC,361,Removal of esophageal sphincter augmentation device High Cost Surgery,,,2369.0,2369.0,5 RC,361,Removal of fecal impaction or foreign body (separate procedure) under anesthesia ,,,450.72,3128.0,32 RC,361,Removal of foreign body from pharynx ,,,745.36,5841.0,28 RC,361,Removal of foreign body in scrotum ,,,685.44,5571.0,32 RC,361,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,31 RC,361,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,745.36,5841.0,16 RC,361,"Removal of foreign body, external eye; conjunctival superficial ",,,223.51,5841.0,16 RC,361,"Removal of foreign body, external eye; corneal, with slit lamp ",,,223.51,5841.0,16 RC,361,"Removal of foreign body, external eye; corneal, without slit lamp ",,,745.36,5841.0,16 RC,361,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,32 RC,361,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,31 RC,361,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,32 RC,361,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,361,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,15899.38,31 RC,361,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,361,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,361,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,948.0,6819.81,32 RC,361,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,361,Removal of implanted intra-arterial infusion pump ,,,948.0,8146.35,32 RC,361,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,32 RC,361,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,27 RC,361,"Removal of implanted material, posterior segment; extraocular High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,27 RC,361,"Removal of implanted material, posterior segment; intraocular High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,32 RC,361,Removal of intrauterine device (IUD) ,,,53.78,5841.0,31 RC,361,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,32 RC,361,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,32 RC,361,Removal of lens material; intracapsular ,,,892.44,8234.0,32 RC,361,"Removal of lens material; intracapsular, for dislocated lens ",,,948.0,13394.0,32 RC,361,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,948.0,10424.04,32 RC,361,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,32 RC,361,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,361,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,948.0,12562.0,32 RC,361,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,361,Removal of ocular implant ,,,948.0,8536.87,32 RC,361,Removal of pancreatic calculus ,,,948.0,16207.0,17 RC,361,Removal of peritoneal foreign body from peritoneal cavity ,,,948.0,8488.5,32 RC,361,Removal of peritoneal-venous shunt ,,,948.0,13835.0,32 RC,361,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,361,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,32 RC,361,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,32 RC,361,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,948.0,15059.0,27 RC,361,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,32 RC,361,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,12909.0,32 RC,361,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,948.0,15039.6,32 RC,361,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,361,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,361,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,361,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,361,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,948.0,5841.0,20 RC,361,"Removal of transplanted intestinal allograft, complete ",,,948.0,19220.19,17 RC,361,Removal of transplanted pancreatic allograft ,,,948.0,15660.09,15 RC,361,Removal of transplanted renal allograft ,,,948.0,16207.0,17 RC,361,"Removal of tumor, temporal bone ",,,948.0,13835.0,29 RC,361,Removal of tunneled intraperitoneal catheter ,,,948.0,7565.59,32 RC,361,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,27 RC,361,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,27 RC,361,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,32 RC,361,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,948.0,11552.32,32 RC,361,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,948.0,13835.0,32 RC,361,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,361,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,948.0,13835.0,31 RC,361,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,948.0,7895.92,31 RC,361,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,7895.92,31 RC,361,Remove interim implant component ,,,12018.0,12018.0,1 RC,361,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,948.0,35181.33,17 RC,361,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,948.0,29697.06,17 RC,361,"Renal autotransplantation, reimplantation of kidney ",,,948.0,24517.95,17 RC,361,Renal biopsy; by surgical exposure of kidney ,,,948.0,16207.0,17 RC,361,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,11552.32,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,22025.45,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,948.0,22025.45,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,948.0,11552.32,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,948.0,22025.45,32 RC,361,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,948.0,11552.32,32 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,4836.33,32 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,948.0,13835.0,20 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,948.0,13835.0,32 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,13835.0,32 RC,361,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,32 RC,361,"Renal exploration, not necessitating other specific procedures ",,,948.0,16207.0,17 RC,361,Reopening of recent laparotomy ,,,948.0,16207.0,17 RC,361,Repair incomplete circumcision ,,,685.44,5571.0,32 RC,361,"Repair inguinal hernia, sliding, any age ",,,1209.12,8488.5,27 RC,361,"Repair inguinal hernia, sliding, any age High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,361,"Repair initial femoral hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair initial femoral hernia, any age; reducible ",,,1209.12,13394.0,27 RC,361,"Repair initial femoral hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,361,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,8488.5,27 RC,361,"Repair initial inguinal hernia, age 5 years or older; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,948.0,15059.0,32 RC,361,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,948.0,8488.5,32 RC,361,"Repair lip, full thickness; over one-half vertical height, or complex ",,,441.67,12562.0,32 RC,361,"Repair lip, full thickness; up to half vertical height ",,,196.58,12562.0,32 RC,361,"Repair lip, full thickness; vermilion only ",,,196.58,12562.0,32 RC,361,Repair lumbar hernia ,,,1983.29,13196.03,27 RC,361,Repair lumbar hernia High Cost Surgery,,,2369.0,2369.0,5 RC,361,Repair of anal fistula with fibrin glue ,,,948.0,6399.61,32 RC,361,"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa ºSIS») ",,,948.0,15059.0,20 RC,361,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,361,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,183 RC,361,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15664.44,177 RC,361,"Repair of anterior palate, including vomer flap ",,,948.0,13394.0,32 RC,361,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,32 RC,361,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,32 RC,361,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,32 RC,361,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,948.0,13394.0,32 RC,361,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,32 RC,361,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,948.0,13394.0,32 RC,361,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,32 RC,361,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; ",,,948.0,47921.29,17 RC,361,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps ",,,948.0,52015.42,17 RC,361,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach ",,,948.0,42911.77,17 RC,361,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,32 RC,361,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,24 RC,361,"Repair of component(s) of a multi-component, inflatable penile prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,361,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,361,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,948.0,16207.0,17 RC,361,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,948.0,16207.0,17 RC,361,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,32 RC,361,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,32 RC,361,Repair of ectropion; suture ,,,733.22,12562.0,32 RC,361,Repair of ectropion; thermocauterization ,,,210.46,5571.0,32 RC,361,"Repair of encephalocele, skull vault, including cranioplasty ",,,948.0,26255.61,17 RC,361,"Repair of enterocele, abdominal approach (separate procedure) ",,,948.0,13835.0,17 RC,361,"Repair of enterocele, vaginal approach (separate procedure) ",,,948.0,12562.0,32 RC,361,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,361,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,32 RC,361,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,32 RC,361,Repair of entropion; suture ,,,733.22,12562.0,32 RC,361,Repair of entropion; thermocauterization ,,,201.75,13835.0,32 RC,361,Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches ,,,948.0,30612.46,17 RC,361,Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach ,,,948.0,26425.19,17 RC,361,Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches ,,,948.0,27904.25,17 RC,361,Repair of high imperforate anus without fistula; perineal or sacroperineal approach ,,,948.0,24178.91,17 RC,361,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,948.0,12562.0,32 RC,361,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,948.0,12562.0,32 RC,361,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,948.0,12562.0,32 RC,361,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach ",,,948.0,27438.08,29 RC,361,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach ",,,948.0,16207.0,29 RC,361,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,32 RC,361,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,32 RC,361,Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue ,,,223.51,5841.0,28 RC,361,Repair of laceration 2.5 cm or less; posterior one-third of tongue ,,,91.96,5841.0,31 RC,361,"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex ",,,91.96,3755.0,32 RC,361,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,32 RC,361,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,948.0,16207.0,29 RC,361,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,32 RC,361,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,32 RC,361,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,948.0,10424.04,32 RC,361,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,948.0,10424.04,32 RC,361,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,948.0,8536.87,32 RC,361,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,948.0,60402.77,29 RC,361,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,948.0,16207.0,17 RC,361,Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) ,,,948.0,16207.0,17 RC,361,Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula ,,,948.0,16207.0,17 RC,361,Repair of meningocele; larger than 5 cm diameter ,,,948.0,17728.44,17 RC,361,Repair of meningocele; less than 5 cm diameter ,,,948.0,16207.0,17 RC,361,Repair of myelomeningocele; larger than 5 cm diameter ,,,948.0,21911.47,17 RC,361,Repair of myelomeningocele; less than 5 cm diameter ,,,948.0,19758.45,17 RC,361,Repair of nasolabial fistula ,,,948.0,13241.95,32 RC,361,Repair of omphalocele (Gross type operation); first stage ,,,948.0,16207.0,17 RC,361,Repair of omphalocele (Gross type operation); second stage ,,,948.0,16207.0,17 RC,361,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,948.0,15059.0,28 RC,361,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,948.0,9370.6,28 RC,361,Repair of rectocele (separate procedure) ,,,948.0,7014.0,32 RC,361,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,27 RC,361,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,27 RC,361,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,15 RC,361,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,32 RC,361,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,32 RC,361,Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy ,,,948.0,16207.0,17 RC,361,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,Repair of scleral staphyloma with graft ,,,948.0,10424.04,32 RC,361,"Repair of small omphalocele, with primary closure ",,,948.0,8488.5,32 RC,361,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,32 RC,361,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,32 RC,361,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,948.0,8536.87,32 RC,361,Repair of traumatic corporeal tear(s) ,,,948.0,12909.0,32 RC,361,Repair of tunica vaginalis hydrocele (Bottle type) ,,,948.0,8240.61,32 RC,361,"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site ",,,234.94,6212.0,33 RC,361,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,948.0,12562.0,32 RC,361,Repair oval window fistula ,,,930.95,8234.0,27 RC,361,Repair oval window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,361,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,15059.0,27 RC,361,Repair recurrent femoral hernia; incarcerated or strangulated High Cost Surgery,,,2369.0,2369.0,5 RC,361,Repair recurrent femoral hernia; reducible ,,,1209.12,13394.0,27 RC,361,Repair recurrent femoral hernia; reducible High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,361,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,12909.0,27 RC,361,"Repair recurrent inguinal hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,361,Repair round window fistula ,,,930.95,8234.0,27 RC,361,Repair round window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,361,"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute ",,,948.0,16207.0,17 RC,361,"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic ",,,948.0,16207.0,17 RC,361,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,948.0,8488.5,64 RC,361,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,948.0,13835.0,29 RC,361,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,948.0,13835.0,29 RC,361,"Repair, laceration of diaphragm, any approach ",,,948.0,16207.0,17 RC,361,"Repair, laceration of palate; over 2 cm or complex ",,,948.0,13241.95,32 RC,361,"Repair, laceration of palate; up to 2 cm ",,,196.58,5841.0,31 RC,361,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia ",,,948.0,73655.7,17 RC,361,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,361,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,361,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,16418.72,17 RC,361,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,16207.0,17 RC,361,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis ",,,948.0,18898.08,17 RC,361,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis ",,,948.0,18571.74,17 RC,361,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,361,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,948.0,35621.26,31 RC,361,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,948.0,34379.68,31 RC,361,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,16330.72,32 RC,361,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,948.0,16207.0,17 RC,361,Replacement of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,361,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,32 RC,361,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract ",,,115.66,5841.0,31 RC,361,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract ",,,115.66,5841.0,31 RC,361,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,361,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,32 RC,361,"Replacement or irrigation, ventricular catheter ",,,948.0,15039.6,32 RC,361,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,948.0,15039.6,32 RC,361,"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,948.0,7565.59,33 RC,361,"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,33 RC,361,"Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, an",,,468.58,6212.0,33 RC,361,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access ",,,948.0,12562.0,33 RC,361,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access ",,,948.0,12562.0,33 RC,361,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,948.0,15039.6,32 RC,361,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,361,"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition ",,,115.66,3128.0,32 RC,361,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,32 RC,361,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,19 RC,361,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,948.0,13973.35,17 RC,361,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,948.0,20267.07,17 RC,361,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,948.0,17864.03,17 RC,361,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,948.0,21716.49,17 RC,361,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,361,"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls ",,,948.0,13241.95,32 RC,361,"Resection of lip, more than one-fourth, without reconstruction ",,,930.95,7150.66,32 RC,361,Resection of mediastinal cyst ,,,948.0,16207.0,17 RC,361,Resection of mediastinal tumor ,,,948.0,16207.0,17 RC,361,Resection of palate or extensive resection of lesion ,,,948.0,13241.95,32 RC,361,"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis ",,,948.0,29052.84,17 RC,361,Resection of scrotum ,,,948.0,8240.61,32 RC,361,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,948.0,34939.67,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,948.0,26098.85,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,948.0,29709.76,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,948.0,34719.28,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,948.0,41237.62,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,948.0,26340.4,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,948.0,36321.35,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,948.0,32985.86,17 RC,361,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,948.0,40559.53,17 RC,361,"Resection temporal bone, external approach ",,,948.0,32511.23,17 RC,361,"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap) ",,,948.0,16207.0,17 RC,361,"Resection, diaphragm; with simple repair (eg, primary suture) ",,,948.0,16207.0,17 RC,361,Retrobulbar injection; alcohol ,,,36.62,5841.0,31 RC,361,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,19 RC,361,"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) ",,,948.0,16207.0,17 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,23 RC,361,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,1986.0,15874.51,78 RC,361,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,1986.0,51129.32,78 RC,361,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,1986.0,32198.25,78 RC,361,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,1986.0,51129.32,78 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed ",,,5796.69,11113.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty ",,,2638.63,9653.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when",,,8579.0,13313.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5604.99,11113.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)",,,9124.0,9653.0,3 RC,361,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when p",,,9124.0,9653.0,3 RC,361,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty ",,,2454.04,9653.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5352.25,11113.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,1986.0,15874.51,78 RC,361,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,1986.0,32198.25,78 RC,361,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,1986.0,32198.25,78 RC,361,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,361,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,361,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,361,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,361,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,1986.0,32198.25,78 RC,361,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,1986.0,51129.32,78 RC,361,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,1986.0,51129.32,78 RC,361,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,1986.0,51129.32,78 RC,361,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed ",,,9049.29,11113.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty ",,,4988.47,9653.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same v",,,8579.0,13313.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf",,,8922.21,11113.0,6 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,23 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,23 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List s",,,10586.0,11113.0,3 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary proced",,,9124.0,9653.0,3 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the",,,9124.0,9653.0,3 RC,361,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, wh",,,9124.0,9653.0,3 RC,361,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,948.0,18300.83,20 RC,361,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,948.0,16207.0,17 RC,361,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,948.0,12562.0,32 RC,361,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,948.0,54750.0,32 RC,361,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,54750.0,32 RC,361,Revision mastoidectomy; resulting in complete mastoidectomy ,,,948.0,13241.95,32 RC,361,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,948.0,13241.95,32 RC,361,Revision mastoidectomy; resulting in radical mastoidectomy ,,,948.0,13241.95,32 RC,361,Revision mastoidectomy; resulting in tympanoplasty ,,,948.0,13241.95,32 RC,361,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,32 RC,361,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,32 RC,361,Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,13835.0,29 RC,361,Revision of colostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,12562.0,32 RC,361,Revision of colostomy; with repair of paracolostomy hernia (separate procedure) ,,,948.0,14524.31,29 RC,361,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy ",,,948.0,20945.15,17 RC,361,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy ",,,948.0,20101.72,17 RC,361,Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) ,,,948.0,16207.0,29 RC,361,Revision of ileostomy; simple (release of superficial scar) (separate procedure) ,,,948.0,8128.0,32 RC,361,Revision of implanted intra-arterial infusion pump ,,,948.0,8146.35,32 RC,361,Revision of peritoneal-venous shunt ,,,948.0,8488.5,32 RC,361,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,948.0,12562.0,32 RC,361,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,27 RC,361,Revision of stapedectomy or stapedotomy High Cost Surgery,,,2369.0,2369.0,5 RC,361,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,948.0,13835.0,20 RC,361,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,948.0,16207.0,17 RC,361,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,948.0,16890.86,32 RC,361,"Revision or removal of gastric neurostimulator electrodes, antrum, open ",,,948.0,21907.23,17 RC,361,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,32 RC,361,Revision or removal of intracranial neurostimulator electrodes ,,,948.0,13835.0,20 RC,361,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,948.0,27181.65,27 RC,361,Revision or removal of peripheral neurostimulator electrode array ,,,948.0,8595.41,32 RC,361,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,32 RC,361,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,32 RC,361,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,948.0,9751.1,22 RC,361,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,948.0,86066.14,22 RC,361,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,948.0,16890.86,32 RC,361,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,948.0,31349.63,31 RC,361,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,361,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,361,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,948.0,56900.95,27 RC,361,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,28 RC,361,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,12547.6,28 RC,361,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) ",,,948.0,23695.81,11 RC,361,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,361,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,361,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,361,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,361,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,361,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,361,Right ventricular recording ,,,2024.5,43890.0,10 RC,361,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,361,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,361,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,948.0,28395.93,12 RC,361,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,948.0,28768.84,12 RC,361,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,948.0,25611.4,12 RC,361,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,948.0,26874.42,12 RC,361,SIGMOIDOSCOPY W/ABLATE TUMR ,,,3390.0,5841.0,2 RC,361,SIGMOIDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,361,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER ",,,4988.0,7014.0,3 RC,361,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,3 RC,361,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,361,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,361,SURGICAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,361,SURGICAL OPENING ESOPHAGUS ,,,3390.0,5841.0,2 RC,361,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,361,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,361,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,361,Salpingostomy (salpingoneostomy) ,,,948.0,13835.0,29 RC,361,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,361,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,32 RC,361,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,32 RC,361,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,948.0,12909.0,29 RC,361,"Scraping of cornea, diagnostic, for smear and/or culture ",,,745.36,5841.0,16 RC,361,Screening proctoscopy ,,,343.69,440.76,5 RC,361,Scrotal exploration ,,,948.0,8240.61,32 RC,361,Scrotoplasty; complicated ,,,948.0,11552.32,32 RC,361,Scrotoplasty; simple ,,,948.0,8240.61,32 RC,361,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,948.0,16207.0,17 RC,361,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,948.0,17546.16,17 RC,361,"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast inje",,,948.0,13835.0,29 RC,361,"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (List in addition to code for initial seco",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family ",,,948.0,5841.0,20 RC,361,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,29 RC,361,"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological superv",,,948.0,13835.0,29 RC,361,"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological su",,,948.0,13835.0,23 RC,361,"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (List",,,948.0,13835.0,23 RC,361,"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, ",,,948.0,13835.0,29 RC,361,"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, inc",,,948.0,13835.0,29 RC,361,"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiograp",,,948.0,13835.0,29 RC,361,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,361,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,361,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,32 RC,361,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,948.0,10424.04,32 RC,361,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,32 RC,361,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,32 RC,361,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,32 RC,361,Severing of tarsorrhaphy ,,,179.07,3128.0,32 RC,361,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,27 RC,361,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Sialolithotomy; parotid, extraoral or complicated intraoral ",,,930.95,7150.66,32 RC,361,"Sialolithotomy; submandibular (submaxillary), complicated, intraoral ",,,265.4,12562.0,32 RC,361,"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral ",,,127.91,13835.0,32 RC,361,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,137.2,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,32 RC,361,"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,32 RC,361,"Sigmoidoscopy, flexible; with biopsy, single or multiple ",,,344.93,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with control of bleeding, any method ",,,450.72,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance ",,,344.93,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with endoscopic mucosal resection ",,,948.0,8234.0,32 RC,361,"Sigmoidoscopy, flexible; with endoscopic ultrasound examination ",,,344.93,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,948.0,13051.67,32 RC,361,"Sigmoidoscopy, flexible; with removal of foreign body(s) ",,,450.72,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,344.93,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3128.0,32 RC,361,"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) ",,,450.72,3128.0,32 RC,361,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,31 RC,361,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,223.51,5841.0,16 RC,361,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,361,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,361,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,948.0,22025.45,34 RC,361,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,948.0,16632.0,34 RC,361,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,32 RC,361,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,948.0,8240.61,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, pl",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedu",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s) ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,32 RC,361,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) ",,,948.0,15059.0,32 RC,361,Snip incision of lacrimal punctum ,,,56.97,5841.0,31 RC,361,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,361,Sperm washing for artificial insemination ,,,44.33,5841.0,16 RC,361,"Sphincteroplasty, anal, for incontinence or prolapse; adult ",,,948.0,12562.0,32 RC,361,"Sphincteroplasty, anal, for incontinence or prolapse; child ",,,948.0,16207.0,17 RC,361,"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) ",,,948.0,12562.0,32 RC,361,"Sphincteroplasty, anal, for incontinence, adult; muscle transplant ",,,948.0,7014.0,32 RC,361,"Sphincterotomy, anal, division of sphincter (separate procedure) ",,,948.0,12562.0,32 RC,361,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,31 RC,361,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,32 RC,361,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,31 RC,361,Splenectomy; partial (separate procedure) ,,,948.0,16207.0,17 RC,361,Splenectomy; total (separate procedure) ,,,948.0,16207.0,17 RC,361,"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions ",,,204.65,12562.0,32 RC,361,"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions ",,,223.55,12562.0,32 RC,361,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,27 RC,361,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,27 RC,361,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out High Cost Surgery",,,2369.0,2369.0,5 RC,361,Stapes mobilization ,,,930.95,12909.0,27 RC,361,Stapes mobilization High Cost Surgery,,,2369.0,2369.0,5 RC,361,Stem cell collection ,,,3390.0,5841.0,2 RC,361,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,948.0,17554.62,17 RC,361,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,948.0,17156.19,17 RC,361,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,948.0,19516.9,17 RC,361,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,948.0,15059.0,17 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,948.0,29069.0,10 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,19113.0,29069.0,5 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,948.0,29069.0,10 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,361,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,361,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,948.0,12562.0,32 RC,361,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,361,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,112.77,5841.0,16 RC,361,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,948.0,5841.0,20 RC,361,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,32 RC,361,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,32 RC,361,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,32 RC,361,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,948.0,8536.87,32 RC,361,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,32 RC,361,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,361,Subconjunctival injection ,,,223.51,5841.0,16 RC,361,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,948.0,14948.14,17 RC,361,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,32 RC,361,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,32 RC,361,"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session ",,,948.0,12909.0,29 RC,361,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,948.0,17554.62,17 RC,361,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,948.0,13835.0,15 RC,361,"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheter",,,948.0,13835.0,29 RC,361,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,24 RC,361,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,456.3,5841.0,15 RC,361,Suprahyoid lymphadenectomy ,,,948.0,14297.8,32 RC,361,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,948.0,26865.96,17 RC,361,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,948.0,31193.16,17 RC,361,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,948.0,31862.78,17 RC,361,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,53176.72,17 RC,361,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,59338.96,17 RC,361,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,948.0,16537.5,17 RC,361,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,948.0,46115.78,17 RC,361,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,948.0,26984.61,17 RC,361,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,948.0,57821.69,17 RC,361,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,948.0,35240.6,17 RC,361,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,948.0,52341.76,17 RC,361,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,948.0,28014.44,17 RC,361,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,42699.85,17 RC,361,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,50133.7,17 RC,361,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,361,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,361,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,361,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,361,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,361,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,361,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,361,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,361,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,361,Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric ,,,948.0,12562.0,32 RC,361,Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage ,,,948.0,6399.61,32 RC,361,Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous ,,,948.0,12562.0,32 RC,361,"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed ",,,948.0,8234.0,32 RC,361,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,948.0,16207.0,17 RC,361,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,948.0,16207.0,17 RC,361,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,948.0,16207.0,17 RC,361,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,948.0,13835.0,29 RC,361,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,948.0,13835.0,29 RC,361,Suture and/or ligation of thoracic duct; abdominal approach ,,,948.0,16207.0,17 RC,361,Suture and/or ligation of thoracic duct; cervical approach ,,,948.0,16207.0,17 RC,361,Suture and/or ligation of thoracic duct; thoracic approach ,,,948.0,16207.0,17 RC,361,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,948.0,13394.0,32 RC,361,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,948.0,13394.0,32 RC,361,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,948.0,15039.6,32 RC,361,Suture of 1 nerve; median motor thenar ,,,948.0,15039.6,32 RC,361,Suture of 1 nerve; ulnar motor ,,,948.0,15039.6,32 RC,361,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,32 RC,361,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Suture of esophageal wound or injury; cervical approach ,,,948.0,16207.0,17 RC,361,Suture of esophageal wound or injury; transthoracic or transabdominal approach ,,,948.0,31642.4,17 RC,361,Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) ,,,948.0,16846.79,17 RC,361,Suture of facial nerve; extracranial ,,,948.0,15039.6,32 RC,361,"Suture of facial nerve; infratemporal, with or without grafting ",,,948.0,15039.6,32 RC,361,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,32 RC,361,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy ",,,948.0,16207.0,17 RC,361,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy ",,,948.0,16207.0,17 RC,361,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,948.0,15039.6,32 RC,361,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,948.0,15039.6,32 RC,361,Suture of mesentery (separate procedure) ,,,948.0,16207.0,17 RC,361,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,948.0,5841.0,20 RC,361,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,948.0,5841.0,20 RC,361,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,948.0,5841.0,20 RC,361,Suture of posterior tibial nerve ,,,948.0,15039.6,32 RC,361,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,32 RC,361,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,32 RC,361,Suture of sciatic nerve ,,,948.0,8104.0,32 RC,361,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations ",,,948.0,19923.79,17 RC,361,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation ",,,948.0,17359.64,17 RC,361,Suture of tongue to lip for micrognathia (Douglas type procedure) ,,,930.95,7150.66,32 RC,361,Suture of; brachial plexus ,,,692.94,12562.0,32 RC,361,Suture of; lumbar plexus ,,,948.0,15039.6,32 RC,361,Suture or repair of testicular injury ,,,948.0,12562.0,32 RC,361,Suture pharynx for wound or injury ,,,783.57,5571.0,32 RC,361,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,948.0,16207.0,17 RC,361,"Sympathectomy, cervical ",,,692.94,4693.83,32 RC,361,"Sympathectomy, cervicothoracic ",,,948.0,13835.0,17 RC,361,"Sympathectomy, lumbar ",,,948.0,16207.0,17 RC,361,"Sympathectomy, thoracolumbar ",,,948.0,16207.0,17 RC,361,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,20 RC,361,Sympathectomy; radial artery ,,,948.0,8234.0,32 RC,361,Sympathectomy; superficial palmar arch ,,,948.0,7473.24,32 RC,361,Sympathectomy; ulnar artery ,,,948.0,12562.0,32 RC,361,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,948.0,16207.0,17 RC,361,TRANSCATH IV STENT OPEN ,,,5841.0,5841.0,1 RC,361,TRANSCATH IV STENT PERCUT ,,,5841.0,5841.0,1 RC,361,TRANSCATH IV STENT/OPEN ADDL ,,,5841.0,5841.0,1 RC,361,TRANSCATH IV STENT/PERC ADDL ,,,5841.0,5841.0,1 RC,361,TRANSCATHETER OCCLUSION ,,,5841.0,5841.0,1 RC,361,TRANSCATHETER RETRIEVAL ,,,5841.0,5841.0,1 RC,361,TRANSCATHETER THERAPY INFUSE ,,,3390.0,5841.0,3 RC,361,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,361,"TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGEAL VARICES ",,,3390.0,16207.0,3 RC,361,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,361,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,361,TRANSPLANTATION OF LIVER ,,,3390.0,5841.0,2 RC,361,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,361,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,32 RC,361,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,361,Therapeutic apheresis; for plasma pheresis ,,,592.85,13835.0,32 RC,361,Therapeutic apheresis; for platelets ,,,172.52,13835.0,32 RC,361,Therapeutic apheresis; for red blood cells ,,,592.85,13835.0,32 RC,361,Therapeutic apheresis; for white blood cells ,,,592.85,13835.0,32 RC,361,"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion ",,,948.0,27628.58,32 RC,361,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,948.0,34379.68,31 RC,361,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,361,"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,15059.0,28 RC,361,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Thrombolysis, cerebral, by intravenous infusion ",,,634.68,5841.0,16 RC,361,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,361,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,361,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,948.0,16745.06,17 RC,361,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,948.0,16207.0,17 RC,361,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,948.0,13835.0,29 RC,361,"Thyroidectomy, including substernal thyroid; cervical approach ",,,948.0,13835.0,29 RC,361,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,948.0,16715.43,17 RC,361,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,948.0,13835.0,29 RC,361,"Thyroidectomy, total or complete ",,,948.0,13835.0,32 RC,361,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,361,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,948.0,13835.0,29 RC,361,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,948.0,20402.66,29 RC,361,"Tongue base suspension, permanent suture technique ",,,948.0,13241.95,29 RC,361,Tonsillectomy and adenoidectomy; age 12 or over ,,,930.95,13394.0,32 RC,361,Tonsillectomy and adenoidectomy; younger than age 12 ,,,948.0,13241.95,32 RC,361,"Tonsillectomy, primary or secondary; age 12 or over ",,,930.95,8234.0,32 RC,361,"Tonsillectomy, primary or secondary; younger than age 12 ",,,948.0,13241.95,32 RC,361,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,948.0,16207.0,29 RC,361,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,948.0,16207.0,29 RC,361,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,24 RC,361,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,361,Total facial nerve decompression and/or repair (may include graft) ,,,948.0,13835.0,29 RC,361,"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es) ",,,948.0,53753.08,17 RC,361,"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy) ",,,948.0,43081.23,17 RC,361,"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es) ",,,948.0,55066.91,17 RC,361,"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) ",,,948.0,36660.39,17 RC,361,"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy ",,,948.0,46819.38,17 RC,361,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13196.03,32 RC,361,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13196.03,32 RC,361,Trabeculoplasty by laser surgery ,,,114.82,3249.0,32 RC,361,Trabeculotomy ab externo ,,,892.44,8234.0,32 RC,361,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,948.0,12562.0,32 RC,361,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,948.0,12562.0,32 RC,361,"Transabdominal amnioinfusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,361,Transcatheter biopsy ,,,948.0,12547.6,32 RC,361,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,361,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,361,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,1986.0,43890.0,57 RC,361,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each",,,1986.0,43890.0,23 RC,361,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; init",,,2369.0,43890.0,34 RC,361,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal em",,,2369.0,43890.0,30 RC,361,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal",,,2369.0,43890.0,30 RC,361,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angiop",,,2369.0,43890.0,29 RC,361,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiolo",,,2369.0,43890.0,29 RC,361,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,361,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day ",,,1986.0,12547.6,28 RC,361,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day High Cost Surger",,,2369.0,2369.0,5 RC,361,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day ",,,1594.88,8234.0,28 RC,361,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,948.0,19655.45,27 RC,361,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,948.0,17689.64,29 RC,361,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,948.0,29709.76,17 RC,361,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,948.0,36245.03,17 RC,361,"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure) ",,,948.0,16207.0,17 RC,361,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,20 RC,361,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,948.0,12562.0,17 RC,361,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,32 RC,361,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,32 RC,361,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,32 RC,361,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,32 RC,361,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,32 RC,361,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,32 RC,361,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,32 RC,361,Transection or avulsion of; mental nerve ,,,692.94,4693.83,32 RC,361,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,32 RC,361,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,32 RC,361,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,948.0,16207.0,17 RC,361,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,948.0,16207.0,17 RC,361,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,361,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,948.0,16207.0,17 RC,361,"Transfusion, blood or blood components ",,,32.27,5841.0,31 RC,361,"Transfusion, intrauterine, fetal ",,,795.48,5841.0,28 RC,361,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1672.0,13835.0,51 RC,361,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,361,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,361,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,948.0,13394.0,29 RC,361,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,948.0,13394.0,29 RC,361,Transmastoid antrotomy (simple mastoidectomy) ,,,948.0,13241.95,32 RC,361,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,948.0,31201.63,17 RC,361,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,948.0,51345.81,17 RC,361,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,948.0,5841.0,20 RC,361,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,948.0,16330.72,32 RC,361,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,948.0,16330.72,32 RC,361,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,948.0,15059.0,31 RC,361,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,29 RC,361,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,948.0,35134.65,17 RC,361,"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer ",,,795.48,3128.0,17 RC,361,Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage ,,,795.48,5841.0,16 RC,361,Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion ,,,795.48,3128.0,17 RC,361,Transplant preparation of hematopoietic progenitor cells; platelet depletion ,,,795.48,3128.0,17 RC,361,Transplant preparation of hematopoietic progenitor cells; red blood cell removal ,,,795.48,3128.0,17 RC,361,"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion ",,,795.48,3128.0,17 RC,361,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor ",,,795.48,5841.0,16 RC,361,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor ",,,795.48,5841.0,16 RC,361,Transplant preparation of hematopoietic progenitor cells; tumor cell depletion ,,,795.48,3128.0,17 RC,361,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,361,Transplantation of pancreatic allograft ,,,948.0,31320.29,15 RC,361,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,361,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,948.0,12562.0,32 RC,361,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,"Transposition, ovary(s) ",,,948.0,13835.0,29 RC,361,Transrectal drainage of pelvic abscess ,,,450.72,5571.0,32 RC,361,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,948.0,28879.03,17 RC,361,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,948.0,16207.0,17 RC,361,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,948.0,19718.21,32 RC,361,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,948.0,15059.0,31 RC,361,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,948.0,18816.77,32 RC,361,Transurethral drainage of prostatic abscess ,,,948.0,8240.61,32 RC,361,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,32 RC,361,Transurethral incision of prostate ,,,948.0,12562.0,32 RC,361,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,948.0,12909.0,29 RC,361,Transurethral resection of bladder neck (separate procedure) ,,,948.0,12562.0,32 RC,361,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,27 RC,361,Transurethral resection; of postoperative bladder neck contracture High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,32 RC,361,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,948.0,26403.19,22 RC,361,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,23 RC,361,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,23 RC,361,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,23 RC,361,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,23 RC,361,Transvesical ureterolithotomy ,,,948.0,13835.0,17 RC,361,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,27 RC,361,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,32 RC,361,"Treatment of incomplete abortion, any trimester, completed surgically ",,,948.0,13394.0,32 RC,361,"Treatment of missed abortion, completed surgically; first trimester ",,,948.0,13394.0,32 RC,361,"Treatment of missed abortion, completed surgically; second trimester ",,,948.0,13394.0,32 RC,361,"Treatment of septic abortion, completed surgically ",,,948.0,16207.0,29 RC,361,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,361,"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure) ",,,948.0,16207.0,17 RC,361,Tubotubal anastomosis ,,,948.0,13835.0,29 RC,361,Tubouterine implantation ,,,948.0,13835.0,29 RC,361,Twist drill hole for subdural or ventricular puncture ,,,948.0,16207.0,17 RC,361,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,948.0,16207.0,17 RC,361,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,948.0,16207.0,17 RC,361,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,948.0,16207.0,17 RC,361,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,28345.13,68 RC,361,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,32 RC,361,Tympanic neurectomy ,,,930.95,12562.0,27 RC,361,Tympanic neurectomy High Cost Surgery,,,2369.0,2369.0,5 RC,361,"Tympanolysis, transcanal ",,,930.95,9653.0,32 RC,361,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,32 RC,361,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,361,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,27 RC,361,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,32 RC,361,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,27 RC,361,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,32 RC,361,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,31 RC,361,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,361,U-tube hepaticoenterostomy ,,,3390.0,16207.0,3 RC,361,UPPER GI ENDOSCOPY EXAM ,,,3390.0,5841.0,2 RC,361,UPPR GI ENDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,361,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,361,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,361,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,361,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,948.0,8488.5,32 RC,361,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,361,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,361,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,361,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,340.4,13835.0,28 RC,361,"Unlisted hysteroscopy procedure, uterus ",,,340.4,13835.0,11 RC,361,"Unlisted hysteroscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopic procedure, liver ",,,948.0,13835.0,17 RC,361,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, appendix ",,,6326.0,13196.03,9 RC,361,"Unlisted laparoscopy procedure, appendix High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, biliary tract ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, biliary tract High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, bladder ",,,948.0,13835.0,17 RC,361,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, endocrine system High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, esophagus ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, esophagus High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, intestine (except rectum) ",,,948.0,13835.0,17 RC,361,"Unlisted laparoscopy procedure, lymphatic system ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, lymphatic system High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,24 RC,361,"Unlisted laparoscopy procedure, maternity care and delivery High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, oviduct, ovary High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, rectum ",,,948.0,13835.0,17 RC,361,"Unlisted laparoscopy procedure, renal ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, renal High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, spermatic cord High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, spleen ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, spleen High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, stomach ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, stomach High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, testis ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, testis High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, ureter High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13835.0,12 RC,361,"Unlisted laparoscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Unlisted procedure, Meckel's diverticulum and the mesentery ",,,948.0,16207.0,17 RC,361,"Unlisted procedure, abdomen, peritoneum and omentum ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, anterior segment of eye ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, anus ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, biliary tract ",,,948.0,13835.0,17 RC,361,"Unlisted procedure, colon ",,,948.0,13394.0,29 RC,361,"Unlisted procedure, conjunctiva ",,,554.5,13835.0,16 RC,361,"Unlisted procedure, dentoalveolar structures ",,,417.46,13835.0,30 RC,361,"Unlisted procedure, diaphragm ",,,948.0,16207.0,17 RC,361,"Unlisted procedure, endocrine system ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, esophagus ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, external ear ",,,417.46,5841.0,16 RC,361,"Unlisted procedure, extraocular muscle ",,,554.5,13835.0,16 RC,361,"Unlisted procedure, eyelids ",,,554.5,13835.0,16 RC,361,"Unlisted procedure, female genital system (nonobstetrical) ",,,340.4,13835.0,28 RC,361,"Unlisted procedure, hemic or lymphatic system ",,,795.48,13835.0,28 RC,361,"Unlisted procedure, inner ear ",,,417.46,13835.0,28 RC,361,"Unlisted procedure, lacrimal system ",,,554.5,13835.0,16 RC,361,"Unlisted procedure, lips ",,,417.46,13835.0,16 RC,361,"Unlisted procedure, liver ",,,948.0,13835.0,16 RC,361,"Unlisted procedure, male genital system ",,,481.54,13835.0,28 RC,361,"Unlisted procedure, maternity care and delivery ",,,340.4,13835.0,28 RC,361,"Unlisted procedure, mediastinum ",,,948.0,16207.0,17 RC,361,"Unlisted procedure, middle ear ",,,417.46,13835.0,28 RC,361,"Unlisted procedure, nervous system ",,,536.63,13835.0,28 RC,361,"Unlisted procedure, orbit ",,,554.5,13835.0,16 RC,361,"Unlisted procedure, palate, uvula ",,,417.46,13835.0,16 RC,361,"Unlisted procedure, pancreas ",,,948.0,13835.0,16 RC,361,"Unlisted procedure, pharynx, adenoids, or tonsils ",,,417.46,13835.0,28 RC,361,"Unlisted procedure, posterior segment ",,,948.0,13835.0,17 RC,361,"Unlisted procedure, rectum ",,,948.0,13835.0,17 RC,361,"Unlisted procedure, salivary glands or ducts ",,,417.46,13835.0,28 RC,361,"Unlisted procedure, small intestine ",,,948.0,13835.0,29 RC,361,"Unlisted procedure, stomach ",,,948.0,13835.0,26 RC,361,"Unlisted procedure, temporal bone, middle fossa approach ",,,417.46,13835.0,28 RC,361,"Unlisted procedure, tongue, floor of mouth ",,,417.46,13835.0,16 RC,361,"Unlisted procedure, urinary system ",,,481.54,13835.0,28 RC,361,"Unlisted procedure, vascular injection ",,,948.0,5841.0,8 RC,361,"Unlisted procedure, vestibule of mouth ",,,417.46,13835.0,28 RC,361,Unlisted vascular endoscopy procedure ,,,948.0,13835.0,17 RC,361,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,948.0,5841.0,20 RC,361,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,361,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,948.0,8240.61,32 RC,361,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,32 RC,361,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,32 RC,361,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,948.0,8240.61,32 RC,361,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,948.0,16207.0,29 RC,361,"Ureterectomy, with bladder cuff (separate procedure) ",,,948.0,16207.0,29 RC,361,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,948.0,16207.0,17 RC,361,"Ureterocolon conduit, including intestine anastomosis ",,,948.0,16207.0,17 RC,361,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,948.0,16207.0,17 RC,361,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,948.0,16207.0,17 RC,361,Ureterolithotomy; lower one-third of ureter ,,,948.0,16207.0,29 RC,361,Ureterolithotomy; middle one-third of ureter ,,,948.0,16207.0,29 RC,361,Ureterolithotomy; upper one-third of ureter ,,,948.0,16207.0,29 RC,361,Ureterolysis for ovarian vein syndrome ,,,948.0,16207.0,17 RC,361,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,948.0,16207.0,17 RC,361,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,948.0,16207.0,17 RC,361,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,948.0,16207.0,17 RC,361,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,948.0,16207.0,17 RC,361,Ureteroneocystostomy; with extensive ureteral tailoring ,,,948.0,16207.0,17 RC,361,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,948.0,16207.0,17 RC,361,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,948.0,16207.0,17 RC,361,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,948.0,16207.0,17 RC,361,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,948.0,16207.0,17 RC,361,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,948.0,17194.41,17 RC,361,"Ureterostomy, transplantation of ureter to skin ",,,948.0,16207.0,17 RC,361,"Ureterotomy for insertion of indwelling stent, all types ",,,948.0,16207.0,29 RC,361,Ureterotomy with exploration or drainage (separate procedure) ,,,948.0,16207.0,29 RC,361,Ureteroureterostomy ,,,948.0,16207.0,17 RC,361,"Urethrectomy, total, including cystostomy; female ",,,948.0,13394.0,32 RC,361,"Urethrectomy, total, including cystostomy; male ",,,948.0,13394.0,32 RC,361,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,948.0,13835.0,29 RC,361,"Urethromeatoplasty, with mucosal advancement ",,,948.0,8240.61,32 RC,361,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,948.0,8240.61,32 RC,361,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,948.0,12562.0,32 RC,361,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,948.0,12562.0,32 RC,361,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,948.0,12562.0,32 RC,361,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,948.0,12562.0,32 RC,361,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,948.0,11552.32,32 RC,361,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,948.0,11552.32,32 RC,361,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,948.0,12562.0,32 RC,361,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,948.0,11552.32,32 RC,361,"Urethroplasty, reconstruction of female urethra ",,,948.0,11552.32,32 RC,361,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,948.0,13858.92,17 RC,361,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,948.0,12562.0,32 RC,361,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,948.0,11552.32,32 RC,361,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,948.0,8240.61,32 RC,361,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,948.0,11552.32,32 RC,361,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,948.0,11552.32,32 RC,361,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,948.0,11552.32,32 RC,361,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,32 RC,361,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,948.0,11552.32,32 RC,361,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,948.0,22102.21,17 RC,361,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,361,Uterine evacuation and curettage for hydatidiform mole ,,,948.0,13394.0,32 RC,361,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,948.0,16207.0,29 RC,361,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,948.0,16207.0,17 RC,361,"Uvulectomy, excision of uvula ",,,930.95,7150.66,32 RC,361,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,361,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,361,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,948.0,13835.0,29 RC,361,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,948.0,12689.16,24 RC,361,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,948.0,13835.0,29 RC,361,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,948.0,13841.99,12 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,27 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,948.0,13835.0,17 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,948.0,15059.0,32 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,948.0,15059.0,29 RC,361,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,948.0,15059.0,29 RC,361,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,948.0,18300.83,29 RC,361,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,13835.0,29 RC,361,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,948.0,18300.83,29 RC,361,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,948.0,13835.0,29 RC,361,"Vaginal hysterectomy, radical (Schauta type operation) ",,,948.0,17741.14,17 RC,361,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,948.0,13835.0,17 RC,361,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,948.0,13835.0,17 RC,361,"Vaginectomy, complete removal of vaginal wall; ",,,948.0,16207.0,29 RC,361,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,21606.3,29 RC,361,"Vaginectomy, partial removal of vaginal wall; ",,,948.0,13835.0,29 RC,361,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,13835.0,29 RC,361,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,948.0,13835.0,29 RC,361,Vaginoplasty for intersex state ,,,948.0,13835.0,29 RC,361,"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective) ",,,948.0,16207.0,17 RC,361,"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective ",,,948.0,16207.0,17 RC,361,Vagotomy when performed with partial distal gastrectomy (List separately in addition to codeºs» for primary procedure) ,,,948.0,16207.0,17 RC,361,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,361,"Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) ",,,2036.11,12562.0,9 RC,361,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,32 RC,361,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,948.0,5841.0,20 RC,361,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,948.0,8240.61,29 RC,361,"Vasovasostomy, vasovasorrhaphy ",,,948.0,8240.61,29 RC,361,"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for ",248.53,248.53,948.0,948.0,5 RC,361,"Venipuncture, cutdown; age 1 or over ",,,745.36,3244.0,26 RC,361,"Venipuncture, cutdown; younger than age 1 year ",,,112.77,3244.0,26 RC,361,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein ",,,948.0,948.0,5 RC,361,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein ",,,948.0,948.0,5 RC,361,"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein ",,,948.0,948.0,5 RC,361,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,361,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,361,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,361,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,361,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,361,"Venous anastomosis, open; caval-mesenteric ",,,948.0,27217.7,17 RC,361,"Venous anastomosis, open; portocaval ",,,948.0,28565.51,17 RC,361,"Venous anastomosis, open; renoportal ",,,948.0,26488.69,17 RC,361,"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique) ",,,948.0,28565.51,17 RC,361,"Venous anastomosis, open; splenorenal, proximal ",,,948.0,26162.35,17 RC,361,Venous catheterization for selective organ blood sampling ,,,948.0,5841.0,20 RC,361,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,32 RC,361,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,32 RC,361,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,32 RC,361,Ventriculocisternostomy (Torkildsen type operation) ,,,948.0,19949.19,17 RC,361,"Ventriculocisternostomy, third ventricle; ",,,948.0,17075.76,17 RC,361,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,948.0,16207.0,17 RC,361,"Vermilionectomy (lip shave), with mucosal advancement ",,,930.95,7150.66,32 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,948.0,16207.0,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,948.0,21674.15,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,948.0,16207.0,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,948.0,29803.02,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,948.0,16207.0,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,948.0,22725.26,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,26781.17,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,948.0,26832.09,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,948.0,27196.53,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,948.0,28616.31,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,30091.25,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,948.0,29773.38,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,948.0,31277.95,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,28743.44,51 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,948.0,24149.28,34 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,948.0,16207.0,17 RC,361,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,948.0,23729.68,17 RC,361,"Vesiculectomy, any approach ",,,948.0,13835.0,29 RC,361,Vesiculotomy; ,,,685.44,11308.65,32 RC,361,Vesiculotomy; complicated ,,,948.0,13835.0,29 RC,361,"Vestibular nerve section, transcranial approach ",,,948.0,21449.53,17 RC,361,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,32 RC,361,Vestibuloplasty; anterior ,,,948.0,13241.95,32 RC,361,"Vestibuloplasty; complex (including ridge extension, muscle repositioning) ",,,948.0,13394.0,32 RC,361,Vestibuloplasty; entire arch ,,,948.0,13394.0,32 RC,361,"Vestibuloplasty; posterior, bilateral ",,,948.0,13241.95,32 RC,361,"Vestibuloplasty; posterior, unilateral ",,,948.0,13241.95,32 RC,361,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,361,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,27 RC,361,"Vitrectomy, mechanical, pars plana approach; High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,27 RC,361,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,27 RC,361,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,32 RC,361,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,27 RC,361,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) High Cost Surgery",,,2369.0,2369.0,5 RC,361,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,32 RC,361,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,361,Vulvectomy simple; complete ,,,948.0,12909.0,32 RC,361,Vulvectomy simple; partial ,,,948.0,13394.0,32 RC,361,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,948.0,18478.49,17 RC,361,"Vulvectomy, radical, complete; ",,,948.0,14986.24,17 RC,361,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,948.0,18618.43,17 RC,361,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,948.0,16058.52,17 RC,361,"Vulvectomy, radical, partial; ",,,948.0,16207.0,29 RC,361,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,948.0,17240.98,17 RC,361,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,948.0,14609.1,17 RC,361,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,948.0,18300.83,29 RC,361,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,362,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,1200.05,1200.05,1 RC,362,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,1200.05,1200.05,1 RC,362,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,1200.05,1200.05,1 RC,362,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,1200.05,1200.05,1 RC,362,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,351.7,351.7,1 RC,362,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,351.7,1 RC,362,"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation ",,,2954.51,2954.51,1 RC,362,"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency ",,,1983.29,1983.29,1 RC,362,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,1983.29,1983.29,1 RC,362,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,4877.66,4877.66,1 RC,362,"Adenoidectomy, primary; age 12 or over ",,,930.95,930.95,1 RC,362,"Adenoidectomy, primary; younger than age 12 ",,,930.95,930.95,1 RC,362,"Adenoidectomy, secondary; age 12 or over ",,,930.95,930.95,1 RC,362,"Adenoidectomy, secondary; younger than age 12 ",,,930.95,930.95,1 RC,362,Allogeneic lymphocyte infusions ,,,592.85,592.85,1 RC,362,"Alveolectomy, including curettage of osteitis or sequestrectomy ",,,289.82,289.82,1 RC,362,"Alveoloplasty, each quadrant (specify) ",,,234.0,234.0,1 RC,362,Amniocentesis; diagnostic ,,,52.04,52.04,1 RC,362,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,122.58,1 RC,362,Amputation of penis; partial ,,,1200.05,1200.05,1 RC,362,"Anoplasty, plastic operation for stricture; adult ",,,986.93,986.93,1 RC,362,"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic ",,,986.93,986.93,1 RC,362,Anorectal myomectomy ,,,986.93,986.93,1 RC,362,"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique ",,,986.93,986.93,1 RC,362,"Anoscopy; with biopsy, single or multiple ",,,211.33,211.33,1 RC,362,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,115.98,115.98,1 RC,362,"Anoscopy; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,450.72,1 RC,362,Anoscopy; with removal of foreign body ,,,344.93,344.93,1 RC,362,"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,986.93,986.93,1 RC,362,"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,986.93,986.93,1 RC,362,"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique ",,,344.93,344.93,1 RC,362,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,1603.34,1603.34,1 RC,362,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,2167.86,2167.86,1 RC,362,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,2091.35,2091.35,1 RC,362,"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown ",,,1174.13,1174.13,1 RC,362,"Arteriovenous anastomosis, open; by forearm vein transposition ",,,2036.11,2036.11,1 RC,362,"Arteriovenous anastomosis, open; by upper arm basilic vein transposition ",,,2036.11,2036.11,1 RC,362,"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition ",,,2036.11,2036.11,1 RC,362,"Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure) ",,,1174.13,1174.13,1 RC,362,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,270.48,1 RC,362,"Aspiration and/or injection, thyroid cyst ",,,62.5,62.5,1 RC,362,Aspiration of bladder; by needle ,,,38.37,38.37,1 RC,362,Aspiration of bladder; by trocar or intracatheter ,,,103.77,103.77,1 RC,362,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,685.44,1 RC,362,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,892.44,1 RC,362,Axillary lymphadenectomy; complete ,,,1983.29,1983.29,1 RC,362,Axillary lymphadenectomy; superficial ,,,1983.29,1983.29,1 RC,362,"Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) ",,,1209.12,1209.12,1 RC,362,"Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple ",,,1209.12,1209.12,1 RC,362,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent ",,,2960.31,2960.31,1 RC,362,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent ",,,1637.09,1637.09,1 RC,362,"Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi ",,,1983.29,1983.29,1 RC,362,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,1200.05,1200.05,1 RC,362,Biopsy external auditory canal ,,,99.71,99.71,1 RC,362,Biopsy external ear ,,,57.56,57.56,1 RC,362,"Biopsy of anorectal wall, anal approach (eg, congenital megacolon) ",,,986.93,986.93,1 RC,362,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,95.93,1 RC,362,Biopsy of conjunctiva ,,,113.96,113.96,1 RC,362,Biopsy of cornea ,,,733.22,733.22,1 RC,362,"Biopsy of epididymis, needle ",,,510.77,510.77,1 RC,362,Biopsy of extraocular muscle ,,,1158.59,1158.59,1 RC,362,Biopsy of floor of mouth ,,,110.18,110.18,1 RC,362,"Biopsy of intestine by capsule, tube, peroral (1 or more specimens) ",,,351.7,351.7,1 RC,362,Biopsy of lacrimal gland ,,,733.22,733.22,1 RC,362,Biopsy of lacrimal sac ,,,733.22,733.22,1 RC,362,Biopsy of lip ,,,67.44,67.44,1 RC,362,"Biopsy of liver, needle; percutaneous ",,,510.77,510.77,1 RC,362,Biopsy of nerve ,,,692.94,692.94,1 RC,362,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,1116.7,1116.7,1 RC,362,"Biopsy of pancreas, percutaneous needle ",,,510.77,510.77,1 RC,362,Biopsy of penis; (separate procedure) ,,,510.77,510.77,1 RC,362,Biopsy of penis; deep structures ,,,855.96,855.96,1 RC,362,Biopsy of salivary gland; incisional ,,,441.67,441.67,1 RC,362,Biopsy of salivary gland; needle ,,,60.46,60.46,1 RC,362,"Biopsy of spinal cord, percutaneous needle ",,,510.77,510.77,1 RC,362,"Biopsy of testis, incisional (separate procedure) ",,,1200.05,1200.05,1 RC,362,"Biopsy of testis, needle (separate procedure) ",,,855.96,855.96,1 RC,362,Biopsy of tongue; anterior two-thirds ,,,116.86,116.86,1 RC,362,Biopsy of tongue; posterior one-third ,,,115.11,115.11,1 RC,362,Biopsy of urethra ,,,685.44,685.44,1 RC,362,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,1116.7,1116.7,1 RC,362,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,49.41,1 RC,362,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,47.09,1 RC,362,"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary) ",,,510.77,510.77,1 RC,362,"Biopsy or excision of lymph node(s); open, deep axillary node(s) ",,,1011.84,1011.84,1 RC,362,"Biopsy or excision of lymph node(s); open, deep cervical node(s) ",,,1011.84,1011.84,1 RC,362,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad ",,,1011.84,1011.84,1 RC,362,"Biopsy or excision of lymph node(s); open, internal mammary node(s) ",,,1011.84,1011.84,1 RC,362,"Biopsy or excision of lymph node(s); open, superficial ",,,1011.84,1011.84,1 RC,362,"Biopsy thyroid, percutaneous core needle ",,,44.76,44.76,1 RC,362,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,510.77,1 RC,362,"Biopsy, prostate, any approach, nonimaging-guided ",,,1200.05,1200.05,1 RC,362,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,685.44,1 RC,362,"Biopsy, vestibule of mouth ",,,113.09,113.09,1 RC,362,"Biopsy; nasopharynx, survey for unknown primary lesion ",,,930.95,930.95,1 RC,362,"Biopsy; nasopharynx, visible lesion, simple ",,,930.95,930.95,1 RC,362,Biopsy; oropharynx ,,,89.82,89.82,1 RC,362,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,47.09,1 RC,362,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,46.52,1 RC,362,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,113.7,1 RC,362,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous ",,,592.85,592.85,1 RC,362,Bone marrow harvesting for transplantation; allogeneic ,,,592.85,592.85,1 RC,362,Bone marrow harvesting for transplantation; autologous ,,,1757.86,1757.86,1 RC,362,Canthoplasty (reconstruction of canthus) ,,,733.22,733.22,1 RC,362,Canthotomy (separate procedure) ,,,733.22,733.22,1 RC,362,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,110.18,1 RC,362,Cautery of cervix; electro or thermal ,,,83.14,83.14,1 RC,362,Cautery of cervix; laser ablation ,,,1116.7,1116.7,1 RC,362,"Cerclage of cervix, during pregnancy; vaginal ",,,1116.7,1116.7,1 RC,362,Change of cystostomy tube; complicated ,,,250.06,250.06,1 RC,362,Change of cystostomy tube; simple ,,,54.36,54.36,1 RC,362,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,685.44,685.44,1 RC,362,Chemodenervation of eccrine glands; both axillae ,,,53.19,53.19,1 RC,362,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,60.75,1 RC,362,Chemodenervation of extraocular muscle ,,,107.27,107.27,1 RC,362,Chemodenervation of internal anal sphincter ,,,450.72,450.72,1 RC,362,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,78.19,1 RC,362,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,68.02,1 RC,362,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,62.21,1 RC,362,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,60.16,1 RC,362,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,72.09,1 RC,362,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,89.82,1 RC,362,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,70.93,1 RC,362,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,72.09,1 RC,362,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,79.06,1 RC,362,"Chorionic villus sampling, any method ",,,52.32,52.32,1 RC,362,Ciliary body destruction; cryotherapy ,,,733.22,733.22,1 RC,362,Ciliary body destruction; cyclodialysis ,,,733.22,733.22,1 RC,362,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,892.44,1 RC,362,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,733.22,1 RC,362,Ciliary body destruction; diathermy ,,,892.44,892.44,1 RC,362,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,250.06,1 RC,362,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,685.44,1 RC,362,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,685.44,1 RC,362,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,113.56,1 RC,362,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,113.56,1 RC,362,Clitoroplasty for intersex state ,,,1116.7,1116.7,1 RC,362,Closure of anal fistula with rectal advancement flap ,,,986.93,986.93,1 RC,362,Closure of cystostomy (separate procedure) ,,,1200.05,1200.05,1 RC,362,"Closure of gastrostomy, surgical ",,,1175.22,1175.22,1 RC,362,"Closure of laceration, vestibule of mouth; 2.5 cm or less ",,,91.96,91.96,1 RC,362,"Closure of laceration, vestibule of mouth; over 2.5 cm or complex ",,,196.58,196.58,1 RC,362,Closure of lacrimal fistula (separate procedure) ,,,733.22,733.22,1 RC,362,Closure of rectovaginal fistula; vaginal or transanal approach ,,,1116.7,1116.7,1 RC,362,"Closure of the lacrimal punctum; by plug, each ",,,82.55,82.55,1 RC,362,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,113.7,1 RC,362,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,1773.9,1773.9,1 RC,362,Closure of urethrovaginal fistula; ,,,2390.64,2390.64,1 RC,362,Closure of vesicovaginal fistula; vaginal approach ,,,1603.34,1603.34,1 RC,362,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,441.67,1 RC,362,Closure salivary fistula ,,,930.95,930.95,1 RC,362,"Cochlear device implantation, with or without mastoidectomy ",,,27258.08,27258.08,1 RC,362,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,344.93,1 RC,362,"Colonoscopy through stoma; with biopsy, single or multiple ",,,450.72,450.72,1 RC,362,"Colonoscopy through stoma; with control of bleeding, any method ",,,450.72,450.72,1 RC,362,"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,344.93,1 RC,362,"Colonoscopy through stoma; with directed submucosal injection(s), any substance ",,,450.72,450.72,1 RC,362,Colonoscopy through stoma; with endoscopic mucosal resection ,,,450.72,450.72,1 RC,362,"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures ",,,450.72,450.72,1 RC,362,Colonoscopy through stoma; with removal of foreign body(s) ,,,344.93,344.93,1 RC,362,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,450.72,1 RC,362,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,450.72,1 RC,362,Colonoscopy through stoma; with transendoscopic balloon dilation ,,,450.72,450.72,1 RC,362,"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descendi",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,344.93,1 RC,362,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with biopsy, single or multiple ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with control of bleeding, any method ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with directed submucosal injection(s), any substance ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with endoscopic mucosal resection ",,,986.93,986.93,1 RC,362,"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) ",,,2941.94,2941.94,1 RC,362,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with removal of foreign body(s) ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,450.72,1 RC,362,"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, desc",,,450.72,450.72,1 RC,362,Colpocentesis (separate procedure) ,,,1603.34,1603.34,1 RC,362,Colpocleisis (Le Fort type) ,,,1603.34,1603.34,1 RC,362,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,1116.7,1116.7,1 RC,362,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,1116.7,1116.7,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,59.59,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,73.54,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,68.31,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,69.76,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,183.14,1 RC,362,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,194.48,1 RC,362,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,60.75,1 RC,362,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,79.95,1 RC,362,Colposcopy of the vulva; ,,,57.86,57.86,1 RC,362,Colposcopy of the vulva; with biopsy(s) ,,,76.17,76.17,1 RC,362,Colpotomy; with drainage of pelvic abscess ,,,1116.7,1116.7,1 RC,362,Colpotomy; with exploration ,,,1116.7,1116.7,1 RC,362,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,1603.34,1603.34,1 RC,362,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,1603.34,1603.34,1 RC,362,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,115.66,1 RC,362,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,229.65,1 RC,362,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,233.43,1 RC,362,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,233.71,1 RC,362,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,1116.7,1116.7,1 RC,362,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,1116.7,1116.7,1 RC,362,Conjunctival flap; bridge or partial (separate procedure) ,,,1158.59,1158.59,1 RC,362,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,733.22,1 RC,362,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,733.22,1 RC,362,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,1158.59,1158.59,1 RC,362,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,1158.59,1158.59,1 RC,362,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,733.22,1 RC,362,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,1158.59,1158.59,1 RC,362,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,1158.59,1158.59,1 RC,362,Construction of artificial vagina; without graft ,,,1603.34,1603.34,1 RC,362,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,733.22,1 RC,362,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,733.22,1 RC,362,"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report ",,,83.43,83.43,1 RC,362,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery ",,,91.96,91.96,1 RC,362,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention ",,,930.95,930.95,1 RC,362,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple ",,,196.58,196.58,1 RC,362,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention ",,,930.95,930.95,1 RC,362,"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), ",,,1209.12,1209.12,1 RC,362,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,593.22,1 RC,362,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,685.44,1 RC,362,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,351.98,1 RC,362,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,733.22,1 RC,362,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,1200.05,1200.05,1 RC,362,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,1200.05,1200.05,1 RC,362,"Correction of everted punctum, cautery ",,,113.7,113.7,1 RC,362,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,733.22,1 RC,362,Correction of lid retraction ,,,733.22,733.22,1 RC,362,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,70.63,1 RC,362,Correction of trichiasis; incision of lid margin ,,,351.98,351.98,1 RC,362,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,733.22,1 RC,362,Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft ,,,2036.11,2036.11,1 RC,362,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft) ",,,2036.11,2036.11,1 RC,362,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,692.94,1 RC,362,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,692.94,1 RC,362,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,692.94,1 RC,362,Cricopharyngeal myotomy ,,,2051.93,2051.93,1 RC,362,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial ",,,154.64,154.64,1 RC,362,"Curettage, postpartum ",,,1116.7,1116.7,1 RC,362,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,1773.9,1773.9,1 RC,362,"Cystostomy, cystotomy with drainage ",,,685.44,685.44,1 RC,362,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,1200.05,1200.05,1 RC,362,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,1200.05,1200.05,1 RC,362,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,685.44,1 RC,362,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,1200.05,1200.05,1 RC,362,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,1200.05,1 RC,362,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,1200.05,1 RC,362,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2550.35,2550.35,1 RC,362,Cystourethroscopy (separate procedure) ,,,250.06,250.06,1 RC,362,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,250.06,1 RC,362,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,685.44,1 RC,362,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,1200.05,1 RC,362,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,1200.05,1200.05,1 RC,362,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with biopsy(s) ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,234.3,1 RC,362,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,250.06,1 RC,362,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with insertion of permanent urethral stent ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,685.44,1 RC,362,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,1773.9,1773.9,1 RC,362,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,1200.05,1 RC,362,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,685.44,1 RC,362,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,1158.59,1158.59,1 RC,362,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,140.69,1 RC,362,Declotting by thrombolytic agent of implanted vascular access device or catheter ,,,27.62,27.62,1 RC,362,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,2051.93,2051.93,1 RC,362,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,692.94,692.94,1 RC,362,Decompression; plantar digital nerve ,,,692.94,692.94,1 RC,362,Decompression; unspecified nerve(s) (specify) ,,,692.94,692.94,1 RC,362,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,593.22,1 RC,362,Delivery of placenta (separate procedure) ,,,1116.7,1116.7,1 RC,362,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,692.94,1 RC,362,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,357.81,1 RC,362,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,692.94,1 RC,362,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,692.94,1 RC,362,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,692.94,1 RC,362,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,692.94,1 RC,362,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,357.81,1 RC,362,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,357.81,1 RC,362,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,357.81,1 RC,362,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,152.61,1 RC,362,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,38.66,1 RC,362,Destruction by neurolytic agent; pudendal nerve ,,,357.81,357.81,1 RC,362,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,218.75,1 RC,362,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,140.41,1 RC,362,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) ",,,137.5,137.5,1 RC,362,"Destruction of lesion (except excision), dentoalveolar structures ",,,441.67,441.67,1 RC,362,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,113.7,1 RC,362,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,132.27,1 RC,362,"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) ",,,187.2,187.2,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,986.93,986.93,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,144.76,144.76,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,78.06,78.06,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,168.02,168.02,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,986.93,986.93,1 RC,362,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,986.93,986.93,1 RC,362,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,744.46,1 RC,362,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,76.74,1 RC,362,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,744.46,1 RC,362,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,744.46,1 RC,362,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,744.46,1 RC,362,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,116.57,1 RC,362,"Destruction of lesion, conjunctiva ",,,74.13,74.13,1 RC,362,"Destruction of lesion, palate or uvula (thermal, cryo or chemical) ",,,142.44,142.44,1 RC,362,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,218.75,1 RC,362,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,123.25,1 RC,362,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,113.7,1 RC,362,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,218.75,1 RC,362,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,1158.59,1 RC,362,"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ",,,986.93,986.93,1 RC,362,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,1116.7,1116.7,1 RC,362,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,103.77,1 RC,362,Diagnostic bone marrow; aspiration(s) ,,,97.38,97.38,1 RC,362,Diagnostic bone marrow; biopsy(ies) ,,,100.58,100.58,1 RC,362,Diagnostic bone marrow; biopsy(ies) and aspiration(s) ,,,855.96,855.96,1 RC,362,Diaphragm or cervical cap fitting with instructions ,,,37.5,37.5,1 RC,362,"Dilation and catheterization of salivary duct, with or without injection ",,,59.88,59.88,1 RC,362,Dilation and curettage of cervical stump ,,,1116.7,1116.7,1 RC,362,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,1116.7,1116.7,1 RC,362,Dilation of anal sphincter (separate procedure) under anesthesia other than local ,,,450.72,450.72,1 RC,362,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,41.85,1 RC,362,"Dilation of esophagus, by unguided sound or bougie, single or multiple passes ",,,351.7,351.7,1 RC,362,"Dilation of esophagus, over guide wire ",,,593.22,593.22,1 RC,362,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,1200.05,1200.05,2 RC,362,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,41.57,1 RC,362,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,31.08,1 RC,362,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,685.44,1 RC,362,Dilation of rectal stricture (separate procedure) under anesthesia other than local ,,,450.72,450.72,1 RC,362,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,97.08,1 RC,362,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,98.84,1 RC,362,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,36.62,1 RC,362,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,41.02,1 RC,362,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,1200.05,1200.05,1 RC,362,Dilation of vagina under anesthesia (other than local) ,,,1116.7,1116.7,1 RC,362,Dilation salivary duct ,,,39.25,39.25,1 RC,362,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,218.75,1 RC,362,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,892.44,1 RC,362,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,892.44,1 RC,362,"Dissection, deep jugular node(s) ",,,1983.29,1983.29,1 RC,362,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach ",,,2051.93,2051.93,1 RC,362,Division of stricture of rectum ,,,450.72,450.72,1 RC,362,"Drainage external auditory canal, abscess ",,,154.94,154.94,1 RC,362,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,118.89,1 RC,362,"Drainage external ear, abscess or hematoma; simple ",,,112.5,112.5,1 RC,362,"Drainage of abscess of palate, uvula ",,,91.96,91.96,1 RC,362,"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated ",,,196.58,196.58,1 RC,362,"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple ",,,138.37,138.37,1 RC,362,"Drainage of abscess; parotid, complicated ",,,930.95,930.95,1 RC,362,"Drainage of abscess; parotid, simple ",,,441.67,441.67,1 RC,362,"Drainage of abscess; submaxillary or sublingual, intraoral ",,,196.58,196.58,1 RC,362,"Drainage of abscess; submaxillary, external ",,,196.58,196.58,1 RC,362,Drainage of deep periurethral abscess ,,,1200.05,1200.05,1 RC,362,Drainage of lymph node abscess or lymphadenitis; extensive ,,,855.96,855.96,1 RC,362,Drainage of lymph node abscess or lymphadenitis; simple ,,,855.96,855.96,1 RC,362,"Drainage of ovarian abscess; vaginal approach, open ",,,1116.7,1116.7,1 RC,362,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,1116.7,1116.7,1 RC,362,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,1116.7,1116.7,1 RC,362,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,250.06,1 RC,362,Drainage of perivesical or prevesical space abscess ,,,855.96,855.96,1 RC,362,Drainage of scrotal wall abscess ,,,510.77,510.77,1 RC,362,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic ",,,71.55,71.55,1 RC,362,"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes d",,,351.7,351.7,1 RC,362,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,23.25,1 RC,362,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,96.51,1 RC,362,Endolymphatic sac operation; with shunt ,,,2051.93,2051.93,1 RC,362,Endolymphatic sac operation; without shunt ,,,2051.93,2051.93,1 RC,362,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,1603.34,1 RC,362,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,1299.68,1299.68,1 RC,362,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,48.26,1 RC,362,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,2518.45,2518.45,1 RC,362,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,344.93,1 RC,362,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); with biopsy, single or multiple ",,,344.93,344.93,1 RC,362,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,1639.76,1639.76,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,1175.22,1175.22,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed ",,,1175.22,1175.22,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple ",,,1175.22,1175.22,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) ",,,1770.48,1770.48,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,2327.33,2327.33,1 RC,362,Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi ,,,1175.22,1175.22,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,2363.19,2363.19,1 RC,362,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) ,,,1175.22,1175.22,1 RC,362,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) ,,,1175.22,1175.22,1 RC,362,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy ,,,1175.22,1175.22,1 RC,362,"Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, ",,,1175.22,1175.22,1 RC,362,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated ",,,1174.13,1174.13,1 RC,362,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated ",,,981.96,981.96,1 RC,362,"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated ",,,1174.13,1174.13,1 RC,362,"Enucleation of eye; with implant, muscles attached to implant ",,,1158.59,1158.59,1 RC,362,"Enucleation of eye; with implant, muscles not attached to implant ",,,1158.59,1158.59,1 RC,362,Enucleation of eye; without implant ,,,1158.59,1158.59,1 RC,362,Epididymectomy; bilateral ,,,1200.05,1200.05,1 RC,362,Epididymectomy; unilateral ,,,1200.05,1200.05,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,351.7,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple ",,,351.7,351.7,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie) ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,351.7,351.7,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed ",,,4234.08,4234.08,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire ",,,351.7,351.7,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy ",,,1175.22,1175.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2856.08,2856.08,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) ",,,351.7,351.7,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) ",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial ma",,,593.22,593.22,1 RC,362,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterºs»/stentºs», when performed, and endoscopic ultrasound, when",,,2955.56,2955.56,1 RC,362,"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,117.44,117.44,1 RC,362,"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple ",,,125.86,125.86,1 RC,362,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,351.7,1 RC,362,"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,1536.84,1536.84,1 RC,362,"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with biopsy, single or multiple ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with optical endomicroscopy ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2800.92,2800.92,1 RC,362,"Esophagoscopy, flexible, transoral; with removal of foreign body(s) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope ",,,2051.93,2051.93,1 RC,362,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) ",,,593.22,593.22,1 RC,362,"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter) ",,,1175.22,1175.22,1 RC,362,"Esophagoscopy, rigid, transoral; with biopsy, single or multiple ",,,593.22,593.22,1 RC,362,"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance ",,,593.22,593.22,1 RC,362,"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire ",,,1175.22,1175.22,1 RC,362,"Esophagoscopy, rigid, transoral; with removal of foreign body(s) ",,,593.22,593.22,1 RC,362,Evisceration of ocular contents; with implant ,,,1158.59,1158.59,1 RC,362,Evisceration of ocular contents; without implant ,,,1158.59,1158.59,1 RC,362,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,685.44,1 RC,362,"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging",,,1209.12,1209.12,1 RC,362,Exchange of intraocular lens ,,,892.44,892.44,1 RC,362,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,593.22,593.22,1 RC,362,"Exchange transfusion, blood; newborn ",,,172.52,172.52,1 RC,362,"Exchange transfusion, blood; other than newborn ",,,172.52,172.52,1 RC,362,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,733.22,2 RC,362,Excision aural glomus tumor; transcanal ,,,2051.93,2051.93,1 RC,362,Excision aural glomus tumor; transmastoid ,,,2051.93,2051.93,1 RC,362,Excision aural polyp ,,,143.6,143.6,1 RC,362,"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ",,,930.95,930.95,1 RC,362,"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx ",,,2051.93,2051.93,1 RC,362,"Excision exostosis(es), external auditory canal ",,,2051.93,2051.93,1 RC,362,Excision external ear; complete amputation ,,,2051.93,2051.93,1 RC,362,"Excision external ear; partial, simple repair ",,,855.96,855.96,1 RC,362,Excision of Bartholin's gland or cyst ,,,1116.7,1116.7,1 RC,362,Excision of Mullerian duct cyst ,,,1200.05,1200.05,1 RC,362,Excision of bulbourethral gland (Cowper's gland) ,,,1200.05,1200.05,1 RC,362,"Excision of cervical stump, vaginal approach; ",,,1603.34,1603.34,1 RC,362,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,1603.34,1603.34,1 RC,362,"Excision of chalazion; multiple, different lids ",,,101.16,101.16,1 RC,362,"Excision of chalazion; multiple, same lid ",,,78.49,78.49,1 RC,362,Excision of chalazion; single ,,,65.12,65.12,1 RC,362,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,733.22,1 RC,362,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,1983.29,1983.29,1 RC,362,"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection ",,,1937.47,1937.47,1 RC,362,"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection ",,,1011.84,1011.84,1 RC,362,Excision of extraparenchymal lesion of testis ,,,1200.05,1200.05,1 RC,362,"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) ",,,441.67,441.67,1 RC,362,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,1200.05,1200.05,1 RC,362,Excision of hydrocele; bilateral ,,,1209.12,1209.12,1 RC,362,Excision of hydrocele; unilateral ,,,1209.12,1209.12,1 RC,362,"Excision of hyperplastic alveolar mucosa, each quadrant (specify) ",,,198.25,198.25,1 RC,362,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,1158.59,1158.59,1 RC,362,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,1158.59,1158.59,1 RC,362,Excision of lacrimal gland tumor; frontal approach ,,,733.22,733.22,1 RC,362,Excision of lacrimal gland tumor; involving osteotomy ,,,1158.59,1158.59,1 RC,362,Excision of lacrimal sac (dacryocystectomy) ,,,1158.59,1158.59,1 RC,362,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,177.9,1 RC,362,"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle ",,,930.95,930.95,1 RC,362,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair ",,,930.95,930.95,1 RC,362,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair ",,,172.67,172.67,1 RC,362,"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair ",,,144.47,144.47,1 RC,362,Excision of lesion of spermatic cord (separate procedure) ,,,1200.05,1200.05,1 RC,362,Excision of lesion of tongue with closure; anterior two-thirds ,,,930.95,930.95,1 RC,362,Excision of lesion of tongue with closure; posterior one-third ,,,930.95,930.95,1 RC,362,Excision of lesion of tongue with closure; with local tongue flap ,,,930.95,930.95,1 RC,362,Excision of lesion of tongue without closure ,,,149.42,149.42,1 RC,362,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair ",,,2051.93,2051.93,1 RC,362,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair ",,,188.37,188.37,1 RC,362,"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair ",,,146.52,146.52,1 RC,362,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,733.22,1 RC,362,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,147.09,1 RC,362,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,733.22,1 RC,362,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,351.98,1 RC,362,"Excision of lesion, sclera ",,,733.22,733.22,1 RC,362,Excision of lingual frenum (frenectomy) ,,,170.34,170.34,1 RC,362,Excision of lip; V-excision with primary direct linear closure ,,,930.95,930.95,1 RC,362,"Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) ",,,2051.93,2051.93,1 RC,362,"Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) ",,,930.95,930.95,1 RC,362,Excision of lip; transverse wedge excision with primary closure ,,,930.95,930.95,1 RC,362,Excision of local lesion of epididymis ,,,1200.05,1200.05,1 RC,362,Excision of mucosa of vestibule of mouth as donor graft ,,,196.58,196.58,1 RC,362,"Excision of multiple external papillae or tags, anus ",,,986.93,986.93,1 RC,362,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,692.94,1 RC,362,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,2096.41,2096.41,1 RC,362,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,692.94,1 RC,362,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,692.94,1 RC,362,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,692.94,1 RC,362,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,692.94,1 RC,362,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,692.94,1 RC,362,Excision of neuroma; sciatic nerve ,,,2096.41,2096.41,1 RC,362,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve ",,,2051.93,2051.93,1 RC,362,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection ",,,2051.93,2051.93,1 RC,362,"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve ",,,2051.93,2051.93,1 RC,362,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve ",,,2051.93,2051.93,1 RC,362,Excision of penile plaque (Peyronie disease); ,,,1200.05,1200.05,1 RC,362,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,3488.38,3488.38,1 RC,362,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,1773.9,1773.9,1 RC,362,"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach ",,,986.93,986.93,1 RC,362,"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) ",,,986.93,986.93,1 RC,362,"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) ",,,986.93,986.93,1 RC,362,"Excision of single external papilla or tag, anus ",,,450.72,450.72,1 RC,362,"Excision of spermatocele, with or without epididymectomy ",,,685.44,685.44,1 RC,362,Excision of sublingual gland ,,,2051.93,2051.93,1 RC,362,Excision of sublingual salivary cyst (ranula) ,,,930.95,930.95,1 RC,362,Excision of submandibular (submaxillary) gland ,,,2051.93,2051.93,1 RC,362,"Excision of thrombosed hemorrhoid, external ",,,131.97,131.97,1 RC,362,Excision of thyroglossal duct cyst or sinus; ,,,1983.29,1983.29,1 RC,362,Excision of thyroglossal duct cyst or sinus; recurrent ,,,1983.29,1983.29,1 RC,362,Excision of tonsil tags ,,,930.95,930.95,1 RC,362,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,1983.29,1983.29,1 RC,362,Excision of urethral diverticulum (separate procedure); female ,,,1773.9,1773.9,1 RC,362,Excision of urethral diverticulum (separate procedure); male ,,,1773.9,1773.9,1 RC,362,Excision of vaginal cyst or tumor ,,,1116.7,1116.7,1 RC,362,Excision of vaginal septum ,,,1116.7,1116.7,1 RC,362,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,1200.05,1200.05,1 RC,362,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,1209.12,1209.12,1 RC,362,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,1209.12,1209.12,1 RC,362,"Excision or destruction lingual tonsil, any method (separate procedure) ",,,2051.93,2051.93,1 RC,362,"Excision or destruction of lesion of pharynx, any method ",,,930.95,930.95,1 RC,362,Excision or fulguration of carcinoma of urethra ,,,1200.05,1200.05,1 RC,362,Excision or fulguration; Skene's glands ,,,1200.05,1200.05,1 RC,362,Excision or fulguration; urethral caruncle ,,,685.44,685.44,1 RC,362,"Excision or fulguration; urethral polyp(s), distal urethra ",,,1200.05,1200.05,1 RC,362,Excision or fulguration; urethral prolapse ,,,1200.05,1200.05,1 RC,362,Excision or transposition of pterygium; with graft ,,,733.22,733.22,1 RC,362,Excision or transposition of pterygium; without graft ,,,733.22,733.22,1 RC,362,"Excision soft tissue lesion, external auditory canal ",,,855.96,855.96,1 RC,362,"Excision, lesion of floor of mouth ",,,930.95,930.95,1 RC,362,"Excision, lesion of palate, uvula; with local flap closure ",,,2051.93,2051.93,1 RC,362,"Excision, lesion of palate, uvula; with simple primary closure ",,,155.23,155.23,1 RC,362,"Excision, lesion of palate, uvula; without closure ",,,133.14,133.14,1 RC,362,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,1158.59,1158.59,1 RC,362,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,1158.59,1158.59,1 RC,362,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,1158.59,1158.59,1 RC,362,Exploration for undescended testis (inguinal or scrotal area) ,,,1209.12,1209.12,1 RC,362,Exploration for undescended testis with abdominal exploration ,,,685.44,685.44,1 RC,362,"Exploration of epididymis, with or without biopsy ",,,1200.05,1200.05,1 RC,362,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,1773.9,1773.9,1 RC,362,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,26.74,1 RC,362,External cannula declotting (separate procedure); with balloon catheter ,,,2861.3,2861.3,1 RC,362,External cannula declotting (separate procedure); without balloon catheter ,,,468.58,468.58,1 RC,362,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,2096.2,2096.2,1 RC,362,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,2725.44,2725.44,1 RC,362,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,892.44,1 RC,362,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,2725.44,3 RC,362,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space ",,,441.67,441.67,1 RC,362,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual ",,,196.58,196.58,1 RC,362,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular ",,,930.95,930.95,1 RC,362,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental ",,,2051.93,2051.93,1 RC,362,Fetal contraction stress test ,,,28.49,28.49,1 RC,362,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,122.58,1 RC,362,Fetal non-stress test ,,,16.57,16.57,1 RC,362,Fine needle aspiration of orbital contents ,,,733.22,733.22,1 RC,362,"Fissurectomy, including sphincterotomy, when performed ",,,986.93,986.93,1 RC,362,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,892.44,1 RC,362,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,2317.12,2317.12,1 RC,362,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,892.44,1 RC,362,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,892.44,1 RC,362,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,1610.16,1610.16,1 RC,362,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,35.18,1 RC,362,Fixation of contralateral testis (separate procedure) ,,,1200.05,1200.05,1 RC,362,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,115.66,1 RC,362,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty) ",,,930.95,930.95,1 RC,362,Frenulotomy of penis ,,,685.44,685.44,1 RC,362,"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ",,,1530.5,1530.5,1 RC,362,"Gastric restrictive procedure, open; removal of subcutaneous port component only ",,,744.46,744.46,1 RC,362,"Gastric restrictive procedure, open; revision of subcutaneous port component only ",,,1530.5,1530.5,1 RC,362,"Gingivectomy, excision gingiva, each quadrant ",,,930.95,930.95,1 RC,362,"Gingivoplasty, each quadrant (specify) ",,,304.35,304.35,1 RC,362,Glossectomy; less than one-half tongue ,,,2051.93,2051.93,1 RC,362,Goniotomy ,,,1610.16,1610.16,1 RC,362,Graft (Thiersch operation) for rectal incontinence and/or prolapse ,,,986.93,986.93,1 RC,362,Hematopoietic progenitor cell (HPC); HPC boost ,,,592.85,592.85,1 RC,362,Hematopoietic progenitor cell (HPC); autologous transplantation ,,,592.85,592.85,1 RC,362,"Hemorrhoidectomy, external, 2 or more columns/groups ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, single column/group; ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance ",,,986.93,986.93,1 RC,362,"Hemorrhoidectomy, internal, by rubber band ligation(s) ",,,171.8,171.8,1 RC,362,"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed ",,,986.93,986.93,1 RC,362,"Hymenotomy, simple incision ",,,1116.7,1116.7,1 RC,362,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,1116.7,1 RC,362,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,2087.34,1 RC,362,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,1603.34,1 RC,362,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,1603.34,1 RC,362,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,1603.34,1 RC,362,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,1116.7,1 RC,362,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,1603.34,1 RC,362,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,1116.7,1 RC,362,"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,351.7,1 RC,362,"Ileoscopy, through stoma; with biopsy, single or multiple ",,,351.7,351.7,1 RC,362,"Ileoscopy, through stoma; with transendoscopic balloon dilation ",,,593.22,593.22,1 RC,362,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,510.77,510.77,1 RC,362,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,510.77,510.77,1 RC,362,Implantation of intrastromal corneal ring segments ,,,1610.16,1610.16,1 RC,362,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,2052.31,1 RC,362,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,11543.55,11543.55,1 RC,362,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,12153.86,12153.86,1 RC,362,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,11838.6,11838.6,1 RC,362,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,6576.47,6576.47,1 RC,362,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,6576.47,6576.47,1 RC,362,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,8279.9,8279.9,1 RC,362,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,3035.04,3035.04,1 RC,362,Incision and drainage abscess; peritonsillar ,,,91.96,91.96,1 RC,362,"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach ",,,2051.93,2051.93,1 RC,362,"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach ",,,930.95,930.95,1 RC,362,Incision and drainage of Bartholin's gland abscess ,,,74.05,74.05,1 RC,362,"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess ",,,986.93,986.93,1 RC,362,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,685.44,1 RC,362,"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia ",,,986.93,986.93,1 RC,362,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) ,,,450.72,450.72,1 RC,362,"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton ",,,986.93,986.93,1 RC,362,"Incision and drainage of penis, deep ",,,510.77,510.77,1 RC,362,"Incision and drainage of submucosal abscess, rectum ",,,450.72,450.72,1 RC,362,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,441.67,1 RC,362,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,855.96,1 RC,362,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,855.96,1 RC,362,Incision and drainage of vulva or perineal abscess ,,,79.36,79.36,1 RC,362,"Incision and drainage, perianal abscess, superficial ",,,344.93,344.93,1 RC,362,"Incision of conjunctiva, drainage of cyst ",,,58.72,58.72,1 RC,362,Incision of labial frenum (frenotomy) ,,,76.45,76.45,1 RC,362,Incision of lingual frenum (frenotomy) ,,,441.67,441.67,1 RC,362,"Incision of thrombosed hemorrhoid, external ",,,115.66,115.66,1 RC,362,"Incision, anal septum (infant) ",,,986.93,986.93,1 RC,362,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,214.82,1 RC,362,Incisional biopsy of eyelid skin including lid margin ,,,113.7,113.7,1 RC,362,"Induced abortion, by dilation and curettage ",,,1116.7,1116.7,1 RC,362,"Induced abortion, by dilation and evacuation ",,,1116.7,1116.7,1 RC,362,"Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) ",,,1937.47,1937.47,1 RC,362,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,36.92,1 RC,362,Injection of medication or other substance into Tenon's capsule ,,,20.35,20.35,1 RC,362,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal v",,,744.46,744.46,1 RC,362,"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity t",,,744.46,744.46,1 RC,362,"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg ",,,122.09,122.09,1 RC,362,Injection of sclerosant; single incompetent vein (other than telangiectasia) ,,,74.13,74.13,1 RC,362,"Injection of sclerosing solution, hemorrhoids ",,,220.64,220.64,1 RC,362,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,892.44,1 RC,362,Injection procedure for Peyronie disease; ,,,63.08,63.08,1 RC,362,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,1773.9,1773.9,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,465.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,41.85,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,146.8,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,31.69,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,64.83,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,276.0,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,276.0,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,41.28,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,45.35,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,18.89,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,77.32,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,40.7,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,357.81,1 RC,362,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,70.93,1 RC,362,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,357.81,1 RC,362,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,357.81,1 RC,362,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,357.81,4 RC,362,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,276.0,4 RC,362,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,357.81,1 RC,362,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,357.81,1 RC,362,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,74.13,1 RC,362,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,357.81,1 RC,362,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,357.81,1 RC,362,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,892.44,1 RC,362,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,892.44,1 RC,362,"Injection, epidural, of blood or clot patch ",,,276.0,276.0,1 RC,362,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,357.81,1 RC,362,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,357.81,1 RC,362,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,357.81,1 RC,362,Insertion of Heyman capsules for clinical brachytherapy ,,,1603.34,1603.34,1 RC,362,Insertion of Thomas shunt (separate procedure) ,,,1747.39,1747.39,1 RC,362,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,536.91,1 RC,362,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,122.58,1 RC,362,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,2340.64,2340.64,1 RC,362,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) ",,,1174.13,1174.13,1 RC,362,"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure ",,,2036.11,2036.11,1 RC,362,"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein ",,,2036.11,2036.11,1 RC,362,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,450.72,450.72,1 RC,362,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,593.22,1 RC,362,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,593.22,1 RC,362,"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver) ",,,2036.11,2036.11,1 RC,362,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,13357.3,13357.3,1 RC,362,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,892.44,1 RC,362,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older ,,,1174.13,1174.13,1 RC,362,Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age ,,,1174.13,1174.13,1 RC,362,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,1158.59,1158.59,1 RC,362,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,1158.59,1158.59,1 RC,362,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,1158.59,1158.59,1 RC,362,"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,1174.13,1174.13,1 RC,362,"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,1174.13,1174.13,1 RC,362,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision a",,,234.94,468.58,2 RC,362,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older ",,,468.58,468.58,1 RC,362,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age ",,,468.58,468.58,1 RC,362,Insertion of pin-retained palatal prosthesis ,,,2051.93,2051.93,1 RC,362,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,2096.41,2096.41,1 RC,362,Insertion of tandem cuff (dual cuff) ,,,12767.55,12767.55,1 RC,362,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,60.68,1 RC,362,Insertion of testicular prosthesis (separate procedure) ,,,2626.34,2626.34,1 RC,362,Insertion of tunneled centrally inserted central venous access device with subcutaneous pump ,,,3619.47,3619.47,1 RC,362,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s) ",,,2036.11,2036.11,1 RC,362,"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter) ",,,1174.13,1174.13,1 RC,362,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older ",,,1174.13,1174.13,1 RC,362,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age ",,,1174.13,1174.13,1 RC,362,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older ",,,1174.13,1174.13,1 RC,362,"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age ",,,2655.69,2655.69,1 RC,362,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,1209.12,1209.12,1 RC,362,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,1209.12,1209.12,1 RC,362,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,2036.11,2036.11,1 RC,362,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,1603.34,1603.34,1 RC,362,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,20613.2,20613.2,1 RC,362,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,15616.36,15616.36,1 RC,362,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,15482.58,15482.58,1 RC,362,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,20514.82,20514.82,1 RC,362,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,43.61,1 RC,362,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,892.44,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual ",,,87.5,87.5,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space ",,,196.58,196.58,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid ",,,441.67,441.67,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial ",,,91.96,91.96,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space ",,,930.95,930.95,1 RC,362,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space ",,,441.67,441.67,1 RC,362,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,50.87,1 RC,362,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,74.05,1 RC,362,"Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) ",,,351.7,351.7,1 RC,362,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,468.58,5533.59,3 RC,362,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,1610.16,1610.16,1 RC,362,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,892.44,1 RC,362,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,892.44,1 RC,362,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,892.44,1 RC,362,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,892.44,1 RC,362,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,218.75,1 RC,362,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,892.44,1 RC,362,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,892.44,1 RC,362,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,161.05,1 RC,362,Irrigation of corpora cavernosa for priapism ,,,115.66,115.66,1 RC,362,Keratoplasty (corneal transplant); anterior lamellar ,,,1610.16,1610.16,1 RC,362,Keratoplasty (corneal transplant); endothelial ,,,1610.16,1610.16,1 RC,362,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,1610.16,1610.16,1 RC,362,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,1610.16,1610.16,1 RC,362,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,1610.16,1610.16,1 RC,362,Labyrinthectomy; transcanal ,,,2051.93,2051.93,1 RC,362,Labyrinthectomy; with mastoidectomy ,,,2051.93,2051.93,1 RC,362,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,130.52,1 RC,362,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,14400.01,14400.01,1 RC,362,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,2518.45,2518.45,1 RC,362,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,2518.45,2518.45,1 RC,362,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,2518.45,2518.45,1 RC,362,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,2518.45,2518.45,3 RC,362,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,2518.45,2518.45,1 RC,362,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,2518.45,2518.45,1 RC,362,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,2518.45,1 RC,362,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,1983.29,1 RC,362,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,1983.29,1 RC,362,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical; cholecystectomy ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; cholecystectomy with cholangiography ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; cholecystectomy with exploration of common duct ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; orchiectomy ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,2724.11,1 RC,362,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including ",,,3265.51,3265.51,1 RC,362,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,1983.29,1 RC,362,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,1983.29,1 RC,362,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,1773.9,1 RC,362,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,1773.9,1773.9,1 RC,362,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,1773.9,1 RC,362,"Lengthening of palate, and pharyngeal flap ",,,2051.93,2051.93,1 RC,362,"Lengthening of palate, with island flap ",,,2051.93,2051.93,1 RC,362,"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of de",,,1174.13,1174.13,1 RC,362,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions ",,,1174.13,1174.13,1 RC,362,Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure) ,,,1174.13,1174.13,1 RC,362,Ligation of femoral vein ,,,1174.13,1174.13,1 RC,362,"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg ",,,1174.13,1174.13,1 RC,362,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg ",,,1174.13,1174.13,1 RC,362,Ligation or banding of angioaccess arteriovenous fistula ,,,1174.13,1174.13,1 RC,362,"Ligation or biopsy, temporal artery ",,,510.77,510.77,1 RC,362,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,1116.7,1116.7,1 RC,362,"Ligation salivary duct, intraoral ",,,930.95,930.95,1 RC,362,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below ",,,1174.13,1174.13,1 RC,362,"Ligation, division, and stripping, short saphenous vein ",,,1174.13,1174.13,1 RC,362,"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg ",,,1174.13,1174.13,1 RC,362,Limited pharyngectomy ,,,2051.93,2051.93,1 RC,362,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,1200.05,1200.05,1 RC,362,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,1200.05,1200.05,1 RC,362,"Lithotripsy, extracorporeal shock wave ",,,1200.05,1200.05,1 RC,362,Lymphangiotomy or other operations on lymphatic channels ,,,1011.84,1011.84,1 RC,362,Lysis of labial adhesions ,,,1116.7,1116.7,1 RC,362,Lysis or excision of penile post-circumcision adhesions ,,,685.44,685.44,1 RC,362,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,250.06,1 RC,362,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,60.68,1 RC,362,Marsupialization of Bartholin's gland cyst ,,,1116.7,1116.7,1 RC,362,Marsupialization of sublingual salivary cyst (ranula) ,,,930.95,930.95,1 RC,362,"Marsupialization of urethral diverticulum, male or female ",,,1200.05,1200.05,1 RC,362,Mastoid obliteration (separate procedure) ,,,2051.93,2051.93,1 RC,362,Mastoidectomy; complete ,,,2051.93,2051.93,1 RC,362,Mastoidectomy; modified radical ,,,2051.93,2051.93,1 RC,362,Mastoidectomy; radical ,,,2051.93,2051.93,1 RC,362,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,685.44,1 RC,362,Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen ,,,468.58,468.58,1 RC,362,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,351.7,1 RC,362,"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access ",,,1525.02,1525.02,1 RC,362,Middle ear exploration through postauricular or ear canal incision ,,,930.95,930.95,1 RC,362,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,733.22,1 RC,362,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,242.73,1 RC,362,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,1116.7,1116.7,1 RC,362,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,930.95,1 RC,362,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,91.96,1 RC,362,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,930.95,1 RC,362,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) ",,,117.96,117.96,1 RC,362,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,3062.57,3062.57,1 RC,362,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,3062.57,3062.57,1 RC,362,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,115.66,1 RC,362,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,3565.6,3565.6,1 RC,362,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,2096.41,2096.41,1 RC,362,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,3123.03,3123.03,1 RC,362,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,2729.23,2729.23,1 RC,362,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,2729.23,2729.23,1 RC,362,Nerve pedicle transfer; first stage ,,,2096.41,2096.41,1 RC,362,Nerve pedicle transfer; second stage ,,,2096.41,2096.41,1 RC,362,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,3248.57,3248.57,1 RC,362,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,3260.21,3260.21,1 RC,362,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,692.94,1 RC,362,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,692.94,1 RC,362,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,692.94,1 RC,362,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,692.94,1 RC,362,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,692.94,1 RC,362,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,692.94,1 RC,362,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,692.94,1 RC,362,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,692.94,1 RC,362,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,692.94,1 RC,362,Neuroplasty; nerve of hand or foot ,,,692.94,692.94,1 RC,362,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,1116.7,1116.7,1 RC,362,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,1499.06,1499.06,1 RC,362,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,20854.81,20854.81,1 RC,362,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,20854.81,20854.81,1 RC,362,Open implantation of neurostimulator electrode array; neuromuscular ,,,12450.41,12450.41,1 RC,362,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,8596.27,8596.27,1 RC,362,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,4154.17,4154.17,1 RC,362,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,1158.59,1158.59,1 RC,362,Orbital implant (implant outside muscle cone); insertion ,,,1158.59,1158.59,1 RC,362,Orbital implant (implant outside muscle cone); removal or revision ,,,1158.59,1158.59,1 RC,362,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,1158.59,1158.59,1 RC,362,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,1158.59,1158.59,1 RC,362,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,1158.59,1158.59,1 RC,362,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,1158.59,1158.59,1 RC,362,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,1158.59,1158.59,1 RC,362,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,1158.59,1158.59,1 RC,362,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,733.22,1 RC,362,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,1158.59,1158.59,1 RC,362,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,733.22,1 RC,362,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,733.22,1 RC,362,"Orchiectomy, partial ",,,1200.05,1200.05,1 RC,362,"Orchiectomy, radical, for tumor; inguinal approach ",,,1209.12,1209.12,1 RC,362,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,1200.05,1200.05,1 RC,362,"Orchiopexy, inguinal or scrotal approach ",,,1209.12,1209.12,1 RC,362,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,930.95,1 RC,362,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) ",,,2051.93,2051.93,1 RC,362,"Palatoplasty for cleft palate, soft and/or hard palate only ",,,2051.93,2051.93,1 RC,362,"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only ",,,930.95,930.95,1 RC,362,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft) ",,,3268.77,3268.77,1 RC,362,Palatoplasty for cleft palate; attachment pharyngeal flap ,,,2051.93,2051.93,1 RC,362,Palatoplasty for cleft palate; major revision ,,,2051.93,2051.93,1 RC,362,Palatoplasty for cleft palate; secondary lengthening procedure ,,,2051.93,2051.93,1 RC,362,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,892.44,1 RC,362,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,892.44,1 RC,362,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,892.44,1 RC,362,Parathyroidectomy or exploration of parathyroid(s); ,,,2051.93,2051.93,1 RC,362,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,276.0,1 RC,362,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,276.0,1 RC,362,"Parotid duct diversion, bilateral (Wilke type procedure); ",,,2051.93,2051.93,1 RC,362,"Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands ",,,2051.93,2051.93,1 RC,362,"Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts ",,,930.95,930.95,1 RC,362,Partial hymenectomy or revision of hymenal ring ,,,1116.7,1116.7,1 RC,362,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,1983.29,1 RC,362,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,1983.29,1 RC,362,Pelvic examination under anesthesia (other than local) ,,,1116.7,1116.7,1 RC,362,"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angi",,,2036.11,2036.11,1 RC,362,"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angiopl",,,2036.11,2036.11,1 RC,362,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,270.48,1 RC,362,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,357.81,1 RC,362,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,3838.82,3838.82,1 RC,362,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,8347.69,8347.69,1 RC,362,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,4103.8,4103.8,1 RC,362,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,3924.71,3924.71,1 RC,362,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,357.81,2 RC,362,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,3488.38,3488.38,2 RC,362,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",,,2480.92,9155.69,3 RC,362,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance ",,,5616.06,5616.06,1 RC,362,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during cours",,,1621.98,1621.98,1 RC,362,"Pereyra procedure, including anterior colporrhaphy ",,,2390.64,2390.64,1 RC,362,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,1116.7,1116.7,1 RC,362,Periodontal mucosal grafting ,,,441.67,441.67,1 RC,362,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,351.7,1 RC,362,Petrous apicectomy including radical mastoidectomy ,,,2051.93,2051.93,1 RC,362,Pharyngoplasty (plastic or reconstructive operation on pharynx) ,,,2051.93,2051.93,1 RC,362,"Pharyngostomy (fistulization of pharynx, external for feeding) ",,,441.67,441.67,1 RC,362,"Photopheresis, extracorporeal ",,,1757.86,1757.86,1 RC,362,"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when per",,,1209.12,1209.12,1 RC,362,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",,,1209.12,1209.12,2 RC,362,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,311.04,1 RC,362,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,74.41,1 RC,362,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,685.44,1 RC,362,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,1200.05,1200.05,1 RC,362,Placement of seton ,,,986.93,986.93,1 RC,362,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,2687.03,3001.44,3 RC,362,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,1200.05,1568.01,3 RC,362,Plastic operation of penis for injury ,,,1200.05,1200.05,1 RC,362,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,1200.05,1200.05,1 RC,362,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,1200.05,1200.05,1 RC,362,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,685.44,1 RC,362,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,685.44,1 RC,362,Plastic operation on penis to correct angulation ,,,1200.05,1200.05,1 RC,362,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,1603.34,1603.34,1 RC,362,Plastic repair of canaliculi ,,,733.22,733.22,1 RC,362,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages ",,,2051.93,2051.93,1 RC,362,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure ",,,2051.93,2051.93,1 RC,362,"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral ",,,2051.93,2051.93,1 RC,362,"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure ",,,930.95,930.95,1 RC,362,"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle ",,,2051.93,2051.93,1 RC,362,Plastic repair of introitus ,,,1116.7,1116.7,1 RC,362,"Plastic repair of salivary duct, sialodochoplasty; primary or simple ",,,2051.93,2051.93,1 RC,362,"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated ",,,2051.93,2051.93,1 RC,362,Plastic repair of urethrocele ,,,1116.7,1116.7,1 RC,362,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,1603.34,1603.34,1 RC,362,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",,,5701.03,5701.03,1 RC,362,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,72.68,1 RC,362,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,113.7,1 RC,362,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,733.22,1 RC,362,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,733.22,1 RC,362,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,733.22,1 RC,362,"Proctopexy (eg, for prolapse); perineal approach ",,,986.93,986.93,1 RC,362,Proctoplasty; for prolapse of mucous membrane ,,,986.93,986.93,1 RC,362,Proctoplasty; for stenosis ,,,986.93,986.93,1 RC,362,"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,86.63,86.63,1 RC,362,"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser) ",,,986.93,986.93,1 RC,362,"Proctosigmoidoscopy, rigid; with biopsy, single or multiple ",,,450.72,450.72,1 RC,362,"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,450.72,450.72,1 RC,362,"Proctosigmoidoscopy, rigid; with decompression of volvulus ",,,986.93,986.93,1 RC,362,"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,450.72,1 RC,362,"Proctosigmoidoscopy, rigid; with removal of foreign body ",,,986.93,986.93,1 RC,362,"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,450.72,450.72,1 RC,362,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,986.93,986.93,1 RC,362,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ",,,450.72,450.72,1 RC,362,"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation) ",,,2288.54,2288.54,1 RC,362,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,113.7,1 RC,362,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,125.86,1 RC,362,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,1200.05,1200.05,1 RC,362,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,1200.05,1200.05,1 RC,362,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,56.97,1 RC,362,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,276.0,1 RC,362,Radical excision external auditory canal lesion; without neck dissection ,,,2051.93,2051.93,1 RC,362,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,692.94,1 RC,362,"Reconstruction external auditory canal for congenital atresia, single stage ",,,2051.93,2051.93,1 RC,362,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,2051.93,2051.93,1 RC,362,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,733.22,1 RC,362,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,733.22,1 RC,362,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,1158.59,1158.59,1 RC,362,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,733.22,1 RC,362,Reduction of overcorrection of ptosis ,,,733.22,733.22,1 RC,362,Reduction of procidentia (separate procedure) under anesthesia ,,,344.93,344.93,1 RC,362,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,1200.05,1200.05,1 RC,362,Reinsertion of ocular implant; with or without conjunctival graft ,,,1158.59,1158.59,1 RC,362,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,1158.59,1158.59,1 RC,362,Release of encircling material (posterior segment) ,,,1610.16,1610.16,1 RC,362,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,733.22,1 RC,362,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,685.44,1 RC,362,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,685.44,1 RC,362,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,685.44,1 RC,362,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,572.66,1 RC,362,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,685.44,685.44,1 RC,362,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,13215.03,13215.03,1 RC,362,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,855.96,1 RC,362,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,510.77,1 RC,362,"Removal of Thiersch wire or suture, anal canal ",,,986.93,986.93,1 RC,362,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,1200.05,1 RC,362,"Removal of anal seton, other marker ",,,450.72,450.72,1 RC,362,"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidan",,,351.7,351.7,1 RC,362,"Removal of blood clot, anterior segment of eye ",,,892.44,892.44,1 RC,362,Removal of cerclage suture under anesthesia (other than local) ,,,1116.7,1116.7,1 RC,362,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,176.16,1 RC,362,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,40.7,1 RC,362,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,2096.41,2096.41,1 RC,362,Removal of embedded foreign body from dentoalveolar structures; bone ,,,272.38,272.38,1 RC,362,Removal of embedded foreign body from dentoalveolar structures; soft tissues ,,,231.98,231.98,1 RC,362,"Removal of embedded foreign body, eyelid ",,,113.7,113.7,1 RC,362,"Removal of embedded foreign body, vestibule of mouth; complicated ",,,158.14,158.14,1 RC,362,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,692.94,1 RC,362,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,892.44,1 RC,362,Removal of fecal impaction or foreign body (separate procedure) under anesthesia ,,,450.72,450.72,1 RC,362,Removal of foreign body in scrotum ,,,685.44,685.44,1 RC,362,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,113.7,1 RC,362,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,892.44,1 RC,362,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,892.44,1 RC,362,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,892.44,1 RC,362,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,2096.41,2096.41,1 RC,362,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,1116.7,1116.7,1 RC,362,Removal of implanted intra-arterial infusion pump ,,,1496.71,1496.71,1 RC,362,"Removal of implanted material, anterior segment of eye ",,,892.44,892.44,1 RC,362,"Removal of implanted material, posterior segment; extraocular ",,,892.44,892.44,1 RC,362,"Removal of implanted material, posterior segment; intraocular ",,,892.44,892.44,1 RC,362,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,1773.9,1 RC,362,Removal of intrauterine device (IUD) ,,,53.78,53.78,1 RC,362,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,892.44,1 RC,362,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,892.44,1 RC,362,Removal of lens material; intracapsular ,,,892.44,892.44,1 RC,362,"Removal of lens material; intracapsular, for dislocated lens ",,,1610.16,1610.16,1 RC,362,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,1610.16,1610.16,1 RC,362,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,892.44,1 RC,362,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,250.06,250.06,1 RC,362,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,1200.05,1200.05,1 RC,362,Removal of ocular implant ,,,1158.59,1158.59,1 RC,362,Removal of peritoneal foreign body from peritoneal cavity ,,,1209.12,1209.12,1 RC,362,Removal of peritoneal-venous shunt ,,,1174.13,1174.13,1 RC,362,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,692.94,1 RC,362,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,892.44,1 RC,362,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,692.94,1 RC,362,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1574.7,1574.7,1 RC,362,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,2096.41,2096.41,1 RC,362,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion ",,,468.58,468.58,1 RC,362,"Removal of tunneled central venous catheter, without subcutaneous port or pump ",,,234.94,234.94,1 RC,362,Removal of tunneled intraperitoneal catheter ,,,1174.13,1174.13,1 RC,362,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,892.44,1 RC,362,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,892.44,1 RC,362,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,930.95,1 RC,362,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,2327.17,2327.17,1 RC,362,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,1116.7,1116.7,1 RC,362,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,1142.68,1142.68,1 RC,362,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,1142.68,1142.68,1 RC,362,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,1142.68,1142.68,1 RC,362,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,510.77,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,3488.38,3488.38,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,3488.38,3488.38,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,3488.38,3488.38,1 RC,362,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,1200.05,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1200.05,1200.05,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,1773.9,1 RC,362,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,250.06,1 RC,362,Repair incomplete circumcision ,,,685.44,685.44,1 RC,362,"Repair inguinal hernia, sliding, any age ",,,1209.12,1209.12,1 RC,362,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,1209.12,1 RC,362,"Repair initial femoral hernia, any age; reducible ",,,1209.12,1209.12,1 RC,362,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,1209.12,1 RC,362,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,1209.12,1 RC,362,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,1209.12,1209.12,1 RC,362,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,1209.12,1209.12,1 RC,362,"Repair lip, full thickness; over one-half vertical height, or complex ",,,441.67,441.67,1 RC,362,"Repair lip, full thickness; up to half vertical height ",,,196.58,196.58,1 RC,362,"Repair lip, full thickness; vermilion only ",,,196.58,196.58,1 RC,362,Repair lumbar hernia ,,,1983.29,1983.29,1 RC,362,Repair of anal fistula with fibrin glue ,,,986.93,986.93,1 RC,362,"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa ºSIS») ",,,1295.61,1295.61,1 RC,362,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,1209.12,1209.12,5 RC,362,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,1983.29,1983.29,3 RC,362,"Repair of anterior palate, including vomer flap ",,,2051.93,2051.93,1 RC,362,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,733.22,1 RC,362,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,733.22,1 RC,362,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,733.22,1 RC,362,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,1158.59,1158.59,1 RC,362,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,733.22,1 RC,362,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,1158.59,1158.59,1 RC,362,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,733.22,1 RC,362,"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,468.58,468.58,1 RC,362,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,1610.16,1 RC,362,Repair of ectropion; excision tarsal wedge ,,,733.22,733.22,1 RC,362,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,733.22,1 RC,362,Repair of ectropion; suture ,,,733.22,733.22,1 RC,362,Repair of ectropion; thermocauterization ,,,210.46,210.46,1 RC,362,"Repair of enterocele, vaginal approach (separate procedure) ",,,1603.34,1603.34,1 RC,362,Repair of entropion; excision tarsal wedge ,,,733.22,733.22,1 RC,362,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,733.22,1 RC,362,Repair of entropion; suture ,,,733.22,733.22,1 RC,362,Repair of entropion; thermocauterization ,,,201.75,201.75,1 RC,362,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,1200.05,1200.05,1 RC,362,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,1773.9,1773.9,1 RC,362,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,1773.9,1773.9,1 RC,362,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,1773.9,1 RC,362,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,892.44,1 RC,362,Repair of laceration 2.5 cm or less; posterior one-third of tongue ,,,91.96,91.96,1 RC,362,"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex ",,,91.96,91.96,1 RC,362,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,391.57,1 RC,362,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,733.22,1 RC,362,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,733.22,1 RC,362,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,1610.16,1610.16,1 RC,362,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,1610.16,1610.16,1 RC,362,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,1158.59,1158.59,1 RC,362,Repair of nasolabial fistula ,,,2051.93,2051.93,1 RC,362,Repair of rectocele (separate procedure) ,,,986.93,986.93,1 RC,362,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,174.12,1 RC,362,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,144.47,1 RC,362,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,434.01,1 RC,362,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,1610.16,1 RC,362,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,1610.16,1 RC,362,Repair of scleral staphyloma with graft ,,,2141.05,2141.05,1 RC,362,"Repair of small omphalocele, with primary closure ",,,1209.12,1209.12,1 RC,362,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,892.44,1 RC,362,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,733.22,1 RC,362,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,1158.59,1158.59,1 RC,362,Repair of traumatic corporeal tear(s) ,,,1200.05,1200.05,1 RC,362,Repair of tunica vaginalis hydrocele (Bottle type) ,,,1200.05,1200.05,1 RC,362,"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site ",,,234.94,234.94,1 RC,362,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,1158.59,1158.59,1 RC,362,Repair oval window fistula ,,,930.95,930.95,1 RC,362,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,1209.12,1 RC,362,Repair recurrent femoral hernia; reducible ,,,1209.12,1209.12,1 RC,362,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,1209.12,1 RC,362,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,1209.12,1 RC,362,Repair round window fistula ,,,930.95,930.95,1 RC,362,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,1209.12,1209.12,2 RC,362,"Repair, laceration of palate; over 2 cm or complex ",,,2051.93,2051.93,1 RC,362,"Repair, laceration of palate; up to 2 cm ",,,196.58,196.58,1 RC,362,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,6576.47,6576.47,1 RC,362,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,6576.47,6576.47,1 RC,362,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,4002.6,4002.6,1 RC,362,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,351.7,1 RC,362,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,351.7,1 RC,362,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,351.7,1 RC,362,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract ",,,115.66,115.66,1 RC,362,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract ",,,115.66,115.66,1 RC,362,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,692.94,1 RC,362,"Replacement or irrigation, ventricular catheter ",,,2096.41,2096.41,1 RC,362,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,2096.41,2096.41,1 RC,362,"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site ",,,1576.12,1576.12,1 RC,362,"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",,,635.9,635.9,1 RC,362,"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access ",,,1174.13,1174.13,1 RC,362,"Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, an",,,468.58,468.58,1 RC,362,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access ",,,1174.13,1174.13,1 RC,362,"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access ",,,3506.05,3506.05,1 RC,362,"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access ",,,1551.66,1551.66,1 RC,362,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,2884.18,2884.18,1 RC,362,"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition ",,,115.66,115.66,1 RC,362,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,892.44,1 RC,362,Repositioning of previously placed central venous catheter under fluoroscopic guidance ,,,468.58,468.58,1 RC,362,Reprogramming of programmable cerebrospinal shunt ,,,31.39,31.39,1 RC,362,"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls ",,,2051.93,2051.93,1 RC,362,"Resection of lip, more than one-fourth, without reconstruction ",,,930.95,930.95,1 RC,362,Resection of palate or extensive resection of lesion ,,,2051.93,2051.93,1 RC,362,Resection of scrotum ,,,1200.05,1200.05,1 RC,362,Retrobulbar injection; alcohol ,,,36.62,36.62,1 RC,362,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,27.62,1 RC,362,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed ",,,5796.69,5796.69,1 RC,362,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty ",,,2638.63,2638.63,1 RC,362,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when",,,9688.25,9688.25,1 RC,362,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5604.99,5604.99,1 RC,362,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty ",,,2454.04,2454.04,1 RC,362,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5352.25,5352.25,1 RC,362,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed ",,,9049.29,9049.29,1 RC,362,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty ",,,4988.47,4988.47,1 RC,362,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same v",,,9081.21,9081.21,1 RC,362,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf",,,8922.21,8922.21,1 RC,362,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,2390.64,2390.64,1 RC,362,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,1116.7,1116.7,1 RC,362,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,3859.98,3859.98,1 RC,362,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,7795.13,7795.13,1 RC,362,Revision mastoidectomy; resulting in complete mastoidectomy ,,,2051.93,2051.93,1 RC,362,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,2051.93,2051.93,1 RC,362,Revision mastoidectomy; resulting in radical mastoidectomy ,,,2051.93,2051.93,1 RC,362,Revision mastoidectomy; resulting in tympanoplasty ,,,2051.93,2051.93,1 RC,362,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,892.44,1 RC,362,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,892.44,1 RC,362,Revision of colostomy; simple (release of superficial scar) (separate procedure) ,,,1530.5,1530.5,1 RC,362,Revision of ileostomy; simple (release of superficial scar) (separate procedure) ,,,1530.5,1530.5,1 RC,362,Revision of implanted intra-arterial infusion pump ,,,2252.39,2252.39,1 RC,362,Revision of peritoneal-venous shunt ,,,1209.12,1209.12,1 RC,362,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,1773.9,1773.9,1 RC,362,Revision of stapedectomy or stapedotomy ,,,2051.93,2051.93,1 RC,362,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,1200.05,1200.05,1 RC,362,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,8616.6,8616.6,1 RC,362,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,2175.62,2175.62,1 RC,362,Revision or removal of intracranial neurostimulator electrodes ,,,1574.7,1574.7,1 RC,362,Revision or removal of peripheral neurostimulator electrode array ,,,1574.7,1574.7,1 RC,362,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,2517.56,2517.56,1 RC,362,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,733.22,1 RC,362,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,9487.38,9487.38,1 RC,362,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,6796.25,6796.25,1 RC,362,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,2036.11,1 RC,362,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,2036.11,1 RC,362,Scleral reinforcement (separate procedure); with graft ,,,892.44,892.44,1 RC,362,Scleral reinforcement (separate procedure); without graft ,,,733.22,733.22,1 RC,362,Scrotal exploration ,,,1200.05,1200.05,1 RC,362,Scrotoplasty; complicated ,,,1773.9,1773.9,1 RC,362,Scrotoplasty; simple ,,,1200.05,1200.05,1 RC,362,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,892.44,1 RC,362,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,1610.16,1610.16,1 RC,362,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,892.44,1 RC,362,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,892.44,1 RC,362,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,148.54,1 RC,362,Severing of tarsorrhaphy ,,,179.07,179.07,1 RC,362,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,218.75,1 RC,362,"Sialolithotomy; parotid, extraoral or complicated intraoral ",,,930.95,930.95,1 RC,362,"Sialolithotomy; submandibular (submaxillary), complicated, intraoral ",,,265.4,265.4,1 RC,362,"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral ",,,127.91,127.91,1 RC,362,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,137.2,137.2,1 RC,362,"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with biopsy, single or multiple ",,,344.93,344.93,1 RC,362,"Sigmoidoscopy, flexible; with control of bleeding, any method ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,344.93,1 RC,362,"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance ",,,344.93,344.93,1 RC,362,"Sigmoidoscopy, flexible; with endoscopic mucosal resection ",,,986.93,986.93,1 RC,362,"Sigmoidoscopy, flexible; with endoscopic ultrasound examination ",,,344.93,344.93,1 RC,362,"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2907.97,2907.97,1 RC,362,"Sigmoidoscopy, flexible; with removal of foreign body(s) ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,344.93,344.93,1 RC,362,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,450.72,1 RC,362,"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) ",,,450.72,450.72,1 RC,362,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,115.66,1 RC,362,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,7961.33,7961.33,1 RC,362,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,2171.17,2171.17,1 RC,362,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,685.44,1 RC,362,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,1200.05,1200.05,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, pl",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) ",,,1770.48,1770.48,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedu",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s) ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,593.22,1 RC,362,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) ",,,3062.79,3062.79,1 RC,362,Snip incision of lacrimal punctum ,,,56.97,56.97,1 RC,362,"Sphincteroplasty, anal, for incontinence or prolapse; adult ",,,986.93,986.93,1 RC,362,"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) ",,,986.93,986.93,1 RC,362,"Sphincteroplasty, anal, for incontinence, adult; muscle transplant ",,,986.93,986.93,1 RC,362,"Sphincterotomy, anal, division of sphincter (separate procedure) ",,,986.93,986.93,1 RC,362,"Spinal puncture, lumbar, diagnostic; ",,,276.0,276.0,1 RC,362,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,276.0,1 RC,362,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,276.0,1 RC,362,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,276.0,1 RC,362,"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions ",,,204.65,204.65,1 RC,362,"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions ",,,223.55,223.55,1 RC,362,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,2051.93,1 RC,362,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,2051.93,1 RC,362,Stapes mobilization ,,,930.95,930.95,1 RC,362,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,1022.29,1022.29,1 RC,362,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,733.22,1 RC,362,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,733.22,1 RC,362,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,733.22,1 RC,362,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,1158.59,1158.59,1 RC,362,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,733.22,1 RC,362,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,276.0,1 RC,362,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,276.0,1 RC,362,Suprahyoid lymphadenectomy ,,,1937.47,1937.47,1 RC,362,Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric ,,,986.93,986.93,1 RC,362,Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage ,,,986.93,986.93,1 RC,362,Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous ,,,986.93,986.93,1 RC,362,"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed ",,,986.93,986.93,1 RC,362,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,2051.93,2051.93,1 RC,362,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,2051.93,2051.93,1 RC,362,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,2096.41,2096.41,1 RC,362,Suture of 1 nerve; median motor thenar ,,,2096.41,2096.41,1 RC,362,Suture of 1 nerve; ulnar motor ,,,2096.41,2096.41,1 RC,362,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,692.94,1 RC,362,Suture of facial nerve; extracranial ,,,2096.41,2096.41,1 RC,362,"Suture of facial nerve; infratemporal, with or without grafting ",,,2096.41,2096.41,1 RC,362,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,892.44,1 RC,362,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,2096.41,2096.41,1 RC,362,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,2096.41,2096.41,1 RC,362,Suture of posterior tibial nerve ,,,2096.41,2096.41,1 RC,362,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,733.22,1 RC,362,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,203.77,1 RC,362,Suture of sciatic nerve ,,,1230.86,1230.86,1 RC,362,Suture of tongue to lip for micrognathia (Douglas type procedure) ,,,930.95,930.95,1 RC,362,Suture of; brachial plexus ,,,692.94,692.94,1 RC,362,Suture of; lumbar plexus ,,,2096.41,2096.41,1 RC,362,Suture or repair of testicular injury ,,,1200.05,1200.05,1 RC,362,Suture pharynx for wound or injury ,,,783.57,783.57,1 RC,362,"Sympathectomy, cervical ",,,692.94,692.94,1 RC,362,"Sympathectomy; digital arteries, each digit ",,,692.94,692.94,1 RC,362,Sympathectomy; radial artery ,,,1142.68,1142.68,1 RC,362,Sympathectomy; superficial palmar arch ,,,1142.68,1142.68,1 RC,362,Sympathectomy; ulnar artery ,,,1142.68,1142.68,1 RC,362,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,351.98,1 RC,362,Therapeutic apheresis; for plasma pheresis ,,,592.85,592.85,1 RC,362,Therapeutic apheresis; for platelets ,,,172.52,172.52,1 RC,362,Therapeutic apheresis; for red blood cells ,,,592.85,592.85,1 RC,362,Therapeutic apheresis; for white blood cells ,,,592.85,592.85,1 RC,362,"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion ",,,1535.14,1535.14,1 RC,362,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,7910.97,7910.97,1 RC,362,"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure) ",,,2036.11,2036.11,1 RC,362,"Thyroidectomy, total or complete ",,,1983.29,1983.29,1 RC,362,Tonsillectomy and adenoidectomy; age 12 or over ,,,930.95,930.95,1 RC,362,Tonsillectomy and adenoidectomy; younger than age 12 ,,,2051.93,2051.93,1 RC,362,"Tonsillectomy, primary or secondary; age 12 or over ",,,930.95,930.95,1 RC,362,"Tonsillectomy, primary or secondary; younger than age 12 ",,,2051.93,2051.93,1 RC,362,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,1983.29,1 RC,362,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,1983.29,1 RC,362,Trabeculoplasty by laser surgery ,,,114.82,114.82,1 RC,362,Trabeculotomy ab externo ,,,892.44,892.44,1 RC,362,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,1603.34,1603.34,1 RC,362,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,1116.7,1116.7,1 RC,362,Transcatheter biopsy ,,,2036.11,2036.11,1 RC,362,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,5254.79,5254.79,1 RC,362,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; init",,,5370.45,5370.45,1 RC,362,"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound",,,1174.13,1174.13,1 RC,362,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day ",,,2658.87,2658.87,1 RC,362,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day ",,,1594.88,1594.88,1 RC,362,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,692.94,1 RC,362,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,692.94,1 RC,362,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,692.94,1 RC,362,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,692.94,1 RC,362,Transection or avulsion of; greater occipital nerve ,,,692.94,692.94,1 RC,362,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,692.94,1 RC,362,Transection or avulsion of; infraorbital nerve ,,,692.94,692.94,1 RC,362,Transection or avulsion of; lingual nerve ,,,692.94,692.94,1 RC,362,Transection or avulsion of; mental nerve ,,,692.94,692.94,1 RC,362,Transection or avulsion of; phrenic nerve ,,,692.94,692.94,1 RC,362,Transection or avulsion of; supraorbital nerve ,,,692.94,692.94,1 RC,362,"Transfusion, blood or blood components ",,,32.27,32.27,1 RC,362,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1853.13,1853.13,1 RC,362,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,2415.23,2415.23,1 RC,362,Transmastoid antrotomy (simple mastoidectomy) ,,,2051.93,2051.93,1 RC,362,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,2518.45,2518.45,1 RC,362,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,2518.45,2518.45,1 RC,362,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,2525.82,2525.82,1 RC,362,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,1773.9,1 RC,362,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,1200.05,1200.05,1 RC,362,Transrectal drainage of pelvic abscess ,,,450.72,450.72,1 RC,362,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,1090.68,1090.68,1 RC,362,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,1200.05,1200.05,1 RC,362,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,1042.71,1042.71,1 RC,362,Transurethral drainage of prostatic abscess ,,,1200.05,1200.05,1 RC,362,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,1773.9,1 RC,362,Transurethral incision of prostate ,,,1200.05,1200.05,1 RC,362,Transurethral resection of bladder neck (separate procedure) ,,,1200.05,1200.05,1 RC,362,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,1200.05,1 RC,362,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,1773.9,1 RC,362,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,60.45,1 RC,362,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,53.82,1 RC,362,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,49.82,1 RC,362,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,43.49,1 RC,362,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,149.42,1 RC,362,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,218.75,1 RC,362,"Treatment of incomplete abortion, any trimester, completed surgically ",,,1116.7,1116.7,1 RC,362,"Treatment of missed abortion, completed surgically; first trimester ",,,1116.7,1116.7,1 RC,362,"Treatment of missed abortion, completed surgically; second trimester ",,,1116.7,1116.7,1 RC,362,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,183.72,1 RC,362,Tympanic neurectomy ,,,930.95,930.95,1 RC,362,"Tympanolysis, transcanal ",,,930.95,930.95,1 RC,362,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,2051.93,1 RC,362,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,2051.93,1 RC,362,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,2051.93,1 RC,362,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,441.67,1 RC,362,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,123.54,1 RC,362,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,1209.12,1209.12,1 RC,362,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,1200.05,1 RC,362,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,1200.05,1200.05,1 RC,362,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,1200.05,1 RC,362,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,1773.9,1 RC,362,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,1200.05,1200.05,1 RC,362,"Urethrectomy, total, including cystostomy; female ",,,1200.05,1200.05,1 RC,362,"Urethrectomy, total, including cystostomy; male ",,,1773.9,1773.9,1 RC,362,"Urethromeatoplasty, with mucosal advancement ",,,1200.05,1200.05,1 RC,362,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,1200.05,1200.05,1 RC,362,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,1773.9,1773.9,1 RC,362,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,1200.05,1200.05,1 RC,362,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,1773.9,1773.9,1 RC,362,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,1200.05,1200.05,1 RC,362,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,1773.9,1773.9,1 RC,362,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,1773.9,1773.9,1 RC,362,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,1773.9,1773.9,1 RC,362,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,1773.9,1773.9,1 RC,362,"Urethroplasty, reconstruction of female urethra ",,,1773.9,1773.9,1 RC,362,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,1773.9,1773.9,1 RC,362,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,1773.9,1773.9,1 RC,362,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,1200.05,1200.05,1 RC,362,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,1773.9,1773.9,1 RC,362,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,1773.9,1773.9,1 RC,362,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,1773.9,1773.9,1 RC,362,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,685.44,1 RC,362,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,1773.9,1773.9,1 RC,362,Uterine evacuation and curettage for hydatidiform mole ,,,1116.7,1116.7,1 RC,362,"Uvulectomy, excision of uvula ",,,930.95,930.95,1 RC,362,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,1603.34,1 RC,362,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,1603.34,1603.34,1 RC,362,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, ot",,,5455.41,5455.41,1 RC,362,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, ",,,3666.16,3666.16,1 RC,362,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, othe",,,4772.84,4772.84,1 RC,362,"Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) ",,,2036.11,2036.11,1 RC,362,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,685.44,1 RC,362,Ventilating tube removal requiring general anesthesia ,,,85.18,85.18,1 RC,362,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,276.0,1 RC,362,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,357.81,1 RC,362,"Vermilionectomy (lip shave), with mucosal advancement ",,,930.95,930.95,1 RC,362,Vesiculotomy; ,,,685.44,685.44,1 RC,362,"Vestibular nerve section, translabyrinthine approach ",,,930.95,930.95,1 RC,362,Vestibuloplasty; anterior ,,,2051.93,2051.93,1 RC,362,"Vestibuloplasty; complex (including ridge extension, muscle repositioning) ",,,2051.93,2051.93,1 RC,362,Vestibuloplasty; entire arch ,,,2051.93,2051.93,1 RC,362,"Vestibuloplasty; posterior, bilateral ",,,2051.93,2051.93,1 RC,362,"Vestibuloplasty; posterior, unilateral ",,,2051.93,2051.93,1 RC,362,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,1610.16,1 RC,362,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,1610.16,1 RC,362,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,1610.16,1 RC,362,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,1610.16,1 RC,362,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,1610.16,1 RC,362,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,1610.16,1 RC,362,Vulvectomy simple; complete ,,,1116.7,1116.7,1 RC,362,Vulvectomy simple; partial ,,,1116.7,1116.7,1 RC,369, Operating Room Services Other ,,,3673.0,5356.0,12 RC,369,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,369,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,369,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,369,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,369,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,369,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,1200.05,12562.0,27 RC,369,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,1200.05,12562.0,27 RC,369,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,1200.05,12562.0,27 RC,369,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,1200.05,12562.0,27 RC,369,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3673.0,13835.0,24 RC,369,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3293.0,13835.0,24 RC,369,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,369,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,369,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,369,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,369,"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure) ",,,2567.78,16207.0,12 RC,369,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,351.7,3249.0,27 RC,369,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,3249.0,27 RC,369,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,3293.0,13835.0,24 RC,369,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,1986.0,3390.0,13 RC,369,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,1986.0,4423.26,18 RC,369,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,2195.0,15059.0,23 RC,369,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,2195.0,5802.38,18 RC,369,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,2699.0,35469.31,18 RC,369,"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation ",,,2954.51,15059.0,27 RC,369,"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency ",,,1983.29,13835.0,27 RC,369,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,1983.29,13196.03,27 RC,369,"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous ",,,2996.0,29647.99,17 RC,369,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,2195.0,29647.99,17 RC,369,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,3390.0,16207.0,24 RC,369,"Ablation, open, of 1 or more liver tumor(s); cryosurgical ",,,3293.0,17999.62,24 RC,369,"Ablation, open, of 1 or more liver tumor(s); radiofrequency ",,,3293.0,17732.67,24 RC,369,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,3965.0,22967.79,27 RC,369,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,369,"Adenoidectomy, primary; age 12 or over ",,,930.95,8234.0,27 RC,369,"Adenoidectomy, primary; younger than age 12 ",,,930.95,8234.0,27 RC,369,"Adenoidectomy, secondary; age 12 or over ",,,930.95,8234.0,27 RC,369,"Adenoidectomy, secondary; younger than age 12 ",,,930.95,8234.0,27 RC,369,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,369,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,369,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,369,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,3390.0,16207.0,24 RC,369,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,3390.0,16207.0,12 RC,369,Allogeneic lymphocyte infusions ,,,592.85,13835.0,15 RC,369,"Alveolectomy, including curettage of osteitis or sequestrectomy ",,,289.82,13835.0,27 RC,369,"Alveoloplasty, each quadrant (specify) ",,,234.0,13835.0,27 RC,369,Amniocentesis; diagnostic ,,,52.04,3083.0,24 RC,369,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,23 RC,369,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,18546.34,12 RC,369,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,3390.0,16207.0,12 RC,369,Amputation of penis; complete ,,,2195.0,13835.0,24 RC,369,Amputation of penis; partial ,,,1200.05,8240.61,27 RC,369,"Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract ",,,3390.0,30468.4,12 RC,369,"Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract ",,,3390.0,40025.51,12 RC,369,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,3390.0,32129.73,12 RC,369,"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract ",,,3390.0,27747.48,12 RC,369,"Anastomosis, of intrahepatic ducts and gastrointestinal tract ",,,3390.0,37283.43,12 RC,369,Anastomosis; facial-hypoglossal ,,,3390.0,16207.0,12 RC,369,Anastomosis; facial-spinal accessory ,,,3390.0,16207.0,12 RC,369,"Anoplasty, plastic operation for stricture; adult ",,,986.93,12562.0,27 RC,369,"Anoplasty, plastic operation for stricture; infant ",,,3390.0,16207.0,12 RC,369,"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic ",,,986.93,6399.61,27 RC,369,Anorectal manometry ,,,1672.0,2358.0,4 RC,369,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,369,Anorectal myomectomy ,,,986.93,6399.61,27 RC,369,"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,223.51,5841.0,23 RC,369,"Anoscopy; diagnostic, with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when p",,,223.51,5841.0,23 RC,369,"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique ",,,986.93,6399.61,27 RC,369,"Anoscopy; with biopsy, single or multiple ",,,211.33,13835.0,27 RC,369,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,115.98,13835.0,27 RC,369,"Anoscopy; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,13835.0,27 RC,369,"Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple ",,,1986.0,8234.0,24 RC,369,Anoscopy; with removal of foreign body ,,,344.93,3128.0,27 RC,369,"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,986.93,6399.61,27 RC,369,"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,986.93,6399.61,27 RC,369,"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique ",,,344.93,3128.0,27 RC,369,Antepartum care only; 4-6 visits ,,,3370.89,5841.0,7 RC,369,Antepartum care only; 7 or more visits ,,,3390.0,7624.48,7 RC,369,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,1603.34,13394.0,27 RC,369,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,3041.0,13835.0,24 RC,369,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,3041.0,13835.0,24 RC,369,Appendectomy; ,,,2996.0,13835.0,24 RC,369,Appendectomy; for ruptured appendix with abscess or generalized peritonitis ,,,3390.0,16207.0,12 RC,369,Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,3 RC,369,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,369,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,369,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,369,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,369,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,369,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,369,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,369,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,369,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,369,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,369,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,1493.79,1915.7,5 RC,369,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,2167.86,13394.0,27 RC,369,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,2091.35,15059.0,27 RC,369,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,369,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,369,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,369,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,369,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,369,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,369,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,369,Artificial insemination; intra-cervical ,,,315.3,5841.0,11 RC,369,Artificial insemination; intra-uterine ,,,333.49,5841.0,11 RC,369,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,27 RC,369,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,27 RC,369,Aspiration of bladder; by needle ,,,38.37,3244.0,27 RC,369,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,27 RC,369,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,27 RC,369,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,27 RC,369,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,369,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,369,Axillary lymphadenectomy; complete ,,,1983.29,13196.03,27 RC,369,Axillary lymphadenectomy; superficial ,,,1983.29,13196.03,27 RC,369,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,369,BIOPSY OF STOMACH ,,,3390.0,5841.0,2 RC,369,BIOPSY OF THROAT ,,,3390.0,5841.0,2 RC,369,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,369,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,3 RC,369,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,2270.4,13835.0,10 RC,369,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each ",,,3390.0,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each ",,,2640.5,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each ",,,3390.0,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each ",,,3116.42,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,1820.98,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,1731.66,16207.0,12 RC,369,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,2078.75,16207.0,12 RC,369,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,3390.0,22352.23,10 RC,369,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,3390.0,17385.04,12 RC,369,"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepa",,,3390.0,28561.16,36 RC,369,"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein ",,,3390.0,16207.0,12 RC,369,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,3390.0,18626.9,12 RC,369,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,3390.0,17224.05,12 RC,369,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,2915.0,16207.0,12 RC,369,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,1625.93,16207.0,12 RC,369,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,3390.0,16207.0,12 RC,369,"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each d",,,1672.0,5841.0,15 RC,369,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,1672.0,5841.0,15 RC,369,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,3390.0,29900.51,12 RC,369,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,3390.0,24971.42,12 RC,369,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,3390.0,27115.97,12 RC,369,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,3390.0,16944.28,12 RC,369,"Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure) ",,,1586.32,13835.0,12 RC,369,"Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) ",,,1209.12,8488.5,27 RC,369,"Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple ",,,1209.12,12562.0,27 RC,369,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent ",,,2699.0,15059.0,27 RC,369,"Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent ",,,1637.09,12562.0,27 RC,369,"Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi ",,,1983.29,13196.03,27 RC,369,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,1200.05,12562.0,27 RC,369,Biopsy external auditory canal ,,,99.71,13835.0,15 RC,369,Biopsy external ear ,,,57.56,5841.0,14 RC,369,"Biopsy of anorectal wall, anal approach (eg, congenital megacolon) ",,,986.93,6399.61,27 RC,369,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,27 RC,369,Biopsy of conjunctiva ,,,113.96,12562.0,27 RC,369,Biopsy of cornea ,,,733.22,5283.1,27 RC,369,"Biopsy of epididymis, needle ",,,510.77,3747.2,27 RC,369,Biopsy of extraocular muscle ,,,1158.59,8536.87,27 RC,369,Biopsy of floor of mouth ,,,110.18,3128.0,27 RC,369,"Biopsy of intestine by capsule, tube, peroral (1 or more specimens) ",,,351.7,3128.0,27 RC,369,Biopsy of lacrimal gland ,,,733.22,5571.0,27 RC,369,Biopsy of lacrimal sac ,,,733.22,5571.0,27 RC,369,Biopsy of lip ,,,67.44,5841.0,14 RC,369,"Biopsy of liver, needle; percutaneous ",,,510.77,3747.2,27 RC,369,"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Biopsy of liver, wedge ",,,3390.0,16207.0,12 RC,369,Biopsy of nerve ,,,692.94,5571.0,27 RC,369,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,1116.7,12562.0,27 RC,369,"Biopsy of palate, uvula ",,,703.52,3128.0,24 RC,369,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,3390.0,16207.0,12 RC,369,"Biopsy of pancreas, percutaneous needle ",,,510.77,3747.2,27 RC,369,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,27 RC,369,Biopsy of penis; deep structures ,,,855.96,6330.57,27 RC,369,Biopsy of salivary gland; incisional ,,,441.67,5571.0,27 RC,369,Biopsy of salivary gland; needle ,,,60.46,3128.0,27 RC,369,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,27 RC,369,"Biopsy of stomach, by laparotomy ",,,3041.0,13835.0,12 RC,369,"Biopsy of testis, incisional (separate procedure) ",,,1200.05,8240.61,27 RC,369,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,27 RC,369,Biopsy of tongue; anterior two-thirds ,,,116.86,3128.0,27 RC,369,Biopsy of tongue; posterior one-third ,,,115.11,3755.0,27 RC,369,Biopsy of urethra ,,,685.44,5571.0,27 RC,369,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,1116.7,6819.81,27 RC,369,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,27 RC,369,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,26 RC,369,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary) ",,,510.77,3747.2,27 RC,369,"Biopsy or excision of lymph node(s); open, deep axillary node(s) ",,,1011.84,8270.67,27 RC,369,"Biopsy or excision of lymph node(s); open, deep cervical node(s) ",,,1011.84,8270.67,27 RC,369,"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad ",,,1011.84,8270.67,27 RC,369,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s) ",,,2195.0,13835.0,23 RC,369,"Biopsy or excision of lymph node(s); open, internal mammary node(s) ",,,1011.84,8270.67,27 RC,369,"Biopsy or excision of lymph node(s); open, superficial ",,,1011.84,8270.67,27 RC,369,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,27 RC,369,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,3747.2,27 RC,369,"Biopsy, prostate, any approach, nonimaging-guided ",,,1200.05,4836.33,27 RC,369,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,369,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,2699.0,14954.75,17 RC,369,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,2699.0,14954.75,17 RC,369,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,17 RC,369,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,9 RC,369,"Biopsy, vestibule of mouth ",,,113.09,5841.0,26 RC,369,"Biopsy; nasopharynx, survey for unknown primary lesion ",,,930.95,7150.66,27 RC,369,"Biopsy; nasopharynx, visible lesion, simple ",,,930.95,7150.66,27 RC,369,Biopsy; oropharynx ,,,89.82,13835.0,27 RC,369,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,14 RC,369,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,26 RC,369,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,26 RC,369,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,369,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,369,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,369,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,369,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,369,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic ",,,786.51,13835.0,11 RC,369,"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous ",,,592.85,13835.0,15 RC,369,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,369,Bone marrow harvesting for transplantation; allogeneic ,,,592.85,13835.0,27 RC,369,Bone marrow harvesting for transplantation; autologous ,,,1757.86,15059.0,27 RC,369,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,369,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,369,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,369,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,369,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,369,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,369,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,369,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,369,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,369,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,369,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,369,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,369,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,369,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,369,Bundle of His recording ,,,3673.0,43890.0,22 RC,369,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,3390.0,16207.0,12 RC,369,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,3390.0,16207.0,12 RC,369,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,3390.0,16207.0,12 RC,369,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,3390.0,16207.0,12 RC,369,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,3390.0,16868.07,12 RC,369,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,3390.0,16207.0,12 RC,369,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,3390.0,16207.0,12 RC,369,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,3390.0,16207.0,12 RC,369,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,369,CHANGE BILE DUCT CATHETER ,,,3390.0,5841.0,2 RC,369,CHANGE IV CATH AT THROMB TX ,,,3390.0,5841.0,2 RC,369,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,369,"CHANGE OF GASTROSTOMY TUBE, PERCUTANEOUS, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE ",,,2358.0,5841.0,2 RC,369,CIRCUMCISION ,,,3390.0,5841.0,2 RC,369,COLONOSCOPY LESION REMOVAL ,,,3390.0,5841.0,2 RC,369,COLONOSCOPY W/STENT ,,,3390.0,5841.0,4 RC,369,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,369,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,369,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,369,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,369,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,369,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,369,CREATE SALIVARY CYST DRAIN ,,,3390.0,5841.0,4 RC,369,CRYOTHERAPY OF RECTAL LESION ,,,3390.0,5841.0,4 RC,369,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,369,"Cannulation, thoracic duct ",,,1672.0,5841.0,3 RC,369,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,27 RC,369,Canthotomy (separate procedure) ,,,733.22,5571.0,27 RC,369,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,369,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,369,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,369,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,369,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,369,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,369,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,369,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,369,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,1672.0,5841.0,15 RC,369,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,369,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,369,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,600.2,3390.0,18 RC,369,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,26 RC,369,Cautery of cervix; electro or thermal ,,,83.14,13835.0,27 RC,369,Cautery of cervix; laser ablation ,,,1116.7,6819.81,27 RC,369,"Cerclage of cervix, during pregnancy; abdominal ",,,2300.11,16207.0,24 RC,369,"Cerclage of cervix, during pregnancy; vaginal ",,,1116.7,6819.81,27 RC,369,"Cerclage of uterine cervix, nonobstetrical ",,,1986.0,6819.81,24 RC,369,Cervical lymphadenectomy (complete) ,,,2996.0,22210.08,24 RC,369,Cervical lymphadenectomy (modified radical neck dissection) ,,,2996.0,17660.58,24 RC,369,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,3390.0,13835.0,10 RC,369,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,3390.0,15889.05,7 RC,369,Cesarean delivery only; ,,,3390.0,13835.0,10 RC,369,Cesarean delivery only; including postpartum care ,,,3293.0,15427.0,19 RC,369,Change of cystostomy tube; complicated ,,,250.06,3390.0,27 RC,369,Change of cystostomy tube; simple ,,,54.36,5841.0,26 RC,369,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,685.44,4836.33,27 RC,369,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,369,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,369,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,369,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,26 RC,369,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,26 RC,369,Chemodenervation of extraocular muscle ,,,107.27,5841.0,26 RC,369,Chemodenervation of internal anal sphincter ,,,450.72,3128.0,27 RC,369,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,27 RC,369,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,26 RC,369,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,26 RC,369,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,27 RC,369,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,27 RC,369,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,27 RC,369,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,26 RC,369,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,27 RC,369,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,27 RC,369,"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous ",,,3390.0,3390.0,1 RC,369,"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day ",,,3390.0,3390.0,1 RC,369,"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage) ",,,3390.0,3390.0,1 RC,369,Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration ,,,3390.0,3390.0,1 RC,369,Cholecystectomy with exploration of common duct; ,,,3375.0,16207.0,24 RC,369,Cholecystectomy with exploration of common duct; with choledochoenterostomy ,,,3375.0,16207.0,24 RC,369,"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography ",,,3390.0,16774.82,24 RC,369,Cholecystectomy; ,,,2996.0,16207.0,24 RC,369,Cholecystectomy; with cholangiography ,,,3293.0,16207.0,24 RC,369,Cholecystoenterostomy; Roux-en-Y ,,,3390.0,16207.0,12 RC,369,Cholecystoenterostomy; Roux-en-Y with gastroenterostomy ,,,3390.0,18126.75,12 RC,369,Cholecystoenterostomy; direct ,,,3390.0,16207.0,12 RC,369,Cholecystoenterostomy; with gastroenterostomy ,,,3390.0,16677.33,12 RC,369,"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation ",,,4988.0,13835.0,12 RC,369,"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty ",,,3390.0,16829.85,12 RC,369,"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty ",,,3390.0,16486.58,12 RC,369,"Chorionic villus sampling, any method ",,,52.32,3244.0,15 RC,369,"Chromotubation of oviduct, including materials ",,,2699.0,12562.0,24 RC,369,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,27 RC,369,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,27 RC,369,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,27 RC,369,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,27 RC,369,Ciliary body destruction; diathermy ,,,892.44,5519.68,27 RC,369,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,27 RC,369,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,27 RC,369,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,27 RC,369,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,27 RC,369,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,27 RC,369,Clitoroplasty for intersex state ,,,1116.7,13835.0,15 RC,369,Closure of anal fistula with rectal advancement flap ,,,986.93,8234.0,27 RC,369,Closure of cystostomy (separate procedure) ,,,1200.05,8240.61,27 RC,369,Closure of enteroenteric or enterocolic fistula ,,,3390.0,17745.37,12 RC,369,"Closure of enterostomy, large or small intestine; ",,,3390.0,16207.0,12 RC,369,"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal ",,,3390.0,16207.0,12 RC,369,"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure) ",,,3390.0,19678.01,12 RC,369,Closure of enterovesical fistula; with intestine and/or bladder resection ,,,3390.0,19063.43,12 RC,369,Closure of enterovesical fistula; without intestinal or bladder resection ,,,3390.0,16401.79,12 RC,369,Closure of esophagostomy or fistula; cervical approach ,,,2195.0,13835.0,24 RC,369,Closure of esophagostomy or fistula; transthoracic or transabdominal approach ,,,3390.0,17647.88,12 RC,369,Closure of gastrocolic fistula ,,,3390.0,19572.05,12 RC,369,"Closure of gastrostomy, surgical ",,,1175.22,8187.49,27 RC,369,Closure of intestinal cutaneous fistula ,,,3390.0,17228.28,12 RC,369,"Closure of laceration, vestibule of mouth; 2.5 cm or less ",,,91.96,5841.0,14 RC,369,"Closure of laceration, vestibule of mouth; over 2.5 cm or complex ",,,196.58,3128.0,27 RC,369,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,27 RC,369,Closure of nephrocutaneous or pyelocutaneous fistula ,,,1986.0,14240.3,24 RC,369,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,3390.0,18071.71,12 RC,369,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,3390.0,19372.84,12 RC,369,Closure of rectourethral fistula; ,,,3390.0,16207.0,12 RC,369,Closure of rectourethral fistula; with colostomy ,,,3390.0,18834.58,12 RC,369,Closure of rectovaginal fistula; abdominal approach ,,,3293.0,16207.0,24 RC,369,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,3390.0,16207.0,12 RC,369,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,3041.0,13835.0,12 RC,369,Closure of rectovaginal fistula; vaginal or transanal approach ,,,1116.7,12562.0,27 RC,369,Closure of rectovesical fistula; ,,,3390.0,16207.0,12 RC,369,Closure of rectovesical fistula; with colostomy ,,,3390.0,18037.72,12 RC,369,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,26 RC,369,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,26 RC,369,Closure of ureterocutaneous fistula ,,,3390.0,16207.0,12 RC,369,Closure of ureterovisceral fistula (including visceral repair) ,,,3390.0,16207.0,12 RC,369,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,1773.9,11552.32,27 RC,369,Closure of urethrovaginal fistula; ,,,2390.64,18300.83,27 RC,369,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,2996.0,13835.0,24 RC,369,Closure of vesicouterine fistula; ,,,2699.0,13835.0,24 RC,369,Closure of vesicouterine fistula; with hysterectomy ,,,3390.0,16207.0,12 RC,369,"Closure of vesicovaginal fistula, abdominal approach ",,,2996.0,13835.0,24 RC,369,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,4988.0,18300.83,12 RC,369,Closure of vesicovaginal fistula; vaginal approach ,,,1603.34,12562.0,27 RC,369,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,27 RC,369,Closure salivary fistula ,,,930.95,7150.66,27 RC,369,"Closure, exstrophy of bladder ",,,3390.0,20139.94,12 RC,369,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,28 RC,369,"Colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,3390.0,16207.0,12 RC,369,"Colectomy, partial; abdominal and transanal approach ",,,3390.0,23882.21,12 RC,369,"Colectomy, partial; with anastomosis ",,,3390.0,16495.05,12 RC,369,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis) ",,,3390.0,20364.56,12 RC,369,"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy ",,,3390.0,26005.59,12 RC,369,"Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) ",,,3390.0,20457.81,12 RC,369,"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula ",,,3390.0,21758.94,12 RC,369,"Colectomy, partial; with skin level cecostomy or colostomy ",,,3390.0,22428.55,12 RC,369,"Colectomy, total, abdominal, with proctectomy; with continent ileostomy ",,,3390.0,28196.72,12 RC,369,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed ",,,3390.0,27671.16,12 RC,369,"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed ",,,3390.0,26954.98,12 RC,369,"Colectomy, total, abdominal, with proctectomy; with ileostomy ",,,3390.0,25492.74,12 RC,369,"Colectomy, total, abdominal, without proctectomy; with continent ileostomy ",,,3390.0,26556.55,12 RC,369,"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy ",,,3390.0,22924.36,12 RC,369,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,369,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,369,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,27 RC,369,"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) ",,,1986.0,8234.0,24 RC,369,"Colonoscopy through stoma; with biopsy, single or multiple ",,,450.72,3128.0,27 RC,369,"Colonoscopy through stoma; with control of bleeding, any method ",,,450.72,3128.0,27 RC,369,"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,8234.0,27 RC,369,"Colonoscopy through stoma; with directed submucosal injection(s), any substance ",,,450.72,8234.0,27 RC,369,Colonoscopy through stoma; with endoscopic mucosal resection ,,,450.72,8234.0,27 RC,369,"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed) ",,,1986.0,13051.67,24 RC,369,"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures ",,,450.72,8234.0,27 RC,369,Colonoscopy through stoma; with removal of foreign body(s) ,,,344.93,3128.0,27 RC,369,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3128.0,27 RC,369,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,27 RC,369,Colonoscopy through stoma; with transendoscopic balloon dilation ,,,450.72,8234.0,27 RC,369,"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descendi",,,450.72,8234.0,27 RC,369,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3755.0,27 RC,369,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,27 RC,369,"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,27 RC,369,"Colonoscopy, flexible; with biopsy, single or multiple ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with control of bleeding, any method ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,450.72,8234.0,27 RC,369,"Colonoscopy, flexible; with directed submucosal injection(s), any substance ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with endoscopic mucosal resection ",,,986.93,8234.0,27 RC,369,"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) ",,,2195.0,13051.67,27 RC,369,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with removal of foreign body(s) ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3755.0,27 RC,369,"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, desc",,,450.72,3755.0,27 RC,369,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,26 RC,369,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,26 RC,369,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,23 RC,369,Colostomy or skin level cecostomy; ,,,3390.0,16207.0,12 RC,369,"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Colotomy, for exploration, biopsy(s), or foreign body removal ",,,3375.0,16207.0,24 RC,369,Colpocentesis (separate procedure) ,,,1603.34,11661.3,27 RC,369,Colpocleisis (Le Fort type) ,,,1603.34,13835.0,27 RC,369,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,1116.7,6819.81,27 RC,369,"Colpopexy, abdominal approach ",,,3041.0,13835.0,24 RC,369,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,3293.0,18300.83,24 RC,369,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,3293.0,18300.83,24 RC,369,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,369,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,1116.7,6819.81,27 RC,369,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,26 RC,369,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,26 RC,369,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,26 RC,369,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,26 RC,369,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,27 RC,369,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,27 RC,369,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,26 RC,369,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,27 RC,369,Colposcopy of the vulva; ,,,57.86,5841.0,26 RC,369,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,26 RC,369,Colpotomy; with drainage of pelvic abscess ,,,1116.7,6819.81,27 RC,369,Colpotomy; with exploration ,,,1116.7,6819.81,27 RC,369,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,1603.34,13394.0,27 RC,369,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,1603.34,12909.0,27 RC,369,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,369,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,369,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,369,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,369,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,27 RC,369,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,27 RC,369,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,27 RC,369,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,27 RC,369,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,283.62,5841.0,11 RC,369,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,369,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,369,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,369,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,369,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,369,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,369,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,1672.0,5841.0,3 RC,369,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,1116.7,6819.81,27 RC,369,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,1116.7,6819.81,27 RC,369,Conjunctival flap; bridge or partial (separate procedure) ,,,1158.59,8536.87,27 RC,369,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,27 RC,369,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,27 RC,369,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,1158.59,8536.87,27 RC,369,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,1158.59,8536.87,27 RC,369,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,27 RC,369,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,1158.59,8536.87,27 RC,369,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,1158.59,8536.87,27 RC,369,Construction of artificial vagina; with graft ,,,2996.0,13835.0,24 RC,369,Construction of artificial vagina; without graft ,,,1603.34,13394.0,27 RC,369,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,27 RC,369,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,27 RC,369,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,369,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,3390.0,20377.26,12 RC,369,Continent ileostomy (Kock procedure) (separate procedure) ,,,3390.0,17410.56,12 RC,369,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,369,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,,,1672.0,5841.0,15 RC,369,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",,,477.73,5841.0,23 RC,369,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization ",,,3390.0,16207.0,12 RC,369,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery ",,,91.96,5841.0,26 RC,369,"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention ",,,930.95,12562.0,27 RC,369,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization ",,,3390.0,16207.0,12 RC,369,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple ",,,196.58,5841.0,26 RC,369,"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention ",,,930.95,7150.66,27 RC,369,"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), ",,,1209.12,15059.0,27 RC,369,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,27 RC,369,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,369,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,27 RC,369,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,369,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,369,"Cordocentesis (intrauterine), any method ",,,554.98,5841.0,11 RC,369,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,27 RC,369,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,27 RC,369,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,3390.0,16207.0,12 RC,369,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,1200.05,8240.61,27 RC,369,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,1200.05,8234.0,27 RC,369,"Correction of everted punctum, cautery ",,,113.7,5841.0,26 RC,369,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,27 RC,369,Correction of lid retraction ,,,733.22,12562.0,27 RC,369,"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure) ",,,3390.0,18393.82,24 RC,369,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,14 RC,369,"Correction of trichiasis; epilation, by forceps only ",,,223.51,5841.0,11 RC,369,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,27 RC,369,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,27 RC,369,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,1672.0,5841.0,3 RC,369,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,8778.0,16330.72,12 RC,369,Craniectomy for craniosynostosis; multiple cranial sutures ,,,3390.0,18444.62,12 RC,369,Craniectomy for craniosynostosis; single cranial suture ,,,3390.0,16207.0,12 RC,369,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,3390.0,46759.99,12 RC,369,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,3390.0,34350.61,12 RC,369,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,3390.0,36766.35,12 RC,369,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,3390.0,39720.34,12 RC,369,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,3390.0,22576.85,12 RC,369,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,3390.0,25611.4,12 RC,369,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,3390.0,25806.38,12 RC,369,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,3390.0,24598.51,12 RC,369,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,2979.0,19402.47,12 RC,369,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,3390.0,29586.87,12 RC,369,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,3390.0,29561.46,12 RC,369,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,3390.0,26149.65,12 RC,369,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,3390.0,23547.4,12 RC,369,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,3390.0,24861.23,12 RC,369,"Craniectomy or craniotomy, exploratory; supratentorial ",,,3390.0,20406.89,12 RC,369,Craniectomy or craniotomy; with excision of foreign body from brain ,,,3390.0,23106.64,12 RC,369,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,3390.0,24297.57,12 RC,369,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,3390.0,41508.92,12 RC,369,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,3390.0,38601.49,12 RC,369,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,3390.0,26679.44,12 RC,369,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,3390.0,25797.91,12 RC,369,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,3390.0,27154.19,12 RC,369,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,3390.0,24954.48,12 RC,369,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,3390.0,26158.12,12 RC,369,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,3390.0,23733.91,12 RC,369,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,3390.0,23716.98,12 RC,369,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,3390.0,27162.66,12 RC,369,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,3390.0,31706.02,12 RC,369,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,3390.0,23081.23,12 RC,369,Craniectomy; for osteomyelitis ,,,3390.0,16207.0,12 RC,369,Craniectomy; with excision of tumor or other bone lesion of skull ,,,3982.0,16194.11,24 RC,369,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,3390.0,29832.65,12 RC,369,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,3390.0,32278.14,12 RC,369,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,3390.0,37546.15,12 RC,369,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,3390.0,35702.54,12 RC,369,Cranioplasty for skull defect with reparative brain surgery ,,,3390.0,17389.28,12 RC,369,Cranioplasty for skull defect; larger than 5 cm diameter ,,,3390.0,16207.0,12 RC,369,Cranioplasty for skull defect; up to 5 cm diameter ,,,3390.0,16207.0,12 RC,369,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,3390.0,17787.71,12 RC,369,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,3390.0,16207.0,12 RC,369,Craniotomy for craniosynostosis; bifrontal bone flap ,,,3390.0,20945.15,12 RC,369,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,3390.0,21263.02,12 RC,369,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,3390.0,28586.68,12 RC,369,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,3390.0,19673.77,12 RC,369,"Craniotomy for repair of encephalocele, skull base ",,,3390.0,19381.3,12 RC,369,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,3390.0,31883.95,12 RC,369,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,3390.0,39423.75,12 RC,369,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,3390.0,20105.95,12 RC,369,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,3390.0,23733.91,12 RC,369,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,3390.0,29514.78,12 RC,369,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,3390.0,26730.36,12 RC,369,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,3390.0,33180.84,12 RC,369,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,3390.0,30709.95,12 RC,369,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,3390.0,30913.39,12 RC,369,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,3390.0,26158.12,12 RC,369,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,3390.0,16207.0,12 RC,369,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,3390.0,27493.23,12 RC,369,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,3390.0,18843.05,12 RC,369,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,3390.0,26577.72,12 RC,369,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,3390.0,15039.6,12 RC,369,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,3390.0,19834.77,12 RC,369,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,27 RC,369,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,27 RC,369,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,27 RC,369,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,3390.0,16207.0,12 RC,369,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,2195.0,15039.6,24 RC,369,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,3390.0,16207.0,12 RC,369,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,12 RC,369,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,3390.0,16207.0,12 RC,369,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,12 RC,369,Cricopharyngeal myotomy ,,,2051.93,13835.0,15 RC,369,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,369,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,3375.0,24948.0,26 RC,369,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial ",,,154.64,13835.0,27 RC,369,"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent ",,,1138.67,3128.0,24 RC,369,"Curettage, postpartum ",,,1116.7,12562.0,27 RC,369,Cutaneous appendico-vesicostomy ,,,3390.0,16207.0,12 RC,369,Cutaneous vesicostomy ,,,3041.0,13835.0,12 RC,369,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,3390.0,28891.85,12 RC,369,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,3390.0,23721.21,12 RC,369,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,26849.02,12 RC,369,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,3390.0,23212.59,12 RC,369,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,25874.23,12 RC,369,"Cystectomy, complete; (separate procedure) ",,,3390.0,18071.71,12 RC,369,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,22360.7,12 RC,369,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,3390.0,16207.0,12 RC,369,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,3390.0,16207.0,12 RC,369,"Cystectomy, partial; simple ",,,3390.0,16207.0,12 RC,369,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,369,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,369,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,369,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,369,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,1773.9,11552.32,27 RC,369,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,2358.0,16207.0,24 RC,369,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,2996.0,13835.0,24 RC,369,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,2195.0,13835.0,24 RC,369,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,27 RC,369,"Cystotomy for excision, incision, or repair of ureterocele ",,,3041.0,13835.0,12 RC,369,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,1200.05,8240.61,27 RC,369,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,8 RC,369,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,1200.05,8240.61,27 RC,369,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,27 RC,369,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,4988.0,13835.0,12 RC,369,Cystotomy; for excision of bladder tumor ,,,4988.0,13835.0,12 RC,369,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,1200.05,8240.61,27 RC,369,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,2358.0,16207.0,24 RC,369,Cystourethroscopy ,,,3390.0,5841.0,2 RC,369,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,27 RC,369,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,27 RC,369,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,27 RC,369,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,27 RC,369,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,27 RC,369,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,27 RC,369,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,369,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,27 RC,369,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,1200.05,12562.0,27 RC,369,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,2699.0,26403.19,17 RC,369,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,1200.05,25988.0,29 RC,369,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,2699.0,25244.72,18 RC,369,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,27 RC,369,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,1200.05,8240.61,27 RC,369,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,2699.0,12562.0,24 RC,369,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,27 RC,369,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,369,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,27 RC,369,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,27 RC,369,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,27 RC,369,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,27 RC,369,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,27 RC,369,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,1773.9,12562.0,27 RC,369,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,1200.05,5571.0,27 RC,369,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,1200.05,5571.0,27 RC,369,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,27 RC,369,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,20 RC,369,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,1672.0,5841.0,20 RC,369,"Cystourethroscopy, with insertion of permanent urethral stent ",,,1200.05,15059.0,27 RC,369,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,369,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,26 RC,369,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,26 RC,369,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,27 RC,369,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,27 RC,369,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,2699.0,15059.0,22 RC,369,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,27 RC,369,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,27 RC,369,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,27 RC,369,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,27 RC,369,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,27 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,11552.32,24 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1773.9,15059.0,27 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,27 RC,369,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,1773.9,11552.32,27 RC,369,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,1200.05,8240.61,27 RC,369,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,27 RC,369,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,27 RC,369,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,369,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,369,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,369,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,369,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,369,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,369,DESTRUCTION OF HEMORRHOIDS ,,,3390.0,5841.0,6 RC,369,DILATE ESOPHAGUS ,,,3390.0,5841.0,4 RC,369,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,369,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,2 RC,369,DRAIN APP ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,369,DRAIN PANCREATIC PSEUDOCYST ,,,3390.0,5841.0,2 RC,369,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,369,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,2 RC,369,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,2 RC,369,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,369,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,369,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,1158.59,8536.87,27 RC,369,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,369,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,369,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,369,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,27 RC,369,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,358.2,5841.0,11 RC,369,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,3293.0,13835.0,24 RC,369,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,2051.93,13394.0,27 RC,369,Decompression internal auditory canal ,,,6326.0,13835.0,12 RC,369,"Decompression of orbit only, transcranial approach ",,,5369.54,13835.0,12 RC,369,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,369,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,692.94,15059.0,27 RC,369,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,1986.0,3083.0,12 RC,369,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,2996.0,20238.53,17 RC,369,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,2195.0,5446.4,17 RC,369,Decompression; plantar digital nerve ,,,692.94,5571.0,27 RC,369,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,27 RC,369,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,369,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,12562.0,27 RC,369,Deligation of ureter ,,,3390.0,16207.0,12 RC,369,Delivery of placenta (separate procedure) ,,,1116.7,13835.0,15 RC,369,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,369,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,26 RC,369,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,27 RC,369,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,1672.0,5841.0,15 RC,369,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,27 RC,369,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,1672.0,5841.0,15 RC,369,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,27 RC,369,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,27 RC,369,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,27 RC,369,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,27 RC,369,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,27 RC,369,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,27 RC,369,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,27 RC,369,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,26 RC,369,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,27 RC,369,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,27 RC,369,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,27 RC,369,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) ",,,137.5,13394.0,27 RC,369,"Destruction of lesion (except excision), dentoalveolar structures ",,,441.67,13835.0,27 RC,369,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,26 RC,369,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,27 RC,369,"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) ",,,187.2,3128.0,27 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,986.93,6399.61,27 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,144.76,5841.0,26 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,78.06,5841.0,26 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,168.02,13835.0,27 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,986.93,6399.61,27 RC,369,"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,986.93,6399.61,27 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,27 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,655.0,5841.0,11 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,358.2,5841.0,11 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,15 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,27 RC,369,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,27 RC,369,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,27 RC,369,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,27 RC,369,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,27 RC,369,"Destruction of lesion, palate or uvula (thermal, cryo or chemical) ",,,142.44,3128.0,27 RC,369,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,27 RC,369,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,27 RC,369,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,369,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,26 RC,369,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,369,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,27 RC,369,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,27 RC,369,"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ",,,986.93,15059.0,27 RC,369,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,1116.7,6819.81,27 RC,369,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,27 RC,369,Diagnostic bone marrow; aspiration(s) ,,,97.38,3128.0,27 RC,369,Diagnostic bone marrow; biopsy(ies) ,,,100.58,3128.0,27 RC,369,Diagnostic bone marrow; biopsy(ies) and aspiration(s) ,,,855.96,6330.57,26 RC,369,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,369,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,369,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,369,"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation neces",,,1672.0,5841.0,15 RC,369,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,369,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,14 RC,369,"Dilation and catheterization of salivary duct, with or without injection ",,,59.88,5841.0,26 RC,369,Dilation and curettage of cervical stump ,,,1116.7,12562.0,27 RC,369,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,1116.7,6819.81,27 RC,369,Dilation of anal sphincter (separate procedure) under anesthesia other than local ,,,450.72,3128.0,27 RC,369,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,27 RC,369,"Dilation of esophagus, by unguided sound or bougie, single or multiple passes ",,,351.7,3128.0,27 RC,369,"Dilation of esophagus, over guide wire ",,,593.22,4251.7,27 RC,369,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,1200.05,15059.0,52 RC,369,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,26 RC,369,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,14 RC,369,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,27 RC,369,"Dilation of lacrimal punctum, with or without irrigation ",,,745.36,5841.0,11 RC,369,Dilation of rectal stricture (separate procedure) under anesthesia other than local ,,,450.72,3128.0,27 RC,369,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,27 RC,369,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,26 RC,369,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,26 RC,369,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,26 RC,369,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,1200.05,4836.33,27 RC,369,Dilation of vagina under anesthesia (other than local) ,,,1116.7,6819.81,27 RC,369,Dilation salivary duct ,,,39.25,3128.0,27 RC,369,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,1672.0,5841.0,15 RC,369,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,3293.0,16330.72,24 RC,369,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,2002.73,16207.0,12 RC,369,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,3390.0,18749.79,12 RC,369,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,27 RC,369,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,26 RC,369,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,27 RC,369,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,369,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,369,"Dissection, deep jugular node(s) ",,,1983.29,13196.03,27 RC,369,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach ",,,2051.93,13835.0,27 RC,369,"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach ",,,3390.0,18033.49,12 RC,369,Division of stricture of rectum ,,,450.72,5571.0,27 RC,369,"Donor enterectomy (including cold preservation), open; from cadaver donor ",,,3390.0,16207.0,12 RC,369,"Donor enterectomy (including cold preservation), open; partial, from living donor ",,,3390.0,23742.38,12 RC,369,"Donor hepatectomy (including cold preservation), from cadaver donor ",,,3390.0,22555.68,12 RC,369,"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) ",,,3390.0,43933.13,12 RC,369,"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV) ",,,3390.0,52591.78,12 RC,369,"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII) ",,,3390.0,57868.37,12 RC,369,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,369,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,3390.0,16207.0,12 RC,369,"Donor nephrectomy (including cold preservation); open, from living donor ",,,3390.0,18414.98,12 RC,369,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,3390.0,16028.88,10 RC,369,"Drainage external auditory canal, abscess ",,,154.94,5841.0,26 RC,369,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,27 RC,369,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,26 RC,369,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,24 RC,369,"Drainage of abscess of palate, uvula ",,,91.96,5841.0,26 RC,369,"Drainage of abscess, cyst, hematoma from dentoalveolar structures ",,,223.51,5841.0,23 RC,369,"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated ",,,196.58,3755.0,27 RC,369,"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple ",,,138.37,5841.0,14 RC,369,"Drainage of abscess; parotid, complicated ",,,930.95,7150.66,27 RC,369,"Drainage of abscess; parotid, simple ",,,441.67,3683.7,27 RC,369,"Drainage of abscess; submaxillary or sublingual, intraoral ",,,196.58,5841.0,26 RC,369,"Drainage of abscess; submaxillary, external ",,,196.58,5841.0,26 RC,369,Drainage of deep periurethral abscess ,,,1200.05,5571.0,27 RC,369,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,3390.0,16207.0,12 RC,369,Drainage of lymph node abscess or lymphadenitis; extensive ,,,855.96,6330.57,27 RC,369,Drainage of lymph node abscess or lymphadenitis; simple ,,,855.96,6330.57,27 RC,369,Drainage of ovarian abscess; abdominal approach ,,,2699.0,13835.0,24 RC,369,"Drainage of ovarian abscess; vaginal approach, open ",,,1116.7,12562.0,27 RC,369,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,1116.7,13835.0,27 RC,369,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,1116.7,12562.0,27 RC,369,Drainage of perineal urinary extravasation; complicated ,,,3041.0,13835.0,12 RC,369,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,27 RC,369,"Drainage of perirenal or renal abscess, open ",,,2195.0,13835.0,24 RC,369,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,3390.0,19550.76,12 RC,369,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,27 RC,369,"Drainage of retroperitoneal abscess, open ",,,3390.0,16207.0,12 RC,369,Drainage of scrotal wall abscess ,,,510.77,3747.2,27 RC,369,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,3390.0,16207.0,12 RC,369,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic ",,,71.55,5841.0,26 RC,369,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,3390.0,21996.26,12 RC,369,"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes d",,,351.7,3128.0,27 RC,369,"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture) ",,,1611.14,5841.0,23 RC,369,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,369,"Duodenotomy, for exploration, biopsy(s), or foreign body removal ",,,3375.0,16207.0,24 RC,369,"Dural graft, spinal ",,,3390.0,16207.0,12 RC,369,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,466.41,13835.0,12 RC,369,EMBOLIZATION UTERINE FIBROID ,,,3390.0,5841.0,2 RC,369,ENDO CHOLANGIOPANCREATOGRAPH ,,,3390.0,5841.0,10 RC,369,ESOPH ENDOSCOPY ABLATION ,,,3390.0,5841.0,2 RC,369,ESOPHAGUS ENDOSCOPY ,,,3390.0,5841.0,2 RC,369,EXCISION OF RECTAL LESION ,,,3390.0,5841.0,2 RC,369,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,369,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,369,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,369,Ear piercing ,,,370.1,16207.0,9 RC,369,Electroejaculation ,,,560.2,3128.0,24 RC,369,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,369,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,369,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,369,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,14 RC,369,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,369,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,1672.0,5841.0,18 RC,369,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,479.41,5841.0,34 RC,369,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,1672.0,5841.0,18 RC,369,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,369,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,369,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,369,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,369,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,3390.0,16207.0,12 RC,369,"Elevation of depressed skull fracture; simple, extradural ",,,5369.54,13835.0,12 RC,369,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,3390.0,18957.47,12 RC,369,"Embryo transfer, intrauterine ",,,1308.84,5841.0,23 RC,369,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,27 RC,369,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,1672.0,5841.0,15 RC,369,"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and ",,,1672.0,5841.0,15 RC,369,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,369,Endolymphatic sac operation; with shunt ,,,2051.93,13241.95,27 RC,369,Endolymphatic sac operation; without shunt ,,,2051.93,13241.95,27 RC,369,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,29 RC,369,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,1299.68,23059.78,29 RC,369,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,26 RC,369,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,369,Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (List separately in addition to code(s) for primary procedure) ,,,1672.0,15059.0,18 RC,369,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,2518.45,16330.72,26 RC,369,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,369,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,344.93,3128.0,27 RC,369,"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir ºS or J»); with biopsy, single or multiple ",,,344.93,3128.0,27 RC,369,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,1639.76,12562.0,27 RC,369,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,1175.22,8187.49,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed ",,,1175.22,15059.0,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple ",,,1175.22,8187.49,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) ",,,1770.48,13051.67,24 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,2327.33,15059.0,27 RC,369,Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi ,,,1175.22,8187.49,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,2363.19,15059.0,27 RC,369,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) ,,,1175.22,8187.49,27 RC,369,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) ,,,1175.22,15059.0,27 RC,369,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy ,,,1175.22,8187.49,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, ",,,1175.22,15059.0,27 RC,369,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,369,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,369,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,369,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,369,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,369,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,369,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,2316.62,16207.0,14 RC,369,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,3390.0,16207.0,14 RC,369,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,3375.0,27050.15,24 RC,369,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (List separately in addit",,,2346.42,16207.0,12 RC,369,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering ",,,3390.0,35172.75,12 RC,369,"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering ",,,3390.0,30231.08,12 RC,369,"Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure) ",,,2326.61,16207.0,12 RC,369,"Enterectomy, resection of small intestine; single resection and anastomosis ",,,3390.0,16207.0,12 RC,369,"Enterectomy, resection of small intestine; with enterostomy ",,,3390.0,16207.0,12 RC,369,"Enterocystoplasty, including intestinal anastomosis ",,,3390.0,16974.03,12 RC,369,"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure) ",,,3390.0,16207.0,12 RC,369,Enterolysis (freeing of intestinal adhesion) (separate procedure) ,,,3390.0,16207.0,24 RC,369,"Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube) ",,,3390.0,16207.0,12 RC,369,"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal ",,,3375.0,16207.0,24 RC,369,"Enucleation of eye; with implant, muscles attached to implant ",,,1158.59,8536.87,27 RC,369,"Enucleation of eye; with implant, muscles not attached to implant ",,,1158.59,12562.0,27 RC,369,Enucleation of eye; without implant ,,,1158.59,12562.0,27 RC,369,Epididymectomy; bilateral ,,,1200.05,8240.61,27 RC,369,Epididymectomy; unilateral ,,,1200.05,12562.0,27 RC,369,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,2996.0,8240.61,24 RC,369,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,2996.0,8234.0,24 RC,369,Epikeratoplasty ,,,2518.0,15664.44,24 RC,369,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,24 RC,369,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,369,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,369,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,369,"Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,1113.7,16207.0,12 RC,369,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,369,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,369,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,369,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,369,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,369,"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, w",,,3390.0,44136.57,11 RC,369,"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with ",,,3390.0,38563.39,11 RC,369,"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric dr",,,3390.0,45963.25,11 RC,369,Esophagogastric fundoplasty partial or complete; laparotomy ,,,3390.0,16207.0,12 RC,369,Esophagogastric fundoplasty partial or complete; thoracotomy ,,,3390.0,16207.0,12 RC,369,"Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) ",,,3390.0,16681.56,12 RC,369,"Esophagogastric tamponade, with balloon (Sengstaken type) ",,,2055.55,16207.0,12 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,593.22,13394.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple ",,,351.7,3755.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease ",,,2699.0,12562.0,24 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon ",,,2613.0,12909.0,23 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie) ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube ",,,593.22,4251.7,24 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,351.7,3755.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,593.22,12562.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed ",,,2699.0,22967.79,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire ",,,351.7,3755.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy ",,,1175.22,13394.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2699.0,15059.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) ",,,351.7,3755.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s) ",,,1692.3,13394.0,23 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) ",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,593.22,4251.7,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial ma",,,593.22,13394.0,27 RC,369,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterºs»/stentºs», when performed, and endoscopic ultrasound, when",,,2195.0,8187.49,27 RC,369,"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach ",,,3390.0,17147.73,12 RC,369,Esophagojejunostomy (without total gastrectomy); abdominal approach ,,,3390.0,16897.71,12 RC,369,Esophagojejunostomy (without total gastrectomy); thoracic approach ,,,3390.0,17207.11,12 RC,369,Esophagomyotomy (Heller type); abdominal approach ,,,3390.0,16401.79,12 RC,369,Esophagomyotomy (Heller type); thoracic approach ,,,3390.0,16414.49,12 RC,369,"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula ",,,3390.0,16207.0,12 RC,369,"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula ",,,3390.0,16207.0,12 RC,369,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula ",,,3390.0,19555.0,12 RC,369,"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula ",,,3390.0,18190.37,12 RC,369,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula ",,,3390.0,34948.13,12 RC,369,"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula ",,,3390.0,33617.37,12 RC,369,"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,117.44,12562.0,27 RC,369,"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple ",,,125.86,12562.0,27 RC,369,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,27 RC,369,"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,1536.84,15059.0,27 RC,369,"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with biopsy, single or multiple ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with control of bleeding, any method ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,27 RC,369,"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) ",,,593.22,13394.0,27 RC,369,"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection ",,,593.22,12562.0,27 RC,369,"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with optical endomicroscopy ",,,593.22,13394.0,27 RC,369,"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2195.0,15059.0,27 RC,369,"Esophagoscopy, flexible, transoral; with removal of foreign body(s) ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,593.22,5571.0,27 RC,369,"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) ",,,593.22,4251.7,27 RC,369,"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope ",,,2051.93,15059.0,27 RC,369,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure) ",,,593.22,12562.0,27 RC,369,"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter) ",,,1175.22,13394.0,27 RC,369,"Esophagoscopy, rigid, transoral; with biopsy, single or multiple ",,,593.22,13394.0,27 RC,369,"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance ",,,593.22,13394.0,27 RC,369,"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire ",,,1175.22,13394.0,27 RC,369,"Esophagoscopy, rigid, transoral; with removal of foreign body(s) ",,,593.22,13394.0,27 RC,369,"Esophagostomy, fistulization of esophagus, external; cervical approach ",,,3390.0,16207.0,12 RC,369,"Esophagostomy, fistulization of esophagus, external; thoracic approach ",,,3390.0,16207.0,12 RC,369,"Esophagotomy, cervical approach, with removal of foreign body ",,,2128.0,3683.7,12 RC,369,"Esophagotomy, thoracic approach, with removal of foreign body ",,,3390.0,16207.0,12 RC,369,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,369,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,369,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,369,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,369,Evisceration of ocular contents; with implant ,,,1158.59,12562.0,27 RC,369,Evisceration of ocular contents; without implant ,,,1158.59,12562.0,27 RC,369,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,27 RC,369,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,369,"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging",,,1209.12,15059.0,27 RC,369,Exchange of intraocular lens ,,,892.44,5571.0,27 RC,369,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,593.22,13835.0,27 RC,369,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,369,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,369,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,369,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,54 RC,369,Excision aural glomus tumor; extended (extratemporal) ,,,3390.0,30451.46,12 RC,369,Excision aural glomus tumor; transcanal ,,,2051.93,13394.0,27 RC,369,Excision aural glomus tumor; transmastoid ,,,2051.93,13241.95,27 RC,369,Excision aural polyp ,,,143.6,13835.0,27 RC,369,"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ",,,930.95,12562.0,27 RC,369,"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx ",,,2051.93,13394.0,27 RC,369,"Excision exostosis(es), external auditory canal ",,,2051.93,13241.95,27 RC,369,Excision external ear; complete amputation ,,,2051.93,13241.95,27 RC,369,"Excision external ear; partial, simple repair ",,,855.96,6330.57,27 RC,369,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies ",,,3390.0,16207.0,12 RC,369,"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy ",,,3390.0,16207.0,12 RC,369,Excision of Bartholin's gland or cyst ,,,1116.7,12562.0,27 RC,369,Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct ,,,3390.0,16207.0,12 RC,369,Excision of Mullerian duct cyst ,,,1200.05,8240.61,27 RC,369,Excision of ampulla of Vater ,,,3390.0,16207.0,12 RC,369,"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic ",,,3390.0,19126.93,12 RC,369,"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic ",,,3390.0,24530.65,12 RC,369,Excision of bulbourethral gland (Cowper's gland) ,,,1200.05,8240.61,27 RC,369,Excision of carotid body tumor; with excision of carotid artery ,,,3390.0,20326.45,12 RC,369,Excision of carotid body tumor; without excision of carotid artery ,,,3390.0,16795.98,12 RC,369,"Excision of cervical stump, abdominal approach; ",,,3390.0,16207.0,12 RC,369,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,3390.0,16207.0,12 RC,369,"Excision of cervical stump, vaginal approach; ",,,1603.34,12562.0,27 RC,369,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,4988.0,13835.0,12 RC,369,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,1603.34,13394.0,27 RC,369,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,26 RC,369,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,27 RC,369,Excision of chalazion; single ,,,65.12,5841.0,26 RC,369,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,27 RC,369,Excision of choledochal cyst ,,,3390.0,16300.07,12 RC,369,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,1983.29,13196.03,27 RC,369,"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection ",,,1937.47,14297.8,27 RC,369,"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection ",,,1011.84,12562.0,27 RC,369,Excision of extraparenchymal lesion of testis ,,,1200.05,8240.61,27 RC,369,"Excision of fibrous tuberosities, dentoalveolar structures ",,,1834.39,13835.0,24 RC,369,"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) ",,,441.67,3683.7,27 RC,369,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,1200.05,12562.0,27 RC,369,Excision of hydrocele; bilateral ,,,1209.12,13394.0,27 RC,369,Excision of hydrocele; unilateral ,,,1209.12,12562.0,27 RC,369,"Excision of hyperplastic alveolar mucosa, each quadrant (specify) ",,,198.25,13835.0,27 RC,369,Excision of ileoanal reservoir with ileostomy ,,,3390.0,22623.54,12 RC,369,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,1158.59,12562.0,27 RC,369,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,1158.59,12562.0,27 RC,369,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,27 RC,369,Excision of lacrimal gland tumor; involving osteotomy ,,,1158.59,12562.0,27 RC,369,Excision of lacrimal sac (dacryocystectomy) ,,,1158.59,12562.0,27 RC,369,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,27 RC,369,Excision of lesion of mesentery (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle ",,,930.95,7150.66,27 RC,369,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair ",,,930.95,7150.66,27 RC,369,"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair ",,,172.67,13835.0,27 RC,369,"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair ",,,144.47,13835.0,27 RC,369,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,3390.0,16207.0,12 RC,369,Excision of lesion of spermatic cord (separate procedure) ,,,1200.05,8240.61,27 RC,369,Excision of lesion of tongue with closure; anterior two-thirds ,,,930.95,7150.66,27 RC,369,Excision of lesion of tongue with closure; posterior one-third ,,,930.95,7150.66,27 RC,369,Excision of lesion of tongue with closure; with local tongue flap ,,,930.95,7150.66,27 RC,369,Excision of lesion of tongue without closure ,,,149.42,3128.0,27 RC,369,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair ",,,2051.93,13241.95,27 RC,369,"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair ",,,188.37,13835.0,27 RC,369,"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair ",,,146.52,13835.0,27 RC,369,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,27 RC,369,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,27 RC,369,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,27 RC,369,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,27 RC,369,"Excision of lesion, esophagus, with primary repair; cervical approach ",,,3390.0,16207.0,12 RC,369,"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach ",,,3390.0,16207.0,12 RC,369,"Excision of lesion, sclera ",,,733.22,12909.0,27 RC,369,Excision of lingual frenum (frenectomy) ,,,170.34,3128.0,27 RC,369,Excision of lip; V-excision with primary direct linear closure ,,,930.95,7150.66,27 RC,369,"Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) ",,,2051.93,13241.95,27 RC,369,"Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) ",,,930.95,7150.66,27 RC,369,Excision of lip; transverse wedge excision with primary closure ,,,930.95,7150.66,27 RC,369,Excision of local lesion of epididymis ,,,1200.05,12562.0,27 RC,369,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,369,Excision of mucosa of vestibule of mouth as donor graft ,,,196.58,5841.0,26 RC,369,"Excision of multiple external papillae or tags, anus ",,,986.93,6399.61,27 RC,369,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,27 RC,369,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,2096.41,15039.6,27 RC,369,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,27 RC,369,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,27 RC,369,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,27 RC,369,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,27 RC,369,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,27 RC,369,Excision of neuroma; sciatic nerve ,,,2096.41,15039.6,27 RC,369,"Excision of osseous tuberosities, dentoalveolar structures ",,,2195.0,13835.0,24 RC,369,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve ",,,2051.93,13241.95,27 RC,369,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection ",,,2051.93,13241.95,27 RC,369,"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve ",,,2051.93,13241.95,27 RC,369,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve ",,,2051.93,13241.95,27 RC,369,"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection ",,,3041.0,16448.48,12 RC,369,Excision of penile plaque (Peyronie disease); ,,,1200.05,9653.0,27 RC,369,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,2195.0,22025.45,27 RC,369,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,1773.9,11552.32,27 RC,369,Excision of perinephric cyst ,,,3390.0,16207.0,12 RC,369,Excision of presacral or sacrococcygeal tumor ,,,3390.0,27243.1,12 RC,369,"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach ",,,3390.0,16207.0,12 RC,369,"Excision of rectal procidentia, with anastomosis; perineal approach ",,,3390.0,16207.0,12 RC,369,"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach ",,,986.93,6399.61,27 RC,369,"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness) ",,,986.93,15059.0,27 RC,369,"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness) ",,,986.93,13394.0,27 RC,369,"Excision of single external papilla or tag, anus ",,,450.72,3128.0,27 RC,369,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,27 RC,369,Excision of sublingual gland ,,,2051.93,13241.95,27 RC,369,Excision of sublingual salivary cyst (ranula) ,,,930.95,12562.0,27 RC,369,Excision of submandibular (submaxillary) gland ,,,2051.93,13241.95,27 RC,369,"Excision of thrombosed hemorrhoid, external ",,,131.97,3128.0,27 RC,369,Excision of thyroglossal duct cyst or sinus; ,,,1983.29,13196.03,27 RC,369,Excision of thyroglossal duct cyst or sinus; recurrent ,,,1983.29,13196.03,27 RC,369,Excision of tonsil tags ,,,930.95,12562.0,27 RC,369,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,1983.29,13196.03,27 RC,369,Excision of urethral diverticulum (separate procedure); female ,,,1773.9,11552.32,27 RC,369,Excision of urethral diverticulum (separate procedure); male ,,,1773.9,12562.0,27 RC,369,Excision of vaginal cyst or tumor ,,,1116.7,6819.81,27 RC,369,Excision of vaginal septum ,,,1116.7,6819.81,27 RC,369,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,1200.05,8240.61,27 RC,369,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,1209.12,8488.5,27 RC,369,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,1209.12,13394.0,27 RC,369,"Excision or destruction lingual tonsil, any method (separate procedure) ",,,2051.93,13241.95,27 RC,369,"Excision or destruction of lesion of pharynx, any method ",,,930.95,7150.66,27 RC,369,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,3390.0,24038.38,6 RC,369,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,3390.0,27963.63,6 RC,369,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,3390.0,15741.23,6 RC,369,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,3390.0,20117.01,6 RC,369,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,3390.0,34471.38,6 RC,369,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,3 RC,369,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,3 RC,369,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,3 RC,369,Excision or fulguration of carcinoma of urethra ,,,1200.05,8240.61,27 RC,369,Excision or fulguration; Skene's glands ,,,1200.05,5571.0,27 RC,369,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,27 RC,369,"Excision or fulguration; urethral polyp(s), distal urethra ",,,1200.05,5571.0,27 RC,369,Excision or fulguration; urethral prolapse ,,,1200.05,5571.0,27 RC,369,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,27 RC,369,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,27 RC,369,Excision or unroofing of cyst(s) of kidney ,,,3390.0,16207.0,12 RC,369,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,27 RC,369,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,3390.0,30069.97,12 RC,369,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,3390.0,24382.36,12 RC,369,"Excision, lesion of floor of mouth ",,,930.95,7150.66,27 RC,369,"Excision, lesion of palate, uvula; with local flap closure ",,,2051.93,13241.95,27 RC,369,"Excision, lesion of palate, uvula; with simple primary closure ",,,155.23,3755.0,27 RC,369,"Excision, lesion of palate, uvula; without closure ",,,133.14,3755.0,27 RC,369,"Excision, local; malignant tumor of stomach ",,,3390.0,16207.0,12 RC,369,"Excision, local; ulcer or benign tumor of stomach ",,,3390.0,16207.0,12 RC,369,"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum) ",,,3390.0,16207.0,12 RC,369,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,1158.59,13394.0,27 RC,369,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,1158.59,12909.0,27 RC,369,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,1158.59,12909.0,27 RC,369,"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography ",,,3390.0,16207.0,12 RC,369,Exploration for undescended testis (inguinal or scrotal area) ,,,1209.12,8488.5,27 RC,369,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,27 RC,369,"Exploration of epididymis, with or without biopsy ",,,1200.05,8240.61,27 RC,369,"Exploration of orbit (transcranial approach), with removal of lesion ",,,3390.0,25276.59,12 RC,369,"Exploration, repair, and presacral drainage for rectal injury; ",,,3390.0,16207.0,12 RC,369,"Exploration, repair, and presacral drainage for rectal injury; with colostomy ",,,3390.0,20228.96,12 RC,369,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,2996.0,16207.0,24 RC,369,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,2996.0,13835.0,24 RC,369,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,1773.9,25988.0,29 RC,369,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,25988.0,14 RC,369,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,25988.0,14 RC,369,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,14 RC,369,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,3390.0,23428.74,12 RC,369,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,3390.0,28192.48,12 RC,369,"External cephalic version, with or without tocolysis ",,,2428.0,6819.81,12 RC,369,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,369,"External drainage, pseudocyst of pancreas, open ",,,3390.0,16207.0,12 RC,369,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,2096.2,15059.0,26 RC,369,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,2725.44,11603.86,26 RC,369,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,27 RC,369,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,15059.0,79 RC,369,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,369,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space ",,,441.67,3683.7,27 RC,369,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual ",,,196.58,5841.0,26 RC,369,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular ",,,930.95,7150.66,27 RC,369,"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental ",,,1986.0,13241.95,27 RC,369,"FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE) ",,,2431.0,2979.0,3 RC,369,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,369,FUSE PANCREAS AND BOWEL ,,,3390.0,5841.0,2 RC,369,FUSION OF BILE DUCT CYST ,,,3390.0,5841.0,4 RC,369,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,369,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,369,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,369,Fetal contraction stress test ,,,28.49,5841.0,9 RC,369,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,26 RC,369,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,399.9,16207.0,9 RC,369,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,482.53,5841.0,8 RC,369,Fetal non-stress test ,,,16.57,5841.0,6 RC,369,Fetal scalp blood sampling ,,,554.98,5841.0,11 RC,369,"Fetal shunt placement, including ultrasound guidance ",,,554.98,5841.0,23 RC,369,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,554.98,5841.0,23 RC,369,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,369,Fimbrioplasty ,,,3293.0,13835.0,24 RC,369,Fine needle aspiration of orbital contents ,,,733.22,5571.0,27 RC,369,"Fissurectomy, including sphincterotomy, when performed ",,,986.93,6399.61,27 RC,369,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,27 RC,369,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,2317.12,10424.04,27 RC,369,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,27 RC,369,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,27 RC,369,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,1610.16,10424.04,27 RC,369,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,14 RC,369,Fixation of contralateral testis (separate procedure) ,,,1200.05,12562.0,27 RC,369,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,369,"Follicle puncture for oocyte retrieval, any method ",,,1308.84,3128.0,24 RC,369,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,26 RC,369,Free jejunum transfer with microvascular anastomosis ,,,3390.0,26721.9,12 RC,369,Free omental flap with microvascular anastomosis ,,,3390.0,19868.64,12 RC,369,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty) ",,,930.95,9653.0,27 RC,369,Frenulotomy of penis ,,,685.44,5571.0,27 RC,369,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,369,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,554.98,5841.0,23 RC,369,"Gastrectomy, partial, distal; with Roux-en-Y reconstruction ",,,3390.0,23653.36,12 RC,369,"Gastrectomy, partial, distal; with formation of intestinal pouch ",,,3390.0,26056.4,12 RC,369,"Gastrectomy, partial, distal; with gastroduodenostomy ",,,3390.0,17838.63,12 RC,369,"Gastrectomy, partial, distal; with gastrojejunostomy ",,,3390.0,25039.27,12 RC,369,"Gastrectomy, total; with Roux-en-Y reconstruction ",,,3390.0,27967.87,12 RC,369,"Gastrectomy, total; with esophagoenterostomy ",,,3390.0,24157.74,12 RC,369,"Gastrectomy, total; with formation of intestinal pouch, any type ",,,3390.0,28395.93,12 RC,369,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed ",,,518.85,5841.0,23 RC,369,"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pent",,,283.62,5841.0,23 RC,369,"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) ",,,518.85,5841.0,23 RC,369,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,369,"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal",,,5841.0,23945.83,9 RC,369,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,369,"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only ",,,1530.5,8128.0,24 RC,369,"Gastric restrictive procedure, open; removal of subcutaneous port component only ",,,744.46,4430.08,24 RC,369,"Gastric restrictive procedure, open; revision of subcutaneous port component only ",,,1530.5,8128.0,24 RC,369,"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed ",,,2699.0,29647.99,17 RC,369,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy ",,,5841.0,19923.79,9 RC,369,"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption ",,,5841.0,22081.05,9 RC,369,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty ",,,6326.0,15511.79,6 RC,369,"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty ",,,3390.0,16207.0,9 RC,369,Gastroduodenostomy ,,,3390.0,16207.0,12 RC,369,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstructi",,,3390.0,33197.77,12 RC,369,"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty ",,,3390.0,27645.76,12 RC,369,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,369,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,369,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,369,"Gastrojejunostomy; with vagotomy, any type ",,,3390.0,16207.0,12 RC,369,Gastrojejunostomy; without vagotomy ,,,3390.0,16516.21,12 RC,369,"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury ",,,3390.0,16715.43,12 RC,369,"Gastrostomy, open; neonatal, for feeding ",,,1611.14,13835.0,12 RC,369,"Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) ",,,3390.0,16207.0,12 RC,369,"Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,3041.0,13835.0,12 RC,369,"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin) ",,,1611.14,13835.0,12 RC,369,Gastrotomy; with exploration or foreign body removal ,,,3390.0,16207.0,12 RC,369,Gastrotomy; with suture repair of bleeding ulcer ,,,3390.0,16545.97,12 RC,369,"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) ",,,3390.0,18648.07,12 RC,369,"Gingivectomy, excision gingiva, each quadrant ",,,930.95,15108.46,27 RC,369,"Gingivoplasty, each quadrant (specify) ",,,304.35,13835.0,15 RC,369,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,369,"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection ",,,3390.0,33829.29,12 RC,369,"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection ",,,3390.0,26704.84,12 RC,369,"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection ",,,3390.0,26920.99,12 RC,369,"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type) ",,,3390.0,36969.79,12 RC,369,"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection ",,,3390.0,29179.97,12 RC,369,Glossectomy; hemiglossectomy ,,,3390.0,16207.0,12 RC,369,Glossectomy; less than one-half tongue ,,,2051.93,13394.0,27 RC,369,"Glossectomy; partial, with unilateral radical neck dissection ",,,3041.0,26666.74,12 RC,369,Goniotomy ,,,1610.16,10424.04,27 RC,369,Graft (Thiersch operation) for rectal incontinence and/or prolapse ,,,986.93,12562.0,27 RC,369,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,369,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,369,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,369,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,369,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,369,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,369,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,369,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,369,"Harvesting conjunctival allograft, living donor ",,,2195.0,5571.0,24 RC,369,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,369,Hematopoietic progenitor cell (HPC); HPC boost ,,,592.85,9577.36,27 RC,369,Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor ,,,3293.0,102199.95,24 RC,369,Hematopoietic progenitor cell (HPC); autologous transplantation ,,,592.85,13835.0,27 RC,369,"Hemorrhoidectomy, external, 2 or more columns/groups ",,,986.93,12562.0,27 RC,369,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; ",,,986.93,12562.0,27 RC,369,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy ",,,986.93,8234.0,27 RC,369,"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed ",,,986.93,8234.0,27 RC,369,"Hemorrhoidectomy, internal and external, single column/group; ",,,986.93,12562.0,27 RC,369,"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy ",,,986.93,12562.0,27 RC,369,"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed ",,,986.93,12562.0,27 RC,369,"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance ",,,986.93,6399.61,27 RC,369,"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance ",,,986.93,15754.86,27 RC,369,"Hemorrhoidectomy, internal, by rubber band ligation(s) ",,,171.8,3128.0,27 RC,369,"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed ",,,986.93,12909.0,26 RC,369,"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling ",,,3673.0,12909.0,24 RC,369,"Hepatectomy, resection of liver; partial lobectomy ",,,3390.0,28730.74,12 RC,369,"Hepatectomy, resection of liver; total left lobectomy ",,,3390.0,37948.81,12 RC,369,"Hepatectomy, resection of liver; total right lobectomy ",,,3390.0,40771.45,12 RC,369,"Hepatectomy, resection of liver; trisegmentectomy ",,,3390.0,42242.16,12 RC,369,"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus ",,,3390.0,26539.62,12 RC,369,"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages ",,,3390.0,16207.0,12 RC,369,Hip core decompression ,,,9913.14,12713.03,5 RC,369,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,369,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,369,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,369,"Hymenotomy, simple incision ",,,1116.7,6819.81,27 RC,369,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,3390.0,19432.11,12 RC,369,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,3390.0,16207.0,24 RC,369,Hysterorrhaphy of ruptured uterus ,,,2670.3,13835.0,10 RC,369,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,3293.0,16207.0,24 RC,369,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,6819.81,15 RC,369,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,15 RC,369,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,15 RC,369,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,15 RC,369,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,15 RC,369,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,15 RC,369,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,15 RC,369,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,15 RC,369,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,3041.0,26010.28,12 RC,369,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,369,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,369,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,369,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,369,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,369,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,369,ILEOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,369,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,369,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,369,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,2 RC,369,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,369,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,369,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,369,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,369,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,369,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,369,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,369,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,369,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,369,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,369,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,369,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,369,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,369,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,369,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,369,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,369,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,369,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,369,INJECTION FOR LIVER X-RAYS ,,,3390.0,5841.0,4 RC,369,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,369,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,369,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,369,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,369,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,2 RC,369,INSERT BILE DUCT DRAIN ,,,3390.0,5841.0,2 RC,369,INSERT CATHETER BILE DUCT ,,,3390.0,5841.0,2 RC,369,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,369,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,369,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,369,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,369,IV US EACH ADD VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,369,IV US FIRST VESSEL ADD-ON ,,,3390.0,5841.0,2 RC,369,"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,351.7,3128.0,27 RC,369,"Ileoscopy, through stoma; with biopsy, single or multiple ",,,351.7,3128.0,27 RC,369,"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,2195.0,8234.0,24 RC,369,"Ileoscopy, through stoma; with transendoscopic balloon dilation ",,,593.22,8234.0,27 RC,369,"Ileostomy or jejunostomy, non-tube ",,,3390.0,16207.0,12 RC,369,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,510.77,15059.0,27 RC,369,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,510.77,12562.0,27 RC,369,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",,,2195.0,15059.0,24 RC,369,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,369,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,369,"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic ",,,3390.0,16207.0,12 RC,369,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,369,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,369,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,369,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,12 RC,369,Implantation of intrastromal corneal ring segments ,,,1610.16,26289.23,27 RC,369,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,27 RC,369,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,3293.0,44816.88,18 RC,369,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,369,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,369,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,1672.0,5841.0,15 RC,369,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,2195.0,45089.88,28 RC,369,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,28 RC,369,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,2195.0,45089.88,29 RC,369,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,2699.0,12562.0,24 RC,369,"Implantation or replacement of gastric neurostimulator electrodes, antrum, open ",,,3390.0,20491.68,12 RC,369,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,3390.0,35621.26,26 RC,369,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,3390.0,34379.68,26 RC,369,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3965.0,32488.94,27 RC,369,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,2195.0,16330.72,24 RC,369,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,2195.0,15039.6,27 RC,369,Incision and drainage abscess; peritonsillar ,,,91.96,5841.0,26 RC,369,"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach ",,,2051.93,13241.95,27 RC,369,"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach ",,,930.95,7150.66,27 RC,369,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,26 RC,369,"Incision and drainage of appendiceal abscess, open ",,,3390.0,16207.0,12 RC,369,"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess ",,,986.93,6399.61,27 RC,369,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,27 RC,369,"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia ",,,986.93,6399.61,27 RC,369,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) ,,,450.72,12562.0,27 RC,369,"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton ",,,986.93,6399.61,27 RC,369,"Incision and drainage of penis, deep ",,,510.77,8234.0,27 RC,369,"Incision and drainage of submucosal abscess, rectum ",,,450.72,3755.0,27 RC,369,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,27 RC,369,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,27 RC,369,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,27 RC,369,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,26 RC,369,"Incision and drainage, perianal abscess, superficial ",,,344.93,3128.0,27 RC,369,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,1232.72,16207.0,12 RC,369,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,24 RC,369,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,27 RC,369,Incision of labial frenum (frenotomy) ,,,76.45,5841.0,26 RC,369,Incision of lingual frenum (frenotomy) ,,,441.67,3683.7,27 RC,369,"Incision of thrombosed hemorrhoid, external ",,,115.66,5841.0,26 RC,369,"Incision, anal septum (infant) ",,,986.93,13835.0,27 RC,369,"Incision, drainage of lacrimal gland ",,,1675.47,3323.1,24 RC,369,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,27 RC,369,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,26 RC,369,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,369,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,369,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,369,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,369,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,2195.0,16207.0,24 RC,369,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,2195.0,16207.0,24 RC,369,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,2195.0,16207.0,24 RC,369,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,3390.0,16207.0,12 RC,369,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,2195.0,16207.0,48 RC,369,"Induced abortion, by dilation and curettage ",,,1116.7,13394.0,27 RC,369,"Induced abortion, by dilation and evacuation ",,,1116.7,13394.0,27 RC,369,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,369,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,3390.0,37783.59,12 RC,369,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,3390.0,37372.46,12 RC,369,"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) ",,,1937.47,14297.8,27 RC,369,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,3293.0,122851.37,17 RC,369,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,369,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,369,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,369,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,369,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,369,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,1672.0,5841.0,15 RC,369,Injection of contrast medium for dacryocystography ,,,1672.0,5841.0,15 RC,369,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,14 RC,369,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,26 RC,369,"Injection of sclerosing solution, hemorrhoids ",,,220.64,13835.0,15 RC,369,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,27 RC,369,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,1672.0,5841.0,15 RC,369,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,1672.0,5841.0,3 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,369,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,369,Injection procedure for Peyronie disease; ,,,63.08,5841.0,14 RC,369,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,1773.9,11552.32,27 RC,369,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,1140.89,12562.0,48 RC,369,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,2195.0,11410.03,24 RC,369,"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and inte",,,1986.0,15059.0,47 RC,369,Injection procedure for corpora cavernosography ,,,1672.0,5841.0,15 RC,369,Injection procedure for cystography or voiding urethrocystography ,,,1672.0,5841.0,3 RC,369,"Injection procedure for discography, each level; cervical or thoracic ",,,1672.0,5841.0,15 RC,369,"Injection procedure for discography, each level; lumbar ",,,1672.0,5841.0,15 RC,369,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,1014.57,16207.0,12 RC,369,"Injection procedure for myelography and/or computed tomography, lumbar ",,,1672.0,5841.0,15 RC,369,Injection procedure for retrograde urethrocystography ,,,1672.0,5841.0,3 RC,369,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,369,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,369,Injection procedure for sialography ,,,1672.0,5841.0,15 RC,369,Injection procedure for splenoportography ,,,1672.0,5841.0,15 RC,369,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,1672.0,5841.0,15 RC,369,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,1672.0,5841.0,15 RC,369,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,1664.7,12562.0,24 RC,369,Injection procedure; lymphangiography ,,,1672.0,5841.0,15 RC,369,Injection procedure; radioactive tracer for identification of sentinel node ,,,754.67,5841.0,23 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,15 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,15 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,26 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,26 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,26 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,15 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,1672.0,5841.0,15 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,1672.0,5841.0,15 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,27 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,26 RC,369,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,23 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,1672.0,5841.0,15 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,27 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,1672.0,5841.0,15 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,1672.0,5841.0,15 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,27 RC,369,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,1672.0,5841.0,15 RC,369,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,104 RC,369,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,104 RC,369,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,27 RC,369,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,27 RC,369,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,26 RC,369,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,27 RC,369,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,27 RC,369,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,27 RC,369,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,27 RC,369,"Injection, epidural, of blood or clot patch ",,,276.0,3128.0,27 RC,369,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,369,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,27 RC,369,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,27 RC,369,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,27 RC,369,Insert urinary catheter ,,,3390.0,5841.0,4 RC,369,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,369,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,369,Insertion of Heyman capsules for clinical brachytherapy ,,,1603.34,11661.3,27 RC,369,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,27 RC,369,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,26 RC,369,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,2340.64,15059.0,27 RC,369,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,450.72,13394.0,27 RC,369,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,369,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,406.49,5841.0,23 RC,369,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,23 RC,369,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,27 RC,369,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,27 RC,369,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,369,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,1986.0,47976.91,29 RC,369,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,27 RC,369,Insertion of intrauterine device (IUD) ,,,508.94,5841.0,23 RC,369,"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imagin",,,2699.0,13835.0,24 RC,369,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,369,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,26 RC,369,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,369,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,369,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,369,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,369,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,223.51,5841.0,23 RC,369,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,1158.59,12562.0,27 RC,369,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,1158.59,8536.87,27 RC,369,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,1158.59,12562.0,27 RC,369,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,26 RC,369,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,2699.0,51975.0,26 RC,369,Insertion of peritoneal-venous shunt ,,,2195.0,13835.0,24 RC,369,Insertion of pin-retained palatal prosthesis ,,,2051.93,13241.95,27 RC,369,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,369,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,3390.0,15111.6,10 RC,369,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,16 RC,369,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,2096.41,41580.0,29 RC,369,Insertion of tandem cuff (dual cuff) ,,,2195.0,47976.91,29 RC,369,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,26 RC,369,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,223.51,5841.0,23 RC,369,Insertion of testicular prosthesis (separate procedure) ,,,2195.0,11552.32,27 RC,369,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,2010.52,3390.0,18 RC,369,"Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract format",,,3390.0,16207.0,24 RC,369,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,1209.12,15059.0,27 RC,369,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,1209.12,8488.5,27 RC,369,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,2036.11,12547.6,27 RC,369,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,1603.34,25988.0,29 RC,369,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,369,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,2699.0,87318.0,28 RC,369,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,2195.0,87318.0,28 RC,369,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,1986.0,5841.0,14 RC,369,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,2195.0,35432.53,22 RC,369,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,2195.0,87318.0,28 RC,369,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,2195.0,87318.0,28 RC,369,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,369,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,26 RC,369,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,3390.0,16207.0,12 RC,369,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,3390.0,16207.0,12 RC,369,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,1672.0,5841.0,15 RC,369,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,369,Intersex surgery; female to male ,,,3390.0,13835.0,10 RC,369,Intersex surgery; male to female ,,,3390.0,13835.0,10 RC,369,Intestinal allotransplantation; from cadaver donor ,,,3390.0,37588.61,12 RC,369,Intestinal allotransplantation; from living donor ,,,3390.0,42394.68,12 RC,369,Intestinal plication (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction ",,,3390.0,16207.0,12 RC,369,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,369,Intra-atrial recording ,,,12065.71,43890.0,10 RC,369,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,369,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,27 RC,369,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,369,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,369,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,369,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,369,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,369,Intraoperative colonic lavage (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,3 RC,369,"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,369,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual ",,,87.5,3128.0,27 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space ",,,196.58,5841.0,26 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid ",,,441.67,5571.0,27 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial ",,,91.96,5841.0,26 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space ",,,930.95,7150.66,27 RC,369,"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space ",,,441.67,5571.0,27 RC,369,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,369,"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotri",,,1986.0,3083.0,12 RC,369,"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within ",,,1986.0,3083.0,12 RC,369,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (L",,,1672.0,5841.0,15 RC,369,"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List sepa",,,1672.0,5841.0,15 RC,369,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,369,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,369,Intraventricular pacing ,,,12065.71,43890.0,10 RC,369,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,369,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,26 RC,369,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,14 RC,369,"Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) ",,,351.7,3128.0,15 RC,369,"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,468.58,27050.15,78 RC,369,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,1610.16,12562.0,27 RC,369,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,27 RC,369,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,27 RC,369,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,27 RC,369,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,27 RC,369,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,27 RC,369,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,26 RC,369,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,27 RC,369,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,27 RC,369,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,26 RC,369,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,112.77,5841.0,11 RC,369,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,369,Keratomileusis ,,,2518.0,17897.9,24 RC,369,Keratophakia ,,,2518.0,19576.28,24 RC,369,Keratoplasty (corneal transplant); anterior lamellar ,,,1610.16,12909.0,27 RC,369,Keratoplasty (corneal transplant); endothelial ,,,1610.16,15059.0,27 RC,369,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,1610.16,12909.0,27 RC,369,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,1610.16,12909.0,27 RC,369,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,1610.16,12909.0,27 RC,369,Keratoprosthesis ,,,3673.0,16924.12,24 RC,369,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,369,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,369,LAPARO W/CHOLANGIO/BIOPSY ,,,3390.0,5841.0,2 RC,369,"LAPAROSCOPE PROC, RECTUM ",,,3390.0,5841.0,2 RC,369,LAPAROSCOPY W/CHOLANGIO ,,,3390.0,5841.0,2 RC,369,"LAPAROSCOPY, ENTEROLYSIS ",,,3390.0,5841.0,2 RC,369,"LAPAROSCOPY, JEJUNOSTOMY ",,,3390.0,5841.0,2 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,369,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,369,LAVH ,,,3390.0,5841.0,2 RC,369,LESION REMOVAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,369,Labyrinthectomy; transcanal ,,,2051.93,13241.95,27 RC,369,Labyrinthectomy; with mastoidectomy ,,,2051.93,13241.95,27 RC,369,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,27 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,9875.0,34473.5,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,3390.0,22297.2,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,9875.0,19224.42,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,3390.0,19618.62,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,3390.0,22153.02,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,3390.0,26255.61,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,9875.0,24454.45,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,3390.0,25950.44,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,3390.0,32557.8,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,3390.0,32066.23,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,9875.0,33960.65,9 RC,369,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,3390.0,23454.14,9 RC,369,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,3390.0,25611.4,9 RC,369,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,9875.0,23386.41,9 RC,369,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,3390.0,23085.47,9 RC,369,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,3390.0,25611.4,9 RC,369,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,3293.0,16330.72,21 RC,369,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,3041.0,16330.72,21 RC,369,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,3293.0,16330.72,21 RC,369,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,3293.0,16330.72,21 RC,369,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,3390.0,36291.71,9 RC,369,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,3390.0,37902.24,9 RC,369,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,9875.0,37686.1,9 RC,369,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,3375.0,87318.0,26 RC,369,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,3390.0,19563.47,9 RC,369,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,3390.0,21237.62,9 RC,369,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,3390.0,17147.73,9 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,2518.45,16330.72,24 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,2518.45,16330.72,24 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,3293.0,16330.72,21 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,2518.45,16330.72,24 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,3375.0,16330.72,21 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,2996.0,16330.72,21 RC,369,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,3375.0,16330.72,21 RC,369,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,3390.0,19678.01,9 RC,369,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,3293.0,16330.72,21 RC,369,Laminectomy with rhizotomy; 1 or 2 segments ,,,9875.0,14087.77,9 RC,369,Laminectomy with rhizotomy; more than 2 segments ,,,9875.0,15253.31,9 RC,369,Laminectomy with section of spinal accessory nerve ,,,9875.0,17173.13,9 RC,369,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,1672.0,16330.72,87 RC,369,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,1672.0,5841.0,30 RC,369,"Laminectomy, with release of tethered spinal cord, lumbar ",,,9875.0,18949.01,9 RC,369,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,3390.0,18436.15,12 RC,369,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,3390.0,21068.04,12 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,3293.0,16330.72,21 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,1986.0,7014.0,32 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,2518.45,16330.72,24 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,2518.45,16330.72,24 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,24 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,1672.0,5841.0,15 RC,369,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,1267.84,3083.0,17 RC,369,"Laparoscope proc, intestine ",,,3390.0,5841.0,2 RC,369,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,369,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,369,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,369,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,369,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,369,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,369,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,369,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,369,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,369,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,369,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,369,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,369,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,369,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,15 RC,369,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,369,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,369,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,369,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,369,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,11558.0,22967.79,6 RC,369,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,3293.0,29647.99,17 RC,369,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,3293.0,29647.99,17 RC,369,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,3293.0,24808.33,23 RC,369,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical ",,,9875.0,22967.79,12 RC,369,"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency ",,,9875.0,22967.79,12 RC,369,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,14 RC,369,"Laparoscopy, surgical, appendectomy ",,,8778.0,13196.03,9 RC,369,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis ",,,3390.0,20457.81,12 RC,369,"Laparoscopy, surgical, colostomy or skin level cecostomy ",,,3390.0,16207.0,12 RC,369,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) ",,,1520.2,16207.0,12 RC,369,"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed ",,,5841.0,22967.79,11 RC,369,"Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed ",,,8778.0,15846.6,12 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) ",,,8778.0,16425.0,12 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) ",,,16024.0,22967.79,8 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only ",,,9909.11,22869.0,8 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components ",,,6148.11,22869.0,8 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only ",,,6148.11,22869.0,8 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only ",,,12151.72,22869.0,8 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) ",,,9124.0,21292.66,6 RC,369,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption ",,,9124.0,22788.76,6 RC,369,"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ",,,1801.08,16207.0,12 RC,369,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,15 RC,369,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical, splenectomy ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,9 RC,369,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,369,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,22967.79,6 RC,369,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,8 RC,369,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14626.03,12 RC,369,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,23335.49,6 RC,369,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,369,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,9 RC,369,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,9 RC,369,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13394.0,12 RC,369,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,12 RC,369,"Laparoscopy, surgical; cholecystectomy ",,,1983.29,13196.03,12 RC,369,"Laparoscopy, surgical; cholecystectomy with cholangiography ",,,1983.29,13196.03,12 RC,369,"Laparoscopy, surgical; cholecystectomy with exploration of common duct ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; cholecystoenterostomy ",,,3390.0,16207.0,12 RC,369,"Laparoscopy, surgical; colectomy, partial, with anastomosis ",,,6326.0,18906.55,12 RC,369,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) ",,,3390.0,22326.83,12 RC,369,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy ",,,3390.0,24331.44,12 RC,369,"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure) ",,,3390.0,21483.4,12 RC,369,"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy ",,,3390.0,16427.31,12 RC,369,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed ",,,3390.0,26679.44,12 RC,369,"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy ",,,3390.0,25073.14,12 RC,369,"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy ",,,3390.0,21826.68,12 RC,369,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,12 RC,369,"Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary procedure) ",,,2300.11,13835.0,12 RC,369,"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis ",,,6326.0,17007.9,12 RC,369,"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube ",,,3390.0,16207.0,12 RC,369,"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum ",,,9875.0,16890.86,12 RC,369,"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,12 RC,369,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,12 RC,369,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,15 RC,369,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when per",,,3390.0,26340.4,12 RC,369,"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy ",,,3390.0,24212.78,12 RC,369,"Laparoscopy, surgical; proctopexy (for prolapse) ",,,3390.0,16207.0,12 RC,369,"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection ",,,3390.0,18575.98,12 RC,369,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,12 RC,369,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,12 RC,369,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum ",,,6326.0,15059.0,12 RC,369,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,17 RC,369,"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical; transection of vagus nerves, truncal ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,15 RC,369,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13394.0,12 RC,369,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy ",,,3265.51,22967.79,15 RC,369,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple ",,,3265.51,22967.79,15 RC,369,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including ",,,3265.51,22967.79,14 RC,369,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,13196.03,12 RC,369,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,15 RC,369,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,15 RC,369,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,15 RC,369,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,15 RC,369,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,15059.0,6 RC,369,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,15059.0,6 RC,369,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,15 RC,369,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,15059.0,15 RC,369,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,15 RC,369,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,369,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,3673.0,13835.0,24 RC,369,"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es) ",,,2431.0,14320.86,12 RC,369,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,369,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,369,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,369,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,369,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,369,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,369,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,369,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,369,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,369,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,369,Lapscp intest resect ,,,3390.0,5841.0,2 RC,369,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,369,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,369,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,369,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,369,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,369,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,369,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,369,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,369,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,369,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,369,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,9 RC,369,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,1773.9,15059.0,27 RC,369,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,369,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,3390.0,13835.0,11 RC,369,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,3390.0,13835.0,11 RC,369,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,27 RC,369,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,369,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,369,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,369,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,369,"Lengthening of palate, and pharyngeal flap ",,,2051.93,13394.0,27 RC,369,"Lengthening of palate, with island flap ",,,2051.93,13835.0,15 RC,369,"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of de",,,1174.13,12562.0,27 RC,369,"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions ",,,1174.13,7565.59,27 RC,369,Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure) ,,,1174.13,12562.0,27 RC,369,Ligation of common iliac vein ,,,3390.0,16207.0,12 RC,369,Ligation of femoral vein ,,,1174.13,7565.59,27 RC,369,Ligation of inferior vena cava ,,,2699.0,13835.0,24 RC,369,"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg ",,,1174.13,8304.31,27 RC,369,"Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg ",,,1174.13,12562.0,27 RC,369,Ligation of peritoneal-venous shunt ,,,2431.0,13835.0,12 RC,369,Ligation or banding of angioaccess arteriovenous fistula ,,,1174.13,12562.0,27 RC,369,"Ligation or biopsy, temporal artery ",,,510.77,3755.0,27 RC,369,Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation ,,,3390.0,17796.17,12 RC,369,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,24 RC,369,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,2195.0,13835.0,24 RC,369,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,1116.7,13394.0,27 RC,369,"Ligation salivary duct, intraoral ",,,930.95,12909.0,27 RC,369,"Ligation, direct, esophageal varices ",,,8778.0,18749.79,12 RC,369,"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below ",,,1174.13,12562.0,27 RC,369,"Ligation, division, and stripping, short saphenous vein ",,,1174.13,12562.0,27 RC,369,"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg ",,,1174.13,12562.0,27 RC,369,"Ligation, internal jugular vein ",,,2012.0,13835.0,12 RC,369,"Ligation, major artery (eg, post-traumatic, rupture); abdomen ",,,3390.0,16461.18,12 RC,369,"Ligation, major artery (eg, post-traumatic, rupture); chest ",,,3390.0,16207.0,12 RC,369,"Ligation, major artery (eg, post-traumatic, rupture); extremity ",,,3390.0,16207.0,12 RC,369,"Ligation, major artery (eg, post-traumatic, rupture); neck ",,,2012.0,13835.0,12 RC,369,Ligation; external carotid artery ,,,4988.0,13835.0,12 RC,369,Ligation; internal or common carotid artery ,,,4988.0,13835.0,12 RC,369,"Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield clamp ",,,4988.0,13835.0,12 RC,369,Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic ,,,3390.0,16207.0,12 RC,369,Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) ,,,3390.0,16207.0,12 RC,369,Limited pharyngectomy ,,,2051.93,13241.95,27 RC,369,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,369,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,1200.05,8240.61,27 RC,369,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,1200.05,8240.61,27 RC,369,"Lithotripsy, extracorporeal shock wave ",,,1200.05,10342.0,9 RC,369,"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age ",,,3390.0,66243.02,12 RC,369,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,369,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,369,"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy ºPOEM») ",,,2195.0,15059.0,23 RC,369,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,369,Lymphangiotomy or other operations on lymphatic channels ,,,1011.84,8270.67,27 RC,369,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,3041.0,13835.0,24 RC,369,Lysis of labial adhesions ,,,1116.7,6819.81,27 RC,369,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,27 RC,369,MEDIASTINOSCOPY INCL BIOPSY ,,,3390.0,5841.0,2 RC,369,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,2699.0,4220.0,13 RC,369,"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation ",,,3390.0,23089.7,12 RC,369,"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver ",,,3390.0,37296.13,12 RC,369,Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing ,,,3390.0,17851.33,12 RC,369,Management of liver hemorrhage; simple suture of liver wound or injury ,,,3390.0,16825.62,12 RC,369,Management of recipient hematopoietic progenitor cell donor search and cell acquisition ,,,3390.0,5841.0,2 RC,369,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,27 RC,369,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,14 RC,369,Marsupialization of Bartholin's gland cyst ,,,1116.7,6819.81,27 RC,369,Marsupialization of cyst or abscess of liver ,,,3390.0,16207.0,12 RC,369,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,369,Marsupialization of pancreatic cyst ,,,3390.0,16207.0,12 RC,369,Marsupialization of sublingual salivary cyst (ranula) ,,,930.95,12562.0,27 RC,369,"Marsupialization of urethral diverticulum, male or female ",,,1200.05,8240.61,27 RC,369,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,27 RC,369,Mastoidectomy; complete ,,,2051.93,13241.95,27 RC,369,Mastoidectomy; modified radical ,,,2051.93,13241.95,27 RC,369,Mastoidectomy; radical ,,,2051.93,13241.95,27 RC,369,Maxillary impression for palatal prosthesis ,,,875.5,5841.0,23 RC,369,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,112.77,5841.0,11 RC,369,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,27 RC,369,"Meatotomy, cutting of meatus (separate procedure); infant ",,,1986.0,13835.0,24 RC,369,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,3128.0,27 RC,369,"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed ",,,2699.0,13835.0,24 RC,369,"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging) ",,,2699.0,13835.0,24 RC,369,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach ",,,3390.0,16207.0,12 RC,369,"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy ",,,3390.0,16207.0,12 RC,369,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,369,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,369,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,27 RC,369,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,369,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,369,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,369,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,369,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,369,Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure) ,,,1160.0,16207.0,12 RC,369,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,15 RC,369,Multifetal pregnancy reduction(s) (MPR) ,,,554.98,5841.0,11 RC,369,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,27 RC,369,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,1395.68,8234.0,24 RC,369,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,1395.68,8234.0,24 RC,369,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,1395.68,8234.0,24 RC,369,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,1395.68,8234.0,24 RC,369,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,3673.0,13835.0,24 RC,369,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,1116.7,13394.0,27 RC,369,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,4988.0,13835.0,12 RC,369,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,27 RC,369,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,26 RC,369,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,27 RC,369,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,369,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,369,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,369,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,369,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,369,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) ",,,117.96,5841.0,26 RC,369,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,369,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,2195.0,15059.0,26 RC,369,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,1986.0,15059.0,26 RC,369,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,26 RC,369,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,3390.0,16207.0,12 RC,369,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,3390.0,17974.22,12 RC,369,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,3390.0,16207.0,12 RC,369,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,3390.0,16207.0,12 RC,369,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,3390.0,16207.0,12 RC,369,"Nephrectomy, partial ",,,3390.0,16253.5,12 RC,369,Nephrolithotomy; complicated by congenital kidney abnormality ,,,3390.0,16207.0,12 RC,369,Nephrolithotomy; removal of calculus ,,,3390.0,16207.0,12 RC,369,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,3390.0,17855.56,12 RC,369,Nephrolithotomy; secondary surgical operation for calculus ,,,3390.0,16207.0,12 RC,369,"Nephrorrhaphy, suture of kidney wound or injury ",,,3390.0,16207.0,12 RC,369,"Nephrostomy, nephrotomy with drainage ",,,2699.0,13835.0,24 RC,369,"Nephrotomy, with exploration ",,,3390.0,16207.0,12 RC,369,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,2195.0,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,2096.41,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,2195.0,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,2195.0,15039.6,27 RC,369,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,2195.0,15039.6,27 RC,369,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Nerve pedicle transfer; first stage ,,,2096.41,15039.6,27 RC,369,Nerve pedicle transfer; second stage ,,,1986.0,15039.6,27 RC,369,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,2195.0,15039.6,24 RC,369,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,2195.0,15039.6,26 RC,369,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,2195.0,15039.6,27 RC,369,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,3390.0,18707.46,12 RC,369,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,3390.0,25882.7,12 RC,369,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,3390.0,18906.55,12 RC,369,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,3390.0,23458.38,12 RC,369,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,27 RC,369,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,27 RC,369,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,27 RC,369,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,27 RC,369,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,27 RC,369,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,27 RC,369,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,27 RC,369,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,27 RC,369,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,27 RC,369,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,27 RC,369,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,23 RC,369,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,369,OPERATIVE UPPER GI ENDOSCOPY ,,,3390.0,5841.0,2 RC,369,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,3390.0,41102.02,12 RC,369,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,1116.7,13835.0,27 RC,369,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,1499.06,13394.0,27 RC,369,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,3293.0,13394.0,24 RC,369,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,3293.0,13394.0,24 RC,369,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,3390.0,17359.64,12 RC,369,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,3387.4,16207.0,12 RC,369,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,2996.0,16207.0,24 RC,369,"Oophorectomy, partial or total, unilateral or bilateral; ",,,3293.0,13835.0,24 RC,369,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,4988.0,14490.44,12 RC,369,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,369,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,2195.0,87318.0,28 RC,369,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,369,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,2195.0,82073.3,25 RC,369,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,369,Open implantation of neurostimulator electrode array; neuromuscular ,,,1986.0,87318.0,29 RC,369,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,29 RC,369,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,2699.0,16890.86,27 RC,369,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,369,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,369,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,369,"Operculectomy, excision pericoronal tissues ",,,1986.0,3683.7,24 RC,369,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,369,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,369,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,1158.59,8536.87,27 RC,369,Orbital implant (implant outside muscle cone); insertion ,,,1158.59,8536.87,27 RC,369,Orbital implant (implant outside muscle cone); removal or revision ,,,1158.59,8536.87,27 RC,369,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,3390.0,40347.62,12 RC,369,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,3390.0,35482.15,12 RC,369,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,3390.0,39228.77,12 RC,369,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,1158.59,13394.0,27 RC,369,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,1158.59,13394.0,27 RC,369,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,1158.59,13394.0,27 RC,369,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,1158.59,13394.0,27 RC,369,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,1158.59,13394.0,27 RC,369,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,1158.59,12562.0,27 RC,369,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,27 RC,369,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,1158.59,13835.0,27 RC,369,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,27 RC,369,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,27 RC,369,"Orchiectomy, partial ",,,1200.05,12562.0,27 RC,369,"Orchiectomy, radical, for tumor; inguinal approach ",,,1209.12,8488.5,27 RC,369,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,4988.0,13835.0,12 RC,369,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,1200.05,12562.0,27 RC,369,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,2996.0,13835.0,24 RC,369,"Orchiopexy, inguinal or scrotal approach ",,,1209.12,8488.5,27 RC,369,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,3225.46,16207.0,9 RC,369,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,369,"Other cranial decompression, posterior fossa ",,,3390.0,25285.06,12 RC,369,Other spinal injection ,,,3390.0,5841.0,2 RC,369,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,369,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,27 RC,369,"Ovarian cystectomy, unilateral or bilateral ",,,3293.0,13835.0,24 RC,369,PAROTID DUCT DIVERSION ,,,3390.0,5841.0,2 RC,369,"PARTIAL REMOVAL, DONOR LIVER ",,,3390.0,5841.0,2 RC,369,PERCUT DRAIN LIVER LESION ,,,3390.0,5841.0,2 RC,369,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,369,PLACE GASTROSTOMY TUBE ,,,3390.0,5841.0,2 RC,369,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,369,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,369,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,369,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,2 RC,369,"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) ",,,2051.93,13394.0,27 RC,369,"Palatoplasty for cleft palate, soft and/or hard palate only ",,,2051.93,13394.0,27 RC,369,"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only ",,,930.95,13394.0,27 RC,369,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft) ",,,3268.77,13394.0,27 RC,369,Palatoplasty for cleft palate; attachment pharyngeal flap ,,,2051.93,13394.0,27 RC,369,Palatoplasty for cleft palate; major revision ,,,2051.93,13241.95,27 RC,369,Palatoplasty for cleft palate; secondary lengthening procedure ,,,2051.93,13394.0,27 RC,369,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,3390.0,20063.62,12 RC,369,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,3390.0,19262.64,12 RC,369,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,3390.0,23102.4,12 RC,369,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,3390.0,38220.12,12 RC,369,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,3390.0,35766.16,12 RC,369,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,3390.0,38398.05,12 RC,369,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,3390.0,35550.01,12 RC,369,"Pancreatectomy, total ",,,3390.0,22322.6,12 RC,369,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,3390.0,16207.0,9 RC,369,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,3390.0,20436.65,12 RC,369,Pancreatorrhaphy for injury ,,,3390.0,16490.81,12 RC,369,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,26 RC,369,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,27 RC,369,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,27 RC,369,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,Parathyroidectomy or exploration of parathyroid(s); ,,,2051.93,13835.0,27 RC,369,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,3673.0,15059.0,24 RC,369,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,3390.0,17020.6,12 RC,369,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,3293.0,22967.79,24 RC,369,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,3293.0,13835.0,24 RC,369,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,2996.0,18300.83,24 RC,369,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,27 RC,369,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,1672.0,5841.0,15 RC,369,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,27 RC,369,"Parotid duct diversion, bilateral (Wilke type procedure); ",,,2051.93,13241.95,27 RC,369,"Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands ",,,2051.93,13241.95,27 RC,369,"Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts ",,,930.95,9653.0,27 RC,369,"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction ",,,3390.0,61720.83,12 RC,369,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including ",,,3390.0,44797.72,12 RC,369,"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor ",,,3390.0,40004.34,12 RC,369,"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty ",,,3390.0,34880.4,12 RC,369,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, prepa",,,3390.0,55100.77,12 RC,369,"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty ",,,3390.0,31409.31,12 RC,369,Partial hymenectomy or revision of hymenal ring ,,,1116.7,6819.81,27 RC,369,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,13835.0,27 RC,369,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,13835.0,27 RC,369,Pelvic examination under anesthesia (other than local) ,,,1116.7,6819.81,27 RC,369,"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or withou",,,3390.0,34142.93,12 RC,369,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,3390.0,35948.44,12 RC,369,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,3390.0,28124.63,12 RC,369,"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) ",,,3390.0,16207.0,12 RC,369,Penile plethysmography ,,,273.57,5841.0,23 RC,369,"Penile revascularization, artery, with or without vein graft ",,,3390.0,16207.0,12 RC,369,Penile venous occlusive procedure ,,,2699.0,12562.0,24 RC,369,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,3375.0,16207.0,24 RC,369,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,27 RC,369,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,27 RC,369,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,369,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,369,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,369,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,369,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,369,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,1899.59,3083.0,17 RC,369,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,369,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,2195.0,87318.0,29 RC,369,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,1986.0,87318.0,29 RC,369,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,29 RC,369,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,2699.0,87318.0,29 RC,369,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,369,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,54 RC,369,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,2996.0,22025.45,48 RC,369,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,369,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,369,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,369,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,369,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,369,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,8 RC,369,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,8 RC,369,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,369,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,369,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,369,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,369,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,369,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,369,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,369,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,369,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,369,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,369,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,369,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,369,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,369,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,369,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,369,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,369,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,369,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,369,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,369,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,369,"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angi",,,2480.92,43516.12,83 RC,369,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance ",,,3965.0,15059.0,27 RC,369,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,369,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during cours",,,1621.98,15059.0,27 RC,369,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,369,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,369,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,369,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,369,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,369,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,369,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,369,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,369,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,369,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,369,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,369,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,369,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,369,"Pereyra procedure, including anterior colporrhaphy ",,,2390.64,18300.83,27 RC,369,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,369,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,369,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,1116.7,13394.0,27 RC,369,Periodontal mucosal grafting ,,,441.67,13835.0,27 RC,369,Perirectal injection of sclerosing solution for prolapse ,,,1565.95,5841.0,23 RC,369,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,3249.0,27 RC,369,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,2996.0,32022.79,23 RC,369,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,995.06,5841.0,23 RC,369,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,2195.0,13835.0,23 RC,369,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,2699.0,13835.0,23 RC,369,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,369,Petrous apicectomy including radical mastoidectomy ,,,2051.93,13241.95,27 RC,369,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,369,Pharyngoesophageal repair ,,,3390.0,16207.0,12 RC,369,Pharyngoplasty (plastic or reconstructive operation on pharynx) ,,,2051.93,13241.95,27 RC,369,"Pharyngostomy (fistulization of pharynx, external for feeding) ",,,441.67,5571.0,27 RC,369,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,369,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,369,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,369,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,369,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,369,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,369,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,369,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,369,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,369,"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when per",,,1209.12,15059.0,27 RC,369,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,1672.0,5841.0,15 RC,369,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,1986.0,8536.87,24 RC,369,Placement of amniotic membrane on the ocular surface; without sutures ,,,1654.29,3755.0,24 RC,369,"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervi",,,1209.12,15059.0,54 RC,369,Placement of choledochal stent ,,,3390.0,16207.0,12 RC,369,"Placement of drains, peripancreatic, for acute pancreatitis; ",,,3390.0,23178.72,12 RC,369,"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy ",,,3390.0,28256.1,12 RC,369,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,369,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,796.41,16207.0,12 RC,369,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,5193.86,27 RC,369,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,27 RC,369,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,369,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,1986.0,15059.0,24 RC,369,"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application ",,,1986.0,13241.95,24 RC,369,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,27 RC,369,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,1200.05,12909.0,27 RC,369,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,369,Placement of seton ,,,986.93,12562.0,27 RC,369,"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter re",,,2687.03,15059.0,81 RC,369,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,1200.05,15059.0,81 RC,369,"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure) ",,,2195.0,16207.0,24 RC,369,Plastic operation of penis for injury ,,,1200.05,8240.61,27 RC,369,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,1200.05,12562.0,27 RC,369,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,1200.05,12562.0,27 RC,369,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,27 RC,369,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,6326.0,15227.79,12 RC,369,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,27 RC,369,Plastic operation on penis to correct angulation ,,,1200.05,12562.0,27 RC,369,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,1603.34,12562.0,27 RC,369,Plastic repair of canaliculi ,,,733.22,5571.0,27 RC,369,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages ",,,2051.93,32170.6,27 RC,369,"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure ",,,2051.93,13241.95,27 RC,369,"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral ",,,2051.93,13241.95,27 RC,369,"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure ",,,930.95,12909.0,27 RC,369,"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle ",,,2051.93,13241.95,27 RC,369,Plastic repair of introitus ,,,1116.7,12562.0,27 RC,369,"Plastic repair of salivary duct, sialodochoplasty; primary or simple ",,,2051.93,13241.95,27 RC,369,"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated ",,,2051.93,13241.95,27 RC,369,Plastic repair of urethrocele ,,,1116.7,12562.0,27 RC,369,"Portoenterostomy (eg, Kasai procedure) ",,,3390.0,21004.54,12 RC,369,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,1603.34,13394.0,27 RC,369,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,755.65,5841.0,23 RC,369,Postpartum care only (separate procedure) ,,,1312.04,5841.0,19 RC,369,"Preparation of fecal microbiota for instillation, including assessment of donor specimen ",,,713.79,5841.0,19 RC,369,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,369,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,3390.0,13835.0,11 RC,369,"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombo",,,1672.0,27050.15,42 RC,369,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,26 RC,369,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,26 RC,369,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,27 RC,369,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,27 RC,369,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,27 RC,369,"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed ",,,3390.0,23712.75,12 RC,369,"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) ",,,3390.0,22894.72,12 RC,369,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation) ",,,3390.0,19512.66,12 RC,369,"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies ",,,3390.0,21178.23,12 RC,369,"Proctectomy, partial, with anastomosis; abdominal and transsacral approach ",,,3390.0,22297.2,12 RC,369,"Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) ",,,3390.0,19122.7,12 RC,369,"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy ",,,3390.0,23178.72,12 RC,369,"Proctectomy, partial, without anastomosis, perineal approach ",,,8778.0,13835.0,12 RC,369,"Proctectomy; complete, combined abdominoperineal, with colostomy ",,,3390.0,22602.37,12 RC,369,"Proctectomy; partial resection of rectum, transabdominal approach ",,,3390.0,16207.0,12 RC,369,"Proctopexy (eg, for prolapse); abdominal approach ",,,3390.0,16207.0,12 RC,369,"Proctopexy (eg, for prolapse); perineal approach ",,,986.93,13835.0,27 RC,369,"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach ",,,3390.0,17974.22,12 RC,369,Proctoplasty; for prolapse of mucous membrane ,,,986.93,7014.0,27 RC,369,Proctoplasty; for stenosis ,,,986.93,6399.61,27 RC,369,"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,86.63,3128.0,27 RC,369,"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser) ",,,986.93,6399.61,27 RC,369,"Proctosigmoidoscopy, rigid; with biopsy, single or multiple ",,,450.72,3128.0,27 RC,369,"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) ",,,450.72,3390.0,27 RC,369,"Proctosigmoidoscopy, rigid; with decompression of volvulus ",,,986.93,6399.61,27 RC,369,"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) ",,,450.72,7266.25,27 RC,369,"Proctosigmoidoscopy, rigid; with removal of foreign body ",,,986.93,6399.61,27 RC,369,"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ",,,450.72,3128.0,27 RC,369,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery ",,,986.93,6399.61,27 RC,369,"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ",,,450.72,3128.0,27 RC,369,"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation) ",,,1986.0,13051.67,27 RC,369,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,369,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,26 RC,369,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,27 RC,369,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,3390.0,16207.0,12 RC,369,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,3390.0,16207.0,12 RC,369,"Prostatectomy, perineal radical; ",,,3390.0,16207.0,12 RC,369,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,21559.73,12 RC,369,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,19741.51,12 RC,369,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,3390.0,16207.0,12 RC,369,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,3390.0,16207.0,12 RC,369,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,16732.36,24 RC,369,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,16207.0,12 RC,369,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,1200.05,8240.61,27 RC,369,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,1200.05,5571.0,27 RC,369,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,15 RC,369,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,27 RC,369,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,3390.0,17109.62,12 RC,369,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,3390.0,16207.0,12 RC,369,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,369,"Pyelotomy; with drainage, pyelostomy ",,,3390.0,16207.0,12 RC,369,Pyelotomy; with exploration ,,,3390.0,16207.0,12 RC,369,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,3390.0,16207.0,12 RC,369,"Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) ",,,3390.0,16207.0,12 RC,369,Pyloroplasty ,,,3390.0,16207.0,12 RC,369,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,369,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,369,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,2 RC,369,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,2 RC,369,REMOVAL OF ANAL CRYPT ,,,3390.0,5841.0,2 RC,369,REMOVAL OF ANAL CRYPTS ,,,3390.0,5841.0,2 RC,369,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,369,REMOVAL OF COLON/ILEOSTOMY ,,,3390.0,5841.0,4 RC,369,REMOVAL OF LEG VEIN ,,,3390.0,5841.0,2 RC,369,REMOVAL OF LEG VEINS ,,,3390.0,5841.0,2 RC,369,"REMOVAL OF STOMACH, PARTIAL ",,,3390.0,5841.0,4 RC,369,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,369,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,2 RC,369,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,2 RC,369,REMOVE BILE DUCT STONE ,,,3390.0,5841.0,2 RC,369,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,369,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,369,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,369,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,369,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,369,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,369,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,3 RC,369,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,369,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,369,REPAIR OF DIAPHRAGM HERNIA ,,,3390.0,5841.0,6 RC,369,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,369,REPAIR PARAESOPHAGEAL HERNIA ,,,3390.0,5841.0,2 RC,369,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,369,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,369,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,3 RC,369,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,369,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,3 RC,369,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,369,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,3 RC,369,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,369,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,369,RESECT/DEBRIDE PANCREAS ,,,3390.0,5841.0,2 RC,369,REVISE ESOPHAGUS & STOMACH ,,,3390.0,5841.0,4 RC,369,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,369,REVISE/REINSERT BILE TUBE ,,,3390.0,5841.0,2 RC,369,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,369,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,369,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITH VAGOTOMY ,,,3390.0,16207.0,3 RC,369,REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITHOUT VAGOTOMY ,,,3390.0,16207.0,3 RC,369,REVISION OF MAJOR VEIN ,,,3390.0,5841.0,2 RC,369,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,369,Radial keratotomy ,,,2518.0,7836.39,24 RC,369,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,24 RC,369,Radical excision external auditory canal lesion; with neck dissection ,,,3390.0,19932.26,12 RC,369,Radical excision external auditory canal lesion; without neck dissection ,,,2051.93,13241.95,27 RC,369,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal) ",,,6326.0,13835.0,12 RC,369,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap ",,,3390.0,27260.03,12 RC,369,"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure ",,,3041.0,13835.0,12 RC,369,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,20288.23,12 RC,369,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,26 RC,369,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,3390.0,13835.0,11 RC,369,Recipient nephrectomy (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Reconstruction external auditory canal for congenital atresia, single stage ",,,2051.93,13241.95,27 RC,369,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,2051.93,13241.95,27 RC,369,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,27 RC,369,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,27 RC,369,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,1158.59,12562.0,27 RC,369,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,27 RC,369,"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis ",,,3390.0,19304.98,12 RC,369,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,369,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,369,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,3390.0,20856.12,12 RC,369,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,3390.0,24513.72,12 RC,369,Reduction of overcorrection of ptosis ,,,733.22,8234.0,27 RC,369,Reduction of procidentia (separate procedure) under anesthesia ,,,344.93,3128.0,27 RC,369,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,1200.05,8240.61,27 RC,369,"Reduction of volvulus, intussusception, internal hernia, by laparotomy ",,,3375.0,16207.0,24 RC,369,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,369,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,369,Reinsertion of ocular implant; with or without conjunctival graft ,,,1158.59,8536.87,27 RC,369,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,1158.59,12562.0,27 RC,369,Release of encircling material (posterior segment) ,,,1610.16,10424.04,27 RC,369,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,27 RC,369,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,27 RC,369,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,27 RC,369,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,27 RC,369,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,27 RC,369,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,26 RC,369,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,1672.0,51975.0,25 RC,369,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,685.44,4836.33,27 RC,369,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,369,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,1986.0,47976.91,27 RC,369,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,2012.0,15672.9,12 RC,369,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,2699.0,51975.0,26 RC,369,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,2012.0,51975.0,26 RC,369,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,27 RC,369,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,27 RC,369,Removal foreign body from external auditory canal; without general anesthesia ,,,223.51,5841.0,11 RC,369,"Removal impacted cerumen requiring instrumentation, unilateral ",,,112.77,5841.0,23 RC,369,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,112.77,5841.0,23 RC,369,"Removal of Thiersch wire or suture, anal canal ",,,986.93,6399.61,27 RC,369,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,27 RC,369,"Removal of anal seton, other marker ",,,450.72,3128.0,27 RC,369,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,2195.0,9751.1,17 RC,369,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,2195.0,9751.1,17 RC,369,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,2195.0,9528.08,17 RC,369,"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidan",,,351.7,3128.0,27 RC,369,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,27 RC,369,Removal of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,12 RC,369,"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging ",,,1672.0,5841.0,15 RC,369,Removal of cerclage suture under anesthesia (other than local) ,,,1116.7,13394.0,27 RC,369,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,3390.0,16207.0,12 RC,369,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,2195.0,13835.0,24 RC,369,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,27 RC,369,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,27 RC,369,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,1986.0,15059.0,27 RC,369,Removal of embedded foreign body from dentoalveolar structures; bone ,,,272.38,4335.95,27 RC,369,Removal of embedded foreign body from dentoalveolar structures; soft tissues ,,,231.98,5571.0,27 RC,369,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,26 RC,369,"Removal of embedded foreign body, vestibule of mouth; complicated ",,,158.14,5571.0,27 RC,369,"Removal of embedded foreign body, vestibule of mouth; simple ",,,1611.14,5841.0,11 RC,369,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,27 RC,369,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,27 RC,369,Removal of esophageal sphincter augmentation device ,,,2996.0,13835.0,23 RC,369,Removal of fecal impaction or foreign body (separate procedure) under anesthesia ,,,450.72,3128.0,27 RC,369,Removal of foreign body from pharynx ,,,745.36,5841.0,23 RC,369,Removal of foreign body in scrotum ,,,685.44,5571.0,27 RC,369,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,26 RC,369,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,745.36,5841.0,11 RC,369,"Removal of foreign body, external eye; conjunctival superficial ",,,223.51,5841.0,11 RC,369,"Removal of foreign body, external eye; corneal, with slit lamp ",,,223.51,5841.0,11 RC,369,"Removal of foreign body, external eye; corneal, without slit lamp ",,,745.36,5841.0,11 RC,369,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,27 RC,369,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,26 RC,369,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,27 RC,369,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,369,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,1986.0,15899.38,26 RC,369,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,369,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,369,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,1116.7,6819.81,27 RC,369,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,369,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,27 RC,369,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,27 RC,369,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,27 RC,369,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,11552.32,27 RC,369,Removal of intrauterine device (IUD) ,,,53.78,5841.0,26 RC,369,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,27 RC,369,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,27 RC,369,Removal of lens material; intracapsular ,,,892.44,8234.0,27 RC,369,"Removal of lens material; intracapsular, for dislocated lens ",,,1610.16,13394.0,27 RC,369,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,1610.16,10424.04,27 RC,369,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,27 RC,369,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,250.06,3128.0,27 RC,369,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,369,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,1200.05,12562.0,27 RC,369,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,369,Removal of ocular implant ,,,1158.59,8536.87,27 RC,369,Removal of pancreatic calculus ,,,3390.0,16207.0,12 RC,369,Removal of peritoneal foreign body from peritoneal cavity ,,,1209.12,8488.5,27 RC,369,Removal of peritoneal-venous shunt ,,,1174.13,13835.0,27 RC,369,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,369,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,27 RC,369,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,27 RC,369,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,2195.0,15059.0,22 RC,369,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,27 RC,369,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1574.7,12909.0,27 RC,369,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,2096.41,15039.6,27 RC,369,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,369,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,369,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,369,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,369,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,1672.0,5841.0,15 RC,369,"Removal of transplanted intestinal allograft, complete ",,,3390.0,19220.19,12 RC,369,Removal of transplanted pancreatic allograft ,,,3390.0,15660.09,10 RC,369,Removal of transplanted renal allograft ,,,3390.0,16207.0,12 RC,369,"Removal of tumor, temporal bone ",,,2996.0,13835.0,24 RC,369,Removal of tunneled intraperitoneal catheter ,,,1174.13,7565.59,27 RC,369,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,27 RC,369,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,27 RC,369,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,27 RC,369,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,1986.0,11552.32,27 RC,369,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,1116.7,13835.0,27 RC,369,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,369,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,1142.68,13835.0,26 RC,369,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,1142.68,7895.92,26 RC,369,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,1142.68,7895.92,26 RC,369,Remove interim implant component ,,,12018.0,12018.0,1 RC,369,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,3390.0,35181.33,12 RC,369,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,3390.0,29697.06,12 RC,369,"Renal autotransplantation, reimplantation of kidney ",,,3390.0,24517.95,12 RC,369,Renal biopsy; by surgical exposure of kidney ,,,3390.0,16207.0,12 RC,369,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1773.9,11552.32,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1986.0,22025.45,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,1986.0,22025.45,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,1773.9,11552.32,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,2012.0,22025.45,27 RC,369,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,1773.9,11552.32,27 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,27 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1200.05,4836.33,27 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,1773.9,13835.0,15 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,1773.9,13835.0,27 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,13835.0,27 RC,369,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,27 RC,369,"Renal exploration, not necessitating other specific procedures ",,,3390.0,16207.0,12 RC,369,Reopening of recent laparotomy ,,,3390.0,16207.0,12 RC,369,Repair incomplete circumcision ,,,685.44,5571.0,27 RC,369,"Repair inguinal hernia, sliding, any age ",,,1209.12,8488.5,27 RC,369,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,369,"Repair initial femoral hernia, any age; reducible ",,,1209.12,13394.0,27 RC,369,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,369,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,8488.5,27 RC,369,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,369,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,1209.12,8488.5,27 RC,369,"Repair lip, full thickness; over one-half vertical height, or complex ",,,441.67,12562.0,27 RC,369,"Repair lip, full thickness; up to half vertical height ",,,196.58,12562.0,27 RC,369,"Repair lip, full thickness; vermilion only ",,,196.58,12562.0,27 RC,369,Repair lumbar hernia ,,,1983.29,13196.03,27 RC,369,Repair of anal fistula with fibrin glue ,,,986.93,6399.61,27 RC,369,"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa ºSIS») ",,,1295.61,15059.0,15 RC,369,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,369,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,1209.12,15059.0,153 RC,369,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,1983.29,15664.44,147 RC,369,"Repair of anterior palate, including vomer flap ",,,2051.93,13394.0,27 RC,369,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,27 RC,369,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,27 RC,369,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,27 RC,369,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,1158.59,13394.0,27 RC,369,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,27 RC,369,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,1158.59,13394.0,27 RC,369,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,27 RC,369,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; ",,,3390.0,47921.29,12 RC,369,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps ",,,3390.0,52015.42,12 RC,369,"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach ",,,3390.0,42911.77,12 RC,369,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,27 RC,369,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,24 RC,369,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,369,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,3390.0,16207.0,12 RC,369,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,3390.0,16207.0,12 RC,369,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,27 RC,369,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,27 RC,369,Repair of ectropion; suture ,,,733.22,12562.0,27 RC,369,Repair of ectropion; thermocauterization ,,,210.46,5571.0,27 RC,369,"Repair of encephalocele, skull vault, including cranioplasty ",,,3390.0,26255.61,12 RC,369,"Repair of enterocele, abdominal approach (separate procedure) ",,,3041.0,13835.0,12 RC,369,"Repair of enterocele, vaginal approach (separate procedure) ",,,1603.34,12562.0,27 RC,369,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,369,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,27 RC,369,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,27 RC,369,Repair of entropion; suture ,,,733.22,12562.0,27 RC,369,Repair of entropion; thermocauterization ,,,201.75,13835.0,27 RC,369,Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches ,,,3390.0,30612.46,12 RC,369,Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach ,,,3390.0,26425.19,12 RC,369,Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches ,,,3390.0,27904.25,12 RC,369,Repair of high imperforate anus without fistula; perineal or sacroperineal approach ,,,3390.0,24178.91,12 RC,369,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,1200.05,12562.0,27 RC,369,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,1773.9,12562.0,27 RC,369,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,1773.9,12562.0,27 RC,369,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach ",,,2699.0,27438.08,24 RC,369,"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach ",,,2699.0,16207.0,24 RC,369,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,11552.32,27 RC,369,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,27 RC,369,Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue ,,,223.51,5841.0,23 RC,369,Repair of laceration 2.5 cm or less; posterior one-third of tongue ,,,91.96,5841.0,26 RC,369,"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex ",,,91.96,3755.0,27 RC,369,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,27 RC,369,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,2195.0,16207.0,24 RC,369,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,27 RC,369,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,27 RC,369,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,1610.16,10424.04,27 RC,369,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,1610.16,10424.04,27 RC,369,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,1158.59,8536.87,27 RC,369,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,2996.0,60402.77,24 RC,369,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,3390.0,16207.0,12 RC,369,Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) ,,,3390.0,16207.0,12 RC,369,Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula ,,,3390.0,16207.0,12 RC,369,Repair of meningocele; larger than 5 cm diameter ,,,3390.0,17728.44,12 RC,369,Repair of meningocele; less than 5 cm diameter ,,,3390.0,16207.0,12 RC,369,Repair of myelomeningocele; larger than 5 cm diameter ,,,3390.0,21911.47,12 RC,369,Repair of myelomeningocele; less than 5 cm diameter ,,,3390.0,19758.45,12 RC,369,Repair of nasolabial fistula ,,,2051.93,13241.95,27 RC,369,Repair of omphalocele (Gross type operation); first stage ,,,3390.0,16207.0,12 RC,369,Repair of omphalocele (Gross type operation); second stage ,,,3390.0,16207.0,12 RC,369,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,3293.0,15059.0,23 RC,369,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,2996.0,9370.6,23 RC,369,Repair of rectocele (separate procedure) ,,,986.93,7014.0,27 RC,369,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,27 RC,369,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,27 RC,369,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,15 RC,369,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,27 RC,369,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,27 RC,369,Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy ,,,3390.0,16207.0,12 RC,369,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,Repair of scleral staphyloma with graft ,,,2141.05,10424.04,27 RC,369,"Repair of small omphalocele, with primary closure ",,,1209.12,8488.5,27 RC,369,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,27 RC,369,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,27 RC,369,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,1158.59,8536.87,27 RC,369,Repair of traumatic corporeal tear(s) ,,,1200.05,12909.0,27 RC,369,Repair of tunica vaginalis hydrocele (Bottle type) ,,,1200.05,8240.61,27 RC,369,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,1158.59,12562.0,27 RC,369,Repair oval window fistula ,,,930.95,8234.0,27 RC,369,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,15059.0,27 RC,369,Repair recurrent femoral hernia; reducible ,,,1209.12,13394.0,27 RC,369,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,27 RC,369,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,12909.0,27 RC,369,Repair round window fistula ,,,930.95,8234.0,27 RC,369,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,369,"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute ",,,3390.0,16207.0,12 RC,369,"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic ",,,3390.0,16207.0,12 RC,369,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,1209.12,8488.5,54 RC,369,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,3293.0,13835.0,24 RC,369,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,2996.0,13835.0,24 RC,369,"Repair, laceration of diaphragm, any approach ",,,3390.0,16207.0,12 RC,369,"Repair, laceration of palate; over 2 cm or complex ",,,2051.93,13241.95,27 RC,369,"Repair, laceration of palate; up to 2 cm ",,,196.58,5841.0,26 RC,369,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia ",,,3390.0,73655.7,12 RC,369,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis ",,,3390.0,16207.0,12 RC,369,"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis ",,,3390.0,16207.0,12 RC,369,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis ",,,3390.0,16418.72,12 RC,369,"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis ",,,3390.0,16207.0,12 RC,369,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis ",,,3390.0,18898.08,12 RC,369,"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis ",,,3390.0,18571.74,12 RC,369,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,369,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,3390.0,35621.26,26 RC,369,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,3390.0,34379.68,26 RC,369,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3390.0,16330.72,27 RC,369,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,3390.0,16207.0,12 RC,369,Replacement of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,12 RC,369,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,27 RC,369,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,27 RC,369,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,27 RC,369,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract ",,,115.66,5841.0,26 RC,369,"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract ",,,115.66,5841.0,26 RC,369,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,369,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,27 RC,369,"Replacement or irrigation, ventricular catheter ",,,1986.0,15039.6,27 RC,369,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,2096.41,15039.6,27 RC,369,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,2699.0,15039.6,27 RC,369,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,369,"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition ",,,115.66,3128.0,27 RC,369,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,27 RC,369,"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and im",,,2699.0,13835.0,24 RC,369,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,14 RC,369,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,4988.0,13973.35,12 RC,369,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,3390.0,20267.07,12 RC,369,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,3390.0,17864.03,12 RC,369,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,3390.0,21716.49,12 RC,369,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,369,"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls ",,,2051.93,13241.95,27 RC,369,"Resection of lip, more than one-fourth, without reconstruction ",,,930.95,7150.66,27 RC,369,Resection of mediastinal cyst ,,,3390.0,16207.0,12 RC,369,Resection of mediastinal tumor ,,,3390.0,16207.0,12 RC,369,Resection of palate or extensive resection of lesion ,,,2051.93,13241.95,27 RC,369,"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis ",,,3390.0,29052.84,12 RC,369,Resection of scrotum ,,,1200.05,8240.61,27 RC,369,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,3390.0,34939.67,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,3390.0,26098.85,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,3390.0,29709.76,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,3390.0,34719.28,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,3390.0,41237.62,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,3390.0,26340.4,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,3390.0,36321.35,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,3390.0,32985.86,12 RC,369,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,3390.0,40559.53,12 RC,369,"Resection temporal bone, external approach ",,,3390.0,32511.23,12 RC,369,"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap) ",,,3390.0,16207.0,12 RC,369,"Resection, diaphragm; with simple repair (eg, primary suture) ",,,3390.0,16207.0,12 RC,369,"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, ",,,2699.0,13835.0,24 RC,369,Retrobulbar injection; alcohol ,,,36.62,5841.0,26 RC,369,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,14 RC,369,"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,23 RC,369,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheter",,,1986.0,15874.51,58 RC,369,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuve",,,1986.0,51129.32,58 RC,369,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all man",,,1986.0,32198.25,58 RC,369,"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty wh",,,1986.0,51129.32,58 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed ",,,5796.69,11113.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty ",,,2638.63,9653.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when",,,8579.0,13313.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5604.99,11113.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)",,,9124.0,9653.0,3 RC,369,"Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when p",,,9124.0,9653.0,3 RC,369,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty ",,,2454.04,9653.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed ",,,5352.25,11113.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery",,,1986.0,15874.51,58 RC,369,"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary",,,1986.0,32198.25,58 RC,369,"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing t",,,1986.0,32198.25,58 RC,369,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,369,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,369,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,369,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,369,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheteriz",,,1986.0,32198.25,58 RC,369,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers",,,1986.0,51129.32,58 RC,369,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneu",,,1986.0,51129.32,58 RC,369,"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when",,,1986.0,51129.32,58 RC,369,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed ",,,9049.29,11113.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty ",,,4988.47,9653.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same v",,,8579.0,13313.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf",,,8922.21,11113.0,6 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,23 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,23 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,23 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List s",,,10586.0,11113.0,3 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (List separately in addition to code for primary proced",,,9124.0,9653.0,3 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the",,,9124.0,9653.0,3 RC,369,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, wh",,,9124.0,9653.0,3 RC,369,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,2390.64,18300.83,15 RC,369,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,3390.0,16207.0,12 RC,369,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,1116.7,12562.0,27 RC,369,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,1986.0,54750.0,27 RC,369,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1986.0,54750.0,27 RC,369,Revision mastoidectomy; resulting in complete mastoidectomy ,,,2051.93,13241.95,27 RC,369,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,2051.93,13241.95,27 RC,369,Revision mastoidectomy; resulting in radical mastoidectomy ,,,2051.93,13241.95,27 RC,369,Revision mastoidectomy; resulting in tympanoplasty ,,,2051.93,13241.95,27 RC,369,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,27 RC,369,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,27 RC,369,Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) ,,,2996.0,13835.0,24 RC,369,Revision of colostomy; simple (release of superficial scar) (separate procedure) ,,,1530.5,12562.0,27 RC,369,Revision of colostomy; with repair of paracolostomy hernia (separate procedure) ,,,2996.0,14524.31,24 RC,369,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy ",,,3390.0,20945.15,12 RC,369,"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy ",,,3390.0,20101.72,12 RC,369,Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) ,,,2996.0,16207.0,24 RC,369,Revision of ileostomy; simple (release of superficial scar) (separate procedure) ,,,1530.5,8128.0,27 RC,369,Revision of peritoneal-venous shunt ,,,1209.12,8488.5,27 RC,369,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,1773.9,12562.0,27 RC,369,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,27 RC,369,"Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannu",,,3965.0,13835.0,24 RC,369,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,1200.05,13835.0,15 RC,369,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,3390.0,16207.0,12 RC,369,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,2195.0,16890.86,27 RC,369,"Revision or removal of gastric neurostimulator electrodes, antrum, open ",,,3390.0,21907.23,12 RC,369,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,27 RC,369,Revision or removal of intracranial neurostimulator electrodes ,,,1574.7,13835.0,15 RC,369,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,1986.0,27181.65,22 RC,369,Revision or removal of peripheral neurostimulator electrode array ,,,1574.7,8595.41,27 RC,369,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,27 RC,369,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,27 RC,369,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,2699.0,9751.1,17 RC,369,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,2699.0,86066.14,17 RC,369,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,2195.0,16890.86,27 RC,369,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,2195.0,31349.63,26 RC,369,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,369,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,369,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,2699.0,56900.95,22 RC,369,"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure) ",,,5841.0,23695.81,6 RC,369,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,369,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,369,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,369,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,369,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,369,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,369,Right ventricular recording ,,,2024.5,43890.0,10 RC,369,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,369,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,369,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,3390.0,28395.93,7 RC,369,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,3390.0,28768.84,7 RC,369,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,3390.0,25611.4,7 RC,369,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,3390.0,26874.42,7 RC,369,SIGMOIDOSCOPY W/ABLATE TUMR ,,,3390.0,5841.0,2 RC,369,SIGMOIDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,369,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER ",,,4988.0,7014.0,3 RC,369,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,3 RC,369,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,369,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,369,SURGICAL COLONOSCOPY ,,,3390.0,5841.0,2 RC,369,SURGICAL OPENING ESOPHAGUS ,,,3390.0,5841.0,2 RC,369,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,369,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,13835.0,24 RC,369,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,13835.0,24 RC,369,Salpingostomy (salpingoneostomy) ,,,3041.0,13835.0,24 RC,369,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,369,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,27 RC,369,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,27 RC,369,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,1250.52,12909.0,24 RC,369,"Scraping of cornea, diagnostic, for smear and/or culture ",,,745.36,5841.0,11 RC,369,Screening proctoscopy ,,,343.69,440.76,5 RC,369,Scrotal exploration ,,,1200.05,8240.61,27 RC,369,Scrotoplasty; complicated ,,,1773.9,11552.32,27 RC,369,Scrotoplasty; simple ,,,1200.05,8240.61,27 RC,369,"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic ",,,1672.0,5841.0,15 RC,369,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,3390.0,16207.0,12 RC,369,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,3390.0,17546.16,12 RC,369,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,369,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,369,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,27 RC,369,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,1610.16,10424.04,27 RC,369,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,27 RC,369,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,27 RC,369,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,27 RC,369,Severing of tarsorrhaphy ,,,179.07,3128.0,27 RC,369,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,27 RC,369,"Sialolithotomy; parotid, extraoral or complicated intraoral ",,,930.95,7150.66,27 RC,369,"Sialolithotomy; submandibular (submaxillary), complicated, intraoral ",,,265.4,12562.0,27 RC,369,"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral ",,,127.91,13835.0,27 RC,369,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) ",,,137.2,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) ",,,450.72,8234.0,27 RC,369,"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) ",,,450.72,8234.0,27 RC,369,"Sigmoidoscopy, flexible; with biopsy, single or multiple ",,,344.93,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with control of bleeding, any method ",,,450.72,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed ",,,344.93,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance ",,,344.93,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with endoscopic mucosal resection ",,,986.93,8234.0,27 RC,369,"Sigmoidoscopy, flexible; with endoscopic ultrasound examination ",,,344.93,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) ",,,1986.0,13051.67,27 RC,369,"Sigmoidoscopy, flexible; with removal of foreign body(s) ",,,450.72,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps ",,,344.93,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,450.72,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with transendoscopic balloon dilation ",,,450.72,3128.0,27 RC,369,"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) ",,,450.72,3128.0,27 RC,369,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,26 RC,369,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,223.51,5841.0,11 RC,369,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,369,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,369,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,2195.0,22025.45,29 RC,369,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,2171.17,16632.0,29 RC,369,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,27 RC,369,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,1200.05,8240.61,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, pl",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) ",,,1770.48,15059.0,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedu",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s) ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique ",,,593.22,4251.7,27 RC,369,"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) ",,,3062.79,15059.0,27 RC,369,Snip incision of lacrimal punctum ,,,56.97,5841.0,26 RC,369,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,369,Sperm washing for artificial insemination ,,,44.33,5841.0,11 RC,369,"Sphincteroplasty, anal, for incontinence or prolapse; adult ",,,986.93,12562.0,27 RC,369,"Sphincteroplasty, anal, for incontinence or prolapse; child ",,,3390.0,16207.0,12 RC,369,"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) ",,,986.93,12562.0,27 RC,369,"Sphincteroplasty, anal, for incontinence, adult; muscle transplant ",,,986.93,7014.0,27 RC,369,"Sphincterotomy, anal, division of sphincter (separate procedure) ",,,986.93,12562.0,27 RC,369,"Spinal puncture, lumbar, diagnostic; ",,,276.0,3128.0,27 RC,369,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,26 RC,369,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,27 RC,369,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,26 RC,369,Splenectomy; partial (separate procedure) ,,,3390.0,16207.0,12 RC,369,Splenectomy; total (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure) ",,,2528.17,16207.0,12 RC,369,"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions ",,,204.65,12562.0,27 RC,369,"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions ",,,223.55,12562.0,27 RC,369,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,27 RC,369,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,27 RC,369,Stapes mobilization ,,,930.95,12909.0,27 RC,369,Stem cell collection ,,,3390.0,5841.0,2 RC,369,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,3390.0,17554.62,12 RC,369,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,3390.0,17156.19,12 RC,369,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,2431.0,19516.9,12 RC,369,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,3390.0,15059.0,12 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,19113.0,29069.0,5 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,19113.0,29069.0,5 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,19113.0,29069.0,5 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,369,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,369,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,1022.29,12562.0,27 RC,369,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,369,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,112.77,5841.0,11 RC,369,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,1672.0,5841.0,15 RC,369,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,27 RC,369,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,27 RC,369,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,27 RC,369,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,1158.59,8536.87,27 RC,369,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,27 RC,369,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,369,Subconjunctival injection ,,,223.51,5841.0,11 RC,369,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,2431.0,14948.14,12 RC,369,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,27 RC,369,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,27 RC,369,"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session ",,,1986.0,12909.0,24 RC,369,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,3390.0,17554.62,12 RC,369,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,3390.0,13835.0,10 RC,369,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,24 RC,369,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,456.3,5841.0,10 RC,369,Suprahyoid lymphadenectomy ,,,1937.47,14297.8,27 RC,369,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,3390.0,26865.96,12 RC,369,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,3390.0,31193.16,12 RC,369,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,3390.0,31862.78,12 RC,369,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,53176.72,12 RC,369,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,59338.96,12 RC,369,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,3390.0,16537.5,12 RC,369,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,3390.0,46115.78,12 RC,369,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,3390.0,26984.61,12 RC,369,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,3390.0,57821.69,12 RC,369,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,3390.0,35240.6,12 RC,369,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,3390.0,52341.76,12 RC,369,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,3390.0,28014.44,12 RC,369,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,42699.85,12 RC,369,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,50133.7,12 RC,369,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,369,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,369,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,369,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,369,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,369,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,369,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,369,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,369,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,369,Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric ,,,986.93,12562.0,27 RC,369,Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage ,,,986.93,6399.61,27 RC,369,Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous ,,,986.93,12562.0,27 RC,369,"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed ",,,986.93,8234.0,27 RC,369,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,3390.0,16207.0,12 RC,369,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,3390.0,16207.0,12 RC,369,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,3390.0,16207.0,12 RC,369,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,2699.0,13835.0,24 RC,369,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,2996.0,13835.0,24 RC,369,Suture and/or ligation of thoracic duct; abdominal approach ,,,3390.0,16207.0,12 RC,369,Suture and/or ligation of thoracic duct; cervical approach ,,,3390.0,16207.0,12 RC,369,Suture and/or ligation of thoracic duct; thoracic approach ,,,3390.0,16207.0,12 RC,369,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,2051.93,13394.0,27 RC,369,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,2051.93,13394.0,27 RC,369,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,2096.41,15039.6,27 RC,369,Suture of 1 nerve; median motor thenar ,,,2096.41,15039.6,27 RC,369,Suture of 1 nerve; ulnar motor ,,,2096.41,15039.6,27 RC,369,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,27 RC,369,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Suture of esophageal wound or injury; cervical approach ,,,3390.0,16207.0,12 RC,369,Suture of esophageal wound or injury; transthoracic or transabdominal approach ,,,3390.0,31642.4,12 RC,369,Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) ,,,3390.0,16846.79,12 RC,369,Suture of facial nerve; extracranial ,,,2096.41,15039.6,27 RC,369,"Suture of facial nerve; infratemporal, with or without grafting ",,,2096.41,15039.6,27 RC,369,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,27 RC,369,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy ",,,3390.0,16207.0,12 RC,369,"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy ",,,3390.0,16207.0,12 RC,369,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,2096.41,15039.6,27 RC,369,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,2096.41,15039.6,27 RC,369,Suture of mesentery (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,1672.0,5841.0,15 RC,369,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,1672.0,5841.0,15 RC,369,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,1672.0,5841.0,15 RC,369,Suture of posterior tibial nerve ,,,2096.41,15039.6,27 RC,369,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,27 RC,369,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,27 RC,369,Suture of sciatic nerve ,,,1230.86,8104.0,27 RC,369,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations ",,,3390.0,19923.79,12 RC,369,"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation ",,,3390.0,17359.64,12 RC,369,Suture of tongue to lip for micrognathia (Douglas type procedure) ,,,930.95,7150.66,27 RC,369,Suture of; brachial plexus ,,,692.94,12562.0,27 RC,369,Suture of; lumbar plexus ,,,2096.41,15039.6,27 RC,369,Suture or repair of testicular injury ,,,1200.05,12562.0,27 RC,369,Suture pharynx for wound or injury ,,,783.57,5571.0,27 RC,369,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,3390.0,16207.0,12 RC,369,"Sympathectomy, cervical ",,,692.94,4693.83,27 RC,369,"Sympathectomy, cervicothoracic ",,,2431.0,13835.0,12 RC,369,"Sympathectomy, lumbar ",,,3390.0,16207.0,12 RC,369,"Sympathectomy, thoracolumbar ",,,3390.0,16207.0,12 RC,369,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,15 RC,369,Sympathectomy; radial artery ,,,1142.68,8234.0,27 RC,369,Sympathectomy; superficial palmar arch ,,,1142.68,7473.24,27 RC,369,Sympathectomy; ulnar artery ,,,1142.68,12562.0,27 RC,369,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,3390.0,16207.0,12 RC,369,TRANSCATH IV STENT OPEN ,,,5841.0,5841.0,1 RC,369,TRANSCATH IV STENT PERCUT ,,,5841.0,5841.0,1 RC,369,TRANSCATH IV STENT/OPEN ADDL ,,,5841.0,5841.0,1 RC,369,TRANSCATH IV STENT/PERC ADDL ,,,5841.0,5841.0,1 RC,369,TRANSCATHETER OCCLUSION ,,,5841.0,5841.0,1 RC,369,TRANSCATHETER RETRIEVAL ,,,5841.0,5841.0,1 RC,369,TRANSCATHETER THERAPY INFUSE ,,,3390.0,5841.0,3 RC,369,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,369,"TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGEAL VARICES ",,,3390.0,16207.0,3 RC,369,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,369,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,369,TRANSPLANTATION OF LIVER ,,,3390.0,5841.0,2 RC,369,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,369,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,27 RC,369,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,369,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,3293.0,34379.68,26 RC,369,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,369,"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) ",,,2058.85,16207.0,12 RC,369,"Thrombolysis, cerebral, by intravenous infusion ",,,634.68,5841.0,11 RC,369,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,369,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,369,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,3390.0,16745.06,12 RC,369,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,2996.0,13835.0,24 RC,369,"Thyroidectomy, including substernal thyroid; cervical approach ",,,2996.0,13835.0,24 RC,369,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,2431.0,16715.43,12 RC,369,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,3293.0,13835.0,24 RC,369,"Thyroidectomy, total or complete ",,,1983.29,13835.0,27 RC,369,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,369,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,3673.0,13835.0,24 RC,369,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,3041.0,20402.66,24 RC,369,"Tongue base suspension, permanent suture technique ",,,2195.0,13241.95,24 RC,369,Tonsillectomy and adenoidectomy; age 12 or over ,,,930.95,13394.0,27 RC,369,Tonsillectomy and adenoidectomy; younger than age 12 ,,,2051.93,13241.95,27 RC,369,"Tonsillectomy, primary or secondary; age 12 or over ",,,930.95,8234.0,27 RC,369,"Tonsillectomy, primary or secondary; younger than age 12 ",,,2051.93,13241.95,27 RC,369,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,3390.0,16207.0,24 RC,369,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,3390.0,16207.0,24 RC,369,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,24 RC,369,Total facial nerve decompression and/or repair (may include graft) ,,,2996.0,13835.0,24 RC,369,"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es) ",,,3390.0,53753.08,12 RC,369,"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy) ",,,3390.0,43081.23,12 RC,369,"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es) ",,,3390.0,55066.91,12 RC,369,"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) ",,,3390.0,36660.39,12 RC,369,"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy ",,,3390.0,46819.38,12 RC,369,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,13196.03,27 RC,369,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,13196.03,27 RC,369,Trabeculoplasty by laser surgery ,,,114.82,3249.0,27 RC,369,Trabeculotomy ab externo ,,,892.44,8234.0,27 RC,369,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,1603.34,12562.0,27 RC,369,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,1116.7,12562.0,27 RC,369,"Transabdominal amnioinfusion, including ultrasound guidance ",,,554.98,5841.0,23 RC,369,Transcatheter biopsy ,,,2036.11,12547.6,27 RC,369,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,369,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,369,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,3375.0,27050.15,48 RC,369,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,1986.0,43890.0,47 RC,369,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each",,,1986.0,43890.0,18 RC,369,"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; init",,,2699.0,43890.0,29 RC,369,"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perfo",,,1672.0,5841.0,15 RC,369,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal em",,,2699.0,43890.0,25 RC,369,"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal",,,2699.0,43890.0,25 RC,369,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,3390.0,18059.01,12 RC,369,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angiop",,,2699.0,43890.0,24 RC,369,"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiolo",,,2699.0,43890.0,24 RC,369,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,369,"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound",,,1174.13,15059.0,27 RC,369,"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day ",,,1986.0,12547.6,28 RC,369,"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during",,,2012.0,15059.0,50 RC,369,"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day ",,,1594.88,8234.0,28 RC,369,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3293.0,19655.45,22 RC,369,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,1986.0,17689.64,24 RC,369,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,3390.0,29709.76,12 RC,369,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,3390.0,36245.03,12 RC,369,"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,15 RC,369,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,3524.67,12562.0,12 RC,369,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,27 RC,369,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,27 RC,369,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,27 RC,369,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,27 RC,369,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,27 RC,369,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,27 RC,369,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,27 RC,369,Transection or avulsion of; mental nerve ,,,692.94,4693.83,27 RC,369,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,27 RC,369,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,27 RC,369,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,3390.0,16207.0,12 RC,369,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,3390.0,16207.0,12 RC,369,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,12 RC,369,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,3390.0,16207.0,12 RC,369,"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the ",,,1672.0,13835.0,41 RC,369,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,369,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,1672.0,22539.28,58 RC,369,"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplast",,,1672.0,5841.0,15 RC,369,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,3293.0,13394.0,24 RC,369,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,3293.0,13394.0,24 RC,369,Transmastoid antrotomy (simple mastoidectomy) ,,,2051.93,13241.95,27 RC,369,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,3390.0,31201.63,12 RC,369,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,3390.0,51345.81,12 RC,369,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,1672.0,5841.0,15 RC,369,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,2518.45,16330.72,27 RC,369,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,2518.45,16330.72,27 RC,369,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,1986.0,15059.0,26 RC,369,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,29 RC,369,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,3390.0,35134.65,12 RC,369,"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer ",,,795.48,3128.0,12 RC,369,Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage ,,,795.48,5841.0,11 RC,369,Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion ,,,795.48,3128.0,12 RC,369,Transplant preparation of hematopoietic progenitor cells; platelet depletion ,,,795.48,3128.0,12 RC,369,Transplant preparation of hematopoietic progenitor cells; red blood cell removal ,,,795.48,3128.0,12 RC,369,"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion ",,,795.48,3128.0,12 RC,369,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor ",,,795.48,5841.0,11 RC,369,"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor ",,,795.48,5841.0,11 RC,369,Transplant preparation of hematopoietic progenitor cells; tumor cell depletion ,,,795.48,3128.0,12 RC,369,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,369,Transplantation of pancreatic allograft ,,,3390.0,31320.29,10 RC,369,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,369,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,1200.05,12562.0,27 RC,369,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,"Transposition, ovary(s) ",,,2699.0,13835.0,24 RC,369,Transrectal drainage of pelvic abscess ,,,450.72,5571.0,27 RC,369,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,3390.0,28879.03,12 RC,369,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,3390.0,16207.0,12 RC,369,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,1090.68,19718.21,27 RC,369,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,1200.05,15059.0,26 RC,369,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,1042.71,18816.77,27 RC,369,Transurethral drainage of prostatic abscess ,,,1200.05,8240.61,27 RC,369,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,27 RC,369,Transurethral incision of prostate ,,,1200.05,12562.0,27 RC,369,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,2195.0,12909.0,24 RC,369,Transurethral resection of bladder neck (separate procedure) ,,,1200.05,12562.0,27 RC,369,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,27 RC,369,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,27 RC,369,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,2195.0,26403.19,17 RC,369,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,18 RC,369,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,18 RC,369,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,18 RC,369,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,18 RC,369,Transvesical ureterolithotomy ,,,3631.68,13835.0,12 RC,369,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,27 RC,369,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,27 RC,369,"Treatment of incomplete abortion, any trimester, completed surgically ",,,1116.7,13394.0,27 RC,369,"Treatment of missed abortion, completed surgically; first trimester ",,,1116.7,13394.0,27 RC,369,"Treatment of missed abortion, completed surgically; second trimester ",,,1116.7,13394.0,27 RC,369,"Treatment of septic abortion, completed surgically ",,,2195.0,16207.0,24 RC,369,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,369,"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure) ",,,1364.86,16207.0,12 RC,369,Tubotubal anastomosis ,,,3293.0,13835.0,24 RC,369,Tubouterine implantation ,,,3293.0,13835.0,24 RC,369,Twist drill hole for subdural or ventricular puncture ,,,3390.0,16207.0,12 RC,369,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,3390.0,16207.0,12 RC,369,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,3040.41,16207.0,12 RC,369,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,3390.0,16207.0,12 RC,369,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,2762.83,28345.13,48 RC,369,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,27 RC,369,Tympanic neurectomy ,,,930.95,12562.0,27 RC,369,"Tympanolysis, transcanal ",,,930.95,9653.0,27 RC,369,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,27 RC,369,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,27 RC,369,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,27 RC,369,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,27 RC,369,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,27 RC,369,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,26 RC,369,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,369,U-tube hepaticoenterostomy ,,,3390.0,16207.0,3 RC,369,UPPER GI ENDOSCOPY EXAM ,,,3390.0,5841.0,2 RC,369,UPPR GI ENDOSCOPY W/STENT ,,,3390.0,5841.0,2 RC,369,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,369,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,369,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,369,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,1209.12,8488.5,27 RC,369,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,369,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,369,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,369,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,340.4,13835.0,23 RC,369,"Unlisted hysteroscopy procedure, uterus ",,,340.4,13835.0,11 RC,369,"Unlisted laparoscopic procedure, liver ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, appendix ",,,6326.0,13196.03,9 RC,369,"Unlisted laparoscopy procedure, biliary tract ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, bladder ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, esophagus ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, intestine (except rectum) ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, lymphatic system ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,24 RC,369,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, rectum ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, renal ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, spleen ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, stomach ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, testis ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13835.0,12 RC,369,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13835.0,12 RC,369,"Unlisted procedure, Meckel's diverticulum and the mesentery ",,,3390.0,16207.0,12 RC,369,"Unlisted procedure, abdomen, peritoneum and omentum ",,,1611.14,13835.0,24 RC,369,"Unlisted procedure, anterior segment of eye ",,,1986.0,13835.0,24 RC,369,"Unlisted procedure, anus ",,,1565.95,13835.0,24 RC,369,"Unlisted procedure, biliary tract ",,,1611.14,13835.0,12 RC,369,"Unlisted procedure, colon ",,,1565.95,13394.0,24 RC,369,"Unlisted procedure, conjunctiva ",,,554.5,13835.0,11 RC,369,"Unlisted procedure, dentoalveolar structures ",,,417.46,13835.0,25 RC,369,"Unlisted procedure, diaphragm ",,,3390.0,16207.0,12 RC,369,"Unlisted procedure, endocrine system ",,,1986.0,13835.0,24 RC,369,"Unlisted procedure, esophagus ",,,1611.14,13835.0,24 RC,369,"Unlisted procedure, external ear ",,,417.46,5841.0,11 RC,369,"Unlisted procedure, extraocular muscle ",,,554.5,13835.0,11 RC,369,"Unlisted procedure, eyelids ",,,554.5,13835.0,11 RC,369,"Unlisted procedure, female genital system (nonobstetrical) ",,,340.4,13835.0,23 RC,369,"Unlisted procedure, hemic or lymphatic system ",,,795.48,13835.0,23 RC,369,"Unlisted procedure, inner ear ",,,417.46,13835.0,23 RC,369,"Unlisted procedure, lacrimal system ",,,554.5,13835.0,11 RC,369,"Unlisted procedure, lips ",,,417.46,13835.0,11 RC,369,"Unlisted procedure, liver ",,,1250.52,13835.0,11 RC,369,"Unlisted procedure, male genital system ",,,481.54,13835.0,23 RC,369,"Unlisted procedure, maternity care and delivery ",,,340.4,13835.0,23 RC,369,"Unlisted procedure, mediastinum ",,,3390.0,16207.0,12 RC,369,"Unlisted procedure, middle ear ",,,417.46,13835.0,23 RC,369,"Unlisted procedure, nervous system ",,,536.63,13835.0,23 RC,369,"Unlisted procedure, orbit ",,,554.5,13835.0,11 RC,369,"Unlisted procedure, palate, uvula ",,,417.46,13835.0,11 RC,369,"Unlisted procedure, pancreas ",,,1250.52,13835.0,11 RC,369,"Unlisted procedure, pharynx, adenoids, or tonsils ",,,417.46,13835.0,23 RC,369,"Unlisted procedure, posterior segment ",,,2431.0,13835.0,12 RC,369,"Unlisted procedure, rectum ",,,1565.95,13835.0,12 RC,369,"Unlisted procedure, salivary glands or ducts ",,,417.46,13835.0,23 RC,369,"Unlisted procedure, small intestine ",,,1611.14,13835.0,24 RC,369,"Unlisted procedure, stomach ",,,1611.14,13835.0,21 RC,369,"Unlisted procedure, temporal bone, middle fossa approach ",,,417.46,13835.0,23 RC,369,"Unlisted procedure, tongue, floor of mouth ",,,417.46,13835.0,11 RC,369,"Unlisted procedure, urinary system ",,,481.54,13835.0,23 RC,369,"Unlisted procedure, vascular surgery ",,,1292.55,13835.0,24 RC,369,"Unlisted procedure, vestibule of mouth ",,,417.46,13835.0,23 RC,369,Unlisted vascular endoscopy procedure ,,,1292.55,13835.0,12 RC,369,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,1672.0,5841.0,15 RC,369,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,27 RC,369,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,1200.05,8240.61,27 RC,369,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,27 RC,369,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,11552.32,27 RC,369,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,1200.05,8240.61,27 RC,369,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,3375.0,16207.0,24 RC,369,"Ureterectomy, with bladder cuff (separate procedure) ",,,3375.0,16207.0,24 RC,369,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,3390.0,16207.0,12 RC,369,"Ureterocolon conduit, including intestine anastomosis ",,,3390.0,16207.0,12 RC,369,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,3390.0,16207.0,12 RC,369,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,3390.0,16207.0,12 RC,369,Ureterolithotomy; lower one-third of ureter ,,,3293.0,16207.0,24 RC,369,Ureterolithotomy; middle one-third of ureter ,,,3293.0,16207.0,24 RC,369,Ureterolithotomy; upper one-third of ureter ,,,3293.0,16207.0,24 RC,369,Ureterolysis for ovarian vein syndrome ,,,3390.0,16207.0,12 RC,369,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,3390.0,16207.0,12 RC,369,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,3390.0,16207.0,12 RC,369,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,3390.0,16207.0,12 RC,369,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,3390.0,16207.0,12 RC,369,Ureteroneocystostomy; with extensive ureteral tailoring ,,,3390.0,16207.0,12 RC,369,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,3390.0,16207.0,12 RC,369,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,3390.0,16207.0,12 RC,369,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,3390.0,16207.0,12 RC,369,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,3390.0,16207.0,12 RC,369,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,3390.0,17194.41,12 RC,369,"Ureterostomy, transplantation of ureter to skin ",,,3390.0,16207.0,12 RC,369,"Ureterotomy for insertion of indwelling stent, all types ",,,3293.0,16207.0,24 RC,369,Ureterotomy with exploration or drainage (separate procedure) ,,,3293.0,16207.0,24 RC,369,Ureteroureterostomy ,,,3390.0,16207.0,12 RC,369,"Urethrectomy, total, including cystostomy; female ",,,1200.05,13394.0,27 RC,369,"Urethrectomy, total, including cystostomy; male ",,,1773.9,13394.0,27 RC,369,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,3293.0,13835.0,24 RC,369,"Urethromeatoplasty, with mucosal advancement ",,,1200.05,8240.61,27 RC,369,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,1200.05,8240.61,27 RC,369,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,1773.9,12562.0,27 RC,369,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,1200.05,12562.0,27 RC,369,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,1773.9,12562.0,27 RC,369,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,1200.05,12562.0,27 RC,369,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,1773.9,11552.32,27 RC,369,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,1773.9,11552.32,27 RC,369,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,1773.9,12562.0,27 RC,369,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,1773.9,11552.32,27 RC,369,"Urethroplasty, reconstruction of female urethra ",,,1773.9,11552.32,27 RC,369,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,6326.0,13858.92,12 RC,369,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,1773.9,12562.0,27 RC,369,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,1773.9,11552.32,27 RC,369,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,1200.05,8240.61,27 RC,369,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,1773.9,11552.32,27 RC,369,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,1773.9,11552.32,27 RC,369,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,1773.9,11552.32,27 RC,369,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,27 RC,369,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,1773.9,11552.32,27 RC,369,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,3390.0,22102.21,12 RC,369,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,369,Uterine evacuation and curettage for hydatidiform mole ,,,1116.7,13394.0,27 RC,369,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,3293.0,16207.0,24 RC,369,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,3390.0,16207.0,12 RC,369,"Uvulectomy, excision of uvula ",,,930.95,7150.66,27 RC,369,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,369,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,369,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,1986.0,13835.0,24 RC,369,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,1986.0,12689.16,19 RC,369,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,2699.0,13835.0,24 RC,369,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,3390.0,13841.99,7 RC,369,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,27 RC,369,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,4988.0,13835.0,12 RC,369,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,1603.34,15059.0,27 RC,369,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,3293.0,15059.0,24 RC,369,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,3293.0,15059.0,24 RC,369,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,3293.0,18300.83,24 RC,369,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3293.0,13835.0,24 RC,369,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,3293.0,18300.83,24 RC,369,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,3293.0,13835.0,24 RC,369,"Vaginal hysterectomy, radical (Schauta type operation) ",,,3390.0,17741.14,12 RC,369,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,4988.0,13835.0,12 RC,369,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,4988.0,13835.0,12 RC,369,"Vaginectomy, complete removal of vaginal wall; ",,,2699.0,16207.0,24 RC,369,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2699.0,21606.3,24 RC,369,"Vaginectomy, partial removal of vaginal wall; ",,,2699.0,13835.0,24 RC,369,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2195.0,13835.0,24 RC,369,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,1986.0,13835.0,24 RC,369,Vaginoplasty for intersex state ,,,2699.0,13835.0,24 RC,369,"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective) ",,,3390.0,16207.0,12 RC,369,"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective ",,,3390.0,16207.0,12 RC,369,Vagotomy when performed with partial distal gastrectomy (List separately in addition to codeºs» for primary procedure) ,,,1077.38,16207.0,12 RC,369,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,369,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, ot",,,2699.0,27050.15,29 RC,369,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial",,,2699.0,27050.15,26 RC,369,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, ",,,2699.0,27050.15,29 RC,369,"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, othe",,,2699.0,59899.7,29 RC,369,"Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) ",,,2036.11,12562.0,9 RC,369,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,27 RC,369,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,1672.0,5841.0,15 RC,369,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,2195.0,8240.61,24 RC,369,"Vasovasostomy, vasovasorrhaphy ",,,1986.0,8240.61,24 RC,369,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,369,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,369,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,369,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,369,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,369,"Venous anastomosis, open; caval-mesenteric ",,,3390.0,27217.7,12 RC,369,"Venous anastomosis, open; portocaval ",,,3390.0,28565.51,12 RC,369,"Venous anastomosis, open; renoportal ",,,3390.0,26488.69,12 RC,369,"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique) ",,,3390.0,28565.51,12 RC,369,"Venous anastomosis, open; splenorenal, proximal ",,,3390.0,26162.35,12 RC,369,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,27 RC,369,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,27 RC,369,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,27 RC,369,Ventriculocisternostomy (Torkildsen type operation) ,,,3390.0,19949.19,12 RC,369,"Ventriculocisternostomy, third ventricle; ",,,3390.0,17075.76,12 RC,369,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,3390.0,16207.0,12 RC,369,"Vermilionectomy (lip shave), with mucosal advancement ",,,930.95,7150.66,27 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,2567.78,16207.0,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,3390.0,21674.15,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,2488.46,16207.0,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,3390.0,29803.02,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,3126.33,16207.0,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,3390.0,22725.26,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,26781.17,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,3390.0,26832.09,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,3390.0,27196.53,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,3390.0,28616.31,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,30091.25,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,3390.0,29773.38,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,3390.0,31277.95,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,2842.15,28743.44,36 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,1711.86,24149.28,24 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,1844.09,16207.0,12 RC,369,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,3390.0,23729.68,12 RC,369,"Vesiculectomy, any approach ",,,1986.0,13835.0,24 RC,369,Vesiculotomy; ,,,685.44,11308.65,27 RC,369,Vesiculotomy; complicated ,,,1986.0,13835.0,24 RC,369,"Vestibular nerve section, transcranial approach ",,,3390.0,21449.53,12 RC,369,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,27 RC,369,Vestibuloplasty; anterior ,,,2051.93,13241.95,27 RC,369,"Vestibuloplasty; complex (including ridge extension, muscle repositioning) ",,,2051.93,13394.0,27 RC,369,Vestibuloplasty; entire arch ,,,2051.93,13394.0,27 RC,369,"Vestibuloplasty; posterior, bilateral ",,,2051.93,13241.95,27 RC,369,"Vestibuloplasty; posterior, unilateral ",,,2051.93,13241.95,27 RC,369,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,369,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,27 RC,369,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,27 RC,369,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,27 RC,369,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,27 RC,369,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,27 RC,369,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,27 RC,369,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,369,Vulvectomy simple; complete ,,,1116.7,12909.0,27 RC,369,Vulvectomy simple; partial ,,,1116.7,13394.0,27 RC,369,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,3390.0,18478.49,12 RC,369,"Vulvectomy, radical, complete; ",,,9875.0,14986.24,12 RC,369,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,18618.43,12 RC,369,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,16058.52,12 RC,369,"Vulvectomy, radical, partial; ",,,3390.0,16207.0,24 RC,369,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,17240.98,12 RC,369,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,14609.1,12 RC,369,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,2699.0,18300.83,24 RC,369,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,370, Anesthesia General Classification ,,,,,0 RC,371, Anesthesia Incident to Radiology ,,,,,0 RC,372, Anesthesia Incident to Other DX Services ,,,,,0 RC,374, Anesthesia Acupuncture ,,,,,0 RC,379, Anesthesia Other ,,,,,0 RC,380, Blood and Blood Components General Classification ,,,,,0 RC,381, Blood and Blood Components Packed Red Cells ,,,,,0 RC,382, Blood and Blood Components Whole Blood ,,,,,0 RC,383, Blood and Blood Components Plasma ,,,,,0 RC,384, Blood and Blood Components Platelets ,,,,,0 RC,385, Blood and Blood Components Leukocytes ,,,,,0 RC,386, Blood and Blood Components Other Blood Components ,,,,,0 RC,387, Blood and Blood Components Other Derivatives (Cryoprecipitate) ,,,,,0 RC,389, Blood and Blood Components Other ,,,,,0 RC,390," Administration, Processing and Storage for Blood and Blood Components General Classification ",,,,,0 RC,391," Administration, Processing and Storage for Blood and Blood Components Administration (e.g., Transfu ",,,,,0 RC,392," Administration, Processing and Storage for Blood and Blood Components Processing and Storage ",,,,,0 RC,399," Administration, Processing and Storage for Blood and Blood Components Other Blood Handling ",,,,,0 RC,400, Other Imaging Services General Classification ,,,,,0 RC,400,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,400,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,400,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,400,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,400,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,400,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,400,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,400,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,400,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,400,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,400,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,400,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,400,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,400,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,400,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,400,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,400,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,Acetaminophen ,,,76.68,98.82,3 RC,400,Acetylcholinesterase ,,,50.18,64.67,3 RC,400,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,400,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,400,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,400,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,400,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,400,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,400,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,400,Adalimumab ,,,158.91,204.79,3 RC,400,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,400,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,400,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,400,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,400,Albumin; ischemia modified ,,,139.38,179.62,3 RC,400,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,400,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,400,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,400,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,400,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,400,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,400,Alcohols ,,,98.98,127.56,3 RC,400,Aldolase ,,,40.44,52.12,3 RC,400,Aldosterone ,,,167.27,215.56,3 RC,400,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,400,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,400,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,400,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,400,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,400,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,400,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,400,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,400,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,400,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,400,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,400,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,400,Aluminum ,,,104.53,134.7,3 RC,400,Amikacin ,,,62.74,80.85,3 RC,400,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,400,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,400,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,400,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,400,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,400,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,400,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,400,Amiodarone ,,,76.68,98.82,3 RC,400,Ammonia ,,,59.93,77.23,3 RC,400,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,400,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,400,Amylase ,,,26.5,34.15,3 RC,400,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,400,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,400,Androstanediol glucuronide ,,,118.47,152.67,3 RC,400,Androstenedione ,,,119.9,154.51,3 RC,400,Androsterone ,,,104.53,134.7,3 RC,400,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,400,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,400,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,400,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,400,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,400,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,400,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,400,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,400,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,400,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,400,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,400,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,400,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,400,Angiotensin II ,,,85.04,109.59,3 RC,400,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,400,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,400,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,400,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,400,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,400,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,400,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,400,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,400,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,400,Antibody; Aspergillus ,,,61.31,79.01,3 RC,400,Antibody; Bartonella ,,,41.83,53.9,3 RC,400,Antibody; Blastomyces ,,,52.96,68.24,3 RC,400,Antibody; Bordetella ,,,54.38,70.08,3 RC,400,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,400,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,400,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,400,Antibody; Brucella ,,,36.24,46.7,3 RC,400,Antibody; Campylobacter ,,,54.38,70.08,3 RC,400,Antibody; Candida ,,,48.8,62.89,3 RC,400,Antibody; Chlamydia ,,,48.8,62.89,3 RC,400,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,400,Antibody; Coccidioides ,,,47.41,61.1,3 RC,400,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,400,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,400,Antibody; Diphtheria ,,,62.74,80.85,3 RC,400,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,400,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,400,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,400,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,400,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,400,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,400,Antibody; HIV-1 ,,,36.24,46.7,3 RC,400,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,400,Antibody; HIV-2 ,,,55.77,71.87,3 RC,400,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,400,Antibody; HTLV-I ,,,37.63,48.49,3 RC,400,Antibody; HTLV-II ,,,57.16,73.66,3 RC,400,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,400,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,400,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,400,Antibody; Legionella ,,,62.74,80.85,3 RC,400,Antibody; Leishmania ,,,50.18,64.67,3 RC,400,Antibody; Leptospira ,,,66.9,86.21,3 RC,400,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,400,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,400,Antibody; Nocardia ,,,65.51,84.43,3 RC,400,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,400,Antibody; Rickettsia ,,,79.46,102.39,3 RC,400,Antibody; Salmonella ,,,54.38,70.08,3 RC,400,Antibody; Shigella ,,,100.37,129.34,3 RC,400,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,400,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,400,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,400,Antibody; Trichinella ,,,51.57,66.46,3 RC,400,Antibody; West Nile virus ,,,58.54,75.44,3 RC,400,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,400,Antibody; Yersinia ,,,54.38,70.08,3 RC,400,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,400,Antibody; actinomyces ,,,41.83,53.9,3 RC,400,Antibody; adenovirus ,,,52.96,68.24,3 RC,400,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,400,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,400,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,400,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,400,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,400,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,400,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,400,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,400,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,400,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,400,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,400,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,400,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,400,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,400,Antibody; histoplasma ,,,57.16,73.66,3 RC,400,Antibody; influenza virus ,,,55.77,71.87,3 RC,400,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,400,Antibody; mucormycosis ,,,61.31,79.01,3 RC,400,Antibody; mumps ,,,54.38,70.08,3 RC,400,Antibody; mycoplasma ,,,54.38,70.08,3 RC,400,Antibody; parvovirus ,,,61.31,79.01,3 RC,400,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,400,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,400,Antibody; rotavirus ,,,75.26,96.98,3 RC,400,Antibody; rubella ,,,58.54,75.44,3 RC,400,Antibody; rubeola ,,,52.96,68.24,3 RC,400,Antibody; tetanus ,,,61.31,79.01,3 RC,400,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,400,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,400,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,400,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,400,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,400,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,400,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,400,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,400,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,400,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,400,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,400,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,400,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,400,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,400,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,400,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,400,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,400,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,400,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,400,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,400,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,400,"Apolipoprotein, each ",,,86.43,111.38,3 RC,400,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,400,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,400,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,400,Arsenic ,,,78.07,100.61,3 RC,400,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,400,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,400,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,400,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,400,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,400,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,400,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,400,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,400,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,400,"B cells, total count ",,,154.71,199.37,3 RC,400,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,400,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,400,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,400,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,400,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,400,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,400,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,400,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,400,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,400,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,400,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,400,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,400,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,400,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,400,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,400,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,400,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,400,Barbiturates ,,,98.98,127.56,3 RC,400,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,400,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,400,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,400,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,400,Beta-2 microglobulin ,,,66.9,86.21,3 RC,400,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,400,Bile acids; total ,,,71.1,91.62,3 RC,400,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,400,Bilirubin; direct ,,,20.91,26.95,3 RC,400,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,400,Bilirubin; total ,,,20.91,26.95,3 RC,400,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,400,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,400,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,400,Bleeding time ,,,19.53,25.17,3 RC,400,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,400,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,400,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,400,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,400,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,400,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,400,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,400,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,400,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,400,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,400,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,400,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,400,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,400,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,400,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,400,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,400,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,400,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,400,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,400,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,400,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,400,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,400,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,400,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,400,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,400,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,400,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,400,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,400,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,400,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,400,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,400,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,400,Bone age studies ,,,26.58,79.3,4 RC,400,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,400,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,400,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,400,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,400,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,400,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,400,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,400,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,400,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,400,Bradykinin ,,,20.91,26.95,3 RC,400,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,400,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,400,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,400,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,400,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,400,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,400,C-peptide ,,,85.04,109.59,3 RC,400,C-reactive protein; ,,,20.91,26.95,3 RC,400,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,400,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,400,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,400,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,400,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,400,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,400,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,400,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,400,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,400,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,400,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,400,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,400,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,400,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,400,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,400,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,400,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,400,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,400,Cadmium ,,,97.55,125.72,3 RC,400,Caffeine ,,,158.91,204.79,3 RC,400,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,400,Calcitonin ,,,110.11,141.9,3 RC,400,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,400,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,400,Calcium; ionized ,,,55.77,71.87,3 RC,400,Calcium; total ,,,20.91,26.95,3 RC,400,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,400,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,400,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,400,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,400,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,400,"Calprotectin, fecal ",,,80.84,104.18,3 RC,400,"Cannabinoids, natural ",,,98.98,127.56,3 RC,400,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,400,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,400,Carbamazepine; free ,,,54.38,70.08,3 RC,400,Carbamazepine; total ,,,59.93,77.23,3 RC,400,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,400,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,400,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,400,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,400,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,400,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,400,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,400,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,400,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,400,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,400,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,400,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,400,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,400,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,400,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,400,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,400,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,400,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,400,Cardiac shunt detection ,,,186.76,186.76,1 RC,400,Cardiokymography ,,,20.04,20.04,1 RC,400,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,400,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,400,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,400,Carotene ,,,37.63,48.49,3 RC,400,Catecholamines; blood ,,,119.9,154.51,3 RC,400,Catecholamines; fractionated ,,,104.53,134.7,3 RC,400,Catecholamines; total urine ,,,112.93,145.53,3 RC,400,Cathepsin-D ,,,73.87,95.19,3 RC,400,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,400,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,400,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,400,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,400,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,400,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,400,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,400,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,400,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,400,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,400,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,400,Ceruloplasmin ,,,44.6,57.47,3 RC,400,Chemiluminescent assay ,,,58.54,75.44,3 RC,400,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,400,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,400,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,400,Chloramphenicol ,,,51.57,66.46,3 RC,400,Chloride; blood ,,,19.53,25.17,3 RC,400,Chloride; other source ,,,20.91,26.95,3 RC,400,Chloride; urine ,,,23.69,30.52,3 RC,400,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,400,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,400,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,400,Cholinesterase; RBC ,,,40.44,52.12,3 RC,400,Cholinesterase; serum ,,,32.04,41.29,3 RC,400,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,400,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,400,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,400,Chromium ,,,83.66,107.81,3 RC,400,Chromogenic substrate assay ,,,48.8,62.89,3 RC,400,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,400,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,400,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,400,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,400,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,400,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,400,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,400,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,400,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,400,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,400,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,400,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,400,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,400,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,400,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,400,Citrate ,,,114.31,147.31,3 RC,400,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,400,Clot retraction ,,,66.9,86.21,3 RC,400,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,400,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,400,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,400,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,400,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,400,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,400,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,400,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,400,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,400,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,400,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,400,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,400,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,400,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,400,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,400,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,400,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,400,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,400,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,400,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,400,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,400,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,400,Clozapine ,,,82.23,105.96,3 RC,400,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,400,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,400,Coagulation time; activated ,,,18.14,23.38,3 RC,400,Coagulation time; other methods ,,,18.14,23.38,3 RC,400,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,400,Cocaine ,,,98.98,127.56,3 RC,400,Cold agglutinin; screen ,,,33.47,43.13,3 RC,400,Cold agglutinin; titer ,,,33.47,43.13,3 RC,400,"Collagen cross links, any method ",,,76.68,98.82,3 RC,400,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,400,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,400,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,400,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,400,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,400,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,400,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,400,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,400,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,400,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,400,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,400,"Complement; antigen, each component ",,,48.8,62.89,3 RC,400,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,400,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,400,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,400,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,400,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,400,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,400,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,400,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,400,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,400,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,400,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,400,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,400,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,400,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,400,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,400,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,400,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,400,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,400,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,400,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,400,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,400,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,400,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,400,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,400,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,400,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,400,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,400,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,400,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,400,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,400,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,400,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,400,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,400,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,400,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,400,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,400,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,400,Copper ,,,51.57,66.46,3 RC,400,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,400,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,400,Corticosterone ,,,92.01,118.58,3 RC,400,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,400,Cortisol; free ,,,68.28,88.0,3 RC,400,Cortisol; total ,,,66.9,86.21,3 RC,400,Creatine ,,,19.53,25.17,3 RC,400,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,400,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,400,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,400,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,400,Creatinine; blood ,,,20.91,26.95,3 RC,400,Creatinine; clearance ,,,39.01,50.28,3 RC,400,Creatinine; other source ,,,20.91,26.95,3 RC,400,Cryofibrinogen ,,,58.54,75.44,3 RC,400,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,400,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,400,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,400,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,400,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,400,Cryopreservation; sperm ,,,442.57,570.33,3 RC,400,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,400,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,400,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,400,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,400,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,400,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,400,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,400,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,400,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,400,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,400,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,400,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,400,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,400,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,400,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,400,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,400,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,400,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,400,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,400,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,400,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,400,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,400,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,400,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,400,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,400,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,400,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,400,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,400,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,400,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,400,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,400,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,400,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,400,"Culture, typing; other methods ",,,32.04,41.29,3 RC,400,Cyanide ,,,79.46,102.39,3 RC,400,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,400,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,400,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,400,Cyclosporine ,,,73.87,95.19,3 RC,400,Cystatin C ,,,76.68,98.82,3 RC,400,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,400,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,400,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,400,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,400,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,400,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,400,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,400,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,400,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,400,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,400,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,400,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,400,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,400,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,400,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,400,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,400,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,400,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,400,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,400,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,400,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,400,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,400,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,400,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,400,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,400,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,400,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,400,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,400,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,400,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,400,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,400,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,400,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,400,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,400,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,400,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,400,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,400,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,400,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,400,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,400,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,400,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,400,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,400,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,400,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,400,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,400,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,400,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,400,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,400,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,400,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,400,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,400,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,400,Dibucaine number ,,,50.18,64.67,3 RC,400,Digoxin; free ,,,54.38,70.08,3 RC,400,Digoxin; total ,,,54.38,70.08,3 RC,400,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,400,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,400,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,400,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,400,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,400,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,400,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,400,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,400,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,400,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,400,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,400,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,400,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,400,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,400,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,400,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,400,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,400,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,400,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,400,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,400,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,400,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,400,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,400,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,400,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,400,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,400,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,400,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,400,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,400,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,400,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,400,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,400,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,400,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,400,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,400,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,400,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,400,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,400,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,400,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,400,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,400,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,400,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,400,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,400,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,400,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,400,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,400,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,400,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,400,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,400,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,400,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,400,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,400,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,400,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,400,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,400,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,400,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,400,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,400,Erythropoietin ,,,76.68,98.82,3 RC,400,Esophageal motility ,,,214.04,214.04,1 RC,400,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,400,Estradiol; total ,,,114.31,147.31,3 RC,400,Estriol ,,,98.98,127.56,3 RC,400,Estrogens; fractionated ,,,132.41,170.64,3 RC,400,Estrogens; total ,,,89.2,114.95,3 RC,400,Estrone ,,,103.14,132.92,3 RC,400,Ethosuximide ,,,66.9,86.21,3 RC,400,Ethylene glycol ,,,61.31,79.01,3 RC,400,Etiocholanolone ,,,107.34,138.33,3 RC,400,Euglobulin lysis ,,,34.86,44.92,3 RC,400,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,400,Everolimus ,,,57.16,73.66,3 RC,400,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,400,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,400,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,400,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,400,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,400,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,400,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,400,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,400,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,400,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,400,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,400,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,400,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,400,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,400,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,400,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,400,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,400,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,400,Factor inhibitor test ,,,52.96,68.24,3 RC,400,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,400,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,400,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,400,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,400,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,400,Felbamate ,,,76.68,98.82,3 RC,400,Fentanyl ,,,98.98,127.56,3 RC,400,Fern test ,,,40.44,52.12,3 RC,400,Ferritin ,,,55.77,71.87,3 RC,400,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,400,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,400,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,400,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,400,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,400,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,400,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,400,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,400,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,400,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,400,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,400,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,400,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,400,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,400,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,400,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,400,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,400,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,400,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,400,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,400,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,400,Fibrinogen; activity ,,,40.44,52.12,3 RC,400,Fibrinogen; antigen ,,,59.93,77.23,3 RC,400,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,400,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,400,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,400,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,400,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,400,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,400,Flecainide ,,,76.68,98.82,3 RC,400,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,400,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,400,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,400,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,400,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,400,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,400,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,400,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,400,Fluoride ,,,76.68,98.82,3 RC,400,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,400,Folic acid; RBC ,,,72.48,93.41,3 RC,400,Folic acid; serum ,,,59.93,77.23,3 RC,400,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,400,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,400,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,400,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,400,"Fructose, semen ",,,71.1,91.62,3 RC,400,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,400,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,400,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,400,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,400,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,400,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,400,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,400,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,400,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,400,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,400,"Galactokinase, RBC ",,,87.81,113.16,3 RC,400,Galactose ,,,45.98,59.26,3 RC,400,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,400,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,400,Galectin-3 ,,,182.6,235.31,3 RC,400,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,400,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,400,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,400,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,400,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,400,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,400,"Gases, blood, pH only ",,,44.6,57.47,3 RC,400,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,400,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,400,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,400,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,400,Gastric mucosa imaging ,,,205.51,205.51,1 RC,400,Gastrin ,,,72.48,93.41,3 RC,400,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,400,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,400,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,400,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,400,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,400,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,400,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,400,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,400,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,400,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,400,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,400,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,400,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,400,Gentamicin ,,,66.9,86.21,3 RC,400,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,400,Glucagon ,,,58.54,75.44,3 RC,400,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,400,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,400,Glucagon tolerance test ,,,72.48,93.41,3 RC,400,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,400,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,400,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,400,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,400,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,400,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,400,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,400,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,400,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,400,"Glucosidase, beta ",,,87.81,113.16,3 RC,400,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,400,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,400,Glutathione ,,,64.13,82.64,3 RC,400,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,400,Glycated protein ,,,68.28,88.0,3 RC,400,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,400,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,400,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,400,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,400,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,400,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,400,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,400,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,400,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,400,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,400,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,400,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,400,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,400,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,400,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,400,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,400,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,400,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,400,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,400,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,400,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,400,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,400,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,400,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,400,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,400,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,400,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,400,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,400,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,400,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,400,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,400,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,400,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,400,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,400,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,400,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,400,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,400,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,400,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,400,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,400,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,400,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,Haloperidol ,,,65.51,84.43,3 RC,400,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,400,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,400,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,400,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,400,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,400,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,400,Heinz bodies; direct ,,,16.71,21.54,3 RC,400,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,400,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,400,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,400,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,400,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,400,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,400,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,400,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,400,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,400,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,400,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,400,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,400,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,400,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,400,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,400,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,400,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,400,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,400,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,400,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,400,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,400,Hemoglobin; plasma ,,,30.66,39.51,3 RC,400,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,400,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,400,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,400,Hemoglobin; urine ,,,16.71,21.54,3 RC,400,"Hemolysin, acid ",,,36.24,46.7,3 RC,400,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,400,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,400,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,400,Heparin assay ,,,54.38,70.08,3 RC,400,Heparin neutralization ,,,48.8,62.89,3 RC,400,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,400,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,400,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,400,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,400,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,400,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,400,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,400,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,400,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,400,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,400,Hepatitis C antibody; ,,,58.54,75.44,3 RC,400,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,400,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,400,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,400,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,400,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,400,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,400,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,400,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,400,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,400,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,400,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,400,Heroin metabolite ,,,98.98,127.56,3 RC,400,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,400,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,400,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,400,Histamine ,,,121.28,156.3,3 RC,400,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,400,Homocysteine ,,,73.87,95.19,3 RC,400,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,400,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,400,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,400,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,400,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,400,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,400,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,400,Hydroxychloroquine ,,,76.68,98.82,3 RC,400,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,400,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,400,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,400,Hydroxyproline; free ,,,93.4,120.36,3 RC,400,Hydroxyproline; total ,,,100.37,129.34,3 RC,400,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,400,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,400,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,400,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,400,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,400,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,400,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,400,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,400,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,400,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,400,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,400,Immune complex assay ,,,100.37,129.34,3 RC,400,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,400,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,400,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,400,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,400,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,400,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,400,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,400,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,400,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,400,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,400,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,400,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,400,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,400,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,400,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,400,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,400,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,400,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,400,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,400,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,400,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,400,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,400,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,400,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,400,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,400,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,400,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,400,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,400,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,400,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,400,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,400,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,400,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,400,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,400,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,400,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,400,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,400,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,400,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,400,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,400,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,400,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,400,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,400,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,400,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,400,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,400,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,400,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,400,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,400,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,400,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,400,Infliximab ,,,158.91,204.79,3 RC,400,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,400,Inhibin A ,,,64.13,82.64,3 RC,400,Insemination of oocytes ,,,442.57,570.33,3 RC,400,Insulin antibodies ,,,87.81,113.16,3 RC,400,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,400,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,400,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,400,Insulin; free ,,,52.96,68.24,3 RC,400,Insulin; total ,,,47.41,61.1,3 RC,400,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,400,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,400,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,400,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,400,Intrinsic factor ,,,80.84,104.18,3 RC,400,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,400,Iron ,,,26.5,34.15,3 RC,400,Iron binding capacity ,,,36.24,46.7,3 RC,400,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,400,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,400,Islet cell antibody ,,,97.55,125.72,3 RC,400,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,400,Itraconazole ,,,111.5,143.69,3 RC,400,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,400,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,400,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,400,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,400,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,400,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,400,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,400,Ketamine and norketamine ,,,98.98,127.56,3 RC,400,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,400,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,400,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,400,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,400,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,400,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,400,Kidney imaging morphology; ,,,172.11,172.11,1 RC,400,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,400,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,400,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,400,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,400,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,400,Lacosamide ,,,111.5,143.69,3 RC,400,Lactate (lactic acid) ,,,47.41,61.1,3 RC,400,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,400,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,400,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,400,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,400,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,400,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,400,Lamotrigine ,,,54.38,70.08,3 RC,400,Lead ,,,50.18,64.67,3 RC,400,Leflunomide ,,,158.91,204.79,3 RC,400,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,400,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,400,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,400,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,400,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,400,Leukocyte transfusion ,,,305.26,393.39,3 RC,400,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,400,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,400,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,400,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,400,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,400,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,400,Levetiracetam ,,,54.38,70.08,3 RC,400,Lidocaine ,,,59.93,77.23,3 RC,400,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,400,Lipase ,,,27.89,35.94,3 RC,400,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,400,Lipoprotein (a) ,,,58.54,75.44,3 RC,400,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,400,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,400,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,400,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,400,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,400,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,400,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,400,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,400,Lithium ,,,27.89,35.94,3 RC,400,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,400,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,400,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,400,Liver imaging; static only ,,,191.2,191.2,1 RC,400,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,400,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,400,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,400,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,400,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,400,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,400,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,400,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,400,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,400,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,400,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,400,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,400,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,400,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,400,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,400,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,400,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,400,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,400,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,400,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,400,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,400,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,400,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,400,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,400,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,400,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,400,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,400,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,400,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,400,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,400,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,400,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,400,Magnesium ,,,27.89,35.94,3 RC,400,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,400,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,400,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,400,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,400,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,400,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,400,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,400,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,400,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,400,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,400,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,400,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,400,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,400,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,400,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,400,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,400,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,400,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,400,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,400,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,400,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,400,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,400,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,400,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,400,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,400,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,400,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,400,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,400,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,400,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,400,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,400,Malate dehydrogenase ,,,30.66,39.51,3 RC,400,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,400,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,400,Manganese ,,,110.11,141.9,3 RC,400,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,400,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,400,"Meat fibers, feces ",,,19.53,25.17,3 RC,400,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,400,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,400,"Mercury, quantitative ",,,66.9,86.21,3 RC,400,Metanephrines ,,,69.71,89.84,3 RC,400,Methadone ,,,98.98,127.56,3 RC,400,Methemalbumin ,,,44.6,57.47,3 RC,400,Methotrexate ,,,158.91,204.79,3 RC,400,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,400,Methylphenidate ,,,98.98,127.56,3 RC,400,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,400,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,400,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,400,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,400,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,400,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,400,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,400,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,400,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,400,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,400,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,400,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,400,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,400,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,400,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,400,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,400,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,400,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,400,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,400,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,400,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,400,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,400,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,400,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,400,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,400,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,400,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,400,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,400,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,400,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,400,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,400,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,400,Muramidase ,,,76.68,98.82,3 RC,400,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,400,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,400,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,400,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,400,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,400,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,400,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,400,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,400,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,400,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,400,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,400,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,400,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,400,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,400,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,400,Myoglobin ,,,52.96,68.24,3 RC,400,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,400,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,400,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,400,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,400,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,400,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,400,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,400,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,400,Natriuretic peptide ,,,161.68,208.36,3 RC,400,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,400,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,400,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,400,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,400,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,400,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,400,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,400,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,400,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,400,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,400,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,400,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,400,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,400,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,400,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,400,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,400,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,400,Nerve teasing preparations ,,,499.29,643.43,3 RC,400,"Neutralization test, viral ",,,69.71,89.84,3 RC,400,Nickel ,,,100.37,129.34,3 RC,400,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,400,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,400,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,400,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,400,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,400,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,400,Nucleotidase 5'- ,,,45.98,59.26,3 RC,400,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,400,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,400,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,400,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,400,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,400,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,400,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,400,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,400,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,400,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,400,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,400,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,400,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,400,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,400,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,400,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,400,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,400,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,400,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,400,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,400,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,400,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,400,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,400,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,400,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,400,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,400,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,400,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,400,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,400,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,400,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,400,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,400,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,400,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,400,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,400,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,400,"Opiates, 1 or more ",,,98.98,127.56,3 RC,400,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,400,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,400,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,400,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,400,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,400,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,400,Osmolality; blood ,,,27.89,35.94,3 RC,400,Osmolality; urine ,,,27.89,35.94,3 RC,400,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,400,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,400,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,400,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,400,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,400,Oxalate ,,,59.93,77.23,3 RC,400,Oxcarbazepine ,,,54.38,70.08,3 RC,400,Oxycodone ,,,98.98,127.56,3 RC,400,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,400,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,400,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,400,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,400,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,400,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,400,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,400,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,400,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,400,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,400,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,400,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,400,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,400,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,400,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,400,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,400,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,400,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,400,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,400,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,400,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,400,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,400,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,400,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,400,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,400,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,400,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,400,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,400,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,400,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,400,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,400,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,400,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,400,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,400,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,400,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,400,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,400,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,400,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,400,Phenobarbital ,,,62.74,80.85,3 RC,400,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,400,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,400,Phenytoin; free ,,,57.16,73.66,3 RC,400,Phenytoin; total ,,,54.38,70.08,3 RC,400,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,400,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,400,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,400,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,400,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,400,Phosphatidylglycerol ,,,68.28,88.0,3 RC,400,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,400,Phosphohexose isomerase ,,,44.6,57.47,3 RC,400,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,400,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,400,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,400,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,400,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,400,Pinworm examinations ,,,18.14,23.38,3 RC,400,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,400,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,400,Platelet survival study ,,,126.1,126.1,1 RC,400,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,400,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,400,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,400,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,400,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,400,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,400,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,400,Posaconazole ,,,111.5,143.69,3 RC,400,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,400,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,400,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,400,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,400,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,400,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,400,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,400,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,400,Potassium; urine ,,,19.53,25.17,3 RC,400,Prealbumin ,,,59.93,77.23,3 RC,400,Pregabalin ,,,98.98,127.56,3 RC,400,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,400,Pregnanediol ,,,87.81,113.16,3 RC,400,Pregnanetriol ,,,86.43,111.38,3 RC,400,Pregnenolone ,,,85.04,109.59,3 RC,400,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,400,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,400,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,400,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,400,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,400,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,400,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,400,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,400,Primidone ,,,68.28,88.0,3 RC,400,Procainamide; ,,,246.72,317.95,3 RC,400,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,400,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,400,Progesterone ,,,86.43,111.38,3 RC,400,Proinsulin ,,,110.11,141.9,3 RC,400,Prolactin ,,,79.46,102.39,3 RC,400,Propoxyphene ,,,98.98,127.56,3 RC,400,"Prostaglandin, each ",,,171.47,220.97,3 RC,400,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,400,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,400,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,400,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,400,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,400,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,400,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,400,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,400,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,400,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,400,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,400,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,400,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,400,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,400,Prothrombin time; ,,,18.14,23.38,3 RC,400,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,400,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,400,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,400,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,400,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,400,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,400,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,400,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,400,Pyruvate ,,,59.93,77.23,3 RC,400,Pyruvate kinase ,,,39.01,50.28,3 RC,400,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,400,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,400,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,400,Quinidine ,,,59.93,77.23,3 RC,400,Quinine ,,,47.41,61.1,3 RC,400,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,400,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,400,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,400,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,400,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,400,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,400,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,400,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,400,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,400,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,400,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,400,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,400,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,400,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,400,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,400,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,400,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,400,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,400,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,400,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,400,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,400,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,400,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,400,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,400,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,400,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,400,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,400,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,400,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,400,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,400,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,400,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,400,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,400,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,400,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,400,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,400,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,400,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,400,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,400,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,400,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,400,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,400,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,400,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,400,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,400,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,400,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,400,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,400,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,400,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,400,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,400,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,400,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,400,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,400,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,400,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,400,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,400,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,400,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,400,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,400,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,400,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,400,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,400,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,400,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,400,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,400,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,400,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,400,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,400,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,400,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,400,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,400,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,400,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,400,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,400,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,400,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,400,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,400,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,400,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,400,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,400,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,400,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,400,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,400,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,400,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,400,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,400,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,400,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,400,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,400,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,400,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,400,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,400,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,400,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,400,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,400,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,400,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,400,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,400,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,400,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,400,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,400,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,400,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,400,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,400,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,400,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,400,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,400,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,400,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,400,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,400,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,400,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,400,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,400,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,400,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,400,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,400,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,400,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,400,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,400,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,400,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,400,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,400,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,400,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,400,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,400,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,400,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,400,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,400,Receptor assay; estrogen ,,,361.04,465.26,3 RC,400,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,400,Receptor assay; progesterone ,,,266.25,343.11,3 RC,400,Red cell survival study ,,,126.1,126.1,1 RC,400,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,400,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,400,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,400,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,400,Renin ,,,90.63,116.79,3 RC,400,Reptilase test ,,,40.44,52.12,3 RC,400,Reticulated platelet assay ,,,146.35,188.6,3 RC,400,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,400,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,400,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,400,Rufinamide ,,,111.5,143.69,3 RC,400,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,400,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,400,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,400,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,400,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,400,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,400,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,400,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,400,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,400,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,400,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,400,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,400,Salicylate ,,,76.68,98.82,3 RC,400,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,400,Salivary gland function study ,,,104.3,104.3,1 RC,400,Salivary gland imaging; ,,,175.52,175.52,1 RC,400,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,400,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,400,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,400,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,400,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,400,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,400,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,400,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,400,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,400,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,400,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,400,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,400,Selenium ,,,104.53,134.7,3 RC,400,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,400,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,400,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,400,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,400,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,400,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,400,Serotonin ,,,126.87,163.49,3 RC,400,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,400,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,400,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,400,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,400,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,400,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,400,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,400,Sialic acid ,,,55.77,71.87,3 RC,400,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,400,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,400,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,400,Silica ,,,103.14,132.92,3 RC,400,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,400,Sirolimus ,,,57.16,73.66,3 RC,400,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,400,Skin test; candida ,,,79.46,102.39,3 RC,400,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,400,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,400,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,400,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,400,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,400,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,400,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,400,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,400,Sodium; other source ,,,19.53,25.17,3 RC,400,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,400,Sodium; urine ,,,20.91,26.95,3 RC,400,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,400,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,400,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,400,Somatomedin ,,,87.81,113.16,3 RC,400,Somatostatin ,,,75.26,96.98,3 RC,400,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,400,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,400,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,400,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,400,Specific gravity (except urine) ,,,13.94,17.97,3 RC,400,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,400,Sperm antibodies ,,,43.21,55.69,3 RC,400,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,400,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,400,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,400,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,400,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,400,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,400,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,400,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,400,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,400,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,400,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,400,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,400,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,400,"Stimulants, synthetic ",,,98.98,127.56,3 RC,400,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,400,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,400,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,400,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,400,"Streptokinase, antibody ",,,51.57,66.46,3 RC,400,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,400,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,400,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,400,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,400,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,400,"Sulfate, urine ",,,22.3,28.74,3 RC,400,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,400,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,400,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,400,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,400,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,400,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,400,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,400,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,400,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,400,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,400,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,400,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,400,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,400,T cells; total count ,,,154.71,199.37,3 RC,400,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,400,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,400,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,400,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,400,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,400,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,400,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,400,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,400,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,400,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,400,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,400,Tacrolimus ,,,57.16,73.66,3 RC,400,Tapentadol ,,,98.98,127.56,3 RC,400,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,400,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,400,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,400,Testosterone; free ,,,104.53,134.7,3 RC,400,Testosterone; total ,,,105.96,136.54,3 RC,400,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,400,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,400,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,400,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,400,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,400,Theophylline ,,,58.54,75.44,3 RC,400,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,400,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,400,Thiocyanate ,,,47.41,61.1,3 RC,400,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,400,Thrombin time; plasma ,,,23.69,30.52,3 RC,400,Thrombin time; titer ,,,27.89,35.94,3 RC,400,Thrombomodulin ,,,71.1,91.62,3 RC,400,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,400,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,400,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,400,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,400,Thyroglobulin ,,,65.51,84.43,3 RC,400,Thyroglobulin antibody ,,,65.51,84.43,3 RC,400,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,400,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,400,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,400,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,400,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,400,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,400,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,400,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,400,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,400,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,400,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,400,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,400,Thyroxine; free ,,,37.63,48.49,3 RC,400,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,400,Thyroxine; total ,,,27.89,35.94,3 RC,400,Tiagabine ,,,111.5,143.69,3 RC,400,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,400,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,400,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,400,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,400,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,400,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,400,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,400,Tobramycin ,,,66.9,86.21,3 RC,400,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,400,Topiramate ,,,48.8,62.89,3 RC,400,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,400,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,400,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,400,Tramadol ,,,98.98,127.56,3 RC,400,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,400,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,400,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,400,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,400,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,400,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,400,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,400,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,400,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,400,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,400,Transferrin ,,,52.96,68.24,3 RC,400,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,400,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,400,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,400,Triglycerides ,,,23.69,30.52,3 RC,400,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,400,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,400,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,400,"Troponin, qualitative ",,,41.83,53.9,3 RC,400,"Troponin, quantitative ",,,51.57,66.46,3 RC,400,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,400,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,400,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,400,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,400,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,400,Tyrosine ,,,43.21,55.69,3 RC,400,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,400,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,400,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,400,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,400,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,400,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,400,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,400,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,400,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,400,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,400,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,400,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,400,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,400,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,400,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,400,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,400,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,400,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,400,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,400,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,400,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,400,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,400,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,400,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,400,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,400,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,400,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,400,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,400,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,400,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,400,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,400,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,400,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,400,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,400,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,400,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,400,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,400,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,400,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,400,Unlisted immunology procedure ,,,99.55,128.28,3 RC,400,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,400,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,400,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,400,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,400,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,400,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,400,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,400,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,400,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,400,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,400,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,400,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,400,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,400,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,400,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,400,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,400,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,400,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,400,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,400,Uric acid; blood ,,,18.14,23.38,3 RC,400,Uric acid; other source ,,,20.91,26.95,3 RC,400,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,400,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,400,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,400,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,400,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,400,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,400,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,400,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,400,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,400,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,400,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,400,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,400,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,400,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,400,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,400,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,400,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,400,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,400,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,400,Vancomycin ,,,55.77,71.87,3 RC,400,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,400,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,400,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,400,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,400,Vedolizumab ,,,158.91,204.79,3 RC,400,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,400,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,400,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,400,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,400,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,400,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,400,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,400,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,400,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,400,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,400,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,400,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,400,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,400,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,400,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,400,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,400,Very long chain fatty acids ,,,80.84,104.18,3 RC,400,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,400,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,400,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,400,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,400,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,400,Viscosity ,,,47.41,61.1,3 RC,400,Vitamin A ,,,47.41,61.1,3 RC,400,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,400,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,400,Vitamin K ,,,55.77,71.87,3 RC,400,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,400,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,400,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,400,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,400,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,400,Voriconazole ,,,111.5,143.69,3 RC,400,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,400,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,400,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,400,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,400,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,400,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,400,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,400,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,400,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,400,Zinc ,,,47.41,61.1,3 RC,400,Zonisamide ,,,54.38,70.08,3 RC,400,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,400,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,400,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,401, Other Imaging Services Diagnostic Mammography ,,,198.0,198.0,1 RC,401,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,401,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,401,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,401,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,401,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,401,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,401,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,401,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,401,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,401,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,401,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,401,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,401,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,401,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,401,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,401,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,401,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,401,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,401,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,401,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,401,Bone age studies ,,,26.58,26.58,1 RC,401,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,401,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,401,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,401,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,401,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,401,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,401,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,401,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,401,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,401,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,401,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,401,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,401,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,401,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,401,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,401,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,401,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,401,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,401,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,401,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,401,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,401,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,401,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,401,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,401,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,401,Cardiac shunt detection ,,,186.76,186.76,1 RC,401,Cardiokymography ,,,20.04,20.04,1 RC,401,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,401,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,401,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,401,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,401,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,401,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,401,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,401,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,401,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,401,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,401,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,401,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,401,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,401,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,401,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,401,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,401,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,401,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,401,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,401,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,401,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,401,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,401,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,401,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,401,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,401,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,401,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,401,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,401,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,401,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,401,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,401,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,401,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,401,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,401,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,401,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,401,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,401,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,401,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,401,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,401,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,665.0,4 RC,401,Diagnostic digital breast tomosynthesis; bilateral ,,,516.0,665.0,3 RC,401,Diagnostic digital breast tomosynthesis; unilateral ,,,516.0,665.0,3 RC,401,"Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral ",,,516.0,665.0,3 RC,401,"Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral ",,,516.0,665.0,3 RC,401,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,401,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,401,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,401,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,401,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,401,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,401,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,401,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,401,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,401,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,401,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,401,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,401,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,401,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,401,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,401,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,401,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,401,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,401,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,401,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,401,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,401,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,401,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,401,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,401,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,401,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,401,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,401,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,401,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,401,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,401,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,401,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,401,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,401,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,401,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,401,Esophageal motility ,,,214.04,214.04,1 RC,401,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,401,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,401,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,401,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,401,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,401,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,401,Gastric mucosa imaging ,,,205.51,205.51,1 RC,401,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,401,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,401,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,401,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,401,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,401,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,401,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,401,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,401,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,401,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,401,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,401,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,401,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,401,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,401,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,401,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,401,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,401,Kidney imaging morphology; ,,,172.11,172.11,1 RC,401,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,401,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,401,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,401,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,401,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,401,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,401,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,401,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,401,Liver imaging; static only ,,,191.2,191.2,1 RC,401,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,401,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,401,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,401,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,401,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,401,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,401,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,401,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,401,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,401,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,401,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,401,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,401,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,401,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,401,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,401,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,401,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,401,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,401,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,401,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,401,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,401,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,401,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,401,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,401,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,401,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,401,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,401,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,401,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,401,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,401,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,401,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,401,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,401,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,401,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,401,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,401,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,401,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,401,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,401,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,401,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,401,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,401,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,401,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,401,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,401,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,401,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,401,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,401,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,401,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,401,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,401,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,401,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,401,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,401,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,401,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,401,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,401,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,401,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,401,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,401,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,401,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,401,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,401,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,401,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,401,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,401,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,401,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,401,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,401,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,401,Platelet survival study ,,,126.1,126.1,1 RC,401,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,401,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,401,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,401,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,401,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,401,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,401,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,401,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,401,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,401,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,401,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,401,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,401,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,401,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,401,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,401,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,401,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,401,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,401,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,401,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,401,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,401,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,401,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,401,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,401,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,401,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,401,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,401,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,401,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,401,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,401,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,401,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,401,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,401,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,401,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,401,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,401,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,401,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,401,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,401,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,401,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,401,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,401,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,401,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,401,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,401,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,401,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,401,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,401,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,401,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,401,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,401,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,401,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,401,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,401,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,401,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,401,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,401,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,401,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,401,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,401,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,401,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,401,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,401,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,401,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,401,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,401,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,401,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,401,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,401,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,401,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,401,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,401,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,401,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,401,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,401,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,401,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,401,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,401,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,401,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,401,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,401,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,401,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,401,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,401,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,401,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,401,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,401,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,401,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,401,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,401,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,401,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,401,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,401,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,401,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,401,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,401,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,401,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,401,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,401,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,401,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,401,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,401,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,401,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,401,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,401,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,401,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,401,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,401,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,401,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,401,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,401,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,401,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,401,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,401,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,401,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,401,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,401,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,401,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,401,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,401,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,401,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,401,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,401,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,401,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,401,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,401,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,401,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,401,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,401,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,401,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,401,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,401,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,401,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,401,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,401,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,401,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,401,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,401,Red cell survival study ,,,126.1,126.1,1 RC,401,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,401,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,401,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,401,Salivary gland function study ,,,104.3,104.3,1 RC,401,Salivary gland imaging; ,,,175.52,175.52,1 RC,401,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,401,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,665.0,4 RC,401,"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed ",,,516.0,665.0,3 RC,401,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,401,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,401,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,401,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,401,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,401,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,401,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,401,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,401,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,401,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,401,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,401,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,401,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,401,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,401,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,401,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,401,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,401,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,401,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,401,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,401,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,401,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,401,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,401,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,401,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,401,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,401,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,401,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,401,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,401,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,401,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,401,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,401,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,401,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,401,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,401,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,401,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,401,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,401,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,401,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,401,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,401,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,401,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,401,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,401,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,401,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,401,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,401,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,401,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,401,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,401,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,401,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,401,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,401,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,401,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,401,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,401,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,401,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,401,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,401,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,401,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,401,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,401,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,401,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,401,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,401,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,401,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,401,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,401,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,401,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,401,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,401,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,401,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,401,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,401,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,401,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,401,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,401,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,401,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,401,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,401,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,401,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,401,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,401,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,401,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,402, Other Imaging Services Ultrasound ,,,221.0,835.0,4 RC,402,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,402,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,402,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,402,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,402,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,402,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,402,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,402,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,402,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,402,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,402,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,402,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,402,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,402,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,402,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,402,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,402,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,402,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,402,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,402,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,402,Bone age studies ,,,26.58,26.58,1 RC,402,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,402,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,402,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,402,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,402,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,402,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,402,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,402,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,402,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,402,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,402,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,402,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,402,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,402,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,402,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,402,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,402,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,402,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,402,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,402,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,402,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,402,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,402,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,402,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,402,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,402,Cardiac shunt detection ,,,186.76,186.76,1 RC,402,Cardiokymography ,,,20.04,20.04,1 RC,402,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,402,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,402,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,402,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,402,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,402,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,402,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,402,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,402,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,402,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,402,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,402,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,402,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,402,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,402,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,402,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,402,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,402,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,402,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,402,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,402,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,402,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,402,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,402,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,402,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,402,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,402,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,402,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,402,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,402,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,402,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,402,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,402,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,402,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,402,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,402,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,402,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,402,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,402,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,402,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,402,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,402,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,402,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,402,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,402,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,402,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,402,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,402,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,402,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,402,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,402,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,402,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,402,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,402,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,402,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,402,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,402,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,402,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,402,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,402,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,402,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,402,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,402,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,402,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,402,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,402,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,402,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,402,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,402,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,402,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,402,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,402,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,402,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,402,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,402,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,402,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,402,Esophageal motility ,,,214.04,214.04,1 RC,402,Fetal biophysical profile; with non-stress testing ,4989.91,4989.91,109.02,109.02,1 RC,402,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,402,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,402,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,402,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,402,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,402,Gastric mucosa imaging ,,,205.51,205.51,1 RC,402,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,402,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,402,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,402,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,402,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,402,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,402,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,402,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,402,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,402,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,402,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,402,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,402,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,402,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,402,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,402,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,402,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,402,Kidney imaging morphology; ,,,172.11,172.11,1 RC,402,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,402,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,402,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,402,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,402,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,402,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,402,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,402,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,402,Liver imaging; static only ,,,191.2,191.2,1 RC,402,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,402,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,402,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,402,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,402,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,402,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,402,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,402,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,402,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,402,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,402,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,402,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,402,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,402,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,402,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,402,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,402,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,402,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,402,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,402,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,402,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,402,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,402,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,402,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,402,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,402,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,402,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,402,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,402,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,402,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,402,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,402,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,402,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,402,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,402,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,402,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,402,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,402,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,402,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,402,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,402,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,402,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,402,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,402,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,402,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,402,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,402,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,402,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,402,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,402,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,402,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,402,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,402,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,402,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,402,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,402,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,402,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,402,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,402,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,402,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,402,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,402,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,402,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,402,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,402,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,402,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,402,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,402,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,402,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,402,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,402,Platelet survival study ,,,126.1,126.1,1 RC,402,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,402,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,402,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,402,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,402,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,402,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,402,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,402,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,402,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,402,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,402,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,402,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,402,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,402,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,402,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,402,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,402,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,402,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,402,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,402,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,402,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,402,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,402,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,402,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,402,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,402,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,402,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,402,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,402,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,402,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,402,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,402,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,402,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,402,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,402,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,402,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,402,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,402,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,402,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,402,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,402,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,402,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,402,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,402,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,402,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,402,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,402,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,402,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,402,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,402,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,402,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,402,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,402,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,402,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,402,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,402,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,402,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,402,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,402,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,402,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,402,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,402,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,402,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,402,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,402,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,402,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,402,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,402,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,402,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,402,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,402,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,402,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,402,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,402,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,402,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,402,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,402,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,402,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,402,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,402,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,402,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,402,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,402,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,402,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,402,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,402,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,402,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,402,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,402,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,402,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,402,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,402,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,402,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,402,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,402,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,402,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,402,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,402,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,402,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,402,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,402,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,402,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,402,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,402,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,402,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,402,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,402,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,402,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,402,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,402,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,402,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,402,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,402,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,402,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,402,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,402,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,402,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,402,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,402,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,402,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,402,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,402,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,402,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,402,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,402,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,402,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,402,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,402,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,402,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,402,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,402,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,402,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,402,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,402,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,402,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,402,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,402,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,402,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,402,Red cell survival study ,,,126.1,126.1,1 RC,402,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,402,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,402,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,402,Salivary gland function study ,,,104.3,104.3,1 RC,402,Salivary gland imaging; ,,,175.52,175.52,1 RC,402,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,402,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,402,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,402,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,402,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,402,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,402,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,402,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,402,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,402,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,402,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,402,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,402,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,402,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,402,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,402,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,402,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,402,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,402,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,402,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,402,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,402,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,402,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,402,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,402,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,402,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,402,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,402,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,402,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,402,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,402,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,402,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,402,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,402,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,402,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",3435.78,3435.78,98.21,98.21,1 RC,402,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,402,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,402,"Ultrasound, elastography; parenchyma (eg, organ) ",697.88,697.88,106.68,106.68,1 RC,402,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,402,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,402,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,402,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,402,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,402,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",3071.36,3071.36,62.37,62.37,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,402,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,402,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,402,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,402,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,402,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,402,"Ultrasound, spinal canal and contents ",4966.09,4966.09,109.02,109.02,1 RC,402,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,402,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,402,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,402,"Ultrasound, transrectal; ",2252.01,2252.01,109.02,109.02,1 RC,402,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,402,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,402,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,402,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,402,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,402,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,402,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,402,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,402,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,402,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,402,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,402,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,402,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,402,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,402,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,402,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,402,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,402,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,402,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,402,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,402,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,402,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,402,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,402,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,402,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,402,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,402,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,402,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,402,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,402,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,402,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,402,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,402,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,403, Other Imaging Services Screening Mammography ,,,198.0,198.0,1 RC,403,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,403,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,403,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,403,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,403,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,403,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,403,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,403,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,403,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,403,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,403,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,403,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,403,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,403,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,403,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,403,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,403,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,403,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,403,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,403,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,403,Bone age studies ,,,26.58,26.58,1 RC,403,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,403,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,403,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,403,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,403,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,403,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,403,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,403,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,403,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,403,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,403,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,403,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,403,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,403,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,403,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,403,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,403,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,403,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,403,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,403,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,403,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,403,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,403,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,403,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,403,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,403,Cardiac shunt detection ,,,186.76,186.76,1 RC,403,Cardiokymography ,,,20.04,20.04,1 RC,403,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,403,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,403,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,403,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,403,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,403,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,403,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,403,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,403,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,403,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,403,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,403,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,403,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,403,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,403,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,403,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,403,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,403,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,403,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,403,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,403,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,403,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,403,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,403,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,403,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,403,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,403,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,403,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,403,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,403,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,403,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,403,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,403,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,403,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,403,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,403,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,403,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,403,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,403,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,403,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,403,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,665.0,4 RC,403,Diagnostic digital breast tomosynthesis; bilateral ,,,516.0,665.0,3 RC,403,Diagnostic digital breast tomosynthesis; unilateral ,,,516.0,665.0,3 RC,403,"Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral ",,,516.0,665.0,3 RC,403,"Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral ",,,516.0,665.0,3 RC,403,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,403,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,403,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,403,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,403,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,403,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,403,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,403,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,403,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,403,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,403,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,403,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,403,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,403,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,403,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,403,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,403,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,403,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,403,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,403,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,403,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,403,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,403,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,403,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,403,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,403,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,403,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,403,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,403,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,403,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,403,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,403,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,403,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,403,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,403,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,403,Esophageal motility ,,,214.04,214.04,1 RC,403,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,403,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,403,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,403,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,403,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,403,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,403,Gastric mucosa imaging ,,,205.51,205.51,1 RC,403,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,403,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,403,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,403,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,403,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,403,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,403,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,403,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,403,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,403,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,403,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,403,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,403,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,403,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,403,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,403,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,403,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,403,Kidney imaging morphology; ,,,172.11,172.11,1 RC,403,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,403,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,403,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,403,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,403,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,403,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,403,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,403,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,403,Liver imaging; static only ,,,191.2,191.2,1 RC,403,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,403,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,403,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,403,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,403,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,403,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,403,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,403,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,403,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,403,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,403,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,403,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,403,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,403,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,403,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,403,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,403,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,403,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,403,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,403,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,403,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,403,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,403,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,403,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,403,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,403,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,403,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,403,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,403,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,403,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,403,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,403,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,403,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,403,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,403,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,403,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,403,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,403,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,403,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,403,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,403,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,403,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,403,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,403,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,403,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,403,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,403,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,403,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,403,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,403,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,403,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,403,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,403,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,403,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,403,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,403,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,403,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,403,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,403,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,403,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,403,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,403,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,403,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,403,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,403,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,403,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,403,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,403,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,403,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,403,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,403,Platelet survival study ,,,126.1,126.1,1 RC,403,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,403,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,403,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,403,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,403,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,403,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,403,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,403,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,403,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,403,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,403,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,403,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,403,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,403,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,403,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,403,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,403,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,403,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,403,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,403,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,403,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,403,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,403,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,403,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,403,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,403,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,403,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,403,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,403,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,403,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,403,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,403,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,403,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,403,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,403,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,403,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,403,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,403,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,403,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,403,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,403,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,403,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,403,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,403,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,403,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,403,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,403,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,403,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,403,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,403,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,403,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,403,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,403,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,403,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,403,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,403,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,403,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,403,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,403,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,403,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,403,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,403,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,403,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,403,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,403,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,403,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,403,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,403,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,403,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,403,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,403,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,403,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,403,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,403,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,403,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,403,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,403,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,403,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,403,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,403,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,403,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,403,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,403,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,403,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,403,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,403,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,403,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,403,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,403,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,403,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,403,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,403,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,403,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,403,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,403,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,403,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,403,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,403,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,403,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,403,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,403,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,403,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,403,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,403,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,403,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,403,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,403,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,403,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,403,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,403,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,403,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,403,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,403,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,403,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,403,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,403,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,403,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,403,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,403,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,403,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,403,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,403,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,403,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,403,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,403,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,403,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,403,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,403,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,403,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,403,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,403,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,403,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,403,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,403,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,403,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,403,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,403,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,403,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,403,Red cell survival study ,,,126.1,126.1,1 RC,403,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,403,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,403,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,403,Salivary gland function study ,,,104.3,104.3,1 RC,403,Salivary gland imaging; ,,,175.52,175.52,1 RC,403,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,403,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,665.0,4 RC,403,"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed ",,,516.0,665.0,3 RC,403,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,403,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,403,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,403,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,403,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,403,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,403,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,403,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,403,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,403,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,403,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,403,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,403,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,403,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,403,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,403,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,403,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,403,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,403,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,403,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,403,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,403,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,403,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,403,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,403,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,403,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,403,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,403,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,403,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,403,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,403,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,403,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,403,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,403,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,403,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,403,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,403,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,403,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,403,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,403,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,403,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,403,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,403,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,403,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,403,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,403,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,403,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,403,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,403,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,403,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,403,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,403,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,403,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,403,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,403,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,403,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,403,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,403,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,403,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,403,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,403,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,403,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,403,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,403,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,403,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,403,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,403,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,403,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,403,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,403,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,403,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,403,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,403,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,403,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,403,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,403,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,403,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,403,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,403,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,403,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,403,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,403,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,403,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,403,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,403,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,404, Other Imaging Services Positron Emission Tomography ,,,2241.0,5748.0,4 RC,404,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,404,"Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (List separately in addition to code for primary procedure) ",,,4254.0,5480.0,3 RC,404,"Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (List separately in addition to code for primary procedure) PET Scan",,,2268.0,5672.0,12 RC,404,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,404,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,404,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,404,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,404,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,404,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,404,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,404,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,404,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,404,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,404,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,404,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,404,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,404,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,404,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,404,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,404,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,404,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,404,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,404,Bone age studies ,,,26.58,26.58,1 RC,404,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,404,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,404,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,404,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,404,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,404,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,404,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,404,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,404,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,404,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,404,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,404,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,404,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,5480.0,4 RC,404,"Brain imaging, positron emission tomography (PET); metabolic evaluation PET Scan",,,2268.0,5672.0,12 RC,404,"Brain imaging, positron emission tomography (PET); perfusion evaluation PET Scan",,,2268.0,5672.0,12 RC,404,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,404,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,404,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,404,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,404,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,404,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,404,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,404,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,404,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,404,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,404,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,404,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,404,Cardiac shunt detection ,,,186.76,186.76,1 RC,404,Cardiokymography ,,,20.04,20.04,1 RC,404,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,404,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,404,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,404,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,404,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,404,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,404,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,404,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,404,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,404,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,404,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,404,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,404,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,404,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,404,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,404,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,404,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,404,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,404,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,404,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,404,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,404,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,404,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,404,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,404,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,404,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,404,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,404,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,404,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,404,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,404,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,404,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,404,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,404,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,404,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,404,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,404,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,404,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,404,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,404,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,404,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,404,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,404,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,404,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,404,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,404,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,404,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,404,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,404,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,404,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,404,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,404,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,404,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,404,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,404,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,404,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,404,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,404,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,404,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,404,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,404,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,404,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,404,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,404,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,404,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,404,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,404,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,404,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,404,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,404,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,404,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,404,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,404,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,404,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,404,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,404,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,404,Esophageal motility ,,,214.04,214.04,1 RC,404,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,404,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,404,Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan) PET Scan,,,2268.0,5672.0,12 RC,404,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,404,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,404,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,404,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,404,Gastric mucosa imaging ,,,205.51,205.51,1 RC,404,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,404,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,404,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,404,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,404,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,404,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,404,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,404,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,404,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,404,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,404,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,404,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,404,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,404,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,404,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,404,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,404,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,404,Kidney imaging morphology; ,,,172.11,172.11,1 RC,404,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,404,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,404,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,404,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,404,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,404,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,404,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,404,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,404,Liver imaging; static only ,,,191.2,191.2,1 RC,404,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,404,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,404,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,404,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,404,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,404,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,404,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,404,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,404,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,404,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,404,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,404,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,404,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,404,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,404,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,404,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,404,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,404,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,404,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,404,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,404,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,404,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,404,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,404,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,404,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,404,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,404,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,404,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,404,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,404,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,404,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,404,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,404,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,404,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,404,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,404,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,404,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,404,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,404,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,404,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,404,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,404,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,404,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,404,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,404,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,404,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,404,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,404,"Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), dual radi",,,2268.0,5672.0,30 RC,404,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; ",,,4254.0,5480.0,3 RC,404,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; PET Scan",,,2268.0,5672.0,12 RC,404,"Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fractionºs», when performed), single study; with concurrently a",,,2268.0,5672.0,15 RC,404,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); multiple studies at rest and stress (exercis",,,2268.0,5672.0,30 RC,404,"Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», when performed); single study, at rest or stress (exercise or",,,2268.0,5672.0,30 RC,404,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,404,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,404,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,404,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,404,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,404,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,404,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,404,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,404,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,404,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,404,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,404,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,404,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,404,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,404,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,404,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,404,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,404,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,404,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,404,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,404,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,404,Pet imaging whole body; melanoma for non-covered indications PET Scan,,,2268.0,5672.0,12 RC,404,"Pet imaging, any site, not otherwise specified PET Scan",,,2268.0,5672.0,12 RC,404,"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) PET Scan",,,2268.0,5672.0,12 RC,404,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,404,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,404,Platelet survival study ,,,126.1,126.1,1 RC,404,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,5480.0,4 RC,404,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) PET Scan",,,2268.0,5672.0,12 RC,404,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,5480.0,4 RC,404,Positron emission tomography (PET) imaging; skull base to mid-thigh PET Scan,,,2268.0,5672.0,12 RC,404,Positron emission tomography (PET) imaging; whole body ,,,1509.95,5480.0,4 RC,404,Positron emission tomography (PET) imaging; whole body PET Scan,,,2268.0,5672.0,12 RC,404,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,5480.0,4 RC,404,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) PET Scan",,,2268.0,5672.0,12 RC,404,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,5480.0,4 RC,404,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh PET Scan,,,2268.0,5672.0,12 RC,404,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,5480.0,4 RC,404,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body PET Scan,,,2268.0,5672.0,12 RC,404,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,404,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,404,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,404,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,404,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,404,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,404,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,404,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,404,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,404,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,404,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,404,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,404,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,404,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,404,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,404,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,404,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,404,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,404,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,404,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,404,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,404,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,404,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,404,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,404,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,404,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,404,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,404,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,404,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,404,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,404,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,404,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,404,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,404,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,404,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,404,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,404,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,404,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,404,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,404,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,404,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,404,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,404,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,404,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,404,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,404,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,404,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,404,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,404,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,404,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,404,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,404,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,404,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,404,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,404,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,404,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,404,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,404,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,404,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,404,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,404,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,404,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,404,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,404,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,404,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,404,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,404,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,404,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,404,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,404,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,404,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,404,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,404,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,404,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,404,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,404,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,404,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,404,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,404,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,404,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,404,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,404,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,404,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,404,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,404,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,404,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,404,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,404,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,404,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,404,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,404,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,404,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,404,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,404,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,404,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,404,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,404,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,404,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,404,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,404,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,404,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,404,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,404,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,404,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,404,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,404,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,404,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,404,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,404,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,404,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,404,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,404,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,404,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,404,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,404,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,404,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,404,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,404,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,404,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,404,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,404,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,404,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,404,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,404,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,404,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,404,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,404,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,404,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,404,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,404,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,404,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,404,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,404,Red cell survival study ,,,126.1,126.1,1 RC,404,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,404,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,404,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,404,Salivary gland function study ,,,104.3,104.3,1 RC,404,Salivary gland imaging; ,,,175.52,175.52,1 RC,404,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,404,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,404,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,404,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,404,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,404,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,404,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,404,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,404,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,404,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,404,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,404,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,404,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,404,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,404,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,404,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,404,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,404,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,404,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,404,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,404,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,404,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,404,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,404,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,404,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,404,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,404,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,404,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,404,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,404,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,404,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,404,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,404,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,404,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,404,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,404,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,404,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,404,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,404,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,404,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,404,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,404,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,404,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,404,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,404,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,404,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,404,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,404,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,404,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,404,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,404,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,404,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,404,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,404,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,404,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,404,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,404,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,404,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,404,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,404,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,404,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,404,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,404,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,404,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,404,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,404,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,404,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,404,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,404,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,404,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,404,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,404,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,404,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,404,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,404,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,404,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,404,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,404,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,404,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,404,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,404,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,404,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,404,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,404,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,404,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,404,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,404,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,409, Other Imaging Services ,,,,,0 RC,409,17-hydroxypregnenolone ,,,93.4,120.36,3 RC,409,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,409,"ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain ",,,1233.66,1589.8,3 RC,409,ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2) ,,,358.26,461.69,3 RC,409,ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2) ,,,322.02,414.98,3 RC,409,ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2) ,,,133.84,172.48,3 RC,409,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; characterization of alleles (eg, expanded size and methylation status) ",,,1130.48,1456.83,3 RC,409,"AFF2 (ALF transcription elongation factor 2 ºFMR2») (eg, fragile X intellectual disability 2 ºFRAXE») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants ",,,822.44,1059.87,3 RC,409,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; full gene sequence ",,,3208.88,4135.23,3 RC,409,"APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; known familial variants ",,,1151.39,1483.78,3 RC,409,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status) ",,,563.16,725.73,3 RC,409,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,409,"AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant ",,,762.47,982.58,3 RC,409,"ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X) ",,,193.77,249.71,3 RC,409,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,409,"ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis ",,,995.29,1282.62,3 RC,409,"ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"ATXN8OS (ATXN8 opposite strand ºnon-protein coding») (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,Acetaminophen ,,,76.68,98.82,3 RC,409,Acetylcholinesterase ,,,50.18,64.67,3 RC,409,"Actin (smooth muscle) antibody (ASMA), each ",,,50.18,64.67,3 RC,409,Activated Protein C (APC) resistance assay ,,,62.74,80.85,3 RC,409,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,409,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA",,,196.54,253.28,3 RC,409,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,409,"Acylcarnitines; qualitative, each specimen ",,,68.28,88.0,3 RC,409,"Acylcarnitines; quantitative, each specimen ",,,69.71,89.84,3 RC,409,Adalimumab ,,,158.91,204.79,3 RC,409,"Adenosine, 5-monophosphate, cyclic (cyclic AMP) ",,,105.96,136.54,3 RC,409,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,409,Adrenocorticotropic hormone (ACTH) ,,,158.91,204.79,3 RC,409,"Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen ",,,29.27,37.72,3 RC,409,Albumin; ischemia modified ,,,139.38,179.62,3 RC,409,"Albumin; other source, quantitative, each specimen ",,,32.04,41.29,3 RC,409,"Albumin; serum, plasma or whole blood ",,,20.91,26.95,3 RC,409,"Albumin; urine (eg, microalbumin), quantitative ",,,23.69,30.52,3 RC,409,"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) ",,,25.07,32.31,3 RC,409,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase) ",,,71.1,91.62,3 RC,409,Alcohol (ethanol); breath ,,,124.05,159.87,3 RC,409,Alcohols ,,,98.98,127.56,3 RC,409,Aldolase ,,,40.44,52.12,3 RC,409,Aldosterone ,,,167.27,215.56,3 RC,409,"Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2) ",,,515.75,664.63,3 RC,409,"Alkaloids, not otherwise specified ",,,98.98,127.56,3 RC,409,All potassium hydroxide (koh) preparations ,,,23.69,30.52,3 RC,409,"Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) ",,,33.47,43.13,3 RC,409,"Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each ",,,20.91,26.95,3 RC,409,"Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each ",,,73.87,95.19,3 RC,409,"Allergen specific IgG quantitative or semiquantitative, each allergen ",,,32.04,41.29,3 RC,409,Alpha-1-antitrypsin; phenotype ,,,59.93,77.23,3 RC,409,Alpha-1-antitrypsin; total ,,,55.77,71.87,3 RC,409,Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) ,,,264.87,341.33,3 RC,409,Alpha-fetoprotein (AFP); amniotic fluid ,,,69.71,89.84,3 RC,409,Alpha-fetoprotein (AFP); serum ,,,68.28,88.0,3 RC,409,Aluminum ,,,104.53,134.7,3 RC,409,Amikacin ,,,62.74,80.85,3 RC,409,"Amines, vaginal fluid, qualitative ",,,25.07,32.31,3 RC,409,"Amino acids, 2 to 5 amino acids, quantitative, each specimen ",,,80.84,104.18,3 RC,409,"Amino acids, 6 or more amino acids, quantitative, each specimen ",,,69.71,89.84,3 RC,409,"Amino acids; multiple, qualitative, each specimen ",,,57.16,73.66,3 RC,409,"Amino acids; single, qualitative, each specimen ",,,58.54,75.44,3 RC,409,"Amino acids; single, quantitative, each specimen ",,,94.78,122.15,3 RC,409,"Aminolevulinic acid, delta (ALA) ",,,68.28,88.0,3 RC,409,Amiodarone ,,,76.68,98.82,3 RC,409,Ammonia ,,,59.93,77.23,3 RC,409,Amniotic fluid scan (spectrophotometric) ,,,39.01,50.28,3 RC,409,Amphetamines; 1 or 2 ,,,98.98,127.56,3 RC,409,Amylase ,,,26.5,34.15,3 RC,409,Anabolic steroids; 1 or 2 ,,,98.98,127.56,3 RC,409,"Analgesics, non-opioid; 1 or 2 ",,,98.98,127.56,3 RC,409,Androstanediol glucuronide ,,,118.47,152.67,3 RC,409,Androstenedione ,,,119.9,154.51,3 RC,409,Androsterone ,,,104.53,134.7,3 RC,409,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,203.89,4 RC,409,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,507.75,4 RC,409,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,462.45,4 RC,409,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,335.09,4 RC,409,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,322.57,4 RC,409,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,499.94,4 RC,409,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,425.01,4 RC,409,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,338.19,4 RC,409,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,385.04,4 RC,409,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,331.93,4 RC,409,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,623.27,4 RC,409,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,363.17,4 RC,409,Angiotensin I - converting enzyme (ACE) ,,,59.93,77.23,3 RC,409,Angiotensin II ,,,85.04,109.59,3 RC,409,"Animal inoculation, small animal, with observation and dissection ",,,69.71,89.84,3 RC,409,Anti-phosphatidylserine (phospholipid) antibody ,,,65.51,84.43,3 RC,409,"Antibody elution (RBC), each elution ",,,126.87,163.49,3 RC,409,"Antibody identification, RBC antibodies, each panel for each serum technique ",,,174.24,224.54,3 RC,409,Antibody identification; leukocyte antibodies ,,,61.31,79.01,3 RC,409,Antibody identification; platelet antibodies ,,,75.26,96.98,3 RC,409,Antibody identification; platelet associated immunoglobulin assay ,,,51.57,66.46,3 RC,409,"Antibody screen, RBC, each serum technique ",,,40.44,52.12,3 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class",,,337.35,506.55,6 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, i",,,1331.22,1726.28,6 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or ",,,263.44,339.49,3 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I ",,,1470.6,1895.14,3 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II ",,,1328.44,1711.94,3 RC,409,"Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and",,,263.44,339.49,3 RC,409,Antibody; Aspergillus ,,,61.31,79.01,3 RC,409,Antibody; Bartonella ,,,41.83,53.9,3 RC,409,Antibody; Blastomyces ,,,52.96,68.24,3 RC,409,Antibody; Bordetella ,,,54.38,70.08,3 RC,409,Antibody; Borrelia (relapsing fever) ,,,54.38,70.08,3 RC,409,Antibody; Borrelia burgdorferi (Lyme disease) ,,,69.71,89.84,3 RC,409,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot) ",,,64.13,82.64,3 RC,409,Antibody; Brucella ,,,36.24,46.7,3 RC,409,Antibody; Campylobacter ,,,54.38,70.08,3 RC,409,Antibody; Candida ,,,48.8,62.89,3 RC,409,Antibody; Chlamydia ,,,48.8,62.89,3 RC,409,"Antibody; Chlamydia, IgM ",,,51.57,66.46,3 RC,409,Antibody; Coccidioides ,,,47.41,61.1,3 RC,409,Antibody; Coxiella burnetii (Q fever) ,,,50.18,64.67,3 RC,409,Antibody; Cryptococcus ,,,59.93,77.23,3 RC,409,Antibody; Diphtheria ,,,62.74,80.85,3 RC,409,Antibody; Ehrlichia ,,,41.83,53.9,3 RC,409,"Antibody; Epstein-Barr (EB) virus, early antigen (EA) ",,,54.38,70.08,3 RC,409,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) ",,,62.74,80.85,3 RC,409,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) ",,,75.26,96.98,3 RC,409,Antibody; Francisella tularensis ,,,58.54,75.44,3 RC,409,Antibody; Giardia lamblia ,,,59.93,77.23,3 RC,409,Antibody; HIV-1 ,,,36.24,46.7,3 RC,409,"Antibody; HIV-1 and HIV-2, single result ",,,55.77,71.87,3 RC,409,Antibody; HIV-2 ,,,55.77,71.87,3 RC,409,"Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) ",,,79.46,102.39,3 RC,409,Antibody; HTLV-I ,,,37.63,48.49,3 RC,409,Antibody; HTLV-II ,,,57.16,73.66,3 RC,409,Antibody; Haemophilus influenza ,,,65.51,84.43,3 RC,409,Antibody; Helicobacter pylori ,,,69.71,89.84,3 RC,409,Antibody; JC (John Cunningham) virus ,,,69.71,89.84,3 RC,409,Antibody; Legionella ,,,62.74,80.85,3 RC,409,Antibody; Leishmania ,,,50.18,64.67,3 RC,409,Antibody; Leptospira ,,,66.9,86.21,3 RC,409,Antibody; Listeria monocytogenes ,,,54.38,70.08,3 RC,409,Antibody; Neisseria meningitidis ,,,54.38,70.08,3 RC,409,Antibody; Nocardia ,,,65.51,84.43,3 RC,409,Antibody; Plasmodium (malaria) ,,,54.38,70.08,3 RC,409,Antibody; Rickettsia ,,,79.46,102.39,3 RC,409,Antibody; Salmonella ,,,54.38,70.08,3 RC,409,Antibody; Shigella ,,,100.37,129.34,3 RC,409,Antibody; Toxoplasma ,,,58.54,75.44,3 RC,409,"Antibody; Toxoplasma, IgM ",,,59.93,77.23,3 RC,409,Antibody; Treponema pallidum ,,,54.38,70.08,3 RC,409,Antibody; Trichinella ,,,51.57,66.46,3 RC,409,Antibody; West Nile virus ,,,58.54,75.44,3 RC,409,"Antibody; West Nile virus, IgM ",,,69.71,89.84,3 RC,409,Antibody; Yersinia ,,,54.38,70.08,3 RC,409,"Antibody; Zika virus, IgM ",,,69.71,89.84,3 RC,409,Antibody; actinomyces ,,,41.83,53.9,3 RC,409,Antibody; adenovirus ,,,52.96,68.24,3 RC,409,"Antibody; bacterium, not elsewhere specified ",,,52.96,68.24,3 RC,409,Antibody; cytomegalovirus (CMV) ,,,58.54,75.44,3 RC,409,"Antibody; cytomegalovirus (CMV), IgM ",,,69.71,89.84,3 RC,409,"Antibody; encephalitis, California (La Crosse) ",,,54.38,70.08,3 RC,409,"Antibody; encephalitis, Eastern equine ",,,54.38,70.08,3 RC,409,"Antibody; encephalitis, St. Louis ",,,54.38,70.08,3 RC,409,"Antibody; encephalitis, Western equine ",,,54.38,70.08,3 RC,409,"Antibody; enterovirus (eg, coxsackie, echo, polio) ",,,52.96,68.24,3 RC,409,"Antibody; fungus, not elsewhere specified ",,,50.18,64.67,3 RC,409,"Antibody; helminth, not elsewhere specified ",,,52.96,68.24,3 RC,409,"Antibody; hepatitis, delta agent ",,,71.1,91.62,3 RC,409,"Antibody; herpes simplex, non-specific type test ",,,58.54,75.44,3 RC,409,"Antibody; herpes simplex, type 1 ",,,54.38,70.08,3 RC,409,"Antibody; herpes simplex, type 2 ",,,79.46,102.39,3 RC,409,Antibody; histoplasma ,,,57.16,73.66,3 RC,409,Antibody; influenza virus ,,,55.77,71.87,3 RC,409,Antibody; lymphocytic choriomeningitis ,,,52.96,68.24,3 RC,409,Antibody; mucormycosis ,,,61.31,79.01,3 RC,409,Antibody; mumps ,,,54.38,70.08,3 RC,409,Antibody; mycoplasma ,,,54.38,70.08,3 RC,409,Antibody; parvovirus ,,,61.31,79.01,3 RC,409,"Antibody; protozoa, not elsewhere specified ",,,51.57,66.46,3 RC,409,Antibody; respiratory syncytial virus ,,,65.51,84.43,3 RC,409,Antibody; rotavirus ,,,75.26,96.98,3 RC,409,Antibody; rubella ,,,58.54,75.44,3 RC,409,Antibody; rubeola ,,,52.96,68.24,3 RC,409,Antibody; tetanus ,,,61.31,79.01,3 RC,409,Antibody; varicella-zoster ,,,52.96,68.24,3 RC,409,"Antibody; virus, not elsewhere specified ",,,52.96,68.24,3 RC,409,"Antidepressants, serotonergic class; 1 or 2 ",,,98.98,127.56,3 RC,409,"Antidepressants, tricyclic and other cyclicals; 1 or 2 ",,,98.98,127.56,3 RC,409,"Antiepileptics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,409,"Antihuman globulin test (Coombs test); direct, each antiserum ",,,22.3,28.74,3 RC,409,"Antihuman globulin test (Coombs test); indirect, each antibody titer ",,,20.91,26.95,3 RC,409,"Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell ",,,23.69,30.52,3 RC,409,"Antineutrophil cytoplasmic antibody (ANCA); screen, each antibody ",,,50.18,64.67,3 RC,409,"Antineutrophil cytoplasmic antibody (ANCA); titer, each antibody ",,,50.18,64.67,3 RC,409,Antinuclear antibodies (ANA); ,,,50.18,64.67,3 RC,409,Antinuclear antibodies (ANA); titer ,,,45.98,59.26,3 RC,409,"Antipsychotics, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,409,Antistreptolysin 0; screen ,,,23.69,30.52,3 RC,409,Antistreptolysin 0; titer ,,,30.66,39.51,3 RC,409,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for ",,,5553.48,7156.68,3 RC,409,"Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at ",,,2072.81,2671.2,3 RC,409,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,301.04,4 RC,409,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,280.72,4 RC,409,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,317.87,4 RC,409,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,755.05,4 RC,409,"Apolipoprotein, each ",,,86.43,111.38,3 RC,409,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,409,Aquaporin-4 (neuromyelitis optica ºNMO») antibody; enzyme-linked immunosorbent immunoassay (ELISA) ,,,47.41,61.1,3 RC,409,"Aquaporin-4 (neuromyelitis optica ºNMO») antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,409,Arsenic ,,,78.07,100.61,3 RC,409,"Ascorbic acid (Vitamin C), blood ",,,40.44,52.12,3 RC,409,"Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analys",,,10072.66,12980.48,3 RC,409,"Assisted embryo hatching, microtechniques (any method) ",,,442.57,570.33,3 RC,409,"Assisted oocyte fertilization, microtechnique; greater than 10 oocytes ",,,442.57,570.33,3 RC,409,"Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes ",,,2185.48,2816.39,3 RC,409,"Atomic absorption spectroscopy, each analyte ",,,65.51,84.43,3 RC,409,"Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score ",,,3458.37,4456.75,3 RC,409,"Autologous blood or component, collection processing and storage; intra- or postoperative salvage ",,,563.16,725.73,3 RC,409,"Autologous blood or component, collection processing and storage; predeposited ",,,398.66,513.75,3 RC,409,"B cells, total count ",,,154.71,199.37,3 RC,409,"BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X) ",,,390.31,502.98,3 RC,409,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative ",,,674.66,869.42,3 RC,409,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative ",,,595.2,767.03,3 RC,409,"BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative ",,,882.37,1137.09,3 RC,409,"BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant ",,,161.68,208.36,3 RC,409,"BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s) ",,,722.07,930.52,3 RC,409,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1239.2,1596.94,3 RC,409,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1163.95,1499.96,3 RC,409,"BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,409,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants ",,,1809.33,2331.66,3 RC,409,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rea",,,2403.15,3096.9,3 RC,409,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,1925.03,2480.76,3 RC,409,"BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, ",,,7506.4,9673.38,3 RC,409,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements) ",,,1163.95,1499.96,3 RC,409,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis ",,,761.08,980.8,3 RC,409,"BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,409,"BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) ",,,722.07,930.52,3 RC,409,Barbiturates ,,,98.98,127.56,3 RC,409,"Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potass",,,57.16,73.66,3 RC,409,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium ",,,34.86,44.92,3 RC,409,Benzodiazepines; 1-12 ,,,98.98,127.56,3 RC,409,"Beta 2 Glycoprotein I antibody, each ",,,104.53,134.7,3 RC,409,Beta-2 microglobulin ,,,66.9,86.21,3 RC,409,Bile acids; cholylglycine ,,,108.73,140.11,3 RC,409,Bile acids; total ,,,71.1,91.62,3 RC,409,"Bilirubin, total, transcutaneous ",,,20.91,26.95,3 RC,409,Bilirubin; direct ,,,20.91,26.95,3 RC,409,"Bilirubin; feces, qualitative ",,,18.14,23.38,3 RC,409,Bilirubin; total ,,,20.91,26.95,3 RC,409,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos ",,,442.57,570.33,3 RC,409,"Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos ",,,442.57,570.33,3 RC,409,"Biotinidase, each specimen ",,,69.71,89.84,3 RC,409,Bleeding time ,,,19.53,25.17,3 RC,409,"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of Rh incompatible units), with written report ",,,138.3,178.23,3 RC,409,"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report ",,,137.35,177.0,3 RC,409,"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report ",,,137.35,177.0,3 RC,409,Blood count; automated differential WBC count ,,,26.5,34.15,3 RC,409,"Blood count; blood smear, microscopic examination with manual differential WBC count ",,,15.33,19.75,3 RC,409,"Blood count; blood smear, microscopic examination without manual differential WBC count ",,,13.94,17.97,3 RC,409,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) ",,,26.5,34.15,3 RC,409,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count ",,,32.04,41.29,3 RC,409,Blood count; hematocrit (Hct) ,,,9.74,12.55,3 RC,409,Blood count; hemoglobin (Hgb) ,,,9.74,12.55,3 RC,409,"Blood count; leukocyte (WBC), automated ",,,9.74,12.55,3 RC,409,"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each ",,,18.14,23.38,3 RC,409,"Blood count; manual differential WBC count, buffy coat ",,,20.91,26.95,3 RC,409,"Blood count; platelet, automated ",,,18.14,23.38,3 RC,409,"Blood count; red blood cell (RBC), automated ",,,12.56,16.18,3 RC,409,"Blood count; reticulocyte, automated ",,,16.71,21.54,3 RC,409,"Blood count; reticulocyte, manual ",,,18.14,23.38,3 RC,409,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content ºCHr», immature reticulocyte fraction ºIRF», reticulocyte volume ºMRV», RNA content)",,,22.3,28.74,3 RC,409,Blood count; spun microhematocrit ,,,29.27,37.72,3 RC,409,"Blood smear, peripheral, interpretation by physician with written report ",,,67.72,87.27,3 RC,409,"Blood typing, for paternity testing, per individual; ABO, Rh and MN ",,,103.14,132.92,3 RC,409,"Blood typing, for paternity testing, per individual; each additional antigen system ",,,89.2,114.95,3 RC,409,"Blood typing, serologic; ABO ",,,12.56,16.18,3 RC,409,"Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each ",,,15.33,19.75,3 RC,409,"Blood typing, serologic; Rh (D) ",,,12.56,16.18,3 RC,409,"Blood typing, serologic; Rh phenotyping, complete ",,,32.04,41.29,3 RC,409,"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened ",,,66.9,86.21,3 RC,409,"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test ",,,26.5,34.15,3 RC,409,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations ",,,65.51,84.43,3 RC,409,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ",,,16.71,21.54,3 RC,409,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o",,,18.14,23.38,3 RC,409,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources ",,,22.3,28.74,3 RC,409,Bone age studies ,,,26.58,79.3,4 RC,409,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,409,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,409,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,409,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,409,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,149.57,4 RC,409,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,409,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,409,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,409,"Bone marrow, smear interpretation ",,,134.49,173.31,3 RC,409,Bradykinin ,,,20.91,26.95,3 RC,409,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,409,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,409,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,409,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,409,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,409,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,409,C-peptide ,,,85.04,109.59,3 RC,409,C-reactive protein; ,,,20.91,26.95,3 RC,409,C-reactive protein; high sensitivity (hsCRP) ,,,52.96,68.24,3 RC,409,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence ",,,3480.71,4485.54,3 RC,409,"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant ",,,762.47,982.58,3 RC,409,"CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9 ",,,500.42,644.88,3 RC,409,"CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed ",,,853.1,1099.37,3 RC,409,"CEBPA (CCAAT/enhancer binding protein ºC/EBP», alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence ",,,995.29,1282.62,3 RC,409,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines) ",,,2290.27,2951.43,3 RC,409,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants ",,,1789.85,2306.55,3 RC,409,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence ",,,2053.29,2646.04,3 RC,409,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) ",,,694.19,894.59,3 RC,409,"CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants ",,,400.05,515.54,3 RC,409,"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,409,"CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,409,"CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17) ",,,1198.8,1544.88,3 RC,409,"CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6) ",,,719.3,926.95,3 RC,409,"CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) ",,,1855.36,2390.97,3 RC,409,"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22) ",,,719.3,926.95,3 RC,409,"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7) ",,,719.3,926.95,3 RC,409,Cadmium ,,,97.55,125.72,3 RC,409,Caffeine ,,,158.91,204.79,3 RC,409,"Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report ",,,174.54,224.93,3 RC,409,Calcitonin ,,,110.11,141.9,3 RC,409,"Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3) ",,,330.38,425.75,3 RC,409,Calcium; after calcium infusion test ,,,54.38,70.08,3 RC,409,Calcium; ionized ,,,55.77,71.87,3 RC,409,Calcium; total ,,,20.91,26.95,3 RC,409,"Calcium; urine quantitative, timed specimen ",,,25.07,32.31,3 RC,409,Calculus; X-ray diffraction ,,,51.57,66.46,3 RC,409,Calculus; infrared spectroscopy ,,,52.96,68.24,3 RC,409,Calculus; qualitative analysis ,,,47.41,61.1,3 RC,409,"Calculus; quantitative analysis, chemical ",,,52.96,68.24,3 RC,409,"Calprotectin, fecal ",,,80.84,104.18,3 RC,409,"Cannabinoids, natural ",,,98.98,127.56,3 RC,409,"Cannabinoids, synthetic; 1-3 ",,,98.98,127.56,3 RC,409,"Carbamazepine; -10,11-epoxide ",,,76.68,98.82,3 RC,409,Carbamazepine; free ,,,54.38,70.08,3 RC,409,Carbamazepine; total ,,,59.93,77.23,3 RC,409,Carbohydrate deficient transferrin ,,,73.87,95.19,3 RC,409,Carbon dioxide (bicarbonate) ,,,19.53,25.17,3 RC,409,Carboxyhemoglobin; qualitative ,,,58.54,75.44,3 RC,409,Carboxyhemoglobin; quantitative ,,,50.18,64.67,3 RC,409,Carcinoembryonic antigen (CEA) ,,,78.07,100.61,3 RC,409,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,409,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,409,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,409,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,409,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,409,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include a",,,2405.96,3100.53,3 RC,409,"Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing",,,2405.96,3100.53,3 RC,409,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,409,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,409,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,409,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,409,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,409,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,409,Cardiac shunt detection ,,,186.76,186.76,1 RC,409,Cardiokymography ,,,20.04,20.04,1 RC,409,"Cardiolipin (phospholipid) antibody, each Ig class ",,,104.53,134.7,3 RC,409,"Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported ",,,13327.57,17175.02,3 RC,409,"Carnitine (total and free), quantitative, each specimen ",,,69.71,89.84,3 RC,409,Carotene ,,,37.63,48.49,3 RC,409,Catecholamines; blood ,,,119.9,154.51,3 RC,409,Catecholamines; fractionated ,,,104.53,134.7,3 RC,409,Catecholamines; total urine ,,,112.93,145.53,3 RC,409,Cathepsin-D ,,,73.87,95.19,3 RC,409,Catheterization for collection of specimen(s) (multiple patients) ,,,34.86,44.92,3 RC,409,"Catheterization for collection of specimen, single patient, all places of service ",,,34.86,44.92,3 RC,409,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; ",,,19.53,25.17,3 RC,409,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count ",,,23.69,30.52,3 RC,409,"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); ",,,1031.54,1329.32,3 RC,409,"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP) ",,,558.96,720.32,3 RC,409,"Cephalogram, orthodontic ",,,16.71,37.15,4 RC,409,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,409,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,409,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,409,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,409,Ceruloplasmin ,,,44.6,57.47,3 RC,409,Chemiluminescent assay ,,,58.54,75.44,3 RC,409,"Chemotaxis assay, specify method ",,,65.51,84.43,3 RC,409,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each ",,,1073.32,1383.17,3 RC,409,"Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection ",,,853.1,1099.37,3 RC,409,Chloramphenicol ,,,51.57,66.46,3 RC,409,Chloride; blood ,,,19.53,25.17,3 RC,409,Chloride; other source ,,,20.91,26.95,3 RC,409,Chloride; urine ,,,23.69,30.52,3 RC,409,"Chlorinated hydrocarbons, screen ",,,25.07,32.31,3 RC,409,"Cholecystography, oral contrast ",,,89.29,336.93,4 RC,409,"Cholesterol, serum or whole blood, total ",,,18.14,23.38,3 RC,409,Cholinesterase; RBC ,,,40.44,52.12,3 RC,409,Cholinesterase; serum ,,,32.04,41.29,3 RC,409,"Chondroitin B sulfate, quantitative ",,,85.04,109.59,3 RC,409,"Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled blood samples) ",,,230.01,296.41,3 RC,409,Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) ,,,211.87,273.03,3 RC,409,Chromium ,,,83.66,107.81,3 RC,409,Chromogenic substrate assay ,,,48.8,62.89,3 RC,409,"Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells ",,,712.33,917.97,3 RC,409,"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile X) ",,,712.33,917.97,3 RC,409,"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation) ",,,712.33,917.97,3 RC,409,"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding ",,,775.03,998.76,3 RC,409,"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding ",,,713.71,919.75,3 RC,409,"Chromosome analysis; additional cells counted, each study ",,,110.11,141.9,3 RC,409,Chromosome analysis; additional high resolution study ,,,142.2,183.25,3 RC,409,"Chromosome analysis; additional karyotypes, each study ",,,138.0,177.83,3 RC,409,"Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) ",,,281.58,362.87,3 RC,409,Chromosome analysis; analyze 20-25 cells ,,,595.2,767.03,3 RC,409,"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding ",,,515.75,664.63,3 RC,409,"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding ",,,618.93,797.61,3 RC,409,"Chromosome analysis; count 5 cells, 1 karyotype, with banding ",,,1087.26,1401.14,3 RC,409,"Cineradiography/videoradiography, except where specifically included ",,,109.02,460.26,4 RC,409,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,525.89,4 RC,409,Citrate ,,,114.31,147.31,3 RC,409,"Clot lysis time, whole blood dilution ",,,83.66,107.81,3 RC,409,Clot retraction ,,,66.9,86.21,3 RC,409,"Clotting inhibitors or anticoagulants; antithrombin III, activity ",,,48.8,62.89,3 RC,409,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay ",,,44.6,57.47,3 RC,409,"Clotting inhibitors or anticoagulants; protein C, activity ",,,57.16,73.66,3 RC,409,"Clotting inhibitors or anticoagulants; protein C, antigen ",,,48.8,62.89,3 RC,409,"Clotting inhibitors or anticoagulants; protein S, free ",,,62.74,80.85,3 RC,409,"Clotting inhibitors or anticoagulants; protein S, total ",,,47.41,61.1,3 RC,409,"Clotting; factor II, prothrombin, specific ",,,52.96,68.24,3 RC,409,Clotting; factor IX (PTC or Christmas) ,,,78.07,100.61,3 RC,409,"Clotting; factor V (AcG or proaccelerin), labile factor ",,,72.48,93.41,3 RC,409,"Clotting; factor VII (proconvertin, stable factor) ",,,73.87,95.19,3 RC,409,"Clotting; factor VIII (AHG), 1-stage ",,,73.87,95.19,3 RC,409,Clotting; factor VIII related antigen ,,,83.66,107.81,3 RC,409,"Clotting; factor VIII, VW factor antigen ",,,94.78,122.15,3 RC,409,"Clotting; factor VIII, VW factor, ristocetin cofactor ",,,94.78,122.15,3 RC,409,"Clotting; factor VIII, von Willebrand factor, multimetric analysis ",,,94.78,122.15,3 RC,409,Clotting; factor X (Stuart-Prower) ,,,73.87,95.19,3 RC,409,Clotting; factor XI (PTA) ,,,73.87,95.19,3 RC,409,Clotting; factor XII (Hageman) ,,,79.46,102.39,3 RC,409,Clotting; factor XIII (fibrin stabilizing) ,,,66.9,86.21,3 RC,409,"Clotting; factor XIII (fibrin stabilizing), screen solubility ",,,37.63,48.49,3 RC,409,Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) ,,,78.07,100.61,3 RC,409,Clotting; prekallikrein assay (Fletcher factor assay) ,,,78.07,100.61,3 RC,409,Clozapine ,,,82.23,105.96,3 RC,409,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte ",,,126.87,163.49,3 RC,409,Coagulation time; Lee and White ,,,19.53,25.17,3 RC,409,Coagulation time; activated ,,,18.14,23.38,3 RC,409,Coagulation time; other methods ,,,18.14,23.38,3 RC,409,"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day ",,,54.38,70.08,3 RC,409,Cocaine ,,,98.98,127.56,3 RC,409,Cold agglutinin; screen ,,,33.47,43.13,3 RC,409,Cold agglutinin; titer ,,,33.47,43.13,3 RC,409,"Collagen cross links, any method ",,,76.68,98.82,3 RC,409,Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) ,,,43.21,55.69,3 RC,409,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,73.87,95.19,3 RC,409,"Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative,",,,98.98,127.56,3 RC,409,Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormo,,,2383.66,3071.79,3 RC,409,"Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in mul",,,1253.15,1614.91,3 RC,409,"Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient ger",,,959.05,1235.91,3 RC,409,Compatibility test each unit; antiglobulin technique ,,,150.55,194.02,3 RC,409,Compatibility test each unit; electronic ,,,112.93,145.53,3 RC,409,Compatibility test each unit; immediate spin technique ,,,140.77,181.41,3 RC,409,Compatibility test each unit; incubation technique ,,,126.87,163.49,3 RC,409,"Complement fixation tests, each antigen ",,,41.83,53.9,3 RC,409,"Complement; antigen, each component ",,,48.8,62.89,3 RC,409,"Complement; functional activity, each component ",,,48.8,62.89,3 RC,409,Complement; total hemolytic (CH50) ,,,83.66,107.81,3 RC,409,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,26.5,34.15,3 RC,409,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,499.02,4 RC,409,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,32.04,41.29,3 RC,409,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,316.66,4 RC,409,"Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8",,,43.21,55.69,3 RC,409,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,409,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,409,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,409,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,409,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,409,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,409,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,409,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,409,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,409,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,409,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,409,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,409,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,409,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,409,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,409,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,409,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,409,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,409,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,409,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,409,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,409,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,409,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,409,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,409,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,409,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,409,"Concentration (any type), for infectious agents ",,,27.89,35.94,3 RC,409,Consultation and report on referred material requiring preparation of slides ,,,116.82,150.55,3 RC,409,Consultation and report on referred slides prepared elsewhere ,,,233.69,301.15,3 RC,409,"Consultation, comprehensive, with review of records and specimens, with report on referred material ",,,373.85,481.78,3 RC,409,Copper ,,,51.57,66.46,3 RC,409,"Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score ",,,4319.87,5566.94,3 RC,409,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,182.36,4 RC,409,Corticosterone ,,,92.01,118.58,3 RC,409,Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6) ,,,3298.07,4250.17,3 RC,409,Cortisol; free ,,,68.28,88.0,3 RC,409,Cortisol; total ,,,66.9,86.21,3 RC,409,Creatine ,,,19.53,25.17,3 RC,409,"Creatine kinase (CK), (CPK); MB fraction only ",,,47.41,61.1,3 RC,409,"Creatine kinase (CK), (CPK); isoenzymes ",,,55.77,71.87,3 RC,409,"Creatine kinase (CK), (CPK); isoforms ",,,48.8,62.89,3 RC,409,"Creatine kinase (CK), (CPK); total ",,,26.5,34.15,3 RC,409,Creatinine; blood ,,,20.91,26.95,3 RC,409,Creatinine; clearance ,,,39.01,50.28,3 RC,409,Creatinine; other source ,,,20.91,26.95,3 RC,409,Cryofibrinogen ,,,58.54,75.44,3 RC,409,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) ",,,26.5,34.15,3 RC,409,"Cryopreservation, freezing and storage of cells, each cell line ",,,54.38,70.08,3 RC,409,"Cryopreservation, mature oocyte(s) ",,,442.57,570.33,3 RC,409,"Cryopreservation, reproductive tissue, testicular ",,,141.11,181.85,3 RC,409,Cryopreservation; embryo(s) ,,,2185.48,2816.39,3 RC,409,Cryopreservation; sperm ,,,442.57,570.33,3 RC,409,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine) ",,,30.66,39.51,3 RC,409,"Culture of oocyte(s)/embryo(s), less than 4 days; ",,,4474.58,5766.32,3 RC,409,"Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos ",,,4654.4,5998.05,3 RC,409,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,409,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate ",,,33.47,43.13,3 RC,409,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates ",,,34.86,44.92,3 RC,409,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates ",,,39.01,50.28,3 RC,409,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ",,,41.83,53.9,3 RC,409,"Culture, bacterial; quantitative colony count, urine ",,,33.47,43.13,3 RC,409,"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,409,"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool ",,,40.44,52.12,3 RC,409,"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate ",,,39.01,50.28,3 RC,409,"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species ",,,39.01,50.28,3 RC,409,"Culture, bacterial; with isolation and presumptive identification of each isolate, urine ",,,33.47,43.13,3 RC,409,"Culture, chlamydia, any source ",,,80.84,104.18,3 RC,409,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood ",,,83.66,107.81,3 RC,409,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood) ",,,34.86,44.92,3 RC,409,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail ",,,32.04,41.29,3 RC,409,"Culture, fungi, definitive identification, each organism; mold ",,,41.83,53.9,3 RC,409,"Culture, fungi, definitive identification, each organism; yeast ",,,41.83,53.9,3 RC,409,"Culture, mycobacterial, definitive identification, each isolate ",,,59.93,77.23,3 RC,409,"Culture, mycoplasma, any source ",,,62.74,80.85,3 RC,409,"Culture, presumptive, pathogenic organisms, screening only; ",,,27.89,35.94,3 RC,409,"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart ",,,111.5,143.69,3 RC,409,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates ",,,44.6,57.47,3 RC,409,"Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method ",,,51.57,66.46,3 RC,409,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed ",,,144.97,186.82,3 RC,409,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed ",,,82.23,105.96,3 RC,409,"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene) ",,,473.96,610.79,3 RC,409,"Culture, typing; identification by pulse field gel typing ",,,32.04,41.29,3 RC,409,"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcrip",,,896.31,1155.06,3 RC,409,"Culture, typing; immunofluorescent method, each antiserum ",,,22.3,28.74,3 RC,409,"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum ",,,20.91,26.95,3 RC,409,"Culture, typing; other methods ",,,32.04,41.29,3 RC,409,Cyanide ,,,79.46,102.39,3 RC,409,Cyanocobalamin (Vitamin B-12); ,,,62.74,80.85,3 RC,409,Cyanocobalamin (Vitamin B-12); unsaturated binding capacity ,,,58.54,75.44,3 RC,409,"Cyclic citrullinated peptide (CCP), antibody ",,,52.96,68.24,3 RC,409,Cyclosporine ,,,73.87,95.19,3 RC,409,Cystatin C ,,,76.68,98.82,3 RC,409,"Cystine and homocystine, urine, qualitative ",,,39.01,50.28,3 RC,409,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,123.04,4 RC,409,"Cytogenetics and molecular cytogenetics, interpretation and report ",,,91.58,118.02,3 RC,409,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis ",,,4771.49,6148.94,3 RC,409,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic",,,4771.49,6148.94,3 RC,409,"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization ºCGH» microarray analysis ",,,3702.32,4771.12,3 RC,409,"Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities ",,,4771.49,6148.94,3 RC,409,"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision ",,,207.71,267.67,3 RC,409,"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision ",,,71.1,91.62,3 RC,409,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision ",,,83.66,107.81,3 RC,409,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision ",,,104.53,134.7,3 RC,409,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision ",,,94.78,122.15,3 RC,409,"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under",,,110.11,141.9,3 RC,409,"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician ",,,64.86,83.59,3 RC,409,"Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique) ",,,183.72,236.76,3 RC,409,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (List separately in additi",,,33.47,43.13,3 RC,409,"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site ",,,86.12,110.99,3 RC,409,"Cytopathology, evaluation of fine needle aspirate; interpretation and report ",,,386.41,497.96,3 RC,409,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation ",,,211.61,272.69,3 RC,409,"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation ",,,176.49,227.44,3 RC,409,"Cytopathology, forensic (eg, sperm) ",,,61.05,78.68,3 RC,409,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual ",,,2247.31,2896.08,3 RC,409,"Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology ",,,1549.79,1997.19,3 RC,409,"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal ",,,165.58,213.38,3 RC,409,"Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision ",,,71.1,91.62,3 RC,409,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision ",,,71.1,91.62,3 RC,409,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision ",,,71.1,91.62,3 RC,409,"Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision ",,,174.24,224.54,3 RC,409,"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to codeºs» for other technical and",,,59.93,77.23,3 RC,409,"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision ",,,71.1,91.62,3 RC,409,"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision ",,,114.31,147.31,3 RC,409,"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision ",,,98.98,127.56,3 RC,409,"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains ",,,333.97,430.39,3 RC,409,"Cytopathology, smears, any other source; preparation, screening and interpretation ",,,215.5,277.72,3 RC,409,"Cytopathology, smears, any other source; screening and interpretation ",,,207.15,266.95,3 RC,409,"DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed ",,,1147.23,1478.42,3 RC,409,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,409,"DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,409,"DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) ",,,719.3,926.95,3 RC,409,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,162.38,4 RC,409,"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection ",,,44.6,57.47,3 RC,409,"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection ",,,45.98,59.26,3 RC,409,Decalcification procedure (List separately in addition to code for surgical pathology examination) ,,,34.55,44.53,3 RC,409,Dehydroepiandrosterone (DHEA) ,,,104.53,134.7,3 RC,409,Dehydroepiandrosterone-sulfate (DHEA-S) ,,,92.01,118.58,3 RC,409,"Deoxycortisol, 11- ",,,119.9,154.51,3 RC,409,"Deoxyribonuclease, antibody ",,,54.38,70.08,3 RC,409,Deoxyribonucleic acid (DNA) antibody; native or double stranded ,,,57.16,73.66,3 RC,409,Deoxyribonucleic acid (DNA) antibody; single stranded ,,,50.18,64.67,3 RC,409,"Desoxycorticosterone, 11- ",,,126.87,163.49,3 RC,409,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,409,"Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2) ",,,666.3,858.65,3 RC,409,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,409,Dibucaine number ,,,50.18,64.67,3 RC,409,Digoxin; free ,,,54.38,70.08,3 RC,409,Digoxin; total ,,,54.38,70.08,3 RC,409,Dihydrotestosterone (DHT) ,,,119.9,154.51,3 RC,409,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,377.52,4 RC,409,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,344.74,4 RC,409,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,335.38,4 RC,409,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,409,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,409,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,409,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,409,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,471.15,1309.57,12 RC,409,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,255.08,328.72,3 RC,409,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay ºeg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA»), c",,,255.08,328.72,3 RC,409,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca",,,51.57,66.46,3 RC,409,"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay ºeg, dipsticks, cups, card",,,71.1,91.62,3 RC,409,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3 ",,,98.98,127.56,3 RC,409,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 ",,,98.98,127.56,3 RC,409,"Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more ",,,98.98,127.56,3 RC,409,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,101.17,4 RC,409,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,133.96,4 RC,409,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,174.55,4 RC,409,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,668.57,4 RC,409,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,441.25,4 RC,409,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study ,,,766.06,985.52,3 RC,409,Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study ,,,452.21,581.76,3 RC,409,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,988.62,4 RC,409,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,566.14,4 RC,409,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,268.25,4 RC,409,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,229.21,4 RC,409,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,716.98,4 RC,409,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,469.33,4 RC,409,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,727.89,4 RC,409,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,459.97,4 RC,409,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,577.05,4 RC,409,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,951.18,4 RC,409,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,563.04,4 RC,409,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,740.4,4 RC,409,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,470.89,4 RC,409,"EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) ",,,1335.42,1720.93,3 RC,409,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646) ",,,722.07,930.52,3 RC,409,"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence ",,,1163.95,1499.96,3 RC,409,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,409,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,409,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,409,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,409,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,409,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,409,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,409,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,409,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,409,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,409,"Elastase, pancreatic (EL-1), fecal; qualitative or semi-quantitative ",,,47.41,61.1,3 RC,409,"Elastase, pancreatic (EL-1), fecal; quantitative ",,,94.78,122.15,3 RC,409,Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) ,,,29.27,37.72,3 RC,409,"Electron microscopy, diagnostic ",,,1650.99,2127.6,3 RC,409,"Electrophoretic technique, not elsewhere specified ",,,252.31,325.15,3 RC,409,"Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm repor",,,282.97,364.65,3 RC,409,"Endomysial antibody (EMA), each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,409,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen ",,,90.63,116.79,3 RC,409,"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen ",,,181.21,233.52,3 RC,409,"Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1",,,10072.66,12980.48,3 RC,409,Erythropoietin ,,,76.68,98.82,3 RC,409,Esophageal motility ,,,214.04,214.04,1 RC,409,"Estradiol; free, direct measurement (eg, equilibrium dialysis) ",,,114.31,147.31,3 RC,409,Estradiol; total ,,,114.31,147.31,3 RC,409,Estriol ,,,98.98,127.56,3 RC,409,Estrogens; fractionated ,,,132.41,170.64,3 RC,409,Estrogens; total ,,,89.2,114.95,3 RC,409,Estrone ,,,103.14,132.92,3 RC,409,Ethosuximide ,,,66.9,86.21,3 RC,409,Ethylene glycol ,,,61.31,79.01,3 RC,409,Etiocholanolone ,,,107.34,138.33,3 RC,409,Euglobulin lysis ,,,34.86,44.92,3 RC,409,"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 ºPAMG-1», placental protein 12 ºPP12», alpha-fetoprotein), qualitative, each specimen ",,,404.25,520.95,3 RC,409,Everolimus ,,,57.16,73.66,3 RC,409,"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) ",,,54.38,70.08,3 RC,409,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,1315.89,1695.76,3 RC,409,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,19663.05,25339.45,3 RC,409,"Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure) ",,,49362.56,63612.73,3 RC,409,"Extended culture of oocyte(s)/embryo(s), 4-7 days ",,,2185.48,2816.39,3 RC,409,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody ",,,73.87,95.19,3 RC,409,"F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant ",,,270.41,348.47,3 RC,409,"F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant ",,,302.49,389.82,3 RC,409,"F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence ",,,2468.71,3181.38,3 RC,409,"FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) ",,,150.55,194.02,3 RC,409,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15) ",,,680.24,876.62,3 RC,409,"FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) ",,,341.51,440.09,3 RC,409,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; characterization of alleles (eg, expanded size and promoter methylation ",,,183.98,237.09,3 RC,409,"FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,234.17,301.77,3 RC,409,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,409,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles ",,,563.16,725.73,3 RC,409,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence ",,,1130.48,1456.83,3 RC,409,"FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s) ",,,762.47,982.58,3 RC,409,Factor inhibitor test ,,,52.96,68.24,3 RC,409,"Fat differential, feces, quantitative ",,,94.78,122.15,3 RC,409,"Fat or lipids, feces; qualitative ",,,20.91,26.95,3 RC,409,"Fat or lipids, feces; quantitative ",,,69.71,89.84,3 RC,409,"Fat stain, feces, urine, or respiratory secretions ",,,23.69,30.52,3 RC,409,"Fatty acids, nonesterified ",,,76.68,98.82,3 RC,409,Felbamate ,,,76.68,98.82,3 RC,409,Fentanyl ,,,98.98,127.56,3 RC,409,Fern test ,,,40.44,52.12,3 RC,409,Ferritin ,,,55.77,71.87,3 RC,409,"Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy ",,,3270.19,4214.24,3 RC,409,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,409,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,409,"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 ",,,3122.45,4023.85,3 RC,409,"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood ",,,3122.45,4023.85,3 RC,409,"Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG, hyperglycosylated hCG, DIA) utilizing maternal serum, algorithm reported as a risk score ",,,285.78,368.28,3 RC,409,"Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG ºany form», DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from pr",,,631.44,813.73,3 RC,409,"Fetal congenital abnormalities, biochemical assays of three analytes (AFP, uE3, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,228.62,294.62,3 RC,409,"Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG ºany form», DIA), utilizing maternal serum, algorithm reported as a risk score ",,,6118.03,7884.21,3 RC,409,"Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG ºany form»), utilizing maternal serum, algorithm reported as a risk score ",,,223.04,287.43,3 RC,409,"Fetal fibronectin, cervicovaginal secretions, semi-quantitative ",,,264.87,341.33,3 RC,409,Fetal lung maturity assessment; fluorescence polarization ,,,78.07,100.61,3 RC,409,Fetal lung maturity assessment; foam stability test ,,,78.07,100.61,3 RC,409,Fetal lung maturity assessment; lamellar body density ,,,79.46,102.39,3 RC,409,Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio ,,,90.63,116.79,3 RC,409,"Fibrin degradation products, D-dimer; qualitative or semiquantitative ",,,40.44,52.12,3 RC,409,"Fibrin degradation products, D-dimer; quantitative ",,,41.83,53.9,3 RC,409,"Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative ",,,41.83,53.9,3 RC,409,"Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative ",,,27.89,35.94,3 RC,409,Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation ,,,330.38,425.75,3 RC,409,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative ,,,51.57,66.46,3 RC,409,Fibrinogen; activity ,,,40.44,52.12,3 RC,409,Fibrinogen; antigen ,,,59.93,77.23,3 RC,409,"Fibrinolysins or coagulopathy screen, interpretation and report ",,,64.13,82.64,3 RC,409,Fibrinolytic factors and inhibitors; alpha-2 antiplasmin ,,,32.04,41.29,3 RC,409,Fibrinolytic factors and inhibitors; plasmin ,,,32.04,41.29,3 RC,409,Fibrinolytic factors and inhibitors; plasminogen activator ,,,71.1,91.62,3 RC,409,"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay ",,,41.83,53.9,3 RC,409,"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay ",,,26.5,34.15,3 RC,409,Flecainide ,,,76.68,98.82,3 RC,409,"Flow cytometry, cell cycle or DNA analysis ",,,507.65,654.2,3 RC,409,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker) ",,,98.98,127.56,3 RC,409,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker ",,,308.9,398.08,3 RC,409,"Flow cytometry, interpretation; 16 or more markers ",,,234.64,302.38,3 RC,409,"Flow cytometry, interpretation; 2 to 8 markers ",,,99.2,127.84,3 RC,409,"Flow cytometry, interpretation; 9 to 15 markers ",,,173.59,223.7,3 RC,409,"Fluorescent noninfectious agent antibody; screen, each antibody ",,,50.18,64.67,3 RC,409,"Fluorescent noninfectious agent antibody; titer, each antibody ",,,50.18,64.67,3 RC,409,Fluoride ,,,76.68,98.82,3 RC,409,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,130.85,4 RC,409,Folic acid; RBC ,,,72.48,93.41,3 RC,409,Folic acid; serum ,,,59.93,77.23,3 RC,409,"Fresh frozen plasma, thawing, each unit ",,,79.46,102.39,3 RC,409,"Frozen blood, each unit; freezing (includes preparation) ",,,469.76,605.37,3 RC,409,"Frozen blood, each unit; freezing (includes preparation) and thawing ",,,398.66,513.75,3 RC,409,"Frozen blood, each unit; thawing ",,,352.68,454.49,3 RC,409,"Fructose, semen ",,,71.1,91.62,3 RC,409,"G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X) ",,,241.14,310.75,3 RC,409,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-) ",,,719.3,926.95,3 RC,409,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,409,"G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s) ",,,1543.08,1988.54,3 RC,409,"GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A) ",,,193.77,249.71,3 RC,409,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence ",,,415.38,535.29,3 RC,409,"GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants ",,,253.69,326.93,3 RC,409,"GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb ºdel(GJB6-D13S1830)» and 232kb ºdel(GJB6-D13S1854)») ",,,143.58,185.03,3 RC,409,"Gabapentin, non-blood ",,,98.98,127.56,3 RC,409,"Gabapentin, whole blood, serum, or plasma ",,,89.2,114.95,3 RC,409,"Galactokinase, RBC ",,,87.81,113.16,3 RC,409,Galactose ,,,45.98,59.26,3 RC,409,Galactose-1-phosphate uridyl transferase; quantitative ,,,86.43,111.38,3 RC,409,Galactose-1-phosphate uridyl transferase; screen ,,,48.8,62.89,3 RC,409,Galectin-3 ,,,182.6,235.31,3 RC,409,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each ",,,37.63,48.49,3 RC,409,Gammaglobulin (immunoglobulin); IgE ,,,68.28,88.0,3 RC,409,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each ",,,33.47,43.13,3 RC,409,"Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry ",,,40.44,52.12,3 RC,409,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); ",,,107.34,138.33,3 RC,409,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry ",,,323.41,416.77,3 RC,409,"Gases, blood, pH only ",,,44.6,57.47,3 RC,409,"Gastric acid analysis, includes pH if performed, each specimen ",,,27.89,35.94,3 RC,409,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,409,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,409,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,409,Gastric mucosa imaging ,,,205.51,205.51,1 RC,409,Gastrin ,,,72.48,93.41,3 RC,409,Gastrin after secretin stimulation ,,,72.48,93.41,3 RC,409,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,409,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,409,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,409,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,409,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,409,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,409,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,409,"General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)",,,167.27,215.56,3 RC,409,"Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders ºeg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher ",,,10072.66,12980.48,3 RC,409,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome) ",,,9615.46,12391.28,3 RC,409,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis ",,,20695.97,26670.56,3 RC,409,"Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)",,,11147.41,14365.49,3 RC,409,Gentamicin ,,,66.9,86.21,3 RC,409,"Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class ",,,50.18,64.67,3 RC,409,Glucagon ,,,58.54,75.44,3 RC,409,Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3) ,,,189.57,244.29,3 RC,409,"Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2) ",,,207.71,267.67,3 RC,409,Glucagon tolerance test ,,,72.48,93.41,3 RC,409,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use ",,,13.94,17.97,3 RC,409,"Glucose, body fluid, other than blood ",,,16.71,21.54,3 RC,409,Glucose-6-phosphate dehydrogenase (G6PD); quantitative ,,,40.44,52.12,3 RC,409,Glucose-6-phosphate dehydrogenase (G6PD); screen ,,,25.07,32.31,3 RC,409,"Glucose; blood, reagent strip ",,,20.91,26.95,3 RC,409,Glucose; post glucose dose (includes glucose) ,,,19.53,25.17,3 RC,409,"Glucose; quantitative, blood (except reagent strip) ",,,16.71,21.54,3 RC,409,"Glucose; tolerance test (GTT), 3 specimens (includes glucose) ",,,52.96,68.24,3 RC,409,"Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure) ",,,16.71,21.54,3 RC,409,"Glucosidase, beta ",,,87.81,113.16,3 RC,409,Glutamate dehydrogenase ,,,54.38,70.08,3 RC,409,"Glutamyltransferase, gamma (GGT) ",,,29.27,37.72,3 RC,409,Glutathione ,,,64.13,82.64,3 RC,409,"Glutathione reductase, RBC ",,,39.01,50.28,3 RC,409,Glycated protein ,,,68.28,88.0,3 RC,409,Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4) ,,,610.53,786.78,3 RC,409,"Gonadotropin, chorionic (hCG); free beta chain ",,,62.74,80.85,3 RC,409,"Gonadotropin, chorionic (hCG); qualitative ",,,30.66,39.51,3 RC,409,"Gonadotropin, chorionic (hCG); quantitative ",,,61.31,79.01,3 RC,409,Gonadotropin; follicle stimulating hormone (FSH) ,,,76.68,98.82,3 RC,409,Gonadotropin; luteinizing hormone (LH) ,,,76.68,98.82,3 RC,409,"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4) ",,,274.61,353.88,3 RC,409,Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4) ,,,532.5,686.23,3 RC,409,"Growth hormone, human (HGH) (somatotropin) ",,,68.28,88.0,3 RC,409,"Growth hormone, human (HGH), antibody ",,,64.13,82.64,3 RC,409,"Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1) ",,,310.85,400.59,3 RC,409,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, M",,,420.96,542.49,3 RC,409,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,409,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence ",,,2468.71,3181.38,3 RC,409,"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant ",,,1543.08,1988.54,3 RC,409,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE) ",,,719.3,926.95,3 RC,409,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) ",,,832.18,1072.42,3 RC,409,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence ",,,1335.42,1720.93,3 RC,409,"HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) ",,,1543.08,1988.54,3 RC,409,"HEXA (hexosaminidase A ºalpha polypeptide») (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S) ",,,211.87,273.03,3 RC,409,"HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D) ",,,269.02,346.69,3 RC,409,"HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1 ",,,1421.84,1832.3,3 RC,409,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1 ",,,1654.62,2132.29,3 RC,409,"HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing) ",,,1664.37,2144.84,3 RC,409,"HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C) ",,,1380.01,1778.4,3 RC,409,"HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each ",,,698.39,900.0,3 RC,409,"HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each ",,,729.04,939.5,3 RC,409,"HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C) ",,,1660.21,2139.48,3 RC,409,"HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each ",,,305.26,393.39,3 RC,409,"HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each ",,,524.15,675.46,3 RC,409,"HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each ",,,448.85,578.42,3 RC,409,"HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,508.78,655.65,3 RC,409,"HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1 ",,,907.48,1169.46,3 RC,409,"HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each ",,,390.31,502.98,3 RC,409,"HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each ",,,503.23,648.51,3 RC,409,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen ",,,105.96,136.54,3 RC,409,"HLA typing; A, B, or C, multiple antigens ",,,238.37,307.18,3 RC,409,"HLA typing; DR/DQ, multiple antigens ",,,436.29,562.24,3 RC,409,"HLA typing; DR/DQ, single antigen ",,,124.05,159.87,3 RC,409,"HLA typing; lymphocyte culture, mixed (MLC) ",,,150.55,194.02,3 RC,409,"HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size) ",,,1130.48,1456.83,3 RC,409,"HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,Haloperidol ,,,65.51,84.43,3 RC,409,Haptoglobin; phenotypes ,,,110.11,141.9,3 RC,409,Haptoglobin; quantitative ,,,51.57,66.46,3 RC,409,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 gen",,,2794.89,3601.72,3 RC,409,"Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including CDH23, CLRN1, GJB2, GPR98, MTRN",,,6684.0,8613.57,3 RC,409,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes ",,,86.43,111.38,3 RC,409,"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified ",,,90.63,116.79,3 RC,409,Heinz bodies; direct ,,,16.71,21.54,3 RC,409,"Heinz bodies; induced, acetyl phenylhydrazine ",,,27.89,35.94,3 RC,409,"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,409,"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) ",,,277.38,357.45,3 RC,409,Helicobacter pylori; drug administration ,,,32.04,41.29,3 RC,409,Hemagglutination inhibition test (HAI) ,,,33.47,43.13,3 RC,409,"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA express",,,3123.84,4025.64,6 RC,409,"Hemoglobin (Hgb), quantitative, transcutaneous ",,,20.91,26.95,3 RC,409,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) ",,,73.87,95.19,3 RC,409,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F) ",,,52.96,68.24,3 RC,409,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke) ",,,32.04,41.29,3 RC,409,"Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette ",,,39.01,50.28,3 RC,409,"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin ",,,39.01,50.28,3 RC,409,"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin ",,,39.01,50.28,3 RC,409,Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) ,,,54.38,70.08,3 RC,409,"Hemoglobin; F (fetal), chemical ",,,44.6,57.47,3 RC,409,"Hemoglobin; F (fetal), qualitative ",,,33.47,43.13,3 RC,409,"Hemoglobin; by copper sulfate method, non-automated ",,,16.71,21.54,3 RC,409,Hemoglobin; glycosylated (A1C) ,,,40.44,52.12,3 RC,409,Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use ,,,40.44,52.12,3 RC,409,"Hemoglobin; methemoglobin, qualitative ",,,26.5,34.15,3 RC,409,"Hemoglobin; methemoglobin, quantitative ",,,33.47,43.13,3 RC,409,Hemoglobin; plasma ,,,30.66,39.51,3 RC,409,"Hemoglobin; sulfhemoglobin, quantitative ",,,36.24,46.7,3 RC,409,Hemoglobin; thermolabile ,,,37.63,48.49,3 RC,409,"Hemoglobin; unstable, screen ",,,39.01,50.28,3 RC,409,Hemoglobin; urine ,,,16.71,21.54,3 RC,409,"Hemolysin, acid ",,,36.24,46.7,3 RC,409,"Hemolysins and agglutinins; auto, screen, each ",,,36.24,46.7,3 RC,409,Hemolysins and agglutinins; incubated ,,,50.18,64.67,3 RC,409,"Hemosiderin, qualitative ",,,19.53,25.17,3 RC,409,Heparin assay ,,,54.38,70.08,3 RC,409,Heparin neutralization ,,,48.8,62.89,3 RC,409,Heparin-protamine tolerance test ,,,54.38,70.08,3 RC,409,"Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani",,,33.47,43.13,3 RC,409,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,339.74,4 RC,409,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,341.29,4 RC,409,Hepatitis A antibody (HAAb) ,,,51.57,66.46,3 RC,409,"Hepatitis A antibody (HAAb), IgM antibody ",,,45.98,59.26,3 RC,409,Hepatitis B core antibody (HBcAb); IgM antibody ,,,48.8,62.89,3 RC,409,Hepatitis B core antibody (HBcAb); total ,,,50.18,64.67,3 RC,409,Hepatitis B surface antibody (HBsAb) ,,,44.6,57.47,3 RC,409,Hepatitis Be antibody (HBeAb) ,,,47.41,61.1,3 RC,409,Hepatitis C antibody; ,,,58.54,75.44,3 RC,409,"Hepatitis C antibody; confirmatory test (eg, immunoblot) ",,,64.13,82.64,3 RC,409,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,115.7,149.1,3 RC,409,"Hepatitis c antibody screening, for individual at high risk and other covered indication(s) ",,,190.95,246.08,3 RC,409,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,409,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,409,"Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer, hereditary pancreatic cancer, hereditary prostate cancer), genomic s",,,2793.46,3599.88,3 RC,409,"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at lea",,,2405.96,3100.53,3 RC,409,"Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogati",,,2405.96,3100.53,3 RC,409,"Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more gene",,,1805.18,2326.3,3 RC,409,"Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2,",,,2405.96,3100.53,3 RC,409,"Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis, cone-rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including ABCA4,",,,2458.92,3168.77,3 RC,409,Heroin metabolite ,,,98.98,127.56,3 RC,409,Heterophile antibodies; screening ,,,20.91,26.95,3 RC,409,Heterophile antibodies; titer ,,,26.5,34.15,3 RC,409,Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney ,,,30.66,39.51,3 RC,409,Histamine ,,,121.28,156.3,3 RC,409,"Hiv antigen/antibody, combination assay, screening ",,,98.98,127.56,3 RC,409,Homocysteine ,,,73.87,95.19,3 RC,409,"Homogenization, tissue, for culture ",,,23.69,30.52,3 RC,409,Homovanillic acid (HVA) ,,,92.01,118.58,3 RC,409,"Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y) ",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib ºplatelet», alpha polypeptide ºGPIba») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), gene analysis, c",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex», antigen CD41 ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-tr",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa», antigen CD61 ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), g",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 ºCD49B, alpha 2 subunit of VLA-2 receptor» ºGPIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ge",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 ºplatelet glycoprotein IIIa, antigen CD61» ºGPIIIa») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-transfusion purpura), ",,,503.23,648.51,3 RC,409,"Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b ºplatelet glycoprotein IIb of IIb/IIIa complex, antigen CD41» ºGPIIb») (eg, neonatal alloimmune thrombocytopenia ºNAIT», post-t",,,503.23,648.51,3 RC,409,Human epididymis protein 4 (HE4) ,,,85.04,109.59,3 RC,409,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure) ",,,150.55,194.02,3 RC,409,"Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution ",,,450.23,580.21,3 RC,409,Hydroxychloroquine ,,,76.68,98.82,3 RC,409,"Hydroxycorticosteroids, 17- (17-OHCS) ",,,73.87,95.19,3 RC,409,"Hydroxyindolacetic acid, 5-(HIAA) ",,,52.96,68.24,3 RC,409,"Hydroxyprogesterone, 17-d ",,,111.5,143.69,3 RC,409,Hydroxyproline; free ,,,93.4,120.36,3 RC,409,Hydroxyproline; total ,,,100.37,129.34,3 RC,409,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,365.06,4 RC,409,"IDH1 (isocitrate dehydrogenase 1 ºNADP+», soluble) (eg, glioma), common variants (eg, R132H, R132C) ",,,794.56,1023.93,3 RC,409,"IDH2 (isocitrate dehydrogenase 2 ºNADP+», mitochondrial) (eg, glioma), common variants (eg, R140W, R172M) ",,,1216.9,1568.2,3 RC,409,"IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant ",,,302.49,389.82,3 RC,409,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis ",,,1211.36,1561.06,3 RC,409,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction",,,814.08,1049.1,3 RC,409,"IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot) ",,,281.58,362.87,3 RC,409,"IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative ",,,853.1,1099.37,3 RC,409,"IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,710.9,916.12,3 RC,409,"IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P) ",,,161.68,208.36,3 RC,409,"Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral ",,,196.64,252.98,3 RC,409,Immune complex assay ,,,100.37,129.34,3 RC,409,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method ",,,47.41,61.1,3 RC,409,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip) ",,,39.01,50.28,3 RC,409,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA) ",,,75.26,96.98,3 RC,409,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified ",,,71.1,91.62,3 RC,409,"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); ",,,73.87,95.19,3 RC,409,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified ",,,61.31,79.01,3 RC,409,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each ",,,85.04,109.59,3 RC,409,"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen) ",,,104.53,134.7,3 RC,409,"Immunoassay for tumor antigen, quantitative; CA 125 ",,,85.04,109.59,3 RC,409,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) ",,,85.04,109.59,3 RC,409,"Immunoassay for tumor antigen, quantitative; CA 19-9 ",,,85.04,109.59,3 RC,409,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody ",,,48.8,62.89,3 RC,409,Immunodiffusion; not elsewhere specified ,,,57.16,73.66,3 RC,409,"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration ",,,94.78,122.15,3 RC,409,Immunoelectrophoresis; serum ,,,122.67,158.08,3 RC,409,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) ",,,121.28,156.3,3 RC,409,Immunofixation electrophoresis; serum ,,,92.01,118.58,3 RC,409,"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,366.32,472.07,3 RC,409,"Immunofluorescence, per specimen; initial single antibody stain procedure ",,,486.22,626.58,3 RC,409,"Immunoglobulin light chains (ie, kappa, lambda), free, each ",,,71.1,91.62,3 RC,409,"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure) ",,,243.95,314.38,3 RC,409,"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure ",,,543.37,700.23,3 RC,409,"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure ",,,274.35,353.55,3 RC,409,"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure) ",,,429.06,552.92,3 RC,409,"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure ",,,906.92,1168.73,3 RC,409,"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure ",,,575.15,741.19,3 RC,409,"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening ",,,80.84,104.18,3 RC,409,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,75.26,96.98,3 RC,409,"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening ",,,48.8,62.89,3 RC,409,"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC",,,41.83,127.56,87 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Chlamydia trachomatis ",,,144.97,186.82,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile toxin A ",,,65.51,84.43,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies ",,,135.23,174.26,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza ",,,68.28,88.0,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae ",,,100.37,129.34,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A ",,,68.28,88.0,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B ",,,52.96,68.24,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Trichomonas vaginalis ",,,62.74,80.85,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus ",,,89.2,114.95,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified ",,,65.51,84.43,3 RC,409,"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus ",,,54.38,70.08,3 RC,409,"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum ",,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis ,,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis ,,,48.8,62.89,3 RC,409,"Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,409,"Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) ",,,55.77,71.87,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1 ,,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2 ,,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila ,,,64.13,82.64,3 RC,409,"Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type ",,,66.9,86.21,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii ,,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Rubeola ,,,249.54,321.58,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum ,,,50.18,64.67,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus ,,,55.77,71.87,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; adenovirus ,,,59.93,77.23,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; cryptosporidium ,,,48.8,62.89,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; giardia ,,,55.77,71.87,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; influenza A virus ,,,65.51,84.43,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; influenza B virus ,,,50.18,64.67,3 RC,409,"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism ",,,66.9,86.21,3 RC,409,Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus ,,,55.77,71.87,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ",,,288.55,371.85,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique ",,,179.82,231.74,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism ",,,124.05,159.87,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification ",,,228.62,294.62,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique ",,,93.4,120.36,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification ",,,220.22,283.8,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique ",,,153.33,197.59,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique ",,,90.63,116.79,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed ",,,349.86,450.86,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique ",,,90.63,116.79,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed ",,,241.14,310.75,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique ",,,238.37,307.18,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44) ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed ",,,167.27,215.56,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique ",,,112.93,145.53,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique ",,,197.92,255.06,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique ",,,110.11,141.9,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification ",,,1244.79,1604.14,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique ",,,110.11,141.9,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each ",,,210.48,271.24,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique ",,,82.23,105.96,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique ",,,210.48,271.24,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus",,,1714.55,2209.51,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique ",,,124.05,159.87,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcript",,,528.3,2209.51,9 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique ",,,128.25,165.28,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed ",,,175.62,226.32,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique ",,,161.68,208.36,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique ",,,122.67,158.08,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification ",,,171.47,220.97,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe techn",,,119.9,508.39,6 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype ",,,210.48,271.24,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique ",,,288.55,371.85,3 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus)",,,586.84,2209.51,9 RC,409,"Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique ",,,144.97,186.82,3 RC,409,"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be p",,,144.97,186.82,3 RC,409,Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics ,,,536.66,691.59,3 RC,409,"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid) ",,,50.18,64.67,3 RC,409,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion) ",,,529.69,682.6,3 RC,409,"Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions ",,,1059.42,1365.26,3 RC,409,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus ,,,1059.42,1365.26,3 RC,409,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus ,,,1059.42,1365.26,3 RC,409,Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus ,,,1059.42,1365.26,3 RC,409,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary proce",,,107.34,138.33,3 RC,409,"Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested ",,,2010.07,2590.35,3 RC,409,"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associa",,,1081.72,1394.0,3 RC,409,"Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens,",,,586.84,756.26,3 RC,409,"Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic alg",,,296.91,382.62,3 RC,409,Infliximab ,,,158.91,204.79,3 RC,409,"Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis congenita, Diamond-Blackfan anemia, Shwachman-Diamond syndrome, GATA2 deficiency syndrome, congenital amegakaryocytic ",,,10072.66,12980.48,3 RC,409,Inhibin A ,,,64.13,82.64,3 RC,409,Insemination of oocytes ,,,442.57,570.33,3 RC,409,Insulin antibodies ,,,87.81,113.16,3 RC,409,Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5) ,,,1172.3,1510.73,3 RC,409,Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5) ,,,423.78,546.11,3 RC,409,Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5) ,,,681.63,878.4,3 RC,409,Insulin; free ,,,52.96,68.24,3 RC,409,Insulin; total ,,,47.41,61.1,3 RC,409,Interleukin-6 (IL-6) ,,,71.1,91.62,3 RC,409,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,409,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,409,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,409,Intrinsic factor ,,,80.84,104.18,3 RC,409,Intrinsic factor antibodies ,,,62.74,80.85,3 RC,409,Iron ,,,26.5,34.15,3 RC,409,Iron binding capacity ,,,36.24,46.7,3 RC,409,"Iron stain, peripheral blood ",,,27.89,35.94,3 RC,409,"Irradiation of blood product, each unit ",,,117.08,150.88,3 RC,409,Islet cell antibody ,,,97.55,125.72,3 RC,409,Isocitric dehydrogenase (IDH) ,,,36.24,46.7,3 RC,409,Itraconazole ,,,111.5,143.69,3 RC,409,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant ",,,376.36,485.01,3 RC,409,"JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13) ",,,762.47,982.58,3 RC,409,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,143.32,4 RC,409,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor ºGIST», acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons ",,,1354.9,1746.04,3 RC,409,"KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s) ",,,512.98,661.06,3 RC,409,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146) ",,,794.56,1023.93,3 RC,409,"KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13) ",,,794.56,1023.93,3 RC,409,Ketamine and norketamine ,,,98.98,127.56,3 RC,409,"Ketogenic steroids, fractionation ",,,64.13,82.64,3 RC,409,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative ",,,18.14,23.38,3 RC,409,"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative ",,,33.47,43.13,3 RC,409,"Ketosteroids, 17- (17-KS); fractionation ",,,117.08,150.88,3 RC,409,"Ketosteroids, 17- (17-KS); total ",,,52.96,68.24,3 RC,409,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,409,Kidney imaging morphology; ,,,172.11,172.11,1 RC,409,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,409,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,409,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,409,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,409,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,409,Lacosamide ,,,111.5,143.69,3 RC,409,Lactate (lactic acid) ,,,47.41,61.1,3 RC,409,"Lactate dehydrogenase (LD), (LDH); ",,,25.07,32.31,3 RC,409,"Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation ",,,52.96,68.24,3 RC,409,"Lactoferrin, fecal; qualitative ",,,80.84,104.18,3 RC,409,"Lactoferrin, fecal; quantitative ",,,80.84,104.18,3 RC,409,"Lactogen, human placental (HPL) human chorionic somatomammotropin ",,,83.66,107.81,3 RC,409,"Lactose, urine, qualitative ",,,45.98,59.26,3 RC,409,Lamotrigine ,,,54.38,70.08,3 RC,409,Lead ,,,50.18,64.67,3 RC,409,Leflunomide ,,,158.91,204.79,3 RC,409,Leucine aminopeptidase (LAP) ,,,40.44,52.12,3 RC,409,Leukocyte alkaline phosphatase with count ,,,34.86,44.92,3 RC,409,"Leukocyte assessment, fecal, qualitative or semiquantitative ",,,18.14,23.38,3 RC,409,Leukocyte histamine release test (LHR) ,,,51.57,66.46,3 RC,409,Leukocyte phagocytosis ,,,43.21,55.69,3 RC,409,Leukocyte transfusion ,,,305.26,393.39,3 RC,409,"Level I - Surgical pathology, gross examination only ",,,48.5,62.5,3 RC,409,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization Fingers/toes, amputation, traumatic Foreskin, newborn Hernia sac, any location Hydro",,,108.47,139.78,3 RC,409,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm - arterial/ventricular Anus, tag Appendix, other than incidental Artery, atheromatous plaque Bartho",,,130.77,168.52,3 RC,409,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, ",,,144.71,186.48,3 RC,409,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection Bone - biopsy/curettings Bone fragment(s), pathologic fracture Brain, biopsy Brain/meninges, tumor resection Breast, ",,,870.11,1121.3,3 RC,409,"Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional lymph nodes Colon, segmental resection for tumor Colon, total resection Esophagus, pa",,,1229.72,1584.72,3 RC,409,Levetiracetam ,,,54.38,70.08,3 RC,409,Lidocaine ,,,59.93,77.23,3 RC,409,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a",,,254.4,327.28,3 RC,409,Lipase ,,,27.89,35.94,3 RC,409,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) ",,,55.77,71.87,3 RC,409,Lipoprotein (a) ,,,58.54,75.44,3 RC,409,"Lipoprotein, blood; electrophoretic separation and quantitation ",,,45.98,59.26,3 RC,409,"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation) ",,,139.38,179.62,3 RC,409,"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed ",,,140.77,181.41,3 RC,409,"Lipoprotein, direct measurement; LDL cholesterol ",,,43.21,55.69,3 RC,409,"Lipoprotein, direct measurement; VLDL cholesterol ",,,52.96,68.24,3 RC,409,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) ",,,33.47,43.13,3 RC,409,"Lipoprotein, direct measurement; small dense LDL cholesterol ",,,140.77,181.41,3 RC,409,Lipoprotein-associated phospholipase A2 (Lp-PLA2) ,,,190.95,246.08,3 RC,409,Lithium ,,,27.89,35.94,3 RC,409,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,409,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,409,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,409,Liver imaging; static only ,,,191.2,191.2,1 RC,409,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,409,Luteinizing releasing factor (LRH) ,,,71.1,91.62,3 RC,409,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,910.54,4 RC,409,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,944.25,4 RC,409,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,964.57,4 RC,409,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,1007.64,4 RC,409,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,409,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis ",,,202.12,260.47,3 RC,409,"Lymphocytotoxicity assay, visual crossmatch; with titration ",,,779.23,1004.18,3 RC,409,"Lymphocytotoxicity assay, visual crossmatch; without titration ",,,195.15,251.49,3 RC,409,"MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb) ",,,161.68,208.36,3 RC,409,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants ",,,617.5,795.76,3 RC,409,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis ",,,2171.75,2798.7,3 RC,409,"MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant ",,,493.45,635.9,3 RC,409,"MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme) promoter methylation analysis ",,,512.98,661.06,3 RC,409,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,832.18,1072.42,3 RC,409,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2778.13,3580.13,3 RC,409,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,409,"MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis ",,,791.78,1020.36,3 RC,409,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, W515A, W515K, W515L, W515R) ",,,618.93,797.61,3 RC,409,"MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10 ",,,762.47,982.58,3 RC,409,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,876.78,1129.89,3 RC,409,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,1569.58,2022.69,3 RC,409,"MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1389.76,1790.96,3 RC,409,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,978.54,1261.02,3 RC,409,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2640.13,3402.29,3 RC,409,"MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1267.09,1632.88,3 RC,409,"MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C) ",,,269.02,346.69,3 RC,409,"MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant ",,,722.07,930.52,3 RC,409,"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node) ",,,31.78,40.96,3 RC,409,Macroscopic examination; arthropod ,,,18.14,23.38,3 RC,409,Macroscopic examination; parasite ,,,18.14,23.38,3 RC,409,Magnesium ,,,27.89,35.94,3 RC,409,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,409,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,409,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,409,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,409,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,409,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,409,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,409,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,409,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,409,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,409,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,409,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,409,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,409,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,409,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,409,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,409,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,409,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,409,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,409,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,409,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,409,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,409,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,409,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,409,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,409,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,409,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,409,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,409,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,409,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,409,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,409,Malate dehydrogenase ,,,30.66,39.51,3 RC,409,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,224.51,4 RC,409,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,169.9,4 RC,409,Manganese ,,,110.11,141.9,3 RC,409,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,382.33,4 RC,409,"Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen ",,,98.98,127.56,3 RC,409,"Meat fibers, feces ",,,19.53,25.17,3 RC,409,"Mechanical fragility, RBC ",,,34.86,44.92,3 RC,409,"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report ",,,1653.71,2127.45,3 RC,409,"Mercury, quantitative ",,,66.9,86.21,3 RC,409,Metanephrines ,,,69.71,89.84,3 RC,409,Methadone ,,,98.98,127.56,3 RC,409,Methemalbumin ,,,44.6,57.47,3 RC,409,Methotrexate ,,,158.91,204.79,3 RC,409,"Methylenedioxyamphetamines (MDA, MDEA, MDMA) ",,,98.98,127.56,3 RC,409,Methylphenidate ,,,98.98,127.56,3 RC,409,Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) ,,,374.98,483.23,3 RC,409,"Microdissection (ie, sample preparation of microscopically identified target); laser capture ",,,294.96,380.11,3 RC,409,"Microdissection (ie, sample preparation of microscopically identified target); manual ",,,741.86,956.02,3 RC,409,"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity ",,,92.01,118.58,3 RC,409,"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and",,,1434.36,1848.43,3 RC,409,"Microsomal antibodies (eg, thyroid or liver-kidney), each ",,,59.93,77.23,3 RC,409,"Mitochondrial antibody (eg, M2), each ",,,104.53,134.7,3 RC,409,"Molecular cytogenetics; DNA probe, each (eg, FISH) ",,,87.81,113.16,3 RC,409,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) ",,,143.58,185.03,3 RC,409,"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) ",,,167.27,215.56,3 RC,409,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells ",,,210.48,271.24,3 RC,409,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells ",,,174.24,224.54,3 RC,409,"Molecular pathology procedure, Level 1 (eg, identification of single germline variant ºeg, SNP» by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase",,,263.44,339.49,3 RC,409,"Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant ºtypically using nonsequencing target variant analysis», or detection of a dynamic mutation disorder/t",,,563.16,725.73,3 RC,409,"Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing target variant analysis», immunoglobulin and T-cell receptor ge",,,618.93,797.61,3 RC,409,"Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or dup",,,762.47,982.58,3 RC,409,"Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation ",,,1130.48,1456.83,3 RC,409,"Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array an",,,1239.2,1596.94,3 RC,409,"Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons) ACADVL (acyl-CoA dehydrogenase, very lo",,,1163.95,1499.96,3 RC,409,"Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on on",,,3480.71,4485.54,3 RC,409,"Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP-binding cassette, sub-family A ºABC1», member 4) (eg, Stargardt disease, age-rel",,,8227.09,10602.11,3 RC,409,Molecular pathology procedure; physician interpretation and report ,,,12.25,15.79,3 RC,409,"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen ",,,110.11,141.9,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary pr",,,373.29,481.05,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure ",,,1387.81,1788.45,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure ",,,421.79,543.55,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (List separately in add",,,182.6,235.31,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure ",,,1087.0,1400.8,3 RC,409,"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure ",,,337.05,434.35,3 RC,409,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual",,,321.72,414.59,3 RC,409,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using ",,,313.36,403.82,3 RC,409,Morphometric analysis; nerve ,,,465.86,600.35,3 RC,409,Morphometric analysis; skeletal muscle ,,,251.75,324.42,3 RC,409,"Morphometric analysis; tumor (eg, DNA ploidy) ",,,377.49,486.46,3 RC,409,"Mucin, synovial fluid (Ropes test) ",,,23.69,30.52,3 RC,409,"Mucopolysaccharides, acid, quantitative ",,,117.08,150.88,3 RC,409,"Mucoprotein, blood (seromucoid) (medical necessity procedure) ",,,20.91,26.95,3 RC,409,Muramidase ,,,76.68,98.82,3 RC,409,Mycophenolate (mycophenolic acid) ,,,73.87,95.19,3 RC,409,"Myelin basic protein, cerebrospinal fluid ",,,71.1,91.62,3 RC,409,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; cell-based immunofluorescence assay (CBA), each ",,,50.18,64.67,3 RC,409,"Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting ºFACS»), each ",,,154.71,199.37,3 RC,409,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,464.97,4 RC,409,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,332.27,4 RC,409,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,329.12,4 RC,409,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,206.12,4 RC,409,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,346.29,4 RC,409,Myeloperoxidase (MPO) ,,,209.1,269.46,3 RC,409,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,409,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,409,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,409,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,409,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,409,Myoglobin ,,,52.96,68.24,3 RC,409,"NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants ",,,1013.39,1305.94,3 RC,409,"NRAS (neuroblastoma RAS viral ºv-ras» oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61) ",,,1216.9,1568.2,3 RC,409,"NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis ",,,2131.36,2746.64,3 RC,409,"NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,409,"NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,409,"NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis ",,,853.1,1099.37,3 RC,409,"NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) ",,,1198.8,1544.88,3 RC,409,Nasal smear for eosinophils ,,,23.69,30.52,3 RC,409,Natriuretic peptide ,,,161.68,208.36,3 RC,409,"Natural killer (NK) cells, total count ",,,154.71,199.37,3 RC,409,"Necropsy (autopsy), gross and microscopic; infant with brain ",,,17.54,22.6,3 RC,409,"Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain ",,,17.54,22.6,3 RC,409,"Necropsy (autopsy), gross and microscopic; with brain ",,,29.23,37.66,3 RC,409,"Necropsy (autopsy), gross and microscopic; with brain and spinal cord ",,,31.18,40.18,3 RC,409,"Necropsy (autopsy), gross and microscopic; without CNS ",,,30.18,38.89,3 RC,409,"Necropsy (autopsy), gross examination only; infant with brain ",,,17.54,22.6,3 RC,409,"Necropsy (autopsy), gross examination only; macerated stillborn ",,,22.39,28.85,3 RC,409,"Necropsy (autopsy), gross examination only; stillborn or newborn with brain ",,,16.06,20.7,3 RC,409,"Necropsy (autopsy), gross examination only; with brain ",,,20.48,26.39,3 RC,409,"Necropsy (autopsy), gross examination only; with brain and spinal cord ",,,21.43,27.62,3 RC,409,"Necropsy (autopsy), gross examination only; without CNS ",,,17.54,22.6,3 RC,409,"Necropsy (autopsy), limited, gross and/or microscopic; regional ",,,8.75,11.27,3 RC,409,"Necropsy (autopsy), limited, gross and/or microscopic; single organ ",,,7.79,10.04,3 RC,409,Necropsy (autopsy); coroner's call ,,,4.85,6.25,3 RC,409,Necropsy (autopsy); forensic examination ,,,48.71,62.77,3 RC,409,"Nephelometry, each analyte not elsewhere specified ",,,55.77,71.87,3 RC,409,Nerve teasing preparations ,,,499.29,643.43,3 RC,409,"Neutralization test, viral ",,,69.71,89.84,3 RC,409,Nickel ,,,100.37,129.34,3 RC,409,Nitroblue tetrazolium dye test (NTD) ,,,55.77,71.87,3 RC,409,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,409,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,624.83,4 RC,409,"Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome, Noonan-like syndrome), genomic sequence analysis panel, must include sequencing of",,,8818.13,11363.78,3 RC,409,"Nuclear Matrix Protein 22 (NMP22), qualitative ",,,89.2,114.95,3 RC,409,"Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, ",,,13673.27,17620.52,3 RC,409,Nucleotidase 5'- ,,,45.98,59.26,3 RC,409,"Obstetric panel (includes HIV testing) This panel must include the following: Blood count, complete (CBC), and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC",,,308.08,397.02,3 RC,409,"Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated ",,,196.54,253.28,3 RC,409,Oligoclonal immune (oligoclonal bands) ,,,112.93,145.53,3 RC,409,"Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence r",,,10326.4,13307.46,3 RC,409,"Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score ",,,15931.46,20530.61,3 RC,409,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage ",,,15931.46,20530.61,3 RC,409,"Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score ",,,15931.46,20530.61,3 RC,409,"Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as i",,,15931.46,20530.61,3 RC,409,"Oncology (breast), mRNA, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as in",,,15931.46,20530.61,3 RC,409,"Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence ",,,12817.36,16517.53,3 RC,409,"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool",,,2093.73,2698.15,3 RC,409,"Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as",,,29587.97,38129.54,3 RC,409,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug ",,,730.43,941.29,3 RC,409,"Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combinatio",,,2383.66,3071.79,3 RC,409,"Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 ºhK2»), utilizing plasma or serum, prognostic algorithm reported as a",,,3126.65,4029.26,3 RC,409,"Oncology (lung), mass spectrometric 8-protein signature, including amyloid A, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival ",,,11809.56,15218.78,3 RC,409,"Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score ",,,3689.77,4754.94,3 RC,409,"Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score ",,,1071.93,1381.38,3 RC,409,"Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease",,,15931.46,20530.61,3 RC,409,"Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score ",,,15931.46,20530.61,3 RC,409,"Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate ",,,8349.76,10760.19,3 RC,409,"Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious) ",,,14807.95,19082.76,3 RC,409,"Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores ",,,2139.71,2757.41,3 RC,409,"Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time RT-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing forma",,,15425.45,19878.53,3 RC,409,"Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, a",,,31986.97,41221.08,3 RC,409,Oncoprotein; HER-2/neu ,,,264.87,341.33,3 RC,409,Oncoprotein; des-gamma-carboxy-prothrombin (DCP) ,,,264.87,341.33,3 RC,409,Oocyte identification from follicular fluid ,,,442.57,570.33,3 RC,409,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,409,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,409,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,409,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,409,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,409,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,409,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,409,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,409,"Opiates, 1 or more ",,,98.98,127.56,3 RC,409,Opioids and opiate analogs; 1 or 2 ,,,98.98,127.56,3 RC,409,"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session ",,,133.54,172.09,3 RC,409,"Organic acid, single, quantitative ",,,87.81,113.16,3 RC,409,"Organic acids; qualitative, each specimen ",,,68.28,88.0,3 RC,409,"Organic acids; total, quantitative, each specimen ",,,97.55,125.72,3 RC,409,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,38.7,4 RC,409,Osmolality; blood ,,,27.89,35.94,3 RC,409,Osmolality; urine ,,,27.89,35.94,3 RC,409,"Osmotic fragility, RBC; incubated ",,,54.38,70.08,3 RC,409,"Osmotic fragility, RBC; unincubated ",,,30.66,39.51,3 RC,409,Osteocalcin (bone g1a protein) ,,,122.67,158.08,3 RC,409,"Ova and parasites, direct smears, concentration and identification ",,,36.24,46.7,3 RC,409,"Ovulation tests, by visual color comparison methods for human luteinizing hormone ",,,51.57,66.46,3 RC,409,Oxalate ,,,59.93,77.23,3 RC,409,Oxcarbazepine ,,,54.38,70.08,3 RC,409,Oxycodone ,,,98.98,127.56,3 RC,409,"PABPN1 (polyºA» binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; full gene sequence ",,,2782.33,3585.54,3 RC,409,"PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant ",,,1239.2,1596.94,3 RC,409,"PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate cancer) ",,,1049.64,1352.65,3 RC,409,"PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor ºGIST»), gene analysis, targeted sequence analysis (eg, exons 12, 18) ",,,1354.9,1746.04,3 RC,409,"PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20) ",,,1130.48,1456.83,3 RC,409,"PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F) ",,,1198.8,1544.88,3 RC,409,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quan",,,853.1,1099.37,3 RC,409,"PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative o",,,853.1,1099.37,3 RC,409,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis ",,,3119.68,4020.28,3 RC,409,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis ",,,3165.66,4079.54,3 RC,409,"PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant ",,,192.38,247.92,3 RC,409,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants ",,,837.77,1079.62,3 RC,409,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis ",,,2782.33,3585.54,3 RC,409,"PMS2 (postmeiotic segregation increased 2 ºS. cerevisiae») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants ",,,1361.87,1755.02,3 RC,409,"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant ",,,1233.66,1589.8,3 RC,409,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis ",,,2468.71,3181.38,3 RC,409,"PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant ",,,192.38,247.92,3 RC,409,Parathormone (parathyroid hormone) ,,,170.08,219.18,3 RC,409,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,409,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,409,"Particle agglutination; screen, each antibody ",,,47.41,61.1,3 RC,409,"Particle agglutination; titer, each antibody ",,,43.21,55.69,3 RC,409,Pathogen(s) test for platelets ,,,161.77,208.47,3 RC,409,"Pathology clinical consultation; for a clinical problem, with limited review of patient's history and medical records and straightforward medical decision making When using time for code selection, 5-",,,62.01,79.91,3 RC,409,"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patient's history and medical records and high level of medical decision making When using time for",,,253.69,326.93,3 RC,409,"Pathology clinical consultation; for a moderately complex clinical problem, with review of patient's history and medical records and moderate level of medical decision making When using time for code ",,,133.54,172.09,3 RC,409,"Pathology clinical consultation; prolonged service, each additional 30 minutes (List separately in addition to code for primary procedure) ",,,121.11,156.07,3 RC,409,Pathology consultation during surgery; ,,,99.2,127.84,3 RC,409,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) ",,,80.84,104.18,3 RC,409,"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site ",,,133.54,172.09,3 RC,409,Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for primary procedure) ,,,102.88,132.58,3 RC,409,"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen ",,,171.16,220.58,3 RC,409,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,338.19,4 RC,409,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,342.85,4 RC,409,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,189.82,244.2,4 RC,409,"Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) ",,,181.21,233.52,3 RC,409,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,409,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,153.02,4 RC,409,Phencyclidine (PCP) ,,,151.94,195.8,3 RC,409,Phenobarbital ,,,62.74,80.85,3 RC,409,"Phenylalanine (PKU), blood ",,,22.3,28.74,3 RC,409,"Phenylketones, qualitative ",,,16.71,21.54,3 RC,409,Phenytoin; free ,,,57.16,73.66,3 RC,409,Phenytoin; total ,,,54.38,70.08,3 RC,409,"Phosphatase, acid; prostatic ",,,40.44,52.12,3 RC,409,"Phosphatase, acid; total ",,,32.04,41.29,3 RC,409,"Phosphatase, alkaline; ",,,20.91,26.95,3 RC,409,"Phosphatase, alkaline; heat stable (total not included) ",,,33.47,43.13,3 RC,409,"Phosphatase, alkaline; isoenzymes ",,,61.31,79.01,3 RC,409,Phosphatidylglycerol ,,,68.28,88.0,3 RC,409,"Phosphogluconate, 6-, dehydrogenase, RBC ",,,39.01,50.28,3 RC,409,Phosphohexose isomerase ,,,44.6,57.47,3 RC,409,Phospholipid neutralization; hexagonal phospholipid ,,,73.87,95.19,3 RC,409,Phospholipid neutralization; platelet ,,,73.87,95.19,3 RC,409,Phosphorus inorganic (phosphate); ,,,19.53,25.17,3 RC,409,Phosphorus inorganic (phosphate); urine ,,,23.69,30.52,3 RC,409,"Pinworm exam (eg, cellophane tape prep) ",,,18.14,23.38,3 RC,409,Pinworm examinations ,,,18.14,23.38,3 RC,409,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,409,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,409,Platelet survival study ,,,126.1,126.1,1 RC,409,"Platelet, aggregation (in vitro), each agent ",,,103.14,132.92,3 RC,409,Pooling of platelets or other blood products ,,,131.03,168.85,3 RC,409,"Porphobilinogen, urine; qualitative ",,,23.69,30.52,3 RC,409,"Porphobilinogen, urine; quantitative ",,,34.86,44.92,3 RC,409,"Porphyrins, feces, quantitative ",,,160.3,206.57,3 RC,409,"Porphyrins, urine; qualitative ",,,54.38,70.08,3 RC,409,"Porphyrins, urine; quantitation and fractionation ",,,59.93,77.23,3 RC,409,Posaconazole ,,,111.5,143.69,3 RC,409,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,409,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,409,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,409,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,409,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,409,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,409,"Post-coital direct, qualitative examinations of vaginal or cervical mucous ",,,103.14,132.92,3 RC,409,"Potassium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,409,Potassium; urine ,,,19.53,25.17,3 RC,409,Prealbumin ,,,59.93,77.23,3 RC,409,Pregabalin ,,,98.98,127.56,3 RC,409,Pregnancy-associated plasma protein-A (PAPP-A) ,,,61.31,79.01,3 RC,409,Pregnanediol ,,,87.81,113.16,3 RC,409,Pregnanetriol ,,,86.43,111.38,3 RC,409,Pregnenolone ,,,85.04,109.59,3 RC,409,Preparation of embryo for transfer (any method) ,,,141.11,181.85,3 RC,409,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation ",,,164.5,211.98,3 RC,409,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each ",,,117.08,150.88,3 RC,409,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each ",,,93.4,120.36,3 RC,409,"Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption ",,,140.77,181.41,3 RC,409,Pretreatment of serum for use in RBC antibody identification; by dilution ,,,140.77,181.41,3 RC,409,"Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each ",,,126.87,163.49,3 RC,409,"Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each ",,,140.77,181.41,3 RC,409,Primidone ,,,68.28,88.0,3 RC,409,Procainamide; ,,,246.72,317.95,3 RC,409,"Procainamide; with metabolites (eg, n-acetyl procainamide) ",,,68.28,88.0,3 RC,409,Procalcitonin (PCT) ,,,111.5,143.69,3 RC,409,Progesterone ,,,86.43,111.38,3 RC,409,Proinsulin ,,,110.11,141.9,3 RC,409,Prolactin ,,,79.46,102.39,3 RC,409,Propoxyphene ,,,98.98,127.56,3 RC,409,"Prostaglandin, each ",,,171.47,220.97,3 RC,409,Prostate cancer screening; prostate specific antigen test (psa) ,,,79.46,102.39,3 RC,409,Prostate specific antigen (PSA); complexed (direct measurement) ,,,75.26,96.98,3 RC,409,Prostate specific antigen (PSA); free ,,,75.26,96.98,3 RC,409,Prostate specific antigen (PSA); total ,,,75.26,96.98,3 RC,409,"Protein analysis of tissue by Western Blot, with interpretation and report; ",,,92.01,118.58,3 RC,409,"Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each ",,,107.34,138.33,3 RC,409,"Protein, total, by refractometry, any source ",,,23.69,30.52,3 RC,409,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid) ",,,16.71,21.54,3 RC,409,"Protein, total, except by refractometry; serum, plasma or whole blood ",,,15.33,19.75,3 RC,409,"Protein, total, except by refractometry; urine ",,,15.33,19.75,3 RC,409,"Protein; Western Blot, with interpretation and report, blood or other body fluid ",,,69.71,89.84,3 RC,409,"Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each ",,,119.9,154.51,3 RC,409,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF) ",,,73.87,95.19,3 RC,409,"Protein; electrophoretic fractionation and quantitation, serum ",,,44.6,57.47,3 RC,409,Prothrombin time; ,,,18.14,23.38,3 RC,409,"Prothrombin time; substitution, plasma fractions, each ",,,16.71,21.54,3 RC,409,"Protoporphyrin, RBC; quantitative ",,,58.54,75.44,3 RC,409,"Protoporphyrin, RBC; screen ",,,40.44,52.12,3 RC,409,"Pulmonary disease (idiopathic pulmonary fibrosis ºIPF»), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positi",,,22706.04,29260.91,3 RC,409,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,409,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,409,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,409,Pyridoxal phosphate (Vitamin B-6) ,,,115.7,149.1,3 RC,409,Pyruvate ,,,59.93,77.23,3 RC,409,Pyruvate kinase ,,,39.01,50.28,3 RC,409,"Quantitation of therapeutic drug, not elsewhere specified ",,,76.68,98.82,3 RC,409,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,409,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,409,Quinidine ,,,59.93,77.23,3 RC,409,Quinine ,,,47.41,61.1,3 RC,409,"RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (eg, exons 3-8) ",,,1354.9,1746.04,3 RC,409,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,77.44,99.62,4 RC,409,"Radiologic examination, abdomen; 1 view ",,,30.68,99.62,4 RC,409,"Radiologic examination, abdomen; 2 views ",,,37.83,121.49,4 RC,409,"Radiologic examination, abdomen; 3 or more views ",,,43.96,141.77,4 RC,409,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,165.19,4 RC,409,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,482.14,4 RC,409,"Radiologic examination, ankle; 2 views ",,,33.41,115.24,4 RC,409,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,133.96,4 RC,409,"Radiologic examination, chest; 2 views ",,,34.42,108.98,4 RC,409,"Radiologic examination, chest; 3 views ",,,43.29,137.06,4 RC,409,"Radiologic examination, chest; 4 or more views ",,,47.38,148.02,4 RC,409,"Radiologic examination, chest; single view ",,,26.58,80.9,4 RC,409,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,772.27,4 RC,409,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,500.86,4 RC,409,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,162.09,4 RC,409,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,397.85,4 RC,409,"Radiologic examination, elbow; 2 views ",,,29.99,99.62,4 RC,409,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,113.68,4 RC,409,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,369.72,4 RC,409,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,332.27,4 RC,409,"Radiologic examination, eye, for detection of foreign body ",,,33.41,112.08,4 RC,409,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,162.09,4 RC,409,"Radiologic examination, facial bones; less than 3 views ",,,33.06,105.88,4 RC,409,"Radiologic examination, femur; 1 view ",,,29.99,99.62,4 RC,409,"Radiologic examination, femur; minimum 2 views ",,,36.47,126.15,4 RC,409,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,146.47,4 RC,409,"Radiologic examination, foot; 2 views ",,,28.97,98.07,4 RC,409,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,123.04,4 RC,409,"Radiologic examination, hand; 2 views ",,,32.04,108.98,4 RC,409,"Radiologic examination, hand; minimum of 3 views ",,,37.83,133.96,4 RC,409,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,483.69,4 RC,409,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,112.08,4 RC,409,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,169.9,4 RC,409,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,216.7,4 RC,409,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,143.32,4 RC,409,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,185.46,4 RC,409,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,219.85,4 RC,409,"Radiologic examination, internal auditory meati, complete ",,,63.05,208.89,4 RC,409,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,458.71,4 RC,409,"Radiologic examination, knee; 1 or 2 views ",,,35.1,123.04,4 RC,409,"Radiologic examination, knee; 3 views ",,,41.58,148.02,4 RC,409,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,148.02,4 RC,409,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,166.74,4 RC,409,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,148.02,4 RC,409,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,140.21,4 RC,409,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,216.7,4 RC,409,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,140.21,4 RC,409,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,140.21,4 RC,409,"Radiologic examination, osseous survey, infant ",,,109.02,347.55,4 RC,409,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,344.45,4 RC,409,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,207.34,4 RC,409,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,91.81,4 RC,409,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,141.77,4 RC,409,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,324.47,4 RC,409,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,205.45,4 RC,409,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,141.77,4 RC,409,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,174.55,4 RC,409,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,123.04,4 RC,409,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,138.66,4 RC,409,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,133.96,4 RC,409,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,116.79,4 RC,409,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,113.68,4 RC,409,"Radiologic examination, salivary gland for calculus ",,,38.52,138.66,4 RC,409,"Radiologic examination, sella turcica ",,,33.74,112.08,4 RC,409,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,493.05,4 RC,409,"Radiologic examination, shoulder; 1 view ",,,22.14,66.83,4 RC,409,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,119.89,4 RC,409,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,290.08,4 RC,409,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,127.7,4 RC,409,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,112.08,4 RC,409,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,146.47,4 RC,409,"Radiologic examination, skull; less than 4 views ",,,36.81,127.7,4 RC,409,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,1493.9,4 RC,409,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,402.5,4 RC,409,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,135.51,4 RC,409,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,188.62,4 RC,409,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,224.51,4 RC,409,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,258.89,4 RC,409,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,290.08,4 RC,409,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,370.98,4 RC,409,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,141.77,4 RC,409,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,137.06,4 RC,409,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,140.21,4 RC,409,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,221.4,4 RC,409,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,182.36,4 RC,409,"Radiologic examination, spine, single view, specify level ",,,25.22,79.3,4 RC,409,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,108.98,4 RC,409,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,133.96,4 RC,409,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,152.68,4 RC,409,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,115.24,4 RC,409,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,477.48,4 RC,409,"Radiologic examination, teeth; complete, full mouth ",,,53.85,196.42,4 RC,409,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,148.02,4 RC,409,"Radiologic examination, teeth; single view ",,,13.29,37.15,4 RC,409,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,194.87,4 RC,409,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,121.49,4 RC,409,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,464.97,4 RC,409,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,405.65,4 RC,409,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,510.27,4 RC,409,"Radiologic examination, wrist; 2 views ",,,34.77,121.49,4 RC,409,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,152.68,4 RC,409,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,91.81,4 RC,409,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,98.07,4 RC,409,"Radiologic examination; clavicle, complete ",,,33.06,113.68,4 RC,409,"Radiologic examination; forearm, 2 views ",,,29.99,101.17,4 RC,409,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,113.68,4 RC,409,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,112.08,4 RC,409,"Radiologic examination; neck, soft tissue ",,,32.37,107.43,4 RC,409,Radiologic examination; optic foramina ,,,38.52,126.15,4 RC,409,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,162.09,4 RC,409,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,408.76,4 RC,409,"Radiologic examination; scapula, complete ",,,24.2,69.94,4 RC,409,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,144.87,4 RC,409,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,113.68,4 RC,409,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,112.08,4 RC,409,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,107.43,4 RC,409,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,87.12,112.08,4 RC,409,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,409,"Radiological examination, surgical specimen ",,,42.94,126.15,4 RC,409,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,409,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,409,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,409,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,409,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,409,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,409,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,409,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,409,"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone) ",,,292.71,377.21,3 RC,409,Receptor assay; estrogen ,,,361.04,465.26,3 RC,409,Receptor assay; non-endocrine (specify receptor) ,,,150.55,194.02,3 RC,409,Receptor assay; progesterone ,,,266.25,343.11,3 RC,409,Red cell survival study ,,,126.1,126.1,1 RC,409,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,409,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,409,"Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i",,,36.24,46.7,3 RC,409,"Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) ",,,861.45,1110.14,3 RC,409,Renin ,,,90.63,116.79,3 RC,409,Reptilase test ,,,40.44,52.12,3 RC,409,Reticulated platelet assay ,,,146.35,188.6,3 RC,409,Rheumatoid factor; qualitative ,,,25.07,32.31,3 RC,409,Rheumatoid factor; quantitative ,,,23.69,30.52,3 RC,409,Riboflavin (Vitamin B-2) ,,,83.66,107.81,3 RC,409,Rufinamide ,,,111.5,143.69,3 RC,409,Russell viper venom time (includes venom); diluted ,,,39.01,50.28,3 RC,409,Russell viper venom time (includes venom); undiluted ,,,72.48,93.41,3 RC,409,"SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis ",,,790.35,1018.52,3 RC,409,"SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z) ",,,179.82,231.74,3 RC,409,"SF3B1 (splicing factor º3b» subunit B1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, A672T, E622D, L833F, R625C, R625L) ",,,794.56,1023.93,3 RC,409,"SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5) ",,,719.3,926.95,3 RC,409,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analys",,,563.16,725.73,3 RC,409,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence ",,,1239.2,1596.94,3 RC,409,"SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s) ",,,762.47,982.58,3 RC,409,"SMPD1 (sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330) ",,,193.77,249.71,3 RC,409,"SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis ",,,210.48,271.24,3 RC,409,"SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, P95H, P95L) ",,,722.07,930.52,3 RC,409,Salicylate ,,,76.68,98.82,3 RC,409,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,409,Salivary gland function study ,,,104.3,104.3,1 RC,409,Salivary gland imaging; ,,,175.52,175.52,1 RC,409,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,409,"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision ",,,71.1,91.62,3 RC,409,"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening ",,,131.03,168.85,3 RC,409,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision ",,,83.66,107.81,3 RC,409,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under ",,,111.5,143.69,3 RC,409,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under ",,,108.73,140.11,3 RC,409,"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision ",,,181.21,233.52,3 RC,409,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,409,"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision ",,,71.1,91.62,3 RC,409,Sedative hypnotics (non-benzodiazepines) ,,,98.98,127.56,3 RC,409,"Sedimentation rate, erythrocyte; automated ",,,11.17,14.4,3 RC,409,"Sedimentation rate, erythrocyte; non-automated ",,,18.14,23.38,3 RC,409,Selenium ,,,104.53,134.7,3 RC,409,Semen analysis; motility and count (not including Huhner test) ,,,34.86,44.92,3 RC,409,Semen analysis; presence and/or motility of sperm excluding huhner ,,,26.5,34.15,3 RC,409,Semen analysis; presence and/or motility of sperm including Huhner test (post coital) ,,,40.44,52.12,3 RC,409,"Semen analysis; sperm presence and motility of sperm, if performed ",,,50.18,64.67,3 RC,409,"Semen analysis; volume, count, motility, and differential ",,,50.18,64.67,3 RC,409,"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger) ",,,64.13,82.64,3 RC,409,Serotonin ,,,126.87,163.49,3 RC,409,Serum bactericidal titer (Schlichter test) ,,,61.31,79.01,3 RC,409,Serum screening for cytotoxic percent reactive antibody (PRA); quick method ,,,122.67,158.08,3 RC,409,Serum screening for cytotoxic percent reactive antibody (PRA); standard method ,,,323.41,416.77,3 RC,409,Sex chromatin identification; Barr bodies ,,,73.87,95.19,3 RC,409,"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks ",,,33.47,43.13,3 RC,409,Sex hormone binding globulin (SHBG) ,,,89.2,114.95,3 RC,409,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,277.61,4 RC,409,Sialic acid ,,,55.77,71.87,3 RC,409,"Sialography, radiological supervision and interpretation ",,,120.98,469.67,4 RC,409,"Sickling of RBC, reduction ",,,22.3,28.74,3 RC,409,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,409,Silica ,,,103.14,132.92,3 RC,409,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,409,Sirolimus ,,,57.16,73.66,3 RC,409,Skeletal muscle relaxants; 1 or 2 ,,,98.98,127.56,3 RC,409,Skin test; candida ,,,79.46,102.39,3 RC,409,Skin test; histoplasmosis ,,,30.4,39.17,3 RC,409,"Skin test; tuberculosis, intradermal ",,,41.52,53.51,3 RC,409,"Skin test; unlisted antigen, each ",,,26.2,33.76,3 RC,409,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types ",,,18.14,23.38,3 RC,409,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites ",,,73.87,95.19,3 RC,409,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types ",,,22.3,28.74,3 RC,409,"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses) ",,,25.07,32.31,3 RC,409,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps) ",,,23.69,30.52,3 RC,409,Sodium; other source ,,,19.53,25.17,3 RC,409,"Sodium; serum, plasma or whole blood ",,,19.53,25.17,3 RC,409,Sodium; urine ,,,20.91,26.95,3 RC,409,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; DNA analysis or combined DNA and RNA an",,,2458.92,3168.77,3 RC,409,"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; RNA analysis ",,,2458.92,3168.77,3 RC,409,"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform exp",,,12010.29,15477.47,6 RC,409,Somatomedin ,,,87.81,113.16,3 RC,409,Somatostatin ,,,75.26,96.98,3 RC,409,"Special stain including interpretation and report; Group I for microorganisms (eg, acid fast, methenamine silver) ",,,359.35,463.08,3 RC,409,"Special stain including interpretation and report; Group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistoche",,,291.06,375.09,3 RC,409,"Special stain including interpretation and report; Group III, for enzyme constituents ",,,453.87,584.9,3 RC,409,Special stain including interpretation and report; histochemical stain on frozen tissue block (List separately in addition to code for primary procedure) ,,,292.45,376.87,3 RC,409,Specific gravity (except urine) ,,,13.94,17.97,3 RC,409,"Spectrophotometry, analyte not elsewhere specified ",,,33.47,43.13,3 RC,409,Sperm antibodies ,,,43.21,55.69,3 RC,409,"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated) ",,,80.84,104.18,3 RC,409,"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test ",,,43.21,55.69,3 RC,409,Sperm evaluation; hamster penetration test ,,,80.84,104.18,3 RC,409,Sperm identification from aspiration (other than seminal fluid) ,,,141.11,181.85,3 RC,409,"Sperm identification from testis tissue, fresh or cryopreserved ",,,141.11,181.85,3 RC,409,"Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,409,"Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis ",,,141.11,181.85,3 RC,409,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,409,"Splenoportography, radiological supervision and interpretation ",,,624.84,1788.29,4 RC,409,"Splitting of blood or blood products, each unit ",,,103.14,132.92,3 RC,409,"Sputum, obtaining specimen, aerosol induced technique (separate procedure) ",,,75.0,96.65,3 RC,409,"Stem cells (ie, CD34), total count ",,,320.59,413.14,3 RC,409,"Stereoisomer (enantiomer) analysis, single drug class ",,,98.98,127.56,3 RC,409,"Stimulants, synthetic ",,,98.98,127.56,3 RC,409,Storage (per year); embryo(s) ,,,442.57,570.33,3 RC,409,Storage (per year); oocyte(s) ,,,912.2,1175.54,3 RC,409,"Storage (per year); reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,409,Storage (per year); sperm/semen ,,,442.57,570.33,3 RC,409,"Streptokinase, antibody ",,,51.57,66.46,3 RC,409,"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen ",,,22.3,28.74,3 RC,409,"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen ",,,47.41,61.1,3 RC,409,"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen ",,,22.3,28.74,3 RC,409,"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen ",,,47.41,61.1,3 RC,409,"Sugars, chromatographic, TLC or paper chromatography ",,,160.3,206.57,3 RC,409,"Sulfate, urine ",,,22.3,28.74,3 RC,409,"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method ",,,773.9,997.31,3 RC,409,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) ",,,19.53,25.17,3 RC,409,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) ",,,30.66,39.51,3 RC,409,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme ",,,19.53,25.17,3 RC,409,"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent ",,,27.89,35.94,3 RC,409,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration ºMIC» or breakpoint), each multi-antimicrobial, per plate ",,,36.24,46.7,3 RC,409,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure) ",,,165.88,213.77,3 RC,409,"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent ",,,30.66,39.51,3 RC,409,Sweat collection by iontophoresis ,,,10.87,14.01,3 RC,409,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) ",,,18.14,23.38,3 RC,409,"Syphilis test, non-treponemal antibody; quantitative ",,,18.14,23.38,3 RC,409,"T cells; absolute CD4 and CD8 count, including ratio ",,,193.77,249.71,3 RC,409,T cells; absolute CD4 count ,,,110.11,141.9,3 RC,409,T cells; total count ,,,154.71,199.37,3 RC,409,"TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles ",,,563.16,725.73,3 RC,409,"TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) ",,,762.47,982.58,3 RC,409,"TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q) ",,,563.16,725.73,3 RC,409,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene sequence ",,,2640.13,3402.29,3 RC,409,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant ",,,1267.09,1632.88,3 RC,409,"TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology) ",,,1354.9,1746.04,3 RC,409,"TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3) ",,,719.3,926.95,3 RC,409,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction) ",,,860.07,1108.36,3 RC,409,"TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot) ",,,203.51,262.26,3 RC,409,"TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) ",,,829.41,1068.85,3 RC,409,"TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant) ",,,719.3,926.95,3 RC,409,Tacrolimus ,,,57.16,73.66,3 RC,409,Tapentadol ,,,98.98,127.56,3 RC,409,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,276.06,4 RC,409,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,409,"Testosterone; bioavailable, direct measurement (eg, differential precipitation) ",,,210.48,271.24,3 RC,409,Testosterone; free ,,,104.53,134.7,3 RC,409,Testosterone; total ,,,105.96,136.54,3 RC,409,"Thawing and expansion of frozen cells, each aliquot ",,,50.18,64.67,3 RC,409,Thawing of cryopreserved; embryo(s) ,,,442.57,570.33,3 RC,409,"Thawing of cryopreserved; oocytes, each aliquot ",,,442.57,570.33,3 RC,409,"Thawing of cryopreserved; reproductive tissue, testicular/ovarian ",,,442.57,570.33,3 RC,409,"Thawing of cryopreserved; sperm/semen, each aliquot ",,,141.11,181.85,3 RC,409,Theophylline ,,,58.54,75.44,3 RC,409,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,739.77,4 RC,409,Thiamine (Vitamin B-1) ,,,87.81,113.16,3 RC,409,Thiocyanate ,,,47.41,61.1,3 RC,409,Thiopurine S-methyltransferase (TPMT) ,,,90.63,116.79,3 RC,409,Thrombin time; plasma ,,,23.69,30.52,3 RC,409,Thrombin time; titer ,,,27.89,35.94,3 RC,409,Thrombomodulin ,,,71.1,91.62,3 RC,409,"Thromboplastin inhibition, tissue ",,,39.01,50.28,3 RC,409,"Thromboplastin time, partial (PTT); plasma or whole blood ",,,25.07,32.31,3 RC,409,"Thromboplastin time, partial (PTT); substitution, plasma fractions, each ",,,26.5,34.15,3 RC,409,"Thromboxane metabolite(s), including thromboxane if performed, urine ",,,144.97,186.82,3 RC,409,Thyroglobulin ,,,65.51,84.43,3 RC,409,Thyroglobulin antibody ,,,65.51,84.43,3 RC,409,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,409,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,409,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,409,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) ,,,26.5,34.15,3 RC,409,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,409,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,409,Thyroid stimulating hormone (TSH) ,,,69.71,89.84,3 RC,409,Thyroid stimulating immune globulins (TSI) ,,,209.1,269.46,3 RC,409,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,409,Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3) ,,,207.71,267.67,3 RC,409,Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) ,,,275.99,355.67,3 RC,409,Thyroxine binding globulin (TBG) ,,,61.31,79.01,3 RC,409,Thyroxine; free ,,,37.63,48.49,3 RC,409,"Thyroxine; requiring elution (eg, neonatal) ",,,26.5,34.15,3 RC,409,Thyroxine; total ,,,27.89,35.94,3 RC,409,Tiagabine ,,,111.5,143.69,3 RC,409,"Tissue culture for neoplastic disorders; bone marrow, blood cells ",,,591.04,761.67,3 RC,409,Tissue culture for neoplastic disorders; solid tumor ,,,606.37,781.42,3 RC,409,Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells ,,,618.93,797.61,3 RC,409,Tissue culture for non-neoplastic disorders; lymphocyte ,,,479.5,617.93,3 RC,409,Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy ,,,578.49,745.49,3 RC,409,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies) ",,,18.14,23.38,3 RC,409,"Tissue transglutaminase, each immunoglobulin (Ig) class ",,,47.41,61.1,3 RC,409,Tobramycin ,,,66.9,86.21,3 RC,409,Tocopherol alpha (Vitamin E) ,,,58.54,75.44,3 RC,409,Topiramate ,,,48.8,62.89,3 RC,409,"Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) ",,,80.84,104.18,3 RC,409,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only ",,,297.19,382.33,3 RC,409,"Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere ",,,297.19,382.33,3 RC,409,Tramadol ,,,98.98,127.56,3 RC,409,Transcortin (cortisol binding globulin) ,,,73.87,95.19,3 RC,409,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,1052.64,4 RC,409,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,409,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,628.61,4 RC,409,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,409,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,409,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,409,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,409,Transferase; alanine amino (ALT) (SGPT) ,,,22.3,28.74,3 RC,409,Transferase; aspartate amino (AST) (SGOT) ,,,20.91,26.95,3 RC,409,Transferrin ,,,52.96,68.24,3 RC,409,"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorith",,,2635.97,3396.94,3 RC,409,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,409,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,409,Triglycerides ,,,23.69,30.52,3 RC,409,Triiodothyronine T3; free ,,,69.71,89.84,3 RC,409,Triiodothyronine T3; reverse ,,,65.51,84.43,3 RC,409,Triiodothyronine T3; total (TT-3) ,,,58.54,75.44,3 RC,409,"Troponin, qualitative ",,,41.83,53.9,3 RC,409,"Troponin, quantitative ",,,51.57,66.46,3 RC,409,Trypsin; duodenal fluid ,,,29.27,37.72,3 RC,409,"Trypsin; feces, qualitative ",,,30.66,39.51,3 RC,409,"Trypsin; feces, quantitative, 24-hour collection ",,,40.44,52.12,3 RC,409,"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension ",,,411.22,529.93,3 RC,409,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon ",,,255.08,328.72,3 RC,409,Tyrosine ,,,43.21,55.69,3 RC,409,"U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, S34F, S34Y, Q157R, Q157P) ",,,794.56,1023.93,3 RC,409,"UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated hyperbilirubinemia ºGilbert syndrome») gene analysis, common variants (eg, *28, *36, *37) ",,,963.21,1241.27,3 RC,409,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,409,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,409,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,409,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,409,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,409,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,409,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,409,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,409,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,409,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,409,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,409,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,409,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,409,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,409,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,409,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,409,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,409,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,409,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,409,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,409,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,409,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,409,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,409,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,409,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,409,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,409,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,409,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,409,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,409,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,409,Unlisted chemistry procedure ,,,99.55,128.28,3 RC,409,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,409,Unlisted cytogenetic study ,,,141.11,181.85,3 RC,409,Unlisted cytopathology procedure ,,,141.11,181.85,3 RC,409,Unlisted diagnostic radiographic procedure ,,,82.52,382.33,4 RC,409,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,207.68,4 RC,409,Unlisted hematology and coagulation procedure ,,,99.55,128.28,3 RC,409,Unlisted immunology procedure ,,,99.55,128.28,3 RC,409,"Unlisted in vivo (eg, transcutaneous) laboratory service ",,,99.55,128.28,3 RC,409,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,409,Unlisted microbiology procedure ,,,99.55,128.28,3 RC,409,Unlisted miscellaneous pathology test ,,,141.11,181.85,3 RC,409,Unlisted molecular pathology procedure ,,,472.97,609.5,3 RC,409,Unlisted multianalyte assay with algorithmic analysis ,,,1010.45,1302.15,3 RC,409,Unlisted necropsy (autopsy) procedure ,,,99.55,128.28,3 RC,409,Unlisted reproductive medicine laboratory procedure ,,,141.11,181.85,3 RC,409,Unlisted surgical pathology procedure ,,,141.11,181.85,3 RC,409,Unlisted transfusion medicine procedure ,,,70.23,90.51,3 RC,409,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,409,Unlisted urinalysis procedure ,,,99.55,128.28,3 RC,409,"Urea nitrogen, clearance ",,,29.27,37.72,3 RC,409,"Urea nitrogen, urine ",,,22.3,28.74,3 RC,409,Urea nitrogen; quantitative ,,,16.71,21.54,3 RC,409,"Urea nitrogen; semiquantitative (eg, reagent strip test) ",,,20.91,26.95,3 RC,409,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,409,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,242.6,4 RC,409,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,419.67,4 RC,409,Uric acid; blood ,,,18.14,23.38,3 RC,409,Uric acid; other source ,,,20.91,26.95,3 RC,409,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w",,,9.74,16.18,6 RC,409,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate",,,13.94,21.54,6 RC,409,Urinalysis; 2 or 3 glass test ,,,19.53,25.17,3 RC,409,"Urinalysis; bacteriuria screen, except by culture or dipstick ",,,122.67,158.08,3 RC,409,Urinalysis; microscopic only ,,,12.56,16.18,3 RC,409,"Urinalysis; qualitative or semiquantitative, except immunoassays ",,,8.36,10.77,3 RC,409,"Urine pregnancy test, by visual color comparison methods ",,,34.86,44.92,3 RC,409,"Urobilinogen, feces, quantitative ",,,69.71,89.84,3 RC,409,"Urobilinogen, urine; qualitative ",,,18.14,23.38,3 RC,409,"Urobilinogen, urine; quantitative, timed specimen ",,,39.01,50.28,3 RC,409,"Urobilinogen, urine; semiquantitative ",,,25.07,32.31,3 RC,409,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,530.25,4 RC,409,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,532.09,4 RC,409,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,556.78,4 RC,409,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,620.8,4 RC,409,"Urography, retrograde, with or without KUB ",,,78.73,247.93,4 RC,409,"VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T) ",,,362.42,467.05,3 RC,409,Valproic acid (dipropylacetic acid); free ,,,55.77,71.87,3 RC,409,Valproic acid (dipropylacetic acid); total ,,,55.77,71.87,3 RC,409,Vancomycin ,,,55.77,71.87,3 RC,409,"Vanillylmandelic acid (VMA), urine ",,,64.13,82.64,3 RC,409,Vasoactive intestinal peptide (VIP) ,,,144.97,186.82,3 RC,409,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,374.42,4 RC,409,"Vasopressin (antidiuretic hormone, ADH) ",,,139.38,179.62,3 RC,409,Vedolizumab ,,,158.91,204.79,3 RC,409,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,409,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,352.26,4 RC,409,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,288.53,4 RC,409,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,310.4,4 RC,409,"Venography, epidural, radiological supervision and interpretation ",,,132.23,352.26,4 RC,409,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,305.7,4 RC,409,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,282.27,4 RC,409,"Venography, orbital, radiological supervision and interpretation ",,,110.76,350.65,4 RC,409,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,364.72,4 RC,409,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,322.57,4 RC,409,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,459.97,4 RC,409,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,341.29,4 RC,409,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,369.42,4 RC,409,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,409,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,409,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,116.79,4 RC,409,Very long chain fatty acids ,,,80.84,104.18,3 RC,409,"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus ",,,80.84,104.18,3 RC,409,"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity) ",,,139.38,179.62,3 RC,409,"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection ",,,80.84,104.18,3 RC,409,"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect ",,,107.34,138.33,3 RC,409,"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate ",,,83.66,107.81,3 RC,409,Viscosity ,,,47.41,61.1,3 RC,409,Vitamin A ,,,47.41,61.1,3 RC,409,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed ",,,158.91,204.79,3 RC,409,"Vitamin D; 25 hydroxy, includes fraction(s), if performed ",,,121.28,156.3,3 RC,409,Vitamin K ,,,55.77,71.87,3 RC,409,"Vitamin, not otherwise specified ",,,69.71,89.84,3 RC,409,"Volatiles (eg, acetic anhydride, diethylether) ",,,69.71,89.84,3 RC,409,"Voltage-gated calcium channel antibody, each ",,,50.18,64.67,3 RC,409,"Volume measurement for timed collection, each ",,,15.33,19.75,3 RC,409,"Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit ",,,131.03,168.85,3 RC,409,Voriconazole ,,,111.5,143.69,3 RC,409,"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s) ",,,496.26,639.52,3 RC,409,"Wet mounts, including preparations of vaginal, cervical or skin specimens ",,,71.1,91.62,3 RC,409,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,409,"Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes ºMELAS», myoclonic epilepsy with ragged-red fibers ºMERFF», neuropathy, ataxi",,,5294.2,6822.55,3 RC,409,"Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed ",,,3850.11,4961.57,3 RC,409,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, ",,,3759.48,4844.78,3 RC,409,"X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, H",,,3759.48,4844.78,3 RC,409,"Xylose absorption test, blood and/or urine ",,,52.96,68.24,3 RC,409,"ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, E65fs, E122fs, R448fs) ",,,794.56,1023.93,3 RC,409,Zinc ,,,47.41,61.1,3 RC,409,Zonisamide ,,,54.38,70.08,3 RC,409,"b-Hexosaminidase, each assay ",,,69.71,89.84,3 RC,409,"pH; body fluid, not otherwise specified ",,,15.33,19.75,3 RC,409,pH; exhaled breath condensate ,,,15.33,19.75,3 RC,410, Respiratory Services General Classification ,,,218.0,502.0,8 RC,412, Respiratory Services Inhalation Services ,,,218.0,502.0,8 RC,413, Respiratory Services Hyperbaric Oxygen Therapy ,,,218.0,2807.0,13 RC,419, Respiratory Services Other ,,,218.0,502.0,8 RC,420, Physical Therapy General Classification ,,,218.0,502.0,8 RC,421, Physical Therapy Visit ,,,218.0,502.0,8 RC,422, Physical Therapy Hourly ,,,218.0,502.0,8 RC,423, Physical Therapy Group ,,,218.0,502.0,8 RC,424, Physical Therapy Evaluation or Reevaluation ,,,218.0,502.0,8 RC,429, Physical Therapy Other ,,,218.0,502.0,8 RC,430, Occupational Therapy General Classification ,,,218.0,502.0,8 RC,431, Occupational Therapy Visit ,,,218.0,502.0,8 RC,432, Occupational Therapy Hourly ,,,218.0,502.0,8 RC,433, Occupational Therapy Group ,,,218.0,502.0,8 RC,434, Occupational Therapy Evaluation or Reevaluation ,,,218.0,502.0,8 RC,439, Occupational Therapy Other ,,,218.0,502.0,8 RC,440, Speech Therapy - Language Pathology General Classification ,,,218.0,502.0,8 RC,441, Speech Therapy - Language Pathology Visit ,,,218.0,502.0,8 RC,442, Speech Therapy - Language Pathology Hourly ,,,218.0,502.0,8 RC,443, Speech Therapy - Language Pathology Group ,,,218.0,502.0,8 RC,444, Speech Therapy - Language Pathology Evaluation or Reevaluation ,,,218.0,502.0,8 RC,449, Speech Therapy - Language Pathology Other ,,,218.0,502.0,8 RC,450, Emergency Room General Classification ,,,261.0,995.0,24 RC,450,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service) ",,,4520.0,7960.0,10 RC,450,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,4258.0,7960.0,13 RC,450,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,77.04,832.0,19 RC,450,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,363.0,7960.0,18 RC,450,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,77.04,4158.0,19 RC,450,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,320.0,4206.0,18 RC,450,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,77.04,1819.0,19 RC,450,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,754.0,8 RC,450,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,1819.0,8 RC,450,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,4158.0,8 RC,450,Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,1160.0,4158.0,7 RC,450,Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,4520.0,7960.0,7 RC,451, Emergency Room EMTALA Emergency Medical Screening ,,,261.0,995.0,24 RC,451,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service) ",,,4520.0,7960.0,10 RC,451,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,4258.0,7960.0,13 RC,451,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,77.04,832.0,19 RC,451,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,363.0,7960.0,18 RC,451,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,77.04,4158.0,19 RC,451,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,320.0,4206.0,18 RC,451,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,77.04,1819.0,19 RC,451,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,754.0,8 RC,451,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,1819.0,8 RC,451,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,4158.0,8 RC,451,Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,1160.0,4158.0,7 RC,451,Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,4520.0,7960.0,7 RC,452, Emergency Room ER Beyond EMTALA ,,,261.0,4060.0,25 RC,452,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service) ",,,4520.0,7960.0,10 RC,452,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,4258.0,7960.0,13 RC,452,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,77.04,832.0,19 RC,452,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,363.0,7960.0,18 RC,452,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,77.04,4158.0,19 RC,452,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,320.0,4206.0,18 RC,452,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,77.04,1819.0,19 RC,452,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,754.0,8 RC,452,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,1819.0,8 RC,452,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,4158.0,8 RC,452,Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,1160.0,4158.0,7 RC,452,Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,4520.0,7960.0,7 RC,456, Emergency Room Urgent Care ,,,218.0,1492.0,28 RC,456,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,4258.0,6166.0,3 RC,456,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,77.04,632.0,9 RC,456,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,363.0,5904.0,8 RC,456,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,77.04,1947.0,9 RC,456,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,320.0,4206.0,8 RC,456,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,77.04,1123.0,9 RC,456,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,77.04,1 RC,456,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,77.04,1 RC,456,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,77.04,1 RC,459, Emergency Room Other ,,,261.0,995.0,24 RC,459,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service) ",,,4520.0,7960.0,10 RC,459,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes ",,,4258.0,7960.0,13 RC,459,Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ,,,77.04,832.0,19 RC,459,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ",,,363.0,7960.0,18 RC,459,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ",,,77.04,4158.0,19 RC,459,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ",,,320.0,4206.0,18 RC,459,"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ",,,77.04,1819.0,19 RC,459,Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,754.0,8 RC,459,Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,1819.0,8 RC,459,Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,77.04,4158.0,8 RC,459,Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,1160.0,4158.0,7 RC,459,Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is loca,,,4520.0,7960.0,7 RC,460, Pulmonary Function General Classification ,,,291.0,416.0,2 RC,469, Pulmonary Function Other ,,,291.0,416.0,2 RC,470, Audiology General Classification ,,,164.0,235.0,2 RC,471, Audiology Diagnostic ,,,164.0,235.0,2 RC,472, Audiology Treatment ,,,164.0,235.0,2 RC,479, Audiology Other ,,,164.0,235.0,2 RC,480, Cardiology General Classification ,,,2331.0,3326.0,2 RC,480,1 epidur inject-C/thor ,,,5841.0,5841.0,1 RC,480,1 epidural inject anes-L ,,,5841.0,5841.0,1 RC,480,1 inject anes-subarach ,,,5841.0,5841.0,1 RC,480,1 subar inject anes-cont ,,,5841.0,5841.0,1 RC,480,1 subar inject anes-diff ,,,5841.0,5841.0,1 RC,480,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,6326.0,6326.0,1 RC,480,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,4988.0,4988.0,1 RC,480,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,6326.0,6326.0,1 RC,480,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,4988.0,4988.0,1 RC,480,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,4988.0,4988.0,1 RC,480,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,4988.0,4988.0,1 RC,480,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,5841.0,5841.0,1 RC,480,ASPIRATE/INJECT THYRIOD CYST ,,,5841.0,5841.0,1 RC,480,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,2251.0,2251.0,1 RC,480,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,2251.0,2251.0,1 RC,480,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,6326.0,6326.0,1 RC,480,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,5841.0,5841.0,1 RC,480,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,9124.0,9124.0,1 RC,480,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,5841.0,5841.0,1 RC,480,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,9124.0,9124.0,1 RC,480,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,21231.0,43890.0,3 RC,480,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,5841.0,5841.0,1 RC,480,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,5841.0,5841.0,1 RC,480,Amniocentesis; diagnostic ,,,2251.0,2251.0,1 RC,480,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,5841.0,5841.0,1 RC,480,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,5841.0,5841.0,1 RC,480,Amputation of penis; complete ,,,2434.0,2434.0,1 RC,480,Amputation of penis; partial ,,,4988.0,4988.0,1 RC,480,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,5841.0,5841.0,1 RC,480,Anastomosis; facial-hypoglossal ,,,5841.0,5841.0,1 RC,480,Anastomosis; facial-spinal accessory ,,,5841.0,5841.0,1 RC,480,Anorectal manometry ,,,2251.0,2251.0,1 RC,480,Antepartum care only; 4-6 visits ,,,5841.0,5841.0,1 RC,480,Antepartum care only; 7 or more visits ,,,5841.0,5841.0,1 RC,480,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,4988.0,4988.0,1 RC,480,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,3041.0,3041.0,1 RC,480,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,3041.0,3041.0,1 RC,480,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,2251.0,2251.0,1 RC,480,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2434.0,2434.0,1 RC,480,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,6326.0,6326.0,1 RC,480,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,6326.0,6326.0,1 RC,480,Artificial insemination; intra-cervical ,,,5841.0,5841.0,1 RC,480,Artificial insemination; intra-uterine ,,,5841.0,5841.0,1 RC,480,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,2434.0,2434.0,1 RC,480,"Aspiration and/or injection, thyroid cyst ",,,2251.0,2251.0,1 RC,480,Aspiration of bladder; by needle ,,,2251.0,2251.0,1 RC,480,Aspiration of bladder; by trocar or intracatheter ,,,2434.0,2434.0,1 RC,480,Aspiration of bladder; with insertion of suprapubic catheter ,,,3041.0,3041.0,1 RC,480,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,3041.0,3041.0,1 RC,480,BIOPSY EYE MUSCLE ,,,5841.0,5841.0,1 RC,480,BRAIN SURGERY USING COMPUTER ,,,5841.0,5841.0,1 RC,480,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,5841.0,5841.0,1 RC,480,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,5841.0,5841.0,1 RC,480,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,5841.0,5841.0,1 RC,480,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,5841.0,5841.0,1 RC,480,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,5841.0,5841.0,1 RC,480,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,5841.0,5841.0,1 RC,480,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,5841.0,5841.0,1 RC,480,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,5841.0,5841.0,1 RC,480,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,5841.0,5841.0,1 RC,480,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,5841.0,5841.0,1 RC,480,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,5841.0,5841.0,1 RC,480,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,5841.0,5841.0,1 RC,480,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,5841.0,5841.0,1 RC,480,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,5841.0,5841.0,1 RC,480,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,2434.0,2434.0,1 RC,480,Biopsy external auditory canal ,,,2434.0,2434.0,1 RC,480,Biopsy external ear ,,,5841.0,5841.0,1 RC,480,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,2251.0,2251.0,1 RC,480,Biopsy of conjunctiva ,,,2251.0,2251.0,1 RC,480,Biopsy of cornea ,,,2251.0,2251.0,1 RC,480,"Biopsy of epididymis, needle ",,,2251.0,2251.0,1 RC,480,Biopsy of extraocular muscle ,,,4988.0,4988.0,1 RC,480,Biopsy of lacrimal gland ,,,3041.0,3041.0,1 RC,480,Biopsy of lacrimal sac ,,,3041.0,3041.0,1 RC,480,Biopsy of nerve ,,,3041.0,3041.0,1 RC,480,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,5841.0,5841.0,1 RC,480,"Biopsy of pancreas, percutaneous needle ",,,2434.0,2434.0,1 RC,480,Biopsy of penis; (separate procedure) ,,,2434.0,2434.0,1 RC,480,Biopsy of penis; deep structures ,,,3041.0,3041.0,1 RC,480,"Biopsy of spinal cord, percutaneous needle ",,,2434.0,2434.0,1 RC,480,"Biopsy of testis, incisional (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Biopsy of testis, needle (separate procedure) ",,,2434.0,2434.0,1 RC,480,Biopsy of urethra ,,,3041.0,3041.0,1 RC,480,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,3041.0,3041.0,1 RC,480,Biopsy of vaginal mucosa; simple (separate procedure) ,,,2251.0,2251.0,1 RC,480,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,5841.0,5841.0,1 RC,480,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Biopsy thyroid, percutaneous core needle ",,,2251.0,2251.0,1 RC,480,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,2434.0,2434.0,1 RC,480,"Biopsy, prostate, any approach, nonimaging-guided ",,,2434.0,2434.0,1 RC,480,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,2434.0,2434.0,1 RC,480,Bladder instillation of anticarcinogenic agent (including retention time) ,,,5841.0,5841.0,1 RC,480,"Bladder irrigation, simple, lavage and/or instillation ",,,5841.0,5841.0,1 RC,480,"Blepharotomy, drainage of abscess, eyelid ",,,5841.0,5841.0,1 RC,480,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,9124.0,9124.0,1 RC,480,Bundle of His recording ,,,21231.0,43890.0,3 RC,480,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,5841.0,5841.0,1 RC,480,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,5841.0,5841.0,1 RC,480,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,5841.0,5841.0,1 RC,480,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,5841.0,5841.0,1 RC,480,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,5841.0,5841.0,1 RC,480,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,5841.0,5841.0,1 RC,480,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,5841.0,5841.0,1 RC,480,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,5841.0,5841.0,1 RC,480,CATHETERIZE MIDDLE EAR CANAL ,,,5841.0,5841.0,1 RC,480,CHANGE KIDNEY TUBE ,,,5841.0,5841.0,1 RC,480,CIRCUMCISION ,,,5841.0,5841.0,1 RC,480,CONTROL POSTOP BLEEDING ,,,5841.0,5841.0,1 RC,480,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,5841.0,1 RC,480,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,5841.0,5841.0,1 RC,480,"CYSTOSCOPY, RESECT DUCTS ",,,5841.0,5841.0,1 RC,480,Canthoplasty (reconstruction of canthus) ,,,3041.0,3041.0,1 RC,480,Canthotomy (separate procedure) ,,,3041.0,3041.0,1 RC,480,Cardioassist-method of circulatory assist; external ,,,5841.0,5841.0,1 RC,480,Cardioassist-method of circulatory assist; internal ,,,5841.0,5841.0,1 RC,480,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,2251.0,2251.0,1 RC,480,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,2251.0,2251.0,1 RC,480,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,10342.0,17384.0,3 RC,480,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,10342.0,17384.0,6 RC,480,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,10342.0,17384.0,6 RC,480,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,10342.0,17384.0,6 RC,480,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,10342.0,17384.0,3 RC,480,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,5841.0,5841.0,1 RC,480,"Cautery of cervix; cryocautery, initial or repeat ",,,5841.0,5841.0,1 RC,480,Cautery of cervix; electro or thermal ,,,3041.0,3041.0,1 RC,480,Cautery of cervix; laser ablation ,,,3041.0,3041.0,1 RC,480,"Cerclage of cervix, during pregnancy; abdominal ",,,5841.0,5841.0,1 RC,480,"Cerclage of cervix, during pregnancy; vaginal ",,,3041.0,3041.0,1 RC,480,"Cerclage of uterine cervix, nonobstetrical ",,,3041.0,3041.0,1 RC,480,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,5841.0,5841.0,1 RC,480,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,5841.0,5841.0,1 RC,480,Cesarean delivery only; ,,,5841.0,5841.0,1 RC,480,Cesarean delivery only; including postpartum care ,,,5841.0,5841.0,1 RC,480,Change of cystostomy tube; complicated ,,,2251.0,2251.0,1 RC,480,Change of cystostomy tube; simple ,,,5841.0,5841.0,1 RC,480,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,2434.0,2434.0,1 RC,480,Chemodenervation of eccrine glands; both axillae ,,,5841.0,5841.0,1 RC,480,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,5841.0,5841.0,1 RC,480,Chemodenervation of extraocular muscle ,,,5841.0,5841.0,1 RC,480,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,2251.0,2251.0,1 RC,480,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,5841.0,5841.0,1 RC,480,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,5841.0,5841.0,1 RC,480,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,2251.0,2251.0,1 RC,480,Chemodenervation of one extremity; 1-4 muscle(s) ,,,2251.0,2251.0,1 RC,480,Chemodenervation of one extremity; 5 or more muscles ,,,2251.0,2251.0,1 RC,480,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,5841.0,5841.0,1 RC,480,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,2251.0,2251.0,1 RC,480,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,2251.0,2251.0,1 RC,480,"Chorionic villus sampling, any method ",,,2251.0,2251.0,1 RC,480,"Chromotubation of oviduct, including materials ",,,4988.0,4988.0,1 RC,480,Ciliary body destruction; cryotherapy ,,,3041.0,3041.0,1 RC,480,Ciliary body destruction; cyclodialysis ,,,3041.0,3041.0,1 RC,480,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,3041.0,3041.0,1 RC,480,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,3041.0,3041.0,1 RC,480,Ciliary body destruction; diathermy ,,,2434.0,2434.0,1 RC,480,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,3041.0,3041.0,1 RC,480,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,3041.0,3041.0,1 RC,480,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,3041.0,3041.0,1 RC,480,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,2251.0,2251.0,1 RC,480,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,2251.0,2251.0,1 RC,480,Clitoroplasty for intersex state ,,,3041.0,3041.0,1 RC,480,Closure of cystostomy (separate procedure) ,,,3041.0,3041.0,1 RC,480,Closure of lacrimal fistula (separate procedure) ,,,2251.0,2251.0,1 RC,480,Closure of nephrocutaneous or pyelocutaneous fistula ,,,2251.0,2251.0,1 RC,480,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,5841.0,5841.0,1 RC,480,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,5841.0,5841.0,1 RC,480,Closure of rectovaginal fistula; abdominal approach ,,,5841.0,5841.0,1 RC,480,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,5841.0,5841.0,1 RC,480,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,3041.0,3041.0,1 RC,480,Closure of rectovaginal fistula; vaginal or transanal approach ,,,3041.0,3041.0,1 RC,480,"Closure of the lacrimal punctum; by plug, each ",,,5841.0,5841.0,1 RC,480,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,5841.0,5841.0,1 RC,480,Closure of ureterocutaneous fistula ,,,5841.0,5841.0,1 RC,480,Closure of ureterovisceral fistula (including visceral repair) ,,,5841.0,5841.0,1 RC,480,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,4988.0,4988.0,1 RC,480,Closure of urethrovaginal fistula; ,,,6326.0,6326.0,1 RC,480,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,4988.0,4988.0,1 RC,480,Closure of vesicouterine fistula; ,,,3041.0,3041.0,1 RC,480,Closure of vesicouterine fistula; with hysterectomy ,,,5841.0,5841.0,1 RC,480,"Closure of vesicovaginal fistula, abdominal approach ",,,4988.0,4988.0,1 RC,480,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,4988.0,4988.0,1 RC,480,Closure of vesicovaginal fistula; vaginal approach ,,,4988.0,4988.0,1 RC,480,"Closure postauricular fistula, mastoid (separate procedure) ",,,2251.0,2251.0,1 RC,480,"Closure, exstrophy of bladder ",,,5841.0,5841.0,1 RC,480,"Cochlear device implantation, with or without mastoidectomy ",,,12167.0,12167.0,1 RC,480,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,5841.0,5841.0,1 RC,480,Colorectal cancer screening; colonoscopy on individual at high risk ,,,2251.0,2251.0,1 RC,480,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,2251.0,2251.0,1 RC,480,Colorectal cancer screening; flexible sigmoidoscopy ,,,2251.0,2251.0,1 RC,480,Colpocentesis (separate procedure) ,,,3041.0,3041.0,1 RC,480,Colpocleisis (Le Fort type) ,,,4988.0,4988.0,1 RC,480,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,3041.0,3041.0,1 RC,480,"Colpopexy, abdominal approach ",,,3041.0,3041.0,1 RC,480,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,6326.0,6326.0,1 RC,480,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,6326.0,6326.0,1 RC,480,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,3041.0,3041.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; ,,,5841.0,5841.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,5841.0,5841.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,5841.0,5841.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,5841.0,5841.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,3041.0,3041.0,1 RC,480,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,3041.0,3041.0,1 RC,480,"Colposcopy of the entire vagina, with cervix if present; ",,,5841.0,5841.0,1 RC,480,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,2251.0,2251.0,1 RC,480,Colposcopy of the vulva; ,,,5841.0,5841.0,1 RC,480,Colposcopy of the vulva; with biopsy(s) ,,,5841.0,5841.0,1 RC,480,Colpotomy; with drainage of pelvic abscess ,,,3041.0,3041.0,1 RC,480,Colpotomy; with exploration ,,,3041.0,3041.0,1 RC,480,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,4988.0,4988.0,1 RC,480,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,6326.0,6326.0,1 RC,480,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,10342.0,17384.0,3 RC,480,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,2251.0,2251.0,1 RC,480,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,2251.0,2251.0,1 RC,480,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,2251.0,2251.0,1 RC,480,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,2251.0,2251.0,1 RC,480,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,5841.0,5841.0,1 RC,480,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,29288.0,43890.0,2 RC,480,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,29288.0,43890.0,2 RC,480,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,21231.0,43890.0,3 RC,480,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,21231.0,43890.0,6 RC,480,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,21231.0,43890.0,3 RC,480,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,21231.0,43890.0,3 RC,480,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,5841.0,5841.0,1 RC,480,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,3041.0,3041.0,1 RC,480,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,3041.0,3041.0,1 RC,480,Conjunctival flap; bridge or partial (separate procedure) ,,,4988.0,4988.0,1 RC,480,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,3041.0,3041.0,1 RC,480,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,3041.0,3041.0,1 RC,480,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,4988.0,4988.0,1 RC,480,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,4988.0,4988.0,1 RC,480,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,3041.0,3041.0,1 RC,480,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,4988.0,4988.0,1 RC,480,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,4988.0,4988.0,1 RC,480,Construction of artificial vagina; with graft ,,,4988.0,4988.0,1 RC,480,Construction of artificial vagina; without graft ,,,3041.0,3041.0,1 RC,480,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,3041.0,3041.0,1 RC,480,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,3041.0,3041.0,1 RC,480,Cont epidur inject-lumb ,,,5841.0,5841.0,1 RC,480,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,5841.0,5841.0,1 RC,480,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",,,5841.0,5841.0,1 RC,480,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2434.0,2434.0,1 RC,480,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,2251.0,2251.0,1 RC,480,"Cordocentesis (intrauterine), any method ",,,5841.0,5841.0,1 RC,480,Corneal relaxing incision for correction of surgically induced astigmatism ,,,2251.0,2251.0,1 RC,480,Corneal wedge resection for correction of surgically induced astigmatism ,,,3041.0,3041.0,1 RC,480,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,5841.0,5841.0,1 RC,480,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,4988.0,4988.0,1 RC,480,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,4988.0,4988.0,1 RC,480,"Correction of everted punctum, cautery ",,,5841.0,5841.0,1 RC,480,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,3041.0,3041.0,1 RC,480,Correction of lid retraction ,,,3041.0,3041.0,1 RC,480,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,5841.0,5841.0,1 RC,480,"Correction of trichiasis; epilation, by forceps only ",,,5841.0,5841.0,1 RC,480,Correction of trichiasis; incision of lid margin ,,,2251.0,2251.0,1 RC,480,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,3041.0,3041.0,1 RC,480,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,5841.0,5841.0,1 RC,480,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,9124.0,9124.0,1 RC,480,Craniectomy for craniosynostosis; multiple cranial sutures ,,,5841.0,5841.0,1 RC,480,Craniectomy for craniosynostosis; single cranial suture ,,,5841.0,5841.0,1 RC,480,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,5841.0,5841.0,1 RC,480,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,5841.0,5841.0,1 RC,480,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,5841.0,5841.0,1 RC,480,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,5841.0,5841.0,1 RC,480,"Craniectomy or craniotomy, exploratory; supratentorial ",,,5841.0,5841.0,1 RC,480,Craniectomy or craniotomy; with excision of foreign body from brain ,,,5841.0,5841.0,1 RC,480,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,5841.0,5841.0,1 RC,480,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,5841.0,5841.0,1 RC,480,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,5841.0,5841.0,1 RC,480,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,5841.0,5841.0,1 RC,480,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,5841.0,5841.0,1 RC,480,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,5841.0,5841.0,1 RC,480,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,5841.0,5841.0,1 RC,480,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,5841.0,5841.0,1 RC,480,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,5841.0,5841.0,1 RC,480,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,5841.0,5841.0,1 RC,480,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,5841.0,5841.0,1 RC,480,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,5841.0,5841.0,1 RC,480,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,5841.0,5841.0,1 RC,480,Craniectomy; for osteomyelitis ,,,5841.0,5841.0,1 RC,480,Craniectomy; with excision of tumor or other bone lesion of skull ,,,9124.0,9124.0,1 RC,480,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,5841.0,5841.0,1 RC,480,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,5841.0,5841.0,1 RC,480,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,5841.0,5841.0,1 RC,480,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,5841.0,5841.0,1 RC,480,Cranioplasty for skull defect with reparative brain surgery ,,,5841.0,5841.0,1 RC,480,Cranioplasty for skull defect; larger than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Cranioplasty for skull defect; up to 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Craniotomy for craniosynostosis; bifrontal bone flap ,,,5841.0,5841.0,1 RC,480,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,5841.0,5841.0,1 RC,480,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,5841.0,5841.0,1 RC,480,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,5841.0,5841.0,1 RC,480,"Craniotomy for repair of encephalocele, skull base ",,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,5841.0,5841.0,1 RC,480,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,5841.0,5841.0,1 RC,480,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,5841.0,5841.0,1 RC,480,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,6326.0,6326.0,1 RC,480,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,5841.0,5841.0,1 RC,480,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,3041.0,3041.0,1 RC,480,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,3041.0,3041.0,1 RC,480,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,3041.0,3041.0,1 RC,480,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,5841.0,5841.0,1 RC,480,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,6326.0,6326.0,1 RC,480,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,5841.0,5841.0,1 RC,480,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,5841.0,5841.0,1 RC,480,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,5841.0,5841.0,1 RC,480,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,5841.0,5841.0,1 RC,480,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,10949.0,10949.0,1 RC,480,"Curettage, postpartum ",,,3041.0,3041.0,1 RC,480,Cutaneous appendico-vesicostomy ,,,5841.0,5841.0,1 RC,480,Cutaneous vesicostomy ,,,3041.0,3041.0,1 RC,480,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete; (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,5841.0,5841.0,1 RC,480,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,5841.0,5841.0,1 RC,480,"Cystectomy, partial; simple ",,,5841.0,5841.0,1 RC,480,Cysto w Bx/fulgur les ,,,5841.0,5841.0,1 RC,480,Cysto w lithotripsy ,,,5841.0,5841.0,1 RC,480,Cysto w rmvl/manip CAL ,,,5841.0,5841.0,1 RC,480,Cysto w tumor resection ,,,5841.0,5841.0,1 RC,480,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,3041.0,3041.0,1 RC,480,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,5841.0,5841.0,1 RC,480,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,4988.0,4988.0,1 RC,480,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,3041.0,3041.0,1 RC,480,"Cystostomy, cystotomy with drainage ",,,3041.0,3041.0,1 RC,480,"Cystotomy for excision, incision, or repair of ureterocele ",,,3041.0,3041.0,1 RC,480,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,3041.0,3041.0,1 RC,480,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,3041.0,3041.0,1 RC,480,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,3041.0,3041.0,1 RC,480,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,2251.0,2251.0,1 RC,480,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,4988.0,4988.0,1 RC,480,Cystotomy; for excision of bladder tumor ,,,4988.0,4988.0,1 RC,480,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,3041.0,3041.0,1 RC,480,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,5841.0,5841.0,1 RC,480,Cystourethroscopy ,,,5841.0,5841.0,1 RC,480,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,3041.0,3041.0,1 RC,480,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,3041.0,3041.0,1 RC,480,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,6326.0,6326.0,1 RC,480,Cystourethroscopy (separate procedure) ,,,2251.0,2251.0,1 RC,480,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,2434.0,2434.0,1 RC,480,Cystourethroscopy with direct vision internal urethrotomy ,,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,3041.0,3041.0,1 RC,480,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,2434.0,2434.0,1 RC,480,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with biopsy(s) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,2434.0,2434.0,1 RC,480,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,2434.0,2434.0,1 RC,480,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,2251.0,2251.0,1 RC,480,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,2251.0,2251.0,1 RC,480,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,2434.0,2434.0,1 RC,480,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,5841.0,5841.0,1 RC,480,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,5841.0,5841.0,1 RC,480,"Cystourethroscopy, with insertion of permanent urethral stent ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,9124.0,9124.0,1 RC,480,"Cystourethroscopy, with internal urethrotomy; female ",,,2434.0,2434.0,1 RC,480,"Cystourethroscopy, with internal urethrotomy; male ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,5841.0,5841.0,1 RC,480,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,2434.0,2434.0,1 RC,480,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with steroid injection into stricture ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,10342.0,10342.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,10342.0,10342.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,3041.0,3041.0,1 RC,480,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,3041.0,3041.0,1 RC,480,D & C OF RESIDUAL CERVIX ,,,5841.0,5841.0,1 RC,480,DESTR PARAVERTEBRAL N ADD-ON ,,,5841.0,5841.0,2 RC,480,DESTR PARAVERTEBRL NERVE C/T ,,,5841.0,5841.0,1 RC,480,DESTR PARAVERTEBRL NERVE L/S ,,,5841.0,5841.0,1 RC,480,DESTROY NERVE EXTREM MUSC ,,,5841.0,5841.0,1 RC,480,DESTROY NERVE NECK MUSCLE ,,,5841.0,5841.0,1 RC,480,DILATION PROSTATIC URETHRA ,,,5841.0,5841.0,1 RC,480,DRAIN ABDOMINAL ABSCESS ,,,5841.0,5841.0,1 RC,480,DRAIN PANCREATIC PSEUDOCYST ,,,5841.0,5841.0,1 RC,480,DRAIN PELVIC ABSCESS PERCUT ,,,5841.0,5841.0,1 RC,480,DRAIN PERCUT ABDOM ABSCESS ,,,5841.0,5841.0,1 RC,480,DRAIN PERCUT RETROPER ABSC ,,,5841.0,5841.0,1 RC,480,DRAINAGE OF BLADDER ,,,5841.0,5841.0,3 RC,480,DRAINAGE OF EYE ,,,5841.0,5841.0,1 RC,480,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,4988.0,4988.0,1 RC,480,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,2251.0,2251.0,1 RC,480,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,5841.0,5841.0,1 RC,480,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,6326.0,6326.0,1 RC,480,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,6326.0,6326.0,1 RC,480,Decompression internal auditory canal ,,,6326.0,6326.0,1 RC,480,"Decompression of orbit only, transcranial approach ",,,6326.0,6326.0,1 RC,480,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,6326.0,6326.0,1 RC,480,Decompression; plantar digital nerve ,,,3041.0,3041.0,1 RC,480,Decompression; unspecified nerve(s) (specify) ,,,3041.0,3041.0,1 RC,480,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,2434.0,2434.0,1 RC,480,Deligation of ureter ,,,5841.0,5841.0,1 RC,480,Delivery of placenta (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2434.0,2434.0,1 RC,480,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,5841.0,5841.0,1 RC,480,"Destruction by neurolytic agent, intercostal nerve ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,5841.0,5841.0,1 RC,480,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,5841.0,5841.0,1 RC,480,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,3041.0,3041.0,1 RC,480,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,2251.0,2251.0,1 RC,480,Destruction by neurolytic agent; other peripheral nerve or branch ,,,2251.0,2251.0,1 RC,480,Destruction by neurolytic agent; plantar common digital nerve ,,,5841.0,5841.0,1 RC,480,Destruction by neurolytic agent; pudendal nerve ,,,2251.0,2251.0,1 RC,480,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,2251.0,2251.0,1 RC,480,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,4988.0,4988.0,1 RC,480,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,5841.0,5841.0,1 RC,480,Destruction of lesion of lid margin (up to 1 cm) ,,,2251.0,2251.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,5841.0,5841.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,5841.0,5841.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,2434.0,2434.0,1 RC,480,"Destruction of lesion, conjunctiva ",,,3041.0,3041.0,1 RC,480,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,2251.0,2251.0,1 RC,480,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,2251.0,2251.0,1 RC,480,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,5841.0,5841.0,1 RC,480,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,2251.0,2251.0,1 RC,480,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,5841.0,5841.0,1 RC,480,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,2251.0,2251.0,1 RC,480,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,4988.0,4988.0,1 RC,480,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,3041.0,3041.0,1 RC,480,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,3041.0,3041.0,1 RC,480,Diagnostic hysteroscopy ,,,5841.0,5841.0,1 RC,480,Diagnostic laparoscopy ,,,5841.0,5841.0,1 RC,480,Diaphragm or cervical cap fitting with instructions ,,,5841.0,5841.0,1 RC,480,Dilation and curettage of cervical stump ,,,3041.0,3041.0,1 RC,480,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,3041.0,3041.0,1 RC,480,"Dilation of cervical canal, instrumental (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,5841.0,5841.0,2 RC,480,Dilation of female urethra including suppository and/or instillation; initial ,,,5841.0,5841.0,1 RC,480,Dilation of female urethra including suppository and/or instillation; subsequent ,,,5841.0,5841.0,1 RC,480,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,3041.0,3041.0,1 RC,480,"Dilation of lacrimal punctum, with or without irrigation ",,,5841.0,5841.0,1 RC,480,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,2251.0,2251.0,1 RC,480,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,5841.0,5841.0,1 RC,480,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,5841.0,5841.0,1 RC,480,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,5841.0,5841.0,1 RC,480,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,2434.0,2434.0,1 RC,480,Dilation of vagina under anesthesia (other than local) ,,,3041.0,3041.0,1 RC,480,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,5841.0,5841.0,1 RC,480,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,9124.0,9124.0,1 RC,480,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,5841.0,5841.0,1 RC,480,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,5841.0,5841.0,1 RC,480,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,2251.0,2251.0,1 RC,480,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,5841.0,5841.0,1 RC,480,"Discission of vitreous strands (without removal), pars plana approach ",,,3041.0,3041.0,1 RC,480,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,5841.0,5841.0,1 RC,480,"Donor nephrectomy (including cold preservation); open, from living donor ",,,5841.0,5841.0,1 RC,480,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,5841.0,5841.0,1 RC,480,"Drainage external auditory canal, abscess ",,,5841.0,5841.0,1 RC,480,"Drainage external ear, abscess or hematoma; complicated ",,,2434.0,2434.0,1 RC,480,"Drainage external ear, abscess or hematoma; simple ",,,5841.0,5841.0,1 RC,480,Drainage of Skene's gland abscess or cyst ,,,3041.0,3041.0,1 RC,480,Drainage of deep periurethral abscess ,,,3041.0,3041.0,1 RC,480,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,5841.0,5841.0,1 RC,480,Drainage of ovarian abscess; abdominal approach ,,,4988.0,4988.0,1 RC,480,"Drainage of ovarian abscess; vaginal approach, open ",,,3041.0,3041.0,1 RC,480,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,3041.0,3041.0,1 RC,480,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,3041.0,3041.0,1 RC,480,Drainage of perineal urinary extravasation; complicated ,,,3041.0,3041.0,1 RC,480,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Drainage of perirenal or renal abscess, open ",,,3041.0,3041.0,1 RC,480,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,5841.0,5841.0,1 RC,480,Drainage of perivesical or prevesical space abscess ,,,2434.0,2434.0,1 RC,480,"Drainage of retroperitoneal abscess, open ",,,5841.0,5841.0,1 RC,480,Drainage of scrotal wall abscess ,,,2434.0,2434.0,1 RC,480,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,5841.0,5841.0,1 RC,480,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,5841.0,5841.0,1 RC,480,Duodenal motility (manometric) study ,,,2434.0,2434.0,1 RC,480,"Dural graft, spinal ",,,5841.0,5841.0,1 RC,480,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,2434.0,2434.0,1 RC,480,EXPLORATION OF EPIDIDYMIS ,,,5841.0,5841.0,1 RC,480,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,5841.0,5841.0,1 RC,480,EXPLORE ORBIT/REMOVE OBJECT ,,,5841.0,5841.0,1 RC,480,Ear piercing ,,,5841.0,5841.0,1 RC,480,Electroejaculation ,,,2251.0,2251.0,1 RC,480,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,5841.0,5841.0,1 RC,480,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,5841.0,5841.0,1 RC,480,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,5841.0,5841.0,2 RC,480,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,5841.0,5841.0,1 RC,480,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,21231.0,43890.0,6 RC,480,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,21231.0,43890.0,3 RC,480,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,3 RC,480,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,5841.0,5841.0,1 RC,480,"Elevation of depressed skull fracture; simple, extradural ",,,6326.0,6326.0,1 RC,480,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,5841.0,5841.0,1 RC,480,"Embryo transfer, intrauterine ",,,5841.0,5841.0,1 RC,480,Endocervical curettage (not done as part of a dilation and curettage) ,,,2251.0,2251.0,1 RC,480,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,5841.0,5841.0,1 RC,480,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,21231.0,43890.0,6 RC,480,Endolymphatic sac operation; with shunt ,,,6326.0,6326.0,1 RC,480,Endolymphatic sac operation; without shunt ,,,6326.0,6326.0,1 RC,480,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,4988.0,4988.0,1 RC,480,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,6326.0,6326.0,1 RC,480,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,5841.0,5841.0,1 RC,480,Endomyocardial biopsy ,,,10342.0,17384.0,3 RC,480,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,5841.0,5841.0,1 RC,480,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,4988.0,4988.0,1 RC,480,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,5841.0,5841.0,1 RC,480,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,5841.0,5841.0,1 RC,480,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,10949.0,10949.0,1 RC,480,"Enterocystoplasty, including intestinal anastomosis ",,,5841.0,5841.0,1 RC,480,"Enucleation of eye; with implant, muscles attached to implant ",,,4988.0,4988.0,1 RC,480,"Enucleation of eye; with implant, muscles not attached to implant ",,,4988.0,4988.0,1 RC,480,Enucleation of eye; without implant ,,,4988.0,4988.0,1 RC,480,Epididymectomy; bilateral ,,,3041.0,3041.0,1 RC,480,Epididymectomy; unilateral ,,,3041.0,3041.0,1 RC,480,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,3041.0,3041.0,1 RC,480,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,3041.0,3041.0,1 RC,480,Epikeratoplasty ,,,3041.0,3041.0,1 RC,480,"Episiotomy or vaginal repair, by other than attending ",,,3041.0,3041.0,1 RC,480,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,21231.0,43890.0,3 RC,480,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,21231.0,43890.0,3 RC,480,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,21231.0,43890.0,3 RC,480,Evisceration of ocular contents; with implant ,,,4988.0,4988.0,1 RC,480,Evisceration of ocular contents; without implant ,,,4988.0,4988.0,1 RC,480,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,2251.0,2251.0,1 RC,480,Exchange of intraocular lens ,,,3041.0,3041.0,1 RC,480,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,2434.0,2434.0,1 RC,480,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,3041.0,3041.0,2 RC,480,Excision aural glomus tumor; extended (extratemporal) ,,,5841.0,5841.0,1 RC,480,Excision aural glomus tumor; transcanal ,,,6326.0,6326.0,1 RC,480,Excision aural glomus tumor; transmastoid ,,,6326.0,6326.0,1 RC,480,Excision aural polyp ,,,2434.0,2434.0,1 RC,480,"Excision exostosis(es), external auditory canal ",,,3041.0,3041.0,1 RC,480,Excision external ear; complete amputation ,,,3041.0,3041.0,1 RC,480,"Excision external ear; partial, simple repair ",,,2434.0,2434.0,1 RC,480,Excision of Bartholin's gland or cyst ,,,3041.0,3041.0,1 RC,480,Excision of Mullerian duct cyst ,,,3041.0,3041.0,1 RC,480,Excision of ampulla of Vater ,,,5841.0,5841.0,1 RC,480,Excision of bulbourethral gland (Cowper's gland) ,,,3041.0,3041.0,1 RC,480,Excision of carotid body tumor; with excision of carotid artery ,,,5841.0,5841.0,1 RC,480,Excision of carotid body tumor; without excision of carotid artery ,,,5841.0,5841.0,1 RC,480,"Excision of cervical stump, abdominal approach; ",,,5841.0,5841.0,1 RC,480,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,5841.0,5841.0,1 RC,480,"Excision of cervical stump, vaginal approach; ",,,3041.0,3041.0,1 RC,480,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,4988.0,4988.0,1 RC,480,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,6326.0,6326.0,1 RC,480,"Excision of chalazion; multiple, different lids ",,,5841.0,5841.0,1 RC,480,"Excision of chalazion; multiple, same lid ",,,2251.0,2251.0,1 RC,480,Excision of chalazion; single ,,,5841.0,5841.0,1 RC,480,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,3041.0,3041.0,1 RC,480,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,9124.0,9124.0,1 RC,480,Excision of extraparenchymal lesion of testis ,,,3041.0,3041.0,1 RC,480,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,4988.0,4988.0,1 RC,480,Excision of hydrocele; bilateral ,,,4988.0,4988.0,1 RC,480,Excision of hydrocele; unilateral ,,,4988.0,4988.0,1 RC,480,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,4988.0,4988.0,1 RC,480,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,4988.0,4988.0,1 RC,480,Excision of lacrimal gland tumor; frontal approach ,,,3041.0,3041.0,1 RC,480,Excision of lacrimal gland tumor; involving osteotomy ,,,4988.0,4988.0,1 RC,480,Excision of lacrimal sac (dacryocystectomy) ,,,4988.0,4988.0,1 RC,480,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,2251.0,2251.0,1 RC,480,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,5841.0,5841.0,1 RC,480,Excision of lesion of spermatic cord (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Excision of lesion, conjunctiva; over 1 cm ",,,3041.0,3041.0,1 RC,480,"Excision of lesion, conjunctiva; up to 1 cm ",,,3041.0,3041.0,1 RC,480,"Excision of lesion, conjunctiva; with adjacent sclera ",,,3041.0,3041.0,1 RC,480,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,2251.0,2251.0,1 RC,480,"Excision of lesion, sclera ",,,3041.0,3041.0,1 RC,480,Excision of local lesion of epididymis ,,,3041.0,3041.0,1 RC,480,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,3041.0,3041.0,1 RC,480,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,6326.0,6326.0,1 RC,480,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,3041.0,3041.0,1 RC,480,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,3041.0,3041.0,1 RC,480,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,3041.0,3041.0,1 RC,480,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Excision of neuroma; hand or foot, except digital nerve ",,,3041.0,3041.0,1 RC,480,"Excision of neuroma; major peripheral nerve, except sciatic ",,,3041.0,3041.0,1 RC,480,Excision of neuroma; sciatic nerve ,,,6326.0,6326.0,1 RC,480,Excision of penile plaque (Peyronie disease); ,,,6326.0,6326.0,1 RC,480,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,6326.0,6326.0,1 RC,480,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,6326.0,6326.0,1 RC,480,Excision of perinephric cyst ,,,5841.0,5841.0,1 RC,480,Excision of presacral or sacrococcygeal tumor ,,,5841.0,5841.0,1 RC,480,"Excision of spermatocele, with or without epididymectomy ",,,3041.0,3041.0,1 RC,480,Excision of thyroglossal duct cyst or sinus; ,,,9124.0,9124.0,1 RC,480,Excision of thyroglossal duct cyst or sinus; recurrent ,,,9124.0,9124.0,1 RC,480,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,4988.0,4988.0,1 RC,480,Excision of urethral diverticulum (separate procedure); female ,,,4988.0,4988.0,1 RC,480,Excision of urethral diverticulum (separate procedure); male ,,,3041.0,3041.0,1 RC,480,Excision of vaginal cyst or tumor ,,,3041.0,3041.0,1 RC,480,Excision of vaginal septum ,,,3041.0,3041.0,1 RC,480,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,3041.0,3041.0,1 RC,480,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,4988.0,4988.0,1 RC,480,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,4988.0,4988.0,1 RC,480,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,3041.0,1 RC,480,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9124.0,1 RC,480,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9124.0,1 RC,480,Excision or fulguration of carcinoma of urethra ,,,4988.0,4988.0,1 RC,480,Excision or fulguration; Skene's glands ,,,3041.0,3041.0,1 RC,480,Excision or fulguration; urethral caruncle ,,,3041.0,3041.0,1 RC,480,"Excision or fulguration; urethral polyp(s), distal urethra ",,,3041.0,3041.0,1 RC,480,Excision or fulguration; urethral prolapse ,,,3041.0,3041.0,1 RC,480,Excision or transposition of pterygium; with graft ,,,3041.0,3041.0,1 RC,480,Excision or transposition of pterygium; without graft ,,,3041.0,3041.0,1 RC,480,Excision or unroofing of cyst(s) of kidney ,,,5841.0,5841.0,1 RC,480,"Excision soft tissue lesion, external auditory canal ",,,2434.0,2434.0,1 RC,480,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,5841.0,5841.0,1 RC,480,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,5841.0,5841.0,1 RC,480,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,4988.0,4988.0,1 RC,480,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,4988.0,4988.0,1 RC,480,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,4988.0,4988.0,1 RC,480,Exploration for undescended testis (inguinal or scrotal area) ,,,4988.0,4988.0,1 RC,480,Exploration for undescended testis with abdominal exploration ,,,3041.0,3041.0,1 RC,480,"Exploration of epididymis, with or without biopsy ",,,3041.0,3041.0,1 RC,480,"Exploration of orbit (transcranial approach), with removal of lesion ",,,5841.0,5841.0,1 RC,480,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,4988.0,4988.0,1 RC,480,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,3041.0,3041.0,1 RC,480,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,5841.0,5841.0,1 RC,480,"Expression of conjunctival follicles (eg, for trachoma) ",,,5841.0,5841.0,1 RC,480,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,5841.0,5841.0,1 RC,480,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,5841.0,5841.0,1 RC,480,"External cephalic version, with or without tocolysis ",,,3041.0,3041.0,1 RC,480,"External drainage, pseudocyst of pancreas, open ",,,5841.0,5841.0,1 RC,480,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,5841.0,5841.0,1 RC,480,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,5841.0,5841.0,1 RC,480,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,3041.0,3041.0,1 RC,480,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,3041.0,5841.0,3 RC,480,FOCUS RADIATION BEAM ,,,5841.0,5841.0,1 RC,480,FUSE PANCREAS AND BOWEL ,,,5841.0,5841.0,1 RC,480,FUSION OF FACIAL/OTHER NERVE ,,,5841.0,5841.0,1 RC,480,Fetal contraction stress test ,,,5841.0,5841.0,1 RC,480,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,5841.0,5841.0,1 RC,480,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,5841.0,5841.0,1 RC,480,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,5841.0,5841.0,1 RC,480,Fetal non-stress test ,,,5841.0,5841.0,1 RC,480,Fetal scalp blood sampling ,,,5841.0,5841.0,1 RC,480,"Fetal shunt placement, including ultrasound guidance ",,,5841.0,5841.0,1 RC,480,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,5841.0,5841.0,1 RC,480,Fimbrioplasty ,,,4988.0,4988.0,1 RC,480,Fine needle aspiration of orbital contents ,,,3041.0,3041.0,1 RC,480,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,3041.0,3041.0,1 RC,480,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,3041.0,3041.0,1 RC,480,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,3041.0,3041.0,1 RC,480,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,3041.0,3041.0,1 RC,480,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,3041.0,3041.0,1 RC,480,Fitting and insertion of pessary or other intravaginal support device ,,,5841.0,5841.0,1 RC,480,Fixation of contralateral testis (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,3041.0,1 RC,480,"Follicle puncture for oocyte retrieval, any method ",,,2251.0,2251.0,1 RC,480,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,5841.0,5841.0,1 RC,480,Free omental flap with microvascular anastomosis ,,,5841.0,5841.0,1 RC,480,Frenulotomy of penis ,,,3041.0,3041.0,1 RC,480,GLAUCOMA SURGERY ,,,5841.0,5841.0,1 RC,480,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,5841.0,5841.0,1 RC,480,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2434.0,2434.0,1 RC,480,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2434.0,2434.0,1 RC,480,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2434.0,2434.0,1 RC,480,Goniotomy ,,,3041.0,3041.0,1 RC,480,HFenestration semicircular canal ,,,6326.0,6326.0,1 RC,480,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,3041.0,1 RC,480,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,9124.0,1 RC,480,HRevision fenestration operation ,,,6326.0,6326.0,1 RC,480,"Harvesting conjunctival allograft, living donor ",,,3041.0,3041.0,1 RC,480,"Hymenotomy, simple incision ",,,3041.0,3041.0,1 RC,480,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,5841.0,5841.0,1 RC,480,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,5841.0,5841.0,1 RC,480,Hysterorrhaphy of ruptured uterus ,,,5841.0,5841.0,1 RC,480,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,5841.0,5841.0,1 RC,480,"Hysteroscopy, diagnostic (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,6326.0,6326.0,1 RC,480,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,4988.0,4988.0,1 RC,480,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,4988.0,4988.0,1 RC,480,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,3041.0,3041.0,1 RC,480,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,3041.0,3041.0,1 RC,480,"Hysteroscopy, surgical; with removal of leiomyomata ",,,4988.0,4988.0,1 RC,480,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,3041.0,3041.0,1 RC,480,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,3041.0,3041.0,1 RC,480,Hystscp IU ADHESIO ,,,5841.0,5841.0,1 RC,480,Hystscp div IU septum ,,,5841.0,5841.0,1 RC,480,Hystscp impacted FB rmvl ,,,5841.0,5841.0,1 RC,480,Hystscp rmvl leiomyomata ,,,5841.0,5841.0,1 RC,480,Hystscp w Bx/polypectomy ,,,5841.0,5841.0,1 RC,480,Hystscp w endomet ablat ,,,5841.0,5841.0,1 RC,480,IMPLANT NEUROELECTRODES ,,,5841.0,5841.0,4 RC,480,"IMPLANT NEUROSTIMUL, SUBCORT ",,,5841.0,5841.0,1 RC,480,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,5841.0,5841.0,1 RC,480,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10949.0,10949.0,1 RC,480,INCISE INNER EAR ,,,5841.0,5841.0,1 RC,480,INCISE SKULL FOR SURGERY ,,,5841.0,5841.0,3 RC,480,INCISION OF HYMEN ,,,5841.0,5841.0,1 RC,480,INCISION OF PELVIS NERVE ,,,5841.0,5841.0,1 RC,480,INCISION OF VAGUS NERVE ,,,5841.0,5841.0,1 RC,480,INFLATE MIDDLE EAR CANAL ,,,5841.0,5841.0,2 RC,480,INJ PARAVERTEBRAL C/T ,,,5841.0,5841.0,1 RC,480,INJ PARAVERTEBRAL C/T ADD-ON ,,,5841.0,5841.0,1 RC,480,INJ PARAVERTEBRAL L/S ,,,5841.0,5841.0,1 RC,480,INJ PARAVERTEBRAL L/S ADD-ON ,,,5841.0,5841.0,1 RC,480,INJECT SPINE CERV/THORACIC ,,,2251.0,2251.0,1 RC,480,INJECT SPINE LUMBAR/SACRAL ,,,2251.0,2251.0,1 RC,480,INJECT SPINE W/CATH CRV/THRC ,,,2251.0,2251.0,1 RC,480,INJECT SPINE W/CATH LMB/SCRL ,,,2251.0,2251.0,1 RC,480,INJECTION FOR KIDNEY X-RAY ,,,5841.0,5841.0,1 RC,480,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,5841.0,5841.0,1 RC,480,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2251.0,2251.0,1 RC,480,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,5841.0,5841.0,1 RC,480,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2251.0,1 RC,480,"INSERT ABDOM DRAIN, TEMP ",,,5841.0,5841.0,1 RC,480,INSERT KIDNEY DRAIN ,,,5841.0,5841.0,1 RC,480,INSERT URETERAL TUBE ,,,5841.0,5841.0,1 RC,480,INSET MIDDLE EAR (BAFFLE) ,,,5841.0,5841.0,1 RC,480,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,3041.0,1 RC,480,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,2434.0,2434.0,1 RC,480,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,2434.0,2434.0,1 RC,480,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",,,2434.0,2434.0,1 RC,480,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,6326.0,1 RC,480,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,4988.0,1 RC,480,Impl cereb subcort elec ,,,5841.0,5841.0,1 RC,480,Impl subcort electrodes ,,,5841.0,5841.0,1 RC,480,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Implantation of intrastromal corneal ring segments ,,,6326.0,6326.0,1 RC,480,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,6326.0,6326.0,1 RC,480,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,5841.0,5841.0,1 RC,480,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,12167.0,12167.0,1 RC,480,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,12167.0,12167.0,1 RC,480,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,6326.0,6326.0,1 RC,480,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,6326.0,6326.0,1 RC,480,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,5841.0,5841.0,1 RC,480,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,5841.0,5841.0,1 RC,480,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,10949.0,10949.0,1 RC,480,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,9124.0,9124.0,1 RC,480,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,6326.0,6326.0,1 RC,480,Incision and drainage of Bartholin's gland abscess ,,,5841.0,5841.0,1 RC,480,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,3041.0,3041.0,1 RC,480,"Incision and drainage of penis, deep ",,,2434.0,2434.0,1 RC,480,"Incision and drainage of thyroglossal duct cyst, infected ",,,2251.0,2251.0,1 RC,480,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,3041.0,3041.0,1 RC,480,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,2434.0,2434.0,1 RC,480,Incision and drainage of vulva or perineal abscess ,,,5841.0,5841.0,1 RC,480,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Incision of conjunctiva, drainage of cyst ",,,2251.0,2251.0,1 RC,480,"Incision, drainage of lacrimal gland ",,,2251.0,2251.0,1 RC,480,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,2251.0,2251.0,1 RC,480,Incisional biopsy of eyelid skin including lid margin ,,,5841.0,5841.0,1 RC,480,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,5841.0,5841.0,1 RC,480,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,5841.0,5841.0,1 RC,480,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,5841.0,5841.0,1 RC,480,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,5841.0,5841.0,1 RC,480,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,5841.0,5841.0,2 RC,480,"Induced abortion, by dilation and curettage ",,,3041.0,3041.0,1 RC,480,"Induced abortion, by dilation and evacuation ",,,3041.0,3041.0,1 RC,480,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,5841.0,5841.0,1 RC,480,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,5841.0,5841.0,1 RC,480,Inject anes 1 L facet N ,,,5841.0,5841.0,1 RC,480,Inject anes 1 paravert N ,,,5841.0,5841.0,1 RC,480,Inject anes >1 paravert ,,,5841.0,5841.0,1 RC,480,Inject anes L facet-ADDL ,,,5841.0,5841.0,1 RC,480,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,5841.0,5841.0,1 RC,480,Injection of contrast medium for dacryocystography ,,,5841.0,5841.0,1 RC,480,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,5841.0,5841.0,1 RC,480,Injection of medication or other substance into Tenon's capsule ,,,5841.0,5841.0,1 RC,480,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,5841.0,5841.0,1 RC,480,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,5841.0,5841.0,1 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,10342.0,17384.0,3 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,10342.0,17384.0,3 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,10342.0,17384.0,3 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,10342.0,17384.0,3 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,10342.0,17384.0,3 RC,480,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,10342.0,17384.0,3 RC,480,Injection procedure for Peyronie disease; ,,,5841.0,5841.0,1 RC,480,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,4988.0,4988.0,1 RC,480,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,2251.0,2251.0,2 RC,480,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,3041.0,3041.0,1 RC,480,Injection procedure for corpora cavernosography ,,,5841.0,5841.0,1 RC,480,Injection procedure for cystography or voiding urethrocystography ,,,5841.0,5841.0,1 RC,480,"Injection procedure for discography, each level; cervical or thoracic ",,,5841.0,5841.0,1 RC,480,"Injection procedure for discography, each level; lumbar ",,,5841.0,5841.0,1 RC,480,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Injection procedure for myelography and/or computed tomography, lumbar ",,,5841.0,5841.0,1 RC,480,Injection procedure for retrograde urethrocystography ,,,5841.0,5841.0,1 RC,480,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,2251.0,2251.0,1 RC,480,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,5841.0,5841.0,1 RC,480,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,5841.0,5841.0,1 RC,480,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,3041.0,3041.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,2251.0,2251.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,5841.0,5841.0,1 RC,480,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,5841.0,5841.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,5841.0,5841.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,2251.0,2251.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,5841.0,5841.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,5841.0,5841.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,2251.0,2251.0,1 RC,480,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,5841.0,5841.0,1 RC,480,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,5841.0,5841.0,4 RC,480,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,5841.0,5841.0,4 RC,480,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,2251.0,2251.0,1 RC,480,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,2251.0,2251.0,1 RC,480,"Injection, anesthetic agent; sphenopalatine ganglion ",,,5841.0,5841.0,1 RC,480,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,2251.0,2251.0,1 RC,480,"Injection, anesthetic agent; superior hypogastric plexus ",,,2251.0,2251.0,1 RC,480,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,2434.0,2434.0,1 RC,480,"Injection, anterior chamber of eye (separate procedure); medication ",,,2434.0,2434.0,1 RC,480,"Injection, epidural, of blood or clot patch ",,,2251.0,2251.0,1 RC,480,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,4988.0,1 RC,480,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,3041.0,3041.0,1 RC,480,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,3041.0,3041.0,1 RC,480,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,2251.0,2251.0,1 RC,480,Insert urinary catheter ,,,5841.0,5841.0,2 RC,480,Insertion of Heyman capsules for clinical brachytherapy ,,,3041.0,3041.0,1 RC,480,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,2251.0,2251.0,1 RC,480,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,5841.0,5841.0,1 RC,480,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,6326.0,6326.0,1 RC,480,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2434.0,2434.0,1 RC,480,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,5841.0,5841.0,1 RC,480,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2434.0,2434.0,1 RC,480,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2434.0,2434.0,1 RC,480,Insertion of implants into the soft palate; minimum of three implants ,,,2251.0,2251.0,1 RC,480,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,10949.0,10949.0,1 RC,480,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,3041.0,3041.0,1 RC,480,Insertion of intrauterine device (IUD) ,,,5841.0,5841.0,1 RC,480,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,10949.0,10949.0,1 RC,480,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,5841.0,5841.0,1 RC,480,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,4988.0,4988.0,1 RC,480,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,4988.0,4988.0,1 RC,480,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,4988.0,4988.0,1 RC,480,Insertion of penile prosthesis; inflatable (self-contained) ,,,10949.0,10949.0,1 RC,480,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,10949.0,10949.0,1 RC,480,Insertion of peritoneal-venous shunt ,,,2434.0,2434.0,1 RC,480,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,5841.0,5841.0,1 RC,480,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,2434.0,2434.0,1 RC,480,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,6326.0,6326.0,1 RC,480,Insertion of tandem cuff (dual cuff) ,,,10949.0,10949.0,1 RC,480,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,5841.0,5841.0,1 RC,480,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,5841.0,5841.0,1 RC,480,Insertion of testicular prosthesis (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,4988.0,4988.0,1 RC,480,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,4988.0,4988.0,1 RC,480,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,4988.0,4988.0,1 RC,480,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,2251.0,2251.0,1 RC,480,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,5841.0,5841.0,1 RC,480,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,12167.0,12167.0,1 RC,480,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,12167.0,12167.0,1 RC,480,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,5841.0,5841.0,1 RC,480,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,5841.0,5841.0,1 RC,480,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,12167.0,12167.0,1 RC,480,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,5841.0,5841.0,1 RC,480,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,5841.0,5841.0,1 RC,480,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,5841.0,5841.0,1 RC,480,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,5841.0,5841.0,1 RC,480,Intersex surgery; female to male ,,,5841.0,5841.0,1 RC,480,Intersex surgery; male to female ,,,5841.0,5841.0,1 RC,480,Intra-atrial pacing ,,,21231.0,43890.0,3 RC,480,Intra-atrial recording ,,,21231.0,43890.0,3 RC,480,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,29288.0,43890.0,2 RC,480,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,3041.0,3041.0,1 RC,480,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,21231.0,43890.0,3 RC,480,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,21231.0,43890.0,3 RC,480,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,21231.0,43890.0,3 RC,480,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,480,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,21231.0,43890.0,3 RC,480,Intraventricular pacing ,,,21231.0,43890.0,3 RC,480,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,5841.0,5841.0,1 RC,480,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,3041.0,3041.0,1 RC,480,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,2434.0,2434.0,1 RC,480,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,2434.0,2434.0,1 RC,480,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,6326.0,6326.0,1 RC,480,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,2251.0,2251.0,1 RC,480,Iridotomy by stab incision (separate procedure); except transfixion ,,,5841.0,5841.0,1 RC,480,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,2434.0,2434.0,1 RC,480,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,2251.0,2251.0,1 RC,480,Irrigation of corpora cavernosa for priapism ,,,5841.0,5841.0,1 RC,480,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,5841.0,5841.0,1 RC,480,Keratomileusis ,,,3041.0,3041.0,1 RC,480,Keratophakia ,,,3041.0,3041.0,1 RC,480,Keratoplasty (corneal transplant); anterior lamellar ,,,6326.0,6326.0,1 RC,480,Keratoplasty (corneal transplant); endothelial ,,,6326.0,6326.0,1 RC,480,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,6326.0,6326.0,1 RC,480,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,6326.0,6326.0,1 RC,480,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,6326.0,6326.0,1 RC,480,Keratoprosthesis ,,,10949.0,10949.0,1 RC,480,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,5841.0,5841.0,1 RC,480,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,5841.0,5841.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9124.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9124.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9124.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9124.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9124.0,1 RC,480,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9124.0,1 RC,480,LAVH ,,,5841.0,5841.0,1 RC,480,Labyrinthectomy; transcanal ,,,6326.0,6326.0,1 RC,480,Labyrinthectomy; with mastoidectomy ,,,6326.0,6326.0,1 RC,480,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,2251.0,2251.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,10949.0,10949.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,10949.0,10949.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,10949.0,10949.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,5841.0,5841.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,10949.0,10949.0,1 RC,480,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,10949.0,10949.0,1 RC,480,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,3041.0,3041.0,1 RC,480,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,5841.0,5841.0,1 RC,480,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,5841.0,5841.0,1 RC,480,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,5841.0,5841.0,1 RC,480,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,5841.0,5841.0,1 RC,480,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,10949.0,10949.0,1 RC,480,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,5841.0,5841.0,1 RC,480,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,5841.0,5841.0,1 RC,480,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,5841.0,5841.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,9124.0,9124.0,1 RC,480,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,9124.0,9124.0,1 RC,480,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,5841.0,5841.0,1 RC,480,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,9124.0,9124.0,1 RC,480,Laminectomy with rhizotomy; 1 or 2 segments ,,,10949.0,10949.0,1 RC,480,Laminectomy with rhizotomy; more than 2 segments ,,,10949.0,10949.0,1 RC,480,Laminectomy with section of spinal accessory nerve ,,,10949.0,10949.0,1 RC,480,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,5841.0,9124.0,4 RC,480,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,5841.0,5841.0,2 RC,480,"Laminectomy, with release of tethered spinal cord, lumbar ",,,10949.0,10949.0,1 RC,480,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,5841.0,5841.0,1 RC,480,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,5841.0,5841.0,1 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,9124.0,9124.0,1 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,4988.0,4988.0,2 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,9124.0,9124.0,1 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,9124.0,9124.0,1 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,9124.0,9124.0,1 RC,480,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,5841.0,5841.0,1 RC,480,Laparoscopic APPY ,,,5841.0,5841.0,1 RC,480,Laparoscopic THC w/o Bx ,,,5841.0,5841.0,1 RC,480,Laparoscopic aspiration ,,,5841.0,5841.0,1 RC,480,Laparoscopic enterolysis ,,,5841.0,5841.0,1 RC,480,Laparoscopic fulgur FALL ,,,5841.0,5841.0,1 RC,480,Laparoscopic fulgur les ,,,5841.0,5841.0,1 RC,480,Laparoscopic jejunostomy ,,,5841.0,5841.0,1 RC,480,Laparoscopic occl FALL ,,,5841.0,5841.0,1 RC,480,Laparoscopic orchiectomy ,,,5841.0,5841.0,1 RC,480,Laparoscopic rmvl adnexa ,,,5841.0,5841.0,1 RC,480,Laparoscopic splenectomy ,,,5841.0,5841.0,1 RC,480,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,9124.0,9124.0,1 RC,480,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,9124.0,9124.0,1 RC,480,Laparoscopy w ADHESIO ,,,5841.0,5841.0,1 RC,480,Laparoscopy w biopsy ,,,5841.0,5841.0,1 RC,480,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,11558.0,1 RC,480,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,10949.0,10949.0,1 RC,480,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; orchiectomy ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; partial nephrectomy ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; pyeloplasty ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; repair initial inguinal hernia ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; ureterolithotomy ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; with fimbrioplasty ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,5841.0,5841.0,1 RC,480,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,9124.0,9124.0,1 RC,480,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,6326.0,6326.0,1 RC,480,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,9124.0,9124.0,1 RC,480,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,9124.0,9124.0,1 RC,480,Lapscp CHOLE w CDE ,,,5841.0,5841.0,1 RC,480,Lapscp CHOLE&cholangrphy ,,,5841.0,5841.0,1 RC,480,Lapscp EG fundoplasty ,,,5841.0,5841.0,1 RC,480,Lapscp REP init IH ,,,5841.0,5841.0,1 RC,480,Lapscp REP recur IH ,,,5841.0,5841.0,1 RC,480,Lapscp adrenalectomy ,,,5841.0,5841.0,1 RC,480,Lapscp bilat pelv LYMPH ,,,5841.0,5841.0,1 RC,480,Lapscp cholcystentstmy ,,,5841.0,5841.0,1 RC,480,Lapscp cholecystectomy ,,,5841.0,5841.0,1 RC,480,Lapscp fimbrioplasty ,,,5841.0,5841.0,1 RC,480,Lapscp intest resect ,,,5841.0,5841.0,1 RC,480,Lapscp lig sperm vein ,,,5841.0,5841.0,1 RC,480,Lapscp lymphocele drain ,,,5841.0,5841.0,1 RC,480,Lapscp pelvic LYMPH & Bx ,,,5841.0,5841.0,1 RC,480,Lapscp retroperit LN Bx ,,,5841.0,5841.0,1 RC,480,Lapscp rmvl leiomyomata ,,,5841.0,5841.0,1 RC,480,Lapscp salpingostomy ,,,5841.0,5841.0,1 RC,480,Lapscp select vagotomy ,,,5841.0,5841.0,1 RC,480,Lapscp temp gastrostomy ,,,5841.0,5841.0,1 RC,480,Lapscp truncal vagotomy ,,,5841.0,5841.0,1 RC,480,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2434.0,2434.0,1 RC,480,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,6326.0,6326.0,1 RC,480,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,6326.0,6326.0,1 RC,480,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,5841.0,5841.0,1 RC,480,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,5841.0,5841.0,1 RC,480,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,6326.0,6326.0,1 RC,480,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,10342.0,17384.0,3 RC,480,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,10342.0,17384.0,3 RC,480,Ligation of peritoneal-venous shunt ,,,2434.0,2434.0,1 RC,480,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,5841.0,5841.0,1 RC,480,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,2434.0,2434.0,1 RC,480,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,3041.0,3041.0,1 RC,480,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,3041.0,3041.0,1 RC,480,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,3041.0,3041.0,1 RC,480,"Lithotripsy, extracorporeal shock wave ",,,10342.0,10342.0,1 RC,480,Lumbar/caudal inject NEC ,,,5841.0,5841.0,1 RC,480,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,3041.0,3041.0,1 RC,480,Lysis of labial adhesions ,,,3041.0,3041.0,1 RC,480,Lysis or excision of penile post-circumcision adhesions ,,,3041.0,3041.0,1 RC,480,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,2251.0,2251.0,1 RC,480,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,5841.0,5841.0,1 RC,480,Marsupialization of Bartholin's gland cyst ,,,3041.0,3041.0,1 RC,480,Marsupialization of pancreatic cyst ,,,5841.0,5841.0,1 RC,480,"Marsupialization of urethral diverticulum, male or female ",,,4988.0,4988.0,1 RC,480,Mastoid obliteration (separate procedure) ,,,6326.0,6326.0,1 RC,480,Mastoidectomy; complete ,,,3041.0,3041.0,1 RC,480,Mastoidectomy; modified radical ,,,6326.0,6326.0,1 RC,480,Mastoidectomy; radical ,,,6326.0,6326.0,1 RC,480,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,5841.0,5841.0,1 RC,480,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,3041.0,3041.0,1 RC,480,"Meatotomy, cutting of meatus (separate procedure); infant ",,,3041.0,3041.0,1 RC,480,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,2251.0,2251.0,1 RC,480,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Middle ear exploration through postauricular or ear canal incision ,,,3041.0,3041.0,1 RC,480,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,3041.0,3041.0,1 RC,480,Multifetal pregnancy reduction(s) (MPR) ,,,5841.0,5841.0,1 RC,480,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,3041.0,3041.0,1 RC,480,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,2251.0,2251.0,1 RC,480,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,2251.0,2251.0,1 RC,480,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,2251.0,2251.0,1 RC,480,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,2251.0,2251.0,1 RC,480,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,4988.0,4988.0,1 RC,480,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,3041.0,3041.0,1 RC,480,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,4988.0,4988.0,1 RC,480,Myringoplasty (surgery confined to drumhead and donor area) ,,,3041.0,3041.0,1 RC,480,Myringotomy including aspiration and/or eustachian tube inflation ,,,5841.0,5841.0,1 RC,480,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,2434.0,2434.0,1 RC,480,N BLOCK INJ SPINAL ACCESSOR ,,,5841.0,5841.0,1 RC,480,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,5841.0,5841.0,1 RC,480,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,5841.0,5841.0,1 RC,480,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,5841.0,5841.0,1 RC,480,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,5841.0,5841.0,1 RC,480,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,5841.0,5841.0,1 RC,480,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,5841.0,5841.0,1 RC,480,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,5841.0,5841.0,1 RC,480,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,5841.0,5841.0,1 RC,480,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,5841.0,5841.0,1 RC,480,"Nephrectomy, partial ",,,5841.0,5841.0,1 RC,480,Nephrolithotomy; complicated by congenital kidney abnormality ,,,5841.0,5841.0,1 RC,480,Nephrolithotomy; removal of calculus ,,,5841.0,5841.0,1 RC,480,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,5841.0,5841.0,1 RC,480,Nephrolithotomy; secondary surgical operation for calculus ,,,5841.0,5841.0,1 RC,480,"Nephrorrhaphy, suture of kidney wound or injury ",,,5841.0,5841.0,1 RC,480,"Nephrostomy, nephrotomy with drainage ",,,3041.0,3041.0,1 RC,480,"Nephrotomy, with exploration ",,,5841.0,5841.0,1 RC,480,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,6326.0,6326.0,1 RC,480,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Nerve pedicle transfer; first stage ,,,6326.0,6326.0,1 RC,480,Nerve pedicle transfer; second stage ,,,6326.0,6326.0,1 RC,480,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,6326.0,6326.0,1 RC,480,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,5841.0,5841.0,1 RC,480,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,6326.0,6326.0,1 RC,480,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,5841.0,5841.0,1 RC,480,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,5841.0,5841.0,1 RC,480,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,5841.0,5841.0,1 RC,480,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,5841.0,5841.0,1 RC,480,Neuroplasty and/or transposition; cranial nerve (specify) ,,,3041.0,3041.0,1 RC,480,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,3041.0,3041.0,1 RC,480,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,3041.0,3041.0,1 RC,480,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,3041.0,3041.0,1 RC,480,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,3041.0,3041.0,1 RC,480,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,3041.0,3041.0,1 RC,480,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,3041.0,3041.0,1 RC,480,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,3041.0,3041.0,1 RC,480,"Neuroplasty; digital, 1 or both, same digit ",,,3041.0,3041.0,1 RC,480,Neuroplasty; nerve of hand or foot ,,,3041.0,3041.0,1 RC,480,Nocturnal penile tumescence and/or rigidity test ,,,5841.0,5841.0,1 RC,480,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,5841.0,5841.0,1 RC,480,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,3041.0,3041.0,1 RC,480,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,4988.0,4988.0,1 RC,480,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,4988.0,4988.0,1 RC,480,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,6326.0,6326.0,1 RC,480,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,5841.0,5841.0,1 RC,480,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Oophorectomy, partial or total, unilateral or bilateral; ",,,4988.0,4988.0,1 RC,480,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,4988.0,4988.0,1 RC,480,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,12167.0,12167.0,1 RC,480,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,5841.0,5841.0,1 RC,480,Open implantation of neurostimulator electrode array; neuromuscular ,,,10949.0,10949.0,1 RC,480,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,10949.0,10949.0,1 RC,480,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,10949.0,10949.0,1 RC,480,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,5841.0,5841.0,1 RC,480,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,5841.0,5841.0,1 RC,480,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,5841.0,5841.0,1 RC,480,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,3041.0,1 RC,480,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,3041.0,1 RC,480,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,4988.0,4988.0,1 RC,480,Orbital implant (implant outside muscle cone); insertion ,,,4988.0,4988.0,1 RC,480,Orbital implant (implant outside muscle cone); removal or revision ,,,4988.0,4988.0,1 RC,480,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,5841.0,5841.0,1 RC,480,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,5841.0,5841.0,1 RC,480,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,5841.0,5841.0,1 RC,480,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,4988.0,4988.0,1 RC,480,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,4988.0,4988.0,1 RC,480,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,4988.0,4988.0,1 RC,480,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,4988.0,4988.0,1 RC,480,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,4988.0,4988.0,1 RC,480,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,4988.0,4988.0,1 RC,480,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,3041.0,3041.0,1 RC,480,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,4988.0,4988.0,1 RC,480,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,3041.0,3041.0,1 RC,480,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,3041.0,3041.0,1 RC,480,"Orchiectomy, partial ",,,3041.0,3041.0,1 RC,480,"Orchiectomy, radical, for tumor; inguinal approach ",,,4988.0,4988.0,1 RC,480,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,4988.0,4988.0,1 RC,480,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,4988.0,4988.0,1 RC,480,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,4988.0,4988.0,1 RC,480,"Orchiopexy, inguinal or scrotal approach ",,,4988.0,4988.0,1 RC,480,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Other cranial decompression, posterior fossa ",,,5841.0,5841.0,1 RC,480,Other spinal injection ,,,5841.0,5841.0,1 RC,480,"Otoplasty, protruding ear, with or without size reduction ",,,3041.0,3041.0,1 RC,480,"Ovarian cystectomy, unilateral or bilateral ",,,4988.0,4988.0,1 RC,480,"PERCUT/NEEDLE INSERT, PROS ",,,5841.0,5841.0,1 RC,480,"PROSTATECTOMY, FIRST STAGE ",,,5841.0,5841.0,1 RC,480,"PROSTATECTOMY, SECOND STAGE ",,,5841.0,5841.0,1 RC,480,PROSTATIC WATER THERMOTHER ,,,5841.0,5841.0,1 RC,480,PUNCTURE PERITONEAL CAVITY ,,,5841.0,5841.0,1 RC,480,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, total ",,,5841.0,5841.0,1 RC,480,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,5841.0,5841.0,1 RC,480,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,5841.0,5841.0,1 RC,480,Pancreatorrhaphy for injury ,,,5841.0,5841.0,1 RC,480,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,5841.0,5841.0,1 RC,480,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,3041.0,3041.0,1 RC,480,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,3041.0,3041.0,1 RC,480,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Parathyroidectomy or exploration of parathyroid(s); ,,,6326.0,6326.0,1 RC,480,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,6326.0,6326.0,1 RC,480,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,5841.0,5841.0,1 RC,480,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,9124.0,9124.0,1 RC,480,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,6326.0,6326.0,1 RC,480,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,6326.0,6326.0,1 RC,480,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,2251.0,2251.0,1 RC,480,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,5841.0,5841.0,1 RC,480,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,2251.0,2251.0,1 RC,480,Partial hymenectomy or revision of hymenal ring ,,,3041.0,3041.0,1 RC,480,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,9124.0,9124.0,1 RC,480,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,9124.0,9124.0,1 RC,480,Pelvic examination under anesthesia (other than local) ,,,3041.0,3041.0,1 RC,480,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,5841.0,5841.0,1 RC,480,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,5841.0,5841.0,1 RC,480,Penile plethysmography ,,,5841.0,5841.0,1 RC,480,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,5841.0,5841.0,1 RC,480,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,2434.0,2434.0,1 RC,480,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,2251.0,2251.0,1 RC,480,Percutaneous balloon valvuloplasty; aortic valve ,,,21231.0,43890.0,3 RC,480,Percutaneous balloon valvuloplasty; mitral valve ,,,21231.0,43890.0,3 RC,480,Percutaneous balloon valvuloplasty; pulmonary valve ,,,21231.0,43890.0,3 RC,480,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,9124.0,9124.0,1 RC,480,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,9124.0,9124.0,1 RC,480,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,9124.0,9124.0,1 RC,480,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,2251.0,3041.0,2 RC,480,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,10342.0,10342.0,2 RC,480,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,4988.0,4988.0,1 RC,480,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,10949.0,43890.0,2 RC,480,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,10949.0,43890.0,2 RC,480,Percutaneous transcatheter closure of patent ductus arteriosus ,,,10949.0,43890.0,2 RC,480,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,43890.0,3 RC,480,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,43890.0,3 RC,480,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,3 RC,480,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,21231.0,43890.0,3 RC,480,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,5841.0,43890.0,2 RC,480,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,43890.0,3 RC,480,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,480,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,480,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,21231.0,43890.0,3 RC,480,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,43890.0,6 RC,480,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,21231.0,43890.0,4 RC,480,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,43890.0,6 RC,480,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,21231.0,43890.0,3 RC,480,"Pereyra procedure, including anterior colporrhaphy ",,,4988.0,4988.0,1 RC,480,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Peritoneal lavage, including imaging guidance, when performed ",,,2251.0,2251.0,1 RC,480,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,5841.0,5841.0,1 RC,480,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,5841.0,5841.0,1 RC,480,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,5841.0,5841.0,1 RC,480,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,5841.0,5841.0,1 RC,480,Pertnscp cholangram w bx ,,,5841.0,5841.0,1 RC,480,Petrous apicectomy including radical mastoidectomy ,,,6326.0,6326.0,1 RC,480,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,5841.0,5841.0,1 RC,480,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,4988.0,4988.0,1 RC,480,Placement of amniotic membrane on the ocular surface; without sutures ,,,2251.0,2251.0,1 RC,480,"Placement of drains, peripancreatic, for acute pancreatitis; ",,,5841.0,5841.0,1 RC,480,"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy ",,,5841.0,5841.0,1 RC,480,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,2251.0,2251.0,1 RC,480,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,5841.0,5841.0,1 RC,480,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,2434.0,2434.0,1 RC,480,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,2434.0,2434.0,1 RC,480,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,4988.0,4988.0,1 RC,480,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,3041.0,3041.0,1 RC,480,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,3041.0,3041.0,1 RC,480,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,4988.0,4988.0,3 RC,480,Plastic operation of penis for injury ,,,4988.0,4988.0,1 RC,480,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,6326.0,6326.0,1 RC,480,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,6326.0,6326.0,1 RC,480,Plastic operation on penis for epispadias distal to external sphincter; ,,,4988.0,4988.0,1 RC,480,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,6326.0,6326.0,1 RC,480,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,4988.0,4988.0,1 RC,480,Plastic operation on penis to correct angulation ,,,6326.0,6326.0,1 RC,480,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,6326.0,6326.0,1 RC,480,Plastic repair of canaliculi ,,,3041.0,3041.0,1 RC,480,Plastic repair of introitus ,,,3041.0,3041.0,1 RC,480,Plastic repair of urethrocele ,,,3041.0,3041.0,1 RC,480,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,4988.0,4988.0,1 RC,480,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,5841.0,5841.0,1 RC,480,Postpartum care only (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,5841.0,5841.0,1 RC,480,"Probing of lacrimal canaliculi, with or without irrigation ",,,5841.0,5841.0,1 RC,480,"Probing of nasolacrimal duct, with or without irrigation; ",,,5841.0,5841.0,1 RC,480,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,3041.0,3041.0,1 RC,480,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,3041.0,3041.0,1 RC,480,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,3041.0,3041.0,1 RC,480,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,29288.0,43890.0,2 RC,480,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,5841.0,5841.0,1 RC,480,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,2251.0,2251.0,1 RC,480,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,5841.0,5841.0,1 RC,480,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, perineal radical; ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,5841.0,5841.0,1 RC,480,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,5841.0,5841.0,1 RC,480,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,3041.0,3041.0,1 RC,480,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,3041.0,3041.0,1 RC,480,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,2251.0,2251.0,1 RC,480,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,2251.0,2251.0,1 RC,480,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,5841.0,5841.0,1 RC,480,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,5841.0,5841.0,1 RC,480,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,5841.0,5841.0,1 RC,480,"Pyelotomy; with drainage, pyelostomy ",,,5841.0,5841.0,1 RC,480,Pyelotomy; with exploration ,,,5841.0,5841.0,1 RC,480,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,5841.0,5841.0,1 RC,480,RECONSTRUCTION OF URETHRA ,,,5841.0,5841.0,1 RC,480,REDUCTION OF SKULL DEFECT ,,,5841.0,5841.0,1 RC,480,REMOVAL OF ABDOMINAL FLUID ,,,5841.0,5841.0,1 RC,480,REMOVAL OF ABDOMINAL LESION ,,,5841.0,5841.0,1 RC,480,REMOVAL OF BRAIN TISSUE ,,,5841.0,5841.0,1 RC,480,REMOVAL OF TESTIS LESION ,,,5841.0,5841.0,1 RC,480,"REMOVE ABDOM LESION, COMPLEX ",,,5841.0,5841.0,1 RC,480,REMOVE ABDOMEN FOREIGN BODY ,,,5841.0,5841.0,1 RC,480,REMOVE MULTI-COMP PROSTHESIS ,,,5841.0,5841.0,1 RC,480,REMOVE PENIS PROSTHESIS ,,,5841.0,5841.0,1 RC,480,REMOVE RESIDUAL PROSTATE ,,,5841.0,5841.0,1 RC,480,RENAL ABSCESS PERCUT DRAIN ,,,5841.0,5841.0,1 RC,480,RENAL ENDOSCOPY/RADIOTRACER ,,,5841.0,5841.0,2 RC,480,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,4988.0,1 RC,480,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,4988.0,1 RC,480,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,4988.0,1 RC,480,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,4988.0,1 RC,480,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,3041.0,1 RC,480,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,4988.0,1 RC,480,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,4988.0,1 RC,480,REPAIR SPIGELIAN HERNIA ,,,4988.0,4988.0,1 RC,480,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,4988.0,1 RC,480,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,4988.0,1 RC,480,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,4988.0,1 RC,480,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,4988.0,1 RC,480,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10949.0,10949.0,1 RC,480,REREPAIR DETACHED RETINA ,,,5841.0,5841.0,1 RC,480,RESECT/DEBRIDE PANCREAS ,,,5841.0,5841.0,1 RC,480,REVISE PENIS PROSTHESIS ,,,5841.0,5841.0,1 RC,480,REVISE/REMOVE NEUROELECTRODE ,,,5841.0,5841.0,1 RC,480,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,6326.0,1 RC,480,Radial keratotomy ,,,3041.0,3041.0,1 RC,480,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,5841.0,5841.0,1 RC,480,Radical excision external auditory canal lesion; with neck dissection ,,,5841.0,5841.0,1 RC,480,Radical excision external auditory canal lesion; without neck dissection ,,,3041.0,3041.0,1 RC,480,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,5841.0,5841.0,1 RC,480,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,5841.0,5841.0,1 RC,480,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,5841.0,5841.0,1 RC,480,Recipient nephrectomy (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Reconstruction external auditory canal for congenital atresia, single stage ",,,6326.0,6326.0,1 RC,480,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,6326.0,6326.0,1 RC,480,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,3041.0,3041.0,1 RC,480,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,3041.0,3041.0,1 RC,480,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,4988.0,4988.0,1 RC,480,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,3041.0,3041.0,1 RC,480,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,5841.0,5841.0,1 RC,480,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,5841.0,5841.0,1 RC,480,Reduction of overcorrection of ptosis ,,,3041.0,3041.0,1 RC,480,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,3041.0,3041.0,1 RC,480,Reinsertion of ocular implant; with or without conjunctival graft ,,,4988.0,4988.0,1 RC,480,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,4988.0,4988.0,1 RC,480,Release of encircling material (posterior segment) ,,,3041.0,3041.0,1 RC,480,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,3041.0,3041.0,1 RC,480,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,3041.0,3041.0,1 RC,480,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,3041.0,3041.0,1 RC,480,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,2434.0,2434.0,1 RC,480,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,2251.0,2251.0,1 RC,480,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,10949.0,10949.0,1 RC,480,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,5841.0,5841.0,1 RC,480,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,2434.0,2434.0,1 RC,480,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,10949.0,10949.0,1 RC,480,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,2251.0,2251.0,1 RC,480,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,10949.0,10949.0,1 RC,480,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,2251.0,2251.0,1 RC,480,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,3041.0,3041.0,1 RC,480,Removal foreign body from external auditory canal; with general anesthesia ,,,2434.0,2434.0,1 RC,480,Removal foreign body from external auditory canal; without general anesthesia ,,,5841.0,5841.0,1 RC,480,"Removal impacted cerumen requiring instrumentation, unilateral ",,,5841.0,5841.0,1 RC,480,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,5841.0,5841.0,1 RC,480,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,4988.0,4988.0,1 RC,480,"Removal of blood clot, anterior segment of eye ",,,3041.0,3041.0,1 RC,480,Removal of bone flap or prosthetic plate of skull ,,,5841.0,5841.0,1 RC,480,Removal of cerclage suture under anesthesia (other than local) ,,,3041.0,3041.0,1 RC,480,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,5841.0,5841.0,1 RC,480,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,2434.0,2434.0,1 RC,480,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,3041.0,3041.0,1 RC,480,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,2251.0,2251.0,1 RC,480,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,6326.0,6326.0,1 RC,480,"Removal of embedded foreign body, eyelid ",,,5841.0,5841.0,1 RC,480,Removal of entire lumbosubarachnoid shunt system without replacement ,,,3041.0,3041.0,1 RC,480,"Removal of epithelial downgrowth, anterior chamber of eye ",,,3041.0,3041.0,1 RC,480,Removal of foreign body in scrotum ,,,3041.0,3041.0,1 RC,480,"Removal of foreign body or dacryolith, lacrimal passages ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, external eye; conjunctival superficial ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, external eye; corneal, with slit lamp ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, external eye; corneal, without slit lamp ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,3041.0,3041.0,1 RC,480,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,5841.0,5841.0,1 RC,480,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,3041.0,3041.0,1 RC,480,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,5841.0,5841.0,1 RC,480,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,3041.0,3041.0,1 RC,480,"Removal of implanted material, anterior segment of eye ",,,3041.0,3041.0,1 RC,480,"Removal of implanted material, posterior segment; extraocular ",,,3041.0,3041.0,1 RC,480,"Removal of implanted material, posterior segment; intraocular ",,,6326.0,6326.0,1 RC,480,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,6326.0,6326.0,1 RC,480,Removal of intrauterine device (IUD) ,,,5841.0,5841.0,1 RC,480,"Removal of lens material; aspiration technique, 1 or more stages ",,,3041.0,3041.0,1 RC,480,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,2434.0,2434.0,1 RC,480,Removal of lens material; intracapsular ,,,3041.0,3041.0,1 RC,480,"Removal of lens material; intracapsular, for dislocated lens ",,,3041.0,3041.0,1 RC,480,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,6326.0,6326.0,1 RC,480,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,3041.0,3041.0,1 RC,480,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,2251.0,2251.0,1 RC,480,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,4988.0,4988.0,1 RC,480,Removal of ocular implant ,,,4988.0,4988.0,1 RC,480,Removal of pancreatic calculus ,,,5841.0,5841.0,1 RC,480,Removal of peritoneal foreign body from peritoneal cavity ,,,4988.0,4988.0,1 RC,480,Removal of peritoneal-venous shunt ,,,4988.0,4988.0,1 RC,480,Removal of previously implanted intrathecal or epidural catheter ,,,3041.0,3041.0,1 RC,480,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,3041.0,3041.0,1 RC,480,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,5841.0,5841.0,1 RC,480,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,3041.0,3041.0,1 RC,480,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,4988.0,4988.0,1 RC,480,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,6326.0,6326.0,1 RC,480,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,5841.0,5841.0,1 RC,480,Removal of transplanted pancreatic allograft ,,,5841.0,5841.0,1 RC,480,Removal of transplanted renal allograft ,,,5841.0,5841.0,1 RC,480,"Removal of tumor, temporal bone ",,,6326.0,6326.0,1 RC,480,Removal of tunneled intraperitoneal catheter ,,,4988.0,4988.0,1 RC,480,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,3041.0,3041.0,1 RC,480,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,3041.0,3041.0,1 RC,480,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,6326.0,6326.0,1 RC,480,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,4988.0,4988.0,1 RC,480,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,3041.0,3041.0,1 RC,480,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,5841.0,5841.0,1 RC,480,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,5841.0,5841.0,1 RC,480,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,5841.0,5841.0,1 RC,480,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,5841.0,5841.0,1 RC,480,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,5841.0,5841.0,1 RC,480,"Renal autotransplantation, reimplantation of kidney ",,,5841.0,5841.0,1 RC,480,Renal biopsy; by surgical exposure of kidney ,,,5841.0,5841.0,1 RC,480,"Renal biopsy; percutaneous, by trocar or needle ",,,2434.0,2434.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,2251.0,2251.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,2251.0,2251.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,3041.0,3041.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,3041.0,3041.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,2251.0,2251.0,1 RC,480,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,3041.0,3041.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,2251.0,2251.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,2251.0,2251.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,6326.0,6326.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,2434.0,2434.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,2434.0,2434.0,1 RC,480,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,2251.0,2251.0,1 RC,480,"Renal exploration, not necessitating other specific procedures ",,,5841.0,5841.0,1 RC,480,Reopening of recent laparotomy ,,,5841.0,5841.0,1 RC,480,Repair incomplete circumcision ,,,3041.0,3041.0,1 RC,480,"Repair inguinal hernia, sliding, any age ",,,4988.0,4988.0,1 RC,480,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,4988.0,4988.0,1 RC,480,"Repair initial femoral hernia, any age; reducible ",,,4988.0,4988.0,1 RC,480,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,4988.0,4988.0,1 RC,480,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,4988.0,4988.0,1 RC,480,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,4988.0,4988.0,1 RC,480,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,4988.0,4988.0,1 RC,480,Repair lumbar hernia ,,,4988.0,4988.0,1 RC,480,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,5841.0,5841.0,6 RC,480,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,5841.0,5841.0,6 RC,480,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,3041.0,3041.0,1 RC,480,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,3041.0,3041.0,1 RC,480,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,3041.0,3041.0,1 RC,480,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,4988.0,4988.0,1 RC,480,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,3041.0,3041.0,1 RC,480,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,4988.0,4988.0,1 RC,480,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,3041.0,3041.0,1 RC,480,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,6326.0,6326.0,1 RC,480,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,6326.0,6326.0,1 RC,480,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,5841.0,5841.0,1 RC,480,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,5841.0,5841.0,1 RC,480,Repair of ectropion; excision tarsal wedge ,,,3041.0,3041.0,1 RC,480,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,3041.0,3041.0,1 RC,480,Repair of ectropion; suture ,,,3041.0,3041.0,1 RC,480,Repair of ectropion; thermocauterization ,,,3041.0,3041.0,1 RC,480,"Repair of encephalocele, skull vault, including cranioplasty ",,,5841.0,5841.0,1 RC,480,"Repair of enterocele, abdominal approach (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Repair of enterocele, vaginal approach (separate procedure) ",,,3041.0,3041.0,1 RC,480,Repair of entropion; excision tarsal wedge ,,,3041.0,3041.0,1 RC,480,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,3041.0,3041.0,1 RC,480,Repair of entropion; suture ,,,3041.0,3041.0,1 RC,480,Repair of entropion; thermocauterization ,,,3041.0,3041.0,1 RC,480,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,4988.0,4988.0,1 RC,480,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,4988.0,4988.0,1 RC,480,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,4988.0,4988.0,1 RC,480,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,4988.0,4988.0,1 RC,480,"Repair of iris, ciliary body (as for iridodialysis) ",,,3041.0,3041.0,1 RC,480,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,2434.0,2434.0,1 RC,480,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,5841.0,5841.0,1 RC,480,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,3041.0,3041.0,1 RC,480,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,3041.0,3041.0,1 RC,480,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,3041.0,3041.0,1 RC,480,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,3041.0,3041.0,1 RC,480,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,4988.0,4988.0,1 RC,480,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,5841.0,5841.0,1 RC,480,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,5841.0,5841.0,1 RC,480,Repair of meningocele; larger than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Repair of meningocele; less than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Repair of myelomeningocele; larger than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Repair of myelomeningocele; less than 5 cm diameter ,,,5841.0,5841.0,1 RC,480,Repair of omphalocele (Gross type operation); first stage ,,,5841.0,5841.0,1 RC,480,Repair of omphalocele (Gross type operation); second stage ,,,5841.0,5841.0,1 RC,480,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,5841.0,5841.0,1 RC,480,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,5841.0,5841.0,1 RC,480,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,3041.0,3041.0,1 RC,480,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,2251.0,2251.0,1 RC,480,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,3041.0,3041.0,1 RC,480,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,6326.0,6326.0,1 RC,480,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,6326.0,6326.0,1 RC,480,Repair of scleral staphyloma with graft ,,,3041.0,3041.0,1 RC,480,"Repair of small omphalocele, with primary closure ",,,4988.0,4988.0,1 RC,480,"Repair of symblepharon; conjunctivoplasty, without graft ",,,3041.0,3041.0,1 RC,480,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,3041.0,3041.0,1 RC,480,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,4988.0,4988.0,1 RC,480,Repair of traumatic corporeal tear(s) ,,,3041.0,3041.0,1 RC,480,Repair of tunica vaginalis hydrocele (Bottle type) ,,,3041.0,3041.0,1 RC,480,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,4988.0,4988.0,1 RC,480,Repair oval window fistula ,,,3041.0,3041.0,1 RC,480,Repair recurrent femoral hernia; incarcerated or strangulated ,,,4988.0,4988.0,1 RC,480,Repair recurrent femoral hernia; reducible ,,,4988.0,4988.0,1 RC,480,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,4988.0,4988.0,1 RC,480,"Repair recurrent inguinal hernia, any age; reducible ",,,4988.0,4988.0,1 RC,480,Repair round window fistula ,,,3041.0,3041.0,1 RC,480,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,4988.0,4988.0,2 RC,480,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,4988.0,4988.0,1 RC,480,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,4988.0,4988.0,1 RC,480,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,5841.0,5841.0,1 RC,480,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,5841.0,5841.0,1 RC,480,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,6326.0,6326.0,1 RC,480,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,5841.0,5841.0,1 RC,480,Replacement of bone flap or prosthetic plate of skull ,,,5841.0,5841.0,1 RC,480,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2251.0,2251.0,1 RC,480,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2251.0,2251.0,1 RC,480,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,2251.0,2251.0,1 RC,480,"Replacement or irrigation, subarachnoid/subdural catheter ",,,3041.0,3041.0,1 RC,480,"Replacement or irrigation, ventricular catheter ",,,2434.0,2434.0,1 RC,480,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,6326.0,6326.0,1 RC,480,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,6326.0,6326.0,1 RC,480,"Replantation, penis, complete amputation including urethral repair ",,,5841.0,5841.0,1 RC,480,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,3041.0,3041.0,1 RC,480,Reprogramming of programmable cerebrospinal shunt ,,,5841.0,5841.0,1 RC,480,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,4988.0,4988.0,1 RC,480,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,5841.0,5841.0,1 RC,480,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,5841.0,5841.0,1 RC,480,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,5841.0,5841.0,1 RC,480,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,5841.0,5841.0,1 RC,480,Resection of scrotum ,,,3041.0,3041.0,1 RC,480,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,5841.0,5841.0,1 RC,480,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,5841.0,5841.0,1 RC,480,"Resection temporal bone, external approach ",,,5841.0,5841.0,1 RC,480,Retrobulbar injection; alcohol ,,,5841.0,5841.0,1 RC,480,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,5841.0,5841.0,1 RC,480,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,4988.0,4988.0,1 RC,480,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,5841.0,5841.0,1 RC,480,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,3041.0,3041.0,1 RC,480,Revision mastoidectomy; resulting in complete mastoidectomy ,,,6326.0,6326.0,1 RC,480,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,6326.0,6326.0,1 RC,480,Revision mastoidectomy; resulting in radical mastoidectomy ,,,6326.0,6326.0,1 RC,480,Revision mastoidectomy; resulting in tympanoplasty ,,,6326.0,6326.0,1 RC,480,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,3041.0,3041.0,1 RC,480,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,3041.0,3041.0,1 RC,480,Revision of peritoneal-venous shunt ,,,4988.0,4988.0,1 RC,480,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,6326.0,6326.0,1 RC,480,Revision of stapedectomy or stapedotomy ,,,6326.0,6326.0,1 RC,480,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,3041.0,3041.0,1 RC,480,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,5841.0,5841.0,1 RC,480,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,4988.0,4988.0,1 RC,480,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,4988.0,4988.0,1 RC,480,Revision or removal of intracranial neurostimulator electrodes ,,,4988.0,4988.0,1 RC,480,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,5841.0,5841.0,1 RC,480,Revision or removal of peripheral neurostimulator electrode array ,,,4988.0,4988.0,1 RC,480,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,4988.0,4988.0,1 RC,480,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,3041.0,3041.0,1 RC,480,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,9124.0,9124.0,1 RC,480,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,5841.0,5841.0,1 RC,480,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,5841.0,5841.0,1 RC,480,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,10342.0,17384.0,3 RC,480,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,4988.0,1 RC,480,Right ventricular recording ,,,21231.0,43890.0,3 RC,480,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,5841.0,5841.0,1 RC,480,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,5841.0,5841.0,1 RC,480,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,5841.0,5841.0,1 RC,480,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,5841.0,5841.0,1 RC,480,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,5841.0,5841.0,1 RC,480,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2434.0,2434.0,1 RC,480,STRIP RETINAL MEMBRANE ,,,5841.0,5841.0,1 RC,480,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,5841.0,5841.0,1 RC,480,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,4988.0,4988.0,1 RC,480,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,6326.0,6326.0,1 RC,480,Salpingostomy (salpingoneostomy) ,,,3041.0,3041.0,1 RC,480,Scleral reinforcement (separate procedure); with graft ,,,3041.0,3041.0,1 RC,480,Scleral reinforcement (separate procedure); without graft ,,,3041.0,3041.0,1 RC,480,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,2434.0,2434.0,1 RC,480,"Scraping of cornea, diagnostic, for smear and/or culture ",,,5841.0,5841.0,1 RC,480,Scrotal exploration ,,,3041.0,3041.0,1 RC,480,Scrotoplasty; complicated ,,,3041.0,3041.0,1 RC,480,Scrotoplasty; simple ,,,6326.0,6326.0,1 RC,480,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,5841.0,5841.0,1 RC,480,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,5841.0,5841.0,1 RC,480,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,3041.0,3041.0,1 RC,480,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,3041.0,3041.0,1 RC,480,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,3041.0,3041.0,1 RC,480,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,3041.0,3041.0,1 RC,480,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,2251.0,2251.0,1 RC,480,Severing of tarsorrhaphy ,,,2251.0,2251.0,1 RC,480,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,2251.0,2251.0,1 RC,480,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,5841.0,5841.0,1 RC,480,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,5841.0,5841.0,1 RC,480,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,10949.0,10949.0,1 RC,480,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,6326.0,6326.0,1 RC,480,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,3041.0,3041.0,1 RC,480,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,3041.0,3041.0,1 RC,480,Snip incision of lacrimal punctum ,,,5841.0,5841.0,1 RC,480,Sperm washing for artificial insemination ,,,5841.0,5841.0,1 RC,480,"Spinal puncture, lumbar, diagnostic; ",,,2251.0,2251.0,1 RC,480,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,5841.0,5841.0,1 RC,480,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,2251.0,2251.0,1 RC,480,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,5841.0,5841.0,1 RC,480,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,6326.0,6326.0,1 RC,480,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,6326.0,6326.0,1 RC,480,Stapes mobilization ,,,3041.0,3041.0,1 RC,480,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,5841.0,5841.0,1 RC,480,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,5841.0,5841.0,1 RC,480,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,2434.0,2434.0,1 RC,480,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,6326.0,6326.0,1 RC,480,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,2434.0,2434.0,1 RC,480,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,5841.0,5841.0,1 RC,480,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,5841.0,5841.0,1 RC,480,"Strabismus surgery, any procedure, superior oblique muscle ",,,3041.0,3041.0,1 RC,480,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,3041.0,3041.0,1 RC,480,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,3041.0,3041.0,1 RC,480,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,4988.0,4988.0,1 RC,480,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,3041.0,3041.0,1 RC,480,Subarachnoid inject NEC ,,,5841.0,5841.0,1 RC,480,Subconjunctival injection ,,,5841.0,5841.0,1 RC,480,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,2434.0,2434.0,1 RC,480,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,2251.0,2251.0,1 RC,480,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,2251.0,2251.0,1 RC,480,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,5841.0,5841.0,1 RC,480,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,5841.0,5841.0,1 RC,480,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,5841.0,5841.0,1 RC,480,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,5841.0,5841.0,1 RC,480,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,5841.0,5841.0,1 RC,480,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,5841.0,5841.0,1 RC,480,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,5841.0,5841.0,1 RC,480,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,5841.0,5841.0,1 RC,480,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,5841.0,5841.0,1 RC,480,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,5841.0,5841.0,1 RC,480,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,5841.0,5841.0,1 RC,480,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,5841.0,5841.0,1 RC,480,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,5841.0,5841.0,1 RC,480,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,4988.0,4988.0,1 RC,480,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,4988.0,4988.0,1 RC,480,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,6326.0,6326.0,1 RC,480,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,6326.0,6326.0,1 RC,480,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,6326.0,6326.0,1 RC,480,Suture of 1 nerve; median motor thenar ,,,6326.0,6326.0,1 RC,480,Suture of 1 nerve; ulnar motor ,,,6326.0,6326.0,1 RC,480,"Suture of digital nerve, hand or foot; 1 nerve ",,,6326.0,6326.0,1 RC,480,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Suture of facial nerve; extracranial ,,,6326.0,6326.0,1 RC,480,"Suture of facial nerve; infratemporal, with or without grafting ",,,6326.0,6326.0,1 RC,480,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,3041.0,3041.0,1 RC,480,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,6326.0,6326.0,1 RC,480,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,6326.0,6326.0,1 RC,480,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,5841.0,5841.0,1 RC,480,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,5841.0,5841.0,1 RC,480,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,5841.0,5841.0,1 RC,480,Suture of posterior tibial nerve ,,,6326.0,6326.0,1 RC,480,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,3041.0,3041.0,1 RC,480,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,3041.0,3041.0,1 RC,480,Suture of sciatic nerve ,,,6326.0,6326.0,1 RC,480,Suture of; brachial plexus ,,,6326.0,6326.0,1 RC,480,Suture of; lumbar plexus ,,,6326.0,6326.0,1 RC,480,Suture or repair of testicular injury ,,,3041.0,3041.0,1 RC,480,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,5841.0,5841.0,1 RC,480,"Sympathectomy, cervical ",,,2434.0,2434.0,1 RC,480,"Sympathectomy, cervicothoracic ",,,2434.0,2434.0,1 RC,480,"Sympathectomy, lumbar ",,,5841.0,5841.0,1 RC,480,"Sympathectomy, thoracolumbar ",,,5841.0,5841.0,1 RC,480,"Sympathectomy; digital arteries, each digit ",,,3041.0,3041.0,1 RC,480,Sympathectomy; radial artery ,,,4988.0,4988.0,1 RC,480,Sympathectomy; superficial palmar arch ,,,4988.0,4988.0,1 RC,480,Sympathectomy; ulnar artery ,,,4988.0,4988.0,1 RC,480,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,5841.0,5841.0,1 RC,480,TRANSECT ARTERY SINUS ,,,5841.0,5841.0,1 RC,480,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,5841.0,5841.0,1 RC,480,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,5841.0,5841.0,1 RC,480,TUR cong post valve/fold ,,,5841.0,5841.0,1 RC,480,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,2251.0,2251.0,1 RC,480,Temporary transcutaneous pacing ,,,2251.0,2251.0,1 RC,480,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,5841.0,5841.0,1 RC,480,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,6326.0,6326.0,1 RC,480,"Thyroidectomy, including substernal thyroid; cervical approach ",,,6326.0,6326.0,1 RC,480,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,2434.0,2434.0,1 RC,480,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,6326.0,6326.0,1 RC,480,"Thyroidectomy, total or complete ",,,9124.0,9124.0,1 RC,480,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,6326.0,6326.0,1 RC,480,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,3041.0,3041.0,1 RC,480,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,5841.0,5841.0,1 RC,480,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,5841.0,5841.0,1 RC,480,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,5841.0,5841.0,1 RC,480,Total facial nerve decompression and/or repair (may include graft) ,,,6326.0,6326.0,1 RC,480,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,9124.0,9124.0,1 RC,480,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,9124.0,9124.0,1 RC,480,Trabeculoplasty by laser surgery ,,,2251.0,2251.0,1 RC,480,Trabeculotomy ab externo ,,,3041.0,3041.0,1 RC,480,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,3041.0,3041.0,1 RC,480,"Transabdominal amnioinfusion, including ultrasound guidance ",,,5841.0,5841.0,1 RC,480,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,5841.0,10949.0,2 RC,480,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,5841.0,5841.0,1 RC,480,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,480,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,5841.0,5841.0,1 RC,480,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,3041.0,3041.0,1 RC,480,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,5841.0,5841.0,1 RC,480,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,5841.0,5841.0,1 RC,480,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,2434.0,2434.0,1 RC,480,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,6326.0,6326.0,1 RC,480,"Transection or avulsion of other cranial nerve, extradural ",,,3041.0,3041.0,1 RC,480,"Transection or avulsion of other spinal nerve, extradural ",,,3041.0,3041.0,1 RC,480,"Transection or avulsion of; facial nerve, differential or complete ",,,3041.0,3041.0,1 RC,480,Transection or avulsion of; greater occipital nerve ,,,3041.0,3041.0,1 RC,480,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,2434.0,2434.0,1 RC,480,Transection or avulsion of; infraorbital nerve ,,,2434.0,2434.0,1 RC,480,Transection or avulsion of; lingual nerve ,,,3041.0,3041.0,1 RC,480,Transection or avulsion of; mental nerve ,,,2434.0,2434.0,1 RC,480,Transection or avulsion of; phrenic nerve ,,,2434.0,2434.0,1 RC,480,Transection or avulsion of; supraorbital nerve ,,,2434.0,2434.0,1 RC,480,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,5841.0,5841.0,1 RC,480,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,5841.0,5841.0,1 RC,480,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,5841.0,5841.0,1 RC,480,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,6326.0,6326.0,1 RC,480,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,6326.0,6326.0,1 RC,480,Transmastoid antrotomy (simple mastoidectomy) ,,,6326.0,6326.0,1 RC,480,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,5841.0,5841.0,1 RC,480,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,5841.0,5841.0,1 RC,480,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,5841.0,5841.0,1 RC,480,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,9124.0,9124.0,1 RC,480,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,9124.0,9124.0,1 RC,480,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,5841.0,5841.0,1 RC,480,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,3041.0,3041.0,1 RC,480,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,5841.0,5841.0,1 RC,480,Transplantation of pancreatic allograft ,,,5841.0,5841.0,1 RC,480,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,3041.0,3041.0,1 RC,480,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,"Transposition, ovary(s) ",,,4988.0,4988.0,1 RC,480,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,5841.0,5841.0,1 RC,480,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,5841.0,5841.0,1 RC,480,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,2434.0,2434.0,1 RC,480,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,5841.0,5841.0,1 RC,480,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,6326.0,6326.0,1 RC,480,Transurethral drainage of prostatic abscess ,,,3041.0,3041.0,1 RC,480,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,6326.0,6326.0,1 RC,480,Transurethral incision of prostate ,,,3041.0,3041.0,1 RC,480,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,2434.0,2434.0,1 RC,480,Transurethral resection of bladder neck (separate procedure) ,,,3041.0,3041.0,1 RC,480,Transurethral resection; of postoperative bladder neck contracture ,,,3041.0,3041.0,1 RC,480,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,6326.0,6326.0,1 RC,480,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,5841.0,5841.0,1 RC,480,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,5841.0,5841.0,1 RC,480,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,5841.0,5841.0,1 RC,480,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,5841.0,5841.0,1 RC,480,Transvesical ureterolithotomy ,,,6326.0,6326.0,1 RC,480,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,2251.0,2251.0,1 RC,480,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,2251.0,2251.0,1 RC,480,"Treatment of incomplete abortion, any trimester, completed surgically ",,,3041.0,3041.0,1 RC,480,"Treatment of missed abortion, completed surgically; first trimester ",,,3041.0,3041.0,1 RC,480,"Treatment of missed abortion, completed surgically; second trimester ",,,3041.0,3041.0,1 RC,480,"Treatment of septic abortion, completed surgically ",,,5841.0,5841.0,1 RC,480,Tubotubal anastomosis ,,,4988.0,4988.0,1 RC,480,Tubouterine implantation ,,,4988.0,4988.0,1 RC,480,Twist drill hole for subdural or ventricular puncture ,,,5841.0,5841.0,1 RC,480,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,5841.0,5841.0,1 RC,480,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,5841.0,5841.0,1 RC,480,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,5841.0,5841.0,1 RC,480,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,5841.0,5841.0,4 RC,480,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,3041.0,3041.0,1 RC,480,Tympanic neurectomy ,,,3041.0,3041.0,1 RC,480,"Tympanolysis, transcanal ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,6326.0,6326.0,1 RC,480,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,6326.0,6326.0,1 RC,480,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,6326.0,6326.0,1 RC,480,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,2434.0,2434.0,1 RC,480,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,5841.0,5841.0,1 RC,480,URETER ENDOSCOPY & TRACER ,,,5841.0,5841.0,2 RC,480,URETHRA PRESSURE PROFILE ,,,5841.0,5841.0,1 RC,480,URINE VOIDING PRESSURE STUDY ,,,5841.0,5841.0,1 RC,480,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,4988.0,4988.0,1 RC,480,Unlist px-laparascopy ,,,5841.0,5841.0,1 RC,480,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,5841.0,5841.0,1 RC,480,"Unlisted hysteroscopy procedure, uterus ",,,5841.0,5841.0,1 RC,480,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, bladder ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, maternity care and delivery ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, renal ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, testis ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, ureter ",,,6326.0,6326.0,1 RC,480,"Unlisted laparoscopy procedure, uterus ",,,6326.0,6326.0,1 RC,480,"Unlisted procedure, abdomen, peritoneum and omentum ",,,4988.0,4988.0,1 RC,480,"Unlisted procedure, anterior segment of eye ",,,2434.0,2434.0,1 RC,480,"Unlisted procedure, conjunctiva ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, endocrine system ",,,9124.0,9124.0,1 RC,480,"Unlisted procedure, external ear ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, extraocular muscle ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, eyelids ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, female genital system (nonobstetrical) ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, inner ear ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, lacrimal system ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, male genital system ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, maternity care and delivery ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, middle ear ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, nervous system ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, orbit ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, pancreas ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, posterior segment ",,,2434.0,2434.0,1 RC,480,"Unlisted procedure, temporal bone, middle fossa approach ",,,5841.0,5841.0,1 RC,480,"Unlisted procedure, urinary system ",,,5841.0,5841.0,1 RC,480,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,5841.0,5841.0,1 RC,480,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,2251.0,2251.0,1 RC,480,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,3041.0,3041.0,1 RC,480,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,3041.0,3041.0,1 RC,480,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,3041.0,3041.0,1 RC,480,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,2251.0,2251.0,1 RC,480,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,2251.0,2251.0,1 RC,480,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,2434.0,2434.0,1 RC,480,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,2434.0,2434.0,1 RC,480,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,3041.0,3041.0,1 RC,480,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,2251.0,2251.0,1 RC,480,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,5841.0,5841.0,1 RC,480,"Ureterectomy, with bladder cuff (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,5841.0,5841.0,1 RC,480,"Ureterocolon conduit, including intestine anastomosis ",,,5841.0,5841.0,1 RC,480,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,5841.0,5841.0,1 RC,480,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,5841.0,5841.0,1 RC,480,Ureterolithotomy; lower one-third of ureter ,,,5841.0,5841.0,1 RC,480,Ureterolithotomy; middle one-third of ureter ,,,5841.0,5841.0,1 RC,480,Ureterolithotomy; upper one-third of ureter ,,,5841.0,5841.0,1 RC,480,Ureterolysis for ovarian vein syndrome ,,,5841.0,5841.0,1 RC,480,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,5841.0,5841.0,1 RC,480,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,5841.0,5841.0,1 RC,480,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,5841.0,5841.0,1 RC,480,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,5841.0,5841.0,1 RC,480,Ureteroneocystostomy; with extensive ureteral tailoring ,,,5841.0,5841.0,1 RC,480,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,5841.0,5841.0,1 RC,480,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,5841.0,5841.0,1 RC,480,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,5841.0,5841.0,1 RC,480,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,5841.0,5841.0,1 RC,480,"Ureterostomy, transplantation of ureter to skin ",,,5841.0,5841.0,1 RC,480,"Ureterotomy for insertion of indwelling stent, all types ",,,5841.0,5841.0,1 RC,480,Ureterotomy with exploration or drainage (separate procedure) ,,,5841.0,5841.0,1 RC,480,Ureteroureterostomy ,,,5841.0,5841.0,1 RC,480,"Urethrectomy, total, including cystostomy; female ",,,4988.0,4988.0,1 RC,480,"Urethrectomy, total, including cystostomy; male ",,,3041.0,3041.0,1 RC,480,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,4988.0,4988.0,1 RC,480,"Urethromeatoplasty, with mucosal advancement ",,,4988.0,4988.0,1 RC,480,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,3041.0,3041.0,1 RC,480,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,4988.0,4988.0,1 RC,480,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,4988.0,4988.0,1 RC,480,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,6326.0,6326.0,1 RC,480,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,4988.0,4988.0,1 RC,480,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,4988.0,4988.0,1 RC,480,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,4988.0,4988.0,1 RC,480,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,4988.0,4988.0,1 RC,480,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,4988.0,4988.0,1 RC,480,"Urethroplasty, reconstruction of female urethra ",,,4988.0,4988.0,1 RC,480,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,6326.0,6326.0,1 RC,480,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,4988.0,4988.0,1 RC,480,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,4988.0,4988.0,1 RC,480,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,3041.0,3041.0,1 RC,480,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,4988.0,4988.0,1 RC,480,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,3041.0,3041.0,1 RC,480,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,4988.0,4988.0,1 RC,480,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,3041.0,3041.0,1 RC,480,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,3041.0,3041.0,1 RC,480,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,5841.0,5841.0,1 RC,480,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,5841.0,5841.0,1 RC,480,Uterine evacuation and curettage for hydatidiform mole ,,,3041.0,3041.0,1 RC,480,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,5841.0,5841.0,1 RC,480,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,5841.0,5841.0,1 RC,480,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,4988.0,1 RC,480,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,5841.0,5841.0,1 RC,480,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,3041.0,3041.0,1 RC,480,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,5841.0,5841.0,1 RC,480,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,3041.0,3041.0,1 RC,480,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,5841.0,5841.0,1 RC,480,"Vaginal hysterectomy, for uterus 250 g or less; ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,6326.0,6326.0,1 RC,480,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,6326.0,6326.0,1 RC,480,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,6326.0,6326.0,1 RC,480,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,6326.0,6326.0,1 RC,480,"Vaginal hysterectomy, radical (Schauta type operation) ",,,5841.0,5841.0,1 RC,480,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,4988.0,4988.0,1 RC,480,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,4988.0,4988.0,1 RC,480,"Vaginectomy, complete removal of vaginal wall; ",,,5841.0,5841.0,1 RC,480,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,4988.0,4988.0,1 RC,480,"Vaginectomy, partial removal of vaginal wall; ",,,3041.0,3041.0,1 RC,480,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,3041.0,3041.0,1 RC,480,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,3041.0,3041.0,1 RC,480,Vaginoplasty for intersex state ,,,3041.0,3041.0,1 RC,480,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,3041.0,3041.0,1 RC,480,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,5841.0,5841.0,1 RC,480,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,3041.0,3041.0,1 RC,480,"Vasovasostomy, vasovasorrhaphy ",,,3041.0,3041.0,1 RC,480,Ventilating tube removal requiring general anesthesia ,,,2434.0,2434.0,1 RC,480,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,2251.0,2251.0,1 RC,480,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,2251.0,2251.0,1 RC,480,Ventriculocisternostomy (Torkildsen type operation) ,,,5841.0,5841.0,1 RC,480,"Ventriculocisternostomy, third ventricle; ",,,5841.0,5841.0,1 RC,480,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,5841.0,5841.0,3 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,5841.0,5841.0,2 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,5841.0,5841.0,1 RC,480,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,5841.0,5841.0,1 RC,480,"Vesiculectomy, any approach ",,,2251.0,2251.0,1 RC,480,Vesiculotomy; ,,,3041.0,3041.0,1 RC,480,Vesiculotomy; complicated ,,,2251.0,2251.0,1 RC,480,"Vestibular nerve section, transcranial approach ",,,5841.0,5841.0,1 RC,480,"Vestibular nerve section, translabyrinthine approach ",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; ",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,6326.0,6326.0,1 RC,480,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,6326.0,6326.0,1 RC,480,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,5841.0,5841.0,1 RC,480,Vulvectomy simple; complete ,,,3041.0,3041.0,1 RC,480,Vulvectomy simple; partial ,,,3041.0,3041.0,1 RC,480,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,5841.0,5841.0,1 RC,480,"Vulvectomy, radical, complete; ",,,10949.0,10949.0,1 RC,480,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,10949.0,10949.0,1 RC,480,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,10949.0,10949.0,1 RC,480,"Vulvectomy, radical, partial; ",,,5841.0,5841.0,1 RC,480,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,10949.0,10949.0,1 RC,480,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,10949.0,10949.0,1 RC,480,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,4988.0,4988.0,1 RC,481, Cardiology Cardiac Cath Lab ,,,3673.0,22194.0,15 RC,481,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,481,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,481,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,481,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,481,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,481,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,1226.38,9653.0,18 RC,481,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,1226.38,8240.61,18 RC,481,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,1226.38,9653.0,18 RC,481,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,1226.38,7014.0,18 RC,481,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3673.0,8240.61,17 RC,481,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3293.0,8240.61,17 RC,481,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,481,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,481,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,481,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,481,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,359.42,3249.0,18 RC,481,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,359.42,3249.0,18 RC,481,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,3293.0,11661.3,17 RC,481,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,1986.0,3390.0,13 RC,481,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,1986.0,4423.26,14 RC,481,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,2195.0,12049.95,16 RC,481,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,2195.0,5644.5,14 RC,481,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,2699.0,35469.31,14 RC,481,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,2026.81,13196.03,18 RC,481,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,2195.0,29647.99,13 RC,481,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,3390.0,16207.0,17 RC,481,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,3965.0,22967.79,18 RC,481,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,481,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12367.1,13 RC,481,Adrenal tissue transplant to brain ,,,12367.1,12367.1,1 RC,481,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,3390.0,16207.0,17 RC,481,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,3390.0,16207.0,5 RC,481,Amniocentesis; diagnostic ,,,53.18,3083.0,18 RC,481,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,125.27,5841.0,17 RC,481,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,18041.68,5 RC,481,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,3390.0,16207.0,5 RC,481,Amputation of penis; complete ,,,2195.0,9717.59,17 RC,481,Amputation of penis; partial ,,,1226.38,8240.61,18 RC,481,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,3390.0,31255.45,5 RC,481,Anastomosis; facial-hypoglossal ,,,3390.0,16207.0,5 RC,481,Anastomosis; facial-spinal accessory ,,,3390.0,16207.0,5 RC,481,Anorectal manometry ,,,1672.0,2358.0,4 RC,481,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,481,Antepartum care only; 4-6 visits ,,,3390.0,5841.0,3 RC,481,Antepartum care only; 7 or more visits ,,,3390.0,7417.01,3 RC,481,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,1638.52,11661.3,18 RC,481,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,3041.0,9264.11,17 RC,481,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,3041.0,7957.09,17 RC,481,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,481,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,481,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,30 RC,481,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,481,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,14 RC,481,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,481,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,3249.0,16 RC,481,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,481,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,14 RC,481,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,481,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,1863.58,1863.58,1 RC,481,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,2215.43,10424.04,18 RC,481,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,2137.24,10424.04,18 RC,481,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,12367.1,14 RC,481,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,42276.86,13 RC,481,"Arthroereisis, subtalar ",,,12367.1,12367.1,1 RC,481,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,12367.1,12367.1,1 RC,481,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,481,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,14 RC,481,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1372.91,1372.91,1 RC,481,Artificial insemination; intra-cervical ,,,625.35,5841.0,4 RC,481,Artificial insemination; intra-uterine ,,,661.44,5841.0,4 RC,481,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,276.42,3083.0,18 RC,481,"Aspiration and/or injection, thyroid cyst ",,,63.87,3083.0,18 RC,481,Aspiration of bladder; by needle ,,,39.21,3083.0,18 RC,481,Aspiration of bladder; by trocar or intracatheter ,,,106.05,3083.0,18 RC,481,Aspiration of bladder; with insertion of suprapubic catheter ,,,700.49,5571.0,18 RC,481,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,912.02,5571.0,18 RC,481,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,4775.48,4775.48,1 RC,481,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,4430.08,4430.08,1 RC,481,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,481,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,481,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,3 RC,481,"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each ",,,2832.43,5841.0,3 RC,481,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,2271.76,16207.0,5 RC,481,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,2160.33,16207.0,5 RC,481,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,2593.33,16207.0,5 RC,481,"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile",,,3390.0,21744.01,3 RC,481,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,3390.0,16911.98,5 RC,481,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,3390.0,18120.04,5 RC,481,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,3390.0,16755.37,5 RC,481,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,5 RC,481,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,2028.43,16207.0,5 RC,481,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,3390.0,16207.0,5 RC,481,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,1672.0,5841.0,15 RC,481,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,3390.0,29086.89,5 RC,481,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,3390.0,24291.92,5 RC,481,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,3390.0,26378.12,5 RC,481,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,3390.0,16483.21,5 RC,481,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,1226.38,8240.61,18 RC,481,Biopsy external auditory canal ,,,101.9,2979.0,6 RC,481,Biopsy external ear ,,,58.82,5841.0,5 RC,481,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,98.03,3083.0,18 RC,481,Biopsy of conjunctiva ,,,116.45,3083.0,18 RC,481,Biopsy of cornea ,,,749.3,5283.1,18 RC,481,"Biopsy of epididymis, needle ",,,521.99,3747.2,18 RC,481,Biopsy of extraocular muscle ,,,1184.02,8536.87,18 RC,481,Biopsy of lacrimal gland ,,,749.3,5571.0,18 RC,481,Biopsy of lacrimal sac ,,,749.3,5571.0,18 RC,481,Biopsy of nerve ,,,708.15,5571.0,18 RC,481,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,1141.2,6819.81,18 RC,481,"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) ",,,3390.0,16207.0,5 RC,481,"Biopsy of pancreas, percutaneous needle ",,,521.99,3747.2,18 RC,481,Biopsy of penis; (separate procedure) ,,,521.99,3747.2,18 RC,481,Biopsy of penis; deep structures ,,,874.74,6330.57,18 RC,481,"Biopsy of spinal cord, percutaneous needle ",,,521.99,3747.2,18 RC,481,"Biopsy of testis, incisional (separate procedure) ",,,1226.38,8240.61,18 RC,481,"Biopsy of testis, needle (separate procedure) ",,,874.74,6330.57,18 RC,481,Biopsy of urethra ,,,700.49,5571.0,18 RC,481,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,1141.2,6819.81,18 RC,481,Biopsy of vaginal mucosa; simple (separate procedure) ,,,50.5,3083.0,18 RC,481,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,48.12,5841.0,17 RC,481,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,"Biopsy thyroid, percutaneous core needle ",,,45.75,3083.0,18 RC,481,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,521.99,3747.2,18 RC,481,"Biopsy, prostate, any approach, nonimaging-guided ",,,1226.38,4836.33,18 RC,481,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,481,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,2699.0,14954.75,13 RC,481,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,2699.0,14954.75,13 RC,481,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,13 RC,481,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,700.49,2979.0,4 RC,481,Bladder instillation of anticarcinogenic agent (including retention time) ,,,48.12,5841.0,5 RC,481,"Bladder irrigation, simple, lavage and/or instillation ",,,47.53,5841.0,17 RC,481,"Blepharotomy, drainage of abscess, eyelid ",,,116.2,5841.0,17 RC,481,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,481,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,5 RC,481,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,26618.87,26618.87,1 RC,481,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,34126.36,34126.36,1 RC,481,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,14 RC,481,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,481,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,12367.1,12367.1,1 RC,481,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,12367.1,12367.1,1 RC,481,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,12367.1,12367.1,1 RC,481,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,12367.1,12367.1,1 RC,481,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,481,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,12367.1,14 RC,481,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28039.67,13 RC,481,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,13 RC,481,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,7799.0,13 RC,481,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,17922.13,13 RC,481,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,12367.1,14 RC,481,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,12367.1,14 RC,481,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,12367.1,14 RC,481,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,481,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,3390.0,16207.0,5 RC,481,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,3390.0,16207.0,5 RC,481,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,3390.0,16207.0,5 RC,481,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,3390.0,16207.0,5 RC,481,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,3390.0,16409.08,5 RC,481,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,3390.0,16207.0,5 RC,481,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,3390.0,16207.0,5 RC,481,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,3390.0,16207.0,5 RC,481,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,3390.0,16207.0,5 RC,481,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,481,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,481,CIRCUMCISION ,,,3390.0,5841.0,2 RC,481,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,481,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,481,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,481,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,481,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,481,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,481,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,481,Canthoplasty (reconstruction of canthus) ,,,749.3,5571.0,18 RC,481,Canthotomy (separate procedure) ,,,749.3,5571.0,18 RC,481,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,481,Cardioassist-method of circulatory assist; internal ,,,2275.87,16207.0,4 RC,481,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1464.54,2315.0,5 RC,481,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1464.54,2315.0,5 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,481,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,481,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,481,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,1672.0,5841.0,15 RC,481,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,481,"Catheterization for collection of specimen, single patient, all places of service ",,,90.72,3083.0,13 RC,481,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,1190.42,3390.0,14 RC,481,"Cautery of cervix; cryocautery, initial or repeat ",,,112.6,5841.0,17 RC,481,Cautery of cervix; electro or thermal ,,,84.97,5571.0,18 RC,481,Cautery of cervix; laser ablation ,,,1141.2,6819.81,18 RC,481,"Cerclage of cervix, during pregnancy; abdominal ",,,2869.5,16207.0,17 RC,481,"Cerclage of cervix, during pregnancy; vaginal ",,,1141.2,6819.81,18 RC,481,"Cerclage of uterine cervix, nonobstetrical ",,,1986.0,6819.81,17 RC,481,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,3390.0,11156.52,3 RC,481,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,3390.0,15456.7,3 RC,481,Cesarean delivery only; ,,,3390.0,10855.53,3 RC,481,Cesarean delivery only; including postpartum care ,,,3293.0,15007.22,15 RC,481,Change of cystostomy tube; complicated ,,,255.54,3390.0,18 RC,481,Change of cystostomy tube; simple ,,,55.55,5841.0,17 RC,481,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,700.49,4836.33,18 RC,481,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,12367.1,14 RC,481,Chemodenervation of abductor muscle(s) of vocal cord ,,,2564.39,2564.39,1 RC,481,Chemodenervation of adductor muscle(s) of vocal cord ,,,12367.1,12367.1,1 RC,481,Chemodenervation of eccrine glands; both axillae ,,,54.36,5841.0,17 RC,481,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,62.09,5841.0,17 RC,481,Chemodenervation of extraocular muscle ,,,109.62,5841.0,17 RC,481,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,79.91,3390.0,18 RC,481,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,69.51,5841.0,17 RC,481,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,63.58,5841.0,17 RC,481,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,61.49,3083.0,18 RC,481,Chemodenervation of one extremity; 1-4 muscle(s) ,,,73.67,3083.0,18 RC,481,Chemodenervation of one extremity; 5 or more muscles ,,,91.79,3083.0,18 RC,481,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,72.48,5841.0,17 RC,481,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,73.67,3083.0,18 RC,481,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,80.8,3083.0,18 RC,481,"Chorionic villus sampling, any method ",,,53.47,2315.0,6 RC,481,"Chromotubation of oviduct, including materials ",,,2699.0,11661.3,17 RC,481,Ciliary body destruction; cryotherapy ,,,749.3,5571.0,18 RC,481,Ciliary body destruction; cyclodialysis ,,,749.3,5571.0,18 RC,481,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,912.02,5571.0,18 RC,481,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,749.3,5571.0,18 RC,481,Ciliary body destruction; diathermy ,,,912.02,5519.68,18 RC,481,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,255.54,5571.0,18 RC,481,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,700.49,5571.0,18 RC,481,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,700.49,5571.0,18 RC,481,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,116.05,3083.0,18 RC,481,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,116.05,5571.0,18 RC,481,Clitoroplasty for intersex state ,,,1141.2,6819.81,6 RC,481,Closure of cystostomy (separate procedure) ,,,1226.38,8240.61,18 RC,481,Closure of lacrimal fistula (separate procedure) ,,,749.3,5283.1,18 RC,481,Closure of nephrocutaneous or pyelocutaneous fistula ,,,1986.0,13852.81,17 RC,481,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,3390.0,17579.96,5 RC,481,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,3390.0,18845.68,5 RC,481,Closure of rectovaginal fistula; abdominal approach ,,,3293.0,16207.0,17 RC,481,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,3390.0,16207.0,5 RC,481,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,3041.0,7825.19,5 RC,481,Closure of rectovaginal fistula; vaginal or transanal approach ,,,1141.2,6819.81,18 RC,481,"Closure of the lacrimal punctum; by plug, each ",,,84.36,5841.0,17 RC,481,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,116.2,5841.0,17 RC,481,Closure of ureterocutaneous fistula ,,,3390.0,16207.0,5 RC,481,Closure of ureterovisceral fistula (including visceral repair) ,,,3390.0,16207.0,5 RC,481,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,1812.83,11552.32,18 RC,481,Closure of urethrovaginal fistula; ,,,2443.09,18300.83,18 RC,481,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,2996.0,7014.0,17 RC,481,Closure of vesicouterine fistula; ,,,2699.0,9103.27,17 RC,481,Closure of vesicouterine fistula; with hysterectomy ,,,3390.0,16207.0,5 RC,481,"Closure of vesicovaginal fistula, abdominal approach ",,,2996.0,9820.67,17 RC,481,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,4988.0,18300.83,5 RC,481,Closure of vesicovaginal fistula; vaginal approach ,,,1638.52,11661.3,18 RC,481,"Closure postauricular fistula, mastoid (separate procedure) ",,,451.36,5571.0,18 RC,481,"Closure, exstrophy of bladder ",,,3390.0,19591.92,5 RC,481,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,19 RC,481,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1508.94,16207.0,4 RC,481,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,481,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3249.0,18 RC,481,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3249.0,18 RC,481,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,18 RC,481,Colpocentesis (separate procedure) ,,,1638.52,11661.3,18 RC,481,Colpocleisis (Le Fort type) ,,,1638.52,11661.3,18 RC,481,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,1141.2,6819.81,18 RC,481,"Colpopexy, abdominal approach ",,,3041.0,11243.12,17 RC,481,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,3293.0,18300.83,17 RC,481,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,3293.0,18300.83,17 RC,481,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,7161.36,14 RC,481,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,1141.2,6819.81,18 RC,481,Colposcopy of the cervix including upper/adjacent vagina; ,,,60.89,5841.0,17 RC,481,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,75.15,5841.0,17 RC,481,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,69.81,5841.0,17 RC,481,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,71.29,5841.0,17 RC,481,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,187.16,5571.0,18 RC,481,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,198.75,5571.0,18 RC,481,"Colposcopy of the entire vagina, with cervix if present; ",,,62.09,5841.0,17 RC,481,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,81.7,3083.0,18 RC,481,Colposcopy of the vulva; ,,,59.13,5841.0,17 RC,481,Colposcopy of the vulva; with biopsy(s) ,,,77.84,5841.0,17 RC,481,Colpotomy; with drainage of pelvic abscess ,,,1141.2,6819.81,18 RC,481,Colpotomy; with exploration ,,,1141.2,6819.81,18 RC,481,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,1638.52,11661.3,18 RC,481,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,1638.52,11661.3,18 RC,481,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,481,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,12367.1,12367.1,1 RC,481,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,12367.1,12367.1,1 RC,481,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,12367.1,12367.1,1 RC,481,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,118.2,3390.0,18 RC,481,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,234.68,3503.96,18 RC,481,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,238.55,3612.51,18 RC,481,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,238.83,3596.9,18 RC,481,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,377.7,5841.0,4 RC,481,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,1672.0,5841.0,3 RC,481,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,1141.2,6819.81,18 RC,481,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,1141.2,6819.81,18 RC,481,Conjunctival flap; bridge or partial (separate procedure) ,,,1184.02,8536.87,18 RC,481,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,749.3,5571.0,18 RC,481,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,749.3,5571.0,18 RC,481,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,1184.02,8536.87,18 RC,481,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,1184.02,8536.87,18 RC,481,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,749.3,5571.0,18 RC,481,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,1184.02,8536.87,18 RC,481,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,1184.02,8536.87,18 RC,481,Construction of artificial vagina; with graft ,,,2996.0,11661.3,17 RC,481,Construction of artificial vagina; without graft ,,,1638.52,11661.3,18 RC,481,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,749.3,5571.0,18 RC,481,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,749.3,5571.0,18 RC,481,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,481,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,3390.0,19822.77,5 RC,481,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,481,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,,,1672.0,5841.0,15 RC,481,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",,,636.2,5841.0,16 RC,481,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,606.24,4251.7,18 RC,481,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,12018.0,18 RC,481,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,700.49,4836.33,18 RC,481,"Cord blood harvesting for transplantation, allogeneic ",,,12367.1,12367.1,1 RC,481,"Cord blood-derived stem-cell transplantation, allogeneic ",,,12367.1,12367.1,1 RC,481,"Cordocentesis (intrauterine), any method ",,,739.07,5841.0,4 RC,481,Corneal relaxing incision for correction of surgically induced astigmatism ,,,359.7,4390.0,18 RC,481,Corneal wedge resection for correction of surgically induced astigmatism ,,,749.3,5571.0,18 RC,481,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,3390.0,16207.0,5 RC,481,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,1226.38,8240.61,18 RC,481,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,1226.38,7014.0,18 RC,481,"Correction of everted punctum, cautery ",,,116.2,5841.0,17 RC,481,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,749.3,5571.0,18 RC,481,Correction of lid retraction ,,,749.3,5571.0,18 RC,481,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,72.19,5841.0,5 RC,481,"Correction of trichiasis; epilation, by forceps only ",,,297.65,5841.0,4 RC,481,Correction of trichiasis; incision of lid margin ,,,359.7,3249.0,18 RC,481,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,749.3,5571.0,18 RC,481,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,1672.0,5841.0,3 RC,481,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,8778.0,16330.72,5 RC,481,Craniectomy for craniosynostosis; multiple cranial sutures ,,,3390.0,17942.72,5 RC,481,Craniectomy for craniosynostosis; single cranial suture ,,,3390.0,16207.0,5 RC,481,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,3390.0,45487.61,5 RC,481,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,3390.0,33415.9,5 RC,481,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,3390.0,35765.9,5 RC,481,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,3390.0,38639.52,5 RC,481,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,3390.0,21962.51,5 RC,481,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,3390.0,24914.49,5 RC,481,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,3390.0,25104.16,5 RC,481,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,3390.0,23929.16,5 RC,481,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,2979.0,18874.51,5 RC,481,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,3390.0,28781.78,5 RC,481,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,3390.0,28757.07,5 RC,481,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,3390.0,25438.1,5 RC,481,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,3390.0,22906.66,5 RC,481,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,3390.0,24184.73,5 RC,481,"Craniectomy or craniotomy, exploratory; supratentorial ",,,3390.0,19851.6,5 RC,481,Craniectomy or craniotomy; with excision of foreign body from brain ,,,3390.0,22477.88,5 RC,481,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,3390.0,23636.41,5 RC,481,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,3390.0,40379.42,5 RC,481,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,3390.0,37551.11,5 RC,481,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,3390.0,25953.47,5 RC,481,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,3390.0,25095.93,5 RC,481,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,3390.0,26415.3,5 RC,481,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,3390.0,24275.45,5 RC,481,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,3390.0,25446.34,5 RC,481,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,3390.0,23088.09,5 RC,481,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,3390.0,23071.62,5 RC,481,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,3390.0,26423.54,5 RC,481,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,3390.0,30843.27,5 RC,481,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,3390.0,22453.17,5 RC,481,Craniectomy; for osteomyelitis ,,,3390.0,16207.0,5 RC,481,Craniectomy; with excision of tumor or other bone lesion of skull ,,,3982.0,15753.45,17 RC,481,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,3390.0,29020.88,5 RC,481,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,3390.0,31399.83,5 RC,481,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,3390.0,36524.49,5 RC,481,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,3390.0,34731.04,5 RC,481,Cranioplasty for skull defect with reparative brain surgery ,,,3390.0,16916.1,5 RC,481,Cranioplasty for skull defect; larger than 5 cm diameter ,,,3390.0,16207.0,5 RC,481,Cranioplasty for skull defect; up to 5 cm diameter ,,,3390.0,16207.0,5 RC,481,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,3390.0,17303.69,5 RC,481,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,3390.0,16207.0,5 RC,481,Craniotomy for craniosynostosis; bifrontal bone flap ,,,3390.0,20375.21,5 RC,481,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,3390.0,20684.44,5 RC,481,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,3390.0,27808.81,5 RC,481,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,3390.0,19138.43,5 RC,481,"Craniotomy for repair of encephalocele, skull base ",,,3390.0,18853.92,5 RC,481,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,3390.0,31016.36,5 RC,481,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,3390.0,38351.0,5 RC,481,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,3390.0,19558.85,5 RC,481,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,3390.0,23088.09,5 RC,481,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,3390.0,28711.65,5 RC,481,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,3390.0,26003.01,5 RC,481,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,3390.0,32277.96,5 RC,481,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,3390.0,29874.3,5 RC,481,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,3390.0,30072.21,5 RC,481,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,3390.0,25446.34,5 RC,481,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,3390.0,16207.0,5 RC,481,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,3390.0,26745.12,5 RC,481,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,3390.0,18330.31,5 RC,481,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,3390.0,25854.51,5 RC,481,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,3390.0,15039.6,5 RC,481,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,3390.0,19295.05,5 RC,481,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,708.15,4807.0,18 RC,481,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,708.15,4807.0,18 RC,481,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,708.15,5571.0,18 RC,481,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,3390.0,16207.0,5 RC,481,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,2195.0,15039.6,17 RC,481,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,3390.0,16207.0,5 RC,481,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,5 RC,481,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,3390.0,16207.0,5 RC,481,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,5 RC,481,"Cryopreserved embryo transfer, case rate ",,,12367.1,12367.1,1 RC,481,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,3375.0,24948.0,19 RC,481,"Curettage, postpartum ",,,1141.2,6819.81,18 RC,481,Cutaneous appendico-vesicostomy ,,,3390.0,16207.0,5 RC,481,Cutaneous vesicostomy ,,,3041.0,8501.41,5 RC,481,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,3390.0,28105.68,5 RC,481,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,3390.0,23075.74,5 RC,481,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,26118.44,5 RC,481,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,3390.0,22580.96,5 RC,481,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,25170.17,5 RC,481,"Cystectomy, complete; (separate procedure) ",,,3390.0,17579.96,5 RC,481,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,21752.24,5 RC,481,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,3390.0,16207.0,5 RC,481,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,3390.0,16207.0,5 RC,481,"Cystectomy, partial; simple ",,,3390.0,16207.0,5 RC,481,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,481,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,481,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,481,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,481,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,1812.83,11552.32,18 RC,481,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,2358.0,16207.0,17 RC,481,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,2996.0,10698.8,17 RC,481,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,2195.0,11552.32,17 RC,481,"Cystostomy, cystotomy with drainage ",,,700.49,5571.0,18 RC,481,"Cystotomy for excision, incision, or repair of ureterocele ",,,3041.0,8240.61,5 RC,481,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,1226.38,8240.61,18 RC,481,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,5571.0,4 RC,481,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,1226.38,8240.61,18 RC,481,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,700.49,4836.33,18 RC,481,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,4988.0,10241.2,5 RC,481,Cystotomy; for excision of bladder tumor ,,,4988.0,9173.39,5 RC,481,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,1226.38,8240.61,18 RC,481,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,2358.0,16207.0,17 RC,481,Cystourethroscopy ,,,3390.0,5841.0,2 RC,481,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1226.38,8240.61,18 RC,481,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1226.38,8240.61,18 RC,481,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,18 RC,481,Cystourethroscopy (separate procedure) ,,,255.54,3083.0,18 RC,481,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,255.54,3249.0,18 RC,481,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12367.1,14 RC,481,Cystourethroscopy with direct vision internal urethrotomy ,,,700.49,5571.0,18 RC,481,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,1226.38,8240.61,18 RC,481,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,2699.0,26403.19,13 RC,481,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,1226.38,25988.0,20 RC,481,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,2699.0,25244.72,14 RC,481,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1226.38,8240.61,18 RC,481,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,1226.38,8240.61,18 RC,481,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,2699.0,8240.61,17 RC,481,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,12367.1,14 RC,481,"Cystourethroscopy, with biopsy(s) ",,,700.49,5571.0,18 RC,481,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,700.49,4836.33,18 RC,481,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,700.49,4836.33,18 RC,481,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,239.43,3891.46,18 RC,481,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,255.54,3249.0,18 RC,481,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,1226.38,5571.0,18 RC,481,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,1226.38,5571.0,18 RC,481,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,700.49,4836.33,18 RC,481,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,721.52,5841.0,16 RC,481,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,1672.0,5841.0,16 RC,481,"Cystourethroscopy, with insertion of permanent urethral stent ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,4807.0,13 RC,481,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,11552.32,18 RC,481,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,18 RC,481,"Cystourethroscopy, with internal urethrotomy; female ",,,700.49,4836.33,18 RC,481,"Cystourethroscopy, with internal urethrotomy; male ",,,700.49,5571.0,18 RC,481,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,2699.0,13459.12,15 RC,481,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,700.49,5571.0,18 RC,481,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,700.49,4836.33,18 RC,481,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with steroid injection into stricture ",,,700.49,5571.0,18 RC,481,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,700.49,5571.0,18 RC,481,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,11552.32,14 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,12367.1,12367.1,1 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1812.83,11552.32,15 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,1812.83,11552.32,18 RC,481,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1226.38,5571.0,18 RC,481,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1226.38,8240.61,18 RC,481,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,700.49,5571.0,18 RC,481,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,481,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,481,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,481,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,481,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,481,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,481,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,481,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,2 RC,481,DRAIN PANCREATIC PSEUDOCYST ,,,3390.0,5841.0,2 RC,481,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,481,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,2 RC,481,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,2 RC,481,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,481,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,481,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,1184.02,8536.87,18 RC,481,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,481,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,481,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12367.1,14 RC,481,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,143.78,3249.0,18 RC,481,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,477.01,5841.0,4 RC,481,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,3293.0,13241.95,17 RC,481,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,2096.96,13241.95,18 RC,481,Decompression internal auditory canal ,,,6326.0,13241.95,5 RC,481,"Decompression of orbit only, transcranial approach ",,,6326.0,9653.0,5 RC,481,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,12367.1,12367.1,1 RC,481,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,708.15,8104.0,18 RC,481,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,1986.0,3083.0,12 RC,481,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,2996.0,20238.53,13 RC,481,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,2195.0,5446.4,13 RC,481,Decompression; plantar digital nerve ,,,708.15,5571.0,18 RC,481,Decompression; unspecified nerve(s) (specify) ,,,708.15,5571.0,18 RC,481,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,481,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,606.24,4251.7,18 RC,481,Deligation of ureter ,,,3390.0,16207.0,5 RC,481,Delivery of placenta (separate procedure) ,,,1141.2,6819.81,6 RC,481,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,481,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,708.15,5841.0,17 RC,481,"Destruction by neurolytic agent, intercostal nerve ",,,365.66,5571.0,18 RC,481,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,1672.0,5841.0,15 RC,481,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,708.15,5571.0,18 RC,481,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,1672.0,5841.0,15 RC,481,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,708.15,5571.0,18 RC,481,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,708.15,5571.0,18 RC,481,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,708.15,5571.0,18 RC,481,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,365.66,5571.0,18 RC,481,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,365.66,5571.0,18 RC,481,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,365.66,3249.0,18 RC,481,Destruction by neurolytic agent; other peripheral nerve or branch ,,,155.96,3083.0,18 RC,481,Destruction by neurolytic agent; plantar common digital nerve ,,,39.5,5841.0,17 RC,481,Destruction by neurolytic agent; pudendal nerve ,,,365.66,3249.0,18 RC,481,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,223.54,3667.92,18 RC,481,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,143.48,7014.0,18 RC,481,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,116.2,5841.0,17 RC,481,Destruction of lesion of lid margin (up to 1 cm) ,,,135.17,3083.0,18 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,760.8,4430.08,18 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,872.26,5841.0,4 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,477.01,5841.0,4 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,78.43,2979.0,6 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,760.8,4430.08,18 RC,481,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,760.8,4430.08,18 RC,481,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,760.8,4430.08,18 RC,481,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,119.13,3083.0,18 RC,481,"Destruction of lesion, conjunctiva ",,,75.76,5571.0,18 RC,481,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,223.54,3667.92,18 RC,481,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,125.95,3083.0,18 RC,481,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,481,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,18 RC,481,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,116.2,5841.0,17 RC,481,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,223.54,4788.0,18 RC,481,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1184.02,8536.87,18 RC,481,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,1141.2,6819.81,18 RC,481,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,106.05,5571.0,18 RC,481,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,12367.1,14 RC,481,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,481,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,481,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,12018.0,72 RC,481,Diaphragm or cervical cap fitting with instructions ,,,38.32,5841.0,5 RC,481,Dilation and curettage of cervical stump ,,,1141.2,6819.81,18 RC,481,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,1141.2,6819.81,18 RC,481,"Dilation of cervical canal, instrumental (separate procedure) ",,,42.77,5571.0,18 RC,481,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,1226.38,8240.61,34 RC,481,Dilation of female urethra including suppository and/or instillation; initial ,,,42.48,5841.0,17 RC,481,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.76,5841.0,5 RC,481,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,700.49,5571.0,18 RC,481,"Dilation of lacrimal punctum, with or without irrigation ",,,992.6,5841.0,4 RC,481,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,99.22,3083.0,18 RC,481,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,101.0,5841.0,17 RC,481,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,37.42,5841.0,17 RC,481,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.92,5841.0,17 RC,481,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,1226.38,4836.33,18 RC,481,Dilation of vagina under anesthesia (other than local) ,,,1141.2,6819.81,18 RC,481,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,1672.0,5841.0,15 RC,481,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,3293.0,16330.72,17 RC,481,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,2498.5,16207.0,5 RC,481,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,3390.0,18239.59,5 RC,481,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,223.54,3249.0,18 RC,481,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,912.02,5841.0,17 RC,481,"Discission of vitreous strands (without removal), pars plana approach ",,,912.02,5571.0,18 RC,481,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,3397.22,3397.22,1 RC,481,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,16112.21,16112.21,1 RC,481,"Donor lobectomy (lung) for transplantation, living donor ",,,12367.1,12367.1,1 RC,481,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,3390.0,16207.0,5 RC,481,"Donor nephrectomy (including cold preservation); open, from living donor ",,,3390.0,17913.9,5 RC,481,"Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation ",,,3390.0,15592.72,3 RC,481,"Drainage external auditory canal, abscess ",,,158.33,5841.0,17 RC,481,"Drainage external ear, abscess or hematoma; complicated ",,,121.5,3083.0,18 RC,481,"Drainage external ear, abscess or hematoma; simple ",,,114.96,5841.0,17 RC,481,Drainage of Skene's gland abscess or cyst ,,,1173.09,5571.0,17 RC,481,Drainage of deep periurethral abscess ,,,1226.38,5571.0,18 RC,481,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,3390.0,16207.0,5 RC,481,Drainage of ovarian abscess; abdominal approach ,,,2699.0,8167.36,17 RC,481,"Drainage of ovarian abscess; vaginal approach, open ",,,1141.2,6819.81,18 RC,481,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,1141.2,6819.81,18 RC,481,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,1141.2,6819.81,18 RC,481,Drainage of perineal urinary extravasation; complicated ,,,3041.0,5571.0,5 RC,481,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,255.54,5571.0,18 RC,481,"Drainage of perirenal or renal abscess, open ",,,2195.0,5571.0,17 RC,481,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,3390.0,19018.77,5 RC,481,Drainage of perivesical or prevesical space abscess ,,,874.74,6330.57,18 RC,481,"Drainage of retroperitoneal abscess, open ",,,3390.0,16207.0,5 RC,481,Drainage of scrotal wall abscess ,,,521.99,3747.2,18 RC,481,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,3390.0,16207.0,5 RC,481,Duodenal exclusion with gastrojejunostomy for pancreatic injury ,,,3390.0,21397.72,5 RC,481,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,481,"Dural graft, spinal ",,,3390.0,16207.0,5 RC,481,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,925.07,2979.0,5 RC,481,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,481,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,481,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,481,Ear piercing ,,,461.72,16207.0,5 RC,481,Electroejaculation ,,,1111.09,3083.0,17 RC,481,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,481,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,481,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,12367.1,12367.1,1 RC,481,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.76,5841.0,5 RC,481,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,98.96,297.65,2 RC,481,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,1672.0,5841.0,15 RC,481,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,950.85,5841.0,20 RC,481,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,1672.0,5841.0,15 RC,481,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,16 RC,481,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,481,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,481,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,481,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,3390.0,16207.0,5 RC,481,"Elevation of depressed skull fracture; simple, extradural ",,,6326.0,9653.0,5 RC,481,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,3390.0,18441.62,5 RC,481,"Embryo transfer, intrauterine ",,,1743.0,5841.0,16 RC,481,Endocervical curettage (not done as part of a dilation and curettage) ,,,98.62,3083.0,18 RC,481,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,1672.0,5841.0,15 RC,481,Endolymphatic sac operation; with shunt ,,,2096.96,13241.95,18 RC,481,Endolymphatic sac operation; without shunt ,,,2096.96,13241.95,18 RC,481,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1638.52,12474.0,20 RC,481,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,1328.2,23059.78,20 RC,481,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,49.32,5841.0,17 RC,481,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,2573.7,16330.72,17 RC,481,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,13 RC,481,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,1675.75,8240.61,18 RC,481,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,14 RC,481,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,12367.1,14 RC,481,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,12367.1,14 RC,481,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,20581.59,13 RC,481,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,12367.1,14 RC,481,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,6670.45,14 RC,481,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,481,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,2890.09,16207.0,7 RC,481,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,3390.0,16207.0,7 RC,481,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,3375.0,27050.15,17 RC,481,"Enterocystoplasty, including intestinal anastomosis ",,,3390.0,16512.15,5 RC,481,"Enucleation of eye; with implant, muscles attached to implant ",,,1184.02,8536.87,18 RC,481,"Enucleation of eye; with implant, muscles not attached to implant ",,,1184.02,8536.87,18 RC,481,Enucleation of eye; without implant ,,,1184.02,8536.87,18 RC,481,Epididymectomy; bilateral ,,,1226.38,8240.61,18 RC,481,Epididymectomy; unilateral ,,,1226.38,5571.0,18 RC,481,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,2996.0,8240.61,17 RC,481,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,2996.0,5571.0,17 RC,481,Epikeratoplasty ,,,3041.0,15238.19,17 RC,481,"Episiotomy or vaginal repair, by other than attending ",,,1602.12,5571.0,17 RC,481,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,481,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,481,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,481,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,481,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,481,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,4807.0,13 RC,481,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,481,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,481,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,481,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,481,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,481,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,481,Evisceration of ocular contents; with implant ,,,1184.02,8536.87,18 RC,481,Evisceration of ocular contents; without implant ,,,1184.02,8536.87,18 RC,481,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,700.49,4836.33,18 RC,481,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,12018.0,18 RC,481,Exchange of intraocular lens ,,,912.02,5571.0,18 RC,481,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,606.24,4251.7,18 RC,481,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,477.01,3083.0,13 RC,481,Excimer laser treatment for psoriasis; over 500 sq cm ,,,872.26,3083.0,13 RC,481,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,477.01,3083.0,13 RC,481,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,749.3,5571.0,36 RC,481,Excision aural glomus tumor; extended (extratemporal) ,,,3390.0,29622.85,5 RC,481,Excision aural glomus tumor; transcanal ,,,2096.96,13241.95,18 RC,481,Excision aural glomus tumor; transmastoid ,,,2096.96,13241.95,18 RC,481,Excision aural polyp ,,,146.75,3249.0,18 RC,481,"Excision exostosis(es), external auditory canal ",,,2096.96,13241.95,18 RC,481,Excision external ear; complete amputation ,,,2096.96,13241.95,18 RC,481,"Excision external ear; partial, simple repair ",,,874.74,6330.57,18 RC,481,Excision of Bartholin's gland or cyst ,,,1141.2,6819.81,18 RC,481,Excision of Mullerian duct cyst ,,,1226.38,8240.61,18 RC,481,Excision of ampulla of Vater ,,,3390.0,16207.0,5 RC,481,Excision of bulbourethral gland (Cowper's gland) ,,,1226.38,8240.61,18 RC,481,Excision of carotid body tumor; with excision of carotid artery ,,,3390.0,19773.35,5 RC,481,Excision of carotid body tumor; without excision of carotid artery ,,,3390.0,16338.95,5 RC,481,"Excision of cervical stump, abdominal approach; ",,,3390.0,16207.0,5 RC,481,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,3390.0,16207.0,5 RC,481,"Excision of cervical stump, vaginal approach; ",,,1638.52,11661.3,18 RC,481,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,4988.0,11661.3,5 RC,481,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,1638.52,11661.3,18 RC,481,"Excision of chalazion; multiple, different lids ",,,103.38,5841.0,17 RC,481,"Excision of chalazion; multiple, same lid ",,,80.21,3083.0,18 RC,481,Excision of chalazion; single ,,,66.56,5841.0,17 RC,481,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,749.3,5571.0,18 RC,481,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,2026.81,13196.03,18 RC,481,Excision of extraparenchymal lesion of testis ,,,1226.38,8240.61,18 RC,481,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,1226.38,8240.61,18 RC,481,Excision of hydrocele; bilateral ,,,1235.65,8488.5,18 RC,481,Excision of hydrocele; unilateral ,,,1235.65,8488.5,18 RC,481,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,1184.02,8536.87,18 RC,481,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,1184.02,8536.87,18 RC,481,Excision of lacrimal gland tumor; frontal approach ,,,749.3,5571.0,18 RC,481,Excision of lacrimal gland tumor; involving osteotomy ,,,1184.02,8536.87,18 RC,481,Excision of lacrimal sac (dacryocystectomy) ,,,1184.02,8536.87,18 RC,481,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,181.8,3249.0,18 RC,481,"Excision of lesion of pancreas (eg, cyst, adenoma) ",,,3390.0,16207.0,5 RC,481,Excision of lesion of spermatic cord (separate procedure) ,,,1226.38,8240.61,18 RC,481,"Excision of lesion, conjunctiva; over 1 cm ",,,749.3,5571.0,18 RC,481,"Excision of lesion, conjunctiva; up to 1 cm ",,,150.32,5571.0,18 RC,481,"Excision of lesion, conjunctiva; with adjacent sclera ",,,749.3,5571.0,18 RC,481,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,359.7,3083.0,18 RC,481,"Excision of lesion, sclera ",,,749.3,5571.0,18 RC,481,Excision of local lesion of epididymis ,,,1226.38,5571.0,18 RC,481,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,12367.1,14 RC,481,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,708.15,5571.0,18 RC,481,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,2142.41,15039.6,18 RC,481,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,708.15,5571.0,18 RC,481,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,708.15,5571.0,18 RC,481,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,708.15,5571.0,18 RC,481,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Excision of neuroma; hand or foot, except digital nerve ",,,708.15,5571.0,18 RC,481,"Excision of neuroma; major peripheral nerve, except sciatic ",,,708.15,5571.0,18 RC,481,Excision of neuroma; sciatic nerve ,,,2142.41,15039.6,18 RC,481,Excision of penile plaque (Peyronie disease); ,,,1226.38,9653.0,18 RC,481,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,2195.0,22025.45,18 RC,481,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,1812.83,11552.32,18 RC,481,Excision of perinephric cyst ,,,3390.0,16207.0,5 RC,481,Excision of presacral or sacrococcygeal tumor ,,,3390.0,26501.79,5 RC,481,"Excision of spermatocele, with or without epididymectomy ",,,700.49,5571.0,18 RC,481,Excision of thyroglossal duct cyst or sinus; ,,,2026.81,13196.03,18 RC,481,Excision of thyroglossal duct cyst or sinus; recurrent ,,,2026.81,13196.03,18 RC,481,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,2026.81,13196.03,18 RC,481,Excision of urethral diverticulum (separate procedure); female ,,,1812.83,11552.32,18 RC,481,Excision of urethral diverticulum (separate procedure); male ,,,1812.83,11552.32,18 RC,481,Excision of vaginal cyst or tumor ,,,1141.2,6819.81,18 RC,481,Excision of vaginal septum ,,,1141.2,6819.81,18 RC,481,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,1226.38,8240.61,18 RC,481,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,1235.65,8488.5,18 RC,481,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,1235.65,8488.5,18 RC,481,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,3390.0,23384.28,2 RC,481,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,3390.0,27202.72,2 RC,481,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,3390.0,15312.9,2 RC,481,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,3390.0,19569.61,2 RC,481,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,3390.0,33533.39,2 RC,481,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,3 RC,481,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,3 RC,481,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,3 RC,481,Excision or fulguration of carcinoma of urethra ,,,1226.38,8240.61,18 RC,481,Excision or fulguration; Skene's glands ,,,1226.38,5571.0,18 RC,481,Excision or fulguration; urethral caruncle ,,,700.49,5571.0,18 RC,481,"Excision or fulguration; urethral polyp(s), distal urethra ",,,1226.38,5571.0,18 RC,481,Excision or fulguration; urethral prolapse ,,,1226.38,5571.0,18 RC,481,Excision or transposition of pterygium; with graft ,,,749.3,5571.0,18 RC,481,Excision or transposition of pterygium; without graft ,,,749.3,5571.0,18 RC,481,Excision or unroofing of cyst(s) of kidney ,,,3390.0,16207.0,5 RC,481,"Excision soft tissue lesion, external auditory canal ",,,874.74,6330.57,18 RC,481,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,3390.0,29251.74,5 RC,481,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,3390.0,23718.9,5 RC,481,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,1184.02,8536.87,18 RC,481,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,1184.02,8536.87,18 RC,481,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,1184.02,8536.87,18 RC,481,Exploration for undescended testis (inguinal or scrotal area) ,,,1235.65,8488.5,18 RC,481,Exploration for undescended testis with abdominal exploration ,,,700.49,5571.0,18 RC,481,"Exploration of epididymis, with or without biopsy ",,,1226.38,8240.61,18 RC,481,"Exploration of orbit (transcranial approach), with removal of lesion ",,,3390.0,24588.79,5 RC,481,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,2996.0,16207.0,17 RC,481,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,2996.0,9202.22,17 RC,481,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,1812.83,25988.0,20 RC,481,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,25988.0,7 RC,481,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,25988.0,7 RC,481,"Expression of conjunctival follicles (eg, for trachoma) ",,,27.33,5841.0,5 RC,481,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,3390.0,22791.23,5 RC,481,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,3390.0,27425.34,5 RC,481,"External cephalic version, with or without tocolysis ",,,3041.0,6819.81,5 RC,481,"External drainage, pseudocyst of pancreas, open ",,,3390.0,16207.0,5 RC,481,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,2142.19,10424.04,17 RC,481,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,2785.24,11603.86,17 RC,481,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,912.02,5571.0,18 RC,481,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,912.02,11603.86,52 RC,481,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,12367.1,12367.1,1 RC,481,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,481,FUSE PANCREAS AND BOWEL ,,,3390.0,5841.0,2 RC,481,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,481,Fabric wrapping of abdominal aneurysm ,,,12367.1,12367.1,1 RC,481,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,8853.58,12018.0,2 RC,481,Fetal contraction stress test ,,,29.11,5841.0,4 RC,481,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,125.27,5841.0,17 RC,481,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,498.9,16207.0,5 RC,481,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,601.97,5841.0,4 RC,481,Fetal non-stress test ,,,16.93,5841.0,4 RC,481,Fetal scalp blood sampling ,,,739.07,5841.0,4 RC,481,"Fetal shunt placement, including ultrasound guidance ",,,739.07,5841.0,16 RC,481,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,739.07,5841.0,16 RC,481,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,12367.1,12367.1,1 RC,481,Fimbrioplasty ,,,3293.0,9457.91,17 RC,481,Fine needle aspiration of orbital contents ,,,749.3,5571.0,18 RC,481,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,912.02,5571.0,18 RC,481,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,2367.96,10424.04,18 RC,481,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,912.02,5519.68,18 RC,481,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,912.02,5519.68,18 RC,481,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,1645.49,10424.04,18 RC,481,Fitting and insertion of pessary or other intravaginal support device ,,,35.94,5841.0,5 RC,481,Fixation of contralateral testis (separate procedure) ,,,1226.38,8240.61,18 RC,481,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,5 RC,481,"Follicle puncture for oocyte retrieval, any method ",,,1743.0,3083.0,17 RC,481,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,118.2,5841.0,17 RC,481,Free omental flap with microvascular anastomosis ,,,3390.0,19327.99,5 RC,481,Frenulotomy of penis ,,,700.49,5571.0,18 RC,481,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,481,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,739.07,5841.0,16 RC,481,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,481,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,8778.0,13 RC,481,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,481,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,481,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,481,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,12367.1,12367.1,1 RC,481,Goniotomy ,,,1645.49,10424.04,18 RC,481,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,481,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,481,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,481,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,481,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,481,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,481,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,481,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,481,"Harvesting conjunctival allograft, living donor ",,,2195.0,5571.0,17 RC,481,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,12367.1,12367.1,1 RC,481,Hip core decompression ,,,12367.1,12367.1,1 RC,481,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,4390.0,12 RC,481,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,12367.1,12367.1,1 RC,481,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,12367.1,12367.1,1 RC,481,"Hymenotomy, simple incision ",,,1141.2,6819.81,18 RC,481,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,3390.0,18903.34,5 RC,481,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,3390.0,16207.0,17 RC,481,Hysterorrhaphy of ruptured uterus ,,,3331.33,5841.0,3 RC,481,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,3293.0,16207.0,17 RC,481,"Hysteroscopy, diagnostic (separate procedure) ",,,1141.2,6819.81,6 RC,481,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2133.14,11661.3,6 RC,481,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1638.52,11661.3,6 RC,481,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1638.52,11661.3,6 RC,481,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1638.52,11661.3,6 RC,481,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1141.2,6819.81,6 RC,481,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1638.52,11661.3,6 RC,481,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1141.2,6819.81,6 RC,481,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,3041.0,26010.28,5 RC,481,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,481,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,481,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,481,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,481,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,481,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,481,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,481,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,481,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,2 RC,481,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,481,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,481,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,481,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,481,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,481,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,481,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,481,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,481,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,481,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,481,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,481,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,481,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,481,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,481,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,481,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,481,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,481,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,481,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,481,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,481,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,481,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,481,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,2 RC,481,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,481,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,481,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,481,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,481,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,521.99,3747.2,18 RC,481,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,521.99,4220.0,18 RC,481,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",,,2195.0,3747.2,17 RC,481,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,9653.0,4 RC,481,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,7014.0,4 RC,481,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,481,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,481,Implantation of auditory brain stem implant ,,,12367.1,12367.1,1 RC,481,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,1067.81,16207.0,5 RC,481,Implantation of intrastromal corneal ring segments ,,,1645.49,26289.23,18 RC,481,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2097.34,35151.83,18 RC,481,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,3293.0,44816.88,14 RC,481,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,12367.1,12367.1,1 RC,481,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,13 RC,481,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,1672.0,5841.0,15 RC,481,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,2195.0,45089.88,19 RC,481,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,19 RC,481,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,2195.0,45089.88,20 RC,481,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,2699.0,9653.0,17 RC,481,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,3390.0,35621.26,17 RC,481,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,3390.0,34379.68,17 RC,481,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3965.0,32488.94,18 RC,481,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,2195.0,16330.72,17 RC,481,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,2195.0,15039.6,18 RC,481,Incision and drainage of Bartholin's gland abscess ,,,75.67,5841.0,17 RC,481,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,700.49,5571.0,18 RC,481,"Incision and drainage of penis, deep ",,,521.99,5571.0,18 RC,481,"Incision and drainage of thyroglossal duct cyst, infected ",,,451.36,3683.7,18 RC,481,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,874.74,6330.57,18 RC,481,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,874.74,14238.95,18 RC,481,Incision and drainage of vulva or perineal abscess ,,,81.1,5841.0,17 RC,481,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,1537.88,16207.0,5 RC,481,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,1071.93,16207.0,17 RC,481,"Incision of conjunctiva, drainage of cyst ",,,60.01,3249.0,18 RC,481,"Incision, drainage of lacrimal gland ",,,1986.0,3323.1,17 RC,481,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,219.53,3519.43,18 RC,481,Incisional biopsy of eyelid skin including lid margin ,,,116.2,5841.0,17 RC,481,"Induced abortion, 17 to 24 weeks ",,,12367.1,12367.1,1 RC,481,"Induced abortion, 25 to 28 weeks ",,,12367.1,12367.1,1 RC,481,"Induced abortion, 29 to 31 weeks ",,,12367.1,12367.1,1 RC,481,"Induced abortion, 32 weeks or greater ",,,12367.1,12367.1,1 RC,481,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,2195.0,16207.0,17 RC,481,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,2195.0,16207.0,17 RC,481,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,2195.0,16207.0,17 RC,481,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,3390.0,16207.0,5 RC,481,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,2195.0,16207.0,34 RC,481,"Induced abortion, by dilation and curettage ",,,1141.2,6819.81,18 RC,481,"Induced abortion, by dilation and evacuation ",,,1141.2,6819.81,18 RC,481,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,481,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,3390.0,36755.46,5 RC,481,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,3390.0,36355.52,5 RC,481,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,3293.0,122851.37,13 RC,481,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,481,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,481,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,481,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,481,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,481,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,1672.0,5841.0,15 RC,481,Injection of contrast medium for dacryocystography ,,,1672.0,5841.0,15 RC,481,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,37.73,5841.0,5 RC,481,Injection of medication or other substance into Tenon's capsule ,,,20.8,5841.0,17 RC,481,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,912.02,5571.0,18 RC,481,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,1672.0,5841.0,15 RC,481,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,1672.0,5841.0,3 RC,481,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,481,Injection procedure for Peyronie disease; ,,,64.46,5841.0,5 RC,481,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,1812.83,11552.32,18 RC,481,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,1519.33,3083.0,34 RC,481,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,2195.0,11410.03,17 RC,481,Injection procedure for corpora cavernosography ,,,1672.0,5841.0,15 RC,481,Injection procedure for cystography or voiding urethrocystography ,,,1672.0,5841.0,3 RC,481,"Injection procedure for discography, each level; cervical or thoracic ",,,1672.0,5841.0,15 RC,481,"Injection procedure for discography, each level; lumbar ",,,1672.0,5841.0,15 RC,481,Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure) ,,,1265.72,16207.0,5 RC,481,"Injection procedure for myelography and/or computed tomography, lumbar ",,,1672.0,5841.0,15 RC,481,Injection procedure for retrograde urethrocystography ,,,1672.0,5841.0,3 RC,481,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,481,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1706.39,3083.0,17 RC,481,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,1672.0,5841.0,15 RC,481,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,1672.0,5841.0,15 RC,481,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,2012.0,4220.0,17 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,365.66,3390.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,476.03,5571.0,6 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,42.77,2315.0,6 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,150.02,5841.0,17 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,32.38,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,66.25,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,282.06,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,282.06,5841.0,17 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,42.18,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,46.35,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,19.31,5841.0,17 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,365.66,2315.0,6 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,79.02,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,41.6,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,1672.0,5841.0,15 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,1672.0,5841.0,15 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,365.66,3083.0,18 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,72.48,5841.0,17 RC,481,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,583.97,5841.0,16 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,1672.0,5841.0,15 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,365.66,3083.0,18 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,1672.0,5841.0,15 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,1672.0,5841.0,15 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,365.66,3083.0,18 RC,481,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,1672.0,5841.0,15 RC,481,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,365.66,5841.0,68 RC,481,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,282.06,5841.0,68 RC,481,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,365.66,3083.0,18 RC,481,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,365.66,3083.0,18 RC,481,"Injection, anesthetic agent; sphenopalatine ganglion ",,,75.76,5841.0,17 RC,481,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,365.66,3083.0,18 RC,481,"Injection, anesthetic agent; superior hypogastric plexus ",,,365.66,3390.0,18 RC,481,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,912.02,5519.68,18 RC,481,"Injection, anterior chamber of eye (separate procedure); medication ",,,912.02,5519.68,18 RC,481,"Injection, epidural, of blood or clot patch ",,,282.06,3083.0,18 RC,481,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,481,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,365.66,5571.0,18 RC,481,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,365.66,5571.0,18 RC,481,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,365.66,3083.0,18 RC,481,Insert urinary catheter ,,,3390.0,5841.0,4 RC,481,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,481,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,1088.4,1088.4,1 RC,481,Insertion of Heyman capsules for clinical brachytherapy ,,,1638.52,11661.3,18 RC,481,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,548.69,9953.69,18 RC,481,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,125.27,5841.0,17 RC,481,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,2392.0,10424.04,18 RC,481,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,460.61,3249.0,18 RC,481,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,14 RC,481,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,806.22,5841.0,16 RC,481,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,889.0,5841.0,16 RC,481,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,606.24,4251.7,18 RC,481,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,606.24,4251.7,18 RC,481,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,5 RC,481,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,1986.0,47976.91,20 RC,481,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,912.02,5571.0,18 RC,481,Insertion of intrauterine device (IUD) ,,,634.92,5841.0,16 RC,481,Insertion of levonorgestrel-releasing intrauterine system ,,,12367.1,12367.1,1 RC,481,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,19 RC,481,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,12018.0,18 RC,481,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,12018.0,18 RC,481,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,12018.0,18 RC,481,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,992.6,3083.0,14 RC,481,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,297.65,5841.0,16 RC,481,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,1184.02,8536.87,18 RC,481,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,1184.02,8536.87,18 RC,481,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,1184.02,8536.87,18 RC,481,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,19 RC,481,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,2699.0,51975.0,19 RC,481,Insertion of peritoneal-venous shunt ,,,2195.0,8596.24,17 RC,481,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,13 RC,481,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,3390.0,14700.4,3 RC,481,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,16 RC,481,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,2142.41,41580.0,20 RC,481,Insertion of tandem cuff (dual cuff) ,,,2195.0,47976.91,20 RC,481,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,62.02,5841.0,17 RC,481,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,297.65,5841.0,16 RC,481,Insertion of testicular prosthesis (separate procedure) ,,,2195.0,11552.32,18 RC,481,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,2195.0,3390.0,14 RC,481,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,1235.65,8488.5,18 RC,481,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,1235.65,8488.5,18 RC,481,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,2080.79,12547.6,18 RC,481,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,1638.52,25988.0,20 RC,481,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,453.48,16207.0,4 RC,481,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,2699.0,87318.0,19 RC,481,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,2195.0,87318.0,19 RC,481,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,1986.0,5841.0,14 RC,481,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,2195.0,35432.53,15 RC,481,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,2195.0,87318.0,19 RC,481,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,2195.0,87318.0,19 RC,481,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,6143.86,14 RC,481,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,44.56,5841.0,17 RC,481,Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y ,,,3390.0,16207.0,5 RC,481,Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct ,,,3390.0,16207.0,5 RC,481,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,1672.0,5841.0,15 RC,481,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,481,Intersex surgery; female to male ,,,3390.0,8240.61,3 RC,481,Intersex surgery; male to female ,,,3390.0,11661.3,3 RC,481,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,481,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,912.02,5571.0,18 RC,481,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,481,Intragastric hypothermia using gastric freezing ,,,12367.1,12367.1,1 RC,481,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,481,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,481,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,845.21,845.21,1 RC,481,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,481,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,35575.88,35575.88,1 RC,481,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,51.99,5841.0,17 RC,481,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,75.67,5841.0,5 RC,481,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,1645.49,10424.04,18 RC,481,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,912.02,5571.0,18 RC,481,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,912.02,5519.68,18 RC,481,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,912.02,5519.68,18 RC,481,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,912.02,9653.0,18 RC,481,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,223.54,3667.92,18 RC,481,Iridotomy by stab incision (separate procedure); except transfixion ,,,912.02,5841.0,17 RC,481,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,912.02,5519.68,18 RC,481,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,164.59,3083.0,18 RC,481,Irrigation of corpora cavernosa for priapism ,,,118.2,5841.0,17 RC,481,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,150.18,5841.0,4 RC,481,Islet cell tissue transplant from pancreas; allogeneic ,,,12367.1,12367.1,1 RC,481,Keratomileusis ,,,3041.0,17410.88,17 RC,481,Keratophakia ,,,3041.0,19043.6,17 RC,481,Keratoplasty (corneal transplant); anterior lamellar ,,,1645.49,10424.04,18 RC,481,Keratoplasty (corneal transplant); endothelial ,,,1645.49,10424.04,18 RC,481,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,1645.49,10424.04,18 RC,481,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,1645.49,10424.04,18 RC,481,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,1645.49,10424.04,18 RC,481,Keratoprosthesis ,,,3673.0,16924.12,17 RC,481,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,481,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,481,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,481,LAVH ,,,3390.0,5841.0,2 RC,481,Labyrinthectomy; transcanal ,,,2096.96,13241.95,18 RC,481,Labyrinthectomy; with mastoidectomy ,,,2096.96,13241.95,18 RC,481,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,133.38,4788.0,18 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,9875.0,33535.44,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,3390.0,21690.47,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,9875.0,18701.31,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,3390.0,19084.78,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,3390.0,21550.21,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,3390.0,25541.17,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,9875.0,23789.02,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,3390.0,25244.3,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,3390.0,31671.87,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,3390.0,31193.68,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,9875.0,33036.55,5 RC,481,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,3390.0,22815.94,5 RC,481,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,3390.0,24914.49,5 RC,481,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,9875.0,22750.04,5 RC,481,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,3390.0,22457.29,5 RC,481,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,3390.0,24914.49,5 RC,481,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,3293.0,16330.72,17 RC,481,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,3041.0,16330.72,17 RC,481,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,3293.0,16330.72,17 RC,481,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,3293.0,16330.72,17 RC,481,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,3390.0,35304.18,5 RC,481,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,3390.0,36870.89,5 RC,481,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,9875.0,36660.62,5 RC,481,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,3375.0,87318.0,20 RC,481,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,3390.0,19031.13,5 RC,481,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,3390.0,20659.72,5 RC,481,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,3390.0,16681.12,5 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,2573.7,16330.72,18 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,2573.7,16330.72,18 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,3293.0,16330.72,17 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,2573.7,16330.72,18 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,3375.0,16330.72,17 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,2996.0,16330.72,17 RC,481,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,3375.0,16330.72,17 RC,481,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,3390.0,19142.55,5 RC,481,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,3293.0,16330.72,17 RC,481,Laminectomy with rhizotomy; 1 or 2 segments ,,,9875.0,13704.43,5 RC,481,Laminectomy with rhizotomy; more than 2 segments ,,,9875.0,14838.25,5 RC,481,Laminectomy with section of spinal accessory nerve ,,,9875.0,16705.83,5 RC,481,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,1672.0,16330.72,69 RC,481,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,1672.0,5841.0,30 RC,481,"Laminectomy, with release of tethered spinal cord, lumbar ",,,9875.0,18433.39,5 RC,481,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,3390.0,17934.49,5 RC,481,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,3390.0,20494.76,5 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,14 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,3293.0,16330.72,17 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,1986.0,7014.0,32 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,2573.7,16330.72,18 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,2573.7,16330.72,18 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2573.7,16330.72,18 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,1672.0,5841.0,15 RC,481,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,1581.69,3083.0,13 RC,481,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,481,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,481,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,481,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,481,Laparoscopic esophagomyotomy (heller type) ,,,12367.1,12367.1,1 RC,481,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,481,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,481,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,481,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,481,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,481,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,481,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,481,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,2026.81,13196.03,6 RC,481,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,2026.81,13196.03,6 RC,481,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,8340.56,8340.56,1 RC,481,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,481,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,481,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,481,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,11558.0,22967.79,2 RC,481,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,3293.0,29647.99,13 RC,481,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,3293.0,29647.99,13 RC,481,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,3293.0,24808.33,16 RC,481,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3337.16,22967.79,5 RC,481,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,8778.0,22967.79,5 RC,481,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3337.16,22967.79,6 RC,481,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,2026.81,13196.03,3 RC,481,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,2 RC,481,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,22967.79,2 RC,481,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,22440.82,4 RC,481,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14228.04,5 RC,481,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,22700.51,2 RC,481,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,2 RC,481,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,2026.81,13196.03,3 RC,481,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3337.16,22967.79,3 RC,481,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13196.03,5 RC,481,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,5 RC,481,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19167.26,5 RC,481,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16207.0,5 RC,481,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,5 RC,481,"Laparoscopy, surgical; orchiectomy ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,5 RC,481,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,5 RC,481,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16207.0,5 RC,481,"Laparoscopy, surgical; repair initial inguinal hernia ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2783.89,16632.0,8 RC,481,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13196.03,5 RC,481,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3337.16,22967.79,6 RC,481,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13196.03,5 RC,481,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,13196.03,5 RC,481,"Laparoscopy, surgical; with fimbrioplasty ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,3 RC,481,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,5841.0,3 RC,481,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,2026.81,13196.03,6 RC,481,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,2026.81,13196.03,6 RC,481,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,13774.56,13774.56,1 RC,481,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,3673.0,11651.18,17 RC,481,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,481,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,481,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,481,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,481,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,481,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,481,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,481,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,481,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,481,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,481,Lapscp intest resect ,,,3390.0,5841.0,2 RC,481,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,481,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,481,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,481,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,481,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,481,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,481,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,481,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,481,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,481,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,481,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1812.83,9653.0,4 RC,481,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,1812.83,11552.32,18 RC,481,Laser in situ keratomileusis (lasik) ,,,1096.64,1096.64,1 RC,481,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,3390.0,13123.05,4 RC,481,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,3390.0,12018.0,4 RC,481,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1812.83,11552.32,18 RC,481,Laser-assisted uvulopalatoplasty (laup) ,,,12367.1,12367.1,1 RC,481,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,481,Ligation of peritoneal-venous shunt ,,,2431.0,5157.72,5 RC,481,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,894.61,16207.0,17 RC,481,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,2195.0,3854.94,17 RC,481,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,1141.2,6819.81,18 RC,481,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,481,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,1226.38,8240.61,18 RC,481,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,1226.38,8240.61,18 RC,481,"Lithotripsy, extracorporeal shock wave ",,,1226.38,10342.0,3 RC,481,Lobar lung transplantation ,,,12367.1,12367.1,1 RC,481,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,12367.1,12367.1,1 RC,481,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,481,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,3041.0,10529.83,17 RC,481,Lysis of labial adhesions ,,,1141.2,6819.81,18 RC,481,Lysis or excision of penile post-circumcision adhesions ,,,700.49,5571.0,18 RC,481,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,2699.0,4220.0,13 RC,481,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,255.54,3083.0,18 RC,481,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,62.02,5841.0,5 RC,481,Marsupialization of Bartholin's gland cyst ,,,1141.2,6819.81,18 RC,481,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,481,Marsupialization of pancreatic cyst ,,,3390.0,16207.0,5 RC,481,"Marsupialization of urethral diverticulum, male or female ",,,1226.38,8240.61,18 RC,481,Mastoid obliteration (separate procedure) ,,,2096.96,13241.95,18 RC,481,Mastoidectomy; complete ,,,2096.96,13241.95,18 RC,481,Mastoidectomy; modified radical ,,,2096.96,13241.95,18 RC,481,Mastoidectomy; radical ,,,2096.96,13241.95,18 RC,481,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,150.18,5841.0,4 RC,481,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,700.49,5571.0,18 RC,481,"Meatotomy, cutting of meatus (separate procedure); infant ",,,1986.0,11308.65,17 RC,481,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,359.42,3083.0,18 RC,481,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,12367.1,12367.1,1 RC,481,Microsurgical epididymal sperm aspiration (mesa) ,,,12367.1,12367.1,1 RC,481,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Middle ear exploration through postauricular or ear canal incision ,,,951.37,7150.66,18 RC,481,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,22626.38,22626.38,1 RC,481,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,24869.19,24869.19,1 RC,481,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,24679.51,24679.51,1 RC,481,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,26922.32,26922.32,1 RC,481,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,22053.23,22053.23,1 RC,481,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,749.3,5571.0,6 RC,481,Multifetal pregnancy reduction(s) (MPR) ,,,739.07,5841.0,4 RC,481,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,248.05,5571.0,18 RC,481,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,1858.64,3249.0,17 RC,481,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,1858.64,3083.0,17 RC,481,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,1858.64,3083.0,17 RC,481,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,1858.64,3083.0,17 RC,481,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,3673.0,10793.64,17 RC,481,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,1141.2,6819.81,18 RC,481,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,4988.0,13419.92,5 RC,481,Myringoplasty (surgery confined to drumhead and donor area) ,,,951.37,7150.66,18 RC,481,Myringotomy including aspiration and/or eustachian tube inflation ,,,93.97,5841.0,17 RC,481,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,951.37,7150.66,18 RC,481,"Myringotomy, laser-assisted ",,,2699.0,12367.1,13 RC,481,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,481,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,481,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,12367.1,12367.1,1 RC,481,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,481,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,481,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,2195.0,13884.92,17 RC,481,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,1986.0,13884.92,17 RC,481,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,118.2,5841.0,17 RC,481,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,3390.0,16207.0,5 RC,481,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,3390.0,17485.12,5 RC,481,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,3390.0,16207.0,5 RC,481,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,3390.0,16207.0,5 RC,481,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,3390.0,16207.0,5 RC,481,"Nephrectomy, partial ",,,3390.0,16207.0,5 RC,481,Nephrolithotomy; complicated by congenital kidney abnormality ,,,3390.0,16207.0,5 RC,481,Nephrolithotomy; removal of calculus ,,,3390.0,16207.0,5 RC,481,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,3390.0,17369.7,5 RC,481,Nephrolithotomy; secondary surgical operation for calculus ,,,3390.0,16207.0,5 RC,481,"Nephrorrhaphy, suture of kidney wound or injury ",,,3390.0,16207.0,5 RC,481,"Nephrostomy, nephrotomy with drainage ",,,2699.0,11049.32,17 RC,481,"Nephrotomy, with exploration ",,,3390.0,16207.0,5 RC,481,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,2195.0,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,2142.41,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,2195.0,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,2195.0,15039.6,18 RC,481,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,2195.0,15039.6,18 RC,481,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Nerve pedicle transfer; first stage ,,,2142.41,15039.6,18 RC,481,Nerve pedicle transfer; second stage ,,,1986.0,15039.6,18 RC,481,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,2195.0,15039.6,17 RC,481,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,2195.0,15039.6,17 RC,481,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,2195.0,15039.6,18 RC,481,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,3390.0,18198.41,5 RC,481,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,3390.0,25178.41,5 RC,481,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,3390.0,18392.09,5 RC,481,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,3390.0,22820.05,5 RC,481,Neuroplasty and/or transposition; cranial nerve (specify) ,,,708.15,5571.0,18 RC,481,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,708.15,5571.0,18 RC,481,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,708.15,5571.0,18 RC,481,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,708.15,5571.0,18 RC,481,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,708.15,5571.0,18 RC,481,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,708.15,5571.0,18 RC,481,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,708.15,5571.0,18 RC,481,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,708.15,5571.0,18 RC,481,"Neuroplasty; digital, 1 or both, same digit ",,,708.15,5571.0,18 RC,481,Neuroplasty; nerve of hand or foot ,,,708.15,5571.0,18 RC,481,Nocturnal penile tumescence and/or rigidity test ,,,175.71,5841.0,16 RC,481,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,481,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,3390.0,39983.6,5 RC,481,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,1141.2,6819.81,18 RC,481,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,1531.96,8536.87,18 RC,481,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,3293.0,8536.87,17 RC,481,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,3293.0,10424.04,17 RC,481,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,3390.0,16887.27,5 RC,481,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,5 RC,481,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,2996.0,16207.0,17 RC,481,"Oophorectomy, partial or total, unilateral or bilateral; ",,,3293.0,7014.0,17 RC,481,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,4988.0,14096.14,5 RC,481,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,12367.1,14 RC,481,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,2195.0,87318.0,19 RC,481,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,481,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,2195.0,82073.3,16 RC,481,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,481,Open implantation of neurostimulator electrode array; neuromuscular ,,,1986.0,87318.0,20 RC,481,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,20 RC,481,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,2699.0,16890.86,18 RC,481,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,16 RC,481,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,16 RC,481,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16359.54,16 RC,481,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,5 RC,481,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,5 RC,481,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,1184.02,8536.87,18 RC,481,Orbital implant (implant outside muscle cone); insertion ,,,1184.02,8536.87,18 RC,481,Orbital implant (implant outside muscle cone); removal or revision ,,,1184.02,8536.87,18 RC,481,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,3390.0,39249.72,5 RC,481,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,3390.0,34516.65,5 RC,481,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,3390.0,38161.32,5 RC,481,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,1184.02,8536.87,18 RC,481,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,1184.02,8536.87,18 RC,481,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,1184.02,8536.87,18 RC,481,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,1184.02,8536.87,18 RC,481,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,1184.02,8536.87,18 RC,481,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,1184.02,8536.87,18 RC,481,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,749.3,5571.0,18 RC,481,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,1184.02,8536.87,18 RC,481,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,749.3,5571.0,18 RC,481,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,749.3,5571.0,18 RC,481,"Orchiectomy, partial ",,,1226.38,8240.61,18 RC,481,"Orchiectomy, radical, for tumor; inguinal approach ",,,1235.65,8488.5,18 RC,481,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,4988.0,8240.61,5 RC,481,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,1226.38,8240.61,18 RC,481,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,2996.0,8488.5,17 RC,481,"Orchiopexy, inguinal or scrotal approach ",,,1235.65,8488.5,18 RC,481,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,5 RC,481,"Osteotomy, periacetabular, with internal fixation ",,,12367.1,12367.1,1 RC,481,"Other cranial decompression, posterior fossa ",,,3390.0,24597.03,5 RC,481,Other spinal injection ,,,3390.0,5841.0,2 RC,481,Otolaryngologic examination under general anesthesia ,,,1205.9,2358.0,3 RC,481,"Otoplasty, protruding ear, with or without size reduction ",,,951.37,7150.66,18 RC,481,"Ovarian cystectomy, unilateral or bilateral ",,,3293.0,11661.3,17 RC,481,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,481,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,481,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,481,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,481,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,2 RC,481,"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy ",,,3390.0,19517.67,5 RC,481,"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy ",,,3390.0,18738.49,5 RC,481,"Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) ",,,3390.0,22473.77,5 RC,481,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy ",,,3390.0,37180.11,5 RC,481,"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy ",,,3390.0,34792.93,5 RC,481,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy ",,,3390.0,37353.2,5 RC,481,"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without pancreatojejunostomy ",,,3390.0,34582.66,5 RC,481,"Pancreatectomy, total ",,,3390.0,21715.18,5 RC,481,"Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells ",,,3390.0,16207.0,5 RC,481,"Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) ",,,3390.0,19880.55,5 RC,481,Pancreatorrhaphy for injury ,,,3390.0,16207.0,5 RC,481,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,912.02,5841.0,17 RC,481,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,912.02,5571.0,18 RC,481,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,912.02,5571.0,18 RC,481,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,Parathyroidectomy or exploration of parathyroid(s); ,,,2096.96,13241.95,18 RC,481,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,3673.0,13241.95,17 RC,481,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,3390.0,16557.46,5 RC,481,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,3293.0,22967.79,17 RC,481,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,3293.0,11661.3,17 RC,481,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,2996.0,18300.83,17 RC,481,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,282.06,3083.0,18 RC,481,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,1672.0,5841.0,15 RC,481,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,282.06,3083.0,18 RC,481,Partial hymenectomy or revision of hymenal ring ,,,1141.2,6819.81,18 RC,481,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,2026.81,13196.03,18 RC,481,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,2026.81,13196.03,18 RC,481,Pelvic examination under anesthesia (other than local) ,,,1141.2,6819.81,18 RC,481,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,3390.0,34970.25,5 RC,481,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,3390.0,27359.33,5 RC,481,Penile plethysmography ,,,542.58,5841.0,16 RC,481,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,3375.0,16207.0,17 RC,481,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,276.42,3083.0,18 RC,481,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,365.66,3083.0,18 RC,481,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12367.1,14 RC,481,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12367.1,14 RC,481,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,1986.0,3083.0,13 RC,481,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,12367.1,14 RC,481,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,2195.0,87318.0,20 RC,481,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,1986.0,87318.0,20 RC,481,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,20 RC,481,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,2699.0,87318.0,20 RC,481,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,4444.44,4444.44,1 RC,481,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,365.66,5571.0,36 RC,481,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,2996.0,22025.45,30 RC,481,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,481,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,17 RC,481,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,481,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,481,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,481,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,481,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,481,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,481,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,481,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,481,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,74835.9,13 RC,481,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,481,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,481,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,481,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,481,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,481,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,481,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,481,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,481,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,481,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,481,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,481,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,481,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,481,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,12367.1,54054.0,6 RC,481,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,481,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,481,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,481,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,481,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,481,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,12367.1,14 RC,481,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,12367.1,14 RC,481,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,12367.1,14 RC,481,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,12367.1,14 RC,481,"Pereyra procedure, including anterior colporrhaphy ",,,2443.09,18300.83,18 RC,481,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,481,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,481,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,1141.2,6819.81,18 RC,481,"Peritoneal lavage, including imaging guidance, when performed ",,,359.42,3249.0,18 RC,481,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,2996.0,32022.79,16 RC,481,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,1672.0,5841.0,16 RC,481,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,2195.0,8572.31,16 RC,481,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,2699.0,12301.08,16 RC,481,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,481,Petrous apicectomy including radical mastoidectomy ,,,2096.96,13241.95,18 RC,481,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,481,"Phlebotomy, therapeutic (separate procedure) ",,,297.65,297.65,1 RC,481,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,481,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,481,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,481,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,481,Photorefractive keratectomy (prk) ,,,1096.64,1096.64,1 RC,481,Phototherapeutic keratectomy (ptk) ,,,12367.1,12367.1,1 RC,481,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,481,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,481,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,1672.0,5841.0,15 RC,481,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,1986.0,8536.87,17 RC,481,Placement of amniotic membrane on the ocular surface; without sutures ,,,1986.0,3083.0,17 RC,481,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,2012.0,2315.0,5 RC,481,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,993.56,16207.0,5 RC,481,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,317.86,5193.86,18 RC,481,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,76.05,3083.0,18 RC,481,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,3399.78,3399.78,1 RC,481,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,1986.0,11661.3,17 RC,481,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,700.49,5571.0,18 RC,481,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,1226.38,8240.61,18 RC,481,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,1226.38,8240.61,54 RC,481,Plastic operation of penis for injury ,,,1226.38,8240.61,18 RC,481,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,1226.38,9653.0,18 RC,481,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,1226.38,9653.0,18 RC,481,Plastic operation on penis for epispadias distal to external sphincter; ,,,700.49,7014.0,18 RC,481,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,6326.0,14813.43,5 RC,481,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,700.49,7014.0,18 RC,481,Plastic operation on penis to correct angulation ,,,1226.38,9653.0,18 RC,481,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,1638.52,11661.3,18 RC,481,Plastic repair of canaliculi ,,,749.3,5571.0,18 RC,481,Plastic repair of introitus ,,,1141.2,6819.81,18 RC,481,Plastic repair of urethrocele ,,,1141.2,6819.81,18 RC,481,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,1638.52,11661.3,18 RC,481,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,1498.73,5841.0,16 RC,481,Postpartum care only (separate procedure) ,,,1636.84,5841.0,15 RC,481,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1986.0,3083.0,13 RC,481,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,3390.0,12018.0,4 RC,481,"Probing of lacrimal canaliculi, with or without irrigation ",,,74.28,5841.0,17 RC,481,"Probing of nasolacrimal duct, with or without irrigation; ",,,116.2,5841.0,17 RC,481,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,749.3,5571.0,18 RC,481,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,749.3,5571.0,18 RC,481,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,749.3,5571.0,18 RC,481,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,116.2,5841.0,17 RC,481,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,128.62,3667.92,18 RC,481,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,3390.0,16207.0,5 RC,481,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,3390.0,16207.0,5 RC,481,"Prostatectomy, perineal radical; ",,,3390.0,16207.0,5 RC,481,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,20973.07,5 RC,481,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,19204.33,5 RC,481,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,3390.0,16207.0,5 RC,481,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,3390.0,16207.0,5 RC,481,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,16277.06,17 RC,481,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,16207.0,5 RC,481,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,1226.38,8240.61,18 RC,481,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,1226.38,5571.0,18 RC,481,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,58.22,2315.0,6 RC,481,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,282.06,3083.0,18 RC,481,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,3390.0,16644.06,5 RC,481,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,3390.0,16207.0,5 RC,481,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,481,"Pyelotomy; with drainage, pyelostomy ",,,3390.0,16207.0,5 RC,481,Pyelotomy; with exploration ,,,3390.0,16207.0,5 RC,481,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,3390.0,16207.0,5 RC,481,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,481,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,481,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,2 RC,481,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,2 RC,481,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,481,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,481,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,2 RC,481,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,2 RC,481,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,481,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,481,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,481,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,481,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,481,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,481,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,3 RC,481,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,481,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,481,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,481,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,481,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,481,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,3 RC,481,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,481,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,3 RC,481,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,481,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,3 RC,481,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,481,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,481,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,481,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,481,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,481,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,481,Radial keratotomy ,,,3041.0,7623.16,17 RC,481,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22024.4,17 RC,481,Radical excision external auditory canal lesion; with neck dissection ,,,3390.0,19389.88,5 RC,481,Radical excision external auditory canal lesion; without neck dissection ,,,2096.96,13241.95,18 RC,481,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,19736.17,5 RC,481,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,708.15,5841.0,17 RC,481,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,3390.0,12018.0,4 RC,481,Recipient nephrectomy (separate procedure) ,,,3390.0,16207.0,5 RC,481,"Reconstruction external auditory canal for congenital atresia, single stage ",,,2096.96,13241.95,18 RC,481,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,2096.96,13241.95,18 RC,481,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,749.3,5571.0,18 RC,481,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,749.3,5571.0,18 RC,481,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,1184.02,8536.87,18 RC,481,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,749.3,5571.0,18 RC,481,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,481,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,481,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,3390.0,20288.61,5 RC,481,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,3390.0,23846.68,5 RC,481,Reduction of overcorrection of ptosis ,,,749.3,5571.0,18 RC,481,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,1226.38,8240.61,18 RC,481,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,481,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,481,Reinsertion of ocular implant; with or without conjunctival graft ,,,1184.02,8536.87,18 RC,481,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,1184.02,8536.87,18 RC,481,Release of encircling material (posterior segment) ,,,1645.49,10424.04,18 RC,481,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,749.3,5571.0,18 RC,481,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,700.49,5571.0,18 RC,481,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,700.49,5571.0,18 RC,481,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,700.49,4836.33,18 RC,481,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,585.23,9157.78,18 RC,481,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,19 RC,481,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,1672.0,51975.0,18 RC,481,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,700.49,4836.33,18 RC,481,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,12367.1,14 RC,481,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,1986.0,47976.91,18 RC,481,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,2012.0,15246.43,5 RC,481,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,2699.0,51975.0,19 RC,481,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,2012.0,51975.0,19 RC,481,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,874.74,6330.57,18 RC,481,Removal foreign body from external auditory canal; with general anesthesia ,,,521.99,5571.0,18 RC,481,Removal foreign body from external auditory canal; without general anesthesia ,,,297.65,5841.0,4 RC,481,"Removal impacted cerumen requiring instrumentation, unilateral ",,,150.18,5841.0,16 RC,481,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,150.18,5841.0,16 RC,481,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1226.38,8240.61,18 RC,481,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,2195.0,9751.1,13 RC,481,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,2195.0,9751.1,13 RC,481,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,2195.0,9528.08,13 RC,481,"Removal of blood clot, anterior segment of eye ",,,912.02,5571.0,18 RC,481,Removal of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,5 RC,481,Removal of cerclage suture under anesthesia (other than local) ,,,1141.2,6819.81,18 RC,481,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,3390.0,16207.0,5 RC,481,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,2195.0,7231.57,17 RC,481,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,180.02,5571.0,18 RC,481,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,41.6,3083.0,18 RC,481,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,1986.0,15039.6,18 RC,481,"Removal of embedded foreign body, eyelid ",,,116.2,5841.0,17 RC,481,Removal of entire lumbosubarachnoid shunt system without replacement ,,,708.15,5571.0,18 RC,481,"Removal of epithelial downgrowth, anterior chamber of eye ",,,912.02,5571.0,18 RC,481,Removal of foreign body in scrotum ,,,700.49,5571.0,18 RC,481,"Removal of foreign body or dacryolith, lacrimal passages ",,,116.2,5841.0,17 RC,481,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,992.6,5841.0,4 RC,481,"Removal of foreign body, external eye; conjunctival superficial ",,,297.65,5841.0,4 RC,481,"Removal of foreign body, external eye; corneal, with slit lamp ",,,297.65,5841.0,4 RC,481,"Removal of foreign body, external eye; corneal, without slit lamp ",,,992.6,5841.0,4 RC,481,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,912.02,5571.0,18 RC,481,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,912.02,5841.0,17 RC,481,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,912.02,5571.0,18 RC,481,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,481,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,1986.0,15899.38,17 RC,481,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,481,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,481,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,1141.2,6819.81,18 RC,481,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,481,"Removal of implanted material, anterior segment of eye ",,,912.02,5571.0,18 RC,481,"Removal of implanted material, posterior segment; extraocular ",,,912.02,5571.0,18 RC,481,"Removal of implanted material, posterior segment; intraocular ",,,912.02,9653.0,18 RC,481,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1812.83,11552.32,18 RC,481,Removal of intrauterine device (IUD) ,,,54.96,5841.0,17 RC,481,"Removal of lens material; aspiration technique, 1 or more stages ",,,912.02,5571.0,18 RC,481,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,912.02,5519.68,18 RC,481,Removal of lens material; intracapsular ,,,912.02,5571.0,18 RC,481,"Removal of lens material; intracapsular, for dislocated lens ",,,1645.49,10424.04,18 RC,481,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,1645.49,10424.04,18 RC,481,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,912.02,5571.0,18 RC,481,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,255.54,3083.0,18 RC,481,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,992.6,3083.0,14 RC,481,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,1226.38,8240.61,18 RC,481,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,481,Removal of ocular implant ,,,1184.02,8536.87,18 RC,481,Removal of peritoneal foreign body from peritoneal cavity ,,,1235.65,8488.5,18 RC,481,Removal of peritoneal-venous shunt ,,,1199.9,7565.59,18 RC,481,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,12018.0,18 RC,481,Removal of previously implanted intrathecal or epidural catheter ,,,708.15,5571.0,18 RC,481,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,912.02,5571.0,18 RC,481,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,2195.0,8419.4,15 RC,481,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,708.15,5571.0,18 RC,481,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1609.24,8595.41,18 RC,481,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,2142.41,15039.6,18 RC,481,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,12367.1,12367.1,1 RC,481,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,481,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,481,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,481,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,1672.0,5841.0,15 RC,481,Removal of transplanted pancreatic allograft ,,,3390.0,15233.96,3 RC,481,Removal of transplanted renal allograft ,,,3390.0,16207.0,5 RC,481,"Removal of tumor, temporal bone ",,,2996.0,13241.95,17 RC,481,Removal of tunneled intraperitoneal catheter ,,,1199.9,7565.59,18 RC,481,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,912.02,5571.0,18 RC,481,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,912.02,5571.0,18 RC,481,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,951.37,9653.0,18 RC,481,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,1986.0,11552.32,18 RC,481,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,1141.2,6819.81,18 RC,481,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,992.6,3083.0,14 RC,481,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,1167.76,8126.28,17 RC,481,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,1167.76,7895.92,17 RC,481,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,1167.76,7895.92,17 RC,481,Remove interim implant component ,,,12018.0,12018.0,1 RC,481,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,3390.0,34224.02,5 RC,481,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,3390.0,28888.97,5 RC,481,"Renal autotransplantation, reimplantation of kidney ",,,3390.0,23850.8,5 RC,481,Renal biopsy; by surgical exposure of kidney ,,,3390.0,16207.0,5 RC,481,"Renal biopsy; percutaneous, by trocar or needle ",,,521.99,3747.2,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1812.83,11552.32,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1986.0,22025.45,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,1986.0,22025.45,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,1812.83,11552.32,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,2012.0,22025.45,18 RC,481,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,1812.83,11552.32,18 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1226.38,8240.61,18 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1226.38,4836.33,18 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,1812.83,11552.32,6 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,1812.83,11552.32,18 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1812.83,11552.32,18 RC,481,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,255.54,3083.0,18 RC,481,"Renal exploration, not necessitating other specific procedures ",,,3390.0,16207.0,5 RC,481,Reopening of recent laparotomy ,,,3390.0,16207.0,5 RC,481,Repair incomplete circumcision ,,,700.49,5571.0,18 RC,481,"Repair inguinal hernia, sliding, any age ",,,1235.65,8488.5,18 RC,481,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1235.65,8488.5,18 RC,481,"Repair initial femoral hernia, any age; reducible ",,,1235.65,8488.5,18 RC,481,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1235.65,8488.5,18 RC,481,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1235.65,8488.5,18 RC,481,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,1235.65,8488.5,18 RC,481,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,1235.65,8488.5,18 RC,481,Repair lumbar hernia ,,,2026.81,13196.03,18 RC,481,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,30936.73,13 RC,481,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,1235.65,14229.17,101 RC,481,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,2026.81,15238.19,99 RC,481,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,749.3,5571.0,18 RC,481,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,749.3,5571.0,18 RC,481,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,749.3,5571.0,18 RC,481,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,1184.02,8536.87,18 RC,481,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,749.3,5571.0,18 RC,481,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,1184.02,8536.87,18 RC,481,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,749.3,5571.0,18 RC,481,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1645.49,10424.04,18 RC,481,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,11552.32,17 RC,481,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,481,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,3390.0,16207.0,5 RC,481,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,3390.0,16207.0,5 RC,481,Repair of ectropion; excision tarsal wedge ,,,749.3,5571.0,18 RC,481,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,749.3,5283.1,18 RC,481,Repair of ectropion; suture ,,,749.3,5571.0,18 RC,481,Repair of ectropion; thermocauterization ,,,215.08,5571.0,18 RC,481,"Repair of encephalocele, skull vault, including cranioplasty ",,,3390.0,25541.17,5 RC,481,"Repair of enterocele, abdominal approach (separate procedure) ",,,3041.0,9494.97,5 RC,481,"Repair of enterocele, vaginal approach (separate procedure) ",,,1638.52,11661.3,18 RC,481,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,7303.41,13 RC,481,Repair of entropion; excision tarsal wedge ,,,749.3,5571.0,18 RC,481,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,749.3,5571.0,18 RC,481,Repair of entropion; suture ,,,749.3,5571.0,18 RC,481,Repair of entropion; thermocauterization ,,,206.17,5571.0,18 RC,481,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,1226.38,8240.61,18 RC,481,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,1812.83,11552.32,18 RC,481,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,1812.83,11552.32,18 RC,481,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1812.83,11552.32,18 RC,481,"Repair of iris, ciliary body (as for iridodialysis) ",,,912.02,5571.0,18 RC,481,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,400.16,6625.43,18 RC,481,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,2195.0,16207.0,17 RC,481,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,749.3,5571.0,18 RC,481,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,749.3,5571.0,18 RC,481,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,1645.49,10424.04,18 RC,481,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,1645.49,10424.04,18 RC,481,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,1184.02,8536.87,18 RC,481,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,2996.0,58759.16,17 RC,481,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,3390.0,16207.0,5 RC,481,Repair of meningocele; larger than 5 cm diameter ,,,3390.0,17246.03,5 RC,481,Repair of meningocele; less than 5 cm diameter ,,,3390.0,16207.0,5 RC,481,Repair of myelomeningocele; larger than 5 cm diameter ,,,3390.0,21315.24,5 RC,481,Repair of myelomeningocele; less than 5 cm diameter ,,,3390.0,19220.8,5 RC,481,Repair of omphalocele (Gross type operation); first stage ,,,3390.0,16207.0,5 RC,481,Repair of omphalocele (Gross type operation); second stage ,,,3390.0,16207.0,5 RC,481,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,3293.0,11247.24,16 RC,481,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,2996.0,9115.62,16 RC,481,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,177.94,5571.0,18 RC,481,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,147.63,4788.0,18 RC,481,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,443.53,7281.72,6 RC,481,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1645.49,10424.04,18 RC,481,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1645.49,10424.04,18 RC,481,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,Repair of scleral staphyloma with graft ,,,2188.03,10424.04,18 RC,481,"Repair of small omphalocele, with primary closure ",,,1235.65,8488.5,18 RC,481,"Repair of symblepharon; conjunctivoplasty, without graft ",,,912.02,5571.0,18 RC,481,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,749.3,5571.0,18 RC,481,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,1184.02,8536.87,18 RC,481,Repair of traumatic corporeal tear(s) ,,,1226.38,8240.61,18 RC,481,Repair of tunica vaginalis hydrocele (Bottle type) ,,,1226.38,8240.61,18 RC,481,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,1184.02,8536.87,18 RC,481,Repair oval window fistula ,,,951.37,7150.66,18 RC,481,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1235.65,8488.5,18 RC,481,Repair recurrent femoral hernia; reducible ,,,1235.65,8488.5,18 RC,481,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1235.65,8488.5,18 RC,481,"Repair recurrent inguinal hernia, any age; reducible ",,,1235.65,8488.5,18 RC,481,Repair round window fistula ,,,951.37,7150.66,18 RC,481,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,12367.1,12367.1,1 RC,481,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,1235.65,8488.5,36 RC,481,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,3293.0,8488.5,17 RC,481,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,2996.0,13196.03,17 RC,481,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,12367.1,12367.1,1 RC,481,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,3390.0,35621.26,17 RC,481,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,3390.0,34379.68,17 RC,481,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3390.0,16330.72,18 RC,481,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,3390.0,16207.0,5 RC,481,Replacement of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,5 RC,481,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,359.42,3083.0,18 RC,481,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,359.42,3083.0,18 RC,481,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,359.42,3083.0,18 RC,481,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,481,"Replacement or irrigation, subarachnoid/subdural catheter ",,,708.15,5571.0,18 RC,481,"Replacement or irrigation, ventricular catheter ",,,1986.0,15039.6,18 RC,481,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,2142.41,15039.6,18 RC,481,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,2699.0,15039.6,18 RC,481,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,481,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,912.02,5571.0,18 RC,481,Reprogramming of programmable cerebrospinal shunt ,,,32.08,5841.0,5 RC,481,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,4988.0,13593.12,5 RC,481,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,3390.0,19715.58,5 RC,481,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,3390.0,17377.93,5 RC,481,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,3390.0,21125.56,5 RC,481,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,481,Resection of scrotum ,,,1226.38,8240.61,18 RC,481,Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis ,,,3390.0,33988.93,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,3390.0,25388.68,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,3390.0,28901.33,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,3390.0,33774.54,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,3390.0,40115.5,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,3390.0,25623.66,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,3390.0,35333.01,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,3390.0,32088.28,5 RC,481,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,3390.0,39455.87,5 RC,481,"Resection temporal bone, external approach ",,,3390.0,31626.57,5 RC,481,Retrobulbar injection; alcohol ,,,37.42,5841.0,17 RC,481,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,28.22,5841.0,5 RC,481,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,15 RC,481,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,481,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,481,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,481,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,14 RC,481,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,14 RC,481,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,14 RC,481,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13524.17,14 RC,481,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,15 RC,481,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,15 RC,481,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,15 RC,481,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,2443.09,18300.83,6 RC,481,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,3390.0,16207.0,5 RC,481,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,1141.2,6819.81,18 RC,481,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,1986.0,54750.0,18 RC,481,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1986.0,54750.0,18 RC,481,Revision mastoidectomy; resulting in complete mastoidectomy ,,,2096.96,13241.95,18 RC,481,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,2096.96,13241.95,18 RC,481,Revision mastoidectomy; resulting in radical mastoidectomy ,,,2096.96,13241.95,18 RC,481,Revision mastoidectomy; resulting in tympanoplasty ,,,2096.96,13241.95,18 RC,481,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,912.02,9653.0,18 RC,481,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,912.02,9653.0,18 RC,481,Revision of peritoneal-venous shunt ,,,1235.65,8488.5,18 RC,481,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,1812.83,11552.32,18 RC,481,Revision of stapedectomy or stapedotomy ,,,2096.96,13241.95,18 RC,481,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,1226.38,8240.61,6 RC,481,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,3390.0,16207.0,5 RC,481,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,2195.0,16890.86,18 RC,481,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,18 RC,481,Revision or removal of intracranial neurostimulator electrodes ,,,1609.24,8595.41,6 RC,481,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,1986.0,27181.65,15 RC,481,Revision or removal of peripheral neurostimulator electrode array ,,,1609.24,8595.41,18 RC,481,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,18 RC,481,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,749.3,5571.0,18 RC,481,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,2699.0,9751.1,13 RC,481,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,2699.0,86066.14,13 RC,481,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,2195.0,16890.86,18 RC,481,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,2195.0,31349.63,17 RC,481,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,481,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,481,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,2699.0,56900.95,15 RC,481,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,481,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,481,Right ventricular recording ,,,2696.04,43890.0,6 RC,481,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,477.01,477.01,1 RC,481,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,12367.1,12367.1,1 RC,481,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,3390.0,27623.25,3 RC,481,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,3390.0,27986.02,3 RC,481,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,3390.0,24914.49,3 RC,481,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,3390.0,26143.15,3 RC,481,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,3 RC,481,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,481,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,481,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,481,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,9222.81,17 RC,481,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,9653.0,17 RC,481,Salpingostomy (salpingoneostomy) ,,,3041.0,6819.81,17 RC,481,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,12367.1,12367.1,1 RC,481,Scleral reinforcement (separate procedure); with graft ,,,912.02,5571.0,18 RC,481,Scleral reinforcement (separate procedure); without graft ,,,749.3,5571.0,18 RC,481,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,1665.33,3249.0,17 RC,481,"Scraping of cornea, diagnostic, for smear and/or culture ",,,992.6,5841.0,4 RC,481,Screening proctoscopy ,,,428.77,428.77,1 RC,481,Scrotal exploration ,,,1226.38,8240.61,18 RC,481,Scrotoplasty; complicated ,,,1812.83,11552.32,18 RC,481,Scrotoplasty; simple ,,,1226.38,8240.61,18 RC,481,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,3390.0,16207.0,5 RC,481,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,3390.0,17068.71,5 RC,481,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,481,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,481,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,912.02,5571.0,18 RC,481,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,1645.49,10424.04,18 RC,481,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,912.02,5571.0,18 RC,481,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,912.02,5571.0,18 RC,481,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,151.81,4390.0,18 RC,481,Severing of tarsorrhaphy ,,,183.0,3083.0,18 RC,481,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,223.54,3249.0,18 RC,481,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,118.2,5841.0,17 RC,481,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,297.65,5841.0,4 RC,481,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,481,Simultaneous pancreas kidney transplantation ,,,12367.1,12367.1,1 RC,481,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,2195.0,22025.45,20 RC,481,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,2218.81,16632.0,20 RC,481,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,700.49,5571.0,18 RC,481,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,1226.38,8240.61,18 RC,481,Snip incision of lacrimal punctum ,,,58.22,5841.0,17 RC,481,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,12367.1,12367.1,1 RC,481,Sperm washing for artificial insemination ,,,87.92,5841.0,4 RC,481,"Spinal puncture, lumbar, diagnostic; ",,,282.06,3083.0,18 RC,481,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,282.06,5841.0,17 RC,481,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,282.06,3083.0,18 RC,481,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,282.06,5841.0,17 RC,481,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2096.96,13241.95,18 RC,481,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2096.96,13241.95,18 RC,481,Stapes mobilization ,,,951.37,7150.66,18 RC,481,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,3390.0,17076.95,5 RC,481,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,3390.0,16689.36,5 RC,481,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,2431.0,18985.82,5 RC,481,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,3390.0,15039.6,5 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,29069.0,29069.0,1 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,29069.0,29069.0,1 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,29069.0,29069.0,1 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,29069.0,29069.0,1 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,29069.0,29069.0,1 RC,481,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,29069.0,29069.0,1 RC,481,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,1044.72,4693.83,18 RC,481,"Stimulated intrauterine insemination (iui), case rate ",,,12367.1,12367.1,1 RC,481,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,150.18,5841.0,4 RC,481,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,1672.0,5841.0,15 RC,481,"Strabismus surgery, any procedure, superior oblique muscle ",,,749.3,5571.0,18 RC,481,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,749.3,5571.0,18 RC,481,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,749.3,5571.0,18 RC,481,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,1184.02,8536.87,18 RC,481,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,749.3,5571.0,18 RC,481,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,481,Subconjunctival injection ,,,297.65,5841.0,4 RC,481,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,2431.0,14541.38,5 RC,481,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,282.06,4522.69,18 RC,481,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,282.06,4522.69,18 RC,481,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,3390.0,17076.95,5 RC,481,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,3390.0,5841.0,3 RC,481,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,17 RC,481,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,905.02,5841.0,3 RC,481,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,3390.0,26134.91,5 RC,481,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,3390.0,30344.37,5 RC,481,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,3390.0,30995.76,5 RC,481,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,51729.74,5 RC,481,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,57724.3,5 RC,481,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,3390.0,16207.0,5 RC,481,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,3390.0,44860.93,5 RC,481,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,3390.0,26250.34,5 RC,481,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,3390.0,56248.31,5 RC,481,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,3390.0,34281.68,5 RC,481,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,3390.0,50917.5,5 RC,481,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,3390.0,27252.14,5 RC,481,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,41537.95,5 RC,481,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,48769.52,5 RC,481,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,481,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,481,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,481,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,481,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,481,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,481,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,481,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,481,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,12367.1,12367.1,1 RC,481,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,3390.0,16207.0,5 RC,481,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,3390.0,16207.0,5 RC,481,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,3390.0,16207.0,5 RC,481,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,2699.0,9499.09,17 RC,481,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,2996.0,9511.44,17 RC,481,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,2096.96,13241.95,18 RC,481,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,2096.96,13241.95,18 RC,481,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,2142.41,15039.6,18 RC,481,Suture of 1 nerve; median motor thenar ,,,2142.41,15039.6,18 RC,481,Suture of 1 nerve; ulnar motor ,,,2142.41,15039.6,18 RC,481,"Suture of digital nerve, hand or foot; 1 nerve ",,,708.15,8104.0,18 RC,481,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Suture of facial nerve; extracranial ,,,2142.41,15039.6,18 RC,481,"Suture of facial nerve; infratemporal, with or without grafting ",,,2142.41,15039.6,18 RC,481,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,912.02,5571.0,18 RC,481,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,2142.41,15039.6,18 RC,481,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,2142.41,15039.6,18 RC,481,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,1672.0,5841.0,15 RC,481,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,1672.0,5841.0,15 RC,481,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,1672.0,5841.0,15 RC,481,Suture of posterior tibial nerve ,,,2142.41,15039.6,18 RC,481,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,749.3,5571.0,18 RC,481,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,208.24,5571.0,18 RC,481,Suture of sciatic nerve ,,,1257.87,8104.0,18 RC,481,Suture of; brachial plexus ,,,708.15,8104.0,18 RC,481,Suture of; lumbar plexus ,,,2142.41,15039.6,18 RC,481,Suture or repair of testicular injury ,,,1226.38,5571.0,18 RC,481,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,3390.0,16207.0,5 RC,481,"Sympathectomy, cervical ",,,708.15,4693.83,18 RC,481,"Sympathectomy, cervicothoracic ",,,2431.0,4693.83,5 RC,481,"Sympathectomy, lumbar ",,,3390.0,16207.0,5 RC,481,"Sympathectomy, thoracolumbar ",,,3390.0,16207.0,5 RC,481,"Sympathectomy; digital arteries, each digit ",,,708.15,5571.0,6 RC,481,Sympathectomy; radial artery ,,,1167.76,7473.24,18 RC,481,Sympathectomy; superficial palmar arch ,,,1167.76,7473.24,18 RC,481,Sympathectomy; ulnar artery ,,,1167.76,7473.24,18 RC,481,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,3390.0,16207.0,5 RC,481,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,481,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,481,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,481,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,481,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,359.7,3083.0,18 RC,481,Temporary transcutaneous pacing ,,,1464.54,2315.0,5 RC,481,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,3293.0,34379.68,17 RC,481,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,481,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,481,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,481,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,3390.0,16289.42,5 RC,481,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,3390.0,16207.0,5 RC,481,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,2996.0,13241.95,17 RC,481,"Thyroidectomy, including substernal thyroid; cervical approach ",,,2996.0,13241.95,17 RC,481,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,2431.0,16260.59,5 RC,481,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,3293.0,13241.95,17 RC,481,"Thyroidectomy, total or complete ",,,2026.81,13196.03,18 RC,481,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,12367.1,14 RC,481,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,3673.0,13241.95,17 RC,481,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,3041.0,19847.48,17 RC,481,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,3390.0,16207.0,17 RC,481,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,3390.0,16207.0,17 RC,481,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16371.9,17 RC,481,Total facial nerve decompression and/or repair (may include graft) ,,,2996.0,13241.95,17 RC,481,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,2026.81,13196.03,18 RC,481,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,2026.81,13196.03,18 RC,481,Trabeculoplasty by laser surgery ,,,117.34,3249.0,18 RC,481,Trabeculotomy ab externo ,,,912.02,5571.0,18 RC,481,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,1638.52,11661.3,18 RC,481,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,1141.2,6819.81,18 RC,481,"Transabdominal amnioinfusion, including ultrasound guidance ",,,739.07,5841.0,16 RC,481,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,481,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12367.1,13 RC,481,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,3375.0,27050.15,34 RC,481,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,3390.0,17567.61,5 RC,481,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,481,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3293.0,19655.45,15 RC,481,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,1986.0,17689.64,17 RC,481,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,3390.0,28901.33,5 RC,481,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,3390.0,35258.77,5 RC,481,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,708.15,4693.83,6 RC,481,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,4693.83,8104.0,5 RC,481,"Transection or avulsion of other cranial nerve, extradural ",,,708.15,5571.0,18 RC,481,"Transection or avulsion of other spinal nerve, extradural ",,,708.15,5571.0,18 RC,481,"Transection or avulsion of; facial nerve, differential or complete ",,,708.15,5571.0,18 RC,481,Transection or avulsion of; greater occipital nerve ,,,708.15,5571.0,18 RC,481,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,708.15,4693.83,18 RC,481,Transection or avulsion of; infraorbital nerve ,,,708.15,4693.83,18 RC,481,Transection or avulsion of; lingual nerve ,,,708.15,5571.0,18 RC,481,Transection or avulsion of; mental nerve ,,,708.15,4693.83,18 RC,481,Transection or avulsion of; phrenic nerve ,,,708.15,4693.83,18 RC,481,Transection or avulsion of; supraorbital nerve ,,,708.15,4693.83,18 RC,481,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,3390.0,16207.0,5 RC,481,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,3390.0,16207.0,5 RC,481,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,5 RC,481,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,3390.0,16207.0,5 RC,481,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,481,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,481,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,3293.0,10424.04,17 RC,481,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,3293.0,10424.04,17 RC,481,Transmastoid antrotomy (simple mastoidectomy) ,,,2096.96,13241.95,18 RC,481,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,3390.0,30352.61,5 RC,481,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,3390.0,49948.64,5 RC,481,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,1672.0,5841.0,15 RC,481,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,2573.7,16330.72,18 RC,481,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,2573.7,16330.72,18 RC,481,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,1986.0,11552.32,17 RC,481,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1812.83,25988.0,20 RC,481,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,3390.0,34178.6,5 RC,481,Transplantation of multivisceral organs ,,,12367.1,12367.1,1 RC,481,Transplantation of pancreatic allograft ,,,3390.0,30468.04,3 RC,481,Transplantation of small intestine and liver allografts ,,,12367.1,12367.1,1 RC,481,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,1226.38,8240.61,18 RC,481,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,"Transposition, ovary(s) ",,,2699.0,8109.7,17 RC,481,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,3390.0,28093.21,5 RC,481,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,3390.0,16207.0,5 RC,481,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,1114.61,19718.21,18 RC,481,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,1226.38,5841.0,17 RC,481,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,1065.59,18816.77,18 RC,481,Transurethral drainage of prostatic abscess ,,,1226.38,8240.61,18 RC,481,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1812.83,11552.32,18 RC,481,Transurethral incision of prostate ,,,1226.38,8240.61,18 RC,481,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,2195.0,11308.65,17 RC,481,Transurethral resection of bladder neck (separate procedure) ,,,1226.38,8240.61,18 RC,481,Transurethral resection; of postoperative bladder neck contracture ,,,1226.38,8240.61,18 RC,481,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1812.83,11552.32,18 RC,481,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,2195.0,26403.19,13 RC,481,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,61.77,5841.0,16 RC,481,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,55.01,5841.0,16 RC,481,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,50.92,5841.0,16 RC,481,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,44.44,5841.0,16 RC,481,Transvesical ureterolithotomy ,,,4836.33,9653.0,5 RC,481,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,152.69,3083.0,18 RC,481,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,223.54,3667.92,18 RC,481,"Treatment of incomplete abortion, any trimester, completed surgically ",,,1141.2,6819.81,18 RC,481,"Treatment of missed abortion, completed surgically; first trimester ",,,1141.2,6819.81,18 RC,481,"Treatment of missed abortion, completed surgically; second trimester ",,,1141.2,6819.81,18 RC,481,"Treatment of septic abortion, completed surgically ",,,2195.0,16207.0,17 RC,481,"Trimming of dystrophic nails, any number ",,,150.18,2358.0,3 RC,481,Tubotubal anastomosis ,,,3293.0,10513.36,17 RC,481,Tubouterine implantation ,,,3293.0,10484.42,17 RC,481,Twist drill hole for subdural or ventricular puncture ,,,3390.0,16207.0,5 RC,481,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,3390.0,16207.0,5 RC,481,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,3390.0,16207.0,5 RC,481,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,3390.0,16207.0,5 RC,481,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,3390.0,27573.83,20 RC,481,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,187.75,5571.0,18 RC,481,Tympanic neurectomy ,,,951.37,7150.66,18 RC,481,"Tympanolysis, transcanal ",,,951.37,9653.0,18 RC,481,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2096.96,13241.95,18 RC,481,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2096.96,13241.95,18 RC,481,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2096.96,13241.95,18 RC,481,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,451.36,4220.0,18 RC,481,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,126.26,5841.0,17 RC,481,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,481,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,481,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,481,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,481,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,1235.65,8488.5,18 RC,481,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,481,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,481,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,481,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,453.32,5841.0,16 RC,481,"Unlisted hysteroscopy procedure, uterus ",,,453.32,5841.0,4 RC,481,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, bladder ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13196.03,17 RC,481,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, renal ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, testis ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13196.03,5 RC,481,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13196.03,5 RC,481,"Unlisted procedure, abdomen, peritoneum and omentum ",,,1986.0,7014.0,17 RC,481,"Unlisted procedure, anterior segment of eye ",,,1986.0,5519.68,17 RC,481,"Unlisted procedure, conjunctiva ",,,738.44,5841.0,4 RC,481,"Unlisted procedure, endocrine system ",,,1986.0,13196.03,17 RC,481,"Unlisted procedure, external ear ",,,555.94,5841.0,4 RC,481,"Unlisted procedure, extraocular muscle ",,,738.44,5841.0,4 RC,481,"Unlisted procedure, eyelids ",,,738.44,5841.0,4 RC,481,"Unlisted procedure, female genital system (nonobstetrical) ",,,453.32,5841.0,16 RC,481,"Unlisted procedure, inner ear ",,,555.94,5841.0,16 RC,481,"Unlisted procedure, lacrimal system ",,,738.44,5841.0,4 RC,481,"Unlisted procedure, male genital system ",,,641.28,5841.0,16 RC,481,"Unlisted procedure, maternity care and delivery ",,,453.32,5841.0,16 RC,481,"Unlisted procedure, middle ear ",,,555.94,5841.0,16 RC,481,"Unlisted procedure, nervous system ",,,714.63,5841.0,16 RC,481,"Unlisted procedure, orbit ",,,738.44,5841.0,4 RC,481,"Unlisted procedure, pancreas ",,,1665.33,5841.0,4 RC,481,"Unlisted procedure, posterior segment ",,,2431.0,5519.68,5 RC,481,"Unlisted procedure, temporal bone, middle fossa approach ",,,555.94,5841.0,16 RC,481,"Unlisted procedure, urinary system ",,,641.28,5841.0,16 RC,481,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,1672.0,5841.0,15 RC,481,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1226.38,8240.61,18 RC,481,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,1226.38,8240.61,18 RC,481,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1226.38,8240.61,18 RC,481,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1812.83,11552.32,18 RC,481,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,1226.38,8240.61,18 RC,481,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,3375.0,16207.0,17 RC,481,"Ureterectomy, with bladder cuff (separate procedure) ",,,3375.0,16207.0,17 RC,481,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,3390.0,16207.0,5 RC,481,"Ureterocolon conduit, including intestine anastomosis ",,,3390.0,16207.0,5 RC,481,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,3390.0,16207.0,5 RC,481,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,3390.0,16207.0,5 RC,481,Ureterolithotomy; lower one-third of ureter ,,,3293.0,16207.0,17 RC,481,Ureterolithotomy; middle one-third of ureter ,,,3293.0,16207.0,17 RC,481,Ureterolithotomy; upper one-third of ureter ,,,3293.0,16207.0,17 RC,481,Ureterolysis for ovarian vein syndrome ,,,3390.0,16207.0,5 RC,481,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,3390.0,16207.0,5 RC,481,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,3390.0,16207.0,5 RC,481,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,3390.0,16207.0,5 RC,481,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,3390.0,16207.0,5 RC,481,Ureteroneocystostomy; with extensive ureteral tailoring ,,,3390.0,16207.0,5 RC,481,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,3390.0,16207.0,5 RC,481,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,3390.0,16207.0,5 RC,481,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,3390.0,16207.0,5 RC,481,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,3390.0,16207.0,5 RC,481,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,3390.0,16726.54,5 RC,481,"Ureterostomy, transplantation of ureter to skin ",,,3390.0,16207.0,5 RC,481,"Ureterotomy for insertion of indwelling stent, all types ",,,3293.0,16207.0,17 RC,481,Ureterotomy with exploration or drainage (separate procedure) ,,,3293.0,16207.0,17 RC,481,Ureteroureterostomy ,,,3390.0,16207.0,5 RC,481,"Urethrectomy, total, including cystostomy; female ",,,1226.38,8240.61,18 RC,481,"Urethrectomy, total, including cystostomy; male ",,,1812.83,11552.32,18 RC,481,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,3293.0,8240.61,17 RC,481,"Urethromeatoplasty, with mucosal advancement ",,,1226.38,8240.61,18 RC,481,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,1226.38,8240.61,18 RC,481,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,1812.83,11552.32,18 RC,481,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,1226.38,8240.61,18 RC,481,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,1812.83,11552.32,18 RC,481,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,1226.38,8240.61,18 RC,481,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,1812.83,11552.32,18 RC,481,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,1812.83,11552.32,18 RC,481,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,1812.83,11552.32,18 RC,481,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,1812.83,11552.32,18 RC,481,"Urethroplasty, reconstruction of female urethra ",,,1812.83,11552.32,18 RC,481,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,6326.0,13481.81,5 RC,481,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,1812.83,11552.32,18 RC,481,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,1812.83,11552.32,18 RC,481,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,1226.38,8240.61,18 RC,481,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,1812.83,11552.32,18 RC,481,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,1812.83,11552.32,18 RC,481,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,1812.83,11552.32,18 RC,481,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,700.49,5571.0,18 RC,481,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,1812.83,11552.32,18 RC,481,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,3390.0,21500.79,5 RC,481,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,481,Uterine evacuation and curettage for hydatidiform mole ,,,1141.2,6819.81,18 RC,481,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,3293.0,16207.0,17 RC,481,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,3390.0,16207.0,5 RC,481,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,481,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,481,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,1986.0,6819.81,17 RC,481,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,1986.0,12343.87,15 RC,481,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,2699.0,6819.81,17 RC,481,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,3390.0,13465.34,3 RC,481,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1638.52,11661.3,18 RC,481,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,4988.0,12306.81,5 RC,481,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,1638.52,11661.3,18 RC,481,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,3293.0,11661.3,17 RC,481,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,3293.0,11661.3,17 RC,481,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,3293.0,18300.83,17 RC,481,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3293.0,11661.3,17 RC,481,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,3293.0,18300.83,17 RC,481,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,3293.0,11661.3,17 RC,481,"Vaginal hysterectomy, radical (Schauta type operation) ",,,3390.0,17258.38,5 RC,481,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,4988.0,11511.04,5 RC,481,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,4988.0,12257.27,5 RC,481,"Vaginectomy, complete removal of vaginal wall; ",,,2699.0,16207.0,17 RC,481,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2699.0,21018.37,17 RC,481,"Vaginectomy, partial removal of vaginal wall; ",,,2699.0,6819.81,17 RC,481,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2195.0,6819.81,17 RC,481,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,1986.0,6819.81,17 RC,481,Vaginoplasty for intersex state ,,,2699.0,11661.3,17 RC,481,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,17 RC,481,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,700.49,5571.0,18 RC,481,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,1672.0,5841.0,15 RC,481,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,2195.0,8240.61,17 RC,481,"Vasovasostomy, vasovasorrhaphy ",,,1986.0,8240.61,17 RC,481,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,481,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,481,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,481,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,481,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,481,Ventilating tube removal requiring general anesthesia ,,,87.05,5849.0,18 RC,481,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,282.06,3083.0,18 RC,481,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,365.66,3083.0,18 RC,481,Ventriculocisternostomy (Torkildsen type operation) ,,,3390.0,19406.36,5 RC,481,"Ventriculocisternostomy, third ventricle; ",,,3390.0,16611.11,5 RC,481,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,3390.0,16207.0,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,3203.43,16207.0,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,3390.0,21084.38,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,3104.47,16207.0,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,3390.0,28992.05,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,3390.0,16207.0,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,3390.0,22106.88,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,26052.43,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,3390.0,26101.96,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,3390.0,26456.49,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,3390.0,27837.64,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,29272.44,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,3390.0,28963.22,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,3390.0,30426.85,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,3390.0,27961.3,15 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,2135.62,23492.15,10 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,2300.58,16207.0,5 RC,481,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,3390.0,23083.98,5 RC,481,"Vesiculectomy, any approach ",,,1986.0,8542.59,17 RC,481,Vesiculotomy; ,,,700.49,11308.65,18 RC,481,Vesiculotomy; complicated ,,,1986.0,6225.53,17 RC,481,"Vestibular nerve section, transcranial approach ",,,3390.0,20865.87,5 RC,481,"Vestibular nerve section, translabyrinthine approach ",,,951.37,9653.0,18 RC,481,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,481,"Vitrectomy, mechanical, pars plana approach; ",,,1645.49,10424.04,18 RC,481,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1645.49,10424.04,18 RC,481,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1645.49,10424.04,18 RC,481,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1645.49,10424.04,18 RC,481,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1645.49,10424.04,18 RC,481,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1645.49,10424.04,18 RC,481,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,481,Vulvectomy simple; complete ,,,1141.2,6819.81,18 RC,481,Vulvectomy simple; partial ,,,1141.2,6819.81,18 RC,481,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,3390.0,17975.67,5 RC,481,"Vulvectomy, radical, complete; ",,,9875.0,14578.45,5 RC,481,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,18111.81,5 RC,481,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,15621.55,5 RC,481,"Vulvectomy, radical, partial; ",,,3390.0,16207.0,17 RC,481,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,16771.84,5 RC,481,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,14211.57,5 RC,481,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,2699.0,18300.83,17 RC,481,Wound closure utilizing tissue adhesive(s) only ,,,272.16,2358.0,3 RC,482, Cardiology Stress Test ,,,2549.0,3638.0,2 RC,483, Cardiology Echocardiology ,,,1530.0,2183.0,2 RC,483,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,483,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,483,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,483,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,483,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,483,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,483,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,483,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,483,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,483,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,483,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,483,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,483,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,483,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,483,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,483,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,483,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,483,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,483,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,483,Bone age studies ,,,26.58,26.58,1 RC,483,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,483,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,483,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,483,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,483,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,483,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,483,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,483,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,483,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,483,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,483,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,483,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,483,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,483,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,483,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,483,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,483,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,483,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,483,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,483,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,483,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,483,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,483,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,483,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,483,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,483,Cardiac shunt detection ,,,186.76,186.76,1 RC,483,Cardiokymography ,,,20.04,20.04,1 RC,483,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,483,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,483,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,483,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,483,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,483,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,483,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,483,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,483,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,483,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,483,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,483,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,483,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,483,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,483,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,483,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,483,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,483,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,483,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,483,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,483,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,483,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,483,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,483,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,483,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,483,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,483,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,483,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,483,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,483,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,483,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,483,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,483,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,483,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,483,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,483,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,483,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,483,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,483,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,483,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,483,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,483,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,483,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,483,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,483,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,483,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,483,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,483,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,483,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,483,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,483,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,483,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,483,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,483,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,483,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,483,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,483,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,483,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,483,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,483,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,483,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,483,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,483,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,483,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,483,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,483,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,483,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,483,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,483,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,483,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,483,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,483,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,483,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,483,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,483,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,483,Esophageal motility ,,,214.04,214.04,1 RC,483,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,483,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,483,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,483,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,483,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,483,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,483,Gastric mucosa imaging ,,,205.51,205.51,1 RC,483,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,483,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,483,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,483,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,483,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,483,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,483,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,483,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,483,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,483,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,483,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,483,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,483,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,483,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,483,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,483,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,483,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,483,Kidney imaging morphology; ,,,172.11,172.11,1 RC,483,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,483,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,483,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,483,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,483,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,483,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,483,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,483,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,483,Liver imaging; static only ,,,191.2,191.2,1 RC,483,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,483,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,483,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,483,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,483,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,483,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,483,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,483,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,483,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,483,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,483,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,288.33,1 RC,483,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,208.23,1 RC,483,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,339.46,1 RC,483,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,400.45,1 RC,483,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,483,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,483,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,483,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,483,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,286.62,1 RC,483,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,361.95,1 RC,483,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,286.97,1 RC,483,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,360.24,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,293.44,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,202.45,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,288.33,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,203.12,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,291.06,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,202.45,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,341.15,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,340.48,1 RC,483,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,341.84,1 RC,483,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,483,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,483,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,483,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,483,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,241.98,1 RC,483,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,229.03,1 RC,483,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,350.71,1 RC,483,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,261.74,1 RC,483,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,229.38,1 RC,483,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,367.74,1 RC,483,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,238.19,1 RC,483,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,483,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,483,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,483,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,483,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,483,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,483,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,483,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,483,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,483,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,483,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,483,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,483,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,483,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,483,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,483,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,483,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,483,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,483,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,483,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,483,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,483,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,483,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,483,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,483,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,483,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,483,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,483,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,483,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,483,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,483,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,483,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,483,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,483,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,483,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,483,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,483,Platelet survival study ,,,126.1,126.1,1 RC,483,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,483,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,483,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,483,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,483,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,483,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,483,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,483,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,483,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,483,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,483,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,483,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,483,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,483,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,483,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,483,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,483,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,483,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,483,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,483,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,483,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,483,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,483,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,483,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,483,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,483,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,483,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,483,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,483,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,483,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,483,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,483,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,483,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,483,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,483,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,483,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,483,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,483,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,483,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,483,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,483,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,483,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,483,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,483,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,483,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,483,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,483,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,483,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,483,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,483,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,483,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,483,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,483,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,483,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,483,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,483,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,483,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,483,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,483,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,483,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,483,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,483,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,483,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,483,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,483,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,483,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,483,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,483,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,483,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,483,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,483,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,483,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,483,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,483,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,483,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,483,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,483,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,483,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,483,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,483,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,483,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,483,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,483,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,483,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,483,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,483,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,483,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,483,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,483,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,483,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,483,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,483,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,483,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,483,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,483,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,483,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,483,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,483,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,483,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,483,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,483,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,483,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,483,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,483,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,483,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,483,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,483,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,483,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,483,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,483,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,483,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,483,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,483,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,483,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,483,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,483,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,483,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,483,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,483,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,483,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,483,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,483,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,483,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,483,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,483,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,483,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,483,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,483,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,483,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,483,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,483,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,483,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,483,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,483,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,483,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,483,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,483,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,483,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,483,Red cell survival study ,,,126.1,126.1,1 RC,483,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,483,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,483,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,483,Salivary gland function study ,,,104.3,104.3,1 RC,483,Salivary gland imaging; ,,,175.52,175.52,1 RC,483,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,483,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,483,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,483,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,483,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,483,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,483,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,483,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,483,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,483,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,483,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,483,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,483,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,483,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,483,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,483,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,483,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,483,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,483,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,483,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,483,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,483,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,483,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,483,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,483,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,483,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,483,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,483,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,483,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,483,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,483,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,483,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,483,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,483,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,483,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,483,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,483,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,483,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,483,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,483,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,483,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,483,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,483,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,483,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,483,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,483,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,483,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,483,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,483,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,483,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,483,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,483,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,483,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,483,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,483,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,483,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,483,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,483,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,483,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,483,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,483,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,483,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,483,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,483,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,483,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,483,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,483,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,483,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,483,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,483,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,483,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,483,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,483,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,483,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,483,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,483,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,483,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,483,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,483,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,483,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,483,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,483,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,483,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,483,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,483,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,483,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,483,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,489, Cardiology Other ,,,2331.0,3326.0,2 RC,490, Ambulatory Surgical Care General Classification ,,,3673.0,5356.0,12 RC,490,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,490,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,490,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,490,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,490,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,490,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,948.0,12562.0,31 RC,490,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,948.0,12562.0,31 RC,490,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,948.0,12562.0,31 RC,490,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,948.0,12562.0,31 RC,490,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,490,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,948.0,13835.0,29 RC,490,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,490,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,490,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,490,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,490,Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance ,,,351.7,3249.0,31 RC,490,Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance ,,,351.7,3249.0,31 RC,490,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,948.0,13835.0,29 RC,490,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,948.0,3390.0,18 RC,490,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,948.0,4423.26,23 RC,490,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,948.0,15059.0,28 RC,490,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,948.0,5802.38,23 RC,490,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,948.0,35469.31,23 RC,490,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,948.0,13196.03,31 RC,490,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,948.0,29647.99,22 RC,490,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,948.0,16207.0,29 RC,490,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,948.0,22967.79,31 RC,490,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,490,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,490,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,490,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,490,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,948.0,16207.0,29 RC,490,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,948.0,16207.0,17 RC,490,Amniocentesis; diagnostic ,,,52.04,3083.0,28 RC,490,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,27 RC,490,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,18546.34,17 RC,490,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,948.0,16207.0,17 RC,490,Amputation of penis; complete ,,,948.0,13835.0,29 RC,490,Amputation of penis; partial ,,,948.0,8240.61,31 RC,490,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,948.0,32129.73,17 RC,490,Anastomosis; facial-hypoglossal ,,,948.0,16207.0,17 RC,490,Anastomosis; facial-spinal accessory ,,,948.0,16207.0,17 RC,490,Anorectal manometry ,,,1672.0,2358.0,4 RC,490,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,490,Antepartum care only; 4-6 visits ,,,948.0,5841.0,12 RC,490,Antepartum care only; 7 or more visits ,,,948.0,7624.48,12 RC,490,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,948.0,13394.0,31 RC,490,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,948.0,13835.0,29 RC,490,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,948.0,13835.0,29 RC,490,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,490,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,490,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,490,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,490,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,490,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,490,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,490,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,490,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,490,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,490,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,948.0,1915.7,10 RC,490,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,948.0,13394.0,31 RC,490,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,948.0,15059.0,31 RC,490,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,490,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,490,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,490,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,490,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,490,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,490,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,490,Artificial insemination; intra-cervical ,,,315.3,5841.0,16 RC,490,Artificial insemination; intra-uterine ,,,333.49,5841.0,16 RC,490,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,31 RC,490,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,31 RC,490,Aspiration of bladder; by needle ,,,38.37,3244.0,31 RC,490,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,31 RC,490,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,31 RC,490,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,26 RC,490,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,490,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,490,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,490,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,490,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,8 RC,490,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,948.0,16207.0,17 RC,490,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,948.0,16207.0,17 RC,490,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,948.0,16207.0,17 RC,490,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,948.0,17385.04,17 RC,490,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,948.0,18626.9,17 RC,490,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,948.0,17224.05,17 RC,490,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,490,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,490,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,948.0,16207.0,17 RC,490,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,948.0,5841.0,20 RC,490,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,948.0,29900.51,17 RC,490,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,948.0,24971.42,17 RC,490,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,948.0,27115.97,17 RC,490,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,948.0,16944.28,17 RC,490,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,948.0,12562.0,31 RC,490,Biopsy external auditory canal ,,,99.71,13835.0,19 RC,490,Biopsy external ear ,,,57.56,5841.0,18 RC,490,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,31 RC,490,Biopsy of conjunctiva ,,,113.96,12562.0,31 RC,490,Biopsy of cornea ,,,733.22,5283.1,31 RC,490,"Biopsy of epididymis, needle ",,,510.77,3747.2,31 RC,490,Biopsy of extraocular muscle ,,,948.0,8536.87,31 RC,490,Biopsy of lacrimal gland ,,,733.22,5571.0,31 RC,490,Biopsy of lacrimal sac ,,,733.22,5571.0,31 RC,490,Biopsy of nerve ,,,692.94,5571.0,31 RC,490,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,948.0,12562.0,31 RC,490,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,31 RC,490,Biopsy of penis; deep structures ,,,855.96,6330.57,31 RC,490,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,31 RC,490,"Biopsy of testis, incisional (separate procedure) ",,,948.0,8240.61,31 RC,490,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,31 RC,490,Biopsy of urethra ,,,685.44,5571.0,31 RC,490,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,948.0,6819.81,31 RC,490,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,31 RC,490,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,30 RC,490,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,31 RC,490,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle ",,,510.77,3747.2,31 RC,490,"Biopsy, prostate, any approach, nonimaging-guided ",,,948.0,4836.33,31 RC,490,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,948.0,3083.0,17 RC,490,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,948.0,14954.75,22 RC,490,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,948.0,14954.75,22 RC,490,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,948.0,9831.63,22 RC,490,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,8 RC,490,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,18 RC,490,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,30 RC,490,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,30 RC,490,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,490,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,490,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,490,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,490,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,490,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,490,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,490,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,490,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,490,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,490,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,490,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,490,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,490,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,490,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,490,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,490,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,490,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,490,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,490,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,490,Bundle of His recording ,,,3673.0,43890.0,22 RC,490,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,948.0,16207.0,17 RC,490,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,948.0,16207.0,17 RC,490,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,948.0,16207.0,17 RC,490,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,948.0,16207.0,17 RC,490,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,948.0,16868.07,17 RC,490,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,948.0,16207.0,17 RC,490,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,948.0,16207.0,17 RC,490,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,948.0,16207.0,17 RC,490,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,948.0,16207.0,17 RC,490,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,490,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,490,CIRCUMCISION ,,,3390.0,5841.0,2 RC,490,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,490,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,490,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,490,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,490,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,490,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,490,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,490,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,31 RC,490,Canthotomy (separate procedure) ,,,733.22,5571.0,31 RC,490,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,490,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,490,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,490,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,490,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,490,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,490,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,490,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,490,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,948.0,5841.0,20 RC,490,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,490,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,490,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,600.2,3390.0,23 RC,490,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,30 RC,490,Cautery of cervix; electro or thermal ,,,83.14,13835.0,31 RC,490,Cautery of cervix; laser ablation ,,,948.0,6819.81,31 RC,490,"Cerclage of cervix, during pregnancy; abdominal ",,,948.0,16207.0,29 RC,490,"Cerclage of cervix, during pregnancy; vaginal ",,,948.0,6819.81,31 RC,490,"Cerclage of uterine cervix, nonobstetrical ",,,948.0,6819.81,29 RC,490,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,948.0,13835.0,15 RC,490,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,948.0,15889.05,12 RC,490,Cesarean delivery only; ,,,948.0,13835.0,15 RC,490,Cesarean delivery only; including postpartum care ,,,948.0,15427.0,24 RC,490,Change of cystostomy tube; complicated ,,,250.06,3390.0,31 RC,490,Change of cystostomy tube; simple ,,,54.36,5841.0,30 RC,490,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,685.44,4836.33,31 RC,490,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,490,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,490,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,490,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,30 RC,490,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,30 RC,490,Chemodenervation of extraocular muscle ,,,107.27,5841.0,30 RC,490,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,31 RC,490,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,30 RC,490,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,30 RC,490,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,31 RC,490,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,31 RC,490,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,31 RC,490,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,30 RC,490,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,31 RC,490,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,31 RC,490,"Chorionic villus sampling, any method ",,,52.32,3244.0,19 RC,490,"Chromotubation of oviduct, including materials ",,,948.0,12562.0,29 RC,490,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,31 RC,490,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,31 RC,490,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,31 RC,490,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,31 RC,490,Ciliary body destruction; diathermy ,,,892.44,5519.68,31 RC,490,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,31 RC,490,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,31 RC,490,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,31 RC,490,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,31 RC,490,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,31 RC,490,Clitoroplasty for intersex state ,,,948.0,13835.0,19 RC,490,Closure of cystostomy (separate procedure) ,,,948.0,8240.61,31 RC,490,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,31 RC,490,Closure of nephrocutaneous or pyelocutaneous fistula ,,,948.0,14240.3,29 RC,490,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,948.0,18071.71,17 RC,490,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,948.0,19372.84,17 RC,490,Closure of rectovaginal fistula; abdominal approach ,,,948.0,16207.0,29 RC,490,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,948.0,16207.0,17 RC,490,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,948.0,13835.0,17 RC,490,Closure of rectovaginal fistula; vaginal or transanal approach ,,,948.0,12562.0,31 RC,490,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,30 RC,490,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,30 RC,490,Closure of ureterocutaneous fistula ,,,948.0,16207.0,17 RC,490,Closure of ureterovisceral fistula (including visceral repair) ,,,948.0,16207.0,17 RC,490,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,948.0,11552.32,31 RC,490,Closure of urethrovaginal fistula; ,,,948.0,18300.83,31 RC,490,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,948.0,13835.0,29 RC,490,Closure of vesicouterine fistula; ,,,948.0,13835.0,29 RC,490,Closure of vesicouterine fistula; with hysterectomy ,,,948.0,16207.0,17 RC,490,"Closure of vesicovaginal fistula, abdominal approach ",,,948.0,13835.0,29 RC,490,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,948.0,18300.83,17 RC,490,Closure of vesicovaginal fistula; vaginal approach ,,,948.0,12562.0,31 RC,490,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,31 RC,490,"Closure, exstrophy of bladder ",,,948.0,20139.94,17 RC,490,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,27 RC,490,"Cochlear device implantation, with or without mastoidectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,490,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,490,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,25 RC,490,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,25 RC,490,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,22 RC,490,Colpocentesis (separate procedure) ,,,948.0,11661.3,31 RC,490,Colpocleisis (Le Fort type) ,,,948.0,13835.0,31 RC,490,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,948.0,6819.81,31 RC,490,"Colpopexy, abdominal approach ",,,948.0,13835.0,29 RC,490,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,948.0,18300.83,29 RC,490,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,948.0,18300.83,29 RC,490,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,490,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,948.0,6819.81,31 RC,490,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,30 RC,490,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,30 RC,490,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,30 RC,490,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,30 RC,490,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,31 RC,490,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,31 RC,490,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,30 RC,490,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,31 RC,490,Colposcopy of the vulva; ,,,57.86,5841.0,30 RC,490,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,30 RC,490,Colpotomy; with drainage of pelvic abscess ,,,948.0,6819.81,31 RC,490,Colpotomy; with exploration ,,,948.0,6819.81,31 RC,490,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,948.0,13394.0,31 RC,490,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,948.0,12909.0,31 RC,490,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,490,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,490,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,490,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,490,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,31 RC,490,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,31 RC,490,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,31 RC,490,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,31 RC,490,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,283.62,5841.0,16 RC,490,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,490,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,490,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,490,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,490,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,490,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,490,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,948.0,5841.0,8 RC,490,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,948.0,6819.81,31 RC,490,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,948.0,6819.81,31 RC,490,Conjunctival flap; bridge or partial (separate procedure) ,,,948.0,8536.87,31 RC,490,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,31 RC,490,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,31 RC,490,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,948.0,8536.87,31 RC,490,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,948.0,8536.87,31 RC,490,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,31 RC,490,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,948.0,8536.87,31 RC,490,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,948.0,8536.87,31 RC,490,Construction of artificial vagina; with graft ,,,948.0,13835.0,29 RC,490,Construction of artificial vagina; without graft ,,,948.0,13394.0,31 RC,490,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,31 RC,490,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,31 RC,490,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,490,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,948.0,20377.26,17 RC,490,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,490,Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure) ,,,948.0,5841.0,20 RC,490,"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i",,,477.73,5841.0,28 RC,490,"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,31 RC,490,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,490,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,31 RC,490,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,490,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,490,"Cordocentesis (intrauterine), any method ",,,554.98,5841.0,16 RC,490,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,31 RC,490,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,31 RC,490,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,948.0,16207.0,17 RC,490,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,948.0,8240.61,31 RC,490,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,948.0,8234.0,31 RC,490,"Correction of everted punctum, cautery ",,,113.7,5841.0,30 RC,490,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,31 RC,490,Correction of lid retraction ,,,733.22,12562.0,31 RC,490,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,18 RC,490,"Correction of trichiasis; epilation, by forceps only ",,,223.51,5841.0,16 RC,490,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,31 RC,490,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,31 RC,490,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,948.0,5841.0,8 RC,490,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,948.0,16330.72,17 RC,490,Craniectomy for craniosynostosis; multiple cranial sutures ,,,948.0,18444.62,17 RC,490,Craniectomy for craniosynostosis; single cranial suture ,,,948.0,16207.0,17 RC,490,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,948.0,46759.99,17 RC,490,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,948.0,34350.61,17 RC,490,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,948.0,36766.35,17 RC,490,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,948.0,39720.34,17 RC,490,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,948.0,22576.85,17 RC,490,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,948.0,25611.4,17 RC,490,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,948.0,25806.38,17 RC,490,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,948.0,24598.51,17 RC,490,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,948.0,19402.47,17 RC,490,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,948.0,29586.87,17 RC,490,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,948.0,29561.46,17 RC,490,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,948.0,26149.65,17 RC,490,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,948.0,23547.4,17 RC,490,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,948.0,24861.23,17 RC,490,"Craniectomy or craniotomy, exploratory; supratentorial ",,,948.0,20406.89,17 RC,490,Craniectomy or craniotomy; with excision of foreign body from brain ,,,948.0,23106.64,17 RC,490,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,948.0,24297.57,17 RC,490,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,948.0,41508.92,17 RC,490,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,948.0,38601.49,17 RC,490,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,948.0,26679.44,17 RC,490,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,948.0,25797.91,17 RC,490,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,948.0,27154.19,17 RC,490,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,948.0,24954.48,17 RC,490,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,948.0,26158.12,17 RC,490,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,948.0,23733.91,17 RC,490,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,948.0,23716.98,17 RC,490,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,948.0,27162.66,17 RC,490,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,948.0,31706.02,17 RC,490,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,948.0,23081.23,17 RC,490,Craniectomy; for osteomyelitis ,,,948.0,16207.0,17 RC,490,Craniectomy; with excision of tumor or other bone lesion of skull ,,,948.0,16194.11,29 RC,490,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,948.0,29832.65,17 RC,490,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,948.0,32278.14,17 RC,490,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,948.0,37546.15,17 RC,490,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,948.0,35702.54,17 RC,490,Cranioplasty for skull defect with reparative brain surgery ,,,948.0,17389.28,17 RC,490,Cranioplasty for skull defect; larger than 5 cm diameter ,,,948.0,16207.0,17 RC,490,Cranioplasty for skull defect; up to 5 cm diameter ,,,948.0,16207.0,17 RC,490,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,948.0,17787.71,17 RC,490,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,948.0,16207.0,17 RC,490,Craniotomy for craniosynostosis; bifrontal bone flap ,,,948.0,20945.15,17 RC,490,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,948.0,21263.02,17 RC,490,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,948.0,28586.68,17 RC,490,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,948.0,19673.77,17 RC,490,"Craniotomy for repair of encephalocele, skull base ",,,948.0,19381.3,17 RC,490,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,948.0,31883.95,17 RC,490,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,948.0,39423.75,17 RC,490,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,948.0,20105.95,17 RC,490,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,948.0,23733.91,17 RC,490,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,948.0,29514.78,17 RC,490,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,948.0,26730.36,17 RC,490,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,948.0,33180.84,17 RC,490,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,948.0,30709.95,17 RC,490,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,948.0,30913.39,17 RC,490,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,948.0,26158.12,17 RC,490,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,948.0,16207.0,17 RC,490,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,948.0,27493.23,17 RC,490,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,948.0,18843.05,17 RC,490,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,948.0,26577.72,17 RC,490,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,948.0,15039.6,17 RC,490,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,948.0,19834.77,17 RC,490,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,31 RC,490,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,31 RC,490,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,31 RC,490,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,948.0,16207.0,17 RC,490,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,948.0,15039.6,29 RC,490,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,490,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,490,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,948.0,16207.0,17 RC,490,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,948.0,16207.0,17 RC,490,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,490,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,948.0,24948.0,31 RC,490,"Curettage, postpartum ",,,948.0,12562.0,31 RC,490,Cutaneous appendico-vesicostomy ,,,948.0,16207.0,17 RC,490,Cutaneous vesicostomy ,,,948.0,13835.0,17 RC,490,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,948.0,28891.85,17 RC,490,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,948.0,23721.21,17 RC,490,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,26849.02,17 RC,490,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,948.0,23212.59,17 RC,490,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,25874.23,17 RC,490,"Cystectomy, complete; (separate procedure) ",,,948.0,18071.71,17 RC,490,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,22360.7,17 RC,490,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,948.0,16207.0,17 RC,490,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,948.0,16207.0,17 RC,490,"Cystectomy, partial; simple ",,,948.0,16207.0,17 RC,490,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,490,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,490,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,490,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,490,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,948.0,11552.32,31 RC,490,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,948.0,16207.0,29 RC,490,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,948.0,13835.0,29 RC,490,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,948.0,13835.0,29 RC,490,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,31 RC,490,"Cystotomy for excision, incision, or repair of ureterocele ",,,948.0,13835.0,17 RC,490,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,948.0,8240.61,31 RC,490,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,7 RC,490,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,948.0,8240.61,31 RC,490,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,31 RC,490,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,948.0,13835.0,17 RC,490,Cystotomy; for excision of bladder tumor ,,,948.0,13835.0,17 RC,490,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,948.0,8240.61,31 RC,490,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,948.0,16207.0,29 RC,490,Cystourethroscopy ,,,3390.0,5841.0,2 RC,490,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,26 RC,490,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,26 RC,490,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus High Cost Surgery",,,2369.0,2369.0,5 RC,490,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,26 RC,490,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus High Cost Surgery,,,2369.0,2369.0,5 RC,490,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,26 RC,490,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material High Cost Surgery,,,2369.0,2369.0,5 RC,490,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,31 RC,490,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,31 RC,490,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,490,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,31 RC,490,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,948.0,12562.0,31 RC,490,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,948.0,26403.19,22 RC,490,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,948.0,25988.0,33 RC,490,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,948.0,25244.72,23 RC,490,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde High Cost Surgery",,,2369.0,2369.0,5 RC,490,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,948.0,8240.61,31 RC,490,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,948.0,12562.0,29 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,26 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,490,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,31 RC,490,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,31 RC,490,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,31 RC,490,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,31 RC,490,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,31 RC,490,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,948.0,12562.0,31 RC,490,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,948.0,12562.0,31 RC,490,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,948.0,8240.61,31 RC,490,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,948.0,5571.0,31 RC,490,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,948.0,5571.0,31 RC,490,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,31 RC,490,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,26 RC,490,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,25 RC,490,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,948.0,5841.0,25 RC,490,"Cystourethroscopy, with insertion of permanent urethral stent ",,,948.0,15059.0,31 RC,490,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,490,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,25 RC,490,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,25 RC,490,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,31 RC,490,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,31 RC,490,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,948.0,15059.0,27 RC,490,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,31 RC,490,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,31 RC,490,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,948.0,8240.61,31 RC,490,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,31 RC,490,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,31 RC,490,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,948.0,8240.61,31 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,26 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,11552.32,23 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,948.0,15059.0,31 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,26 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,26 RC,490,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,948.0,11552.32,31 RC,490,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,948.0,12562.0,31 RC,490,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,948.0,8240.61,31 RC,490,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,490,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,31 RC,490,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,490,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,490,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,490,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,490,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,490,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,490,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,490,DRAIN ABDOMINAL ABSCESS ,,,3390.0,5841.0,2 RC,490,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,490,DRAIN PERCUT ABDOM ABSCESS ,,,3390.0,5841.0,2 RC,490,DRAIN PERCUT RETROPER ABSC ,,,3390.0,5841.0,2 RC,490,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,490,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,490,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,948.0,8536.87,31 RC,490,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,490,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,490,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,490,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,31 RC,490,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,358.2,5841.0,16 RC,490,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,948.0,13835.0,29 RC,490,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,948.0,13394.0,31 RC,490,Decompression internal auditory canal ,,,948.0,13835.0,17 RC,490,"Decompression of orbit only, transcranial approach ",,,948.0,13835.0,17 RC,490,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,490,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,692.94,15059.0,31 RC,490,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,948.0,3083.0,17 RC,490,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,948.0,20238.53,22 RC,490,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,948.0,5446.4,22 RC,490,Decompression; plantar digital nerve ,,,692.94,5571.0,31 RC,490,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,31 RC,490,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,490,Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter ,,,593.22,12562.0,31 RC,490,Deligation of ureter ,,,948.0,16207.0,17 RC,490,Delivery of placenta (separate procedure) ,,,948.0,13835.0,19 RC,490,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,490,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,30 RC,490,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,31 RC,490,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,948.0,5841.0,20 RC,490,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,31 RC,490,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,948.0,5841.0,20 RC,490,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,31 RC,490,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,31 RC,490,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,31 RC,490,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,31 RC,490,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,31 RC,490,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,31 RC,490,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,31 RC,490,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,30 RC,490,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,31 RC,490,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,31 RC,490,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,26 RC,490,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,30 RC,490,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,31 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,31 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,655.0,5841.0,16 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,358.2,5841.0,16 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,19 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,31 RC,490,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,31 RC,490,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,31 RC,490,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,31 RC,490,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,31 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,26 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,26 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,490,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) High ",,,2369.0,2369.0,5 RC,490,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,25 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,25 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,26 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,26 RC,490,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,948.0,6819.81,31 RC,490,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,31 RC,490,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,490,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,490,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,490,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,490,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,18 RC,490,Dilation and curettage of cervical stump ,,,948.0,12562.0,31 RC,490,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,948.0,6819.81,31 RC,490,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,31 RC,490,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,948.0,15059.0,60 RC,490,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,30 RC,490,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,18 RC,490,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,31 RC,490,"Dilation of lacrimal punctum, with or without irrigation ",,,745.36,5841.0,16 RC,490,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,31 RC,490,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,30 RC,490,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,30 RC,490,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,30 RC,490,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,948.0,4836.33,31 RC,490,Dilation of vagina under anesthesia (other than local) ,,,948.0,6819.81,31 RC,490,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,948.0,5841.0,20 RC,490,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,948.0,16330.72,29 RC,490,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,948.0,16207.0,17 RC,490,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,948.0,18749.79,17 RC,490,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,31 RC,490,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,30 RC,490,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,26 RC,490,"Discission of vitreous strands (without removal), pars plana approach High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,490,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,490,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,490,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,948.0,16207.0,17 RC,490,"Donor nephrectomy (including cold preservation); open, from living donor ",,,948.0,18414.98,17 RC,490,"Drainage external auditory canal, abscess ",,,154.94,5841.0,30 RC,490,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,31 RC,490,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,30 RC,490,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,29 RC,490,Drainage of deep periurethral abscess ,,,948.0,5571.0,31 RC,490,"Drainage of extraperitoneal lymphocele to peritoneal cavity, open ",,,948.0,16207.0,17 RC,490,Drainage of ovarian abscess; abdominal approach ,,,948.0,13835.0,29 RC,490,"Drainage of ovarian abscess; vaginal approach, open ",,,948.0,12562.0,31 RC,490,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,948.0,13835.0,31 RC,490,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,948.0,12562.0,31 RC,490,Drainage of perineal urinary extravasation; complicated ,,,948.0,13835.0,17 RC,490,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,31 RC,490,"Drainage of perirenal or renal abscess, open ",,,948.0,13835.0,29 RC,490,"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open ",,,948.0,19550.76,17 RC,490,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,31 RC,490,"Drainage of retroperitoneal abscess, open ",,,948.0,16207.0,17 RC,490,Drainage of scrotal wall abscess ,,,510.77,3747.2,31 RC,490,"Drainage of subdiaphragmatic or subphrenic abscess, open ",,,948.0,16207.0,17 RC,490,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,490,"Dural graft, spinal ",,,948.0,16207.0,17 RC,490,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,466.41,13835.0,17 RC,490,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,490,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,490,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,490,Ear piercing ,,,370.1,16207.0,14 RC,490,Electroejaculation ,,,560.2,3128.0,29 RC,490,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,490,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,490,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,490,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,18 RC,490,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,490,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,948.0,5841.0,23 RC,490,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,479.41,5841.0,44 RC,490,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,948.0,5841.0,23 RC,490,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,490,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,490,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,490,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,490,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,948.0,16207.0,17 RC,490,"Elevation of depressed skull fracture; simple, extradural ",,,948.0,13835.0,17 RC,490,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,948.0,18957.47,17 RC,490,"Embryo transfer, intrauterine ",,,948.0,5841.0,28 RC,490,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,31 RC,490,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,948.0,5841.0,20 RC,490,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,490,Endolymphatic sac operation; with shunt ,,,948.0,13241.95,31 RC,490,Endolymphatic sac operation; without shunt ,,,948.0,13241.95,31 RC,490,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,28 RC,490,"Endometrial ablation, thermal, without hysteroscopic guidance High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,948.0,23059.78,33 RC,490,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,30 RC,490,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,490,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,948.0,16330.72,30 RC,490,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,490,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,948.0,12562.0,31 RC,490,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,490,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,490,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,490,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,490,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,490,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,490,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,490,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,948.0,16207.0,19 RC,490,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,948.0,16207.0,19 RC,490,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,948.0,27050.15,29 RC,490,"Enterocystoplasty, including intestinal anastomosis ",,,948.0,16974.03,17 RC,490,"Enucleation of eye; with implant, muscles attached to implant ",,,948.0,8536.87,31 RC,490,"Enucleation of eye; with implant, muscles not attached to implant ",,,948.0,12562.0,31 RC,490,Enucleation of eye; without implant ,,,948.0,12562.0,31 RC,490,Epididymectomy; bilateral ,,,948.0,8240.61,31 RC,490,Epididymectomy; unilateral ,,,948.0,12562.0,31 RC,490,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,948.0,8240.61,29 RC,490,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,948.0,8234.0,29 RC,490,Epikeratoplasty ,,,948.0,15664.44,29 RC,490,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,29 RC,490,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,490,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,490,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,490,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,490,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,490,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,490,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,490,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,490,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,490,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,490,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,490,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,490,Evisceration of ocular contents; with implant ,,,948.0,12562.0,31 RC,490,Evisceration of ocular contents; without implant ,,,948.0,12562.0,31 RC,490,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,31 RC,490,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,490,Exchange of intraocular lens ,,,892.44,5571.0,31 RC,490,Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) ,,,593.22,13835.0,31 RC,490,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,490,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,490,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,490,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,62 RC,490,Excision aural glomus tumor; extended (extratemporal) ,,,948.0,30451.46,17 RC,490,Excision aural glomus tumor; transcanal ,,,948.0,13394.0,31 RC,490,Excision aural glomus tumor; transmastoid ,,,948.0,13241.95,31 RC,490,Excision aural polyp ,,,143.6,13835.0,31 RC,490,"Excision exostosis(es), external auditory canal ",,,948.0,13241.95,31 RC,490,Excision external ear; complete amputation ,,,948.0,13241.95,31 RC,490,"Excision external ear; partial, simple repair ",,,855.96,6330.57,31 RC,490,Excision of Bartholin's gland or cyst ,,,948.0,12562.0,31 RC,490,Excision of Mullerian duct cyst ,,,948.0,8240.61,31 RC,490,Excision of bulbourethral gland (Cowper's gland) ,,,948.0,8240.61,31 RC,490,Excision of carotid body tumor; with excision of carotid artery ,,,948.0,20326.45,17 RC,490,Excision of carotid body tumor; without excision of carotid artery ,,,948.0,16795.98,17 RC,490,"Excision of cervical stump, abdominal approach; ",,,948.0,16207.0,17 RC,490,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,948.0,16207.0,17 RC,490,"Excision of cervical stump, vaginal approach; ",,,948.0,12562.0,31 RC,490,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,948.0,13835.0,17 RC,490,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,948.0,13394.0,31 RC,490,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,30 RC,490,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,31 RC,490,Excision of chalazion; single ,,,65.12,5841.0,30 RC,490,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,31 RC,490,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,948.0,13196.03,31 RC,490,Excision of extraparenchymal lesion of testis ,,,948.0,8240.61,31 RC,490,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,948.0,12562.0,31 RC,490,Excision of hydrocele; bilateral ,,,948.0,13394.0,31 RC,490,Excision of hydrocele; unilateral ,,,948.0,12562.0,31 RC,490,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,948.0,12562.0,31 RC,490,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,948.0,12562.0,31 RC,490,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,31 RC,490,Excision of lacrimal gland tumor; involving osteotomy ,,,948.0,12562.0,31 RC,490,Excision of lacrimal sac (dacryocystectomy) ,,,948.0,12562.0,31 RC,490,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,31 RC,490,Excision of lesion of spermatic cord (separate procedure) ,,,948.0,8240.61,31 RC,490,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,31 RC,490,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,31 RC,490,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,31 RC,490,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,31 RC,490,"Excision of lesion, sclera ",,,733.22,12909.0,31 RC,490,Excision of local lesion of epididymis ,,,948.0,12562.0,31 RC,490,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,490,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,31 RC,490,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,948.0,15039.6,31 RC,490,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,31 RC,490,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,31 RC,490,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,31 RC,490,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,31 RC,490,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,31 RC,490,Excision of neuroma; sciatic nerve ,,,948.0,15039.6,31 RC,490,Excision of penile plaque (Peyronie disease); ,,,948.0,9653.0,31 RC,490,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,948.0,22025.45,31 RC,490,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,948.0,11552.32,31 RC,490,Excision of perinephric cyst ,,,948.0,16207.0,17 RC,490,Excision of presacral or sacrococcygeal tumor ,,,948.0,27243.1,17 RC,490,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,31 RC,490,Excision of thyroglossal duct cyst or sinus; ,,,948.0,13196.03,31 RC,490,Excision of thyroglossal duct cyst or sinus; recurrent ,,,948.0,13196.03,31 RC,490,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,948.0,13196.03,31 RC,490,Excision of urethral diverticulum (separate procedure); female ,,,948.0,11552.32,31 RC,490,Excision of urethral diverticulum (separate procedure); male ,,,948.0,12562.0,31 RC,490,Excision of vaginal cyst or tumor ,,,948.0,6819.81,31 RC,490,Excision of vaginal septum ,,,948.0,6819.81,31 RC,490,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,948.0,8240.61,31 RC,490,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,948.0,8488.5,31 RC,490,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,948.0,13394.0,31 RC,490,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm ",,,948.0,24038.38,11 RC,490,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm ",,,948.0,27963.63,11 RC,490,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less ",,,948.0,15741.23,11 RC,490,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm ",,,948.0,20117.01,11 RC,490,"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 3",,,948.0,34471.38,11 RC,490,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less ",,,3041.0,5571.0,3 RC,490,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter ",,,9124.0,9653.0,3 RC,490,"Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diam",,,9124.0,9653.0,3 RC,490,Excision or fulguration of carcinoma of urethra ,,,948.0,8240.61,31 RC,490,Excision or fulguration; Skene's glands ,,,948.0,5571.0,31 RC,490,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,31 RC,490,"Excision or fulguration; urethral polyp(s), distal urethra ",,,948.0,5571.0,31 RC,490,Excision or fulguration; urethral prolapse ,,,948.0,5571.0,31 RC,490,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,31 RC,490,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,31 RC,490,Excision or unroofing of cyst(s) of kidney ,,,948.0,16207.0,17 RC,490,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,31 RC,490,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,948.0,30069.97,17 RC,490,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,948.0,24382.36,17 RC,490,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,948.0,13394.0,31 RC,490,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,948.0,12909.0,31 RC,490,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,948.0,12909.0,31 RC,490,Exploration for undescended testis (inguinal or scrotal area) ,,,948.0,8488.5,31 RC,490,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,31 RC,490,"Exploration of epididymis, with or without biopsy ",,,948.0,8240.61,31 RC,490,"Exploration of orbit (transcranial approach), with removal of lesion ",,,948.0,25276.59,17 RC,490,"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) ",,,948.0,16207.0,29 RC,490,"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) ",,,948.0,13835.0,29 RC,490,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,948.0,25988.0,33 RC,490,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,25988.0,19 RC,490,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,25988.0,19 RC,490,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,18 RC,490,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,948.0,23428.74,17 RC,490,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,948.0,28192.48,17 RC,490,"External cephalic version, with or without tocolysis ",,,948.0,6819.81,17 RC,490,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,490,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,948.0,15059.0,30 RC,490,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,948.0,11603.86,30 RC,490,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,31 RC,490,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,15059.0,91 RC,490,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,490,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,490,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,490,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,490,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,490,Fetal contraction stress test ,,,28.49,5841.0,13 RC,490,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,30 RC,490,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,399.9,16207.0,14 RC,490,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,482.53,5841.0,13 RC,490,Fetal non-stress test ,,,16.57,5841.0,10 RC,490,Fetal scalp blood sampling ,,,554.98,5841.0,16 RC,490,"Fetal shunt placement, including ultrasound guidance ",,,554.98,5841.0,28 RC,490,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,490,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,490,Fimbrioplasty ,,,948.0,13835.0,29 RC,490,Fine needle aspiration of orbital contents ,,,733.22,5571.0,31 RC,490,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,31 RC,490,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,948.0,10424.04,31 RC,490,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,31 RC,490,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,31 RC,490,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,948.0,10424.04,31 RC,490,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,18 RC,490,Fixation of contralateral testis (separate procedure) ,,,948.0,12562.0,31 RC,490,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,490,"Follicle puncture for oocyte retrieval, any method ",,,948.0,3128.0,29 RC,490,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,30 RC,490,Free omental flap with microvascular anastomosis ,,,948.0,19868.64,17 RC,490,Frenulotomy of penis ,,,685.44,5571.0,31 RC,490,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,490,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,554.98,5841.0,28 RC,490,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,490,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,490,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,490,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,490,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,490,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,490,Goniotomy ,,,948.0,10424.04,31 RC,490,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,490,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,490,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,490,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,490,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,490,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,490,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,490,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,490,"Harvesting conjunctival allograft, living donor ",,,948.0,5571.0,29 RC,490,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,490,Hip core decompression ,,,9913.14,12713.03,5 RC,490,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,490,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,490,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,490,"Hymenotomy, simple incision ",,,948.0,6819.81,31 RC,490,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,948.0,19432.11,17 RC,490,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,948.0,16207.0,29 RC,490,Hysterorrhaphy of ruptured uterus ,,,948.0,13835.0,15 RC,490,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,948.0,16207.0,29 RC,490,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,6819.81,14 RC,490,"Hysteroscopy, diagnostic (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,14 RC,490,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,14 RC,490,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,14 RC,490,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,14 RC,490,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,14 RC,490,"Hysteroscopy, surgical; with removal of impacted foreign body High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,14 RC,490,"Hysteroscopy, surgical; with removal of leiomyomata High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,14 RC,490,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,948.0,26010.28,17 RC,490,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,490,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,490,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,490,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,490,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,490,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,490,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,490,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,490,IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR OPEN INCISIONAL OR VENTRAL HERNIA REPAIR OR MESH FOR CLOSURE OF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION (LIST SEPARATELY IN ADDITION TO CODE FOR ,,,2358.0,5841.0,2 RC,490,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,490,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,490,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,490,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,490,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,490,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,490,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,490,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,490,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,490,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,490,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,490,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,490,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,490,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,490,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,490,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,490,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,490,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,490,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,490,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,490,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,490,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,490,"INSERT ABDOM DRAIN, TEMP ",,,3390.0,5841.0,2 RC,490,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,490,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,490,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,490,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,490,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous ",,,510.77,15059.0,31 RC,490,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal ",,,510.77,12562.0,31 RC,490,"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous ",,,948.0,15059.0,29 RC,490,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,490,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,490,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,490,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,490,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,490,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,17 RC,490,Implantation of intrastromal corneal ring segments ,,,948.0,26289.23,31 RC,490,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,26 RC,490,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,948.0,44816.88,23 RC,490,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,490,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,490,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,948.0,5841.0,20 RC,490,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,948.0,45089.88,32 RC,490,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,27 RC,490,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming High Cost Surgery",,,2369.0,2369.0,5 RC,490,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,948.0,45089.88,33 RC,490,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,948.0,12562.0,29 RC,490,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,948.0,35621.26,30 RC,490,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,948.0,34379.68,30 RC,490,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,32488.94,31 RC,490,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,948.0,16330.72,29 RC,490,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,948.0,15039.6,31 RC,490,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,30 RC,490,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,31 RC,490,"Incision and drainage of penis, deep ",,,510.77,8234.0,31 RC,490,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,31 RC,490,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,31 RC,490,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,31 RC,490,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,30 RC,490,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,948.0,16207.0,17 RC,490,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,29 RC,490,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,31 RC,490,"Incision, drainage of lacrimal gland ",,,948.0,3323.1,29 RC,490,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,31 RC,490,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,30 RC,490,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,490,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,490,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,490,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,490,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,29 RC,490,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,948.0,16207.0,29 RC,490,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,948.0,16207.0,29 RC,490,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,948.0,16207.0,17 RC,490,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,948.0,16207.0,58 RC,490,"Induced abortion, by dilation and curettage ",,,948.0,13394.0,31 RC,490,"Induced abortion, by dilation and evacuation ",,,948.0,13394.0,31 RC,490,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,490,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,948.0,37783.59,17 RC,490,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,948.0,37372.46,17 RC,490,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,948.0,122851.37,22 RC,490,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,490,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,490,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,490,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,490,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,490,Injection of air or contrast into peritoneal cavity (separate procedure) ,,,948.0,5841.0,20 RC,490,Injection of contrast medium for dacryocystography ,,,948.0,5841.0,20 RC,490,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,18 RC,490,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,30 RC,490,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,26 RC,490,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt ",,,948.0,5841.0,20 RC,490,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,948.0,5841.0,8 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,490,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,490,Injection procedure for Peyronie disease; ,,,63.08,5841.0,18 RC,490,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,948.0,11552.32,31 RC,490,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,948.0,12562.0,58 RC,490,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,948.0,11410.03,29 RC,490,Injection procedure for corpora cavernosography ,,,948.0,5841.0,20 RC,490,Injection procedure for cystography or voiding urethrocystography ,,,948.0,5841.0,8 RC,490,"Injection procedure for discography, each level; cervical or thoracic ",,,948.0,5841.0,20 RC,490,"Injection procedure for discography, each level; lumbar ",,,948.0,5841.0,20 RC,490,"Injection procedure for myelography and/or computed tomography, lumbar ",,,948.0,5841.0,20 RC,490,Injection procedure for retrograde urethrocystography ,,,948.0,5841.0,8 RC,490,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,490,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,490,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,948.0,5841.0,20 RC,490,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,948.0,5841.0,20 RC,490,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,948.0,12562.0,29 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,19 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,19 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,30 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,30 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,30 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,19 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,948.0,5841.0,20 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,948.0,5841.0,20 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,31 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,30 RC,490,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,28 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,948.0,5841.0,20 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,31 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,948.0,5841.0,20 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,948.0,5841.0,20 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,31 RC,490,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,948.0,5841.0,20 RC,490,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,120 RC,490,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,120 RC,490,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,31 RC,490,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,31 RC,490,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,30 RC,490,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,31 RC,490,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,31 RC,490,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,31 RC,490,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,31 RC,490,"Injection, epidural, of blood or clot patch ",,,276.0,3128.0,31 RC,490,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,490,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,31 RC,490,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,31 RC,490,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,31 RC,490,Insert urinary catheter ,,,3390.0,5841.0,4 RC,490,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,490,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,490,Insertion of Heyman capsules for clinical brachytherapy ,,,948.0,11661.3,31 RC,490,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,31 RC,490,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,30 RC,490,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,948.0,15059.0,31 RC,490,"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,450.72,13394.0,31 RC,490,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,490,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,406.49,5841.0,28 RC,490,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,28 RC,490,"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,31 RC,490,"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,593.22,4251.7,31 RC,490,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,490,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,948.0,47976.91,33 RC,490,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,31 RC,490,Insertion of intrauterine device (IUD) ,,,508.94,5841.0,28 RC,490,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,490,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,26 RC,490,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,490,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,490,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,490,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,490,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,223.51,5841.0,28 RC,490,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,948.0,12562.0,31 RC,490,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,948.0,8536.87,31 RC,490,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,948.0,12562.0,31 RC,490,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,26 RC,490,Insertion of penile prosthesis; inflatable (self-contained) High Cost Surgery,,,2369.0,2369.0,5 RC,490,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,948.0,51975.0,31 RC,490,Insertion of peritoneal-venous shunt ,,,948.0,13835.0,29 RC,490,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,490,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,948.0,15111.6,15 RC,490,Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) ,,,948.0,3083.0,21 RC,490,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,948.0,41580.0,33 RC,490,Insertion of tandem cuff (dual cuff) ,,,948.0,47976.91,33 RC,490,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,30 RC,490,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,223.51,5841.0,28 RC,490,Insertion of testicular prosthesis (separate procedure) ,,,948.0,11552.32,31 RC,490,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,948.0,3390.0,23 RC,490,"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con",,,948.0,15059.0,31 RC,490,"Insertion of tunneled intraperitoneal catheter for dialysis, open ",,,948.0,8488.5,31 RC,490,"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) ",,,948.0,12547.6,31 RC,490,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,948.0,25988.0,33 RC,490,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,490,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,948.0,87318.0,32 RC,490,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,948.0,87318.0,32 RC,490,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,948.0,5841.0,19 RC,490,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,948.0,35432.53,27 RC,490,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,948.0,87318.0,32 RC,490,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,948.0,87318.0,32 RC,490,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,490,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,30 RC,490,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,948.0,5841.0,20 RC,490,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,490,Intersex surgery; female to male ,,,948.0,13835.0,15 RC,490,Intersex surgery; male to female ,,,948.0,13835.0,15 RC,490,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,490,Intra-atrial recording ,,,12065.71,43890.0,10 RC,490,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,490,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,31 RC,490,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,490,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,490,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,490,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,490,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,490,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,490,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,490,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,490,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,490,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,490,Intraventricular pacing ,,,12065.71,43890.0,10 RC,490,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,490,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,25 RC,490,Intravitreal injection of a pharmacologic agent (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,490,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,18 RC,490,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,948.0,12562.0,31 RC,490,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,31 RC,490,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,31 RC,490,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,31 RC,490,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,31 RC,490,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,31 RC,490,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,30 RC,490,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,31 RC,490,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,31 RC,490,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,30 RC,490,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,112.77,5841.0,16 RC,490,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,490,Keratomileusis ,,,948.0,17897.9,29 RC,490,Keratophakia ,,,948.0,19576.28,29 RC,490,Keratoplasty (corneal transplant); anterior lamellar ,,,948.0,12909.0,31 RC,490,Keratoplasty (corneal transplant); endothelial ,,,948.0,15059.0,31 RC,490,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,948.0,12909.0,31 RC,490,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,948.0,12909.0,31 RC,490,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,948.0,12909.0,31 RC,490,Keratoprosthesis ,,,948.0,16924.12,29 RC,490,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,490,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, RECURRENT INCISIONAL HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); INCARCERATED OR STRANGULATED ",,,9124.0,9653.0,3 RC,490,"LAPAROSCOPY, SURGICAL, REPAIR, VENTRAL, UMBILICAL, SPIGELIAN OR EPIGASTRIC HERNIA (INCLUDES MESH INSERTION, WHEN PERFORMED); REDUCIBLE ",,,9124.0,9653.0,3 RC,490,LAVH ,,,3390.0,5841.0,2 RC,490,Labyrinthectomy; transcanal ,,,948.0,13241.95,31 RC,490,Labyrinthectomy; with mastoidectomy ,,,948.0,13241.95,31 RC,490,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,31 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,948.0,34473.5,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,948.0,22297.2,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,948.0,19224.42,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,948.0,19618.62,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,948.0,22153.02,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,948.0,26255.61,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,948.0,24454.45,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,948.0,25950.44,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,948.0,32557.8,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,948.0,32066.23,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,948.0,33960.65,14 RC,490,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,948.0,23454.14,14 RC,490,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,948.0,25611.4,14 RC,490,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,948.0,23386.41,14 RC,490,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,948.0,23085.47,14 RC,490,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,948.0,25611.4,14 RC,490,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,948.0,16330.72,26 RC,490,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,948.0,16330.72,26 RC,490,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,948.0,16330.72,26 RC,490,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,948.0,16330.72,26 RC,490,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,948.0,36291.71,14 RC,490,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,948.0,37902.24,14 RC,490,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,948.0,37686.1,14 RC,490,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,948.0,87318.0,30 RC,490,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,948.0,19563.47,14 RC,490,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,948.0,21237.62,14 RC,490,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,948.0,17147.73,14 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,948.0,16330.72,28 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,948.0,16330.72,28 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,948.0,16330.72,26 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,948.0,16330.72,28 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,948.0,16330.72,26 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,948.0,16330.72,26 RC,490,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,948.0,16330.72,26 RC,490,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,948.0,19678.01,14 RC,490,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,948.0,16330.72,26 RC,490,Laminectomy with rhizotomy; 1 or 2 segments ,,,948.0,14087.77,14 RC,490,Laminectomy with rhizotomy; more than 2 segments ,,,948.0,15253.31,14 RC,490,Laminectomy with section of spinal accessory nerve ,,,948.0,17173.13,14 RC,490,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,948.0,16330.72,104 RC,490,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,948.0,5841.0,40 RC,490,"Laminectomy, with release of tethered spinal cord, lumbar ",,,948.0,18949.01,14 RC,490,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,948.0,18436.15,17 RC,490,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,948.0,21068.04,17 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,948.0,16330.72,26 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,948.0,7014.0,42 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,948.0,16330.72,28 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,948.0,16330.72,28 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,23 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,948.0,5841.0,20 RC,490,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,948.0,3083.0,22 RC,490,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,490,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,490,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,490,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,490,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,490,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,490,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,490,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,490,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,490,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,490,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,490,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,490,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,14 RC,490,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,490,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,14 RC,490,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,490,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,490,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,490,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,490,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,948.0,22967.79,11 RC,490,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,948.0,29647.99,22 RC,490,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,948.0,29647.99,22 RC,490,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,948.0,24808.33,28 RC,490,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,13 RC,490,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,948.0,22967.79,17 RC,490,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,14 RC,490,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,948.0,13196.03,13 RC,490,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,13 RC,490,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,948.0,22967.79,11 RC,490,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,22967.79,11 RC,490,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,8 RC,490,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14626.03,12 RC,490,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,23335.49,6 RC,490,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed High Cost",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,8 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,490,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13394.0,12 RC,490,"Laparoscopy, surgical; ablation of renal cysts High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,12 RC,490,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,12 RC,490,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,12 RC,490,"Laparoscopy, surgical; nephrectomy with total ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,12 RC,490,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical; orchiectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,12 RC,490,"Laparoscopy, surgical; partial nephrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,12 RC,490,"Laparoscopy, surgical; pyeloplasty High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,12 RC,490,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; repair initial inguinal hernia ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; repair initial inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; repair recurrent inguinal hernia ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; repair recurrent inguinal hernia High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,16 RC,490,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13394.0,12 RC,490,"Laparoscopy, surgical; ureterolithotomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,14 RC,490,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13394.0,12 RC,490,"Laparoscopy, surgical; urethral suspension for stress incontinence High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with biopsy (single or multiple) ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; with biopsy (single or multiple) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity ",,,6326.0,13196.03,12 RC,490,"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; with fimbrioplasty High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,14 RC,490,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) ",,,1672.0,15059.0,6 RC,490,"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imagin",,,1672.0,15059.0,11 RC,490,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed ",,,1983.29,15059.0,14 RC,490,"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,14 RC,490,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,490,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,948.0,13835.0,29 RC,490,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,490,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,490,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,490,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,490,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,490,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,490,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,490,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,490,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,490,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,490,Lapscp intest resect ,,,3390.0,5841.0,2 RC,490,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,490,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,490,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,490,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,490,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,490,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,490,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,490,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,490,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,490,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,490,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,8 RC,490,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,948.0,15059.0,31 RC,490,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,490,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,948.0,13835.0,16 RC,490,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,948.0,13835.0,16 RC,490,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,31 RC,490,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,490,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,490,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,490,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,490,Ligation of peritoneal-venous shunt ,,,948.0,13835.0,17 RC,490,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,29 RC,490,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,948.0,13835.0,29 RC,490,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,948.0,13394.0,31 RC,490,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,490,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,948.0,8240.61,31 RC,490,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,948.0,8240.61,31 RC,490,"Lithotripsy, extracorporeal shock wave ",,,1200.05,10342.0,8 RC,490,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,490,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,490,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,490,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,948.0,13835.0,29 RC,490,Lysis of labial adhesions ,,,948.0,6819.81,31 RC,490,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,31 RC,490,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,948.0,4220.0,18 RC,490,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,31 RC,490,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,18 RC,490,Marsupialization of Bartholin's gland cyst ,,,948.0,6819.81,31 RC,490,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,490,"Marsupialization of urethral diverticulum, male or female ",,,948.0,8240.61,31 RC,490,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,26 RC,490,Mastoid obliteration (separate procedure) High Cost Surgery,,,2369.0,2369.0,5 RC,490,Mastoidectomy; complete ,,,948.0,13241.95,31 RC,490,Mastoidectomy; modified radical ,,,948.0,13241.95,31 RC,490,Mastoidectomy; radical ,,,948.0,13241.95,31 RC,490,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,112.77,5841.0,16 RC,490,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,31 RC,490,"Meatotomy, cutting of meatus (separate procedure); infant ",,,948.0,13835.0,29 RC,490,"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including cont",,,351.7,3128.0,31 RC,490,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,490,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,490,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,31 RC,490,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,490,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,490,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,490,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,490,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,490,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,19 RC,490,Multifetal pregnancy reduction(s) (MPR) ,,,554.98,5841.0,16 RC,490,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,31 RC,490,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,948.0,8234.0,29 RC,490,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,948.0,8234.0,29 RC,490,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,948.0,8234.0,29 RC,490,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,948.0,8234.0,29 RC,490,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,948.0,13835.0,29 RC,490,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,948.0,13394.0,31 RC,490,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,948.0,13835.0,17 RC,490,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,31 RC,490,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,30 RC,490,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,31 RC,490,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,490,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,490,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,490,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,490,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,490,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,490,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,948.0,15059.0,30 RC,490,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,948.0,15059.0,30 RC,490,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,30 RC,490,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,948.0,16207.0,17 RC,490,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,948.0,17974.22,17 RC,490,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,948.0,16207.0,17 RC,490,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,948.0,16207.0,17 RC,490,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,948.0,16207.0,17 RC,490,"Nephrectomy, partial ",,,948.0,16253.5,17 RC,490,Nephrolithotomy; complicated by congenital kidney abnormality ,,,948.0,16207.0,17 RC,490,Nephrolithotomy; removal of calculus ,,,948.0,16207.0,17 RC,490,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,948.0,17855.56,17 RC,490,Nephrolithotomy; secondary surgical operation for calculus ,,,948.0,16207.0,17 RC,490,"Nephrorrhaphy, suture of kidney wound or injury ",,,948.0,16207.0,17 RC,490,"Nephrostomy, nephrotomy with drainage ",,,948.0,13835.0,29 RC,490,"Nephrotomy, with exploration ",,,948.0,16207.0,17 RC,490,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,948.0,15039.6,31 RC,490,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Nerve pedicle transfer; first stage ,,,948.0,15039.6,31 RC,490,Nerve pedicle transfer; second stage ,,,948.0,15039.6,31 RC,490,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,948.0,15039.6,29 RC,490,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,948.0,15039.6,30 RC,490,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,948.0,15039.6,31 RC,490,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,948.0,18707.46,17 RC,490,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,948.0,25882.7,17 RC,490,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,948.0,18906.55,17 RC,490,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,948.0,23458.38,17 RC,490,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,31 RC,490,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,26 RC,490,Neuroplasty and/or transposition; median nerve at carpal tunnel High Cost Surgery,,,2369.0,2369.0,5 RC,490,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,31 RC,490,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,31 RC,490,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,31 RC,490,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,31 RC,490,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,31 RC,490,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,31 RC,490,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,31 RC,490,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,31 RC,490,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,28 RC,490,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,490,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,948.0,41102.02,17 RC,490,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,948.0,13835.0,31 RC,490,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,948.0,13394.0,31 RC,490,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,948.0,13394.0,29 RC,490,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,948.0,13394.0,29 RC,490,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,948.0,17359.64,17 RC,490,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,490,"Omentectomy, epiploectomy, resection of omentum (separate procedure) ",,,948.0,16207.0,29 RC,490,"Oophorectomy, partial or total, unilateral or bilateral; ",,,948.0,13835.0,29 RC,490,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,948.0,14490.44,17 RC,490,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,490,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,87318.0,32 RC,490,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,490,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,82073.3,29 RC,490,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,490,Open implantation of neurostimulator electrode array; neuromuscular ,,,948.0,87318.0,33 RC,490,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,33 RC,490,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,948.0,16890.86,31 RC,490,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,490,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,490,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,490,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,490,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,490,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,948.0,8536.87,31 RC,490,Orbital implant (implant outside muscle cone); insertion ,,,948.0,8536.87,31 RC,490,Orbital implant (implant outside muscle cone); removal or revision ,,,948.0,8536.87,31 RC,490,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,948.0,40347.62,17 RC,490,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,948.0,35482.15,17 RC,490,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,948.0,39228.77,17 RC,490,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,948.0,13394.0,31 RC,490,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,948.0,13394.0,31 RC,490,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,948.0,13394.0,31 RC,490,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,948.0,13394.0,31 RC,490,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,948.0,13394.0,31 RC,490,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,948.0,12562.0,31 RC,490,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,31 RC,490,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,948.0,13835.0,31 RC,490,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,31 RC,490,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,31 RC,490,"Orchiectomy, partial ",,,948.0,12562.0,31 RC,490,"Orchiectomy, radical, for tumor; inguinal approach ",,,948.0,8488.5,31 RC,490,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,948.0,13835.0,17 RC,490,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,948.0,12562.0,31 RC,490,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,948.0,13835.0,29 RC,490,"Orchiopexy, inguinal or scrotal approach ",,,948.0,8488.5,31 RC,490,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,948.0,16207.0,14 RC,490,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,490,"Other cranial decompression, posterior fossa ",,,948.0,25285.06,17 RC,490,Other spinal injection ,,,3390.0,5841.0,2 RC,490,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,490,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,31 RC,490,"Ovarian cystectomy, unilateral or bilateral ",,,948.0,13835.0,29 RC,490,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,490,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,490,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,490,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,490,PUNCTURE PERITONEAL CAVITY ,,,3390.0,5841.0,2 RC,490,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,30 RC,490,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,31 RC,490,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,31 RC,490,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,Parathyroidectomy or exploration of parathyroid(s); ,,,948.0,13835.0,31 RC,490,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,948.0,15059.0,29 RC,490,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,948.0,17020.6,17 RC,490,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,948.0,22967.79,29 RC,490,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,948.0,13835.0,29 RC,490,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,948.0,18300.83,29 RC,490,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,31 RC,490,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,948.0,5841.0,20 RC,490,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,31 RC,490,Partial hymenectomy or revision of hymenal ring ,,,948.0,6819.81,31 RC,490,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13835.0,31 RC,490,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13835.0,31 RC,490,Pelvic examination under anesthesia (other than local) ,,,948.0,6819.81,31 RC,490,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,2369.0,35948.44,17 RC,490,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,948.0,28124.63,17 RC,490,Penile plethysmography ,,,273.57,5841.0,28 RC,490,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,948.0,16207.0,29 RC,490,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,31 RC,490,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,31 RC,490,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,490,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,490,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,490,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,490,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,490,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,948.0,3083.0,22 RC,490,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,490,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,948.0,87318.0,33 RC,490,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,948.0,87318.0,33 RC,490,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,948.0,87318.0,33 RC,490,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,948.0,87318.0,33 RC,490,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,490,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,62 RC,490,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,948.0,22025.45,56 RC,490,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,490,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,490,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,490,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,490,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,490,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,7 RC,490,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,7 RC,490,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,490,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,490,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,490,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,490,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,490,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,490,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,490,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,490,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,490,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,490,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,490,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,490,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,490,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,490,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,490,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,490,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,490,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,490,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,490,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,490,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,490,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,490,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,490,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,490,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,490,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,490,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,490,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,490,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,490,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,490,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,490,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,490,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,490,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,490,"Pereyra procedure, including anterior colporrhaphy ",,,948.0,18300.83,31 RC,490,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,490,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,490,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,948.0,13394.0,31 RC,490,"Peritoneal lavage, including imaging guidance, when performed ",,,351.7,3249.0,31 RC,490,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,32022.79,28 RC,490,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,948.0,5841.0,28 RC,490,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,948.0,13835.0,28 RC,490,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,948.0,13835.0,28 RC,490,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,490,Petrous apicectomy including radical mastoidectomy ,,,948.0,13241.95,31 RC,490,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,490,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,490,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,490,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,490,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,490,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,490,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,490,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,490,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,490,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,490,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,948.0,5841.0,20 RC,490,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,948.0,8536.87,29 RC,490,Placement of amniotic membrane on the ocular surface; without sutures ,,,948.0,3755.0,29 RC,490,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,490,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed",,,796.41,16207.0,17 RC,490,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or m",,,311.04,5193.86,31 RC,490,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,31 RC,490,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,490,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,948.0,15059.0,29 RC,490,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,31 RC,490,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,948.0,12909.0,31 RC,490,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,490,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,948.0,15059.0,93 RC,490,Plastic operation of penis for injury ,,,948.0,8240.61,31 RC,490,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,948.0,12562.0,31 RC,490,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,948.0,12562.0,31 RC,490,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,31 RC,490,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,948.0,15227.79,17 RC,490,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,31 RC,490,Plastic operation on penis to correct angulation ,,,948.0,12562.0,31 RC,490,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,948.0,12562.0,31 RC,490,Plastic repair of canaliculi ,,,733.22,5571.0,31 RC,490,Plastic repair of introitus ,,,948.0,12562.0,31 RC,490,Plastic repair of urethrocele ,,,948.0,12562.0,31 RC,490,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,948.0,13394.0,31 RC,490,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,755.65,5841.0,28 RC,490,Postpartum care only (separate procedure) ,,,948.0,5841.0,24 RC,490,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,490,"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration ",,,948.0,13835.0,16 RC,490,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,30 RC,490,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,30 RC,490,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,31 RC,490,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,31 RC,490,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,31 RC,490,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,490,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,25 RC,490,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,26 RC,490,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,948.0,16207.0,17 RC,490,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,948.0,16207.0,17 RC,490,"Prostatectomy, perineal radical; ",,,948.0,16207.0,17 RC,490,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,948.0,21559.73,17 RC,490,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,19741.51,17 RC,490,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,948.0,16207.0,17 RC,490,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,948.0,16207.0,17 RC,490,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,948.0,16732.36,29 RC,490,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,948.0,16207.0,17 RC,490,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,948.0,8240.61,31 RC,490,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,948.0,5571.0,31 RC,490,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,19 RC,490,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,31 RC,490,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,948.0,17109.62,17 RC,490,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,948.0,16207.0,17 RC,490,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,490,"Pyelotomy; with drainage, pyelostomy ",,,948.0,16207.0,17 RC,490,Pyelotomy; with exploration ,,,948.0,16207.0,17 RC,490,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,948.0,16207.0,17 RC,490,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,490,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,490,REMOVAL OF ABDOMINAL FLUID ,,,3390.0,5841.0,2 RC,490,REMOVAL OF ABDOMINAL LESION ,,,3390.0,5841.0,2 RC,490,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,490,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,490,"REMOVE ABDOM LESION, COMPLEX ",,,3390.0,5841.0,2 RC,490,REMOVE ABDOMEN FOREIGN BODY ,,,3390.0,5841.0,2 RC,490,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,490,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,490,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,490,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,490,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,490,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,490,"REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) ",,,4988.0,7014.0,3 RC,490,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,490,REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,490,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,490,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ,,,4988.0,7014.0,3 RC,490,REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE ,,,4988.0,7014.0,3 RC,490,REPAIR SPIGELIAN HERNIA ,,,4988.0,7014.0,3 RC,490,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,490,"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OLDER; REDUCIBLE ",,,4988.0,7014.0,3 RC,490,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; INCARCERATED OR STRANGULATED ",,,4988.0,7014.0,3 RC,490,"REPAIR UMBILICAL HERNIA, YOUNGER THAN AGE 5 YEARS; REDUCIBLE ",,,4988.0,7014.0,3 RC,490,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,490,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,490,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,490,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,490,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,490,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,490,Radial keratotomy ,,,948.0,7836.39,29 RC,490,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,24 RC,490,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) High C",,,2369.0,2369.0,5 RC,490,Radical excision external auditory canal lesion; with neck dissection ,,,948.0,19932.26,17 RC,490,Radical excision external auditory canal lesion; without neck dissection ,,,948.0,13241.95,31 RC,490,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,948.0,20288.23,17 RC,490,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,30 RC,490,"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed ",,,948.0,13835.0,16 RC,490,Recipient nephrectomy (separate procedure) ,,,948.0,16207.0,17 RC,490,"Reconstruction external auditory canal for congenital atresia, single stage ",,,948.0,13241.95,31 RC,490,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,948.0,13241.95,31 RC,490,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,31 RC,490,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,31 RC,490,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,948.0,12562.0,31 RC,490,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,31 RC,490,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,490,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,490,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,948.0,20856.12,17 RC,490,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,948.0,24513.72,17 RC,490,Reduction of overcorrection of ptosis ,,,733.22,8234.0,31 RC,490,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,948.0,8240.61,31 RC,490,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,490,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,490,Reinsertion of ocular implant; with or without conjunctival graft ,,,948.0,8536.87,31 RC,490,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,948.0,12562.0,31 RC,490,Release of encircling material (posterior segment) ,,,1610.16,10424.04,26 RC,490,Release of encircling material (posterior segment) High Cost Surgery,,,2369.0,2369.0,5 RC,490,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,31 RC,490,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,31 RC,490,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,31 RC,490,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,31 RC,490,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,31 RC,490,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,26 RC,490,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,948.0,51975.0,30 RC,490,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,685.44,4836.33,31 RC,490,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,490,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,948.0,47976.91,31 RC,490,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,948.0,15672.9,17 RC,490,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,948.0,51975.0,31 RC,490,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,948.0,51975.0,31 RC,490,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,31 RC,490,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,31 RC,490,Removal foreign body from external auditory canal; without general anesthesia ,,,223.51,5841.0,16 RC,490,"Removal impacted cerumen requiring instrumentation, unilateral ",,,112.77,5841.0,28 RC,490,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,112.77,5841.0,28 RC,490,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,26 RC,490,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,490,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,948.0,9751.1,22 RC,490,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,948.0,9751.1,22 RC,490,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,948.0,9528.08,22 RC,490,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,31 RC,490,Removal of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,490,Removal of cerclage suture under anesthesia (other than local) ,,,948.0,13394.0,31 RC,490,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,948.0,16207.0,17 RC,490,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,948.0,13835.0,29 RC,490,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,31 RC,490,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,31 RC,490,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,948.0,15059.0,31 RC,490,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,30 RC,490,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,31 RC,490,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,31 RC,490,Removal of foreign body in scrotum ,,,685.44,5571.0,31 RC,490,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,30 RC,490,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,745.36,5841.0,16 RC,490,"Removal of foreign body, external eye; conjunctival superficial ",,,223.51,5841.0,16 RC,490,"Removal of foreign body, external eye; corneal, with slit lamp ",,,223.51,5841.0,16 RC,490,"Removal of foreign body, external eye; corneal, without slit lamp ",,,745.36,5841.0,16 RC,490,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,31 RC,490,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,30 RC,490,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,31 RC,490,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,490,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,948.0,15899.38,30 RC,490,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,490,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,490,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,948.0,6819.81,31 RC,490,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,490,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,31 RC,490,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,26 RC,490,"Removal of implanted material, posterior segment; extraocular High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,26 RC,490,"Removal of implanted material, posterior segment; intraocular High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,31 RC,490,Removal of intrauterine device (IUD) ,,,53.78,5841.0,30 RC,490,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,31 RC,490,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,31 RC,490,Removal of lens material; intracapsular ,,,892.44,8234.0,31 RC,490,"Removal of lens material; intracapsular, for dislocated lens ",,,948.0,13394.0,31 RC,490,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,948.0,10424.04,31 RC,490,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,31 RC,490,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,250.06,3128.0,31 RC,490,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,490,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,948.0,12562.0,31 RC,490,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,490,Removal of ocular implant ,,,948.0,8536.87,31 RC,490,Removal of peritoneal foreign body from peritoneal cavity ,,,948.0,8488.5,31 RC,490,Removal of peritoneal-venous shunt ,,,948.0,13835.0,31 RC,490,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,490,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,31 RC,490,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,31 RC,490,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,948.0,15059.0,27 RC,490,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,31 RC,490,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,12909.0,31 RC,490,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,948.0,15039.6,31 RC,490,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,490,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,490,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,490,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,490,"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparosco",,,948.0,5841.0,20 RC,490,Removal of transplanted renal allograft ,,,948.0,16207.0,17 RC,490,"Removal of tumor, temporal bone ",,,948.0,13835.0,29 RC,490,Removal of tunneled intraperitoneal catheter ,,,948.0,7565.59,31 RC,490,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,26 RC,490,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,26 RC,490,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,31 RC,490,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,948.0,11552.32,31 RC,490,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,948.0,13835.0,31 RC,490,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,490,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,948.0,13835.0,30 RC,490,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,948.0,7895.92,30 RC,490,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,7895.92,30 RC,490,Remove interim implant component ,,,12018.0,12018.0,1 RC,490,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,948.0,35181.33,17 RC,490,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,948.0,29697.06,17 RC,490,"Renal autotransplantation, reimplantation of kidney ",,,948.0,24517.95,17 RC,490,Renal biopsy; by surgical exposure of kidney ,,,948.0,16207.0,17 RC,490,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,11552.32,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,22025.45,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,948.0,22025.45,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,948.0,11552.32,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,948.0,22025.45,31 RC,490,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,948.0,11552.32,31 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,31 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,4836.33,31 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,948.0,13835.0,19 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,948.0,13835.0,31 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,13835.0,31 RC,490,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,31 RC,490,"Renal exploration, not necessitating other specific procedures ",,,948.0,16207.0,17 RC,490,Reopening of recent laparotomy ,,,948.0,16207.0,17 RC,490,Repair incomplete circumcision ,,,685.44,5571.0,31 RC,490,"Repair inguinal hernia, sliding, any age ",,,1209.12,8488.5,26 RC,490,"Repair inguinal hernia, sliding, any age High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair initial femoral hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,26 RC,490,"Repair initial femoral hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair initial femoral hernia, any age; reducible ",,,1209.12,13394.0,26 RC,490,"Repair initial femoral hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated ",,,1209.12,15059.0,26 RC,490,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair initial inguinal hernia, age 5 years or older; reducible ",,,1209.12,8488.5,26 RC,490,"Repair initial inguinal hernia, age 5 years or older; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated ",,,948.0,15059.0,31 RC,490,"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible ",,,948.0,8488.5,31 RC,490,Repair lumbar hernia ,,,1983.29,13196.03,26 RC,490,Repair lumbar hernia High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,490,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other pro",,,948.0,15059.0,178 RC,490,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other p",,,948.0,15664.44,174 RC,490,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,31 RC,490,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,31 RC,490,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,31 RC,490,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,948.0,13394.0,31 RC,490,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,31 RC,490,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,948.0,13394.0,31 RC,490,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,31 RC,490,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,31 RC,490,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,24 RC,490,"Repair of component(s) of a multi-component, inflatable penile prosthesis High Cost Surgery",,,2369.0,2369.0,5 RC,490,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,490,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,948.0,16207.0,17 RC,490,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,948.0,16207.0,17 RC,490,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,31 RC,490,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,31 RC,490,Repair of ectropion; suture ,,,733.22,12562.0,31 RC,490,Repair of ectropion; thermocauterization ,,,210.46,5571.0,31 RC,490,"Repair of encephalocele, skull vault, including cranioplasty ",,,948.0,26255.61,17 RC,490,"Repair of enterocele, abdominal approach (separate procedure) ",,,948.0,13835.0,17 RC,490,"Repair of enterocele, vaginal approach (separate procedure) ",,,948.0,12562.0,31 RC,490,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,490,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,31 RC,490,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,31 RC,490,Repair of entropion; suture ,,,733.22,12562.0,31 RC,490,Repair of entropion; thermocauterization ,,,201.75,13835.0,31 RC,490,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,948.0,12562.0,31 RC,490,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,948.0,12562.0,31 RC,490,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,948.0,12562.0,31 RC,490,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,948.0,11552.32,31 RC,490,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,31 RC,490,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,31 RC,490,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,948.0,16207.0,29 RC,490,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,31 RC,490,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,31 RC,490,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,948.0,10424.04,31 RC,490,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,948.0,10424.04,31 RC,490,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,948.0,8536.87,31 RC,490,Repair of large omphalocele or gastroschisis; with or without prosthesis ,,,948.0,60402.77,29 RC,490,"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room ",,,948.0,16207.0,17 RC,490,Repair of meningocele; larger than 5 cm diameter ,,,948.0,17728.44,17 RC,490,Repair of meningocele; less than 5 cm diameter ,,,948.0,16207.0,17 RC,490,Repair of myelomeningocele; larger than 5 cm diameter ,,,948.0,21911.47,17 RC,490,Repair of myelomeningocele; less than 5 cm diameter ,,,948.0,19758.45,17 RC,490,Repair of omphalocele (Gross type operation); first stage ,,,948.0,16207.0,17 RC,490,Repair of omphalocele (Gross type operation); second stage ,,,948.0,16207.0,17 RC,490,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated ",,,948.0,15059.0,28 RC,490,"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible ",,,948.0,9370.6,28 RC,490,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,26 RC,490,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,26 RC,490,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,14 RC,490,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,31 RC,490,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,31 RC,490,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,Repair of scleral staphyloma with graft ,,,948.0,10424.04,31 RC,490,"Repair of small omphalocele, with primary closure ",,,948.0,8488.5,31 RC,490,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,31 RC,490,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,31 RC,490,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,948.0,8536.87,31 RC,490,Repair of traumatic corporeal tear(s) ,,,948.0,12909.0,31 RC,490,Repair of tunica vaginalis hydrocele (Bottle type) ,,,948.0,8240.61,31 RC,490,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,948.0,12562.0,31 RC,490,Repair oval window fistula ,,,930.95,8234.0,26 RC,490,Repair oval window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,490,Repair recurrent femoral hernia; incarcerated or strangulated ,,,1209.12,15059.0,26 RC,490,Repair recurrent femoral hernia; incarcerated or strangulated High Cost Surgery,,,2369.0,2369.0,5 RC,490,Repair recurrent femoral hernia; reducible ,,,1209.12,13394.0,26 RC,490,Repair recurrent femoral hernia; reducible High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated ",,,1209.12,15059.0,26 RC,490,"Repair recurrent inguinal hernia, any age; incarcerated or strangulated High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Repair recurrent inguinal hernia, any age; reducible ",,,1209.12,12909.0,26 RC,490,"Repair recurrent inguinal hernia, any age; reducible High Cost Surgery",,,2369.0,2369.0,5 RC,490,Repair round window fistula ,,,930.95,8234.0,26 RC,490,Repair round window fistula High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,490,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or with",,,948.0,8488.5,62 RC,490,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or stra",,,948.0,13835.0,29 RC,490,"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible ",,,948.0,13835.0,29 RC,490,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,490,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,948.0,35621.26,30 RC,490,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,948.0,34379.68,30 RC,490,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,948.0,16330.72,31 RC,490,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,948.0,16207.0,17 RC,490,Replacement of bone flap or prosthetic plate of skull ,,,948.0,16207.0,17 RC,490,"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,31 RC,490,"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,31 RC,490,"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report ",,,351.7,3128.0,31 RC,490,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,490,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,31 RC,490,"Replacement or irrigation, ventricular catheter ",,,948.0,15039.6,31 RC,490,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,948.0,15039.6,31 RC,490,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,948.0,15039.6,31 RC,490,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,490,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,31 RC,490,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,18 RC,490,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,948.0,13973.35,17 RC,490,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,948.0,20267.07,17 RC,490,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,948.0,17864.03,17 RC,490,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,948.0,21716.49,17 RC,490,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,490,Resection of scrotum ,,,948.0,8240.61,31 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,948.0,26098.85,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,948.0,29709.76,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,948.0,34719.28,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,948.0,41237.62,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,948.0,26340.4,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,948.0,36321.35,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,948.0,32985.86,17 RC,490,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,948.0,40559.53,17 RC,490,"Resection temporal bone, external approach ",,,948.0,32511.23,17 RC,490,Retrobulbar injection; alcohol ,,,36.62,5841.0,30 RC,490,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,18 RC,490,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,22 RC,490,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,490,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,490,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,490,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,490,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,490,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,490,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,490,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,22 RC,490,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,22 RC,490,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,22 RC,490,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,948.0,18300.83,19 RC,490,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,948.0,16207.0,17 RC,490,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,948.0,12562.0,31 RC,490,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,948.0,54750.0,31 RC,490,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,948.0,54750.0,31 RC,490,Revision mastoidectomy; resulting in complete mastoidectomy ,,,948.0,13241.95,31 RC,490,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,948.0,13241.95,31 RC,490,Revision mastoidectomy; resulting in radical mastoidectomy ,,,948.0,13241.95,31 RC,490,Revision mastoidectomy; resulting in tympanoplasty ,,,948.0,13241.95,31 RC,490,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,31 RC,490,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,31 RC,490,Revision of peritoneal-venous shunt ,,,948.0,8488.5,31 RC,490,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,948.0,12562.0,31 RC,490,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,26 RC,490,Revision of stapedectomy or stapedotomy High Cost Surgery,,,2369.0,2369.0,5 RC,490,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,948.0,13835.0,19 RC,490,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,948.0,16207.0,17 RC,490,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,948.0,16890.86,31 RC,490,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,31 RC,490,Revision or removal of intracranial neurostimulator electrodes ,,,948.0,13835.0,19 RC,490,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,948.0,27181.65,27 RC,490,Revision or removal of peripheral neurostimulator electrode array ,,,948.0,8595.41,31 RC,490,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,948.0,8595.41,31 RC,490,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,31 RC,490,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,948.0,9751.1,22 RC,490,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,948.0,86066.14,22 RC,490,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,948.0,16890.86,31 RC,490,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,948.0,31349.63,30 RC,490,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,490,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,490,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,948.0,56900.95,27 RC,490,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,490,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,490,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,490,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,490,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,490,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,490,Right ventricular recording ,,,2024.5,43890.0,10 RC,490,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,490,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,490,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,948.0,28395.93,12 RC,490,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,948.0,28768.84,12 RC,490,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,948.0,25611.4,12 RC,490,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,948.0,26874.42,12 RC,490,"STAGING LAPAROTOMY FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOP",,,3390.0,16207.0,3 RC,490,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,490,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,490,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,490,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,490,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,948.0,13835.0,29 RC,490,Salpingostomy (salpingoneostomy) ,,,948.0,13835.0,29 RC,490,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,490,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,31 RC,490,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,31 RC,490,"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluor",,,948.0,12909.0,29 RC,490,"Scraping of cornea, diagnostic, for smear and/or culture ",,,745.36,5841.0,16 RC,490,Screening proctoscopy ,,,343.69,440.76,5 RC,490,Scrotal exploration ,,,948.0,8240.61,31 RC,490,Scrotoplasty; complicated ,,,948.0,11552.32,31 RC,490,Scrotoplasty; simple ,,,948.0,8240.61,31 RC,490,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,948.0,16207.0,17 RC,490,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,948.0,17546.16,17 RC,490,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,490,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,490,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,31 RC,490,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,948.0,10424.04,31 RC,490,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,31 RC,490,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,31 RC,490,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,31 RC,490,Severing of tarsorrhaphy ,,,179.07,3128.0,31 RC,490,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,26 RC,490,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,30 RC,490,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,223.51,5841.0,16 RC,490,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,490,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,490,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,948.0,22025.45,33 RC,490,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,948.0,16632.0,33 RC,490,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,31 RC,490,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,948.0,8240.61,31 RC,490,Snip incision of lacrimal punctum ,,,56.97,5841.0,30 RC,490,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,490,Sperm washing for artificial insemination ,,,44.33,5841.0,16 RC,490,"Spinal puncture, lumbar, diagnostic; ",,,276.0,3128.0,31 RC,490,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,30 RC,490,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,31 RC,490,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,30 RC,490,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,26 RC,490,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,26 RC,490,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out High Cost Surgery",,,2369.0,2369.0,5 RC,490,Stapes mobilization ,,,930.95,12909.0,26 RC,490,Stapes mobilization High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,948.0,17554.62,17 RC,490,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,948.0,17156.19,17 RC,490,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,948.0,19516.9,17 RC,490,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,948.0,15059.0,17 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,948.0,29069.0,10 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,19113.0,29069.0,5 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,948.0,29069.0,10 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,490,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,948.0,29069.0,10 RC,490,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,948.0,12562.0,31 RC,490,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,490,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,112.77,5841.0,16 RC,490,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,948.0,5841.0,20 RC,490,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,31 RC,490,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,31 RC,490,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,31 RC,490,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,948.0,8536.87,31 RC,490,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,31 RC,490,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,490,Subconjunctival injection ,,,223.51,5841.0,16 RC,490,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,948.0,14948.14,17 RC,490,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,31 RC,490,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,31 RC,490,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,948.0,17554.62,17 RC,490,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,948.0,13835.0,15 RC,490,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,24 RC,490,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,456.3,5841.0,15 RC,490,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,948.0,26865.96,17 RC,490,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,948.0,31193.16,17 RC,490,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,948.0,31862.78,17 RC,490,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,53176.72,17 RC,490,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,59338.96,17 RC,490,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,948.0,16537.5,17 RC,490,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,948.0,46115.78,17 RC,490,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,948.0,26984.61,17 RC,490,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,948.0,57821.69,17 RC,490,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,948.0,35240.6,17 RC,490,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,948.0,52341.76,17 RC,490,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,948.0,28014.44,17 RC,490,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,948.0,42699.85,17 RC,490,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,948.0,50133.7,17 RC,490,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,490,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,490,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,490,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,490,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,490,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,490,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,490,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,490,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,490,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,948.0,16207.0,17 RC,490,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,948.0,16207.0,17 RC,490,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,948.0,16207.0,17 RC,490,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,948.0,13835.0,29 RC,490,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,948.0,13835.0,29 RC,490,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,948.0,13394.0,31 RC,490,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,948.0,13394.0,31 RC,490,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,948.0,15039.6,31 RC,490,Suture of 1 nerve; median motor thenar ,,,948.0,15039.6,31 RC,490,Suture of 1 nerve; ulnar motor ,,,948.0,15039.6,31 RC,490,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,31 RC,490,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Suture of facial nerve; extracranial ,,,948.0,15039.6,31 RC,490,"Suture of facial nerve; infratemporal, with or without grafting ",,,948.0,15039.6,31 RC,490,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,31 RC,490,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,948.0,15039.6,31 RC,490,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,948.0,15039.6,31 RC,490,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,948.0,5841.0,20 RC,490,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,948.0,5841.0,20 RC,490,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,948.0,5841.0,20 RC,490,Suture of posterior tibial nerve ,,,948.0,15039.6,31 RC,490,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,31 RC,490,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,31 RC,490,Suture of sciatic nerve ,,,948.0,8104.0,31 RC,490,Suture of; brachial plexus ,,,692.94,12562.0,31 RC,490,Suture of; lumbar plexus ,,,948.0,15039.6,31 RC,490,Suture or repair of testicular injury ,,,948.0,12562.0,31 RC,490,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,948.0,16207.0,17 RC,490,"Sympathectomy, cervical ",,,692.94,4693.83,31 RC,490,"Sympathectomy, cervicothoracic ",,,948.0,13835.0,17 RC,490,"Sympathectomy, lumbar ",,,948.0,16207.0,17 RC,490,"Sympathectomy, thoracolumbar ",,,948.0,16207.0,17 RC,490,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,19 RC,490,Sympathectomy; radial artery ,,,948.0,8234.0,31 RC,490,Sympathectomy; superficial palmar arch ,,,948.0,7473.24,31 RC,490,Sympathectomy; ulnar artery ,,,948.0,12562.0,31 RC,490,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,948.0,16207.0,17 RC,490,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,490,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,490,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,490,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,490,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,31 RC,490,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,490,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,948.0,34379.68,30 RC,490,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,948.0,3390.0,18 RC,490,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,490,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,490,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,948.0,16745.06,17 RC,490,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,948.0,16207.0,17 RC,490,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,948.0,13835.0,29 RC,490,"Thyroidectomy, including substernal thyroid; cervical approach ",,,948.0,13835.0,29 RC,490,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,948.0,16715.43,17 RC,490,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,948.0,13835.0,29 RC,490,"Thyroidectomy, total or complete ",,,948.0,13835.0,31 RC,490,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,490,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,948.0,13835.0,29 RC,490,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,948.0,20402.66,29 RC,490,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,948.0,16207.0,29 RC,490,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,948.0,16207.0,29 RC,490,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,24 RC,490,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) High Cost Surgery",,,2369.0,2369.0,5 RC,490,Total facial nerve decompression and/or repair (may include graft) ,,,948.0,13835.0,29 RC,490,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,948.0,13196.03,31 RC,490,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,948.0,13196.03,31 RC,490,Trabeculoplasty by laser surgery ,,,114.82,3249.0,31 RC,490,Trabeculotomy ab externo ,,,892.44,8234.0,31 RC,490,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,948.0,12562.0,31 RC,490,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,948.0,12562.0,31 RC,490,"Transabdominal amnioinfusion, including ultrasound guidance ",,,554.98,5841.0,28 RC,490,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,490,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,490,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,948.0,27050.15,58 RC,490,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,948.0,18059.01,17 RC,490,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,490,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,948.0,19655.45,27 RC,490,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,948.0,17689.64,29 RC,490,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,948.0,29709.76,17 RC,490,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,948.0,36245.03,17 RC,490,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,19 RC,490,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,948.0,12562.0,17 RC,490,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,31 RC,490,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,31 RC,490,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,31 RC,490,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,31 RC,490,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,31 RC,490,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,31 RC,490,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,31 RC,490,Transection or avulsion of; mental nerve ,,,692.94,4693.83,31 RC,490,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,31 RC,490,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,31 RC,490,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,948.0,16207.0,17 RC,490,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,948.0,16207.0,17 RC,490,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,948.0,16207.0,17 RC,490,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,948.0,16207.0,17 RC,490,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,490,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,490,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,948.0,13394.0,29 RC,490,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,948.0,13394.0,29 RC,490,Transmastoid antrotomy (simple mastoidectomy) ,,,948.0,13241.95,31 RC,490,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,948.0,31201.63,17 RC,490,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,948.0,51345.81,17 RC,490,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,948.0,5841.0,20 RC,490,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,948.0,16330.72,31 RC,490,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,948.0,16330.72,31 RC,490,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,948.0,15059.0,30 RC,490,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,28 RC,490,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,948.0,35134.65,17 RC,490,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,490,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,490,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,948.0,12562.0,31 RC,490,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,"Transposition, ovary(s) ",,,948.0,13835.0,29 RC,490,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,948.0,28879.03,17 RC,490,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,948.0,16207.0,17 RC,490,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,948.0,19718.21,31 RC,490,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,948.0,15059.0,30 RC,490,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,948.0,18816.77,31 RC,490,Transurethral drainage of prostatic abscess ,,,948.0,8240.61,31 RC,490,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,31 RC,490,Transurethral incision of prostate ,,,948.0,12562.0,31 RC,490,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,948.0,12909.0,29 RC,490,Transurethral resection of bladder neck (separate procedure) ,,,948.0,12562.0,31 RC,490,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,26 RC,490,Transurethral resection; of postoperative bladder neck contracture High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,31 RC,490,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,948.0,26403.19,22 RC,490,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,22 RC,490,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,22 RC,490,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,22 RC,490,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,22 RC,490,Transvesical ureterolithotomy ,,,948.0,13835.0,17 RC,490,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,26 RC,490,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,31 RC,490,"Treatment of incomplete abortion, any trimester, completed surgically ",,,948.0,13394.0,31 RC,490,"Treatment of missed abortion, completed surgically; first trimester ",,,948.0,13394.0,31 RC,490,"Treatment of missed abortion, completed surgically; second trimester ",,,948.0,13394.0,31 RC,490,"Treatment of septic abortion, completed surgically ",,,948.0,16207.0,29 RC,490,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,490,Tubotubal anastomosis ,,,948.0,13835.0,29 RC,490,Tubouterine implantation ,,,948.0,13835.0,29 RC,490,Twist drill hole for subdural or ventricular puncture ,,,948.0,16207.0,17 RC,490,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,948.0,16207.0,17 RC,490,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,948.0,16207.0,17 RC,490,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,948.0,16207.0,17 RC,490,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,948.0,28345.13,68 RC,490,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,31 RC,490,Tympanic neurectomy ,,,930.95,12562.0,26 RC,490,Tympanic neurectomy High Cost Surgery,,,2369.0,2369.0,5 RC,490,"Tympanolysis, transcanal ",,,930.95,9653.0,31 RC,490,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,31 RC,490,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,490,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,26 RC,490,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,31 RC,490,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,26 RC,490,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,31 RC,490,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,30 RC,490,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,490,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,490,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,490,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,490,"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) ",,,948.0,8488.5,31 RC,490,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,490,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,490,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,490,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,340.4,13835.0,28 RC,490,"Unlisted hysteroscopy procedure, uterus ",,,340.4,13835.0,11 RC,490,"Unlisted hysteroscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, abdomen, peritoneum and omentum High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, bladder ",,,948.0,13835.0,17 RC,490,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, endocrine system High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,24 RC,490,"Unlisted laparoscopy procedure, maternity care and delivery High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, oviduct, ovary High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, renal ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, renal High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, spermatic cord High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, testis ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, testis High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, ureter High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13835.0,12 RC,490,"Unlisted laparoscopy procedure, uterus High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Unlisted procedure, abdomen, peritoneum and omentum ",,,948.0,13835.0,29 RC,490,"Unlisted procedure, anterior segment of eye ",,,948.0,13835.0,29 RC,490,"Unlisted procedure, conjunctiva ",,,554.5,13835.0,16 RC,490,"Unlisted procedure, endocrine system ",,,948.0,13835.0,29 RC,490,"Unlisted procedure, external ear ",,,417.46,5841.0,16 RC,490,"Unlisted procedure, extraocular muscle ",,,554.5,13835.0,16 RC,490,"Unlisted procedure, eyelids ",,,554.5,13835.0,16 RC,490,"Unlisted procedure, female genital system (nonobstetrical) ",,,340.4,13835.0,28 RC,490,"Unlisted procedure, inner ear ",,,417.46,13835.0,28 RC,490,"Unlisted procedure, lacrimal system ",,,554.5,13835.0,16 RC,490,"Unlisted procedure, male genital system ",,,481.54,13835.0,28 RC,490,"Unlisted procedure, maternity care and delivery ",,,340.4,13835.0,28 RC,490,"Unlisted procedure, middle ear ",,,417.46,13835.0,28 RC,490,"Unlisted procedure, nervous system ",,,536.63,13835.0,28 RC,490,"Unlisted procedure, orbit ",,,554.5,13835.0,16 RC,490,"Unlisted procedure, posterior segment ",,,948.0,13835.0,17 RC,490,"Unlisted procedure, temporal bone, middle fossa approach ",,,417.46,13835.0,28 RC,490,"Unlisted procedure, urinary system ",,,481.54,13835.0,28 RC,490,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,948.0,5841.0,20 RC,490,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,31 RC,490,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,948.0,8240.61,31 RC,490,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,948.0,8240.61,31 RC,490,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,948.0,11552.32,31 RC,490,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,948.0,8240.61,31 RC,490,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,948.0,16207.0,29 RC,490,"Ureterectomy, with bladder cuff (separate procedure) ",,,948.0,16207.0,29 RC,490,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,948.0,16207.0,17 RC,490,"Ureterocolon conduit, including intestine anastomosis ",,,948.0,16207.0,17 RC,490,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,948.0,16207.0,17 RC,490,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,948.0,16207.0,17 RC,490,Ureterolithotomy; lower one-third of ureter ,,,948.0,16207.0,29 RC,490,Ureterolithotomy; middle one-third of ureter ,,,948.0,16207.0,29 RC,490,Ureterolithotomy; upper one-third of ureter ,,,948.0,16207.0,29 RC,490,Ureterolysis for ovarian vein syndrome ,,,948.0,16207.0,17 RC,490,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,948.0,16207.0,17 RC,490,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,948.0,16207.0,17 RC,490,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,948.0,16207.0,17 RC,490,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,948.0,16207.0,17 RC,490,Ureteroneocystostomy; with extensive ureteral tailoring ,,,948.0,16207.0,17 RC,490,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,948.0,16207.0,17 RC,490,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,948.0,16207.0,17 RC,490,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,948.0,16207.0,17 RC,490,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,948.0,16207.0,17 RC,490,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,948.0,17194.41,17 RC,490,"Ureterostomy, transplantation of ureter to skin ",,,948.0,16207.0,17 RC,490,"Ureterotomy for insertion of indwelling stent, all types ",,,948.0,16207.0,29 RC,490,Ureterotomy with exploration or drainage (separate procedure) ,,,948.0,16207.0,29 RC,490,Ureteroureterostomy ,,,948.0,16207.0,17 RC,490,"Urethrectomy, total, including cystostomy; female ",,,948.0,13394.0,31 RC,490,"Urethrectomy, total, including cystostomy; male ",,,948.0,13394.0,31 RC,490,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,948.0,13835.0,29 RC,490,"Urethromeatoplasty, with mucosal advancement ",,,948.0,8240.61,31 RC,490,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,948.0,8240.61,31 RC,490,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,948.0,12562.0,31 RC,490,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,948.0,12562.0,31 RC,490,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,948.0,12562.0,31 RC,490,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,948.0,12562.0,31 RC,490,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,948.0,11552.32,31 RC,490,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,948.0,11552.32,31 RC,490,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,948.0,12562.0,31 RC,490,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,948.0,11552.32,31 RC,490,"Urethroplasty, reconstruction of female urethra ",,,948.0,11552.32,31 RC,490,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,948.0,13858.92,17 RC,490,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,948.0,12562.0,31 RC,490,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,948.0,11552.32,31 RC,490,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,948.0,8240.61,31 RC,490,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,948.0,11552.32,31 RC,490,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,948.0,11552.32,31 RC,490,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,948.0,11552.32,31 RC,490,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,31 RC,490,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,948.0,11552.32,31 RC,490,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,948.0,22102.21,17 RC,490,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,948.0,5841.0,20 RC,490,Uterine evacuation and curettage for hydatidiform mole ,,,948.0,13394.0,31 RC,490,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,948.0,16207.0,29 RC,490,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,948.0,16207.0,17 RC,490,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,490,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,490,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,948.0,13835.0,29 RC,490,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,948.0,12689.16,24 RC,490,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,948.0,13835.0,29 RC,490,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,948.0,13841.99,12 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,26 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,948.0,13835.0,17 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,948.0,15059.0,31 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,948.0,15059.0,29 RC,490,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,948.0,15059.0,29 RC,490,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,948.0,18300.83,29 RC,490,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,948.0,13835.0,29 RC,490,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,948.0,18300.83,29 RC,490,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,948.0,13835.0,29 RC,490,"Vaginal hysterectomy, radical (Schauta type operation) ",,,948.0,17741.14,17 RC,490,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,948.0,13835.0,17 RC,490,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,948.0,13835.0,17 RC,490,"Vaginectomy, complete removal of vaginal wall; ",,,948.0,16207.0,29 RC,490,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,21606.3,29 RC,490,"Vaginectomy, partial removal of vaginal wall; ",,,948.0,13835.0,29 RC,490,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,948.0,13835.0,29 RC,490,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,948.0,13835.0,29 RC,490,Vaginoplasty for intersex state ,,,948.0,13835.0,29 RC,490,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,490,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,31 RC,490,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,948.0,5841.0,20 RC,490,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,948.0,8240.61,29 RC,490,"Vasovasostomy, vasovasorrhaphy ",,,948.0,8240.61,29 RC,490,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,490,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,490,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,490,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,490,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,490,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,31 RC,490,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,31 RC,490,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,31 RC,490,Ventriculocisternostomy (Torkildsen type operation) ,,,948.0,19949.19,17 RC,490,"Ventriculocisternostomy, third ventricle; ",,,948.0,17075.76,17 RC,490,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,948.0,16207.0,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,948.0,16207.0,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,948.0,21674.15,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,948.0,16207.0,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,948.0,29803.02,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,948.0,16207.0,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,948.0,22725.26,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,26781.17,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,948.0,26832.09,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,948.0,27196.53,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,948.0,28616.31,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,948.0,30091.25,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,948.0,29773.38,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,948.0,31277.95,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,948.0,28743.44,51 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,948.0,24149.28,34 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,948.0,16207.0,17 RC,490,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,948.0,23729.68,17 RC,490,"Vesiculectomy, any approach ",,,948.0,13835.0,29 RC,490,Vesiculotomy; ,,,685.44,11308.65,31 RC,490,Vesiculotomy; complicated ,,,948.0,13835.0,29 RC,490,"Vestibular nerve section, transcranial approach ",,,948.0,21449.53,17 RC,490,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,31 RC,490,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,490,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,26 RC,490,"Vitrectomy, mechanical, pars plana approach; High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,26 RC,490,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,26 RC,490,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,31 RC,490,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,26 RC,490,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) High Cost Surgery",,,2369.0,2369.0,5 RC,490,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,31 RC,490,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,948.0,5841.0,20 RC,490,Vulvectomy simple; complete ,,,948.0,12909.0,31 RC,490,Vulvectomy simple; partial ,,,948.0,13394.0,31 RC,490,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,948.0,18478.49,17 RC,490,"Vulvectomy, radical, complete; ",,,948.0,14986.24,17 RC,490,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,948.0,18618.43,17 RC,490,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,948.0,16058.52,17 RC,490,"Vulvectomy, radical, partial; ",,,948.0,16207.0,29 RC,490,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,948.0,17240.98,17 RC,490,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,948.0,14609.1,17 RC,490,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,948.0,18300.83,29 RC,490,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,499, Ambulatory Surgical Care Other ,,,3673.0,5356.0,12 RC,499,1 epidur inject-C/thor ,,,3390.0,5841.0,2 RC,499,1 epidural inject anes-L ,,,3390.0,5841.0,2 RC,499,1 inject anes-subarach ,,,3390.0,5841.0,2 RC,499,1 subar inject anes-cont ,,,3390.0,5841.0,2 RC,499,1 subar inject anes-diff ,,,3390.0,5841.0,2 RC,499,"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap ",,,1200.05,12562.0,26 RC,499,"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) ",,,1200.05,12562.0,26 RC,499,"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) ",,,1200.05,12562.0,26 RC,499,1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra ,,,1200.05,12562.0,26 RC,499,1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3673.0,13835.0,24 RC,499,1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap ,,,3293.0,13835.0,24 RC,499,"APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR (EG, TENS UNIT) ",,,2358.0,5841.0,2 RC,499,ASPIRATE/INJECT THYRIOD CYST ,,,3390.0,5841.0,2 RC,499,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,499,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,499,"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) ",,,3293.0,13835.0,24 RC,499,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure) ",,,1986.0,3390.0,13 RC,499,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency ",,,1986.0,4423.26,18 RC,499,"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance ",,,2195.0,15059.0,23 RC,499,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; ",,,2195.0,5802.38,18 RC,499,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,2699.0,35469.31,18 RC,499,"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency ",,,1983.29,13196.03,26 RC,499,"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous ",,,2195.0,29647.99,17 RC,499,"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed ",,,3390.0,16207.0,24 RC,499,"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy ",,,3965.0,22967.79,26 RC,499,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,499,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,499,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,499,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,499,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ",,,3390.0,16207.0,24 RC,499,"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor ",,,3390.0,16207.0,12 RC,499,Amniocentesis; diagnostic ,,,52.04,3083.0,23 RC,499,Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance) ,,,122.58,5841.0,22 RC,499,"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,18546.34,12 RC,499,"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy ",,,3390.0,16207.0,12 RC,499,Amputation of penis; complete ,,,2195.0,13835.0,24 RC,499,Amputation of penis; partial ,,,1200.05,8240.61,26 RC,499,"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries ",,,3390.0,32129.73,12 RC,499,Anastomosis; facial-hypoglossal ,,,3390.0,16207.0,12 RC,499,Anastomosis; facial-spinal accessory ,,,3390.0,16207.0,12 RC,499,Anorectal manometry ,,,1672.0,2358.0,4 RC,499,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,499,Antepartum care only; 4-6 visits ,,,3370.89,5841.0,7 RC,499,Antepartum care only; 7 or more visits ,,,3390.0,7624.48,7 RC,499,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed ",,,1603.34,13394.0,26 RC,499,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) ",,,3041.0,13835.0,24 RC,499,"Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple ",,,3041.0,13835.0,24 RC,499,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,499,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,499,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,499,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,499,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,499,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,499,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,499,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,499,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,499,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,499,Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) ,,,1493.79,1915.7,5 RC,499,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft ",,,2167.86,13394.0,26 RC,499,"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft ",,,2091.35,15059.0,26 RC,499,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,499,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,499,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,499,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,499,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,499,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,499,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,499,Artificial insemination; intra-cervical ,,,315.3,5841.0,11 RC,499,Artificial insemination; intra-uterine ,,,333.49,5841.0,11 RC,499,"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous ",,,270.48,3128.0,26 RC,499,"Aspiration and/or injection, thyroid cyst ",,,62.5,3244.0,26 RC,499,Aspiration of bladder; by needle ,,,38.37,3244.0,26 RC,499,Aspiration of bladder; by trocar or intracatheter ,,,103.77,3244.0,26 RC,499,Aspiration of bladder; with insertion of suprapubic catheter ,,,685.44,5571.0,26 RC,499,"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy) ",,,892.44,5571.0,26 RC,499,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,499,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,499,BIOPSY EYE MUSCLE ,,,3390.0,5841.0,2 RC,499,BRAIN SURGERY USING COMPUTER ,,,3390.0,5841.0,2 RC,499,Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,3 RC,499,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each ",,,1820.98,16207.0,12 RC,499,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each ",,,1731.66,16207.0,12 RC,499,"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each ",,,2078.75,16207.0,12 RC,499,"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision o",,,3390.0,17385.04,12 RC,499,"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal ",,,3390.0,18626.9,12 RC,499,"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous ",,,3390.0,17224.05,12 RC,499,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) ",,,2915.0,16207.0,12 RC,499,"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) ",,,1625.93,16207.0,12 RC,499,"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel ",,,3390.0,16207.0,12 RC,499,"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code",,,1672.0,5841.0,15 RC,499,"Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft ",,,3390.0,29900.51,12 RC,499,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; ",,,3390.0,24971.42,12 RC,499,"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy ",,,3390.0,27115.97,12 RC,499,"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy ",,,3390.0,16944.28,12 RC,499,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance ",,,1200.05,12562.0,26 RC,499,Biopsy external auditory canal ,,,99.71,13835.0,14 RC,499,Biopsy external ear ,,,57.56,5841.0,13 RC,499,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) ",,,95.93,3128.0,26 RC,499,Biopsy of conjunctiva ,,,113.96,12562.0,26 RC,499,Biopsy of cornea ,,,733.22,5283.1,26 RC,499,"Biopsy of epididymis, needle ",,,510.77,3747.2,26 RC,499,Biopsy of extraocular muscle ,,,1158.59,8536.87,26 RC,499,Biopsy of lacrimal gland ,,,733.22,5571.0,26 RC,499,Biopsy of lacrimal sac ,,,733.22,5571.0,26 RC,499,Biopsy of nerve ,,,692.94,5571.0,26 RC,499,"Biopsy of ovary, unilateral or bilateral (separate procedure) ",,,1116.7,12562.0,26 RC,499,Biopsy of penis; (separate procedure) ,,,510.77,3747.2,26 RC,499,Biopsy of penis; deep structures ,,,855.96,6330.57,26 RC,499,"Biopsy of spinal cord, percutaneous needle ",,,510.77,3747.2,26 RC,499,"Biopsy of testis, incisional (separate procedure) ",,,1200.05,8240.61,26 RC,499,"Biopsy of testis, needle (separate procedure) ",,,855.96,6330.57,26 RC,499,Biopsy of urethra ,,,685.44,5571.0,26 RC,499,"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) ",,,1116.7,6819.81,26 RC,499,Biopsy of vaginal mucosa; simple (separate procedure) ,,,49.41,3128.0,26 RC,499,Biopsy of vulva or perineum (separate procedure); 1 lesion ,,,47.09,5841.0,25 RC,499,Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,"Biopsy thyroid, percutaneous core needle ",,,44.76,3128.0,26 RC,499,"Biopsy, prostate, any approach, nonimaging-guided ",,,1200.05,4836.33,26 RC,499,"Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,499,"Biopsy, prostate, in-bore CT- or MRI-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion ",,,2699.0,14954.75,17 RC,499,"Biopsy, prostate, in-bore CT- or MRI-guided targeted lesion(s) only, first targeted lesion ",,,2699.0,14954.75,17 RC,499,"Biopsy, prostate, transperineal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance biopsy, first targeted lesion ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate, transrectal, MRI-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with MRI-fusion-guidance, first targeted lesion ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesionºs») ",,,2195.0,9831.63,17 RC,499,"Biopsy, prostate; needle or punch, single or multiple, any approach ",,,685.44,3755.0,8 RC,499,Bladder instillation of anticarcinogenic agent (including retention time) ,,,47.09,5841.0,13 RC,499,"Bladder irrigation, simple, lavage and/or instillation ",,,46.52,5841.0,25 RC,499,"Blepharotomy, drainage of abscess, eyelid ",,,113.7,5841.0,25 RC,499,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,499,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,499,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,499,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,499,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,499,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,499,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,499,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,499,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,499,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,499,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,499,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,499,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,499,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,499,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,499,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,499,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,499,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,499,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,499,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,499,Bundle of His recording ,,,3673.0,43890.0,22 RC,499,"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material) ",,,3390.0,16207.0,12 RC,499,"Burr hole(s) or trephine, infratentorial, unilateral or bilateral ",,,3390.0,16207.0,12 RC,499,"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery ",,,3390.0,16207.0,12 RC,499,Burr hole(s) or trephine; with biopsy of brain or intracranial lesion ,,,3390.0,16207.0,12 RC,499,Burr hole(s) or trephine; with drainage of brain abscess or cyst ,,,3390.0,16868.07,12 RC,499,Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst ,,,3390.0,16207.0,12 RC,499,"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural ",,,3390.0,16207.0,12 RC,499,"Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) ",,,3390.0,16207.0,12 RC,499,"Burr hole(s); with aspiration of hematoma or cyst, intracerebral ",,,3390.0,16207.0,12 RC,499,CATHETERIZE MIDDLE EAR CANAL ,,,3390.0,5841.0,2 RC,499,CHANGE KIDNEY TUBE ,,,3390.0,5841.0,2 RC,499,CIRCUMCISION ,,,3390.0,5841.0,2 RC,499,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,499,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,499,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,499,CONTROL POSTOP BLEEDING ,,,3390.0,5841.0,2 RC,499,"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR, CORTICAL ",,,5841.0,16207.0,3 RC,499,"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY ",,,3390.0,16207.0,3 RC,499,"CYSTOSCOPY, RESECT DUCTS ",,,3390.0,5841.0,2 RC,499,Canthoplasty (reconstruction of canthus) ,,,733.22,5571.0,26 RC,499,Canthotomy (separate procedure) ,,,733.22,5571.0,26 RC,499,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,499,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,499,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,499,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,499,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,499,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,499,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,499,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,499,Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography ,,,1672.0,5841.0,15 RC,499,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,499,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,499,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,600.2,3390.0,18 RC,499,"Cautery of cervix; cryocautery, initial or repeat ",,,110.18,5841.0,25 RC,499,Cautery of cervix; electro or thermal ,,,83.14,13835.0,26 RC,499,Cautery of cervix; laser ablation ,,,1116.7,6819.81,26 RC,499,"Cerclage of cervix, during pregnancy; abdominal ",,,2300.11,16207.0,24 RC,499,"Cerclage of cervix, during pregnancy; vaginal ",,,1116.7,6819.81,26 RC,499,"Cerclage of uterine cervix, nonobstetrical ",,,1986.0,6819.81,24 RC,499,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; ",,,3390.0,13835.0,10 RC,499,"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care ",,,3390.0,15889.05,7 RC,499,Cesarean delivery only; ,,,3390.0,13835.0,10 RC,499,Cesarean delivery only; including postpartum care ,,,3293.0,15427.0,19 RC,499,Change of cystostomy tube; complicated ,,,250.06,3390.0,26 RC,499,Change of cystostomy tube; simple ,,,54.36,5841.0,25 RC,499,Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit ,,,685.44,4836.33,26 RC,499,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,499,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,499,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,499,Chemodenervation of eccrine glands; both axillae ,,,53.19,5841.0,25 RC,499,"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day ",,,60.75,5841.0,25 RC,499,Chemodenervation of extraocular muscle ,,,107.27,5841.0,25 RC,499,"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed ",,,78.19,3390.0,26 RC,499,"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) ",,,68.02,5841.0,25 RC,499,"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) ",,,62.21,5841.0,25 RC,499,"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) ",,,60.16,3244.0,26 RC,499,Chemodenervation of one extremity; 1-4 muscle(s) ,,,72.09,3244.0,26 RC,499,Chemodenervation of one extremity; 5 or more muscles ,,,89.82,3244.0,26 RC,499,"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Chemodenervation of parotid and submandibular salivary glands, bilateral ",,,70.93,5841.0,25 RC,499,Chemodenervation of trunk muscle(s); 1-5 muscle(s) ,,,72.09,3244.0,26 RC,499,Chemodenervation of trunk muscle(s); 6 or more muscles ,,,79.06,3244.0,26 RC,499,"Chorionic villus sampling, any method ",,,52.32,3244.0,14 RC,499,"Chromotubation of oviduct, including materials ",,,2699.0,12562.0,24 RC,499,Ciliary body destruction; cryotherapy ,,,733.22,5571.0,26 RC,499,Ciliary body destruction; cyclodialysis ,,,733.22,5571.0,26 RC,499,"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens ",,,892.44,5571.0,26 RC,499,"Ciliary body destruction; cyclophotocoagulation, transscleral ",,,733.22,5571.0,26 RC,499,Ciliary body destruction; diathermy ,,,892.44,5519.68,26 RC,499,"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) ",,,250.06,5571.0,26 RC,499,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age ",,,685.44,5571.0,26 RC,499,"Circumcision, using clamp or other device with regional dorsal penile or ring block ",,,685.44,5571.0,26 RC,499,Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment ,,,113.56,3128.0,26 RC,499,Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) ,,,113.56,5571.0,26 RC,499,Clitoroplasty for intersex state ,,,1116.7,13835.0,14 RC,499,Closure of cystostomy (separate procedure) ,,,1200.05,8240.61,26 RC,499,Closure of lacrimal fistula (separate procedure) ,,,733.22,8234.0,26 RC,499,Closure of nephrocutaneous or pyelocutaneous fistula ,,,1986.0,14240.3,24 RC,499,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach ",,,3390.0,18071.71,12 RC,499,"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach ",,,3390.0,19372.84,12 RC,499,Closure of rectovaginal fistula; abdominal approach ,,,3293.0,16207.0,24 RC,499,"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy ",,,3390.0,16207.0,12 RC,499,"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication ",,,3041.0,13835.0,12 RC,499,Closure of rectovaginal fistula; vaginal or transanal approach ,,,1116.7,12562.0,26 RC,499,"Closure of the lacrimal punctum; by plug, each ",,,82.55,5841.0,25 RC,499,"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery ",,,113.7,5841.0,25 RC,499,Closure of ureterocutaneous fistula ,,,3390.0,16207.0,12 RC,499,Closure of ureterovisceral fistula (including visceral repair) ,,,3390.0,16207.0,12 RC,499,"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) ",,,1773.9,11552.32,26 RC,499,Closure of urethrovaginal fistula; ,,,2390.64,18300.83,26 RC,499,Closure of urethrovaginal fistula; with bulbocavernosus transplant ,,,2996.0,13835.0,24 RC,499,Closure of vesicouterine fistula; ,,,2699.0,13835.0,24 RC,499,Closure of vesicouterine fistula; with hysterectomy ,,,3390.0,16207.0,12 RC,499,"Closure of vesicovaginal fistula, abdominal approach ",,,2996.0,13835.0,24 RC,499,Closure of vesicovaginal fistula; transvesical and vaginal approach ,,,4988.0,18300.83,12 RC,499,Closure of vesicovaginal fistula; vaginal approach ,,,1603.34,12562.0,26 RC,499,"Closure postauricular fistula, mastoid (separate procedure) ",,,441.67,12562.0,26 RC,499,"Closure, exstrophy of bladder ",,,3390.0,20139.94,12 RC,499,"Cochlear device implantation, with or without mastoidectomy ",,,3673.0,97713.0,27 RC,499,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,499,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,499,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,25 RC,499,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,25 RC,499,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,22 RC,499,Colpocentesis (separate procedure) ,,,1603.34,11661.3,26 RC,499,Colpocleisis (Le Fort type) ,,,1603.34,13835.0,26 RC,499,"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) ",,,1116.7,6819.81,26 RC,499,"Colpopexy, abdominal approach ",,,3041.0,13835.0,24 RC,499,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) ",,,3293.0,18300.83,24 RC,499,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) ",,,3293.0,18300.83,24 RC,499,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,499,"Colporrhaphy, suture of injury of vagina (nonobstetrical) ",,,1116.7,6819.81,26 RC,499,Colposcopy of the cervix including upper/adjacent vagina; ,,,59.59,5841.0,25 RC,499,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix ,,,73.54,5841.0,25 RC,499,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage ,,,68.31,5841.0,25 RC,499,Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage ,,,69.76,5841.0,25 RC,499,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix ,,,183.14,13835.0,26 RC,499,Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix ,,,194.48,5571.0,26 RC,499,"Colposcopy of the entire vagina, with cervix if present; ",,,60.75,5841.0,25 RC,499,"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix ",,,79.95,3128.0,26 RC,499,Colposcopy of the vulva; ,,,57.86,5841.0,25 RC,499,Colposcopy of the vulva; with biopsy(s) ,,,76.17,5841.0,25 RC,499,Colpotomy; with drainage of pelvic abscess ,,,1116.7,6819.81,26 RC,499,Colpotomy; with exploration ,,,1116.7,6819.81,26 RC,499,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; ",,,1603.34,13394.0,26 RC,499,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair ",,,1603.34,12909.0,26 RC,499,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,499,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,499,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,499,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,499,"Complex cystometrogram (ie, calibrated electronic equipment); ",,,115.66,3390.0,26 RC,499,"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique ",,,229.65,3503.96,26 RC,499,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile)",,,233.43,3612.51,26 RC,499,"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique ",,,233.71,3596.9,26 RC,499,"Complex uroflowmetry (eg, calibrated electronic equipment) ",,,283.62,5841.0,11 RC,499,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,499,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,499,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,499,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,499,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,499,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,499,"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code fo",,,1672.0,5841.0,3 RC,499,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser ",,,1116.7,6819.81,26 RC,499,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision ",,,1116.7,6819.81,26 RC,499,Conjunctival flap; bridge or partial (separate procedure) ,,,1158.59,8536.87,26 RC,499,Conjunctival flap; total (such as Gunderson thin flap or purse string flap) ,,,733.22,5571.0,26 RC,499,"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft) ",,,733.22,8234.0,26 RC,499,"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement ",,,1158.59,8536.87,26 RC,499,Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft) ,,,1158.59,8536.87,26 RC,499,Conjunctivoplasty; with conjunctival graft or extensive rearrangement ,,,733.22,8234.0,26 RC,499,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent ,,,1158.59,8536.87,26 RC,499,Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube ,,,1158.59,8536.87,26 RC,499,Construction of artificial vagina; with graft ,,,2996.0,13835.0,24 RC,499,Construction of artificial vagina; without graft ,,,1603.34,13394.0,26 RC,499,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; ",,,733.22,12562.0,26 RC,499,"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate ",,,733.22,12562.0,26 RC,499,Cont epidur inject-lumb ,,,3390.0,5841.0,2 RC,499,"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty) ",,,3390.0,20377.26,12 RC,499,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,499,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,499,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and al",,,685.44,12562.0,26 RC,499,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,499,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,499,"Cordocentesis (intrauterine), any method ",,,554.98,5841.0,11 RC,499,Corneal relaxing incision for correction of surgically induced astigmatism ,,,351.98,8234.0,26 RC,499,Corneal wedge resection for correction of surgically induced astigmatism ,,,733.22,8234.0,26 RC,499,"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral ",,,3390.0,16207.0,12 RC,499,"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism ",,,1200.05,8240.61,26 RC,499,"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral ",,,1200.05,8234.0,26 RC,499,"Correction of everted punctum, cautery ",,,113.7,5841.0,25 RC,499,"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight) ",,,733.22,12562.0,26 RC,499,Correction of lid retraction ,,,733.22,12562.0,26 RC,499,"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery) ",,,70.63,5841.0,13 RC,499,"Correction of trichiasis; epilation, by forceps only ",,,223.51,5841.0,11 RC,499,Correction of trichiasis; incision of lid margin ,,,351.98,3755.0,26 RC,499,"Correction of trichiasis; incision of lid margin, with free mucous membrane graft ",,,733.22,5571.0,26 RC,499,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary proce",,,1672.0,5841.0,3 RC,499,"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment ",,,8778.0,16330.72,12 RC,499,Craniectomy for craniosynostosis; multiple cranial sutures ,,,3390.0,18444.62,12 RC,499,Craniectomy for craniosynostosis; single cranial suture ,,,3390.0,16207.0,12 RC,499,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor ",,,3390.0,46759.99,12 RC,499,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull ",,,3390.0,34350.61,12 RC,499,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma ",,,3390.0,36766.35,12 RC,499,"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull ",,,3390.0,39720.34,12 RC,499,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural ",,,3390.0,22576.85,12 RC,499,"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar ",,,3390.0,25611.4,12 RC,499,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural ",,,3390.0,25806.38,12 RC,499,"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral ",,,3390.0,24598.51,12 RC,499,"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical ",,,2979.0,19402.47,12 RC,499,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy ",,,3390.0,29586.87,12 RC,499,"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy ",,,3390.0,29561.46,12 RC,499,"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial ",,,3390.0,26149.65,12 RC,499,"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial ",,,3390.0,23547.4,12 RC,499,"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) ",,,3390.0,24861.23,12 RC,499,"Craniectomy or craniotomy, exploratory; supratentorial ",,,3390.0,20406.89,12 RC,499,Craniectomy or craniotomy; with excision of foreign body from brain ,,,3390.0,23106.64,12 RC,499,Craniectomy or craniotomy; with treatment of penetrating wound of brain ,,,3390.0,24297.57,12 RC,499,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; ",,,3390.0,41508.92,12 RC,499,"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy ",,,3390.0,38601.49,12 RC,499,"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess ",,,3390.0,26679.44,12 RC,499,"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst ",,,3390.0,25797.91,12 RC,499,"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) ",,,3390.0,27154.19,12 RC,499,"Craniectomy, suboccipital; for exploration or decompression of cranial nerves ",,,3390.0,24954.48,12 RC,499,"Craniectomy, suboccipital; for section of 1 or more cranial nerves ",,,3390.0,26158.12,12 RC,499,"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion ",,,3390.0,23733.91,12 RC,499,"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial ",,,3390.0,23716.98,12 RC,499,"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma ",,,3390.0,27162.66,12 RC,499,"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial ",,,3390.0,31706.02,12 RC,499,"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial ",,,3390.0,23081.23,12 RC,499,Craniectomy; for osteomyelitis ,,,3390.0,16207.0,12 RC,499,Craniectomy; with excision of tumor or other bone lesion of skull ,,,3982.0,16194.11,24 RC,499,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration ",,,3390.0,29832.65,12 RC,499,"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy ",,,3390.0,32278.14,12 RC,499,"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa ",,,3390.0,37546.15,12 RC,499,"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa ",,,3390.0,35702.54,12 RC,499,Cranioplasty for skull defect with reparative brain surgery ,,,3390.0,17389.28,12 RC,499,Cranioplasty for skull defect; larger than 5 cm diameter ,,,3390.0,16207.0,12 RC,499,Cranioplasty for skull defect; up to 5 cm diameter ,,,3390.0,16207.0,12 RC,499,Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter ,,,3390.0,17787.71,12 RC,499,Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter ,,,3390.0,16207.0,12 RC,499,Craniotomy for craniosynostosis; bifrontal bone flap ,,,3390.0,20945.15,12 RC,499,Craniotomy for craniosynostosis; frontal or parietal bone flap ,,,3390.0,21263.02,12 RC,499,"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach ",,,3390.0,28586.68,12 RC,499,"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea ",,,3390.0,19673.77,12 RC,499,"Craniotomy for repair of encephalocele, skull base ",,,3390.0,19381.3,12 RC,499,"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) ",,,3390.0,31883.95,12 RC,499,Craniotomy with elevation of bone flap; for excision of craniopharyngioma ,,,3390.0,39423.75,12 RC,499,Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery ,,,3390.0,20105.95,12 RC,499,Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus ,,,3390.0,23733.91,12 RC,499,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery ",,,3390.0,29514.78,12 RC,499,"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery ",,,3390.0,26730.36,12 RC,499,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery ",,,3390.0,33180.84,12 RC,499,"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery ",,,3390.0,30709.95,12 RC,499,"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery ",,,3390.0,30913.39,12 RC,499,Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy ,,,3390.0,26158.12,12 RC,499,"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) ",,,3390.0,16207.0,12 RC,499,Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy ,,,3390.0,27493.23,12 RC,499,"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring ",,,3390.0,18843.05,12 RC,499,Craniotomy with elevation of bone flap; for transection of corpus callosum ,,,3390.0,26577.72,12 RC,499,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus ",,,3390.0,15039.6,12 RC,499,"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus ",,,3390.0,19834.77,12 RC,499,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion ",,,692.94,12562.0,26 RC,499,"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract ",,,692.94,12562.0,26 RC,499,"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) ",,,692.94,8234.0,26 RC,499,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy ",,,3390.0,16207.0,12 RC,499,"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy ",,,2195.0,15039.6,24 RC,499,"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ",,,3390.0,16207.0,12 RC,499,"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,12 RC,499,"Creation of shunt; ventriculo-atrial, -jugular, -auricular ",,,3390.0,16207.0,12 RC,499,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ",,,3390.0,16207.0,12 RC,499,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,499,Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) ,,,3375.0,24948.0,26 RC,499,"Curettage, postpartum ",,,1116.7,12562.0,26 RC,499,Cutaneous appendico-vesicostomy ,,,3390.0,16207.0,12 RC,499,Cutaneous vesicostomy ,,,3041.0,13835.0,12 RC,499,"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder ",,,3390.0,28891.85,12 RC,499,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; ",,,3390.0,23721.21,12 RC,499,"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,26849.02,12 RC,499,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; ",,,3390.0,23212.59,12 RC,499,"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,25874.23,12 RC,499,"Cystectomy, complete; (separate procedure) ",,,3390.0,18071.71,12 RC,499,"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,22360.7,12 RC,499,"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) ",,,3390.0,16207.0,12 RC,499,"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) ",,,3390.0,16207.0,12 RC,499,"Cystectomy, partial; simple ",,,3390.0,16207.0,12 RC,499,Cysto w Bx/fulgur les ,,,3390.0,5841.0,2 RC,499,Cysto w lithotripsy ,,,3390.0,5841.0,2 RC,499,Cysto w rmvl/manip CAL ,,,3390.0,5841.0,2 RC,499,Cysto w tumor resection ,,,3390.0,5841.0,2 RC,499,"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection ",,,1773.9,11552.32,26 RC,499,"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical n",,,2358.0,16207.0,24 RC,499,"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated ",,,2996.0,13835.0,24 RC,499,"Cystorrhaphy, suture of bladder wound, injury or rupture; simple ",,,2195.0,13835.0,24 RC,499,"Cystostomy, cystotomy with drainage ",,,685.44,8234.0,26 RC,499,"Cystotomy for excision, incision, or repair of ureterocele ",,,3041.0,13835.0,12 RC,499,"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material ",,,1200.05,8240.61,26 RC,499,Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion ,,,1226.38,8234.0,7 RC,499,"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus ",,,1200.05,8240.61,26 RC,499,"Cystotomy, with insertion of ureteral catheter or stent (separate procedure) ",,,685.44,8234.0,26 RC,499,"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) ",,,4988.0,13835.0,12 RC,499,Cystotomy; for excision of bladder tumor ,,,4988.0,13835.0,12 RC,499,Cystotomy; for simple excision of vesical neck (separate procedure) ,,,1200.05,8240.61,26 RC,499,Cystourethroplasty with unilateral or bilateral ureteroneocystostomy ,,,2358.0,16207.0,24 RC,499,Cystourethroscopy ,,,3390.0,5841.0,2 RC,499,"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) ",,,1773.9,11552.32,26 RC,499,"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus ",,,1200.05,8240.61,26 RC,499,Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus ,,,1200.05,13394.0,26 RC,499,Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material ,,,2195.0,11552.32,26 RC,499,Cystourethroscopy (separate procedure) ,,,250.06,3128.0,26 RC,499,"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, ",,,250.06,3755.0,26 RC,499,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,499,Cystourethroscopy with direct vision internal urethrotomy ,,,685.44,12562.0,26 RC,499,"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds ",,,1200.05,12562.0,26 RC,499,Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon ca,,,2699.0,26403.19,17 RC,499,"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration ",,,1200.05,25988.0,28 RC,499,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate ",,,2699.0,25244.72,18 RC,499,"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde ",,,1200.05,12562.0,26 RC,499,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots ,,,1200.05,8240.61,26 RC,499,Cystourethroscopy with transurethral resection or incision of ejaculatory ducts ,,,2699.0,12562.0,24 RC,499,"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1773.9,12562.0,26 RC,499,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,499,"Cystourethroscopy, with biopsy(s) ",,,685.44,5571.0,26 RC,499,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female ",,,685.44,4836.33,26 RC,499,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia ",,,685.44,4836.33,26 RC,499,"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia ",,,234.3,3891.46,26 RC,499,"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service ",,,250.06,3755.0,26 RC,499,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) ",,,1773.9,12562.0,26 RC,499,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands ",,,1200.05,5571.0,26 RC,499,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy ",,,1200.05,5571.0,26 RC,499,"Cystourethroscopy, with injection(s) for chemodenervation of the bladder ",,,685.44,13394.0,26 RC,499,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure",,,578.35,5841.0,20 RC,499,"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant ",,,1672.0,5841.0,20 RC,499,"Cystourethroscopy, with insertion of permanent urethral stent ",,,1200.05,15059.0,26 RC,499,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,499,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,25 RC,499,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,25 RC,499,"Cystourethroscopy, with internal urethrotomy; female ",,,685.44,4836.33,26 RC,499,"Cystourethroscopy, with internal urethrotomy; male ",,,685.44,5571.0,26 RC,499,"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when perfor",,,2699.0,15059.0,22 RC,499,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated ",,,685.44,5571.0,26 RC,499,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple ",,,685.44,4836.33,26 RC,499,"Cystourethroscopy, with resection of external sphincter (sphincterotomy) ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy, with steroid injection into stricture ",,,685.44,5571.0,26 RC,499,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,685.44,5571.0,26 RC,499,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion ",,,1773.9,11552.32,26 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) ",,,1773.9,11552.32,23 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type) ",,,1773.9,15059.0,26 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor ",,,1773.9,11552.32,26 RC,499,"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple ",,,1773.9,11552.32,26 RC,499,"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral ",,,1200.05,8240.61,26 RC,499,"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) ",,,1200.05,12562.0,26 RC,499,"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral ",,,685.44,5571.0,26 RC,499,D & C OF RESIDUAL CERVIX ,,,3390.0,5841.0,2 RC,499,DESTR PARAVERTEBRAL N ADD-ON ,,,3390.0,5841.0,4 RC,499,DESTR PARAVERTEBRL NERVE C/T ,,,3390.0,5841.0,2 RC,499,DESTR PARAVERTEBRL NERVE L/S ,,,3390.0,5841.0,2 RC,499,DESTROY NERVE EXTREM MUSC ,,,3390.0,5841.0,2 RC,499,DESTROY NERVE NECK MUSCLE ,,,3390.0,5841.0,2 RC,499,DILATION PROSTATIC URETHRA ,,,3390.0,5841.0,2 RC,499,DRAIN PELVIC ABSCESS PERCUT ,,,3390.0,5841.0,2 RC,499,DRAINAGE OF BLADDER ,,,3390.0,5841.0,6 RC,499,DRAINAGE OF EYE ,,,3390.0,5841.0,2 RC,499,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) ,,,1158.59,8536.87,26 RC,499,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,499,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,499,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,499,"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning) ",,,140.69,13835.0,26 RC,499,"Debridement, mastoidectomy cavity, simple (eg, routine cleaning) ",,,358.2,5841.0,11 RC,499,"Decompression facial nerve, intratemporal; including medial to geniculate ganglion ",,,3293.0,13835.0,24 RC,499,"Decompression facial nerve, intratemporal; lateral to geniculate ganglion ",,,2051.93,13394.0,26 RC,499,Decompression internal auditory canal ,,,6326.0,13835.0,12 RC,499,"Decompression of orbit only, transcranial approach ",,,5369.54,13835.0,12 RC,499,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,499,"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visual",,,692.94,15059.0,26 RC,499,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; additional interspa",,,1986.0,3083.0,12 RC,499,"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, CT or fluoroscopy), bilateral; one interspace, lum",,,2996.0,20238.53,17 RC,499,"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance ",,,2195.0,5446.4,17 RC,499,Decompression; plantar digital nerve ,,,692.94,5571.0,26 RC,499,Decompression; unspecified nerve(s) (specify) ,,,692.94,5571.0,26 RC,499,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,499,Deligation of ureter ,,,3390.0,16207.0,12 RC,499,Delivery of placenta (separate procedure) ,,,1116.7,13835.0,14 RC,499,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,499,"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed ",,,692.94,5841.0,25 RC,499,"Destruction by neurolytic agent, intercostal nerve ",,,357.81,5571.0,26 RC,499,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code f",,,1672.0,5841.0,15 RC,499,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint ",,,692.94,5571.0,26 RC,499,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for p",,,1672.0,5841.0,15 RC,499,"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint ",,,692.94,13394.0,26 RC,499,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale ",,,692.94,5571.0,26 RC,499,"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring ",,,692.94,5571.0,26 RC,499,"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch ",,,357.81,5571.0,26 RC,499,"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus ",,,357.81,5571.0,26 RC,499,"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus ",,,357.81,3755.0,26 RC,499,Destruction by neurolytic agent; other peripheral nerve or branch ,,,152.61,3128.0,26 RC,499,Destruction by neurolytic agent; plantar common digital nerve ,,,38.66,5841.0,25 RC,499,Destruction by neurolytic agent; pudendal nerve ,,,357.81,3755.0,26 RC,499,Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) ,,,218.75,3667.92,26 RC,499,"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy ",,,140.41,7014.0,26 RC,499,"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization ",,,113.7,5841.0,25 RC,499,Destruction of lesion of lid margin (up to 1 cm) ,,,132.27,3128.0,26 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,4430.08,26 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical ",,,655.0,5841.0,11 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery ",,,358.2,5841.0,11 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation ",,,76.74,13835.0,14 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery ",,,744.46,4430.08,26 RC,499,"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision ",,,744.46,4430.08,26 RC,499,"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,744.46,12562.0,26 RC,499,"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,116.57,13835.0,26 RC,499,"Destruction of lesion, conjunctiva ",,,74.13,5571.0,26 RC,499,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions ",,,218.75,3667.92,26 RC,499,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion) ",,,123.25,3128.0,26 RC,499,"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment) ",,,1672.0,5841.0,15 RC,499,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,25 RC,499,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy ",,,113.7,5841.0,25 RC,499,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation ",,,218.75,4788.0,26 RC,499,"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) ",,,1158.59,13394.0,26 RC,499,"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,1116.7,6819.81,26 RC,499,"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) ",,,103.77,13835.0,26 RC,499,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,499,Diagnostic hysteroscopy ,,,3390.0,5841.0,2 RC,499,Diagnostic laparoscopy ,,,3390.0,5841.0,2 RC,499,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,499,Diaphragm or cervical cap fitting with instructions ,,,37.5,5841.0,13 RC,499,Dilation and curettage of cervical stump ,,,1116.7,12562.0,26 RC,499,"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ",,,1116.7,6819.81,26 RC,499,"Dilation of cervical canal, instrumental (separate procedure) ",,,41.85,5571.0,26 RC,499,"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, w",,,1200.05,15059.0,50 RC,499,Dilation of female urethra including suppository and/or instillation; initial ,,,41.57,5841.0,25 RC,499,Dilation of female urethra including suppository and/or instillation; subsequent ,,,31.08,5841.0,13 RC,499,"Dilation of female urethra, general or conduction (spinal) anesthesia ",,,685.44,5571.0,26 RC,499,"Dilation of lacrimal punctum, with or without irrigation ",,,745.36,5841.0,11 RC,499,"Dilation of urethral stricture by passage of filiform and follower, male; initial ",,,97.08,13835.0,26 RC,499,"Dilation of urethral stricture by passage of filiform and follower, male; subsequent ",,,98.84,5841.0,25 RC,499,"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial ",,,36.62,5841.0,25 RC,499,"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent ",,,41.02,5841.0,25 RC,499,"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia ",,,1200.05,4836.33,26 RC,499,Dilation of vagina under anesthesia (other than local) ,,,1116.7,6819.81,26 RC,499,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (List separately in addition to code for primary procedure",,,1672.0,5841.0,15 RC,499,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace ",,,3293.0,16330.72,24 RC,499,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List separately in addition to code for primary procedure",,,2002.73,16207.0,12 RC,499,"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace ",,,3390.0,18749.79,12 RC,499,"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages) ",,,218.75,3755.0,26 RC,499,Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) ,,,892.44,5841.0,25 RC,499,"Discission of vitreous strands (without removal), pars plana approach ",,,892.44,5571.0,26 RC,499,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,499,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,499,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,499,"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral ",,,3390.0,16207.0,12 RC,499,"Donor nephrectomy (including cold preservation); open, from living donor ",,,3390.0,18414.98,12 RC,499,"Drainage external auditory canal, abscess ",,,154.94,5841.0,25 RC,499,"Drainage external ear, abscess or hematoma; complicated ",,,118.89,13835.0,26 RC,499,"Drainage external ear, abscess or hematoma; simple ",,,112.5,5841.0,25 RC,499,Drainage of Skene's gland abscess or cyst ,,,591.46,13835.0,24 RC,499,Drainage of deep periurethral abscess ,,,1200.05,5571.0,26 RC,499,Drainage of ovarian abscess; abdominal approach ,,,2699.0,13835.0,24 RC,499,"Drainage of ovarian abscess; vaginal approach, open ",,,1116.7,12562.0,26 RC,499,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach ",,,1116.7,13835.0,26 RC,499,"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach ",,,1116.7,12562.0,26 RC,499,Drainage of perineal urinary extravasation; complicated ,,,3041.0,13835.0,12 RC,499,Drainage of perineal urinary extravasation; uncomplicated (separate procedure) ,,,250.06,12562.0,26 RC,499,"Drainage of perirenal or renal abscess, open ",,,2195.0,13835.0,24 RC,499,Drainage of perivesical or prevesical space abscess ,,,855.96,6330.57,26 RC,499,Drainage of scrotal wall abscess ,,,510.77,3747.2,26 RC,499,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,499,"Dural graft, spinal ",,,3390.0,16207.0,12 RC,499,"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) ",,,466.41,13835.0,12 RC,499,EXPLORATION OF EPIDIDYMIS ,,,3390.0,5841.0,2 RC,499,EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY ,,,3390.0,16207.0,3 RC,499,EXPLORE ORBIT/REMOVE OBJECT ,,,3390.0,5841.0,2 RC,499,Ear piercing ,,,370.1,16207.0,9 RC,499,Electroejaculation ,,,560.2,3128.0,24 RC,499,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,499,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,499,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,499,"Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique ",,,23.25,5841.0,13 RC,499,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,499,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming ",,,1672.0,5841.0,18 RC,499,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and ",,,479.41,5841.0,34 RC,499,"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming o",,,1672.0,5841.0,18 RC,499,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,499,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,499,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,499,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,499,"Elevation of depressed skull fracture; compound or comminuted, extradural ",,,3390.0,16207.0,12 RC,499,"Elevation of depressed skull fracture; simple, extradural ",,,5369.54,13835.0,12 RC,499,Elevation of depressed skull fracture; with repair of dura and/or debridement of brain ,,,3390.0,18957.47,12 RC,499,"Embryo transfer, intrauterine ",,,1308.84,5841.0,23 RC,499,Endocervical curettage (not done as part of a dilation and curettage) ,,,96.51,3128.0,26 RC,499,"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List se",,,1672.0,5841.0,15 RC,499,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,499,Endolymphatic sac operation; with shunt ,,,2051.93,13241.95,26 RC,499,Endolymphatic sac operation; without shunt ,,,2051.93,13241.95,26 RC,499,"Endometrial ablation, thermal, without hysteroscopic guidance ",,,1603.34,12909.0,28 RC,499,"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed ",,,1299.68,23059.78,28 RC,499,Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) ",,,48.26,5841.0,25 RC,499,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,499,"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar ",,,2518.45,16330.72,25 RC,499,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,499,Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck ,,,1639.76,12562.0,26 RC,499,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,499,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,499,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,499,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,499,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,499,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,499,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,499,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each add",,,2316.62,16207.0,14 RC,499,"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial ",,,3390.0,16207.0,14 RC,499,"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon",,,3375.0,27050.15,24 RC,499,"Enterocystoplasty, including intestinal anastomosis ",,,3390.0,16974.03,12 RC,499,"Enucleation of eye; with implant, muscles attached to implant ",,,1158.59,8536.87,26 RC,499,"Enucleation of eye; with implant, muscles not attached to implant ",,,1158.59,12562.0,26 RC,499,Enucleation of eye; without implant ,,,1158.59,12562.0,26 RC,499,Epididymectomy; bilateral ,,,1200.05,8240.61,26 RC,499,Epididymectomy; unilateral ,,,1200.05,12562.0,26 RC,499,"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral ",,,2996.0,8240.61,24 RC,499,"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral ",,,2996.0,8234.0,24 RC,499,Epikeratoplasty ,,,2518.0,15664.44,24 RC,499,"Episiotomy or vaginal repair, by other than attending ",,,807.77,13835.0,24 RC,499,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,499,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,499,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,499,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,499,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,499,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,499,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,499,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,499,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,499,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,499,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,499,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,499,Evisceration of ocular contents; with implant ,,,1158.59,12562.0,26 RC,499,Evisceration of ocular contents; without implant ,,,1158.59,12562.0,26 RC,499,"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological ",,,685.44,12562.0,26 RC,499,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,499,Exchange of intraocular lens ,,,892.44,5571.0,26 RC,499,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,499,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,499,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,499,"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangem",,,733.22,12562.0,52 RC,499,Excision aural glomus tumor; extended (extratemporal) ,,,3390.0,30451.46,12 RC,499,Excision aural glomus tumor; transcanal ,,,2051.93,13394.0,26 RC,499,Excision aural glomus tumor; transmastoid ,,,2051.93,13241.95,26 RC,499,Excision aural polyp ,,,143.6,13835.0,26 RC,499,"Excision exostosis(es), external auditory canal ",,,2051.93,13241.95,26 RC,499,Excision external ear; complete amputation ,,,2051.93,13241.95,26 RC,499,"Excision external ear; partial, simple repair ",,,855.96,6330.57,26 RC,499,Excision of Bartholin's gland or cyst ,,,1116.7,12562.0,26 RC,499,Excision of Mullerian duct cyst ,,,1200.05,8240.61,26 RC,499,Excision of bulbourethral gland (Cowper's gland) ,,,1200.05,8240.61,26 RC,499,Excision of carotid body tumor; with excision of carotid artery ,,,3390.0,20326.45,12 RC,499,Excision of carotid body tumor; without excision of carotid artery ,,,3390.0,16795.98,12 RC,499,"Excision of cervical stump, abdominal approach; ",,,3390.0,16207.0,12 RC,499,"Excision of cervical stump, abdominal approach; with pelvic floor repair ",,,3390.0,16207.0,12 RC,499,"Excision of cervical stump, vaginal approach; ",,,1603.34,12562.0,26 RC,499,"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair ",,,4988.0,13835.0,12 RC,499,"Excision of cervical stump, vaginal approach; with repair of enterocele ",,,1603.34,13394.0,26 RC,499,"Excision of chalazion; multiple, different lids ",,,101.16,5841.0,25 RC,499,"Excision of chalazion; multiple, same lid ",,,78.49,3128.0,26 RC,499,Excision of chalazion; single ,,,65.12,5841.0,25 RC,499,"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple ",,,733.22,5571.0,26 RC,499,"Excision of cyst or adenoma of thyroid, or transection of isthmus ",,,1983.29,13196.03,26 RC,499,Excision of extraparenchymal lesion of testis ,,,1200.05,8240.61,26 RC,499,"Excision of hydrocele of spermatic cord, unilateral (separate procedure) ",,,1200.05,12562.0,26 RC,499,Excision of hydrocele; bilateral ,,,1209.12,13394.0,26 RC,499,Excision of hydrocele; unilateral ,,,1209.12,12562.0,26 RC,499,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial ",,,1158.59,12562.0,26 RC,499,"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total ",,,1158.59,12562.0,26 RC,499,Excision of lacrimal gland tumor; frontal approach ,,,733.22,12562.0,26 RC,499,Excision of lacrimal gland tumor; involving osteotomy ,,,1158.59,12562.0,26 RC,499,Excision of lacrimal sac (dacryocystectomy) ,,,1158.59,12562.0,26 RC,499,Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure ,,,177.9,3249.0,26 RC,499,Excision of lesion of spermatic cord (separate procedure) ,,,1200.05,8240.61,26 RC,499,"Excision of lesion, conjunctiva; over 1 cm ",,,733.22,5571.0,26 RC,499,"Excision of lesion, conjunctiva; up to 1 cm ",,,147.09,5571.0,26 RC,499,"Excision of lesion, conjunctiva; with adjacent sclera ",,,733.22,5571.0,26 RC,499,"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium ",,,351.98,3128.0,26 RC,499,"Excision of lesion, sclera ",,,733.22,12909.0,26 RC,499,Excision of local lesion of epididymis ,,,1200.05,12562.0,26 RC,499,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,499,Excision of neurofibroma or neurolemmoma; cutaneous nerve ,,,692.94,12562.0,26 RC,499,Excision of neurofibroma or neurolemmoma; extensive (including malignant type) ,,,2096.41,15039.6,26 RC,499,Excision of neurofibroma or neurolemmoma; major peripheral nerve ,,,692.94,12562.0,26 RC,499,"Excision of neuroma; cutaneous nerve, surgically identifiable ",,,692.94,5571.0,26 RC,499,"Excision of neuroma; digital nerve, 1 or both, same digit ",,,692.94,12562.0,26 RC,499,"Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Excision of neuroma; hand or foot, except digital nerve ",,,692.94,12562.0,26 RC,499,"Excision of neuroma; major peripheral nerve, except sciatic ",,,692.94,12562.0,26 RC,499,Excision of neuroma; sciatic nerve ,,,2096.41,15039.6,26 RC,499,Excision of penile plaque (Peyronie disease); ,,,1200.05,9653.0,26 RC,499,Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length ,,,2195.0,22025.45,26 RC,499,Excision of penile plaque (Peyronie disease); with graft to 5 cm in length ,,,1773.9,11552.32,26 RC,499,Excision of perinephric cyst ,,,3390.0,16207.0,12 RC,499,"Excision of spermatocele, with or without epididymectomy ",,,685.44,8234.0,26 RC,499,Excision of thyroglossal duct cyst or sinus; ,,,1983.29,13196.03,26 RC,499,Excision of thyroglossal duct cyst or sinus; recurrent ,,,1983.29,13196.03,26 RC,499,"Excision of urachal cyst or sinus, with or without umbilical hernia repair ",,,1983.29,13196.03,26 RC,499,Excision of urethral diverticulum (separate procedure); female ,,,1773.9,11552.32,26 RC,499,Excision of urethral diverticulum (separate procedure); male ,,,1773.9,12562.0,26 RC,499,Excision of vaginal cyst or tumor ,,,1116.7,6819.81,26 RC,499,Excision of vaginal septum ,,,1116.7,6819.81,26 RC,499,Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) ,,,1200.05,8240.61,26 RC,499,Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach ,,,1209.12,8488.5,26 RC,499,Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair ,,,1209.12,13394.0,26 RC,499,Excision or fulguration of carcinoma of urethra ,,,1200.05,8240.61,26 RC,499,Excision or fulguration; Skene's glands ,,,1200.05,5571.0,26 RC,499,Excision or fulguration; urethral caruncle ,,,685.44,5571.0,26 RC,499,"Excision or fulguration; urethral polyp(s), distal urethra ",,,1200.05,5571.0,26 RC,499,Excision or fulguration; urethral prolapse ,,,1200.05,5571.0,26 RC,499,Excision or transposition of pterygium; with graft ,,,733.22,13394.0,26 RC,499,Excision or transposition of pterygium; without graft ,,,733.22,5571.0,26 RC,499,Excision or unroofing of cyst(s) of kidney ,,,3390.0,16207.0,12 RC,499,"Excision soft tissue lesion, external auditory canal ",,,855.96,6330.57,26 RC,499,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression ",,,3390.0,30069.97,12 RC,499,"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression ",,,3390.0,24382.36,12 RC,499,"Exenteration of orbit (does not include skin graft), removal of orbital contents; only ",,,1158.59,13394.0,26 RC,499,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap ",,,1158.59,12909.0,26 RC,499,"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone ",,,1158.59,12909.0,26 RC,499,Exploration for undescended testis (inguinal or scrotal area) ,,,1209.12,8488.5,26 RC,499,Exploration for undescended testis with abdominal exploration ,,,685.44,13835.0,26 RC,499,"Exploration of epididymis, with or without biopsy ",,,1200.05,8240.61,26 RC,499,"Exploration of orbit (transcranial approach), with removal of lesion ",,,3390.0,25276.59,12 RC,499,"Exposure of prostate, any approach, for insertion of radioactive substance; ",,,1773.9,25988.0,28 RC,499,"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,25988.0,14 RC,499,"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,25988.0,14 RC,499,"Expression of conjunctival follicles (eg, for trachoma) ",,,26.74,5841.0,13 RC,499,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts ",,,3390.0,23428.74,12 RC,499,"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining g",,,3390.0,28192.48,12 RC,499,"External cephalic version, with or without tocolysis ",,,2428.0,6819.81,12 RC,499,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,499,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic",,,2096.2,15059.0,25 RC,499,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion ",,,2725.44,11603.86,25 RC,499,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endosco",,,892.44,5571.0,26 RC,499,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requir",,,892.44,15059.0,76 RC,499,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,499,FOCUS RADIATION BEAM ,,,3390.0,5841.0,2 RC,499,FUSION OF FACIAL/OTHER NERVE ,,,3390.0,5841.0,2 RC,499,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,499,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,499,Fetal contraction stress test ,,,28.49,5841.0,8 RC,499,"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance ",,,122.58,5841.0,25 RC,499,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only ",,,399.9,16207.0,9 RC,499,"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation ",,,482.53,5841.0,8 RC,499,Fetal non-stress test ,,,16.57,5841.0,5 RC,499,Fetal scalp blood sampling ,,,554.98,5841.0,11 RC,499,"Fetal shunt placement, including ultrasound guidance ",,,554.98,5841.0,23 RC,499,"Fetal umbilical cord occlusion, including ultrasound guidance ",,,554.98,5841.0,23 RC,499,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,499,Fimbrioplasty ,,,3293.0,13835.0,24 RC,499,Fine needle aspiration of orbital contents ,,,733.22,5571.0,26 RC,499,"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy ",,,892.44,5571.0,26 RC,499,Fistulization of sclera for glaucoma; thermocauterization with iridectomy ,,,2317.12,10424.04,26 RC,499,Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery ,,,892.44,8234.0,26 RC,499,Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) ,,,892.44,8234.0,26 RC,499,Fistulization of sclera for glaucoma; trephination with iridectomy ,,,1610.16,10424.04,26 RC,499,Fitting and insertion of pessary or other intravaginal support device ,,,35.18,5841.0,13 RC,499,Fixation of contralateral testis (separate procedure) ,,,1200.05,12562.0,26 RC,499,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,499,"Follicle puncture for oocyte retrieval, any method ",,,1308.84,3128.0,24 RC,499,Foreskin manipulation including lysis of preputial adhesions and stretching ,,,115.66,5841.0,25 RC,499,Free omental flap with microvascular anastomosis ,,,3390.0,19868.64,12 RC,499,Frenulotomy of penis ,,,685.44,5571.0,26 RC,499,GLAUCOMA SURGERY ,,,3390.0,5841.0,2 RC,499,"Gamete, zygote, or embryo intrafallopian transfer, any method ",,,554.98,5841.0,23 RC,499,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,499,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,499,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,499,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,499,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,499,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,499,Goniotomy ,,,1610.16,10424.04,26 RC,499,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,499,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,499,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,499,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,499,HFenestration semicircular canal ,,,6326.0,9653.0,3 RC,499,"HLigation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) ",,,3041.0,5571.0,3 RC,499,HPercutaneous implantation of neurostimulator electrode array; neuromuscular ,,,9124.0,87318.0,5 RC,499,HRevision fenestration operation ,,,6326.0,9653.0,3 RC,499,"Harvesting conjunctival allograft, living donor ",,,2195.0,5571.0,24 RC,499,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,499,Hip core decompression ,,,9913.14,12713.03,5 RC,499,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,499,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,499,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,499,"Hymenotomy, simple incision ",,,1116.7,6819.81,26 RC,499,"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic ",,,3390.0,19432.11,12 RC,499,"Hysteroplasty, repair of uterine anomaly (Strassman type) ",,,3390.0,16207.0,24 RC,499,Hysterorrhaphy of ruptured uterus ,,,2670.3,13835.0,10 RC,499,"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) ",,,3293.0,16207.0,24 RC,499,"Hysteroscopy, diagnostic (separate procedure) ",,,1116.7,6819.81,14 RC,499,"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants ",,,2087.34,15059.0,14 RC,499,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) ",,,1603.34,12562.0,14 RC,499,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) ",,,1603.34,15059.0,14 RC,499,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) ",,,1603.34,11661.3,14 RC,499,"Hysteroscopy, surgical; with removal of impacted foreign body ",,,1116.7,12562.0,14 RC,499,"Hysteroscopy, surgical; with removal of leiomyomata ",,,1603.34,12562.0,14 RC,499,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C ",,,1116.7,12562.0,14 RC,499,"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) ",,,3041.0,26010.28,12 RC,499,Hystscp IU ADHESIO ,,,3390.0,5841.0,2 RC,499,Hystscp div IU septum ,,,3390.0,5841.0,2 RC,499,Hystscp impacted FB rmvl ,,,3390.0,5841.0,2 RC,499,Hystscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,499,Hystscp w Bx/polypectomy ,,,3390.0,5841.0,2 RC,499,Hystscp w endomet ablat ,,,3390.0,5841.0,2 RC,499,IMPLANT NEUROELECTRODES ,,,3390.0,5841.0,8 RC,499,"IMPLANT NEUROSTIMUL, SUBCORT ",,,3390.0,5841.0,2 RC,499,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,499,INCISE INNER EAR ,,,3390.0,5841.0,2 RC,499,INCISE SKULL FOR SURGERY ,,,3390.0,5841.0,6 RC,499,INCISION OF HYMEN ,,,3390.0,5841.0,2 RC,499,INCISION OF PELVIS NERVE ,,,3390.0,5841.0,2 RC,499,INCISION OF VAGUS NERVE ,,,3390.0,5841.0,2 RC,499,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,499,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,499,INFLATE MIDDLE EAR CANAL ,,,3390.0,5841.0,4 RC,499,INJ PARAVERTEBRAL C/T ,,,3390.0,5841.0,2 RC,499,INJ PARAVERTEBRAL C/T ADD-ON ,,,3390.0,5841.0,2 RC,499,INJ PARAVERTEBRAL L/S ,,,3390.0,5841.0,2 RC,499,INJ PARAVERTEBRAL L/S ADD-ON ,,,3390.0,5841.0,2 RC,499,INJECT SPINE CERV/THORACIC ,,,2128.0,2315.0,3 RC,499,INJECT SPINE LUMBAR/SACRAL ,,,2128.0,2315.0,3 RC,499,INJECT SPINE W/CATH CRV/THRC ,,,2128.0,2315.0,3 RC,499,INJECT SPINE W/CATH LMB/SCRL ,,,2128.0,2315.0,3 RC,499,INJECTION FOR KIDNEY X-RAY ,,,3390.0,5841.0,2 RC,499,"INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE) ",,,2358.0,5841.0,2 RC,499,"INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS ",,,2128.0,2315.0,3 RC,499,"INJECTION, ANESTHETIC AGENT; FACIAL NERVE ",,,2358.0,5841.0,2 RC,499,"INJECTION, ANESTHETIC AGENT; PHRENIC NERVE ",,,2251.0,2358.0,3 RC,499,INSERT KIDNEY DRAIN ,,,3390.0,5841.0,2 RC,499,INSERT URETERAL TUBE ,,,3390.0,5841.0,2 RC,499,INSET MIDDLE EAR (BAFFLE) ,,,3390.0,5841.0,2 RC,499,"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS ",,,3041.0,5571.0,3 RC,499,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,499,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,499,Impl cereb subcort elec ,,,3390.0,5841.0,2 RC,499,Impl subcort electrodes ,,,3390.0,5841.0,2 RC,499,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,499,Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) ,,,855.93,16207.0,12 RC,499,Implantation of intrastromal corneal ring segments ,,,1610.16,26289.23,26 RC,499,"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous ",,,2052.31,35151.83,26 RC,499,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed ",,,3293.0,44816.88,18 RC,499,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,499,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,499,Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) ,,,1672.0,5841.0,15 RC,499,Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump ,,,2195.0,45089.88,27 RC,499,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming ",,,2195.0,45089.88,27 RC,499,Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir ,,,2195.0,45089.88,28 RC,499,Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone ,,,2699.0,12562.0,24 RC,499,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq m",,,3390.0,35621.26,25 RC,499,"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area o",,,3390.0,34379.68,25 RC,499,"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3965.0,32488.94,26 RC,499,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminect",,,2195.0,16330.72,24 RC,499,"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without lamin",,,2195.0,15039.6,26 RC,499,Incision and drainage of Bartholin's gland abscess ,,,74.05,5841.0,25 RC,499,"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) ",,,685.44,5571.0,26 RC,499,"Incision and drainage of penis, deep ",,,510.77,8234.0,26 RC,499,"Incision and drainage of thyroglossal duct cyst, infected ",,,441.67,3683.7,26 RC,499,"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) ",,,855.96,6330.57,26 RC,499,Incision and drainage of vaginal hematoma; obstetrical/postpartum ,,,855.96,14238.95,26 RC,499,Incision and drainage of vulva or perineal abscess ,,,79.36,5841.0,25 RC,499,Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure) ,,,1232.72,16207.0,12 RC,499,Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) ,,,859.23,16207.0,24 RC,499,"Incision of conjunctiva, drainage of cyst ",,,58.72,13835.0,26 RC,499,"Incision, drainage of lacrimal gland ",,,1675.47,3323.1,24 RC,499,"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) ",,,214.82,13394.0,26 RC,499,Incisional biopsy of eyelid skin including lid margin ,,,113.7,5841.0,25 RC,499,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,499,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,499,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,499,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,499,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; ",,,2195.0,16207.0,24 RC,499,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacu",,,2195.0,16207.0,24 RC,499,"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic ",,,2195.0,16207.0,24 RC,499,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; ",,,3390.0,16207.0,12 RC,499,"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; w",,,2195.0,16207.0,48 RC,499,"Induced abortion, by dilation and curettage ",,,1116.7,13394.0,26 RC,499,"Induced abortion, by dilation and evacuation ",,,1116.7,13394.0,26 RC,499,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,499,"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resect",,,3390.0,37783.59,12 RC,499,"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parot",,,3390.0,37372.46,12 RC,499,"Initial open implantation of baroreflex activation therapy (BAT) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distan",,,3293.0,122851.37,17 RC,499,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,499,Inject anes 1 L facet N ,,,3390.0,5841.0,2 RC,499,Inject anes 1 paravert N ,,,3390.0,5841.0,2 RC,499,Inject anes >1 paravert ,,,3390.0,5841.0,2 RC,499,Inject anes L facet-ADDL ,,,3390.0,5841.0,2 RC,499,Injection of contrast medium for dacryocystography ,,,1672.0,5841.0,15 RC,499,"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) ",,,36.92,5841.0,13 RC,499,Injection of medication or other substance into Tenon's capsule ,,,20.35,5841.0,25 RC,499,"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) ",,,892.44,5571.0,26 RC,499,Injection procedure and placement of chain for contrast and/or chain urethrocystography ,,,1672.0,5841.0,3 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,499,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,499,Injection procedure for Peyronie disease; ,,,63.08,5841.0,13 RC,499,Injection procedure for Peyronie disease; with surgical exposure of plaque ,,,1773.9,11552.32,26 RC,499,"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervisio",,,1140.89,12562.0,48 RC,499,"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar ",,,2195.0,11410.03,24 RC,499,Injection procedure for corpora cavernosography ,,,1672.0,5841.0,15 RC,499,Injection procedure for cystography or voiding urethrocystography ,,,1672.0,5841.0,3 RC,499,"Injection procedure for discography, each level; cervical or thoracic ",,,1672.0,5841.0,15 RC,499,"Injection procedure for discography, each level; lumbar ",,,1672.0,5841.0,15 RC,499,"Injection procedure for myelography and/or computed tomography, lumbar ",,,1672.0,5841.0,15 RC,499,Injection procedure for retrograde urethrocystography ,,,1672.0,5841.0,3 RC,499,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,499,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,499,Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter ,,,1672.0,5841.0,15 RC,499,"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service ",,,1672.0,5841.0,15 RC,499,"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal ",,,1664.7,12562.0,24 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed ",,,357.81,3390.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,465.81,5571.0,14 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed ",,,41.85,3128.0,14 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed ",,,146.8,5841.0,25 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve ",,,31.69,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves ",,,64.83,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure) ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level ",,,276.0,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,276.0,5841.0,25 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ",,,41.28,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve ",,,45.35,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, Morton's neuroma) ",,,18.89,5841.0,25 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed ",,,357.81,3128.0,14 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed ",,,77.32,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve ",,,40.7,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, each additional level (List separately in addition to code f",,,1672.0,5841.0,15 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), cervical or thoracic, single level ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for p",,,1672.0,5841.0,15 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level ",,,357.81,3128.0,26 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular) ",,,70.93,5841.0,25 RC,499,"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve ",,,294.43,5841.0,23 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level ",,,1672.0,5841.0,15 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level ",,,357.81,3128.0,26 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any",,,1672.0,5841.0,15 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (Lis",,,1672.0,5841.0,15 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level ",,,357.81,3128.0,26 RC,499,"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any add",,,1672.0,5841.0,15 RC,499,"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solut",,,357.81,5841.0,100 RC,499,"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i",,,276.0,5841.0,100 RC,499,"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring ",,,357.81,3128.0,26 RC,499,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) ",,,357.81,3128.0,26 RC,499,"Injection, anesthetic agent; sphenopalatine ganglion ",,,74.13,5841.0,25 RC,499,"Injection, anesthetic agent; stellate ganglion (cervical sympathetic) ",,,357.81,3128.0,26 RC,499,"Injection, anesthetic agent; superior hypogastric plexus ",,,357.81,3755.0,26 RC,499,"Injection, anterior chamber of eye (separate procedure); air or liquid ",,,892.44,5519.68,26 RC,499,"Injection, anterior chamber of eye (separate procedure); medication ",,,892.44,5519.68,26 RC,499,"Injection, epidural, of blood or clot patch ",,,276.0,3128.0,26 RC,499,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,499,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic ",,,357.81,5571.0,26 RC,499,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal) ",,,357.81,5571.0,26 RC,499,"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid ",,,357.81,3128.0,26 RC,499,Insert urinary catheter ,,,3390.0,5841.0,4 RC,499,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,499,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,499,Insertion of Heyman capsules for clinical brachytherapy ,,,1603.34,11661.3,26 RC,499,"Insertion of a temporary prostatic urethral stent, including urethral measurement ",,,536.91,9953.69,26 RC,499,Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy ,,,122.58,5841.0,25 RC,499,"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach ",,,2340.64,15059.0,26 RC,499,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,499,"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) ",,,406.49,5841.0,23 RC,499,"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each ",,,667.56,5841.0,23 RC,499,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,499,"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff ",,,1986.0,47976.91,28 RC,499,"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal ",,,892.44,5571.0,26 RC,499,Insertion of intrauterine device (IUD) ,,,508.94,5841.0,23 RC,499,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,499,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir ",,,2699.0,51975.0,26 RC,499,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,499,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,499,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,499,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,499,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) ",,,223.51,5841.0,23 RC,499,"Insertion of ocular implant secondary; after enucleation, muscles attached to implant ",,,1158.59,12562.0,26 RC,499,"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant ",,,1158.59,8536.87,26 RC,499,"Insertion of ocular implant secondary; after evisceration, in scleral shell ",,,1158.59,12562.0,26 RC,499,Insertion of penile prosthesis; inflatable (self-contained) ,,,2699.0,51975.0,26 RC,499,Insertion of penile prosthesis; non-inflatable (semi-rigid) ,,,2699.0,51975.0,26 RC,499,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,499,"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or ",,,3390.0,15111.6,10 RC,499,"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter ",,,2096.41,41580.0,28 RC,499,Insertion of tandem cuff (dual cuff) ,,,2195.0,47976.91,28 RC,499,"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ",,,60.68,5841.0,25 RC,499,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley) ",,,223.51,5841.0,23 RC,499,Insertion of testicular prosthesis (separate procedure) ,,,2195.0,11552.32,26 RC,499,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,2010.52,3390.0,18 RC,499,Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy ,,,1603.34,25988.0,28 RC,499,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,499,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays ",,,2699.0,87318.0,27 RC,499,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array ",,,2195.0,87318.0,27 RC,499,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (List separatel",,,1986.0,5841.0,14 RC,499,"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array ",,,2195.0,35432.53,22 RC,499,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,2195.0,87318.0,27 RC,499,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver ",,,2195.0,87318.0,27 RC,499,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,499,"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) ",,,43.61,5841.0,25 RC,499,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) ",,,1672.0,5841.0,15 RC,499,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,499,Intersex surgery; female to male ,,,3390.0,13835.0,10 RC,499,Intersex surgery; male to female ,,,3390.0,13835.0,10 RC,499,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,499,Intra-atrial recording ,,,12065.71,43890.0,10 RC,499,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,499,Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) ,,,892.44,5571.0,26 RC,499,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,499,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,499,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,499,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,499,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,499,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,499,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,499,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,499,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,499,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,499,Intraventricular pacing ,,,12065.71,43890.0,10 RC,499,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,499,Intravitreal injection of a pharmacologic agent (separate procedure) ,,,50.87,5841.0,25 RC,499,Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) ,,,74.05,5841.0,13 RC,499,"Iridectomy, with corneoscleral or corneal section; for removal of lesion ",,,1610.16,12562.0,26 RC,499,"Iridectomy, with corneoscleral or corneal section; optical (separate procedure) ",,,892.44,12562.0,26 RC,499,"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) ",,,892.44,12562.0,26 RC,499,"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure) ",,,892.44,12562.0,26 RC,499,"Iridectomy, with corneoscleral or corneal section; with cyclectomy ",,,892.44,12562.0,26 RC,499,"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle) ",,,218.75,3667.92,26 RC,499,Iridotomy by stab incision (separate procedure); except transfixion ,,,892.44,5841.0,25 RC,499,Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe ,,,892.44,5519.68,26 RC,499,"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) ",,,161.05,3128.0,26 RC,499,Irrigation of corpora cavernosa for priapism ,,,115.66,5841.0,25 RC,499,"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease ",,,112.77,5841.0,11 RC,499,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,499,Keratomileusis ,,,2518.0,17897.9,24 RC,499,Keratophakia ,,,2518.0,19576.28,24 RC,499,Keratoplasty (corneal transplant); anterior lamellar ,,,1610.16,12909.0,26 RC,499,Keratoplasty (corneal transplant); endothelial ,,,1610.16,15059.0,26 RC,499,Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) ,,,1610.16,12909.0,26 RC,499,Keratoplasty (corneal transplant); penetrating (in aphakia) ,,,1610.16,12909.0,26 RC,499,Keratoplasty (corneal transplant); penetrating (in pseudophakia) ,,,1610.16,12909.0,26 RC,499,Keratoprosthesis ,,,3673.0,16924.12,24 RC,499,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; 1 OR 2 SEGMENTS ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THAN 2 SEGMENTS ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; CERVICAL ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 2 STAGES WITHIN 14 DAYS; THORACIC ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF 1 SPINOTHALAMIC TRACT, 1 STAGE; THORACIC ",,,3390.0,16207.0,3 RC,499,"LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, 1 STAGE; CERVICAL ",,,3390.0,16207.0,3 RC,499,LAVH ,,,3390.0,5841.0,2 RC,499,Labyrinthectomy; transcanal ,,,2051.93,13241.95,26 RC,499,Labyrinthectomy; with mastoidectomy ,,,2051.93,13241.95,26 RC,499,"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal ",,,130.52,13394.0,26 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level ",,,9875.0,34473.5,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical ",,,3390.0,22297.2,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar ",,,9875.0,19224.42,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral ",,,3390.0,19618.62,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic ",,,3390.0,22153.02,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical ",,,3390.0,26255.61,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar ",,,9875.0,24454.45,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic ",,,3390.0,25950.44,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical ",,,3390.0,32557.8,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic ",,,3390.0,32066.23,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar ",,,9875.0,33960.65,9 RC,499,"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral ",,,3390.0,23454.14,9 RC,499,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical ",,,3390.0,25611.4,9 RC,499,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar ",,,9875.0,23386.41,9 RC,499,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral ",,,3390.0,23085.47,9 RC,499,"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic ",,,3390.0,25611.4,9 RC,499,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical ",,,3293.0,16330.72,21 RC,499,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar ",,,3041.0,16330.72,21 RC,499,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral ",,,3293.0,16330.72,21 RC,499,"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic ",,,3293.0,16330.72,21 RC,499,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical ,,,3390.0,36291.71,9 RC,499,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic ,,,3390.0,37902.24,9 RC,499,Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar ,,,9875.0,37686.1,9 RC,499,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural ",,,3375.0,87318.0,25 RC,499,"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic ",,,3390.0,19563.47,9 RC,499,Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space ,,,3390.0,21237.62,9 RC,499,Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space ,,,3390.0,17147.73,9 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical ",,,2518.45,16330.72,23 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except f",,,2518.45,16330.72,23 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral ",,,3293.0,16330.72,21 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic ",,,2518.45,16330.72,23 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical ",,,3375.0,16330.72,21 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar ",,,2996.0,16330.72,21 RC,499,"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic ",,,3375.0,16330.72,21 RC,499,"Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar ",,,3390.0,19678.01,9 RC,499,"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) ",,,3293.0,16330.72,21 RC,499,Laminectomy with rhizotomy; 1 or 2 segments ,,,9875.0,14087.77,9 RC,499,Laminectomy with rhizotomy; more than 2 segments ,,,9875.0,15253.31,9 RC,499,Laminectomy with section of spinal accessory nerve ,,,9875.0,17173.13,9 RC,499,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs», ºeg, spinal or lateral recess stenosis»), single vertebral segm",,,1672.0,16330.72,84 RC,499,"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve rootºs» ºeg, spinal or lateral recess stenosis»), during posterior inter",,,1672.0,5841.0,30 RC,499,"Laminectomy, with release of tethered spinal cord, lumbar ",,,9875.0,18949.01,9 RC,499,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; ",,,3390.0,18436.15,12 RC,499,"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and no",,,3390.0,21068.04,12 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervi",,,3293.0,16330.72,21 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each ",,,1986.0,7014.0,32 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,2518.45,16330.72,23 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical ",,,2518.45,16330.72,23 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar ",,,2518.45,16330.72,23 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or",,,1672.0,5841.0,15 RC,499,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implan",,,1267.84,3083.0,17 RC,499,Laparoscopic APPY ,,,3390.0,5841.0,2 RC,499,Laparoscopic THC w/o Bx ,,,3390.0,5841.0,2 RC,499,Laparoscopic aspiration ,,,3390.0,5841.0,2 RC,499,Laparoscopic enterolysis ,,,3390.0,5841.0,2 RC,499,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,499,Laparoscopic fulgur FALL ,,,3390.0,5841.0,2 RC,499,Laparoscopic fulgur les ,,,3390.0,5841.0,2 RC,499,Laparoscopic jejunostomy ,,,3390.0,5841.0,2 RC,499,Laparoscopic occl FALL ,,,3390.0,5841.0,2 RC,499,Laparoscopic orchiectomy ,,,3390.0,5841.0,2 RC,499,Laparoscopic rmvl adnexa ,,,3390.0,5841.0,2 RC,499,Laparoscopic splenectomy ,,,3390.0,5841.0,2 RC,499,Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy ,,,1983.29,13835.0,14 RC,499,Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy ,,,1983.29,13835.0,14 RC,499,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,499,Laparoscopy w ADHESIO ,,,3390.0,5841.0,2 RC,499,Laparoscopy w biopsy ,,,3390.0,5841.0,2 RC,499,"Laparoscopy, remove myoma ",,,3390.0,3390.0,1 RC,499,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; ",,,11558.0,22967.79,6 RC,499,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogast",,,3293.0,29647.99,17 RC,499,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy) ",,,3293.0,29647.99,17 RC,499,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,3293.0,24808.33,23 RC,499,"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3265.51,22967.79,13 RC,499,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex) ",,,8778.0,22967.79,12 RC,499,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas ",,,1983.29,15059.0,14 RC,499,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g ",,,3265.51,22967.79,14 RC,499,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,8 RC,499,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,499,"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,11558.0,22967.79,6 RC,499,"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed ",,,3390.0,23068.53,8 RC,499,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ",,,6326.0,14626.03,12 RC,499,"Laparoscopy, surgical, with ligation of spermatic veins for varicocele ",,,1983.29,15059.0,14 RC,499,"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed ",,,11558.0,23335.49,6 RC,499,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; ",,,11558.0,22967.79,6 RC,499,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; ",,,1983.29,13196.03,8 RC,499,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3265.51,22967.79,8 RC,499,"Laparoscopy, surgical; ablation of renal cysts ",,,6326.0,13394.0,12 RC,499,"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed ",,,9875.0,22967.79,12 RC,499,"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor ",,,3390.0,19703.41,12 RC,499,"Laparoscopy, surgical; nephrectomy with total ureterectomy ",,,3390.0,16524.68,12 RC,499,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy ",,,3390.0,16207.0,12 RC,499,"Laparoscopy, surgical; orchiectomy ",,,1983.29,15059.0,14 RC,499,"Laparoscopy, surgical; orchiopexy for intra-abdominal testis ",,,1983.29,13394.0,14 RC,499,"Laparoscopy, surgical; partial nephrectomy ",,,8778.0,22967.79,12 RC,499,"Laparoscopy, surgical; pyeloplasty ",,,8778.0,22967.79,12 RC,499,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) ",,,3390.0,16431.54,12 RC,499,"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) ",,,2724.11,16632.0,16 RC,499,"Laparoscopy, surgical; ureterolithotomy ",,,8778.0,13394.0,12 RC,499,"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement ",,,1983.29,15059.0,14 RC,499,"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement ",,,3265.51,22967.79,14 RC,499,"Laparoscopy, surgical; urethral suspension for stress incontinence ",,,8778.0,13394.0,12 RC,499,"Laparoscopy, surgical; with fimbrioplasty ",,,1983.29,13394.0,14 RC,499,"Laparoscopy, surgical; with fulguration of oviducts (with or without transection) ",,,1983.29,13196.03,14 RC,499,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method ",,,1983.29,13394.0,14 RC,499,"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) ",,,1983.29,13394.0,14 RC,499,"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) ",,,1983.29,13196.03,14 RC,499,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) ",,,1983.29,13394.0,14 RC,499,"Laparoscopy, surgical; with salpingostomy (salpingoneostomy) ",,,1983.29,13394.0,14 RC,499,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,499,"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diap",,,3673.0,13835.0,24 RC,499,Lapscp CHOLE w CDE ,,,3390.0,5841.0,2 RC,499,Lapscp CHOLE&cholangrphy ,,,3390.0,5841.0,2 RC,499,Lapscp EG fundoplasty ,,,3390.0,5841.0,2 RC,499,Lapscp REP init IH ,,,3390.0,5841.0,2 RC,499,Lapscp REP recur IH ,,,3390.0,5841.0,2 RC,499,Lapscp adrenalectomy ,,,3390.0,5841.0,2 RC,499,Lapscp bilat pelv LYMPH ,,,3390.0,5841.0,2 RC,499,Lapscp cholcystentstmy ,,,3390.0,5841.0,2 RC,499,Lapscp cholecystectomy ,,,3390.0,5841.0,2 RC,499,Lapscp fimbrioplasty ,,,3390.0,5841.0,2 RC,499,Lapscp intest resect ,,,3390.0,5841.0,2 RC,499,Lapscp lig sperm vein ,,,3390.0,5841.0,2 RC,499,Lapscp lymphocele drain ,,,3390.0,5841.0,2 RC,499,Lapscp pelvic LYMPH & Bx ,,,3390.0,5841.0,2 RC,499,Lapscp retroperit LN Bx ,,,3390.0,5841.0,2 RC,499,Lapscp rmvl leiomyomata ,,,3390.0,5841.0,2 RC,499,Lapscp salpingostomy ,,,3390.0,5841.0,2 RC,499,Lapscp select vagotomy ,,,3390.0,5841.0,2 RC,499,Lapscp temp gastrostomy ,,,3390.0,5841.0,2 RC,499,Lapscp truncal vagotomy ,,,3390.0,5841.0,2 RC,499,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,499,"Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are includ",,,1773.9,15059.0,8 RC,499,"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret",,,1773.9,15059.0,26 RC,499,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,499,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesio",,,3390.0,13835.0,11 RC,499,"Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion ",,,3390.0,13835.0,11 RC,499,"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuret",,,1773.9,15059.0,26 RC,499,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,499,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,499,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,499,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,499,Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure,,,717.09,16207.0,24 RC,499,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) ",,,2195.0,13835.0,24 RC,499,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral ",,,1116.7,13394.0,26 RC,499,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,499,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) ,,,1200.05,8240.61,26 RC,499,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) ,,,1200.05,8240.61,26 RC,499,"Lithotripsy, extracorporeal shock wave ",,,1200.05,10342.0,8 RC,499,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,499,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,499,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,Lumbar/caudal inject NEC ,,,3390.0,5841.0,2 RC,499,"Lysis of adhesions (salpingolysis, ovariolysis) ",,,3041.0,13835.0,24 RC,499,Lysis of labial adhesions ,,,1116.7,6819.81,26 RC,499,Lysis or excision of penile post-circumcision adhesions ,,,685.44,5571.0,26 RC,499,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed ",,,2699.0,4220.0,13 RC,499,"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter ",,,250.06,3128.0,26 RC,499,Manometric studies through ureterostomy or indwelling ureteral catheter ,,,60.68,5841.0,13 RC,499,Marsupialization of Bartholin's gland cyst ,,,1116.7,6819.81,26 RC,499,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,499,"Marsupialization of urethral diverticulum, male or female ",,,1200.05,8240.61,26 RC,499,Mastoid obliteration (separate procedure) ,,,2051.93,13241.95,26 RC,499,Mastoidectomy; complete ,,,2051.93,13241.95,26 RC,499,Mastoidectomy; modified radical ,,,2051.93,13241.95,26 RC,499,Mastoidectomy; radical ,,,2051.93,13241.95,26 RC,499,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging ",,,112.77,5841.0,11 RC,499,"Meatotomy, cutting of meatus (separate procedure); except infant ",,,685.44,5571.0,26 RC,499,"Meatotomy, cutting of meatus (separate procedure); infant ",,,1986.0,13835.0,24 RC,499,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,499,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,499,"Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Middle ear exploration through postauricular or ear canal incision ,,,930.95,12562.0,26 RC,499,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,499,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,499,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,499,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,499,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,499,"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure) ",,,733.22,13394.0,14 RC,499,Multifetal pregnancy reduction(s) (MPR) ,,,554.98,5841.0,11 RC,499,"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) ",,,242.73,13835.0,26 RC,499,"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) ",,,1395.68,8234.0,24 RC,499,"Myelography via lumbar injection, including radiological supervision and interpretation; cervical ",,,1395.68,8234.0,24 RC,499,"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ",,,1395.68,8234.0,24 RC,499,"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ",,,1395.68,8234.0,24 RC,499,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach ",,,3673.0,13835.0,24 RC,499,"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach ",,,1116.7,13394.0,26 RC,499,"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach ",,,4988.0,13835.0,12 RC,499,Myringoplasty (surgery confined to drumhead and donor area) ,,,930.95,7150.66,26 RC,499,Myringotomy including aspiration and/or eustachian tube inflation ,,,91.96,5841.0,25 RC,499,Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia ,,,930.95,12562.0,26 RC,499,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,499,N BLOCK INJ SPINAL ACCESSOR ,,,3390.0,5841.0,2 RC,499,"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY ",,,3390.0,16207.0,3 RC,499,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,499,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,499,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,499,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral ",,,2195.0,15059.0,25 RC,499,"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral ",,,1986.0,15059.0,25 RC,499,"Needle electromyography studies (EMG) of anal or urethral sphincter, any technique ",,,115.66,5841.0,25 RC,499,Nephrectomy with total ureterectomy and bladder cuff; through same incision ,,,3390.0,16207.0,12 RC,499,Nephrectomy with total ureterectomy and bladder cuff; through separate incision ,,,3390.0,17974.22,12 RC,499,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; ",,,3390.0,16207.0,12 RC,499,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney ",,,3390.0,16207.0,12 RC,499,"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy ",,,3390.0,16207.0,12 RC,499,"Nephrectomy, partial ",,,3390.0,16253.5,12 RC,499,Nephrolithotomy; complicated by congenital kidney abnormality ,,,3390.0,16207.0,12 RC,499,Nephrolithotomy; removal of calculus ,,,3390.0,16207.0,12 RC,499,Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) ,,,3390.0,17855.56,12 RC,499,Nephrolithotomy; secondary surgical operation for calculus ,,,3390.0,16207.0,12 RC,499,"Nephrorrhaphy, suture of kidney wound or injury ",,,3390.0,16207.0,12 RC,499,"Nephrostomy, nephrotomy with drainage ",,,2699.0,13835.0,24 RC,499,"Nephrotomy, with exploration ",,,3390.0,16207.0,12 RC,499,"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length ",,,2195.0,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length ",,,2096.41,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length ",,,2195.0,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length ",,,2195.0,15039.6,26 RC,499,"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length ",,,2195.0,15039.6,26 RC,499,"Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Nerve pedicle transfer; first stage ,,,2096.41,15039.6,26 RC,499,Nerve pedicle transfer; second stage ,,,1986.0,15039.6,26 RC,499,"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve ",,,2195.0,15039.6,24 RC,499,"Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Nerve repair; with nerve allograft, each nerve, first strand (cable) ",,,2195.0,15039.6,25 RC,499,"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve ",,,2195.0,15039.6,26 RC,499,"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter) ",,,3390.0,18707.46,12 RC,499,"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage ",,,3390.0,25882.7,12 RC,499,"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach ",,,3390.0,18906.55,12 RC,499,"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage ",,,3390.0,23458.38,12 RC,499,Neuroplasty and/or transposition; cranial nerve (specify) ,,,692.94,12562.0,26 RC,499,Neuroplasty and/or transposition; median nerve at carpal tunnel ,,,692.94,5571.0,26 RC,499,Neuroplasty and/or transposition; ulnar nerve at elbow ,,,692.94,5571.0,26 RC,499,Neuroplasty and/or transposition; ulnar nerve at wrist ,,,692.94,5571.0,26 RC,499,"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus ",,,692.94,5571.0,26 RC,499,"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus ",,,692.94,5571.0,26 RC,499,"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified ",,,692.94,5571.0,26 RC,499,"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve ",,,692.94,5571.0,26 RC,499,"Neuroplasty; digital, 1 or both, same digit ",,,692.94,5571.0,26 RC,499,Neuroplasty; nerve of hand or foot ,,,692.94,5571.0,26 RC,499,Nocturnal penile tumescence and/or rigidity test ,,,88.59,5841.0,23 RC,499,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,499,"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus ",,,3390.0,41102.02,12 RC,499,"Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach ",,,1116.7,13835.0,26 RC,499,"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers ",,,1499.06,13394.0,26 RC,499,Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft) ,,,3293.0,13394.0,24 RC,499,"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) ",,,3293.0,13394.0,24 RC,499,"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) ",,,3390.0,17359.64,12 RC,499,"Omental flap, intra-abdominal (List separately in addition to code for primary procedure) ",,,3387.4,16207.0,12 RC,499,"Oophorectomy, partial or total, unilateral or bilateral; ",,,3293.0,13835.0,24 RC,499,"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies,",,,4988.0,14490.44,12 RC,499,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,499,"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,2195.0,87318.0,27 RC,499,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,499,"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,2195.0,82073.3,24 RC,499,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,499,Open implantation of neurostimulator electrode array; neuromuscular ,,,1986.0,87318.0,28 RC,499,Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,28 RC,499,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) ,,,2699.0,16890.86,26 RC,499,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,499,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,499,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,499,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,499,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,499,"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) ",,,1158.59,8536.87,26 RC,499,Orbital implant (implant outside muscle cone); insertion ,,,1158.59,8536.87,26 RC,499,Orbital implant (implant outside muscle cone); removal or revision ,,,1158.59,8536.87,26 RC,499,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration ",,,3390.0,40347.62,12 RC,499,"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration ",,,3390.0,35482.15,12 RC,499,"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural el",,,3390.0,39228.77,12 RC,499,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy ",,,1158.59,13394.0,26 RC,499,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage ",,,1158.59,13394.0,26 RC,499,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression ",,,1158.59,13394.0,26 RC,499,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body ",,,1158.59,13394.0,26 RC,499,"Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion ",,,1158.59,13394.0,26 RC,499,"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy ",,,1158.59,12562.0,26 RC,499,Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only ,,,733.22,8234.0,26 RC,499,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression ,,,1158.59,13835.0,26 RC,499,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body ,,,733.22,13394.0,26 RC,499,Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion ,,,733.22,13394.0,26 RC,499,"Orchiectomy, partial ",,,1200.05,12562.0,26 RC,499,"Orchiectomy, radical, for tumor; inguinal approach ",,,1209.12,8488.5,26 RC,499,"Orchiectomy, radical, for tumor; with abdominal exploration ",,,4988.0,13835.0,12 RC,499,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach ",,,1200.05,12562.0,26 RC,499,"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) ",,,2996.0,13835.0,24 RC,499,"Orchiopexy, inguinal or scrotal approach ",,,1209.12,8488.5,26 RC,499,"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) ",,,3225.46,16207.0,9 RC,499,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,499,"Other cranial decompression, posterior fossa ",,,3390.0,25285.06,12 RC,499,Other spinal injection ,,,3390.0,5841.0,2 RC,499,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,499,"Otoplasty, protruding ear, with or without size reduction ",,,930.95,12562.0,26 RC,499,"Ovarian cystectomy, unilateral or bilateral ",,,3293.0,13835.0,24 RC,499,"PERCUT/NEEDLE INSERT, PROS ",,,3390.0,5841.0,2 RC,499,"PROSTATECTOMY, FIRST STAGE ",,,3390.0,5841.0,2 RC,499,"PROSTATECTOMY, SECOND STAGE ",,,3390.0,5841.0,2 RC,499,PROSTATIC WATER THERMOTHER ,,,3390.0,5841.0,2 RC,499,Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous ,,,892.44,5841.0,25 RC,499,"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection ",,,892.44,5571.0,26 RC,499,"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection ",,,892.44,12562.0,26 RC,499,Parathyroid autotransplantation (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,Parathyroidectomy or exploration of parathyroid(s); ,,,2051.93,13835.0,26 RC,499,Parathyroidectomy or exploration of parathyroid(s); re-exploration ,,,3673.0,15059.0,24 RC,499,"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach ",,,3390.0,17020.6,12 RC,499,"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach ",,,3293.0,22967.79,24 RC,499,"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach ",,,3293.0,13835.0,24 RC,499,"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach ",,,2996.0,18300.83,24 RC,499,"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed) ",,,276.0,3244.0,26 RC,499,"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary proced",,,1672.0,5841.0,15 RC,499,"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed) ",,,276.0,3244.0,26 RC,499,Partial hymenectomy or revision of hymenal ring ,,,1116.7,6819.81,26 RC,499,"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,13835.0,26 RC,499,"Partial thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,13835.0,26 RC,499,Pelvic examination under anesthesia (other than local) ,,,1116.7,6819.81,26 RC,499,"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ",,,3390.0,35948.44,12 RC,499,"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of r",,,3390.0,28124.63,12 RC,499,Penile plethysmography ,,,273.57,5841.0,23 RC,499,"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and ",,,3375.0,16207.0,24 RC,499,"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes ",,,270.48,3128.0,26 RC,499,"Percutaneous aspiration, spinal cord cyst or syrinx ",,,357.81,3128.0,26 RC,499,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,499,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,499,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,499,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,499,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,499,"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation ",,,1899.59,3083.0,17 RC,499,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,499,"Percutaneous implantation of neurostimulator electrode array, epidural ",,,2195.0,87318.0,28 RC,499,Percutaneous implantation of neurostimulator electrode array; cranial nerve ,,,1986.0,87318.0,28 RC,499,Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) ,,,1986.0,87318.0,28 RC,499,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed ",,,2699.0,87318.0,28 RC,499,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,499,"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administe",,,357.81,5571.0,52 RC,499,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,2996.0,22025.45,46 RC,499,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,499,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,499,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,499,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,499,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,499,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,7 RC,499,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,7 RC,499,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,499,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,499,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,499,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,499,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,499,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,499,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,499,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,499,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,499,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,499,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,499,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,499,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,499,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,499,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,499,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,499,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,499,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,499,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,499,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,499,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,499,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,499,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,499,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,499,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,499,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,499,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,499,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,499,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,499,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,499,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,499,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,499,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,499,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,499,"Pereyra procedure, including anterior colporrhaphy ",,,2390.64,18300.83,26 RC,499,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,499,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,499,"Perineoplasty, repair of perineum, nonobstetrical (separate procedure) ",,,1116.7,13394.0,26 RC,499,"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance ",,,2996.0,32022.79,23 RC,499,Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume ,,,995.06,5841.0,23 RC,499,"Periurethral transperineal adjustable balloon continence device; removal, each balloon ",,,2195.0,13835.0,23 RC,499,"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance ",,,2699.0,13835.0,23 RC,499,Pertnscp cholangram w bx ,,,3390.0,5841.0,2 RC,499,Petrous apicectomy including radical mastoidectomy ,,,2051.93,13241.95,26 RC,499,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,499,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,499,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,499,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,499,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,499,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,499,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,499,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,499,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,499,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,499,"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in addition to code for specific strabismus surgery) ",,,1672.0,5841.0,15 RC,499,"Placement of amniotic membrane on the ocular surface; single layer, sutured ",,,1986.0,8536.87,24 RC,499,Placement of amniotic membrane on the ocular surface; without sutures ,,,1654.29,3755.0,24 RC,499,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,499,"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple ",,,74.41,3128.0,26 RC,499,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,499,Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application ,,,1986.0,15059.0,24 RC,499,"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiologi",,,685.44,12909.0,26 RC,499,"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiol",,,1200.05,12909.0,26 RC,499,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,499,"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological s",,,1200.05,15059.0,78 RC,499,Plastic operation of penis for injury ,,,1200.05,8240.61,26 RC,499,"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra ",,,1200.05,12562.0,26 RC,499,Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps ,,,1200.05,12562.0,26 RC,499,Plastic operation on penis for epispadias distal to external sphincter; ,,,685.44,12562.0,26 RC,499,Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder ,,,6326.0,15227.79,12 RC,499,Plastic operation on penis for epispadias distal to external sphincter; with incontinence ,,,685.44,12562.0,26 RC,499,Plastic operation on penis to correct angulation ,,,1200.05,12562.0,26 RC,499,"Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) ",,,1603.34,12562.0,26 RC,499,Plastic repair of canaliculi ,,,733.22,5571.0,26 RC,499,Plastic repair of introitus ,,,1116.7,12562.0,26 RC,499,Plastic repair of urethrocele ,,,1116.7,12562.0,26 RC,499,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy ",,,1603.34,13394.0,26 RC,499,"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming ",,,755.65,5841.0,23 RC,499,Postpartum care only (separate procedure) ,,,1312.04,5841.0,19 RC,499,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,499,"Probing of lacrimal canaliculi, with or without irrigation ",,,72.68,5841.0,25 RC,499,"Probing of nasolacrimal duct, with or without irrigation; ",,,113.7,5841.0,25 RC,499,"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia ",,,733.22,5571.0,26 RC,499,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent ",,,733.22,5571.0,26 RC,499,"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation ",,,733.22,13394.0,26 RC,499,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,499,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy ",,,113.7,5841.0,25 RC,499,"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation ",,,125.86,3667.92,26 RC,499,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal ",,,3390.0,16207.0,12 RC,499,"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages ",,,3390.0,16207.0,12 RC,499,"Prostatectomy, perineal radical; ",,,3390.0,16207.0,12 RC,499,"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes ",,,3390.0,21559.73,12 RC,499,"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,19741.51,12 RC,499,"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) ",,,3390.0,16207.0,12 RC,499,"Prostatectomy, retropubic radical, with or without nerve sparing; ",,,3390.0,16207.0,12 RC,499,"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes ",,,3390.0,16732.36,24 RC,499,"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ",,,3390.0,16207.0,12 RC,499,"Prostatotomy, external drainage of prostatic abscess, any approach; complicated ",,,1200.05,8240.61,26 RC,499,"Prostatotomy, external drainage of prostatic abscess, any approach; simple ",,,1200.05,5571.0,26 RC,499,"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication ",,,56.97,3244.0,14 RC,499,Puncture of shunt tubing or reservoir for aspiration or injection procedure ,,,276.0,3128.0,26 RC,499,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital k",,,3390.0,17109.62,12 RC,499,"Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple ",,,3390.0,16207.0,12 RC,499,"Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) ",,,3390.0,16207.0,3 RC,499,"Pyelotomy; with drainage, pyelostomy ",,,3390.0,16207.0,12 RC,499,Pyelotomy; with exploration ,,,3390.0,16207.0,12 RC,499,"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) ",,,3390.0,16207.0,12 RC,499,RECONSTRUCTION OF URETHRA ,,,3390.0,5841.0,2 RC,499,REDUCTION OF SKULL DEFECT ,,,3390.0,5841.0,2 RC,499,REMOVAL OF BRAIN TISSUE ,,,3390.0,5841.0,2 RC,499,REMOVAL OF TESTIS LESION ,,,3390.0,5841.0,2 RC,499,REMOVE MULTI-COMP PROSTHESIS ,,,3390.0,5841.0,2 RC,499,REMOVE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,499,REMOVE RESIDUAL PROSTATE ,,,3390.0,5841.0,2 RC,499,RENAL ABSCESS PERCUT DRAIN ,,,3390.0,5841.0,2 RC,499,RENAL ENDOSCOPY/RADIOTRACER ,,,3390.0,5841.0,4 RC,499,REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT ,,,3041.0,5571.0,3 RC,499,"REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY ",,,10586.0,11113.0,3 RC,499,REREPAIR DETACHED RETINA ,,,3390.0,5841.0,2 RC,499,REVISE PENIS PROSTHESIS ,,,3390.0,5841.0,2 RC,499,REVISE/REMOVE NEUROELECTRODE ,,,3390.0,5841.0,2 RC,499,REVISION MASTOIDECTOMY; WITH APICECTOMY ,,,6326.0,9653.0,3 RC,499,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,499,Radial keratotomy ,,,2518.0,7836.39,24 RC,499,"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,22640.47,24 RC,499,Radical excision external auditory canal lesion; with neck dissection ,,,3390.0,19932.26,12 RC,499,Radical excision external auditory canal lesion; without neck dissection ,,,2051.93,13241.95,26 RC,499,"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,20288.23,12 RC,499,"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) ",,,692.94,12909.0,25 RC,499,Recipient nephrectomy (separate procedure) ,,,3390.0,16207.0,12 RC,499,"Reconstruction external auditory canal for congenital atresia, single stage ",,,2051.93,13241.95,26 RC,499,"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure) ",,,2051.93,13241.95,26 RC,499,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage ",,,733.22,12562.0,26 RC,499,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage ",,,733.22,12562.0,26 RC,499,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage ",,,1158.59,12562.0,26 RC,499,"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage ",,,733.22,12562.0,26 RC,499,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,499,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,499,"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty ",,,3390.0,20856.12,12 RC,499,"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts) ",,,3390.0,24513.72,12 RC,499,Reduction of overcorrection of ptosis ,,,733.22,8234.0,26 RC,499,"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis ",,,1200.05,8240.61,26 RC,499,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,499,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,499,Reinsertion of ocular implant; with or without conjunctival graft ,,,1158.59,8536.87,26 RC,499,Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant ,,,1158.59,12562.0,26 RC,499,Release of encircling material (posterior segment) ,,,1610.16,10424.04,26 RC,499,Release of extensive scar tissue without detaching extraocular muscle (separate procedure) ,,,733.22,12909.0,26 RC,499,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,5571.0,26 RC,499,"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,685.44,13394.0,26 RC,499,"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation ",,,685.44,4836.33,26 RC,499,"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation ",,,572.66,9157.78,26 RC,499,"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session ",,,2699.0,51975.0,26 RC,499,"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected ti",,,1672.0,51975.0,25 RC,499,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation ",,,685.44,4836.33,26 RC,499,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,499,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session ",,,1986.0,47976.91,26 RC,499,"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement o",,,2012.0,15672.9,12 RC,499,Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session ,,,2699.0,51975.0,26 RC,499,"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of",,,2012.0,51975.0,26 RC,499,"Removal foreign body from deep penile tissue (eg, plastic implant) ",,,855.96,6330.57,26 RC,499,Removal foreign body from external auditory canal; with general anesthesia ,,,510.77,5571.0,26 RC,499,Removal foreign body from external auditory canal; without general anesthesia ,,,223.51,5841.0,11 RC,499,"Removal impacted cerumen requiring instrumentation, unilateral ",,,112.77,5841.0,23 RC,499,"Removal impacted cerumen using irrigation/lavage, unilateral ",,,112.77,5841.0,23 RC,499,"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis ",,,1200.05,12562.0,26 RC,499,Removal of baroreflex activation therapy (BAT) modulation system; lead only ,,,2195.0,9751.1,17 RC,499,Removal of baroreflex activation therapy (BAT) modulation system; pulse generator only ,,,2195.0,9751.1,17 RC,499,"Removal of baroreflex activation therapy (BAT) modulation system; total system, including lead and pulse generator ",,,2195.0,9528.08,17 RC,499,"Removal of blood clot, anterior segment of eye ",,,892.44,13394.0,26 RC,499,Removal of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,12 RC,499,Removal of cerclage suture under anesthesia (other than local) ,,,1116.7,13394.0,26 RC,499,Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation ,,,3390.0,16207.0,12 RC,499,Removal of complete cerebrospinal fluid shunt system; without replacement ,,,2195.0,13835.0,24 RC,499,"Removal of corneal epithelium; with application of chelating agent (eg, EDTA) ",,,176.16,5571.0,26 RC,499,"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) ",,,40.7,3128.0,26 RC,499,"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator ",,,1986.0,15059.0,26 RC,499,"Removal of embedded foreign body, eyelid ",,,113.7,5841.0,25 RC,499,Removal of entire lumbosubarachnoid shunt system without replacement ,,,692.94,5571.0,26 RC,499,"Removal of epithelial downgrowth, anterior chamber of eye ",,,892.44,13394.0,26 RC,499,Removal of foreign body in scrotum ,,,685.44,5571.0,26 RC,499,"Removal of foreign body or dacryolith, lacrimal passages ",,,113.7,5841.0,25 RC,499,"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating ",,,745.36,5841.0,11 RC,499,"Removal of foreign body, external eye; conjunctival superficial ",,,223.51,5841.0,11 RC,499,"Removal of foreign body, external eye; corneal, with slit lamp ",,,223.51,5841.0,11 RC,499,"Removal of foreign body, external eye; corneal, without slit lamp ",,,745.36,5841.0,11 RC,499,"Removal of foreign body, intraocular; from anterior chamber of eye or lens ",,,892.44,5571.0,26 RC,499,"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route ",,,892.44,12562.0,25 RC,499,"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction ",,,892.44,8234.0,26 RC,499,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,499,"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array ",,,1986.0,15899.38,25 RC,499,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,499,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,499,Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) ,,,1116.7,6819.81,26 RC,499,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,499,"Removal of implanted material, anterior segment of eye ",,,892.44,12909.0,26 RC,499,"Removal of implanted material, posterior segment; extraocular ",,,892.44,5571.0,26 RC,499,"Removal of implanted material, posterior segment; intraocular ",,,892.44,9653.0,26 RC,499,"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,11552.32,26 RC,499,Removal of intrauterine device (IUD) ,,,53.78,5841.0,25 RC,499,"Removal of lens material; aspiration technique, 1 or more stages ",,,892.44,8234.0,26 RC,499,"Removal of lens material; extracapsular (other than 66840, 66850, 66852) ",,,892.44,13394.0,26 RC,499,Removal of lens material; intracapsular ,,,892.44,8234.0,26 RC,499,"Removal of lens material; intracapsular, for dislocated lens ",,,1610.16,13394.0,26 RC,499,"Removal of lens material; pars plana approach, with or without vitrectomy ",,,1610.16,10424.04,26 RC,499,"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration ",,,892.44,12909.0,26 RC,499,"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) ",,,250.06,3128.0,26 RC,499,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,499,"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis ",,,1200.05,12562.0,26 RC,499,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,499,Removal of ocular implant ,,,1158.59,8536.87,26 RC,499,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,499,Removal of previously implanted intrathecal or epidural catheter ,,,692.94,5571.0,26 RC,499,"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) ",,,892.44,8234.0,26 RC,499,"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed ",,,2195.0,15059.0,22 RC,499,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,692.94,12909.0,26 RC,499,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1574.7,12909.0,26 RC,499,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ",,,2096.41,15039.6,26 RC,499,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,499,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,499,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,499,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,499,Removal of transplanted renal allograft ,,,3390.0,16207.0,12 RC,499,"Removal of tumor, temporal bone ",,,2996.0,13835.0,24 RC,499,"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal ",,,892.44,8234.0,26 RC,499,"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy ",,,892.44,8234.0,26 RC,499,Removal or repair of electromagnetic bone conduction hearing device in temporal bone ,,,930.95,9653.0,26 RC,499,"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) ",,,1986.0,11552.32,26 RC,499,"Removal or revision of sling for stress incontinence (eg, fascia or synthetic) ",,,1116.7,13835.0,26 RC,499,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,499,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm",,,1142.68,13835.0,25 RC,499,"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area",,,1142.68,7895.92,25 RC,499,"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,1142.68,7895.92,25 RC,499,Remove interim implant component ,,,12018.0,12018.0,1 RC,499,"Renal allotransplantation, implantation of graft; with recipient nephrectomy ",,,3390.0,35181.33,12 RC,499,"Renal allotransplantation, implantation of graft; without recipient nephrectomy ",,,3390.0,29697.06,12 RC,499,"Renal autotransplantation, reimplantation of kidney ",,,3390.0,24517.95,12 RC,499,Renal biopsy; by surgical exposure of kidney ,,,3390.0,16207.0,12 RC,499,"Renal biopsy; percutaneous, by trocar or needle ",,,510.77,3747.2,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1773.9,11552.32,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1986.0,22025.45,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with ",,,1986.0,22025.45,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculu",,,1773.9,11552.32,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor ",,,2012.0,22025.45,26 RC,499,"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or ",,,1773.9,11552.32,26 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,26 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1200.05,4836.33,26 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy",,,1773.9,13835.0,14 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without bio",,,1773.9,13835.0,26 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,13835.0,26 RC,499,"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilati",,,250.06,3128.0,26 RC,499,"Renal exploration, not necessitating other specific procedures ",,,3390.0,16207.0,12 RC,499,Repair incomplete circumcision ,,,685.44,5571.0,26 RC,499,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,499,"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach ",,,733.22,8234.0,26 RC,499,"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach ",,,733.22,8234.0,26 RC,499,"Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) ",,,733.22,8234.0,26 RC,499,Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia) ,,,1158.59,13394.0,26 RC,499,"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) ",,,733.22,13394.0,26 RC,499,Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) ,,,1158.59,13394.0,26 RC,499,"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) ",,,733.22,8234.0,26 RC,499,"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degre",,,1610.16,15059.0,26 RC,499,"Repair of component(s) of a multi-component, inflatable penile prosthesis ",,,2699.0,12562.0,24 RC,499,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,499,"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy ",,,3390.0,16207.0,12 RC,499,"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy ",,,3390.0,16207.0,12 RC,499,Repair of ectropion; excision tarsal wedge ,,,733.22,8234.0,26 RC,499,"Repair of ectropion; extensive (eg, tarsal strip operations) ",,,733.22,8234.0,26 RC,499,Repair of ectropion; suture ,,,733.22,12562.0,26 RC,499,Repair of ectropion; thermocauterization ,,,210.46,5571.0,26 RC,499,"Repair of encephalocele, skull vault, including cranioplasty ",,,3390.0,26255.61,12 RC,499,"Repair of enterocele, abdominal approach (separate procedure) ",,,3041.0,13835.0,12 RC,499,"Repair of enterocele, vaginal approach (separate procedure) ",,,1603.34,12562.0,26 RC,499,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,499,Repair of entropion; excision tarsal wedge ,,,733.22,8234.0,26 RC,499,"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ",,,733.22,8234.0,26 RC,499,Repair of entropion; suture ,,,733.22,12562.0,26 RC,499,Repair of entropion; thermocauterization ,,,201.75,13835.0,26 RC,499,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple ",,,1200.05,12562.0,26 RC,499,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when perfor",,,1773.9,12562.0,26 RC,499,"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft ",,,1773.9,12562.0,26 RC,499,"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff ",,,1773.9,11552.32,26 RC,499,"Repair of iris, ciliary body (as for iridodialysis) ",,,892.44,12562.0,26 RC,499,"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera ",,,391.57,6625.43,26 RC,499,"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization ",,,2195.0,16207.0,24 RC,499,"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization ",,,733.22,5571.0,26 RC,499,"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure ",,,733.22,5571.0,26 RC,499,"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue ",,,1610.16,10424.04,26 RC,499,"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue ",,,1610.16,10424.04,26 RC,499,"Repair of laceration; cornea, nonperforating, with or without removal foreign body ",,,1158.59,8536.87,26 RC,499,Repair of meningocele; larger than 5 cm diameter ,,,3390.0,17728.44,12 RC,499,Repair of meningocele; less than 5 cm diameter ,,,3390.0,16207.0,12 RC,499,Repair of myelomeningocele; larger than 5 cm diameter ,,,3390.0,21911.47,12 RC,499,Repair of myelomeningocele; less than 5 cm diameter ,,,3390.0,19758.45,12 RC,499,"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy ",,,174.12,5571.0,26 RC,499,"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation ",,,144.47,4788.0,26 RC,499,"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy) ",,,434.01,13835.0,14 RC,499,"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and draina",,,1610.16,13394.0,26 RC,499,"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral bucklin",,,1610.16,12909.0,26 RC,499,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,Repair of scleral staphyloma with graft ,,,2141.05,10424.04,26 RC,499,"Repair of symblepharon; conjunctivoplasty, without graft ",,,892.44,8234.0,26 RC,499,"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens ",,,733.22,8234.0,26 RC,499,Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft) ,,,1158.59,8536.87,26 RC,499,Repair of traumatic corporeal tear(s) ,,,1200.05,12909.0,26 RC,499,Repair of tunica vaginalis hydrocele (Bottle type) ,,,1200.05,8240.61,26 RC,499,"Repair of wound, extraocular muscle, tendon and/or Tenon's capsule ",,,1158.59,12562.0,26 RC,499,Repair oval window fistula ,,,930.95,8234.0,26 RC,499,Repair round window fistula ,,,930.95,8234.0,26 RC,499,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,499,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,499,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defec",,,3390.0,35621.26,25 RC,499,"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony def",,,3390.0,34379.68,25 RC,499,"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor ",,,3390.0,16330.72,26 RC,499,"Replacement of all or part of ureter by intestine segment, including intestine anastomosis ",,,3390.0,16207.0,12 RC,499,Replacement of bone flap or prosthetic plate of skull ,,,3390.0,16207.0,12 RC,499,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,499,"Replacement or irrigation, subarachnoid/subdural catheter ",,,692.94,5571.0,26 RC,499,"Replacement or irrigation, ventricular catheter ",,,1986.0,15039.6,26 RC,499,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system ",,,2096.41,15039.6,26 RC,499,"Replacement, irrigation or revision of lumbosubarachnoid shunt ",,,2699.0,15039.6,26 RC,499,"Replantation, penis, complete amputation including urethral repair ",,,3390.0,16207.0,3 RC,499,"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) ",,,892.44,8234.0,26 RC,499,Reprogramming of programmable cerebrospinal shunt ,,,31.39,5841.0,13 RC,499,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; ",,,4988.0,13973.35,12 RC,499,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction,",,,3390.0,20267.07,12 RC,499,"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphaden",,,3390.0,17864.03,12 RC,499,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy a",,,3390.0,21716.49,12 RC,499,"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; ",,,3390.0,16207.0,3 RC,499,Resection of scrotum ,,,1200.05,8240.61,26 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural ",,,3390.0,26098.85,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft ",,,3390.0,29709.76,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural ",,,3390.0,34719.28,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, w",,,3390.0,41237.62,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural ",,,3390.0,26340.4,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft ",,,3390.0,36321.35,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural ",,,3390.0,32985.86,12 RC,499,"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft ",,,3390.0,40559.53,12 RC,499,"Resection temporal bone, external approach ",,,3390.0,32511.23,12 RC,499,Retrobulbar injection; alcohol ,,,36.62,5841.0,25 RC,499,"Retrobulbar injection; medication (separate procedure, does not include supply of medication) ",,,27.62,5841.0,13 RC,499,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,22 RC,499,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,499,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,499,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,499,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,499,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,499,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,499,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,499,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,22 RC,499,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,22 RC,499,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,22 RC,499,"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach ",,,2390.64,18300.83,14 RC,499,Revision (including removal) of prosthetic vaginal graft; open abdominal approach ,,,3390.0,16207.0,12 RC,499,Revision (including removal) of prosthetic vaginal graft; vaginal approach ,,,1116.7,12562.0,26 RC,499,"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed ",,,1986.0,54750.0,26 RC,499,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed ",,,1986.0,54750.0,26 RC,499,Revision mastoidectomy; resulting in complete mastoidectomy ,,,2051.93,13241.95,26 RC,499,Revision mastoidectomy; resulting in modified radical mastoidectomy ,,,2051.93,13241.95,26 RC,499,Revision mastoidectomy; resulting in radical mastoidectomy ,,,2051.93,13241.95,26 RC,499,Revision mastoidectomy; resulting in tympanoplasty ,,,2051.93,13241.95,26 RC,499,Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft ,,,892.44,9653.0,26 RC,499,Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft ,,,892.44,15059.0,26 RC,499,Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of ,,,1773.9,12562.0,26 RC,499,Revision of stapedectomy or stapedotomy ,,,2051.93,13394.0,26 RC,499,Revision of urinary-cutaneous anastomosis (any type urostomy); ,,,1200.05,13835.0,14 RC,499,Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia ,,,3390.0,16207.0,12 RC,499,Revision or removal of cranial neurostimulator pulse generator or receiver ,,,2195.0,16890.86,26 RC,499,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,26 RC,499,Revision or removal of intracranial neurostimulator electrodes ,,,1574.7,13835.0,14 RC,499,"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator ",,,1986.0,27181.65,22 RC,499,Revision or removal of peripheral neurostimulator electrode array ,,,1574.7,8595.41,26 RC,499,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array ",,,1986.0,8595.41,26 RC,499,"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure ",,,733.22,5571.0,26 RC,499,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; lead only ",,,2699.0,9751.1,17 RC,499,"Revision or replacement of baroreflex activation therapy (BAT) modulation system, with intraoperative interrogation and programming; pulse generator only ",,,2699.0,86066.14,17 RC,499,"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator ",,,2195.0,16890.86,26 RC,499,"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator ",,,2195.0,31349.63,25 RC,499,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,499,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,499,Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s) ,,,2699.0,56900.95,22 RC,499,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,499,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,499,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,499,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,499,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,499,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,499,Right ventricular recording ,,,2024.5,43890.0,10 RC,499,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,499,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,499,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ",,,3390.0,28395.93,7 RC,499,"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery ",,,3390.0,28768.84,7 RC,499,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ",,,3390.0,25611.4,7 RC,499,"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery ",,,3390.0,26874.42,7 RC,499,"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD ",,,2431.0,2979.0,3 RC,499,STRIP RETINAL MEMBRANE ,,,3390.0,5841.0,2 RC,499,"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY ",,,3390.0,16207.0,3 RC,499,"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,13835.0,24 RC,499,"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) ",,,3293.0,13835.0,24 RC,499,Salpingostomy (salpingoneostomy) ,,,3041.0,13835.0,24 RC,499,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,499,Scleral reinforcement (separate procedure); with graft ,,,892.44,12562.0,26 RC,499,Scleral reinforcement (separate procedure); without graft ,,,733.22,12562.0,26 RC,499,"Scraping of cornea, diagnostic, for smear and/or culture ",,,745.36,5841.0,11 RC,499,Screening proctoscopy ,,,343.69,440.76,5 RC,499,Scrotal exploration ,,,1200.05,8240.61,26 RC,499,Scrotoplasty; complicated ,,,1773.9,11552.32,26 RC,499,Scrotoplasty; simple ,,,1200.05,8240.61,26 RC,499,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lat",,,3390.0,16207.0,12 RC,499,"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneo",,,3390.0,17546.16,12 RC,499,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,499,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,499,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae ",,,892.44,8234.0,26 RC,499,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions ",,,1610.16,10424.04,26 RC,499,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae ",,,892.44,5571.0,26 RC,499,"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae ",,,892.44,8234.0,26 RC,499,"Severing adhesions of anterior segment, laser technique (separate procedure) ",,,148.54,4390.0,26 RC,499,Severing of tarsorrhaphy ,,,179.07,3128.0,26 RC,499,"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages) ",,,218.75,3755.0,26 RC,499,"Simple cystometrogram (CMG) (eg, spinal manometer) ",,,115.66,5841.0,25 RC,499,"Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) ",,,223.51,5841.0,11 RC,499,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,499,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,499,"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) ",,,2195.0,22025.45,28 RC,499,"Sling operation for stress incontinence (eg, fascia or synthetic) ",,,2171.17,16632.0,28 RC,499,"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn ",,,685.44,5571.0,26 RC,499,"Slitting of prepuce, dorsal or lateral (separate procedure); newborn ",,,1200.05,8240.61,26 RC,499,Snip incision of lacrimal punctum ,,,56.97,5841.0,25 RC,499,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,499,Sperm washing for artificial insemination ,,,44.33,5841.0,11 RC,499,"Spinal puncture, lumbar, diagnostic; ",,,276.0,3128.0,26 RC,499,"Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance ",,,276.0,5841.0,25 RC,499,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); ",,,276.0,3128.0,26 RC,499,"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance ",,,276.0,5841.0,25 RC,499,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; ",,,2051.93,13394.0,26 RC,499,"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out ",,,2051.93,13394.0,26 RC,499,Stapes mobilization ,,,930.95,12909.0,26 RC,499,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; ",,,3390.0,17554.62,12 RC,499,"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance ",,,3390.0,17156.19,12 RC,499,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring ,,,2431.0,19516.9,12 RC,499,"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source ",,,3390.0,15059.0,12 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion ",,,19113.0,29069.0,5 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion ",,,19113.0,29069.0,5 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion ",,,19113.0,29069.0,5 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,499,"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure) ",,,19113.0,29069.0,5 RC,499,"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery ",,,1022.29,12562.0,26 RC,499,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,499,"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) ",,,112.77,5841.0,11 RC,499,"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (List sep",,,1672.0,5841.0,15 RC,499,"Strabismus surgery, any procedure, superior oblique muscle ",,,733.22,8234.0,26 RC,499,"Strabismus surgery, recession or resection procedure; 1 horizontal muscle ",,,733.22,12562.0,26 RC,499,"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) ",,,733.22,8234.0,26 RC,499,"Strabismus surgery, recession or resection procedure; 2 horizontal muscles ",,,1158.59,8536.87,26 RC,499,"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) ",,,733.22,8234.0,26 RC,499,Subarachnoid inject NEC ,,,3390.0,5841.0,2 RC,499,Subconjunctival injection ,,,223.51,5841.0,11 RC,499,Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring ,,,2431.0,14948.14,12 RC,499,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial ",,,276.0,4522.69,26 RC,499,"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps ",,,276.0,4522.69,26 RC,499,"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) ",,,3390.0,17554.62,12 RC,499,Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) ,,,3390.0,13835.0,10 RC,499,"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16207.0,24 RC,499,Suprachoroidal space injection of pharmacologic agent (separate procedure) ,,,456.3,5841.0,10 RC,499,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter ",,,3390.0,26865.96,12 RC,499,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery ",,,3390.0,31193.16,12 RC,499,"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis ",,,3390.0,31862.78,12 RC,499,"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,53176.72,12 RC,499,"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,59338.96,12 RC,499,"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) ",,,3390.0,16537.5,12 RC,499,"Surgery of intracranial arteriovenous malformation; dural, complex ",,,3390.0,46115.78,12 RC,499,"Surgery of intracranial arteriovenous malformation; dural, simple ",,,3390.0,26984.61,12 RC,499,"Surgery of intracranial arteriovenous malformation; infratentorial, complex ",,,3390.0,57821.69,12 RC,499,"Surgery of intracranial arteriovenous malformation; infratentorial, simple ",,,3390.0,35240.6,12 RC,499,"Surgery of intracranial arteriovenous malformation; supratentorial, complex ",,,3390.0,52341.76,12 RC,499,"Surgery of intracranial arteriovenous malformation; supratentorial, simple ",,,3390.0,28014.44,12 RC,499,"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation ",,,3390.0,42699.85,12 RC,499,"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation ",,,3390.0,50133.7,12 RC,499,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,499,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,499,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,499,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,499,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,499,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,499,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,499,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,499,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,499,Surgical treatment of ectopic pregnancy; abdominal pregnancy ,,,3390.0,16207.0,12 RC,499,"Surgical treatment of ectopic pregnancy; cervical, with evacuation ",,,3390.0,16207.0,12 RC,499,"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus ",,,3390.0,16207.0,12 RC,499,"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ",,,2699.0,13835.0,24 RC,499,"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy ",,,2996.0,13835.0,24 RC,499,"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion ",,,2051.93,13394.0,26 RC,499,"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion ",,,2051.93,13394.0,26 RC,499,"Suture of 1 nerve; hand or foot, common sensory nerve ",,,2096.41,15039.6,26 RC,499,Suture of 1 nerve; median motor thenar ,,,2096.41,15039.6,26 RC,499,Suture of 1 nerve; ulnar motor ,,,2096.41,15039.6,26 RC,499,"Suture of digital nerve, hand or foot; 1 nerve ",,,692.94,8234.0,26 RC,499,"Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,"Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Suture of facial nerve; extracranial ,,,2096.41,15039.6,26 RC,499,"Suture of facial nerve; infratemporal, with or without grafting ",,,2096.41,15039.6,26 RC,499,"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture) ",,,892.44,5571.0,26 RC,499,"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition ",,,2096.41,15039.6,26 RC,499,"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition ",,,2096.41,15039.6,26 RC,499,"Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) ",,,1672.0,5841.0,15 RC,499,Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) ,,,1672.0,5841.0,15 RC,499,Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) ,,,1672.0,5841.0,15 RC,499,Suture of posterior tibial nerve ,,,2096.41,15039.6,26 RC,499,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness ",,,733.22,5571.0,26 RC,499,"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness ",,,203.77,13394.0,26 RC,499,Suture of sciatic nerve ,,,1230.86,8104.0,26 RC,499,Suture of; brachial plexus ,,,692.94,12562.0,26 RC,499,Suture of; lumbar plexus ,,,2096.41,15039.6,26 RC,499,Suture or repair of testicular injury ,,,1200.05,12562.0,26 RC,499,"Suture, secondary, of abdominal wall for evisceration or dehiscence ",,,3390.0,16207.0,12 RC,499,"Sympathectomy, cervical ",,,692.94,4693.83,26 RC,499,"Sympathectomy, cervicothoracic ",,,2431.0,13835.0,12 RC,499,"Sympathectomy, lumbar ",,,3390.0,16207.0,12 RC,499,"Sympathectomy, thoracolumbar ",,,3390.0,16207.0,12 RC,499,"Sympathectomy; digital arteries, each digit ",,,692.94,13835.0,14 RC,499,Sympathectomy; radial artery ,,,1142.68,8234.0,26 RC,499,Sympathectomy; superficial palmar arch ,,,1142.68,7473.24,26 RC,499,Sympathectomy; ulnar artery ,,,1142.68,12562.0,26 RC,499,"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) ",,,3390.0,16207.0,12 RC,499,TRANSECT ARTERY SINUS ,,,3390.0,5841.0,2 RC,499,"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS, WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,499,"TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) ",,,3390.0,16207.0,3 RC,499,TUR cong post valve/fold ,,,3390.0,5841.0,2 RC,499,"Temporary closure of eyelids by suture (eg, Frost suture) ",,,351.98,3128.0,26 RC,499,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,499,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral ",,,3293.0,34379.68,25 RC,499,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed ",,,1986.0,3390.0,13 RC,499,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,499,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,499,"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure) ",,,3390.0,16745.06,12 RC,499,"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure) ",,,3390.0,16207.0,12 RC,499,"Thymectomy, partial or total; transcervical approach (separate procedure) ",,,2996.0,13835.0,24 RC,499,"Thyroidectomy, including substernal thyroid; cervical approach ",,,2996.0,13835.0,24 RC,499,"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach ",,,2431.0,16715.43,12 RC,499,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid ",,,3293.0,13835.0,24 RC,499,"Thyroidectomy, total or complete ",,,1983.29,13835.0,26 RC,499,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,499,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection ",,,3673.0,13835.0,24 RC,499,"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection ",,,3041.0,20402.66,24 RC,499,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); ",,,3390.0,16207.0,24 RC,499,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) ",,,3390.0,16207.0,24 RC,499,"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) ",,,3390.0,16829.85,24 RC,499,Total facial nerve decompression and/or repair (may include graft) ,,,2996.0,13835.0,24 RC,499,"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy ",,,1983.29,13196.03,26 RC,499,"Total thyroid lobectomy, unilateral; with or without isthmusectomy ",,,1983.29,13196.03,26 RC,499,Trabeculoplasty by laser surgery ,,,114.82,3249.0,26 RC,499,Trabeculotomy ab externo ,,,892.44,8234.0,26 RC,499,"Trachelectomy (cervicectomy), amputation of cervix (separate procedure) ",,,1603.34,12562.0,26 RC,499,"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ",,,1116.7,12562.0,26 RC,499,"Transabdominal amnioinfusion, including ultrasound guidance ",,,554.98,5841.0,23 RC,499,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,499,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,499,"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, int",,,3375.0,27050.15,48 RC,499,"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed ",,,3390.0,18059.01,12 RC,499,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,499,"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency ",,,3293.0,19655.45,22 RC,499,"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography ",,,1986.0,17689.64,24 RC,499,"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid ",,,3390.0,29709.76,12 RC,499,"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompres",,,3390.0,36245.03,12 RC,499,"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy ",,,692.94,4693.83,14 RC,499,"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy ",,,3524.67,12562.0,12 RC,499,"Transection or avulsion of other cranial nerve, extradural ",,,692.94,5571.0,26 RC,499,"Transection or avulsion of other spinal nerve, extradural ",,,692.94,5571.0,26 RC,499,"Transection or avulsion of; facial nerve, differential or complete ",,,692.94,5571.0,26 RC,499,Transection or avulsion of; greater occipital nerve ,,,692.94,5571.0,26 RC,499,Transection or avulsion of; inferior alveolar nerve by osteotomy ,,,692.94,4693.83,26 RC,499,Transection or avulsion of; infraorbital nerve ,,,692.94,4693.83,26 RC,499,Transection or avulsion of; lingual nerve ,,,692.94,5571.0,26 RC,499,Transection or avulsion of; mental nerve ,,,692.94,4693.83,26 RC,499,Transection or avulsion of; phrenic nerve ,,,692.94,4693.83,26 RC,499,Transection or avulsion of; supraorbital nerve ,,,692.94,4693.83,26 RC,499,"Transection or avulsion of; vagus nerve (vagotomy), abdominal ",,,3390.0,16207.0,12 RC,499,"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) ",,,3390.0,16207.0,12 RC,499,"Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) ",,,3390.0,16207.0,12 RC,499,Transection or repositioning of aberrant renal vessels (separate procedure) ,,,3390.0,16207.0,12 RC,499,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,499,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,499,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent ",,,3293.0,13394.0,24 RC,499,"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent ",,,3293.0,13394.0,24 RC,499,Transmastoid antrotomy (simple mastoidectomy) ,,,2051.93,13241.95,26 RC,499,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; ",,,3390.0,31201.63,12 RC,499,"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) ",,,3390.0,51345.81,12 RC,499,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately",,,1672.0,5841.0,15 RC,499,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal appr",,,2518.45,16330.72,26 RC,499,"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic ",,,2518.45,16330.72,26 RC,499,"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed ",,,1986.0,15059.0,25 RC,499,"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ",,,1773.9,25988.0,28 RC,499,"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus ",,,3390.0,35134.65,12 RC,499,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,499,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,499,Transplantation of testis(es) to thigh (because of scrotal destruction) ,,,1200.05,12562.0,26 RC,499,"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,"Transposition, ovary(s) ",,,2699.0,13835.0,24 RC,499,"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization ",,,3390.0,28879.03,12 RC,499,"Transureteroureterostomy, anastomosis of ureter to contralateral ureter ",,,3390.0,16207.0,12 RC,499,Transurethral destruction of prostate tissue; by microwave thermotherapy ,,,1090.68,19718.21,26 RC,499,Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy ,,,1200.05,15059.0,25 RC,499,Transurethral destruction of prostate tissue; by radiofrequency thermotherapy ,,,1042.71,18816.77,26 RC,499,Transurethral drainage of prostatic abscess ,,,1200.05,8240.61,26 RC,499,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,1773.9,11552.32,26 RC,499,Transurethral incision of prostate ,,,1200.05,12562.0,26 RC,499,Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence ,,,2195.0,12909.0,24 RC,499,Transurethral resection of bladder neck (separate procedure) ,,,1200.05,12562.0,26 RC,499,Transurethral resection; of postoperative bladder neck contracture ,,,1200.05,8240.61,26 RC,499,"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or",,,1773.9,11552.32,26 RC,499,"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cyst",,,2195.0,26403.19,17 RC,499,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) ",,,60.45,5841.0,17 RC,499,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) ",,,53.82,5841.0,17 RC,499,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) ",,,49.82,5841.0,17 RC,499,"Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) ",,,43.49,5841.0,17 RC,499,Transvesical ureterolithotomy ,,,3631.68,13835.0,12 RC,499,"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation ",,,149.42,3128.0,26 RC,499,"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity)",,,218.75,3667.92,26 RC,499,"Treatment of incomplete abortion, any trimester, completed surgically ",,,1116.7,13394.0,26 RC,499,"Treatment of missed abortion, completed surgically; first trimester ",,,1116.7,13394.0,26 RC,499,"Treatment of missed abortion, completed surgically; second trimester ",,,1116.7,13394.0,26 RC,499,"Treatment of septic abortion, completed surgically ",,,2195.0,16207.0,24 RC,499,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,499,Tubotubal anastomosis ,,,3293.0,13835.0,24 RC,499,Tubouterine implantation ,,,3293.0,13835.0,24 RC,499,Twist drill hole for subdural or ventricular puncture ,,,3390.0,16207.0,12 RC,499,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma ",,,3390.0,16207.0,12 RC,499,"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device ",,,3040.41,16207.0,12 RC,499,"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical ",,,3390.0,16207.0,12 RC,499,"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventri",,,2762.83,28345.13,48 RC,499,"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch ",,,183.72,13835.0,26 RC,499,Tympanic neurectomy ,,,930.95,12562.0,26 RC,499,"Tympanolysis, transcanal ",,,930.95,9653.0,26 RC,499,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg,",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction ",,,2051.93,13241.95,26 RC,499,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration) ",,,2051.93,13394.0,26 RC,499,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicu",,,2051.93,13394.0,26 RC,499,"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction ",,,2051.93,13394.0,26 RC,499,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia ",,,441.67,12562.0,26 RC,499,"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ",,,123.54,5841.0,25 RC,499,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,499,URETER ENDOSCOPY & TRACER ,,,3390.0,5841.0,4 RC,499,URETHRA PRESSURE PROFILE ,,,3390.0,5841.0,2 RC,499,URINE VOIDING PRESSURE STUDY ,,,3390.0,5841.0,2 RC,499,Unlist px-laparascopy ,,,3390.0,5841.0,2 RC,499,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,499,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,499,"Unlisted fetal invasive procedure, including ultrasound guidance, when performed ",,,340.4,13835.0,23 RC,499,"Unlisted hysteroscopy procedure, uterus ",,,340.4,13835.0,11 RC,499,"Unlisted laparoscopy procedure, bladder ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, endocrine system ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, maternity care and delivery ",,,2699.0,13835.0,24 RC,499,"Unlisted laparoscopy procedure, oviduct, ovary ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, renal ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, spermatic cord ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, testis ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, ureter ",,,6326.0,13835.0,12 RC,499,"Unlisted laparoscopy procedure, uterus ",,,6326.0,13835.0,12 RC,499,"Unlisted procedure, abdomen, peritoneum and omentum ",,,1611.14,13835.0,24 RC,499,"Unlisted procedure, anterior segment of eye ",,,1986.0,13835.0,24 RC,499,"Unlisted procedure, conjunctiva ",,,554.5,13835.0,11 RC,499,"Unlisted procedure, endocrine system ",,,1986.0,13835.0,24 RC,499,"Unlisted procedure, external ear ",,,417.46,5841.0,11 RC,499,"Unlisted procedure, extraocular muscle ",,,554.5,13835.0,11 RC,499,"Unlisted procedure, eyelids ",,,554.5,13835.0,11 RC,499,"Unlisted procedure, female genital system (nonobstetrical) ",,,340.4,13835.0,23 RC,499,"Unlisted procedure, inner ear ",,,417.46,13835.0,23 RC,499,"Unlisted procedure, lacrimal system ",,,554.5,13835.0,11 RC,499,"Unlisted procedure, male genital system ",,,481.54,13835.0,23 RC,499,"Unlisted procedure, maternity care and delivery ",,,340.4,13835.0,23 RC,499,"Unlisted procedure, middle ear ",,,417.46,13835.0,23 RC,499,"Unlisted procedure, nervous system ",,,536.63,13835.0,23 RC,499,"Unlisted procedure, orbit ",,,554.5,13835.0,11 RC,499,"Unlisted procedure, posterior segment ",,,2431.0,13835.0,12 RC,499,"Unlisted procedure, temporal bone, middle fossa approach ",,,417.46,13835.0,23 RC,499,"Unlisted procedure, urinary system ",,,481.54,13835.0,23 RC,499,"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code f",,,1672.0,5841.0,15 RC,499,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,26 RC,499,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without di",,,1200.05,8240.61,26 RC,499,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; ",,,1200.05,8240.61,26 RC,499,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy ",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy ",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus ",,,1773.9,11552.32,26 RC,499,"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ure",,,1200.05,8240.61,26 RC,499,"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach ",,,3375.0,16207.0,24 RC,499,"Ureterectomy, with bladder cuff (separate procedure) ",,,3375.0,16207.0,24 RC,499,"Ureterocalycostomy, anastomosis of ureter to renal calyx ",,,3390.0,16207.0,12 RC,499,"Ureterocolon conduit, including intestine anastomosis ",,,3390.0,16207.0,12 RC,499,"Ureteroenterostomy, direct anastomosis of ureter to intestine ",,,3390.0,16207.0,12 RC,499,"Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) ",,,3390.0,16207.0,12 RC,499,Ureterolithotomy; lower one-third of ureter ,,,3293.0,16207.0,24 RC,499,Ureterolithotomy; middle one-third of ureter ,,,3293.0,16207.0,24 RC,499,Ureterolithotomy; upper one-third of ureter ,,,3293.0,16207.0,24 RC,499,Ureterolysis for ovarian vein syndrome ,,,3390.0,16207.0,12 RC,499,"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava ",,,3390.0,16207.0,12 RC,499,"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis ",,,3390.0,16207.0,12 RC,499,Ureteroneocystostomy; anastomosis of duplicated ureter to bladder ,,,3390.0,16207.0,12 RC,499,Ureteroneocystostomy; anastomosis of single ureter to bladder ,,,3390.0,16207.0,12 RC,499,Ureteroneocystostomy; with extensive ureteral tailoring ,,,3390.0,16207.0,12 RC,499,Ureteroneocystostomy; with vesico-psoas hitch or bladder flap ,,,3390.0,16207.0,12 RC,499,"Ureteroplasty, plastic operation on ureter (eg, stricture) ",,,3390.0,16207.0,12 RC,499,"Ureteropyelostomy, anastomosis of ureter and renal pelvis ",,,3390.0,16207.0,12 RC,499,"Ureterorrhaphy, suture of ureter (separate procedure) ",,,3390.0,16207.0,12 RC,499,"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis ",,,3390.0,17194.41,12 RC,499,"Ureterostomy, transplantation of ureter to skin ",,,3390.0,16207.0,12 RC,499,"Ureterotomy for insertion of indwelling stent, all types ",,,3293.0,16207.0,24 RC,499,Ureterotomy with exploration or drainage (separate procedure) ,,,3293.0,16207.0,24 RC,499,Ureteroureterostomy ,,,3390.0,16207.0,12 RC,499,"Urethrectomy, total, including cystostomy; female ",,,1200.05,13394.0,26 RC,499,"Urethrectomy, total, including cystostomy; male ",,,1773.9,13394.0,26 RC,499,"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) ",,,3293.0,13835.0,24 RC,499,"Urethromeatoplasty, with mucosal advancement ",,,1200.05,8240.61,26 RC,499,"Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) ",,,1200.05,8240.61,26 RC,499,Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia ,,,1773.9,12562.0,26 RC,499,Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm ,,,1200.05,12562.0,26 RC,499,Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm ,,,1773.9,12562.0,26 RC,499,"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) ",,,1200.05,12562.0,26 RC,499,"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) ",,,1773.9,11552.32,26 RC,499,"Urethroplasty, 1-stage reconstruction of male anterior urethra ",,,1773.9,11552.32,26 RC,499,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage ",,,1773.9,12562.0,26 RC,499,"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage ",,,1773.9,11552.32,26 RC,499,"Urethroplasty, reconstruction of female urethra ",,,1773.9,11552.32,26 RC,499,"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra ",,,6326.0,13858.92,12 RC,499,"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) ",,,1773.9,12562.0,26 RC,499,"Urethroplasty; second stage (formation of urethra), including urinary diversion ",,,1773.9,11552.32,26 RC,499,"Urethrorrhaphy, suture of urethral wound or injury, female ",,,1200.05,8240.61,26 RC,499,"Urethrorrhaphy, suture of urethral wound or injury; penile ",,,1773.9,11552.32,26 RC,499,"Urethrorrhaphy, suture of urethral wound or injury; perineal ",,,1773.9,11552.32,26 RC,499,"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous ",,,1773.9,11552.32,26 RC,499,"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra ",,,685.44,5571.0,26 RC,499,"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external ",,,1773.9,11552.32,26 RC,499,"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) ",,,3390.0,22102.21,12 RC,499,Use of ophthalmic endoscope (List separately in addition to code for primary procedure) ,,,1672.0,5841.0,15 RC,499,Uterine evacuation and curettage for hydatidiform mole ,,,1116.7,13394.0,26 RC,499,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure) ",,,3293.0,16207.0,24 RC,499,"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy ",,,3390.0,16207.0,12 RC,499,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE) WITH OR WITHOUT ENDOSCOPIC CONTROL ",,,4988.0,7014.0,3 RC,499,"VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY) ",,,3390.0,16207.0,3 RC,499,Vaginal delivery only (with or without episiotomy and/or forceps); ,,,1986.0,13835.0,24 RC,499,Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ,,,1986.0,12689.16,19 RC,499,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); ",,,2699.0,13835.0,24 RC,499,"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care ",,,3390.0,13841.99,7 RC,499,"Vaginal hysterectomy, for uterus 250 g or less; ",,,1603.34,15059.0,26 RC,499,"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control ",,,4988.0,13835.0,12 RC,499,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) ",,,1603.34,15059.0,26 RC,499,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele ",,,3293.0,15059.0,24 RC,499,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele ",,,3293.0,15059.0,24 RC,499,"Vaginal hysterectomy, for uterus greater than 250 g; ",,,3293.0,18300.83,24 RC,499,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) ",,,3293.0,13835.0,24 RC,499,"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele ",,,3293.0,18300.83,24 RC,499,"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele ",,,3293.0,13835.0,24 RC,499,"Vaginal hysterectomy, radical (Schauta type operation) ",,,3390.0,17741.14,12 RC,499,"Vaginal hysterectomy, with total or partial vaginectomy; ",,,4988.0,13835.0,12 RC,499,"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele ",,,4988.0,13835.0,12 RC,499,"Vaginectomy, complete removal of vaginal wall; ",,,2699.0,16207.0,24 RC,499,"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2699.0,21606.3,24 RC,499,"Vaginectomy, partial removal of vaginal wall; ",,,2699.0,13835.0,24 RC,499,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) ",,,2195.0,13835.0,24 RC,499,"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) ",,,1986.0,13835.0,24 RC,499,Vaginoplasty for intersex state ,,,2699.0,13835.0,24 RC,499,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,499,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) ",,,685.44,5571.0,26 RC,499,"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral ",,,1672.0,5841.0,15 RC,499,"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) ",,,2195.0,8240.61,24 RC,499,"Vasovasostomy, vasovasorrhaphy ",,,1986.0,8240.61,24 RC,499,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,499,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,499,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,499,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,499,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,499,Ventilating tube removal requiring general anesthesia ,,,85.18,5849.0,26 RC,499,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment ",,,276.0,3128.0,26 RC,499,"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection ",,,357.81,3128.0,26 RC,499,Ventriculocisternostomy (Torkildsen type operation) ,,,3390.0,19949.19,12 RC,499,"Ventriculocisternostomy, third ventricle; ",,,3390.0,17075.76,12 RC,499,"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method ",,,3390.0,16207.0,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in ad",,,2567.78,16207.0,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment ",,,3390.0,21674.15,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each a",,,2488.46,16207.0,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single",,,3390.0,29803.02,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segme",,,3126.33,16207.0,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical ",,,3390.0,22725.26,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,26781.17,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach ",,,3390.0,26832.09,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach ",,,3390.0,27196.53,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical ",,,3390.0,28616.31,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach ",,,3390.0,30091.25,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach ",,,3390.0,29773.38,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach ",,,3390.0,31277.95,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments",,,2842.15,28743.44,36 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumb",,,1711.86,24149.28,24 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately ",,,1844.09,16207.0,12 RC,499,"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment ",,,3390.0,23729.68,12 RC,499,"Vesiculectomy, any approach ",,,1986.0,13835.0,24 RC,499,Vesiculotomy; ,,,685.44,11308.65,26 RC,499,Vesiculotomy; complicated ,,,1986.0,13835.0,24 RC,499,"Vestibular nerve section, transcranial approach ",,,3390.0,21449.53,12 RC,499,"Vestibular nerve section, translabyrinthine approach ",,,930.95,12909.0,26 RC,499,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,499,"Vitrectomy, mechanical, pars plana approach; ",,,1610.16,10424.04,26 RC,499,"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation ",,,1610.16,12909.0,26 RC,499,"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation ",,,1610.16,12909.0,26 RC,499,"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponad",,,1610.16,15059.0,26 RC,499,"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker) ",,,1610.16,15059.0,26 RC,499,"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and la",,,1610.16,15059.0,26 RC,499,"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) ",,,1672.0,5841.0,15 RC,499,Vulvectomy simple; complete ,,,1116.7,12909.0,26 RC,499,Vulvectomy simple; partial ,,,1116.7,13394.0,26 RC,499,"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy ",,,3390.0,18478.49,12 RC,499,"Vulvectomy, radical, complete; ",,,9875.0,14986.24,12 RC,499,"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,18618.43,12 RC,499,"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,16058.52,12 RC,499,"Vulvectomy, radical, partial; ",,,3390.0,16207.0,24 RC,499,"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy ",,,9875.0,17240.98,12 RC,499,"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy ",,,9875.0,14609.1,12 RC,499,"Wedge resection or bisection of ovary, unilateral or bilateral ",,,2699.0,18300.83,24 RC,499,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,500, Outpatient Services General Classification ,,,,,0 RC,509, Outpatient Services Other ,,,,,0 RC,510, Clinic General Classification ,,,,,0 RC,511, Clinic Chronic Pain Center ,,,,,0 RC,514, Clinic OB-GYN ,,,,,0 RC,515, Clinic Pediatric ,,,,,0 RC,516, Clinic Urgent Care ,,,,,0 RC,517, Clinic Family Practice ,,,,,0 RC,519, Clinic Other ,,,,,0 RC,520, Freestanding Clinic General Classification ,,,,,0 RC,523, Freestanding Clinic Family Practice Clinic ,,,,,0 RC,526, Freestanding Clinic Urgent Care Clinic ,,,,,0 RC,529, Freestanding Clinic Other ,,,,,0 RC,530, Osteopathic Services General Classification ,,,,,0 RC,531, Osteopathic Services Osteopathic Therapy ,,,,,0 RC,539, Osteopathic Services Other ,,,,,0 RC,540, Ambulance General Classification ,,,355.25,355.25,1 RC,541, Ambulance Supplies ,,,,,0 RC,542, Ambulance Medical Transport ,,,355.25,355.25,1 RC,543, Ambulance Heart Mobile ,,,355.25,355.25,1 RC,544, Ambulance Oxygen ,,,,,0 RC,545, Ambulance Air Ambulance ,,,2334.5,2334.5,1 RC,546, Ambulance Neonatal Ambulance Services ,,,355.25,355.25,1 RC,547, Ambulance Pharmacy ,,,355.25,355.25,1 RC,548, Ambulance EKG Transmission ,,,355.25,355.25,1 RC,549, Ambulance Other ,,,355.25,355.25,1 RC,550, Skilled Nursing General Classification ,,,2241.0,2241.0,1 RC,551, Skilled Nursing Visit Charge ,,,2241.0,2241.0,1 RC,552, Skilled Nursing Hourly Charge ,,,2241.0,2241.0,1 RC,559, Skilled Nursing Other ,,,2241.0,2241.0,1 RC,610, Magnetic Resonance Technology (MRT) General Classification ,,,663.0,1724.0,4 RC,610,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,610,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,610,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,610,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,610,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,610,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,610,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,610,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,610,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,610,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,610,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,610,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,610,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,610,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,610,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,610,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,610,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,610,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,610,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,610,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,610,Bone age studies ,,,26.58,26.58,1 RC,610,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,610,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,610,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,610,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,610,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,610,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,610,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,610,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,610,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,610,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,610,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,610,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,610,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,610,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,610,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,610,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,610,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,610,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,610,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,610,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,610,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,610,Cardiac shunt detection ,,,186.76,186.76,1 RC,610,Cardiokymography ,,,20.04,20.04,1 RC,610,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,610,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,610,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,610,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,610,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,610,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,610,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,610,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,610,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,610,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,610,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,610,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,610,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,610,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,610,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,610,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,610,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,610,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,610,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,610,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,610,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,610,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,610,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,610,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,610,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,610,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,610,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,610,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,610,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,610,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,610,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,610,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,610,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,610,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,610,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,610,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,610,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,610,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,610,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,610,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,610,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,610,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,610,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,610,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,610,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,610,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,610,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,610,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,610,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,610,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,610,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,610,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,610,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,610,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,610,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,610,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,610,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,610,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,610,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,610,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,610,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,610,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,610,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,610,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,610,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,610,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,610,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,610,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,610,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,610,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,610,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,610,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,610,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,610,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,610,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,610,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,610,Esophageal motility ,,,214.04,214.04,1 RC,610,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,610,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,610,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,610,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,610,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,610,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,610,Gastric mucosa imaging ,,,205.51,205.51,1 RC,610,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,610,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,610,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,610,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,610,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,610,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,610,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,610,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,610,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,610,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,610,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,610,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,610,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,610,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,610,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,610,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,610,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,610,Kidney imaging morphology; ,,,172.11,172.11,1 RC,610,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,610,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,610,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,610,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,610,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,610,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,610,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,610,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,610,Liver imaging; static only ,,,191.2,191.2,1 RC,610,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,610,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,610,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,610,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,610,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,610,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,610,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,610,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,610,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,610,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,610,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,610,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,610,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,610,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,610,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,610,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,610,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,610,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,610,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,610,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,610,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,610,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,610,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,610,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,610,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,610,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,610,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,610,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,610,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,610,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,610,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,610,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,610,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,610,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,610,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,610,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,610,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,610,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,610,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,610,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,610,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,610,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,610,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,610,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,610,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,610,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,610,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,610,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,610,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,610,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,610,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,610,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,610,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,610,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,610,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,610,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,610,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,610,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,610,Platelet survival study ,,,126.1,126.1,1 RC,610,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,610,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,610,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,610,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,610,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,610,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,610,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,610,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,610,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,610,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,610,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,610,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,610,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,610,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,610,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,610,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,610,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,610,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,610,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,610,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,610,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,610,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,610,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,610,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,610,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,610,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,610,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,610,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,610,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,610,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,610,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,610,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,610,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,610,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,610,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,610,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,610,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,610,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,610,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,610,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,610,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,610,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,610,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,610,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,610,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,610,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,610,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,610,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,610,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,610,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,610,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,610,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,610,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,610,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,610,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,610,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,610,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,610,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,610,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,610,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,610,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,610,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,610,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,610,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,610,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,610,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,610,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,610,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,610,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,610,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,610,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,610,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,610,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,610,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,610,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,610,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,610,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,610,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,610,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,610,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,610,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,610,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,610,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,610,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,610,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,610,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,610,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,610,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,610,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,610,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,610,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,610,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,610,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,610,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,610,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,610,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,610,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,610,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,610,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,610,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,610,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,610,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,610,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,610,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,610,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,610,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,610,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,610,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,610,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,610,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,610,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,610,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,610,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,610,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,610,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,610,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,610,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,610,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,610,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,610,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,610,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,610,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,610,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,610,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,610,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,610,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,610,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,610,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,610,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,610,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,610,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,610,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,610,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,610,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,610,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,610,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,610,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,610,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,610,Red cell survival study ,,,126.1,126.1,1 RC,610,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,610,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,610,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,610,Salivary gland function study ,,,104.3,104.3,1 RC,610,Salivary gland imaging; ,,,175.52,175.52,1 RC,610,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,610,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,610,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,610,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,610,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,610,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,610,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,610,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,610,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,610,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,610,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,610,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,610,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,610,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,610,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,610,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,610,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,610,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,610,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,610,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,610,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,610,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,610,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,610,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,610,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,610,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,610,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,610,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,610,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,610,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,610,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,610,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,610,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,610,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,610,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,610,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,610,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,610,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,610,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,610,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,610,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,610,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,610,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,610,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,610,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,610,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,610,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,610,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,610,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,610,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,610,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,610,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,610,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,610,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,610,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,610,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,610,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,610,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,610,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,610,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,610,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,610,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,610,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,610,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,610,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,610,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,610,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,610,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,610,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,610,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,610,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,610,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,610,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,610,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,610,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,610,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,610,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,610,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,610,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,610,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,610,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,610,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,610,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,610,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,610,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,610,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,610,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,611, Magnetic Resonance Technology (MRT) MRI - Brain/Brainstem ,,,663.0,1724.0,4 RC,611,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,611,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,611,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,611,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,611,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,611,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,611,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,611,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,611,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,611,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,611,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,611,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,611,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,611,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,611,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,611,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,611,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,611,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,611,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,611,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,611,Bone age studies ,,,26.58,26.58,1 RC,611,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,611,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,611,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,611,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,611,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,611,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,611,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,611,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,611,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,611,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,611,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,611,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,611,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,611,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,611,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,611,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,611,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,611,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,611,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,611,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,611,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,611,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,611,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,611,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,611,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,611,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,611,Cardiac shunt detection ,,,186.76,186.76,1 RC,611,Cardiokymography ,,,20.04,20.04,1 RC,611,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,611,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,611,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,611,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,611,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,611,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,611,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,611,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,611,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,611,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,611,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,611,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,611,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,611,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,611,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,611,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,611,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,611,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,611,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,611,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,611,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,611,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,611,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,611,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,611,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,611,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,611,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,611,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,611,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,611,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,611,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,611,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,611,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,611,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,611,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,611,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,611,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,611,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,611,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,611,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,611,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,611,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,611,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,611,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,611,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,611,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,611,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,611,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,611,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,611,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,611,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,611,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,611,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,611,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,611,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,611,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,611,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,611,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,611,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,611,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,611,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,611,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,611,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,611,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,611,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,611,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,611,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,611,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,611,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,611,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,611,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,611,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,611,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,611,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,611,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,611,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,611,Esophageal motility ,,,214.04,214.04,1 RC,611,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,611,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,611,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,611,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,611,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,611,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,611,Gastric mucosa imaging ,,,205.51,205.51,1 RC,611,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,611,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,611,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,611,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,611,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,611,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,611,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,611,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,611,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,611,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,611,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,611,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,611,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,611,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,611,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,611,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,611,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,611,Kidney imaging morphology; ,,,172.11,172.11,1 RC,611,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,611,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,611,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,611,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,611,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,611,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,611,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,611,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,611,Liver imaging; static only ,,,191.2,191.2,1 RC,611,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,611,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,611,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,611,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,611,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,611,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,611,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,611,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,611,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,611,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,611,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,611,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,611,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,611,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,611,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,611,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,611,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,611,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,611,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,611,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,611,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,611,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,611,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,611,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,611,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,611,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,611,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,611,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,611,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,611,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,611,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,611,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,611,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,611,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,611,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,611,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,611,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,611,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,611,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,611,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,611,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,611,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,611,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,611,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,611,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,611,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,611,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,611,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,611,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,611,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,611,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,611,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,611,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,611,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,611,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,611,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,611,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,611,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,611,Platelet survival study ,,,126.1,126.1,1 RC,611,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,611,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,611,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,611,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,611,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,611,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,611,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,611,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,611,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,611,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,611,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,611,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,611,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,611,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,611,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,611,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,611,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,611,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,611,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,611,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,611,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,611,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,611,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,611,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,611,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,611,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,611,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,611,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,611,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,611,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,611,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,611,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,611,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,611,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,611,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,611,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,611,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,611,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,611,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,611,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,611,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,611,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,611,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,611,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,611,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,611,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,611,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,611,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,611,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,611,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,611,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,611,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,611,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,611,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,611,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,611,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,611,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,611,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,611,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,611,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,611,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,611,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,611,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,611,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,611,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,611,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,611,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,611,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,611,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,611,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,611,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,611,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,611,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,611,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,611,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,611,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,611,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,611,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,611,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,611,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,611,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,611,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,611,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,611,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,611,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,611,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,611,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,611,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,611,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,611,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,611,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,611,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,611,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,611,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,611,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,611,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,611,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,611,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,611,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,611,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,611,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,611,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,611,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,611,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,611,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,611,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,611,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,611,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,611,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,611,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,611,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,611,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,611,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,611,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,611,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,611,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,611,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,611,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,611,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,611,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,611,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,611,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,611,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,611,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,611,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,611,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,611,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,611,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,611,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,611,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,611,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,611,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,611,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,611,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,611,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,611,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,611,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,611,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,611,Red cell survival study ,,,126.1,126.1,1 RC,611,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,611,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,611,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,611,Salivary gland function study ,,,104.3,104.3,1 RC,611,Salivary gland imaging; ,,,175.52,175.52,1 RC,611,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,611,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,611,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,611,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,611,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,611,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,611,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,611,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,611,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,611,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,611,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,611,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,611,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,611,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,611,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,611,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,611,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,611,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,611,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,611,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,611,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,611,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,611,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,611,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,611,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,611,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,611,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,611,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,611,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,611,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,611,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,611,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,611,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,611,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,611,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,611,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,611,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,611,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,611,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,611,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,611,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,611,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,611,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,611,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,611,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,611,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,611,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,611,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,611,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,611,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,611,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,611,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,611,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,611,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,611,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,611,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,611,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,611,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,611,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,611,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,611,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,611,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,611,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,611,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,611,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,611,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,611,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,611,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,611,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,611,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,611,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,611,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,611,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,611,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,611,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,611,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,611,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,611,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,611,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,611,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,611,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,611,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,611,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,611,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,611,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,611,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,611,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,612, Magnetic Resonance Technology (MRT) MRI - Spinal Code/Spine ,,,663.0,1724.0,4 RC,612,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,612,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,612,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,612,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,612,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,612,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,612,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,612,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,612,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,612,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,612,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,612,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,612,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,612,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,612,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,612,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,612,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,612,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,612,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,612,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,612,Bone age studies ,,,26.58,26.58,1 RC,612,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,612,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,612,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,612,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,612,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,612,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,612,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,612,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,612,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,612,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,612,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,612,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,612,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,612,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,612,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,612,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,612,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,612,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,612,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,612,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,612,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,612,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,612,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,612,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,612,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,612,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,612,Cardiac shunt detection ,,,186.76,186.76,1 RC,612,Cardiokymography ,,,20.04,20.04,1 RC,612,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,612,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,612,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,612,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,612,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,612,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,612,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,612,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,612,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,612,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,612,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,612,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,612,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,612,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,612,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,612,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,612,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,612,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,612,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,612,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,612,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,612,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,612,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,612,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,612,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,612,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,612,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,612,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,612,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,612,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,612,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,612,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,612,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,612,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,612,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,612,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,612,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,612,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,612,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,612,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,612,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,612,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,612,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,612,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,612,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,612,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,612,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,612,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,612,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,612,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,612,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,612,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,612,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,612,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,612,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,612,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,612,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,612,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,612,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,612,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,612,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,612,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,612,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,612,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,612,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,612,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,612,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,612,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,612,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,612,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,612,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,612,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,612,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,612,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,612,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,612,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,612,Esophageal motility ,,,214.04,214.04,1 RC,612,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,612,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,612,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,612,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,612,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,612,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,612,Gastric mucosa imaging ,,,205.51,205.51,1 RC,612,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,612,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,612,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,612,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,612,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,612,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,612,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,612,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,612,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,612,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,612,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,612,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,612,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,612,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,612,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,612,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,612,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,612,Kidney imaging morphology; ,,,172.11,172.11,1 RC,612,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,612,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,612,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,612,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,612,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,612,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,612,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,612,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,612,Liver imaging; static only ,,,191.2,191.2,1 RC,612,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,612,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,612,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,612,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,612,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,612,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,612,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,612,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,612,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,612,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,612,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,612,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,612,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,612,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,612,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,612,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,612,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,612,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,612,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,612,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,612,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,612,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,612,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,612,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,612,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,612,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,612,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,612,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,612,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,612,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,612,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,612,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,612,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,612,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,612,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,612,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,612,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,612,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,612,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,612,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,612,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,612,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,612,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,612,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,612,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,612,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,612,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,612,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,612,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,612,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,612,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,612,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,612,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,612,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,612,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,612,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,612,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,612,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,612,Platelet survival study ,,,126.1,126.1,1 RC,612,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,612,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,612,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,612,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,612,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,612,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,612,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,612,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,612,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,612,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,612,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,612,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,612,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,612,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,612,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,612,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,612,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,612,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,612,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,612,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,612,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,612,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,612,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,612,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,612,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,612,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,612,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,612,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,612,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,612,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,612,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,612,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,612,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,612,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,612,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,612,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,612,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,612,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,612,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,612,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,612,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,612,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,612,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,612,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,612,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,612,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,612,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,612,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,612,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,612,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,612,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,612,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,612,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,612,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,612,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,612,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,612,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,612,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,612,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,612,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,612,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,612,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,612,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,612,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,612,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,612,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,612,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,612,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,612,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,612,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,612,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,612,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,612,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,612,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,612,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,612,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,612,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,612,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,612,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,612,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,612,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,612,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,612,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,612,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,612,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,612,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,612,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,612,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,612,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,612,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,612,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,612,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,612,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,612,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,612,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,612,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,612,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,612,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,612,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,612,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,612,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,612,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,612,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,612,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,612,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,612,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,612,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,612,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,612,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,612,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,612,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,612,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,612,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,612,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,612,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,612,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,612,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,612,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,612,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,612,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,612,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,612,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,612,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,612,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,612,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,612,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,612,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,612,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,612,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,612,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,612,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,612,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,612,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,612,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,612,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,612,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,612,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,612,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,612,Red cell survival study ,,,126.1,126.1,1 RC,612,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,612,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,612,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,612,Salivary gland function study ,,,104.3,104.3,1 RC,612,Salivary gland imaging; ,,,175.52,175.52,1 RC,612,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,612,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,612,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,612,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,612,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,612,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,612,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,612,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,612,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,612,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,612,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,612,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,612,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,612,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,612,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,612,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,612,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,612,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,612,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,612,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,612,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,612,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,612,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,612,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,612,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,612,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,612,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,612,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,612,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,612,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,612,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,612,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,612,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,612,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,612,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,612,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,612,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,612,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,612,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,612,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,612,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,612,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,612,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,612,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,612,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,612,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,612,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,612,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,612,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,612,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,612,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,612,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,612,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,612,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,612,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,612,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,612,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,612,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,612,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,612,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,612,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,612,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,612,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,612,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,612,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,612,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,612,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,612,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,612,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,612,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,612,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,612,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,612,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,612,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,612,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,612,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,612,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,612,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,612,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,612,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,612,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,612,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,612,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,612,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,612,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,612,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,612,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,614, Magnetic Resonance Technology (MRT) MRI - Other ,,,663.0,1724.0,4 RC,614,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,614,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,614,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,614,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,614,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,614,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,614,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,614,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,614,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,614,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,614,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,614,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,614,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,614,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,614,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,614,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,614,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,614,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,614,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,614,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,614,Bone age studies ,,,26.58,26.58,1 RC,614,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,614,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,614,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,614,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,614,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,614,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,614,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,614,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,614,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,614,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,614,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,614,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,614,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,614,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,614,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,614,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,614,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,614,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,614,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,614,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,614,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,614,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,614,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,614,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,614,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,614,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,614,Cardiac shunt detection ,,,186.76,186.76,1 RC,614,Cardiokymography ,,,20.04,20.04,1 RC,614,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,614,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,614,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,614,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,614,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,614,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,614,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,614,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,614,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,614,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,614,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,614,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,614,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,614,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,614,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,614,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,614,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,614,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,614,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,614,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,614,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,614,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,614,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,614,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,614,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,614,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,614,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,614,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,614,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,614,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,614,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,614,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,614,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,614,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,614,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,614,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,614,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,614,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,614,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,614,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,614,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,614,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,614,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,614,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,614,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,614,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,614,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,614,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,614,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,614,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,614,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,614,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,614,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,614,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,614,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,614,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,614,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,614,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,614,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,614,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,614,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,614,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,614,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,614,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,614,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,614,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,614,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,614,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,614,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,614,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,614,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,614,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,614,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,614,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,614,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,614,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,614,Esophageal motility ,,,214.04,214.04,1 RC,614,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,614,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,614,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,614,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,614,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,614,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,614,Gastric mucosa imaging ,,,205.51,205.51,1 RC,614,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,614,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,614,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,614,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,614,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,614,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,614,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,614,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,614,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,614,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,614,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,614,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,614,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,614,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,614,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,614,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,614,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,614,Kidney imaging morphology; ,,,172.11,172.11,1 RC,614,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,614,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,614,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,614,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,614,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,614,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,614,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,614,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,614,Liver imaging; static only ,,,191.2,191.2,1 RC,614,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,614,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,614,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,614,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,614,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,614,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,614,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,614,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,614,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,614,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,614,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,614,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,614,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,614,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,614,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,614,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,614,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,614,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,614,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,614,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,614,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,614,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,614,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,614,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,614,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,614,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,614,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,614,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,614,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,614,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,614,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,614,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,614,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,614,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,614,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,614,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,614,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,614,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,614,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,614,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,614,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,614,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,614,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,614,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,614,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,614,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,614,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,614,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,614,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,614,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,614,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,614,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,614,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,614,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,614,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,614,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,614,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,614,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,614,Platelet survival study ,,,126.1,126.1,1 RC,614,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,614,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,614,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,614,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,614,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,614,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,614,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,614,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,614,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,614,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,614,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,614,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,614,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,614,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,614,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,614,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,614,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,614,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,614,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,614,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,614,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,614,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,614,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,614,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,614,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,614,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,614,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,614,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,614,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,614,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,614,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,614,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,614,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,614,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,614,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,614,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,614,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,614,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,614,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,614,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,614,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,614,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,614,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,614,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,614,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,614,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,614,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,614,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,614,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,614,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,614,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,614,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,614,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,614,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,614,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,614,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,614,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,614,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,614,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,614,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,614,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,614,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,614,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,614,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,614,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,614,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,614,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,614,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,614,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,614,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,614,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,614,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,614,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,614,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,614,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,614,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,614,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,614,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,614,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,614,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,614,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,614,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,614,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,614,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,614,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,614,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,614,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,614,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,614,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,614,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,614,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,614,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,614,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,614,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,614,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,614,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,614,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,614,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,614,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,614,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,614,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,614,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,614,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,614,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,614,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,614,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,614,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,614,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,614,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,614,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,614,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,614,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,614,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,614,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,614,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,614,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,614,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,614,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,614,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,614,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,614,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,614,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,614,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,614,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,614,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,614,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,614,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,614,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,614,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,614,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,614,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,614,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,614,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,614,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,614,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,614,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,614,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,614,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,614,Red cell survival study ,,,126.1,126.1,1 RC,614,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,614,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,614,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,614,Salivary gland function study ,,,104.3,104.3,1 RC,614,Salivary gland imaging; ,,,175.52,175.52,1 RC,614,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,614,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,614,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,614,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,614,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,614,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,614,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,614,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,614,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,614,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,614,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,614,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,614,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,614,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,614,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,614,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,614,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,614,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,614,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,614,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,614,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,614,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,614,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,614,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,614,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,614,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,614,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,614,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,614,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,614,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,614,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,614,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,614,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,614,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,614,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,614,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,614,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,614,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,614,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,614,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,614,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,614,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,614,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,614,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,614,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,614,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,614,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,614,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,614,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,614,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,614,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,614,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,614,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,614,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,614,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,614,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,614,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,614,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,614,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,614,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,614,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,614,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,614,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,614,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,614,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,614,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,614,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,614,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,614,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,614,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,614,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,614,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,614,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,614,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,614,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,614,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,614,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,614,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,614,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,614,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,614,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,614,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,614,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,614,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,614,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,614,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,614,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,615, Magnetic Resonance Technology (MRT) MRA - Head and Neck ,,,663.0,1724.0,4 RC,615,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,615,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,615,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,615,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,615,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,615,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,615,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,615,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,615,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,615,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,615,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,615,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,615,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,615,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,615,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,615,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,615,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,615,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,615,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,615,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,615,Bone age studies ,,,26.58,26.58,1 RC,615,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,615,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,615,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,615,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,615,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,615,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,615,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,615,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,615,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,615,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,615,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,615,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,615,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,615,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,615,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,615,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,615,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,615,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,615,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,615,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,615,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,615,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,615,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,615,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,615,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,615,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,615,Cardiac shunt detection ,,,186.76,186.76,1 RC,615,Cardiokymography ,,,20.04,20.04,1 RC,615,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,615,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,615,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,615,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,615,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,615,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,615,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,615,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,615,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,615,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,615,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,615,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,615,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,615,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,615,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,615,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,615,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,615,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,615,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,615,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,615,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,615,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,615,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,615,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,615,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,615,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,615,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,615,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,615,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,615,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,615,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,615,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,615,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,615,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,615,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,615,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,615,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,615,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,615,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,615,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,615,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,615,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,615,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,615,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,615,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,615,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,615,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,615,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,615,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,615,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,615,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,615,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,615,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,615,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,615,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,615,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,615,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,615,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,615,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,615,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,615,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,615,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,615,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,615,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,615,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,615,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,615,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,615,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,615,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,615,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,615,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,615,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,615,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,615,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,615,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,615,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,615,Esophageal motility ,,,214.04,214.04,1 RC,615,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,615,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,615,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,615,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,615,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,615,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,615,Gastric mucosa imaging ,,,205.51,205.51,1 RC,615,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,615,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,615,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,615,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,615,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,615,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,615,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,615,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,615,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,615,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,615,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,615,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,615,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,615,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,615,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,615,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,615,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,615,Kidney imaging morphology; ,,,172.11,172.11,1 RC,615,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,615,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,615,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,615,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,615,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,615,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,615,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,615,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,615,Liver imaging; static only ,,,191.2,191.2,1 RC,615,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,615,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,615,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,615,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,615,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,615,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,615,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,615,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,615,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,615,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,615,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,615,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,615,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,615,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,615,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,615,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,615,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,615,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,615,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,615,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,615,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,615,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,615,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,615,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,615,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,615,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,615,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,615,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,615,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,615,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,615,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,615,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,615,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,615,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,615,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,615,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,615,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,615,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,615,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,615,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,615,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,615,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,615,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,615,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,615,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,615,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,615,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,615,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,615,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,615,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,615,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,615,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,615,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,615,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,615,Platelet survival study ,,,126.1,126.1,1 RC,615,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,615,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,615,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,615,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,615,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,615,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,615,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,615,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,615,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,615,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,615,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,615,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,615,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,615,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,615,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,615,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,615,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,615,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,615,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,615,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,615,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,615,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,615,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,615,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,615,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,615,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,615,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,615,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,615,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,615,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,615,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,615,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,615,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,615,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,615,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,615,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,615,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,615,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,615,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,615,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,615,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,615,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,615,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,615,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,615,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,615,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,615,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,615,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,615,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,615,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,615,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,615,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,615,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,615,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,615,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,615,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,615,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,615,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,615,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,615,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,615,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,615,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,615,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,615,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,615,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,615,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,615,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,615,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,615,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,615,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,615,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,615,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,615,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,615,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,615,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,615,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,615,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,615,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,615,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,615,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,615,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,615,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,615,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,615,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,615,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,615,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,615,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,615,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,615,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,615,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,615,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,615,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,615,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,615,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,615,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,615,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,615,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,615,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,615,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,615,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,615,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,615,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,615,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,615,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,615,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,615,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,615,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,615,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,615,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,615,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,615,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,615,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,615,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,615,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,615,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,615,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,615,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,615,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,615,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,615,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,615,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,615,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,615,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,615,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,615,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,615,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,615,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,615,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,615,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,615,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,615,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,615,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,615,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,615,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,615,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,615,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,615,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,615,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,615,Red cell survival study ,,,126.1,126.1,1 RC,615,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,615,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,615,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,615,Salivary gland function study ,,,104.3,104.3,1 RC,615,Salivary gland imaging; ,,,175.52,175.52,1 RC,615,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,615,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,615,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,615,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,615,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,615,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,615,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,615,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,615,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,615,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,615,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,615,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,615,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,615,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,615,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,615,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,615,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,615,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,615,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,615,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,615,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,615,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,615,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,615,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,615,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,615,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,615,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,615,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,615,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,615,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,615,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,615,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,615,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,615,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,615,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,615,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,615,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,615,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,615,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,615,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,615,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,615,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,615,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,615,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,615,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,615,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,615,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,615,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,615,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,615,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,615,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,615,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,615,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,615,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,615,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,615,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,615,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,615,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,615,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,615,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,615,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,615,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,615,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,615,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,615,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,615,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,615,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,615,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,615,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,615,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,615,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,615,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,615,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,615,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,615,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,615,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,615,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,615,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,615,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,615,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,615,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,615,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,615,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,615,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,615,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,615,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,615,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,616, Magnetic Resonance Technology (MRT) MRA - Lower Extremities ,,,663.0,1724.0,4 RC,616,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,616,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,616,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,616,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,616,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,616,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,616,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,616,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,616,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,616,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,616,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,616,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,616,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,616,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,616,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,616,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,616,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,616,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,616,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,616,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,616,Bone age studies ,,,26.58,26.58,1 RC,616,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,616,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,616,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,616,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,616,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,616,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,616,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,616,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,616,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,616,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,616,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,616,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,616,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,616,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,616,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,616,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,616,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,616,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,616,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,616,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,616,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,616,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,616,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,616,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,616,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,616,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,616,Cardiac shunt detection ,,,186.76,186.76,1 RC,616,Cardiokymography ,,,20.04,20.04,1 RC,616,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,616,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,616,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,616,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,616,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,616,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,616,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,616,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,616,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,616,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,616,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,616,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,616,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,616,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,616,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,616,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,616,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,616,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,616,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,616,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,616,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,616,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,616,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,616,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,616,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,616,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,616,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,616,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,616,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,616,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,616,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,616,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,616,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,616,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,616,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,616,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,616,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,616,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,616,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,616,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,616,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,616,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,616,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,616,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,616,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,616,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,616,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,616,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,616,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,616,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,616,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,616,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,616,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,616,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,616,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,616,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,616,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,616,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,616,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,616,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,616,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,616,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,616,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,616,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,616,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,616,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,616,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,616,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,616,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,616,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,616,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,616,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,616,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,616,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,616,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,616,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,616,Esophageal motility ,,,214.04,214.04,1 RC,616,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,616,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,616,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,616,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,616,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,616,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,616,Gastric mucosa imaging ,,,205.51,205.51,1 RC,616,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,616,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,616,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,616,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,616,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,616,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,616,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,616,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,616,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,616,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,616,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,616,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,616,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,616,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,616,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,616,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,616,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,616,Kidney imaging morphology; ,,,172.11,172.11,1 RC,616,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,616,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,616,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,616,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,616,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,616,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,616,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,616,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,616,Liver imaging; static only ,,,191.2,191.2,1 RC,616,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,616,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,616,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,616,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,616,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,616,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,616,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,616,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,616,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,616,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,616,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,616,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,616,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,616,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,616,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,616,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,616,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,616,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,616,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,616,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,616,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,616,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,616,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,616,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,616,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,616,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,616,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,616,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,616,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,616,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,616,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,616,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,616,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,616,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,616,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,616,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,616,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,616,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,616,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,616,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,616,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,616,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,616,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,616,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,616,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,616,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,616,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,616,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,616,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,616,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,616,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,616,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,616,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,616,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,616,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,616,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,616,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,616,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,616,Platelet survival study ,,,126.1,126.1,1 RC,616,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,616,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,616,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,616,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,616,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,616,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,616,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,616,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,616,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,616,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,616,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,616,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,616,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,616,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,616,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,616,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,616,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,616,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,616,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,616,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,616,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,616,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,616,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,616,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,616,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,616,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,616,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,616,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,616,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,616,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,616,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,616,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,616,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,616,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,616,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,616,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,616,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,616,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,616,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,616,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,616,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,616,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,616,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,616,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,616,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,616,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,616,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,616,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,616,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,616,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,616,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,616,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,616,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,616,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,616,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,616,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,616,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,616,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,616,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,616,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,616,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,616,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,616,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,616,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,616,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,616,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,616,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,616,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,616,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,616,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,616,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,616,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,616,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,616,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,616,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,616,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,616,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,616,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,616,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,616,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,616,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,616,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,616,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,616,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,616,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,616,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,616,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,616,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,616,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,616,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,616,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,616,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,616,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,616,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,616,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,616,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,616,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,616,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,616,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,616,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,616,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,616,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,616,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,616,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,616,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,616,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,616,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,616,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,616,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,616,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,616,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,616,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,616,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,616,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,616,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,616,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,616,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,616,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,616,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,616,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,616,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,616,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,616,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,616,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,616,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,616,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,616,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,616,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,616,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,616,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,616,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,616,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,616,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,616,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,616,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,616,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,616,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,616,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,616,Red cell survival study ,,,126.1,126.1,1 RC,616,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,616,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,616,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,616,Salivary gland function study ,,,104.3,104.3,1 RC,616,Salivary gland imaging; ,,,175.52,175.52,1 RC,616,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,616,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,616,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,616,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,616,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,616,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,616,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,616,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,616,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,616,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,616,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,616,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,616,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,616,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,616,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,616,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,616,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,616,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,616,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,616,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,616,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,616,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,616,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,616,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,616,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,616,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,616,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,616,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,616,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,616,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,616,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,616,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,616,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,616,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,616,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,616,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,616,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,616,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,616,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,616,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,616,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,616,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,616,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,616,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,616,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,616,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,616,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,616,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,616,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,616,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,616,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,616,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,616,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,616,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,616,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,616,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,616,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,616,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,616,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,616,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,616,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,616,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,616,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,616,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,616,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,616,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,616,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,616,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,616,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,616,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,616,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,616,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,616,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,616,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,616,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,616,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,616,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,616,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,616,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,616,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,616,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,616,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,616,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,616,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,616,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,616,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,616,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,618, Magnetic Resonance Technolgy (MRT) MRA - Other ,,,663.0,1724.0,4 RC,618,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,618,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,618,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,618,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,618,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,618,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,618,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,618,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,618,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,618,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,618,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,618,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,618,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,618,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,618,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,618,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,618,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,618,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,618,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,618,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,618,Bone age studies ,,,26.58,26.58,1 RC,618,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,618,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,618,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,618,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,618,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,618,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,618,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,618,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,618,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,618,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,618,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,618,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,618,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,618,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,618,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,618,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,618,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,618,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,618,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,618,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,618,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,618,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,618,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,618,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,618,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,618,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,618,Cardiac shunt detection ,,,186.76,186.76,1 RC,618,Cardiokymography ,,,20.04,20.04,1 RC,618,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,618,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,618,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,618,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,618,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,618,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,618,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,618,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,618,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,618,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,618,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,618,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,618,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,618,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,618,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,618,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,618,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,618,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,618,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,618,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,618,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,618,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,618,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,618,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,618,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,618,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,618,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,618,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,618,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,618,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,618,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,618,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,618,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,618,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,618,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,618,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,618,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,618,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,618,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,618,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,618,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,618,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,618,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,618,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,618,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,618,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,618,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,618,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,618,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,618,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,618,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,618,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,618,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,618,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,618,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,618,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,618,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,618,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,618,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,618,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,618,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,618,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,618,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,618,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,618,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,618,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,618,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,618,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,618,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,618,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,618,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,618,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,618,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,618,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,618,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,618,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,618,Esophageal motility ,,,214.04,214.04,1 RC,618,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,618,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,618,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,618,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,618,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,618,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,618,Gastric mucosa imaging ,,,205.51,205.51,1 RC,618,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,618,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,618,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,618,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,618,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,618,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,618,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,618,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,618,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,618,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,618,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,618,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,618,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,618,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,618,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,618,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,618,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,618,Kidney imaging morphology; ,,,172.11,172.11,1 RC,618,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,618,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,618,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,618,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,618,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,618,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,618,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,618,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,618,Liver imaging; static only ,,,191.2,191.2,1 RC,618,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,618,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,618,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,618,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,618,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,618,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,618,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,618,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,618,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,618,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,618,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,618,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,618,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,618,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,618,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,618,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,618,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,618,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,618,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,618,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,618,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,618,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,618,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,618,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,618,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,618,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,618,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,618,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,618,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,618,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,618,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,618,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,618,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,618,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,618,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,618,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,618,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,618,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,618,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,618,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,618,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,618,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,618,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,618,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,618,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,618,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,618,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,618,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,618,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,618,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,618,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,618,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,618,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,618,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,618,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,618,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,618,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,618,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,618,Platelet survival study ,,,126.1,126.1,1 RC,618,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,618,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,618,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,618,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,618,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,618,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,618,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,618,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,618,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,618,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,618,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,618,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,618,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,618,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,618,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,618,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,618,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,618,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,618,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,618,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,618,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,618,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,618,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,618,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,618,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,618,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,618,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,618,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,618,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,618,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,618,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,618,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,618,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,618,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,618,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,618,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,618,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,618,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,618,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,618,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,618,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,618,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,618,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,618,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,618,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,618,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,618,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,618,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,618,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,618,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,618,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,618,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,618,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,618,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,618,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,618,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,618,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,618,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,618,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,618,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,618,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,618,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,618,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,618,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,618,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,618,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,618,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,618,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,618,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,618,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,618,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,618,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,618,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,618,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,618,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,618,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,618,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,618,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,618,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,618,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,618,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,618,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,618,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,618,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,618,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,618,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,618,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,618,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,618,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,618,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,618,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,618,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,618,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,618,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,618,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,618,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,618,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,618,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,618,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,618,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,618,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,618,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,618,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,618,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,618,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,618,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,618,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,618,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,618,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,618,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,618,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,618,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,618,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,618,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,618,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,618,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,618,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,618,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,618,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,618,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,618,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,618,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,618,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,618,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,618,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,618,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,618,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,618,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,618,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,618,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,618,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,618,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,618,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,618,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,618,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,618,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,618,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,618,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,618,Red cell survival study ,,,126.1,126.1,1 RC,618,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,618,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,618,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,618,Salivary gland function study ,,,104.3,104.3,1 RC,618,Salivary gland imaging; ,,,175.52,175.52,1 RC,618,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,618,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,618,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,618,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,618,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,618,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,618,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,618,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,618,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,618,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,618,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,618,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,618,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,618,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,618,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,618,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,618,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,618,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,618,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,618,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,618,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,618,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,618,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,618,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,618,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,618,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,618,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,618,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,618,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,618,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,618,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,618,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,618,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,618,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,618,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,618,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,618,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,618,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,618,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,618,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,618,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,618,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,618,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,618,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,618,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,618,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,618,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,618,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,618,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,618,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,618,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,618,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,618,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,618,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,618,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,618,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,618,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,618,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,618,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,618,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,618,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,618,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,618,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,618,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,618,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,618,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,618,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,618,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,618,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,618,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,618,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,618,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,618,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,618,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,618,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,618,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,618,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,618,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,618,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,618,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,618,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,618,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,618,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,618,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,618,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,618,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,618,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,619, Magnetic Resonance Technology (MRT) Other ,,,663.0,1724.0,4 RC,619,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,619,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,619,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,619,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,619,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,619,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,619,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,619,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,619,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,619,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,619,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,619,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,619,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,619,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,619,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,619,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,619,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,619,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,619,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,619,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,619,Bone age studies ,,,26.58,26.58,1 RC,619,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,619,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,619,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,619,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,619,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,619,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,619,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,619,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,619,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,619,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,619,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,619,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,619,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,619,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,619,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,619,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,619,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,619,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,619,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,619,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,2739.0,4 RC,619,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,2739.0,4 RC,619,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,2739.0,4 RC,619,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,2739.0,4 RC,619,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,2739.0,4 RC,619,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,2739.0,4 RC,619,Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) ,,,2127.0,2739.0,3 RC,619,Cardiac shunt detection ,,,186.76,186.76,1 RC,619,Cardiokymography ,,,20.04,20.04,1 RC,619,"Cephalogram, orthodontic ",,,16.71,16.71,1 RC,619,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,619,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,619,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,619,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,619,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,619,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,619,"Cisternography, positive contrast, radiological supervision and interpretation ",,,172.46,172.46,1 RC,619,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,619,Complex dynamic pharyngeal and speech evaluation by cine or video recording ,,,110.76,110.76,1 RC,619,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,619,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,619,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,619,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,619,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,619,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,619,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,619,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,619,"Computed tomography, cervical spine; with contrast material ",,,178.59,178.59,1 RC,619,"Computed tomography, cervical spine; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, head or brain; with contrast material(s) ",,,156.43,156.43,1 RC,619,"Computed tomography, head or brain; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,619,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,619,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,619,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,619,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,619,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, lumbar spine; with contrast material ",,,178.94,178.94,1 RC,619,"Computed tomography, lumbar spine; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, maxillofacial area; with contrast material(s) ",,,160.86,160.86,1 RC,619,"Computed tomography, maxillofacial area; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) ",,,183.95,183.95,1 RC,619,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, pelvis; with contrast material(s) ",,,183.95,183.95,1 RC,619,"Computed tomography, pelvis; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, soft tissue neck; with contrast material(s) ",,,183.95,183.95,1 RC,619,"Computed tomography, soft tissue neck; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, thoracic spine; with contrast material ",,,179.96,179.96,1 RC,619,"Computed tomography, thoracic spine; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, thorax, diagnostic; with contrast material(s) ",,,176.54,176.54,1 RC,619,"Computed tomography, thorax, diagnostic; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) ",,,109.02,109.02,1 RC,619,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,619,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,619,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,619,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,619,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,619,"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation ",,,58.72,58.72,1 RC,619,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,619,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,619,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,619,"Discography, cervical or thoracic, radiological supervision and interpretation ",,,131.56,131.56,1 RC,619,"Discography, lumbar, radiological supervision and interpretation ",,,113.49,113.49,1 RC,619,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,619,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,619,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,619,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,619,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,619,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,619,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,619,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,619,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,619,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,619,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,619,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,619,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,619,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,619,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,619,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,619,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,619,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,619,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,619,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,619,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,619,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,619,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,619,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,619,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,619,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,619,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,619,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,619,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,619,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,619,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,619,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,619,Esophageal motility ,,,214.04,214.04,1 RC,619,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,619,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,619,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,619,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,619,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,619,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,619,Gastric mucosa imaging ,,,205.51,205.51,1 RC,619,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,619,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,619,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,619,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,619,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,619,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,619,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,619,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,619,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,619,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,619,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,619,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,619,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,619,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,619,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,619,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,619,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,619,Kidney imaging morphology; ,,,172.11,172.11,1 RC,619,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,619,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,619,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,619,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,619,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,619,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,619,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,619,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,619,Liver imaging; static only ,,,191.2,191.2,1 RC,619,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,619,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,619,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,619,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,619,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,619,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,619,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with cont",,,2127.0,2739.0,3 RC,619,"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without c",,,2127.0,2739.0,6 RC,619,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) ",,,288.33,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material ",,,208.23,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences ",,,339.46,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) ",,,400.45,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) ",,,286.62,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,361.95,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) ",,,286.97,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.24,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) ",,,293.44,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material ",,,202.45,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) ",,,288.33,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material ",,,203.12,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ",,,291.06,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material ",,,202.45,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical ",,,341.15,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar ",,,340.48,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic ",,,341.84,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,2739.0,4 RC,619,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,2739.0,4 RC,619,"Magnetic resonance (eg, vibration) elastography ",,,215.73,2739.0,4 RC,619,"Magnetic resonance angiography with contrast, abdomen ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography with contrast, lower extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography with contrast, pelvis ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography with contrast, upper extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, abdomen ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, lower extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, pelvis ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast followed by with contrast, upper extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, abdomen ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, chest (excluding myocardium) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, lower extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, pelvis ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, spinal canal and contents ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography without contrast, upper extremity ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, abdomen, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, head; with contrast material(s) ",,,241.98,2739.0,4 RC,619,"Magnetic resonance angiography, head; without contrast material(s) ",,,229.03,2739.0,4 RC,619,"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences ",,,350.71,2739.0,4 RC,619,"Magnetic resonance angiography, lower extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, neck; with contrast material(s) ",,,261.74,2739.0,4 RC,619,"Magnetic resonance angiography, neck; without contrast material(s) ",,,229.38,2739.0,4 RC,619,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences ",,,367.74,2739.0,4 RC,619,"Magnetic resonance angiography, pelvis, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance angiography, upper extremity, with or without contrast material(s) ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin",,,238.19,2739.0,4 RC,619,"Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when perf",,,2127.0,2739.0,6 RC,619,"Magnetic resonance imaging, breast, without contrast material; bilateral ",,,2127.0,2739.0,3 RC,619,"Magnetic resonance imaging, breast, without contrast material; unilateral ",,,2127.0,2739.0,3 RC,619,Magnetic resonance spectroscopy ,,,2127.0,2739.0,3 RC,619,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,619,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,619,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,619,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,619,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,619,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,619,"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation ",,,168.36,168.36,1 RC,619,"Myelography, cervical, radiological supervision and interpretation ",,,117.59,117.59,1 RC,619,"Myelography, lumbosacral, radiological supervision and interpretation ",,,112.13,112.13,1 RC,619,"Myelography, posterior fossa, radiological supervision and interpretation ",,,59.3,59.3,1 RC,619,"Myelography, thoracic, radiological supervision and interpretation ",,,123.04,123.04,1 RC,619,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,619,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,619,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,619,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,619,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,619,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,619,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,619,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,619,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,619,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,619,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,619,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,619,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,619,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,619,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,619,"Orthopantogram (eg, panoramic x-ray) ",,,18.4,18.4,1 RC,619,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,619,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,619,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,619,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,619,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,619,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,619,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,619,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,619,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,619,Platelet survival study ,,,126.1,126.1,1 RC,619,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,619,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,619,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,619,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,619,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,619,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,619,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,619,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,619,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,619,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,619,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,619,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,619,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,619,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,619,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,619,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,619,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,619,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,619,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,619,"Radiologic examination, chest; 2 views ",,,34.42,34.42,1 RC,619,"Radiologic examination, chest; 3 views ",,,43.29,43.29,1 RC,619,"Radiologic examination, chest; 4 or more views ",,,47.38,47.38,1 RC,619,"Radiologic examination, chest; single view ",,,26.58,26.58,1 RC,619,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,619,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,619,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,619,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,619,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,619,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,619,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,619,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,619,"Radiologic examination, eye, for detection of foreign body ",,,33.41,33.41,1 RC,619,"Radiologic examination, facial bones; complete, minimum of 3 views ",,,48.05,48.05,1 RC,619,"Radiologic examination, facial bones; less than 3 views ",,,33.06,33.06,1 RC,619,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,619,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,619,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,619,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,619,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,619,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,619,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,619,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,619,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,619,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,619,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,619,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,619,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,619,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,619,"Radiologic examination, internal auditory meati, complete ",,,63.05,63.05,1 RC,619,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,619,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,619,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,619,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,619,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,619,"Radiologic examination, mandible; complete, minimum of 4 views ",,,44.31,44.31,1 RC,619,"Radiologic examination, mandible; partial, less than 4 views ",,,39.54,39.54,1 RC,619,"Radiologic examination, mastoids; complete, minimum of 3 views per side ",,,64.07,64.07,1 RC,619,"Radiologic examination, mastoids; less than 3 views per side ",,,39.54,39.54,1 RC,619,"Radiologic examination, nasal bones, complete, minimum of 3 views ",,,39.2,39.2,1 RC,619,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,619,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,619,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,619,"Radiologic examination, pelvis; 1 or 2 views ",,,28.62,28.62,1 RC,619,"Radiologic examination, pelvis; complete, minimum of 3 views ",,,43.29,43.29,1 RC,619,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,619,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,619,"Radiologic examination, ribs, bilateral; 3 views ",,,44.98,44.98,1 RC,619,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views ",,,53.85,53.85,1 RC,619,"Radiologic examination, ribs, unilateral; 2 views ",,,37.83,37.83,1 RC,619,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views ",,,43.29,43.29,1 RC,619,"Radiologic examination, sacroiliac joints; 3 or more views ",,,40.22,40.22,1 RC,619,"Radiologic examination, sacroiliac joints; less than 3 views ",,,33.74,33.74,1 RC,619,"Radiologic examination, sacrum and coccyx, minimum of 2 views ",,,33.41,33.41,1 RC,619,"Radiologic examination, salivary gland for calculus ",,,38.52,38.52,1 RC,619,"Radiologic examination, sella turcica ",,,33.74,33.74,1 RC,619,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,619,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,619,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,619,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,619,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views ",,,38.52,38.52,1 RC,619,"Radiologic examination, sinuses, paranasal, less than 3 views ",,,33.06,33.06,1 RC,619,"Radiologic examination, skull; complete, minimum of 4 views ",,,45.68,45.68,1 RC,619,"Radiologic examination, skull; less than 4 views ",,,36.81,36.81,1 RC,619,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,619,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,619,"Radiologic examination, spine, cervical; 2 or 3 views ",,,40.56,40.56,1 RC,619,"Radiologic examination, spine, cervical; 4 or 5 views ",,,54.53,54.53,1 RC,619,"Radiologic examination, spine, cervical; 6 or more views ",,,63.74,63.74,1 RC,619,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views ",,,71.91,71.91,1 RC,619,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views ",,,80.77,80.77,1 RC,619,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views ",,,101.57,101.57,1 RC,619,"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view ",,,43.64,43.64,1 RC,619,"Radiologic examination, spine, lumbosacral; 2 or 3 views ",,,40.9,40.9,1 RC,619,"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views ",,,41.58,41.58,1 RC,619,"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views ",,,63.39,63.39,1 RC,619,"Radiologic examination, spine, lumbosacral; minimum of 4 views ",,,52.48,52.48,1 RC,619,"Radiologic examination, spine, single view, specify level ",,,25.22,25.22,1 RC,619,"Radiologic examination, spine; thoracic, 2 views ",,,33.74,33.74,1 RC,619,"Radiologic examination, spine; thoracic, 3 views ",,,40.22,40.22,1 RC,619,"Radiologic examination, spine; thoracic, minimum of 4 views ",,,45.33,45.33,1 RC,619,"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views ",,,35.45,35.45,1 RC,619,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,619,"Radiologic examination, teeth; complete, full mouth ",,,53.85,53.85,1 RC,619,"Radiologic examination, teeth; partial examination, less than full mouth ",,,40.22,40.22,1 RC,619,"Radiologic examination, teeth; single view ",,,13.29,13.29,1 RC,619,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral ",,,54.19,54.19,1 RC,619,"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral ",,,35.45,35.45,1 RC,619,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,619,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,619,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,619,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,619,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,619,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,619,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,619,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,619,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,619,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,619,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,619,"Radiologic examination; neck, soft tissue ",,,32.37,32.37,1 RC,619,Radiologic examination; optic foramina ,,,38.52,38.52,1 RC,619,"Radiologic examination; orbits, complete, minimum of 4 views ",,,49.07,49.07,1 RC,619,"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique ",,,88.62,88.62,1 RC,619,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,619,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views ",,,42.27,42.27,1 RC,619,"Radiologic examination; sternum, minimum of 2 views ",,,34.42,34.42,1 RC,619,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,619,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,619,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,619,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,619,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,619,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,619,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,619,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,619,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,619,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,619,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,619,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,619,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,619,Red cell survival study ,,,126.1,126.1,1 RC,619,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,619,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,619,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,619,Salivary gland function study ,,,104.3,104.3,1 RC,619,Salivary gland imaging; ,,,175.52,175.52,1 RC,619,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,619,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,619,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,619,"Sialography, radiological supervision and interpretation ",,,120.98,120.98,1 RC,619,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,619,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,619,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,619,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,619,"Temporomandibular joint arthrography, radiological supervision and interpretation ",,,86.9,86.9,1 RC,619,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,619,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,619,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,619,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,619,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,619,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,619,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,619,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,619,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,619,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,619,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,619,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,619,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,619,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,619,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,619,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,619,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,619,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,619,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,619,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,619,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,619,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,619,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,619,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,619,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,619,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,619,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,619,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,619,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,619,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,619,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,619,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,619,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,619,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,619,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,619,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,619,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,619,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,619,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,619,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,619,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,619,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,619,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,619,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,619,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,619,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,619,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,619,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,619,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,619,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,619,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,2739.0,4 RC,619,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,619,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,619,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,619,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,619,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,619,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,619,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,619,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,619,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,619,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,619,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,619,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,619,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,619,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,619,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,619,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,619,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,619,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,619,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,619,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,619,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,619,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,619,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,619,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,619,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,619,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,619,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,621, Medical/Surgical Supplies and Devices Supplies Incident to Radiology ,,,,,0 RC,622, Medical/Surgical Supplies and Devices Supplies Incident to Other DX Services ,,,,,0 RC,623, Medical/Surgical Supplies and Devices Surgical Dressings ,,,,,0 RC,631, Pharmacy - Single Source Drug ,,,,,0 RC,632, Pharmacy - Multiple Source Drug ,,,,,0 RC,633, Pharmacy - Restrictive Prescription ,,,,,0 RC,634," Pharmacy - Erythropoietin (EPO) < 10,000 Units ",,,,,0 RC,635," Pharmacy - Erythropoietin (EPO) > 10,000 Units ",,,,,0 RC,636, Pharmacy - Drugs Requiring Detailed Coding ,,,,,0 RC,637, Pharmacy - Self-Administrable Drugs ,,,,,0 RC,655, Hospice Service Inpatient Respite Care ,,,1199.0,1711.0,2 RC,656, Hospice Service General Inpatient Care Non-Respite ,,,1199.0,1711.0,2 RC,680, Not Used ,,,948.0,948.0,5 RC,681, Trauma Response - Level I Trauma ,,,750.0,19303.0,14 RC,682, Trauma Response - Level II Trauma ,,,750.0,14470.0,39 RC,683, Trauma Response - Level III Trauma ,,,750.0,10846.0,38 RC,684, Trauma Response - Level IV Trauma ,,,750.0,8000.0,8 RC,689, Trauma Response - Other ,,,750.0,8000.0,8 RC,690, Pre-hospice/Palliative Care Services General Classification ,,,,,0 RC,691, Pre-hospice/Palliative Care Services Visit Charge ,,,,,0 RC,692, Pre-hospice/Palliative Care Services Hourly Charge ,,,,,0 RC,693, Pre-hospice/Palliative Care Services Evaluation ,,,,,0 RC,694, Pre-hospice/Palliative Care Services Consultation and Education ,,,,,0 RC,695, Pre-hospice/Palliative Care Services Inpatient Care ,,,,,0 RC,696, Pre-hospice/Palliative Care Services Physician Services ,,,,,0 RC,699, Pre-hospice/Palliative Care Services Other ,,,,,0 RC,700, Cast Room General Classification ,,,,,0 RC,710, Recovery Room General Classification ,,,,,0 RC,720, Labor Room/Delivery General Classification ,,,1275.0,1819.0,2 RC,721, Labor Room/Delivery Labor ,,,1275.0,1819.0,2 RC,722, Labor Room/Delivery Delivery Room ,,,1275.0,1819.0,2 RC,723, Labor Room/Delivery Circumcision ,,,,,0 RC,724, Labor Room/Delivery Birthing Center ,,,1275.0,1819.0,2 RC,729, Labor Room/Delivery Other ,,,1275.0,1819.0,2 RC,730, EKG/ECG (Electrocardiogram) General Classification ,,,273.0,389.0,2 RC,730,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,730,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,730,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,730,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,730,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,730,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,730,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,730,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,730,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,730,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,730,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,730,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,730,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,730,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,730,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,730,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,730,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,730,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,730,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,730,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,730,Bone age studies ,,,26.58,26.58,1 RC,730,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,730,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,730,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,730,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,730,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,730,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,730,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,730,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,730,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,730,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,730,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,730,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,730,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,730,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,730,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,730,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,730,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,730,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,730,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,730,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,730,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,730,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,730,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,730,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,730,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,730,Cardiac shunt detection ,,,186.76,186.76,1 RC,730,Cardiokymography ,,,20.04,20.04,1 RC,730,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,730,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,730,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,730,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,730,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,730,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,730,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,730,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,730,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,730,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,730,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,730,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,730,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,730,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,730,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,730,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,730,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,730,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,730,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,730,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,730,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,730,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,730,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,730,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,730,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,730,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,730,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,730,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,730,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,730,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,730,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,730,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,730,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,730,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,730,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,730,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,730,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,730,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,730,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,730,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,730,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,730,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,730,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,730,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,730,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,730,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,730,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,730,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,730,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,730,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,730,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,730,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,730,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,730,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,730,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,730,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,730,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,730,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,730,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,730,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,730,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,730,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,730,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,730,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,730,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,730,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,730,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,730,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,730,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,730,Esophageal motility ,,,214.04,214.04,1 RC,730,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,730,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,730,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,730,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,730,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,730,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,730,Gastric mucosa imaging ,,,205.51,205.51,1 RC,730,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,730,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,730,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,730,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,730,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,730,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,730,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,730,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,730,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,730,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,730,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,730,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,730,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,730,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,730,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,730,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,730,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,730,Kidney imaging morphology; ,,,172.11,172.11,1 RC,730,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,730,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,730,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,730,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,730,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,730,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,730,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,730,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,730,Liver imaging; static only ,,,191.2,191.2,1 RC,730,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,730,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,730,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,730,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,730,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,730,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,730,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,730,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,730,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,730,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,730,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,730,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,730,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,730,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,730,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,730,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,730,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,730,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,730,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,730,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,730,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,730,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,730,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,730,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,730,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,730,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,730,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,730,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,730,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,730,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,730,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,730,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,730,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,730,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,730,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,730,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,730,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,730,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,730,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,730,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,730,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,730,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,730,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,730,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,730,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,730,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,730,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,730,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,730,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,730,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,730,Platelet survival study ,,,126.1,126.1,1 RC,730,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,730,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,730,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,730,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,730,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,730,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,730,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,730,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,730,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,730,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,730,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,730,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,730,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,730,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,730,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,730,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,730,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,730,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,730,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,730,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,730,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,730,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,730,"Radiologic examination, elbow, arthrography, radiological supervision and interpretation ",,,114.51,114.51,1 RC,730,"Radiologic examination, elbow; 2 views ",,,29.99,29.99,1 RC,730,"Radiologic examination, elbow; complete, minimum of 3 views ",,,33.41,33.41,1 RC,730,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,730,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,730,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,730,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,730,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,730,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,730,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,730,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,730,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,730,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,730,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,730,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,730,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,730,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,730,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,730,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,730,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,730,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,730,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,730,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,730,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,730,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,730,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,730,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,730,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,730,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,730,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation ",,,134.96,134.96,1 RC,730,"Radiologic examination, shoulder; 1 view ",,,22.14,22.14,1 RC,730,"Radiologic examination, shoulder; complete, minimum of 2 views ",,,35.45,35.45,1 RC,730,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,730,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,730,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,730,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,730,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,730,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,730,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,730,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,730,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,730,"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction ",,,29.31,29.31,1 RC,730,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,730,"Radiologic examination; clavicle, complete ",,,33.06,33.06,1 RC,730,"Radiologic examination; forearm, 2 views ",,,29.99,29.99,1 RC,730,"Radiologic examination; humerus, minimum of 2 views ",,,33.06,33.06,1 RC,730,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,730,"Radiologic examination; scapula, complete ",,,24.2,24.2,1 RC,730,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,730,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,730,"Radiologic examination; upper extremity, infant, minimum of 2 views ",,,109.02,109.02,1 RC,730,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,730,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,730,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,730,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,730,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,730,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,730,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,730,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,730,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,730,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,730,Red cell survival study ,,,126.1,126.1,1 RC,730,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,730,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,730,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,730,Salivary gland function study ,,,104.3,104.3,1 RC,730,Salivary gland imaging; ,,,175.52,175.52,1 RC,730,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,730,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,730,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,730,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,730,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,730,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,730,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,730,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,730,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,730,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,730,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,730,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,730,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,730,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,730,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,730,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,730,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,730,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,730,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,730,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,730,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,730,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,730,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,730,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,730,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,730,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,730,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,730,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,730,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,730,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,730,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,730,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,730,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,730,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,730,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,730,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,730,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,730,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,730,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,730,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,730,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,730,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,730,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,730,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,730,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,730,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,730,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,730,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,730,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,730,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,730,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,730,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,730,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,730,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,730,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,730,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,730,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,730,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,730,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,730,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,730,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,730,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,730,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,730,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,730,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,730,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,730,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,730,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,730,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,730,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,730,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,730,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,730,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,730,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,730,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,730,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,730,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,730,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,730,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,730,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,730,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,730,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,730,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,730,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,730,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,731, EKG/ECG (Electrocardiogram) Holter Monitor ,,,921.0,1314.0,2 RC,731,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,731,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,731,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,731,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,731,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,731,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,731,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,731,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,731,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,731,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,731,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,731,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,731,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,731,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,731,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,731,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,731,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,731,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,731,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,731,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,731,Bone age studies ,,,26.58,26.58,1 RC,731,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,731,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,731,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,731,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,731,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,731,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,731,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,731,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,731,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,731,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,731,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,731,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,731,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,731,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,731,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,731,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,731,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,731,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,731,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,731,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,731,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,731,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,731,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,731,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,731,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,731,Cardiac shunt detection ,,,186.76,186.76,1 RC,731,Cardiokymography ,,,20.04,20.04,1 RC,731,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,731,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,731,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,731,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,731,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,731,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,731,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,731,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,731,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,731,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,731,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,731,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,731,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,731,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,731,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,731,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,731,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,731,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,731,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,731,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,731,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,731,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,731,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,731,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,731,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,731,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,731,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,731,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,731,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,731,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,731,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,731,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,731,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,731,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,731,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,731,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,731,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,731,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,731,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,731,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,731,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,731,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,731,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,731,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,731,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,731,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,731,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,731,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,731,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,731,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,731,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,731,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,731,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,731,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,731,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,731,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,731,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,731,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,731,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,731,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,731,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,731,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,731,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,731,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,731,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,731,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,731,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,731,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,731,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,731,Esophageal motility ,,,214.04,214.04,1 RC,731,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,731,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,731,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,731,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,731,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,731,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,731,Gastric mucosa imaging ,,,205.51,205.51,1 RC,731,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,731,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,731,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,731,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,731,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,731,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,731,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,731,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,731,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,731,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,731,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,731,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,731,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,731,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,731,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,731,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,731,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,731,Kidney imaging morphology; ,,,172.11,172.11,1 RC,731,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,731,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,731,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,731,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,731,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,731,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,731,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,731,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,731,Liver imaging; static only ,,,191.2,191.2,1 RC,731,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,731,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,731,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,731,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,731,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,731,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,731,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,731,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,731,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,731,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,731,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,731,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,731,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,731,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,731,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,731,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,731,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,731,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,731,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,731,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,731,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,731,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,731,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,731,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,731,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,731,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,731,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,731,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,731,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,731,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,731,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,731,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,731,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,731,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,731,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,731,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,731,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,731,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,731,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,731,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,731,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,731,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,731,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,731,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,731,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,731,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,731,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,731,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,731,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,731,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,731,Platelet survival study ,,,126.1,126.1,1 RC,731,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,731,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,731,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,731,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,731,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,731,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,731,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,731,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,731,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,731,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,731,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,731,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,731,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,731,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,731,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,731,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,731,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,731,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,731,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,731,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,731,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,731,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,731,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,731,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,731,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,731,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,731,"Radiologic examination, finger(s), minimum of 2 views ",,,38.85,38.85,1 RC,731,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,731,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,731,"Radiologic examination, hand; 2 views ",,,32.04,32.04,1 RC,731,"Radiologic examination, hand; minimum of 3 views ",,,37.83,37.83,1 RC,731,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,731,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,731,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,731,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,731,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,731,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,731,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,731,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,731,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,731,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,731,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,731,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,731,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,731,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,731,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,731,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,731,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,731,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,731,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,731,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,731,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,731,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,731,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,731,"Radiologic examination, wrist, arthrography, radiological supervision and interpretation ",,,139.06,139.06,1 RC,731,"Radiologic examination, wrist; 2 views ",,,34.77,34.77,1 RC,731,"Radiologic examination, wrist; complete, minimum of 3 views ",,,41.92,41.92,1 RC,731,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,731,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,731,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,731,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,731,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,731,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,731,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,731,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,731,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,731,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,731,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,731,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,731,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,731,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,731,Red cell survival study ,,,126.1,126.1,1 RC,731,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,731,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,731,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,731,Salivary gland function study ,,,104.3,104.3,1 RC,731,Salivary gland imaging; ,,,175.52,175.52,1 RC,731,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,731,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,731,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,731,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,731,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,731,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,731,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,731,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,731,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,731,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,731,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,731,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,731,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,731,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,731,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,731,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,731,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,731,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,731,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,731,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,731,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,731,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,731,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,731,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,731,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,731,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,731,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,731,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,731,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,731,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,731,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,731,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,731,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,731,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,731,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,731,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,731,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,731,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,731,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,731,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,731,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,731,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,731,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,731,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,731,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,731,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,731,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,731,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,731,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,731,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,731,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,731,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,731,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,731,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,731,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,731,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,731,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,731,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,731,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,731,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,731,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,731,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,731,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,731,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,731,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,731,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,731,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,731,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,731,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,731,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,731,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,731,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,731,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,731,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,731,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,731,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,731,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,731,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,731,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,731,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,731,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,731,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,731,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,731,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,731,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,732, EKG/ECG (Electrocardiogram) Telemetry ,,,921.0,1314.0,2 RC,732,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,732,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,732,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,732,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,732,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,732,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,732,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,732,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,732,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,732,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,732,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,732,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,732,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,732,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,732,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,732,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,732,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,732,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,732,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,732,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,732,Bone age studies ,,,26.58,26.58,1 RC,732,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,732,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,732,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,732,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,732,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,732,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,732,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,732,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,732,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,732,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,732,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,732,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,732,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,732,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,732,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,732,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,732,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,732,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,732,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,732,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,732,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,732,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,732,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,732,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,732,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,732,Cardiac shunt detection ,,,186.76,186.76,1 RC,732,Cardiokymography ,,,20.04,20.04,1 RC,732,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,732,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,732,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,732,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,732,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,732,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,732,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,732,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,732,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,732,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,732,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,732,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,732,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,732,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,732,"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,732,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,732,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,732,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,732,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,732,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,732,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,732,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,732,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,732,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,732,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,732,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,732,"Computed tomography, lower extremity; with contrast material(s) ",,,176.54,176.54,1 RC,732,"Computed tomography, lower extremity; without contrast material ",,,109.02,109.02,1 RC,732,"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,732,"Computed tomography, upper extremity; with contrast material(s) ",,,214.04,214.04,1 RC,732,"Computed tomography, upper extremity; without contrast material ",,,109.02,109.02,1 RC,732,"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,732,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,732,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,732,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,732,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,732,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,732,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,732,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,732,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,732,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,732,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,732,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,732,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,732,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,732,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,732,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,732,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,732,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,732,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,732,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,732,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,732,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,732,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,732,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,732,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,732,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,732,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,732,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,732,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,732,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,732,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,732,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,732,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,732,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,732,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,732,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,732,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,732,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,732,Esophageal motility ,,,214.04,214.04,1 RC,732,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,732,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,732,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,732,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,732,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,732,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,732,Gastric mucosa imaging ,,,205.51,205.51,1 RC,732,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,732,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,732,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,732,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,732,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,732,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,732,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,732,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,732,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,732,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,732,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,732,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,732,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,732,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,732,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,732,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,732,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,732,Kidney imaging morphology; ,,,172.11,172.11,1 RC,732,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,732,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,732,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,732,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,732,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,732,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,732,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,732,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,732,Liver imaging; static only ,,,191.2,191.2,1 RC,732,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,732,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,732,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,732,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,732,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,732,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,732,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,732,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,732,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) ",,,335.37,335.37,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material ",,,215.06,215.06,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) ",,,335.02,335.02,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) ",,,215.4,215.4,1 RC,732,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,732,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,732,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,732,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,732,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) ",,,280.14,280.14,1 RC,732,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,732,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,360.58,360.58,1 RC,732,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) ",,,355.47,355.47,1 RC,732,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) ",,,238.19,238.19,1 RC,732,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences ",,,375.8,375.8,1 RC,732,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,732,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,732,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,732,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,732,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,732,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,732,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,732,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,732,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,732,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,732,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,732,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,732,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,732,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,732,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,732,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,732,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,732,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,732,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,732,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,732,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,732,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,732,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,732,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,732,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,732,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,732,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,732,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,732,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,732,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,732,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,732,Platelet survival study ,,,126.1,126.1,1 RC,732,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,732,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,732,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,732,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,732,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,732,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,732,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,732,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,732,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,732,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,732,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,732,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,732,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,732,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,732,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,732,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,732,"Radiologic examination, ankle, arthrography, radiological supervision and interpretation ",,,132.92,132.92,1 RC,732,"Radiologic examination, ankle; 2 views ",,,33.41,33.41,1 RC,732,"Radiologic examination, ankle; complete, minimum of 3 views ",,,37.83,37.83,1 RC,732,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,732,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,732,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,732,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,732,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,732,"Radiologic examination, femur; 1 view ",,,29.99,29.99,1 RC,732,"Radiologic examination, femur; minimum 2 views ",,,36.47,36.47,1 RC,732,"Radiologic examination, foot; 2 views ",,,28.97,28.97,1 RC,732,"Radiologic examination, foot; complete, minimum of 3 views ",,,35.1,35.1,1 RC,732,"Radiologic examination, hip, arthrography, radiological supervision and interpretation ",,,133.94,133.94,1 RC,732,"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view ",,,33.74,33.74,1 RC,732,"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views ",,,48.05,48.05,1 RC,732,"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views ",,,60.67,60.67,1 RC,732,"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views ",,,42.27,42.27,1 RC,732,"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views ",,,54.88,54.88,1 RC,732,"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views ",,,63.39,63.39,1 RC,732,"Radiologic examination, knee, arthrography, radiological supervision and interpretation ",,,130.88,130.88,1 RC,732,"Radiologic examination, knee; 1 or 2 views ",,,35.1,35.1,1 RC,732,"Radiologic examination, knee; 3 views ",,,41.58,41.58,1 RC,732,"Radiologic examination, knee; both knees, standing, anteroposterior ",,,40.9,40.9,1 RC,732,"Radiologic examination, knee; complete, 4 or more views ",,,47.72,47.72,1 RC,732,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,732,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,732,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,732,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,732,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,732,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,732,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,732,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,732,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,732,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,732,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,732,"Radiologic examination; calcaneus, minimum of 2 views ",,,29.31,29.31,1 RC,732,"Radiologic examination; lower extremity, infant, minimum of 2 views ",,,82.52,82.52,1 RC,732,"Radiologic examination; tibia and fibula, 2 views ",,,32.37,32.37,1 RC,732,"Radiologic examination; toe(s), minimum of 2 views ",,,29.99,29.99,1 RC,732,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,732,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,732,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,732,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,732,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,732,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,732,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,732,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,732,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,732,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,732,Red cell survival study ,,,126.1,126.1,1 RC,732,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,732,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,732,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,732,Salivary gland function study ,,,104.3,104.3,1 RC,732,Salivary gland imaging; ,,,175.52,175.52,1 RC,732,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,732,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,732,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,732,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,732,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,732,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,732,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,732,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,732,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,732,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,732,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,732,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,732,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,732,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,732,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,732,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,732,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,732,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,732,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,732,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,732,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,732,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,732,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,732,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,732,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,732,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,732,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,732,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,732,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,732,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,732,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,732,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,732,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,732,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,732,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,732,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,732,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,732,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,732,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,732,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,732,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,732,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,732,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,732,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,732,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,732,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,732,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,732,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,732,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,732,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,732,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,732,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,732,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,732,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,732,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,732,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,732,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,732,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,732,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,732,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,732,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,732,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,732,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,732,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,732,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,732,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,732,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,732,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,732,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,732,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,732,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,732,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,732,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,732,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,732,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,732,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,732,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,732,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,732,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,732,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,732,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,732,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,732,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,732,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,732,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,739, EKG/ECG (Electrogardiogram) Other ,,,273.0,389.0,2 RC,739,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,739,Acute gastrointestinal blood loss imaging ,,,348.99,348.99,1 RC,739,"Acute venous thrombosis imaging, peptide ",,,314.24,314.24,1 RC,739,"Adrenal imaging, cortex and/or medulla ",,,448.85,448.85,1 RC,739,"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis ",,,136.38,136.38,1 RC,739,"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,172.46,172.46,1 RC,739,"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,156.43,156.43,1 RC,739,"Angiography, extremity, bilateral, radiological supervision and interpretation ",,,165.64,165.64,1 RC,739,"Angiography, extremity, unilateral, radiological supervision and interpretation ",,,153.37,153.37,1 RC,739,"Angiography, internal mammary, radiological supervision and interpretation ",,,164.96,164.96,1 RC,739,"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation ",,,145.87,145.87,1 RC,739,"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation ",,,151.32,151.32,1 RC,739,"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation ",,,137.69,137.69,1 RC,739,"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation ",,,133.6,133.6,1 RC,739,"Angiography, spinal, selective, radiological supervision and interpretation ",,,253.56,253.56,1 RC,739,"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation ",,,174.84,174.84,1 RC,739,"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation ",,,159.84,159.84,1 RC,739,"Aortography, abdominal, by serialography, radiological supervision and interpretation ",,,128.83,128.83,1 RC,739,"Aortography, thoracic, by serialography, radiological supervision and interpretation ",,,123.04,123.04,1 RC,739,"Aortography, thoracic, without serialography, radiological supervision and interpretation ",,,188.81,188.81,1 RC,739,Bone age studies ,,,26.58,26.58,1 RC,739,Bone and/or joint imaging; 3 phase study ,,,346.95,346.95,1 RC,739,Bone and/or joint imaging; limited area ,,,230.4,230.4,1 RC,739,Bone and/or joint imaging; multiple areas ,,,278.8,278.8,1 RC,739,Bone and/or joint imaging; whole body ,,,299.92,299.92,1 RC,739,"Bone length studies (orthoroentgenogram, scanogram) ",,,46.01,46.01,1 RC,739,Bone marrow imaging; limited area ,,,172.46,172.46,1 RC,739,Bone marrow imaging; multiple areas ,,,215.4,215.4,1 RC,739,Bone marrow imaging; whole body ,,,249.48,249.48,1 RC,739,"Brain imaging, less than 4 static views; ",,,184.04,184.04,1 RC,739,"Brain imaging, less than 4 static views; with vascular flow ",,,216.42,216.42,1 RC,739,"Brain imaging, minimum 4 static views; ",,,200.06,200.06,1 RC,739,"Brain imaging, minimum 4 static views; with vascular flow ",,,332.63,332.63,1 RC,739,"Brain imaging, positron emission tomography (PET); metabolic evaluation ",,,1453.71,1453.71,1 RC,739,"Brain imaging, vascular flow only ",,,174.84,174.84,1 RC,739,"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantifi",,,242.66,242.66,1 RC,739,"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantificatio",,,177.57,177.57,1 RC,739,"Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing ",,,228.68,228.68,1 RC,739,"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification",,,289.35,289.35,1 RC,739,"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative",,,228.34,228.34,1 RC,739,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; ",,,375.8,375.8,1 RC,739,"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging ",,,450.89,450.89,1 RC,739,Cardiac magnetic resonance imaging for morphology and function without contrast material; ,,,238.19,238.19,1 RC,739,Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging ,,,397.05,397.05,1 RC,739,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,739,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,739,Cardiac shunt detection ,,,186.76,186.76,1 RC,739,Cardiokymography ,,,20.04,20.04,1 RC,739,"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography ",,,338.43,338.43,1 RC,739,"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation ",,,324.45,324.45,1 RC,739,"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography ",,,338.77,338.77,1 RC,739,Cerebrospinal fluid leakage detection and localization ,,,278.45,278.45,1 RC,739,"Cholecystography, oral contrast ",,,89.29,89.29,1 RC,739,"Cineradiography/videoradiography, except where specifically included ",,,109.02,109.02,1 RC,739,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,739,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed ",,,183.95,183.95,1 RC,739,"Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material ",,,109.02,109.02,1 RC,739,"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,375.8,375.8,1 RC,739,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,739,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing ",,,183.95,183.95,1 RC,739,"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo",,,183.95,183.95,1 RC,739,"Computed tomography, abdomen and pelvis; with contrast material(s) ",,,324.45,324.45,1 RC,739,"Computed tomography, abdomen and pelvis; without contrast material ",,,193.59,193.59,1 RC,739,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions ",,,363.31,363.31,1 RC,739,"Computed tomography, abdomen; with contrast material(s) ",,,183.95,183.95,1 RC,739,"Computed tomography, abdomen; without contrast material ",,,109.02,109.02,1 RC,739,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections ",,,183.95,183.95,1 RC,739,"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) ",,,88.62,88.62,1 RC,739,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous stru",,,183.95,183.95,1 RC,739,"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left",,,183.95,183.95,1 RC,739,"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium ",,,88.62,88.62,1 RC,739,"Computed tomography, limited or localized follow-up study ",,,88.62,88.62,1 RC,739,"Corpora cavernosography, radiological supervision and interpretation ",,,106.86,106.86,1 RC,739,"Cystography, minimum of 3 views, radiological supervision and interpretation ",,,42.27,42.27,1 RC,739,"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations ",,,179.61,179.61,1 RC,739,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,739,"Dilation of ureter(s) or urethra, radiological supervision and interpretation ",,,122.02,122.02,1 RC,739,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete ",,,71.24,71.24,1 RC,739,"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study ",,,50.09,50.09,1 RC,739,"Doppler velocimetry, fetal; middle cerebral artery ",,,90.66,90.66,1 RC,739,"Doppler velocimetry, fetal; umbilical artery ",,,45.68,45.68,1 RC,739,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) ",,,32.04,32.04,1 RC,739,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) ",,,38.85,38.85,1 RC,739,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment ",,,52.83,52.83,1 RC,739,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,739,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,739,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,739,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,739,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,739,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,739,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,739,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,739,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,739,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,739,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,739,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,739,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,739,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,739,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,739,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; ",,,268.22,268.22,1 RC,739,"Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ",,,160.53,160.53,1 RC,739,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,739,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,739,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,739,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,739,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,739,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,739,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,739,"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnor",,,109.02,109.02,1 RC,739,Esophageal motility ,,,214.04,214.04,1 RC,739,Fetal biophysical profile; with non-stress testing ,,,109.02,109.02,1 RC,739,Fetal biophysical profile; without non-stress testing ,,,85.88,85.88,1 RC,739,"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time ",,,44.31,44.31,1 RC,739,"Gastric emptying imaging study (eg, solid, liquid, or both); ",,,332.98,332.98,1 RC,739,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days ",,,436.24,436.24,1 RC,739,"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit ",,,384.66,384.66,1 RC,739,Gastric mucosa imaging ,,,205.51,205.51,1 RC,739,Gastroesophageal reflux study ,,,243.0,243.0,1 RC,739,"Gastrointestinal endoscopic ultrasound, supervision and interpretation ",,,112.55,112.55,1 RC,739,Gastrointestinal protein loss ,,,46.11,46.11,1 RC,739,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report ",,,847.66,847.66,1 RC,739,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,825.79,825.79,1 RC,739,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,825.79,825.79,1 RC,739,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,825.79,825.79,1 RC,739,"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation ",,,126.44,126.44,1 RC,739,"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation ",,,127.12,127.12,1 RC,739,"Hepatobiliary system imaging, including gallbladder when present; ",,,328.2,328.2,1 RC,739,"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed ",,,441.7,441.7,1 RC,739,"Hysterosalpingography, radiological supervision and interpretation ",,,68.17,68.17,1 RC,739,"Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) ",,,331.28,331.28,1 RC,739,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,739,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,739,"Joint survey, single view, 2 or more joints (specify) ",,,48.05,48.05,1 RC,739,"Kidney function study, non-imaging radioisotopic study ",,,112.81,112.81,1 RC,739,Kidney imaging morphology; ,,,172.11,172.11,1 RC,739,Kidney imaging morphology; with vascular flow ,,,220.84,220.84,1 RC,739,"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,368.42,368.42,1 RC,739,"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention ",,,231.75,231.75,1 RC,739,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic) ",,,176.88,176.88,1 RC,739,"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) ",,,112.13,112.13,1 RC,739,Liver and spleen imaging; static only ,,,196.31,196.31,1 RC,739,Liver and spleen imaging; with vascular flow ,,,129.52,129.52,1 RC,739,"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report ",,,31.02,31.02,1 RC,739,Liver imaging; static only ,,,191.2,191.2,1 RC,739,Liver imaging; with vascular flow ,,,209.95,209.95,1 RC,739,"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation ",,,305.59,305.59,1 RC,739,"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation ",,,290.34,290.34,1 RC,739,"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation ",,,149.47,149.47,1 RC,739,"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation ",,,319.66,319.66,1 RC,739,Lymphatics and lymph nodes imaging ,,,355.12,355.12,1 RC,739,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) ",,,323.78,323.78,1 RC,739,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) ",,,208.93,208.93,1 RC,739,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences ",,,361.6,361.6,1 RC,739,"Magnetic resonance (eg, proton) imaging, bone marrow blood supply ",,,238.19,238.19,1 RC,739,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure) ",,,211.99,211.99,1 RC,739,"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation ",,,238.19,238.19,1 RC,739,"Magnetic resonance (eg, vibration) elastography ",,,215.73,215.73,1 RC,739,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,739,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,739,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,739,"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation ",,,70.54,70.54,1 RC,739,"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation ",,,54.53,54.53,1 RC,739,"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated ",,,57.54,57.54,1 RC,739,"Myocardial imaging, infarct avid, planar; qualitative or quantitative ",,,198.35,198.35,1 RC,739,"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique ",,,198.01,198.01,1 RC,739,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studie",,,433.86,433.86,1 RC,739,"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, a",,,299.92,299.92,1 RC,739,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat",,,341.15,475.1,2 RC,739,"Non-cardiac vascular flow imaging (ie, angiography, venography) ",,,205.51,205.51,1 RC,739,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,739,"Ophthalmic biometry by ultrasound echography, A-scan; ",,,47.38,47.38,1 RC,739,"Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ",,,68.5,68.5,1 RC,739,Ophthalmic ultrasonic foreign body localization ,,,87.25,87.25,1 RC,739,"Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) ",,,48.74,48.74,1 RC,739,"Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter ",,,70.21,70.21,1 RC,739,"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral ",,,76.35,76.35,1 RC,739,"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness) ",,,11.59,11.59,1 RC,739,"Ophthalmic ultrasound, diagnostic; quantitative A-scan only ",,,57.94,57.94,1 RC,739,"Parathyroid planar imaging (including subtraction, when performed); ",,,295.83,295.83,1 RC,739,"Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) ",,,353.08,353.08,1 RC,739,"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation ",,,139.39,139.39,1 RC,739,"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation ",,,141.43,141.43,1 RC,739,"Perineogram (eg, vaginogram, for sex determination or extent of anomalies) ",,,234.73,234.73,1 RC,739,"Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) ",,,251.18,251.18,1 RC,739,"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation ",,,82.66,82.66,1 RC,739,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings ",,,74.64,74.64,1 RC,739,"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling ",,,70.21,70.21,1 RC,739,Platelet survival study ,,,126.1,126.1,1 RC,739,"Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) ",,,1332.06,1332.06,1 RC,739,Positron emission tomography (PET) imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,739,Positron emission tomography (PET) imaging; whole body ,,,1509.95,1509.95,1 RC,739,"Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck) ",,,1509.95,1509.95,1 RC,739,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh ,,,1509.95,1509.95,1 RC,739,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; whole body ,,,1509.95,1509.95,1 RC,739,"Pulmonary perfusion imaging (eg, particulate) ",,,237.2,237.2,1 RC,739,"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging ",,,333.65,333.65,1 RC,739,"Pulmonary ventilation imaging (eg, aerosol or gas) ",,,187.46,187.46,1 RC,739,"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed ",,,304.68,304.68,1 RC,739,"Quantitative differential pulmonary perfusion, including imaging when performed ",,,202.79,202.79,1 RC,739,"Radiologic examination from nose to rectum for foreign body, single view, child ",,,82.52,82.52,1 RC,739,"Radiologic examination, abdomen; 1 view ",,,30.68,30.68,1 RC,739,"Radiologic examination, abdomen; 2 views ",,,37.83,37.83,1 RC,739,"Radiologic examination, abdomen; 3 or more views ",,,43.96,43.96,1 RC,739,"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation ",,,61.34,61.34,1 RC,739,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administe",,,183.95,183.95,1 RC,739,"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,159.16,159.16,1 RC,739,"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest ",,,51.13,51.13,1 RC,739,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study ",,,114.51,114.51,1 RC,739,"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,101.9,101.9,1 RC,739,"Radiologic examination, osseous survey, infant ",,,109.02,109.02,1 RC,739,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton) ",,,102.24,102.24,1 RC,739,"Radiologic examination, osseous survey; limited (eg, for metastases) ",,,66.45,66.45,1 RC,739,"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,99.51,99.51,1 RC,739,"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation ",,,82.98,82.98,1 RC,739,"Radiologic examination, single plane body section (eg, tomography), other than with urography ",,,92.01,92.01,1 RC,739,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) stu",,,183.95,183.95,1 RC,739,"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study ",,,126.79,126.79,1 RC,739,"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study ",,,130.19,130.19,1 RC,739,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) stu",,,144.51,144.51,1 RC,739,"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study ",,,127.46,127.46,1 RC,739,"Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) ",,,85.54,85.54,1 RC,739,"Radiological examination, surgical specimen ",,,42.94,42.94,1 RC,739,Radiopharmaceutical dacryocystography ,,,190.52,190.52,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas",,,283.21,283.21,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg",,,256.63,256.63,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, req",,,661.87,661.87,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, sin",,,313.89,313.89,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) wit",,,456.35,863.62,2 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), mi",,,674.13,674.13,1 RC,739,"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), si",,,387.84,387.84,1 RC,739,Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure) ,,,94.4,94.4,1 RC,739,"Radiopharmaceutical therapy, by intra-arterial particulate administration ",,,205.51,205.51,1 RC,739,"Radiopharmaceutical therapy, by intra-articular administration ",,,120.98,120.98,1 RC,739,"Radiopharmaceutical therapy, by intracavitary administration ",,,134.63,134.63,1 RC,739,"Radiopharmaceutical therapy, by intravenous administration ",,,147.24,147.24,1 RC,739,"Radiopharmaceutical therapy, by oral administration ",,,135.65,135.65,1 RC,739,Red cell survival study ,,,126.1,126.1,1 RC,739,Red cell volume determination (separate procedure); multiple samplings ,,,78.73,78.73,1 RC,739,Red cell volume determination (separate procedure); single sampling ,,,71.91,71.91,1 RC,739,"Saline infusion sonohysterography (SIS), including color flow Doppler, when performed ",,,119.29,119.29,1 RC,739,Salivary gland function study ,,,104.3,104.3,1 RC,739,Salivary gland imaging; ,,,175.52,175.52,1 RC,739,Salivary gland imaging; with serial images ,,,106.34,106.34,1 RC,739,"Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) ",,,52.83,52.83,1 RC,739,"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation ",,,84.18,84.18,1 RC,739,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,739,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,739,"Spleen imaging only, with or without vascular flow ",,,172.11,172.11,1 RC,739,"Splenoportography, radiological supervision and interpretation ",,,624.84,624.84,1 RC,739,Testicular imaging with vascular flow ,,,212.32,212.32,1 RC,739,"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus) ",,,183.95,183.95,1 RC,739,"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) ",,,227.32,227.32,1 RC,739,Thyroid carcinoma metastases imaging; whole body ,,,314.57,314.57,1 RC,739,"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) ",,,283.91,283.91,1 RC,739,"Thyroid imaging (including vascular flow, when performed); ",,,182.0,182.0,1 RC,739,"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,226.99,226.99,1 RC,739,"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) ",,,82.48,82.48,1 RC,739,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,739,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,739,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,739,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,739,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,739,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,739,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,739,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,739,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,739,"Ultrasound bone density measurement and interpretation, peripheral site(s), any method ",,,7.15,7.15,1 RC,739,"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) ",,,264.48,264.48,1 RC,739,"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA) ",,,109.02,109.02,1 RC,739,"Ultrasound, abdominal, real time with image documentation; complete ",,,109.02,109.02,1 RC,739,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) ",,,90.32,90.32,1 RC,739,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete ",,,105.99,105.99,1 RC,739,"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited ",,,87.25,87.25,1 RC,739,"Ultrasound, chest (includes mediastinum), real time with image documentation ",,,57.94,57.94,1 RC,739,"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation ",,,98.21,98.21,1 RC,739,"Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) ",,,62.37,62.37,1 RC,739,"Ultrasound, elastography; first target lesion ",,,95.77,95.77,1 RC,739,"Ultrasound, elastography; parenchyma (eg, organ) ",,,106.68,106.68,1 RC,739,"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,739,"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation) ",,,82.52,82.52,1 RC,739,"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss",,,30.96,30.96,1 RC,739,"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity ",,,59.65,59.65,1 RC,739,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete ",,,98.21,98.21,1 RC,739,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) ",,,51.81,51.81,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separa",,,195.97,195.97,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation ",,,179.61,179.61,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List",,,90.32,90.32,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately",,,62.37,62.37,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation ",,,109.02,109.02,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separat",,,76.35,76.35,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation ",,,109.02,109.02,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ sy",,,109.02,109.02,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses ",,,83.5,83.5,1 RC,739,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal ",,,95.09,95.09,1 RC,739,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete ",,,109.02,109.02,1 RC,739,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited ",,,60.32,60.32,1 RC,739,"Ultrasound, scrotum and contents ",,,103.61,103.61,1 RC,739,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation ",,,109.02,109.02,1 RC,739,"Ultrasound, spinal canal and contents ",,,109.02,109.02,1 RC,739,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)",,,171.09,171.09,1 RC,739,"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion ",,,183.95,183.95,1 RC,739,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation ",,,109.02,109.02,1 RC,739,"Ultrasound, transrectal; ",,,109.02,109.02,1 RC,739,"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) ",,,109.02,109.02,1 RC,739,"Ultrasound, transvaginal ",,,109.02,109.02,1 RC,739,"Unlisted computed tomography procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,739,Unlisted diagnostic radiographic procedure ,,,82.52,82.52,1 RC,739,"Unlisted fluoroscopic procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,739,"Unlisted magnetic resonance procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,739,"Unlisted ultrasound procedure (eg, diagnostic, interventional) ",,,82.52,82.52,1 RC,739,Ureteral reflux study (radiopharmaceutical voiding cystogram) ,,,221.19,221.19,1 RC,739,"Urethrocystography, retrograde, radiological supervision and interpretation ",,,83.01,83.01,1 RC,739,"Urethrocystography, voiding, radiological supervision and interpretation ",,,107.36,107.36,1 RC,739,"Urography (pyelography), intravenous, with or without KUB, with or without tomography ",,,139.74,139.74,1 RC,739,"Urography, antegrade, radiological supervision and interpretation ",,,140.41,140.41,1 RC,739,"Urography, infusion, drip technique and/or bolus technique; ",,,144.84,144.84,1 RC,739,"Urography, infusion, drip technique and/or bolus technique; with nephrotomography ",,,159.16,159.16,1 RC,739,"Urography, retrograde, with or without KUB ",,,78.73,78.73,1 RC,739,"Vasography, vesiculography, or epididymography, radiological supervision and interpretation ",,,99.51,99.51,1 RC,739,"Venography, adrenal, bilateral, selective, radiological supervision and interpretation ",,,162.57,162.57,1 RC,739,"Venography, adrenal, unilateral, selective, radiological supervision and interpretation ",,,132.23,132.23,1 RC,739,"Venography, caval, inferior, with serialography, radiological supervision and interpretation ",,,116.57,116.57,1 RC,739,"Venography, caval, superior, with serialography, radiological supervision and interpretation ",,,122.02,122.02,1 RC,739,"Venography, epidural, radiological supervision and interpretation ",,,132.23,132.23,1 RC,739,"Venography, extremity, bilateral, radiological supervision and interpretation ",,,135.65,135.65,1 RC,739,"Venography, extremity, unilateral, radiological supervision and interpretation ",,,111.45,111.45,1 RC,739,"Venography, orbital, radiological supervision and interpretation ",,,110.76,110.76,1 RC,739,"Venography, renal, bilateral, selective, radiological supervision and interpretation ",,,149.95,149.95,1 RC,739,"Venography, renal, unilateral, selective, radiological supervision and interpretation ",,,123.04,123.04,1 RC,739,"Venography, superior sagittal sinus, radiological supervision and interpretation ",,,160.18,160.18,1 RC,739,"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation ",,,128.83,128.83,1 RC,739,"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation ",,,105.99,105.99,1 RC,739,"Venous thrombosis imaging, venogram; bilateral ",,,205.85,205.85,1 RC,739,"Venous thrombosis imaging, venogram; unilateral ",,,179.61,179.61,1 RC,739,Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) ,,,33.74,33.74,1 RC,739,"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique) ",,,97.47,97.47,1 RC,740, EEG (Electoencephalogram) General Classification ,,,2039.0,2911.0,2 RC,740,"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness ",,,2476.0,3534.0,2 RC,740,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,740,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a",,,2476.0,3534.0,2 RC,740,"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,740,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,740,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by ",,,2476.0,3534.0,2 RC,740,"Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist ",,,2476.0,3534.0,2 RC,740,"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) ",,,2476.0,3534.0,2 RC,740,"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time ",,,2476.0,3534.0,2 RC,740,"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone) ",,,2476.0,3534.0,2 RC,750, Gastro-Intestinal (GI) Services General Classification ,,,3673.0,5356.0,12 RC,750,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,750,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,750,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,43890.0,6 RC,750,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,750,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,750,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,750,Anorectal manometry ,,,1672.0,2358.0,4 RC,750,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,750,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,750,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,750,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,33 RC,750,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,750,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,750,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,750,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,19 RC,750,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,750,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,750,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,750,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,750,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,750,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,750,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,750,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,750,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,750,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,750,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,750,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,750,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,750,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,12 RC,750,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,750,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,750,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,750,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,750,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,750,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,750,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,750,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,750,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,750,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,750,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,750,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,750,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,750,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,750,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,750,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,750,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,750,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,750,Bundle of His recording ,,,3673.0,43890.0,22 RC,750,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,750,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,750,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,750,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,750,Cardioassist-method of circulatory assist; external ,,,5841.0,16207.0,3 RC,750,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,8 RC,750,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,750,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,9 RC,750,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,9 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,750,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,17384.0,10 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,17384.0,38 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,17384.0,20 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,17384.0,55 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,17384.0,10 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,750,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,750,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,750,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,750,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,750,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,750,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,750,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,8 RC,750,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,750,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,25 RC,750,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,25 RC,750,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,22 RC,750,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,750,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,750,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,750,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,750,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,750,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,43890.0,16 RC,750,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,43890.0,16 RC,750,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,43890.0,22 RC,750,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,34 RC,750,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,43890.0,17 RC,750,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,11 RC,750,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,750,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,750,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,750,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,750,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,750,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,750,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,750,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,750,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,25 RC,750,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,25 RC,750,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,750,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,750,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,750,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,750,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,750,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,750,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,750,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,750,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,3 RC,750,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,25 RC,750,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,750,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,750,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,750,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,750,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,750,Duodenal motility (manometric) study ,,,1672.0,3083.0,16 RC,750,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,750,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,750,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,750,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,750,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,43890.0,32 RC,750,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,43890.0,16 RC,750,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,750,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,9124.0,43890.0,5 RC,750,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,43890.0,8 RC,750,Endomyocardial biopsy ,,,5571.0,17384.0,9 RC,750,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,750,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,750,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,750,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,750,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,750,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,750,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,750,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,750,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,750,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,750,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,750,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,750,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,750,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,750,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,43890.0,5 RC,750,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,43890.0,5 RC,750,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,750,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,750,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,750,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,43890.0,4 RC,750,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,750,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,750,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,750,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,750,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,750,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,750,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,750,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,750,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,750,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,750,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,3041.0,32488.94,12 RC,750,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,750,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,750,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,4 RC,750,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,4 RC,750,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,4 RC,750,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,750,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,750,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,750,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,750,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,750,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,750,Hip core decompression ,,,9913.14,12713.03,5 RC,750,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,750,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,750,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,750,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,750,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,750,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,6326.0,13835.0,7 RC,750,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,4988.0,13835.0,7 RC,750,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,750,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,750,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,750,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,750,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,750,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,750,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,750,Induction of arrhythmia by electrical pacing ,,,3673.0,43890.0,17 RC,750,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,17384.0,4 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,17384.0,4 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,17384.0,4 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,17384.0,4 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,17384.0,4 RC,750,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,17384.0,4 RC,750,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,750,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,24 RC,750,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,4988.0,6077.0,2 RC,750,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,9 RC,750,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,750,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,750,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,9 RC,750,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,750,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,750,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,750,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,750,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,750,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,750,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,11 RC,750,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,750,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,750,Intra-atrial pacing ,,,12065.71,43890.0,10 RC,750,Intra-atrial recording ,,,12065.71,43890.0,10 RC,750,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,43890.0,4 RC,750,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,43890.0,6 RC,750,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,43890.0,10 RC,750,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,43890.0,4 RC,750,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,5 RC,750,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,750,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,750,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,750,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,750,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,750,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,43890.0,17 RC,750,Intraventricular pacing ,,,12065.71,43890.0,10 RC,750,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,750,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,750,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,750,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,750,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,750,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,750,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,3 RC,750,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,750,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,750,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,17384.0,5 RC,750,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,750,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,17384.0,10 RC,750,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,750,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,750,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,750,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,750,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,750,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,750,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,750,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,750,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,750,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,750,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,750,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,750,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,750,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,750,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,750,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,750,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,750,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,750,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,750,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,23 RC,750,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,23 RC,750,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,23 RC,750,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3041.0,5571.0,9 RC,750,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3041.0,5571.0,9 RC,750,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,750,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,750,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,43890.0,22 RC,750,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,43890.0,22 RC,750,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,43890.0,22 RC,750,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,750,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,750,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,750,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,750,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,750,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,24 RC,750,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43890.0,22 RC,750,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43890.0,22 RC,750,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,750,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,7 RC,750,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,7 RC,750,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,21 RC,750,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,54054.0,10 RC,750,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,21231.0,54054.0,5 RC,750,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21231.0,43890.0,10 RC,750,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,22 RC,750,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,750,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,43890.0,20 RC,750,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,750,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,750,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,750,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,750,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,750,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,43890.0,10 RC,750,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,750,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,21231.0,61050.09,10 RC,750,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,21231.0,54054.0,5 RC,750,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,21231.0,61050.09,10 RC,750,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,750,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,750,Percutaneous transluminal coronary mechanical aspiration thrombectomy (List separately in addition to code for primary procedure) ,,,21231.0,43890.0,3 RC,750,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,750,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,43890.0,5 RC,750,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,43890.0,22 RC,750,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,43890.0,10 RC,750,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,10 RC,750,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,21231.0,61050.09,15 RC,750,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,750,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,28 RC,750,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21231.0,54054.0,15 RC,750,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,43890.0,11 RC,750,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,750,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,750,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,750,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,750,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,750,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,750,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,750,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,750,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,750,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,750,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,750,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,750,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,750,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,750,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,750,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,750,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,9 RC,750,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,750,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,750,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,750,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,43890.0,4 RC,750,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,750,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,750,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,750,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,750,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,750,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,750,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,750,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,750,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,750,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,750,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,750,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,750,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,750,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,750,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,750,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,750,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,750,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,750,Remove interim implant component ,,,12018.0,12018.0,1 RC,750,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,750,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,750,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,750,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,750,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,750,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,750,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,22 RC,750,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,750,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,750,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,750,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,750,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,750,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,750,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,750,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,22 RC,750,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,22 RC,750,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,22 RC,750,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,750,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,750,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,750,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,750,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,750,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,750,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,17384.0,10 RC,750,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,4988.0,7014.0,3 RC,750,Right ventricular recording ,,,2024.5,43890.0,10 RC,750,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,750,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,750,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,750,Screening proctoscopy ,,,343.69,440.76,5 RC,750,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,750,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,750,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,750,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,750,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,750,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,750,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,750,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,750,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,750,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,750,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,750,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,750,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,750,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,750,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,750,Temporary transcutaneous pacing ,,,1099.74,2315.0,9 RC,750,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,750,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,750,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,750,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,750,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,750,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,43890.0,4 RC,750,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,750,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,750,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,750,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,750,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,750,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,750,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,750,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,750,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,750,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,750,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,750,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,750,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,750,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,750,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,750,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,760, Specialty Services General Classification ,,,453.0,12540.0,6 RC,760,Hospital outpatient clinic visit for assessment and management of a patient ,,,4060.0,4060.0,1 RC,761, Specialty Services Treatment Room ,,,453.0,4037.0,4 RC,762, Specialty Services Observation Hours ,,,375.0,12540.0,50 RC,762,Comprehensive Observation ,,,5123.47,5123.47,1 RC,769, Specialty Services Other ,,,453.0,4037.0,3 RC,780, Telemedicine General Classification ,,,,,0 RC,790, Extra-Corporeal Shock Wave Therapy (formerly Lithotripsy) General Classification ,,,3673.0,5356.0,12 RC,790,ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION) ,,,16207.0,16207.0,1 RC,790,"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CARDIAC CATHETERIZATION) ",,,16207.0,16207.0,1 RC,790,Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in ad,,,2358.0,36383.0,3 RC,790,Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) ,,,1672.0,3083.0,13 RC,790,Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ,,,1986.0,12713.03,17 RC,790,Adrenal tissue transplant to brain ,,,9913.14,12713.03,5 RC,790,Anorectal manometry ,,,1672.0,2358.0,3 RC,790,"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed ",,,1986.0,3083.0,12 RC,790,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; ",,,1986.0,3249.0,24 RC,790,"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal",,,1986.0,3249.0,24 RC,790,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 ",,,1672.0,3249.0,32 RC,790,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additio",,,1672.0,3083.0,14 RC,790,"Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq ",,,1672.0,3249.0,17 RC,790,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each ",,,1672.0,3083.0,14 RC,790,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and c",,,2195.0,15059.0,18 RC,790,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition ",,,1672.0,3083.0,14 RC,790,"Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area ",,,1672.0,3249.0,17 RC,790,Application of on-body injector (includes cannula insertion) for timed subcutaneous injection ,,,1986.0,3083.0,12 RC,790,"Arthrodesis, interphalangeal joints, with or without internal fixation ",,,2699.0,13835.0,21 RC,790,"Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) ",,,2996.0,43459.43,17 RC,790,"Arthroereisis, subtalar ",,,9913.14,12713.03,5 RC,790,"Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells) ",,,9913.14,12713.03,5 RC,790,"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartme",,,1672.0,2358.0,2 RC,790,"Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenode",,,3293.0,17463.95,21 RC,790,"Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy ",,,1100.49,1411.32,5 RC,790,"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressi",,,3585.98,4775.48,5 RC,790,"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedure",,,3326.62,4430.08,5 RC,790,"Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein",,,3673.0,37344.42,18 RC,790,"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial ",,,8778.0,16330.72,11 RC,790,"Blinded procedure for new york heart association (nyha) class ii or iii heart failure, or canadian cardiovascular society (ccs) class iii or iv chronic refractory angina; transcatheter intramyocardial",,,19988.52,26618.87,5 RC,790,"Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee",,,25626.02,34126.36,5 RC,790,"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus an",,,3673.0,28005.68,18 RC,790,Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service ,,,2358.0,2358.0,1 RC,790,"Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; m",,,9913.14,12713.03,5 RC,790,"Breast reconstruction of a single breast with stacked deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascu",,,9913.14,12713.03,5 RC,790,"Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of d",,,9913.14,12713.03,5 RC,790,"Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral ",,,9913.14,12713.03,5 RC,790,"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) ",,,1672.0,2358.0,2 RC,790,"Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,790,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted im",,,2195.0,28824.0,17 RC,790,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,3673.0,10238.86,17 RC,790,"Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, ",,,3673.0,13835.0,16 RC,790,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage and transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion",,,2195.0,18423.45,20 RC,790,"Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed ",,,2699.0,15059.0,21 RC,790,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with computer-assisted image-guided navigation, including fluoroscopic guidan",,,2699.0,15059.0,21 RC,790,"Bronchoscopy, rigid or flexible, with single or multiple bronchial or endobronchial biopsy(ies), single or multiple sites, with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic dia",,,2699.0,15059.0,21 RC,790,Buccal/ labial frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,790,Bundle of His recording ,,,3673.0,22869.0,19 RC,790,"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,790,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES",,,6077.0,6077.0,1 RC,790,"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,790,"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition t",,,1672.0,1672.0,1 RC,790,Cardioassist-method of circulatory assist; external ,,,12018.0,16207.0,2 RC,790,Cardioassist-method of circulatory assist; internal ,,,1824.28,16207.0,7 RC,790,"Cardiopulmonary resuscitation (eg, in cardiac arrest) ",,,518.85,2358.0,7 RC,790,"Cardioversion, elective, electrical conversion of arrhythmia; external ",,,1099.74,2315.0,8 RC,790,"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) ",,,1099.74,2315.0,8 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography with right heart catheterization with endoluminal imaging of initia",,,2389.1,12018.0,18 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with right heart catheteriz",,,2389.1,12018.0,18 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s)",,,2389.1,12018.0,54 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler",,,3673.0,10445.56,17 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with left heart catheteriz",,,2389.1,12018.0,72 RC,790,"Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart ",,,2389.1,12018.0,54 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary",,,1986.0,10445.56,17 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with left heart catheterizati",,,3982.0,9674.85,17 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; ",,,6298.39,10915.31,7 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i",,,2389.1,12018.0,32 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat",,,6298.39,10915.31,14 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,2389.1,12018.0,49 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza",,,6298.39,10915.31,7 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with endoluminal imaging of initial coronary vessel or graft using i",,,2389.1,12018.0,18 RC,790,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, with iliac and/or femoral artery angiography, non-selective, bilater",,,2389.1,12018.0,18 RC,790,Catheterization for collection of specimen(s) (multiple patients) ,,,1986.0,3083.0,12 RC,790,"Catheterization for collection of specimen, single patient, all places of service ",,,72.72,3083.0,17 RC,790,"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all a",,,2195.0,15059.0,21 RC,790,Chemodenervation of abductor muscle(s) of vocal cord ,,,2055.55,2636.12,5 RC,790,Chemodenervation of adductor muscle(s) of vocal cord ,,,9913.14,12713.03,5 RC,790,"Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex) ",,,1209.52,16207.0,7 RC,790,"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio",,,1672.0,1672.0,1 RC,790,Colorectal cancer screening; colonoscopy on individual at high risk ,,,352.49,3755.0,24 RC,790,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk ,,,352.49,3755.0,24 RC,790,Colorectal cancer screening; flexible sigmoidoscopy ,,,140.21,3083.0,21 RC,790,"Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) ",,,3293.0,13835.0,21 RC,790,"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,10915.31,7 RC,790,"Complete cycle, gamete intrafallopian transfer (gift), case rate ",,,9913.14,12713.03,5 RC,790,"Complete cycle, zygote intrafallopian transfer (zift), case rate ",,,9913.14,12713.03,5 RC,790,"Complete in vitro fertilization cycle, not otherwise specified, case rate ",,,9913.14,12713.03,5 RC,790,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recor,,,3673.0,22869.0,14 RC,790,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and ,,,3673.0,22869.0,14 RC,790,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,3673.0,22869.0,19 RC,790,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,3673.0,55788.29,28 RC,790,"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec",,,3673.0,22869.0,14 RC,790,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,8579.0,55788.29,8 RC,790,"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition",,,1672.0,2358.0,2 RC,790,"Convert nephrostomy catheter to nephroureteral catheter, percutaneous via pre-existing nephrostomy tract, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogra",,,2195.0,15059.0,21 RC,790,"Cord blood harvesting for transplantation, allogeneic ",,,9913.14,12713.03,5 RC,790,"Cord blood-derived stem-cell transplantation, allogeneic ",,,9913.14,12713.03,5 RC,790,"Cryopreserved embryo transfer, case rate ",,,9913.14,12713.03,5 RC,790,Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent ,,,2195.0,12909.0,21 RC,790,"Cystourethroscopy, with biopsy(ies) with adjunctive blue light cystoscopy with fluorescent imaging agent ",,,2195.0,15059.0,21 RC,790,"Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts ",,,2699.0,15059.0,16 RC,790,"Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants ",,,2983.89,15059.0,24 RC,790,"Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants ",,,3293.0,22025.45,24 RC,790,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if",,,2996.0,15059.0,21 RC,790,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) ",,,2996.0,4390.0,12 RC,790,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) ",,,9913.14,12713.03,5 RC,790,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de",,,1672.0,3083.0,28 RC,790,"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin ",,,1672.0,3083.0,13 RC,790,"Debridement, bone including epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed, first 20 sq cm or less with manual preparation and insertion of deep (e.g., subfacial) drug-deli",,,2195.0,12909.0,21 RC,790,"Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar ",,,9913.14,12713.03,5 RC,790,Decoronation or submergence of an erupted tooth ,,,12018.0,12018.0,1 RC,790,"Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies ",,,2431.0,2979.0,2 RC,790,"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions) ",,,223.54,3667.92,24 RC,790,"Diagnostic endoscopic retrograde cholangiopancreatography (ercp), including collection of specimen(s) by brushing or washing, when performed, with endoscopic cannulation of papilla with direct visuali",,,2699.0,13835.0,21 RC,790,"Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contras",,,2389.1,15059.0,84 RC,790,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) ",,,2723.12,3492.25,5 RC,790,"Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace ",,,12915.12,16562.9,5 RC,790,"Donor lobectomy (lung) for transplantation, living donor ",,,9913.14,12713.03,5 RC,790,Duodenal motility (manometric) study ,,,1672.0,3083.0,15 RC,790,"Electrogastrography, diagnostic, transcutaneous; ",,,1672.0,2358.0,2 RC,790,"Electrogastrography, diagnostic, transcutaneous; with provocative testing ",,,1672.0,2358.0,2 RC,790,"Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses ",,,9913.14,12713.03,5 RC,790,"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation,",,,74.31,297.65,10 RC,790,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,2358.0,5356.0,26 RC,790,"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and ",,,2979.0,5356.0,13 RC,790,"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and pr",,,1672.0,2358.0,2 RC,790,"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia ",,,16024.0,22869.0,2 RC,790,Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imagi,,,2358.0,2358.0,2 RC,790,Endomyocardial biopsy ,,,5571.0,10614.0,6 RC,790,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,2699.0,26775.18,17 RC,790,"Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,24808.33,21 RC,790,"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,790,"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/com",,,2699.0,13835.0,21 RC,790,Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with direct visualization of pan,,,2699.0,21157.3,20 RC,790,"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s) ",,,2699.0,13835.0,21 RC,790,"Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed ",,,2699.0,15059.0,21 RC,790,Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,790,"Esophageal balloon distension study, diagnostic, with provocation when performed ",,,1672.0,2358.0,2 RC,790,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; ",,,1672.0,2358.0,2 RC,790,"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to ",,,1672.0,2358.0,2 RC,790,Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; ,,,1672.0,3083.0,14 RC,790,"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (",,,1672.0,2358.0,2 RC,790,"Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy ",,,1986.0,15059.0,16 RC,790,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); ,,,16024.0,22869.0,2 RC,790,Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing ,,,16024.0,22869.0,2 RC,790,"Esophagus, acid perfusion (Bernstein) test for esophagitis ",,,1672.0,2358.0,2 RC,790,"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,790,"Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation ",,,1672.0,2358.0,2 RC,790,"Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention ",,,2358.0,2358.0,1 RC,790,"Exchange nephrostomy catheter, percutaneous, with ureteral stricture balloon dilation, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or flu",,,2195.0,15059.0,21 RC,790,Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm ,,,358.2,3083.0,17 RC,790,Excimer laser treatment for psoriasis; over 500 sq cm ,,,655.0,3083.0,17 RC,790,Excimer laser treatment for psoriasis; total area less than 250 sq cm ,,,358.2,3083.0,17 RC,790,"Excision of major peripheral nerve neuroma, except sciatic, with implantation of nerve end into bone or muscle ",,,2699.0,13835.0,21 RC,790,"External counterpulsation, per treatment session ",,,2428.0,3128.0,3 RC,790,"Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) ",,,9913.14,12713.03,5 RC,790,Fabric wrapping of abdominal aneurysm ,,,9913.14,12713.03,5 RC,790,"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operati",,,6648.29,13835.0,9 RC,790,Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome ,,,9913.14,12713.03,5 RC,790,"Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance ",,,4052.0,32488.94,11 RC,790,Gastric motility (manometric) studies ,,,1672.0,3083.0,14 RC,790,"Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components ",,,2699.0,13835.0,16 RC,790,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report ",,,2431.0,2979.0,3 RC,790,"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report ",,,2431.0,2979.0,3 RC,790,"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report ",,,2431.0,2979.0,3 RC,790,Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) ,,,9913.14,12713.03,5 RC,790,"Guided tissue regeneration - non-resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,790,"Guided tissue regeneration - resorbable barrier, per implant ",,,12018.0,12018.0,1 RC,790,"Guided tissue regeneration, edentulous area - non-resorbably barrier, per site ",,,12018.0,12018.0,1 RC,790,"Guided tissue regeneration, edentulous area - resorbably barrier, per site ",,,12018.0,12018.0,1 RC,790,"Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor ",,,9913.14,12713.03,5 RC,790,Hip core decompression ,,,9913.14,12713.03,5 RC,790,"Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance ",,,2996.0,13835.0,15 RC,790,"Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,790,"Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) ",,,9913.14,12713.03,5 RC,790,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; SUBSEQUENT MEASUREMENT OF CARDIAC OUTPUT ",,,2358.0,2358.0,1 RC,790,"INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMODILUTION, INCLUDING ARTERIAL AND/OR VENOUS CATHETERIZATION; WITH CARDIAC OUTPUT MEASUREMENT (SEPARATE PROCEDURE) ",,,2358.0,2358.0,1 RC,790,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment ",,,7799.0,13835.0,6 RC,790,"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fif",,,5849.0,13835.0,6 RC,790,Implantation of auditory brain stem implant ,,,9913.14,12713.03,5 RC,790,Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear ,,,9913.14,12713.03,5 RC,790,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,2996.0,50204.84,17 RC,790,"Induced abortion, 17 to 24 weeks ",,,9913.14,12713.03,5 RC,790,"Induced abortion, 25 to 28 weeks ",,,9913.14,12713.03,5 RC,790,"Induced abortion, 29 to 31 weeks ",,,9913.14,12713.03,5 RC,790,"Induced abortion, 32 weeks or greater ",,,9913.14,12713.03,5 RC,790,Induction of arrhythmia by electrical pacing ,,,3673.0,22869.0,14 RC,790,"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electroni",,,1672.0,2358.0,2 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for p",,,2358.0,2358.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separatel",,,2358.0,2358.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (List separately in addition to ",,,2358.0,2358.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aorto",,,2358.0,2358.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) a",,,1672.0,1672.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (List separately in addition to co",,,1672.0,1672.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to c",,,1672.0,1672.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac ",,,1672.0,1672.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (List separately in addition t",,,2358.0,2358.0,1 RC,790,"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure) ",,,2358.0,2358.0,1 RC,790,Injection procedure for sacroiliac joint; arthrography ,,,1672.0,3083.0,14 RC,790,"Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography ",,,1281.35,3128.0,23 RC,790,Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies) ,,,6077.0,6077.0,1 RC,790,"Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes ",,,2012.0,6247.23,8 RC,790,Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording ,,,872.43,1118.85,5 RC,790,"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance ",,,2699.0,22523.87,21 RC,790,Insertion of implants into the soft palate; minimum of three implants ,,,2128.0,3683.7,8 RC,790,Insertion of levonorgestrel-releasing intrauterine system ,,,9913.14,12713.03,5 RC,790,"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at ",,,2389.1,13835.0,21 RC,790,"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertio",,,2389.1,13835.0,21 RC,790,"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of ins",,,2389.1,13835.0,21 RC,790,"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) ",,,745.36,3128.0,21 RC,790,"Insertion of pleural-peritoneal shunt with intercostal pump chamber, including imaging, injection(s) of contrast with radiological supervision and interpretation, when performed ",,,2195.0,17034.52,17 RC,790,"Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ve",,,363.5,16207.0,10 RC,790,"Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed ",,,2195.0,15059.0,21 RC,790,"Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of ",,,1672.0,2358.0,2 RC,790,Intra-atrial pacing ,,,12065.71,22869.0,7 RC,790,Intra-atrial recording ,,,12065.71,22869.0,7 RC,790,Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction ,,,16024.0,22869.0,2 RC,790,"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrh",,,2358.0,36383.0,3 RC,790,"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement ",,,12065.71,36383.0,7 RC,790,"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure) ",,,2358.0,2358.0,1 RC,790,Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure) ,,,16024.0,22869.0,2 RC,790,Intragastric hypothermia using gastric freezing ,,,9913.14,12713.03,5 RC,790,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,1672.0,3083.0,13 RC,790,Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) ,,,1986.0,3083.0,12 RC,790,"Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when perform",,,1672.0,2358.0,4 RC,790,"Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump ",,,634.68,845.21,5 RC,790,Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for ,,,3673.0,22869.0,14 RC,790,Intraventricular pacing ,,,12065.71,22869.0,7 RC,790,"Intravertebral body fracture augmentation with implant (e.g., metal, polymer) ",,,10740.0,36571.01,8 RC,790,Islet cell tissue transplant from pancreas; allogeneic ,,,9913.14,12713.03,5 RC,790,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implanta",,,3293.0,32488.94,18 RC,790,Laparoscopic esophagomyotomy (heller type) ,,,9913.14,12713.03,5 RC,790,"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion ",,,6685.57,13835.0,8 RC,790,"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion ",,,10740.0,14159.86,8 RC,790,"Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed ",,,2431.0,2979.0,2 RC,790,Laser in situ keratomileusis (lasik) ,,,879.04,1127.31,5 RC,790,Laser-assisted uvulopalatoplasty (laup) ,,,9913.14,12713.03,5 RC,790,Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) ,,,6919.0,9875.0,2 RC,790,"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections ",,,3673.0,11342.62,18 RC,790,"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed ",,,6298.39,10915.31,7 RC,790,Lingual frenectomy (frenulectomy) ,,,12018.0,12018.0,1 RC,790,Lobar lung transplantation ,,,9913.14,12713.03,5 RC,790,Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation ,,,9913.14,12713.03,5 RC,790,Marsupialization of odontogenic cyst ,,,12018.0,12018.0,1 RC,790,"Metal-on-metal total hip resurfacing, including acetabular and femoral components ",,,9913.14,12713.03,5 RC,790,Microsurgical epididymal sperm aspiration (mesa) ,,,9913.14,12713.03,5 RC,790,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft ",,,18136.7,23259.28,5 RC,790,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts ",,,19934.48,25564.83,5 RC,790,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous ",,,19782.44,25369.85,5 RC,790,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft ",,,21580.22,27675.4,5 RC,790,"Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft ",,,17677.28,22670.1,5 RC,790,"Myringotomy, laser-assisted ",,,2699.0,12713.03,17 RC,790,"Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral ",,,2915.0,12713.03,8 RC,790,"Nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral ",,,4807.0,4807.0,1 RC,790,Nasopharyngoscopy with endoscope (separate procedure) ,,,1986.0,3083.0,12 RC,790,"Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, tr",,,,,0 RC,790,"Open biopsy or excision of deep cervical node(s) with intraoperative identification (e.g., mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed ",,,2195.0,13835.0,21 RC,790,"Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array ",,,2195.0,3249.0,12 RC,790,"Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components ",,,2195.0,3249.0,12 RC,790,"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pub",,,3375.0,16207.0,22 RC,790,"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixat",,,3293.0,16207.0,22 RC,790,"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ",,,3375.0,16817.15,22 RC,790,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; com",,,3967.16,5571.0,8 RC,790,"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; lim",,,3967.16,5571.0,8 RC,790,"Osteotomy, periacetabular, with internal fixation ",,,9913.14,12713.03,5 RC,790,Otolaryngologic examination under general anesthesia ,,,905.53,2358.0,7 RC,790,Percutaneous balloon valvuloplasty; aortic valve ,,,3673.0,24948.0,19 RC,790,Percutaneous balloon valvuloplasty; mitral valve ,,,3673.0,37949.48,19 RC,790,Percutaneous balloon valvuloplasty; pulmonary valve ,,,3673.0,37949.48,19 RC,790,"Percutaneous breast biopsies using magnetic resonance guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when ",,,2699.0,12909.0,21 RC,790,"Percutaneous breast biopsies using stereotactic guidance, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when perfor",,,2195.0,12909.0,21 RC,790,"Percutaneous exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), with removal of calculi/debris from biliary duct(s) and/or ga",,,2699.0,13835.0,21 RC,790,"Percutaneous islet cell transplant, includes portal vein catheterization and infusion ",,,3562.55,13835.0,8 RC,790,"Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral ",,,2699.0,4220.0,12 RC,790,"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and",,,3293.0,16330.72,23 RC,790,Percutaneous transcatheter closure of a congenital ventricular septal defect with implant ,,,3982.0,43516.12,20 RC,790,"Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant ",,,3982.0,43516.12,20 RC,790,Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure) ,,,1672.0,1672.0,1 RC,790,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve ",,,710.22,61050.09,7 RC,790,"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve ",,,859.61,61050.09,7 RC,790,Percutaneous transcatheter closure of patent ductus arteriosus ,,,3982.0,61050.09,19 RC,790,"Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch ",,,21897.74,54054.0,7 RC,790,"Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to",,,37874.0,54054.0,2 RC,790,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segm",,,21897.74,37949.48,7 RC,790,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2",,,3982.0,71730.88,19 RC,790,"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for pri",,,9493.0,9493.0,1 RC,790,"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed ",,,1723.56,16207.0,18 RC,790,"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es) ",,,9888.0,18973.48,7 RC,790,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coh",,,3982.0,25054.33,17 RC,790,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy ",,,3673.0,76929.22,17 RC,790,"Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy ",,,2389.1,12018.0,6 RC,790,Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ,,,9493.0,9493.0,1 RC,790,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,9888.0,37949.48,7 RC,790,"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure) ",,,11113.0,11113.0,1 RC,790,"Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch ",,,35227.33,61050.09,7 RC,790,"Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in a",,,37874.0,54054.0,2 RC,790,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es) ",,,23307.0,61050.09,7 RC,790,"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to co",,,9493.0,9493.0,1 RC,790,Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) ,,,1986.0,3083.0,12 RC,790,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,3673.0,41755.04,17 RC,790,Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) ,,,19665.0,28067.0,2 RC,790,Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel ,,,3673.0,37949.48,19 RC,790,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspirat",,,1544.35,33264.0,7 RC,790,"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intra",,,9913.14,54054.0,7 RC,790,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a",,,35227.33,61050.09,9 RC,790,"Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy an",,,9493.0,9493.0,1 RC,790,"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches",,,3982.0,45171.9,24 RC,790,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a",,,21897.74,54054.0,9 RC,790,"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, i",,,9493.0,37949.48,8 RC,790,"Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) us",,,3293.0,13835.0,21 RC,790,"Percutaneous vertebral augmentations, first thoracic and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) ",,,3293.0,13835.0,21 RC,790,"Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, incl",,,2996.0,13835.0,21 RC,790,"Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusiv",,,2996.0,13835.0,21 RC,790,Peridontal medicament carrier with peripheral seal - laboratory processed - mandibular ,,,12018.0,12018.0,1 RC,790,Peridontal medicament carrier with peripheral seal - laboratory processed - maxillary ,,,12018.0,12018.0,1 RC,790,"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during,",,,1672.0,2358.0,2 RC,790,"Phlebotomy, therapeutic (separate procedure) ",,,223.51,297.65,5 RC,790,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscop,,,1672.0,2358.0,2 RC,790,Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronc,,,1672.0,2358.0,2 RC,790,"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day ",,,1672.0,2358.0,2 RC,790,Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided ,,,1672.0,1672.0,1 RC,790,Photorefractive keratectomy (prk) ,,,879.04,1127.31,5 RC,790,Phototherapeutic keratectomy (ptk) ,,,9913.14,12713.03,5 RC,790,"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) ",,,1672.0,2358.0,2 RC,790,"Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure ",,,1672.0,2358.0,2 RC,790,Placement of endorectal intracavitary applicator for high intensity brachytherapy ,,,1565.95,2315.0,8 RC,790,"Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperit",,,2552.95,3399.78,5 RC,790,"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) ",,,1672.0,2358.0,2 RC,790,"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen ",,,1611.14,3083.0,17 RC,790,Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) ,,,16024.0,22869.0,2 RC,790,"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES ",,,6077.0,6077.0,1 RC,790,"Rectal sensation, tone, and compliance study (eg, barostat) ",,,1986.0,3083.0,12 RC,790,"Rectal sensation, tone, and compliance test (ie, response to graded balloon distention) ",,,1672.0,2358.0,2 RC,790,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; ",,,1672.0,2358.0,2 RC,790,"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requirin",,,1672.0,2358.0,2 RC,790,"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, with ureteral stricture balloon dilation, including imaging guid",,,2195.0,15059.0,21 RC,790,Removal of hypoglossal nerve neurostimulator array and pulse generator ,,,1986.0,3083.0,12 RC,790,Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,1986.0,3083.0,12 RC,790,Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing ,,,1672.0,2358.0,2 RC,790,Removal of implant body not requiring bone removal nor flap elevation ,,,12018.0,12018.0,1 RC,790,"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,790,Removal of non-resorbable barrier ,,,12018.0,12018.0,1 RC,790,"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, ",,,2389.1,13835.0,21 RC,790,Removal of sutures; by a physician other than the physician who originally closed the wound ,,,9913.14,12713.03,5 RC,790,"Removal of temporary anchorage device (screw retained plate), requiring flap ",,,12018.0,12018.0,1 RC,790,Removal of temporary anchorage device without flap ,,,12018.0,12018.0,1 RC,790,"Removal of temporary anchorage device, requiring flap ",,,12018.0,12018.0,1 RC,790,"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) ",,,745.36,3128.0,21 RC,790,Remove interim implant component ,,,12018.0,12018.0,1 RC,790,"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), recurrent, including implantation of mesh or other",,,2996.0,31802.1,17 RC,790,Repair of custom sleep apnea appliance ,,,12018.0,12018.0,1 RC,790,"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa ºsis») ",,,2195.0,13835.0,20 RC,790,"Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified ",,,9913.14,12713.03,5 RC,790,"Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Repair, myelomeningocele in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Repair, urinary tract obstruction in the fetus, procedure performed in utero ",,,9913.14,12713.03,5 RC,790,"Replacement of restorative material used to close an access opening of a screw-retained, implant supported prosthesis, per implant ",,,12018.0,12018.0,1 RC,790,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s",,,2996.0,43854.72,22 RC,790,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with atherectomy, includes angioplasty within the same vessel, when performed with intravascular ultr",,,2389.1,12018.0,18 RC,790,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal angioplasty with intravascular ultrasound (initial noncoronary vessel) during diagn",,,2389.1,12018.0,18 RC,790,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(ies), unilateral, with transluminal stent placement(s), includes angioplasty within the same vessel, when performed, wi",,,2389.1,12018.0,18 RC,790,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(",,,3293.0,27050.15,21 RC,790,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, include",,,3293.0,43516.12,21 RC,790,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty wi",,,2996.0,27050.15,21 RC,790,"Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when perform",,,2996.0,13835.0,21 RC,790,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,27417.23,22 RC,790,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed ",,,2996.0,43854.72,22 RC,790,"Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the",,,2996.0,43854.72,22 RC,790,Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator ,,,2195.0,3249.0,12 RC,790,Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver ,,,2195.0,3249.0,12 RC,790,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections ,,,3673.0,11342.62,20 RC,790,Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections ,,,3673.0,11342.62,20 RC,790,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections ,,,3673.0,11342.62,20 RC,790,Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections ,,,3673.0,11342.62,20 RC,790,"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed ",,,6298.39,10915.31,7 RC,790,"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report ",,,6077.0,7014.0,2 RC,790,Right ventricular recording ,,,2024.5,22869.0,7 RC,790,"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superf",,,358.2,3244.0,8 RC,790,"Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ",,,9913.14,12713.03,5 RC,790,Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy ,,,9913.14,12713.03,5 RC,790,Screening proctoscopy ,,,343.69,440.76,5 RC,790,Semi-precision abutment - placement ,,,12018.0,12018.0,1 RC,790,Semi-precision attachment - placement ,,,12018.0,12018.0,1 RC,790,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,25062.66,43434.38,5 RC,790,Simultaneous pancreas kidney transplantation ,,,9913.14,12713.03,5 RC,790,"Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospital",,,9913.14,12713.03,5 RC,790,"Stimulated intrauterine insemination (iui), case rate ",,,9913.14,12713.03,5 RC,790,Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior ,,,12018.0,12018.0,1 RC,790,Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar ,,,12018.0,12018.0,1 RC,790,Surgical exposure of root surfave without apicoectomy or repair of root resorption - molar ,,,12018.0,12018.0,1 RC,790,Surgical placement of craniofacial implant - extra oral ,,,12018.0,12018.0,1 RC,790,Surgical placement zygomatic implant ,,,12018.0,12018.0,1 RC,790,Surgical repair of root resorption - molar ,,,12018.0,12018.0,1 RC,790,Surgical repair of root resorption- premolar ,,,12018.0,12018.0,1 RC,790,Surgical repair of root resorption-anterior ,,,12018.0,12018.0,1 RC,790,Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) ,,,9913.14,12713.03,5 RC,790,Temporary transcutaneous pacing ,,,1099.74,2315.0,8 RC,790,"Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography ",,,16207.0,16207.0,1 RC,790,"Thrombolysis, coronary; by intravenous infusion ",,,2358.0,2358.0,1 RC,790,"Thyroidectomy, total or complete with parathyroid autotransplantation ",,,3673.0,13835.0,21 RC,790,"Transcatheter intraoperative blood vessel microinfusion(s) (e.g., intraluminal, vascular wall and/or perivascular) therapy, any vessel, including radiological supervision and interpretation, when perf",,,1672.0,1672.0,1 RC,790,"Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres ",,,2699.0,12713.03,17 RC,790,Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) ,,,2358.0,2358.0,1 RC,790,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), initial artery, open or percutaneous, including all",,,2389.1,12018.0,18 RC,790,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,3673.0,22539.28,17 RC,790,Transplantation of multivisceral organs ,,,9913.14,12713.03,5 RC,790,Transplantation of small intestine and liver allografts ,,,9913.14,12713.03,5 RC,790,"Trimming of dystrophic nails, any number ",,,112.77,3244.0,10 RC,790,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use i",,,1986.0,3083.0,12 RC,790,Unlisted cardiovascular service or procedure ,,,1672.0,2358.0,2 RC,790,Unlisted diagnostic gastroenterology procedure ,,,1672.0,2358.0,2 RC,790,"Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, i",,,2699.0,63989.0,20 RC,790,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contrala",,,1986.0,3083.0,12 RC,790,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in addition to code for prima",,,1986.0,3083.0,12 RC,790,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (List separately in addition to code for primary procedure) ",,,1986.0,3083.0,12 RC,790,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate ",,,1986.0,3083.0,12 RC,790,"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena",,,1986.0,3083.0,12 RC,790,"Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent ",,,7799.0,7799.0,1 RC,790,Wound closure utilizing tissue adhesive(s) only ,,,218.15,2358.0,7 RC,800, Inpatient Renal Dialysis General Classification ,,,,,0 RC,801, Inpatient Renal Dialysis Inpatient Hemodialysis ,,,,,0 RC,802, Inpatient Renal Dialysis Inpatient Peritoneal (Non-CAPD) ,,,,,0 RC,803, Inpatient Renal Dialysis Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD) ,,,,,0 RC,804, Inpatient Renal Dialysis Inpatient Continuous Cycling Peritoneal Dialysis (CCPD) ,,,,,0 RC,809, Inpatient Renal Dialysis Other ,,,,,0 RC,810, Acquisition of Body Components General Classification ,,,,,0 RC,811, Acquisition of Body Components Living Donor ,,,,,0 RC,812, Acquisition of Body Components Cadaver Donor ,,,,,0 RC,814, Acquisition of Body Components Unsuccessful Organ Search - Donor Bank Charges ,,,,,0 RC,815, Acquisition of Body Components Stem Cells - Allogeneic ,,,,,0 RC,819, Acquisition of Body Components Other Donor ,,,,,0 RC,820, Hemodialysis - Outpatient or Home General Classification ,,,1510.0,2155.0,2 RC,821, Hemodialysis - Outpatient or Home Composite or Other Rate ,,,490.0,2155.0,10 RC,822, Hemodialysis - Outpatient or Home - Home Supplies ,,,1510.0,2155.0,2 RC,823, Hemodialysis - Outpatient or Home - Home Equipment ,,,1510.0,2155.0,2 RC,824, Hemodialysis - Outpatient or Home - Maintenance 100% ,,,1510.0,2155.0,2 RC,825, Hemodialysis - Outpatient or Home - Support Services ,,,490.0,2155.0,7 RC,829, Hemodialysis - Outpatient or Home - Other OP Hemodialysis ,,,490.0,2155.0,7 RC,830, Peritoneal Dialysis - Outpatient or Home General Classification ,,,1510.0,2155.0,2 RC,831, Peritoneal Dialysis - Outpatient or Home Composite or Other Rate ,,,490.0,2155.0,10 RC,832, Peritoneal Dialysis - Outpatient or Home - Home Supplies ,,,1510.0,2155.0,2 RC,833, Peritoneal Dialysis - Outpatient or Home - Home Equipment ,,,1510.0,2155.0,2 RC,834, Peritoneal Dialysis - Outpatient or Home - Maintenance - 100% ,,,1510.0,2155.0,2 RC,835, Peritoneal Dialysis - Outpatient or Home - Support Services ,,,490.0,2155.0,7 RC,839, Peritoneal Dialysis - Outpatient or Home - Other Outpatient Peritoneal Dialysis ,,,490.0,2155.0,7 RC,840, Continuous Ambulatory Peritoneal Dialysis - Outpatient or Home General Classification ,,,1510.0,2155.0,2 RC,841, Continuous Ambulatory Peritoneal Dialysis - Outpatient or Home - Composite or Other Rate ,,,490.0,2155.0,10 RC,842, Continuous Ambulatory Peritoneal Dialysis - Home Supplies ,,,1510.0,2155.0,2 RC,843, Continuous Ambulatory Peritoneal Dialysis - Home Equipment ,,,1510.0,2155.0,2 RC,844, Continuous Ambulatory Peritoneal Dialysis - Maintenance - 100% ,,,1510.0,2155.0,2 RC,845, Continuous Ambulatory Peritoneal Dialysis - Support Services ,,,490.0,2155.0,7 RC,849, Continuous Ambulatory Peritoneal Dialysis - Other Outpatient CAPD ,,,490.0,2155.0,7 RC,850, Continuous Cycling Peritoneal Dialysis - Outpatient or Home General Classification ,,,1510.0,2155.0,2 RC,851, Continuous Cycling Peritoneal Dialysis - Outpatient or Home - Composite or Other Rate ,,,490.0,2155.0,10 RC,852, Continuous Cycling Peritoneal Dialysis - Outpatient or Home - Home Supplies ,,,1510.0,2155.0,2 RC,853, Continuous Cycling Peritoneal Dialysis - Outpatient or Home - Home Equipment ,,,1510.0,2155.0,2 RC,854, Continuous Cycling Peritoneal Dialysis - Outpatient or Home - Maintenance - 100% ,,,1510.0,2155.0,2 RC,855, Continuous Cycling Peritoneal Dialysis - Outpatient or Home - Support Services ,,,490.0,2155.0,7 RC,859, Continuous Cycling Peritonial Dialysis - Outpatient or Home - Other Outpatient CCPD ,,,490.0,2155.0,7 RC,860, Magnetoencephalography General Classification ,,,2039.0,2911.0,2 RC,861, Magnetoencephalography MEG ,,,2039.0,2911.0,2 RC,880, Miscellaneous Dialysis General Classification ,,,,,0 RC,881, Miscellaneous Dialysis Ultrafiltration ,,,,,0 RC,889, Miscellaneous Dialysis Other Miscellaneous Dialysis ,,,,,0 RC,891, Pharmacy - Extension of 025x and 063x - Special Processed Drugs - FDA Approved Cell Therapy ,,,,,0 RC,892, Pharmacy - Extension of 025x and 063x - Special Processed Drugs - FDA Approved Gene Therapy ,,,,,0 RC,900, Behavioral Health Treatment/Services General Classification ,,,437.0,624.0,2 RC,900,"Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management ",,,601.0,601.0,2 RC,900,"Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session ",,,601.0,601.0,2 RC,900,Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and management ,,,601.0,601.0,2 RC,901, Behavioral Health Treatment/Services Electroshock Treatment ,,,904.0,1251.0,12 RC,901,Electroconvulsive therapy (includes necessary monitoring) ,,,300.0,300.0,2 RC,905, Behavioral Health Treatment/Services Intensive Outpatient Services - Psychiatric ,,,100.0,1285.0,7 RC,906, Behavioral Health Treatment/Services Intensive Outpatient Services - Chemical Dependency ,,,100.0,1285.0,7 RC,912, Behavioral Health Treatment/Services Partial Hospitalization - Less Intensive ,,,180.0,1317.0,2 RC,912, Behavioral Health Treatment/Services Partial Hospitalization - Less Intensive Behavioral Health,,,433.0,646.0,5 RC,912, Behavioral Health Treatment/Services Partial Hospitalization - Less Intensive Chemical Dependency,,,433.0,646.0,5 RC,913, Behavioral Health Treatment/Services Partial Hospitalization - Intensive ,,,1317.0,1317.0,1 RC,913, Behavioral Health Treatment/Services Partial Hospitalization - Intensive Behavioral Health,,,433.0,646.0,5 RC,913, Behavioral Health Treatment/Services Partial Hospitalization - Intensive Chemical Dependency,,,433.0,646.0,5 RC,917, Behavioral Health Treatment/Services Bio Feedback ,,,437.0,624.0,2 RC,918, Behavioral Health Treatment/Services Testing ,,,437.0,624.0,2 RC,920, Other Diagnostic Services General Classification ,,,997.0,1423.0,2 RC,920,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,920,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,920,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,920,Cardiokymography ,,,20.04,20.04,1 RC,920,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,920,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,920,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,920,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,920,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,920,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,920,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,920,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,920,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,920,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,920,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,920,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,920,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,920,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,920,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,920,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,920,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,920,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,920,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,920,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,920,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,920,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,920,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,920,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,920,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,920,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,920,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,920,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,920,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,920,"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness ",,,2476.0,3534.0,2 RC,920,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,920,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,920,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a",,,2476.0,3534.0,2 RC,920,"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,920,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,920,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by ",,,2476.0,3534.0,2 RC,920,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,920,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,920,"Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist ",,,2476.0,3534.0,2 RC,920,"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) ",,,2476.0,3534.0,2 RC,920,"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time ",,,2476.0,3534.0,2 RC,920,"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone) ",,,2476.0,3534.0,2 RC,920,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,920,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,920,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,920,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,920,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,920,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,920,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,920,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,920,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,921, Other Diagnostic Services Peripheral Vascular Lab ,,,2185.0,3119.0,2 RC,921,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,921,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,921,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,921,Cardiokymography ,,,20.04,20.04,1 RC,921,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,921,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,921,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,921,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,921,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,921,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,921,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,921,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,921,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,921,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,921,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,921,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,921,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,921,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,921,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,921,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,921,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,921,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,921,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,921,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,921,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,921,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,921,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,921,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,921,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,921,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,921,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,921,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,921,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,921,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,921,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,921,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,921,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,922, Other Diagnostic Services Electromyogram ,,,656.0,936.0,2 RC,922,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,922,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,922,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,922,Cardiokymography ,,,20.04,20.04,1 RC,922,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,922,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,922,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,922,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,922,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,922,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,922,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,922,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,922,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,922,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,922,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,922,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,922,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,922,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,922,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,922,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,922,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,922,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,922,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,922,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,922,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,922,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,922,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,922,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,922,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,922,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,922,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,922,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,922,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,922,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,922,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,922,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,922,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,922,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,922,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,922,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,922,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,922,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,922,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,922,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,922,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,923, Other Diagnostic Services Pap Smear ,,,,,0 RC,923,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,923,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,923,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,923,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,923,Cardiokymography ,,,20.04,20.04,1 RC,923,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,923,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,15.46,1 RC,923,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,5.54,1 RC,923,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,923,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,6.66,1 RC,923,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,923,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,211.56,4 RC,923,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,53.24,1 RC,923,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,923,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,923,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,923,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,923,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,923,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,923,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,923,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,923,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,923,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,923,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,923,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,923,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,923,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,923,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,923,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,923,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,923,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,923,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,923,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,923,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,923,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,923,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,24.23,1 RC,923,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,15.67,1 RC,923,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,923,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,923,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,923,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,923,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,923,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,923,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,923,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,923,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,923,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,923,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,923,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,923,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,923,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,923,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,923,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,923,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,924, Other Diagnostic Services Allergy Test ,,,106.0,152.0,2 RC,924,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,924,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,924,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,924,Cardiokymography ,,,20.04,20.04,1 RC,924,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,924,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,924,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,924,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,924,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,924,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,924,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,924,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,924,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,924,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,924,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,924,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,924,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,924,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,924,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,924,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,924,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,924,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,924,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,924,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,924,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,924,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,924,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,924,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,924,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,924,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,924,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,924,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,924,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,924,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,924,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,924,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,924,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,924,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,924,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,924,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,924,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,924,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,924,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,924,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,924,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,925, Other Diagnostic Services Pregnancy Test ,,,,,0 RC,925,"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc ",,,52.34,52.34,1 RC,925,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,925,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,925,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,925,Cardiokymography ,,,20.04,20.04,1 RC,925,Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel ,,,36.64,36.64,1 RC,925,"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous ",,,15.46,15.46,1 RC,925,"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) ",,,5.54,5.54,1 RC,925,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,925,"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count ",,,6.66,6.66,1 RC,925,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,925,"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not",,,98.04,211.56,4 RC,925,"Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limi",,,53.24,53.24,1 RC,925,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,925,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,925,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,925,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,925,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,925,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,925,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,925,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,925,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,925,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,925,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,925,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,925,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,925,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,925,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,925,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,925,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,925,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,925,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,925,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,925,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,925,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,925,"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is f",,,24.23,24.23,1 RC,925,"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening ",,,15.67,15.67,1 RC,925,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,925,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,925,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,925,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,925,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,925,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,925,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,925,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,925,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,925,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,925,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,925,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,925,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,925,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,925,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,925,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,925,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,929, Other Diagnostic Service ,,,997.0,1423.0,2 RC,929,"3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac struct",,,61.01,61.01,1 RC,929,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging ",,,426.36,426.36,1 RC,929,"Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging ",,,426.36,426.36,1 RC,929,Cardiokymography ,,,20.04,20.04,1 RC,929,"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia",,,131.9,131.9,1 RC,929,"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) ",,,53.85,53.85,1 RC,929,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ",,,188.48,188.48,1 RC,929,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ",,,111.15,111.15,1 RC,929,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study ",,,234.73,234.73,1 RC,929,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study ",,,111.15,111.15,1 RC,929,Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ,,,111.15,111.15,1 RC,929,Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ,,,72.93,72.93,1 RC,929,Duplex scan of extracranial arteries; complete bilateral study ,,,199.37,199.37,1 RC,929,Duplex scan of extracranial arteries; unilateral or limited study ,,,111.15,111.15,1 RC,929,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study ,,,195.63,195.63,1 RC,929,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study ,,,111.15,111.15,1 RC,929,"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) ",,,111.15,111.15,1 RC,929,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ,,,234.73,234.73,1 RC,929,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,929,Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ,,,206.19,206.19,1 RC,929,Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study ,,,111.15,111.15,1 RC,929,"Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve re",,,223.92,223.92,1 RC,929,"Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (",,,254.25,254.25,1 RC,929,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report ",,,246.41,246.41,1 RC,929,"Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only ",,,11.25,11.25,1 RC,929,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography ",,,143.49,143.49,1 RC,929,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or",,,192.22,192.22,1 RC,929,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study ",,,100.53,100.53,1 RC,929,"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green",,,138.04,138.04,1 RC,929,Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primar,,,138.37,138.37,1 RC,929,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (List separately in addition to",,,928.57,928.57,1 RC,929,"Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization) ",,,564.38,564.38,1 RC,929,"Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization) ",,,964.06,964.06,1 RC,929,"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness ",,,2476.0,3534.0,2 RC,929,"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res",,,163.6,163.6,1 RC,929,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,929,"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a",,,2476.0,3534.0,2 RC,929,"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,929,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist ",,,2476.0,3534.0,2 RC,929,"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by ",,,2476.0,3534.0,2 RC,929,"Signal-averaged electrocardiography (SAECG), with or without ECG ",,,29.66,29.66,1 RC,929,"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) ",,,36.47,36.47,1 RC,929,"Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist ",,,2476.0,3534.0,2 RC,929,"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) ",,,2476.0,3534.0,2 RC,929,"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time ",,,2476.0,3534.0,2 RC,929,"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone) ",,,2476.0,3534.0,2 RC,929,Transcranial Doppler study of the intracranial arteries; complete study ,,,234.73,234.73,1 RC,929,Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection ,,,111.15,111.15,1 RC,929,Transcranial Doppler study of the intracranial arteries; limited study ,,,111.15,111.15,1 RC,929,Transcranial Doppler study of the intracranial arteries; vasoreactivity study ,,,234.73,234.73,1 RC,929,Transcranial Doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection ,,,111.15,111.15,1 RC,929,"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report ",,,360.1,360.1,1 RC,929,Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only ,,,26.93,26.93,1 RC,929,Transthoracic echocardiography for congenital cardiac anomalies; complete ,,,232.44,232.44,1 RC,929,Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ,,,162.9,162.9,1 RC,940, Other Therapeutic Services General Classification ,,,456.0,650.0,2 RC,942, Other Therapeutic Services Education/Training ,,,201.0,287.0,2 RC,943, Other Therapeutic Services Cardiac Rehabilitation ,,,456.0,650.0,2 RC,944, Other Therapeutic Services Drug Rehabilitation ,,,100.0,100.0,1 RC,945, Other Therapeutic Services Alcohol Rehabilitation ,,,100.0,100.0,1 RC,946, Other Therapeutic Services Complex Medical Equipment-Routine ,,,,,0 RC,947, Other Therapeutic Services Complex Medical Equipment-Ancillary ,,,,,0 RC,948, Other Therapeutic Services Pulmonary Rehabilitation ,,,268.0,384.0,2 RC,949, Other Therapeutic Services Other Therapeutic Service ,,,456.0,650.0,2 RC,951, Other Therapeutic Services Athletic Training ,,,,,0 RC,952, Other Therapeutic Services Kinesiotherapy ,,,,,0 TRIS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC ,,,195840.6,195840.6,2 TRIS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC ,,,73425.85,73425.85,2 TRIS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH ",,,138032.4,138032.4,2 TRIS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC ",,,107792.4,107792.4,2 TRIS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT ,,,69971.8,69971.8,2 TRIS-DRG,006,LIVER TRANSPLANT WITHOUT MCC ,,,31871.01,31871.01,2 TRIS-DRG,007,LUNG TRANSPLANT ,,,82845.83,82845.83,2 TRIS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT ,,,36315.68,36315.68,2 TRIS-DRG,010,PANCREAS TRANSPLANT ,,,46495.7,46495.7,2 TRIS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC ",,,44397.7,44397.7,2 TRIS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC ",,,25013.11,25013.11,2 TRIS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC ",,,17255.07,17255.07,2 TRIS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT ,,,70716.66,70716.66,2 TRIS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC ,,,35591.25,35591.25,2 TRIS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC ,,,35199.55,35199.55,2 TRIS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES ,,,222795.3,222795.3,2 TRIS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS ,,,46229.51,46229.51,2 TRIS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC ,,,57706.62,57706.62,2 TRIS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC ,,,34744.23,34744.23,2 TRIS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ ,,,20588.29,20588.29,2 TRIS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI ,,,39920.92,39920.92,2 TRIS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI ,,,25440.42,25440.42,2 TRIS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC ,,,24693.22,24693.22,2 TRIS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC ,,,19389.26,19389.26,2 TRIS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC ,,,15611.81,15611.81,2 TRIS-DRG,028,SPINAL PROCEDURES WITH MCC ,,,26537.87,26537.87,2 TRIS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS ,,,15465.29,15465.29,2 TRIS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC ,,,11600.28,11600.28,2 TRIS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC ,,,18637.97,18637.97,2 TRIS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC ,,,12234.24,12234.24,2 TRIS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC ,,,10390.75,10390.75,2 TRIS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC ,,,25080.83,25080.83,2 TRIS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC ,,,13203.26,13203.26,2 TRIS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC ,,,10391.34,10391.34,2 TRIS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC ,,,27225.52,27225.52,2 TRIS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC ,,,13238.87,13238.87,2 TRIS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC ,,,9642.97,9642.97,2 TRIS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC ",,,18723.2,18723.2,2 TRIS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE ",,,13930.61,13930.61,2 TRIS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC ",,,10023.57,10023.57,2 TRIS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC ,,,16812.59,16812.59,2 TRIS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC ,,,4991.65,4991.65,2 TRIS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC* ,,,10198.12,10198.12,2 TRIS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC* ,,,5092.05,5092.05,2 TRIS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC ,,,12984.36,12984.36,2 TRIS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC ,,,8797.7,8797.7,2 TRIS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC ,,,15504.4,15504.4,2 TRIS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC ,,,8230.29,8230.29,2 TRIS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC ,,,5885.95,5885.95,2 TRIS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,11935.36,11935.36,2 TRIS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,11176.48,11176.48,2 TRIS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A ",,,9527.39,9527.39,2 TRIS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC ,,,13500.97,13500.97,2 TRIS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS ,,,6927.95,6927.95,2 TRIS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC ,,,5100.81,5100.81,2 TRIS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC ,,,9516.88,9516.88,2 TRIS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC ,,,6296.33,6296.33,2 TRIS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC ,,,4838.12,4838.12,2 TRIS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC* ,,,9090.74,9090.74,2 TRIS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC* ,,,5169.11,5169.11,2 TRIS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC* ,,,3954.32,3954.32,2 TRIS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC ,,,10308.44,10308.44,2 TRIS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC ,,,4863.81,4863.81,2 TRIS-DRG,075,VIRAL MENINGITIS WITH CC/MCC ,,,5944.33,5944.33,2 TRIS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC ,,,2903.57,2903.57,2 TRIS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC ,,,6416.0,6416.0,2 TRIS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC ,,,4921.01,4921.01,2 TRIS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC ,,,10403.01,10403.01,2 TRIS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC ,,,7769.13,7769.13,2 TRIS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC ,,,5869.02,5869.02,2 TRIS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC ,,,11056.23,11056.23,2 TRIS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC ,,,6488.97,6488.97,2 TRIS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC ,,,5357.66,5357.66,2 TRIS-DRG,088,CONCUSSION WITH MCC ,,,8759.17,8759.17,2 TRIS-DRG,089,CONCUSSION WITH CC ,,,9140.36,9140.36,2 TRIS-DRG,090,CONCUSSION WITHOUT CC/MCC ,,,9882.31,9882.31,2 TRIS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC* ,,,9359.27,9359.27,2 TRIS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC* ,,,5674.64,5674.64,2 TRIS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC* ,,,4700.94,4700.94,2 TRIS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC ,,,23706.09,23706.09,2 TRIS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC ,,,15233.54,15233.54,2 TRIS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC ,,,15263.32,15263.32,2 TRIS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC ,,,18546.91,18546.91,2 TRIS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC ,,,11345.77,11345.77,2 TRIS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC ,,,9836.77,9836.77,2 TRIS-DRG,100,SEIZURES WITH MCC ,,,9580.51,9580.51,2 TRIS-DRG,101,SEIZURES WITHOUT MCC ,,,4382.8,4382.8,2 TRIS-DRG,102,HEADACHES WITH MCC* ,,,9379.11,9379.11,2 TRIS-DRG,103,HEADACHES WITHOUT MCC* ,,,5159.77,5159.77,2 TRIS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC ,,,17410.35,17410.35,2 TRIS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC ,,,8766.76,8766.76,2 TRIS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT ,,,9945.35,9945.35,2 TRIS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC ,,,12039.26,12039.26,2 TRIS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC ,,,7029.52,7029.52,2 TRIS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC ,,,2184.39,2184.39,2 TRIS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC ,,,3452.88,3452.88,2 TRIS-DRG,123,NEUROLOGICAL EYE DISORDERS ,,,4309.24,4309.24,2 TRIS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT ,,,8572.95,8572.95,2 TRIS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC ,,,3952.57,3952.57,2 TRIS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC ,,,14060.79,14060.79,2 TRIS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC ,,,6578.86,6578.86,2 TRIS-DRG,137,MOUTH PROCEDURES WITH CC/MCC ,,,6652.42,6652.42,2 TRIS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC ,,,4693.35,4693.35,2 TRIS-DRG,139,SALIVARY GLAND PROCEDURES ,,,8006.72,8006.72,2 TRIS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC ,,,2874.97,2874.97,2 TRIS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC ,,,2158.71,2158.71,2 TRIS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC ,,,9687.92,9687.92,2 TRIS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC ",,,8154.41,8154.41,2 TRIS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC ",,,5164.44,5164.44,2 TRIS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC ",,,2911.75,2911.75,2 TRIS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC* ",,,13719.88,13719.88,2 TRIS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC* ",,,8239.05,8239.05,2 TRIS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC* ",,,5165.02,5165.02,2 TRIS-DRG,149,DYSEQUILIBRIUM ,,,4544.49,4544.49,2 TRIS-DRG,150,EPISTAXIS WITH MCC ,,,8627.83,8627.83,2 TRIS-DRG,151,EPISTAXIS WITHOUT MCC ,,,3604.66,3604.66,2 TRIS-DRG,152,OTITIS MEDIA AND URI WITH MCC ,,,3834.66,3834.66,2 TRIS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC ,,,2533.48,2533.48,2 TRIS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC ",,,5431.8,5431.8,2 TRIS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC ",,,3564.38,3564.38,2 TRIS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC ",,,2876.14,2876.14,2 TRIS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC ,,,9078.48,9078.48,2 TRIS-DRG,158,DENTAL AND ORAL DISEASES WITH CC ,,,3825.9,3825.9,2 TRIS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC ,,,2921.67,2921.67,2 TRIS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC ,,,25278.72,25278.72,2 TRIS-DRG,164,MAJOR CHEST PROCEDURES WITH CC ,,,13976.15,13976.15,2 TRIS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC ,,,11901.5,11901.5,2 TRIS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC ,,,23596.35,23596.35,2 TRIS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC ,,,10947.07,10947.07,2 TRIS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,9356.35,9356.35,2 TRIS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY ,,,19285.94,19285.94,2 TRIS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE ,,,6052.91,6052.91,2 TRIS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC ,,,3878.44,3878.44,2 TRIS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC* ,,,7830.43,7830.43,2 TRIS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC* ,,,4379.29,4379.29,2 TRIS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC* ,,,3539.86,3539.86,2 TRIS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC ,,,10466.64,10466.64,2 TRIS-DRG,181,RESPIRATORY NEOPLASMS WITH CC ,,,6540.34,6540.34,2 TRIS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC ,,,4884.24,4884.24,2 TRIS-DRG,183,MAJOR CHEST TRAUMA WITH MCC ,,,5362.91,5362.91,2 TRIS-DRG,184,MAJOR CHEST TRAUMA WITH CC ,,,5008.58,5008.58,2 TRIS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC ,,,5102.56,5102.56,2 TRIS-DRG,186,PLEURAL EFFUSION WITH MCC ,,,7654.13,7654.13,2 TRIS-DRG,187,PLEURAL EFFUSION WITH CC ,,,4998.65,4998.65,2 TRIS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC ,,,3564.96,3564.96,2 TRIS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE ,,,4404.98,4404.98,2 TRIS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC* ,,,5809.48,5809.48,2 TRIS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC* ,,,4380.46,4380.46,2 TRIS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC* ,,,3221.72,3221.72,2 TRIS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC* ,,,5789.63,5789.63,2 TRIS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC* ,,,4100.26,4100.26,2 TRIS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC* ,,,2914.66,2914.66,2 TRIS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC ,,,8578.79,8578.79,2 TRIS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC ,,,5363.5,5363.5,2 TRIS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC ,,,4640.81,4640.81,2 TRIS-DRG,199,PNEUMOTHORAX WITH MCC ,,,6529.25,6529.25,2 TRIS-DRG,200,PNEUMOTHORAX WITH CC ,,,4033.13,4033.13,2 TRIS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC ,,,2667.16,2667.16,2 TRIS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC ,,,4045.97,4045.97,2 TRIS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC ,,,3291.18,3291.18,2 TRIS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS ,,,3797.88,3797.88,2 TRIS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC ,,,6188.92,6188.92,2 TRIS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC ,,,3876.68,3876.68,2 TRIS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS ,,,38277.67,38277.67,2 TRIS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS ,,,12073.12,12073.12,2 TRIS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES ,,,4526.98,4526.98,2 TRIS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES ,,,4376.96,4376.96,2 TRIS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES ,,,36978.82,36978.82,2 TRIS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT ,,,39592.86,39592.86,2 TRIS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,60858.29,60858.29,2 TRIS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,46189.82,46189.82,2 TRIS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA ,,,42605.59,42605.59,2 TRIS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,40004.4,40004.4,2 TRIS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,30072.47,30072.47,2 TRIS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER ,,,29561.69,29561.69,2 TRIS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC ,,,33367.74,33367.74,2 TRIS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC ,,,21340.74,21340.74,2 TRIS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC ,,,54622.67,54622.67,2 TRIS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC ,,,39283.47,39283.47,2 TRIS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC ,,,48828.95,48828.95,2 TRIS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC ,,,37135.85,37135.85,2 TRIS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC ,,,36721.39,36721.39,2 TRIS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC ,,,27366.21,27366.21,2 TRIS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC ,,,29015.89,29015.89,2 TRIS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC ,,,28581.58,28581.58,2 TRIS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC ,,,8970.49,8970.49,2 TRIS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC ,,,20707.95,20707.95,2 TRIS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC ,,,13851.22,13851.22,2 TRIS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC ,,,11843.71,11843.71,2 TRIS-DRG,245,AICD GENERATOR PROCEDURES ,,,29562.86,29562.86,2 TRIS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC ,,,13704.7,13704.7,2 TRIS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC ,,,10631.84,10631.84,2 TRIS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC ,,,24995.02,24995.02,2 TRIS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC ,,,15576.79,15576.79,2 TRIS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC ,,,10950.57,10950.57,2 TRIS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC ,,,17478.06,17478.06,2 TRIS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC ,,,11001.94,11001.94,2 TRIS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC ,,,7076.8,7076.8,2 TRIS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC ,,,20359.46,20359.46,2 TRIS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC ,,,13102.27,13102.27,2 TRIS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC ,,,14603.68,14603.68,2 TRIS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC ,,,11919.59,11919.59,2 TRIS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC ,,,8506.41,8506.41,2 TRIS-DRG,263,VEIN LIGATION AND STRIPPING ,,,18427.83,18427.83,2 TRIS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES ,,,17117.31,17117.31,2 TRIS-DRG,265,AICD LEAD PROCEDURES ,,,23444.57,23444.57,2 TRIS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC ,,,23790.74,23790.74,2 TRIS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC ,,,2220.59,2220.59,2 TRIS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC ,,,10440.96,10440.96,2 TRIS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC ,,,2834.11,2834.11,2 TRIS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC ,,,2618.12,2618.12,2 TRIS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC ,,,2661.9,2661.9,2 TRIS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC ,,,14319.98,14319.98,2 TRIS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC ,,,20078.09,20078.09,2 TRIS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC ,,,21685.73,21685.73,2 TRIS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC ,,,54446.38,54446.38,2 TRIS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR ,,,21560.23,21560.23,2 TRIS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC ,,,33637.44,33637.44,2 TRIS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES ,,,21496.6,21496.6,2 TRIS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES ,,,14088.23,14088.23,2 TRIS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC ",,,8619.66,8619.66,2 TRIS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC ",,,6172.57,6172.57,2 TRIS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC ",,,5676.39,5676.39,2 TRIS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC ",,,16359.6,16359.6,2 TRIS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC ",,,4484.95,4484.95,2 TRIS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC ",,,3880.77,3880.77,2 TRIS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC ",,,12237.74,12237.74,2 TRIS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC ",,,6937.87,6937.87,2 TRIS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC ,,,17535.27,17535.27,2 TRIS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC ,,,11060.31,11060.31,2 TRIS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC ,,,6024.3,6024.3,2 TRIS-DRG,291,HEART FAILURE AND SHOCK WITH MCC* ,,,5927.98,5927.98,2 TRIS-DRG,292,HEART FAILURE AND SHOCK WITH CC* ,,,3675.29,3675.29,2 TRIS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC* ,,,2110.84,2110.84,2 TRIS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC ",,,10329.46,10329.46,2 TRIS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC ",,,4107.85,4107.85,2 TRIS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC ",,,2949.11,2949.11,2 TRIS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC ,,,6473.79,6473.79,2 TRIS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC ,,,5015.0,5015.0,2 TRIS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC ,,,3802.55,3802.55,2 TRIS-DRG,302,ATHEROSCLEROSIS WITH MCC ,,,7313.22,7313.22,2 TRIS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC ,,,3344.89,3344.89,2 TRIS-DRG,304,HYPERTENSION WITH MCC ,,,7328.98,7328.98,2 TRIS-DRG,305,HYPERTENSION WITHOUT MCC ,,,3681.13,3681.13,2 TRIS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC ,,,8236.72,8236.72,2 TRIS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC ,,,5438.8,5438.8,2 TRIS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC ,,,5693.9,5693.9,2 TRIS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC ,,,3138.82,3138.82,2 TRIS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC ,,,2721.44,2721.44,2 TRIS-DRG,311,ANGINA PECTORIS ,,,3392.17,3392.17,2 TRIS-DRG,312,SYNCOPE AND COLLAPSE ,,,4059.98,4059.98,2 TRIS-DRG,313,CHEST PAIN ,,,3848.08,3848.08,2 TRIS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC ,,,11888.07,11888.07,2 TRIS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC ,,,4875.48,4875.48,2 TRIS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,3553.87,3553.87,2 TRIS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION ,,,34544.0,34544.0,2 TRIS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE ,,,29944.63,29944.63,2 TRIS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC ,,,28917.82,28917.82,2 TRIS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC ,,,15585.55,15585.55,2 TRIS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A ,,,16905.99,16905.99,2 TRIS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,13709.37,13709.37,2 TRIS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC ,,,30683.66,30683.66,2 TRIS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,24107.13,24107.13,2 TRIS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE ,,,20801.94,20801.94,2 TRIS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC ",,,25093.08,25093.08,2 TRIS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC ",,,17546.95,17546.95,2 TRIS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC ",,,11524.4,11524.4,2 TRIS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC ,,,20933.28,20933.28,2 TRIS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC ,,,14489.85,14489.85,2 TRIS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC ,,,11496.38,11496.38,2 TRIS-DRG,332,RECTAL RESECTION WITH MCC ,,,23460.92,23460.92,2 TRIS-DRG,333,RECTAL RESECTION WITH CC ,,,15068.93,15068.93,2 TRIS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC ,,,14348.58,14348.58,2 TRIS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC ,,,15914.78,15914.78,2 TRIS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC ,,,11316.0,11316.0,2 TRIS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC ,,,8997.34,8997.34,2 TRIS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC ,,,16735.53,16735.53,2 TRIS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC ,,,9012.52,9012.52,2 TRIS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC ,,,6442.85,6442.85,2 TRIS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC ,,,14874.54,14874.54,2 TRIS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC ,,,7361.09,7361.09,2 TRIS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC ,,,5188.95,5188.95,2 TRIS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC ,,,16146.53,16146.53,2 TRIS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC ,,,11180.57,11180.57,2 TRIS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC ,,,11532.57,11532.57,2 TRIS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC ,,,14732.1,14732.1,2 TRIS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC ,,,11017.7,11017.7,2 TRIS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC ,,,8832.14,8832.14,2 TRIS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC ,,,19400.35,19400.35,2 TRIS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC ,,,12238.32,12238.32,2 TRIS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,8335.37,8335.37,2 TRIS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC ,,,22280.58,22280.58,2 TRIS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC ,,,44897.98,44897.98,2 TRIS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC* ,,,6635.49,6635.49,2 TRIS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC* ,,,4770.41,4770.41,2 TRIS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC* ,,,4106.1,4106.1,2 TRIS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC* ,,,8072.68,8072.68,2 TRIS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC* ,,,4560.84,4560.84,2 TRIS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC* ,,,3070.53,3070.53,2 TRIS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC ,,,11517.97,11517.97,2 TRIS-DRG,375,DIGESTIVE MALIGNANCY WITH CC ,,,6680.44,6680.44,2 TRIS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC ,,,5989.28,5989.28,2 TRIS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC ,,,8472.55,8472.55,2 TRIS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC ,,,5117.74,5117.74,2 TRIS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC ,,,3085.7,3085.7,2 TRIS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC ,,,14249.93,14249.93,2 TRIS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC ,,,5941.99,5941.99,2 TRIS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC ,,,4191.33,4191.33,2 TRIS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC ,,,8946.56,8946.56,2 TRIS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC ,,,5301.62,5301.62,2 TRIS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC ,,,7268.27,7268.27,2 TRIS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC ,,,5125.33,5125.33,2 TRIS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC ,,,3680.55,3680.55,2 TRIS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC* ,,,5093.8,5093.8,2 TRIS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC* ,,,3547.45,3547.45,2 TRIS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC* ,,,2640.89,2640.89,2 TRIS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC ",,,5976.43,5976.43,2 TRIS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC ",,,3829.4,3829.4,2 TRIS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC ,,,7772.05,7772.05,2 TRIS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC ,,,4831.7,4831.7,2 TRIS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,3714.4,3714.4,2 TRIS-DRG,397,APPENDIX PROCEDURES WITH MCC ,,,14814.41,14814.41,2 TRIS-DRG,398,APPENDIX PROCEDURES WITH CC ,,,16905.99,16905.99,2 TRIS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC ,,,11320.67,11320.67,2 TRIS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL ,,,7137.51,7137.51,2 TRIS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC ",,,30925.92,30925.92,2 TRIS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC ",,,18162.8,18162.8,2 TRIS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC ",,,13959.8,13959.8,2 TRIS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,14848.27,14848.27,2 TRIS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,17211.29,17211.29,2 TRIS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH ,,,8226.79,8226.79,2 TRIS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC ,,,21404.37,21404.37,2 TRIS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC ,,,10729.91,10729.91,2 TRIS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC ,,,14427.39,14427.39,2 TRIS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC ,,,23084.4,23084.4,2 TRIS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC ,,,14024.01,14024.01,2 TRIS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC ,,,12378.42,12378.42,2 TRIS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC ,,,12275.1,12275.1,2 TRIS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC ,,,11511.55,11511.55,2 TRIS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC ,,,9314.9,9314.9,2 TRIS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC ,,,16956.19,16956.19,2 TRIS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC ,,,14050.87,14050.87,2 TRIS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC ,,,9067.98,9067.98,2 TRIS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC ,,,65575.58,65575.58,2 TRIS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC ,,,14391.19,14391.19,2 TRIS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC ,,,9721.19,9721.19,2 TRIS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,10948.82,10948.82,2 TRIS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,8995.59,8995.59,2 TRIS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT ,,,6894.67,6894.67,2 TRIS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC ,,,58379.11,58379.11,2 TRIS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC ,,,36109.62,36109.62,2 TRIS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC* ,,,12805.14,12805.14,2 TRIS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC* ,,,5237.41,5237.41,2 TRIS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC* ,,,3936.81,3936.81,2 TRIS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC* ,,,10560.62,10560.62,2 TRIS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC* ,,,5994.53,5994.53,2 TRIS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC* ,,,5888.29,5888.29,2 TRIS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC* ,,,9945.94,9945.94,2 TRIS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC* ,,,4305.74,4305.74,2 TRIS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC* ,,,3050.68,3050.68,2 TRIS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC* ",,,9547.23,9547.23,2 TRIS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC* ",,,5611.59,5611.59,2 TRIS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C ",,,3441.21,3441.21,2 TRIS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC ,,,7902.81,7902.81,2 TRIS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC ,,,5806.56,5806.56,2 TRIS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC ,,,4331.43,4331.43,2 TRIS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL ,,,47483.41,47483.41,2 TRIS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC ,,,27236.62,27236.62,2 TRIS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY ,,,27774.83,27774.83,2 TRIS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC ,,,19552.13,19552.13,2 TRIS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,39344.18,39344.18,2 TRIS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,31625.25,31625.25,2 TRIS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX ",,,25626.63,25626.63,2 TRIS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC ,,,35786.8,35786.8,2 TRIS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC ,,,15594.3,15594.3,2 TRIS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,28813.32,28813.32,2 TRIS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,21007.42,21007.42,2 TRIS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE ,,,13136.71,13136.71,2 TRIS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC ,,,27846.05,27846.05,2 TRIS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC ,,,22524.58,22524.58,2 TRIS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC ,,,16399.29,16399.29,2 TRIS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC ,,,20008.04,20008.04,2 TRIS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT ,,,11425.16,11425.16,2 TRIS-DRG,471,CERVICAL SPINAL FUSION WITH MCC ,,,20912.27,20912.27,2 TRIS-DRG,472,CERVICAL SPINAL FUSION WITH CC ,,,17708.64,17708.64,2 TRIS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC ,,,14805.66,14805.66,2 TRIS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC ,,,63336.31,63336.31,2 TRIS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC ,,,11910.25,11910.25,2 TRIS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC ,,,5339.56,5339.56,2 TRIS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ,,,15287.25,15287.25,2 TRIS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC ,,,12555.88,12555.88,2 TRIS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC ,,,11883.4,11883.4,2 TRIS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC ,,,23197.65,23197.65,2 TRIS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC ,,,13465.95,13465.95,2 TRIS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC ,,,10594.48,10594.48,2 TRIS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES ,,,15877.42,15877.42,2 TRIS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC ,,,20910.52,20910.52,2 TRIS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC ,,,10802.88,10802.88,2 TRIS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC ,,,7531.55,7531.55,2 TRIS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC ,,,8222.7,8222.7,2 TRIS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC ,,,7755.7,7755.7,2 TRIS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC* ",,,23532.14,23532.14,2 TRIS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC* ",,,17670.7,17670.7,2 TRIS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC ",,,12323.55,12323.55,2 TRIS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,23493.03,23493.03,2 TRIS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,13154.23,13154.23,2 TRIS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT ,,,7292.21,7292.21,2 TRIS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC ,,,17026.82,17026.82,2 TRIS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT ,,,12259.34,12259.34,2 TRIS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC ,,,19796.14,19796.14,2 TRIS-DRG,501,SOFT TISSUE PROCEDURES WITH CC ,,,11058.56,11058.56,2 TRIS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC ,,,8313.77,8313.77,2 TRIS-DRG,503,FOOT PROCEDURES WITH MCC ,,,18085.16,18085.16,2 TRIS-DRG,504,FOOT PROCEDURES WITH CC ,,,9805.83,9805.83,2 TRIS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC ,,,8806.45,8806.45,2 TRIS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES ,,,8742.24,8742.24,2 TRIS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC ,,,11704.77,11704.77,2 TRIS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC ,,,9812.84,9812.84,2 TRIS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC ",,,20312.17,20312.17,2 TRIS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC ",,,17554.54,17554.54,2 TRIS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ ",,,9455.58,9455.58,2 TRIS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC ",,,8128.14,8128.14,2 TRIS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC ",,,6333.69,6333.69,2 TRIS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC ,,,19048.94,19048.94,2 TRIS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC ,,,13376.05,13376.05,2 TRIS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC ,,,11657.49,11657.49,2 TRIS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST ,,,16796.83,16796.83,2 TRIS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC ,,,13216.1,13216.1,2 TRIS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC ,,,10548.37,10548.37,2 TRIS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC ,,,18597.7,18597.7,2 TRIS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC ,,,15335.7,15335.7,2 TRIS-DRG,533,FRACTURES OF FEMUR WITH MCC ,,,10157.84,10157.84,2 TRIS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC ,,,3873.18,3873.18,2 TRIS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC ,,,8306.76,8306.76,2 TRIS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC ,,,4365.28,4365.28,2 TRIS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC ",,,6183.67,6183.67,2 TRIS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC ",,,4667.08,4667.08,2 TRIS-DRG,539,OSTEOMYELITIS WITH MCC* ,,,9912.66,9912.66,2 TRIS-DRG,540,OSTEOMYELITIS WITH CC* ,,,4595.28,4595.28,2 TRIS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC* ,,,4871.98,4871.98,2 TRIS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,10792.37,10792.37,2 TRIS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,7675.15,7675.15,2 TRIS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH ,,,3280.68,3280.68,2 TRIS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC ,,,19648.45,19648.45,2 TRIS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC ,,,8131.06,8131.06,2 TRIS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC ,,,5615.68,5615.68,2 TRIS-DRG,548,SEPTIC ARTHRITIS WITH MCC ,,,12511.52,12511.52,2 TRIS-DRG,549,SEPTIC ARTHRITIS WITH CC ,,,4988.15,4988.15,2 TRIS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC ,,,3575.47,3575.47,2 TRIS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC ,,,6638.99,6638.99,2 TRIS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC ,,,4229.27,4229.27,2 TRIS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC* ,,,8399.58,8399.58,2 TRIS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC* ,,,3645.52,3645.52,2 TRIS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ,,,8564.78,8564.78,2 TRIS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC ,,,4155.72,4155.72,2 TRIS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC ",,,6383.89,6383.89,2 TRIS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC ",,,2741.29,2741.29,2 TRIS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC ",,,9878.22,9878.22,2 TRIS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC ",,,9654.65,9654.65,2 TRIS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC ",,,6797.77,6797.77,2 TRIS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT ",,,7767.96,7767.96,2 TRIS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT ",,,4074.58,4074.58,2 TRIS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC* ,,,6832.8,6832.8,2 TRIS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC* ,,,5704.41,5704.41,2 TRIS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC* ,,,3940.31,3940.31,2 TRIS-DRG,570,SKIN DEBRIDEMENT WITH MCC ,,,15338.04,15338.04,2 TRIS-DRG,571,SKIN DEBRIDEMENT WITH CC ,,,8711.89,8711.89,2 TRIS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC ,,,10069.69,10069.69,2 TRIS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC ,,,42450.89,42450.89,2 TRIS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC ,,,22493.64,22493.64,2 TRIS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ,,,11644.06,11644.06,2 TRIS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC ,,,31757.76,31757.76,2 TRIS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC ,,,20208.85,20208.85,2 TRIS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC ,,,11006.03,11006.03,2 TRIS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC ",,,11656.91,11656.91,2 TRIS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC ",,,13048.57,13048.57,2 TRIS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC ",,,14125.0,14125.0,2 TRIS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC ,,,17664.86,17664.86,2 TRIS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC ,,,17035.58,17035.58,2 TRIS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC ",,,22603.97,22603.97,2 TRIS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC ",,,16977.21,16977.21,2 TRIS-DRG,592,SKIN ULCERS WITH MCC* ,,,12540.12,12540.12,2 TRIS-DRG,593,SKIN ULCERS WITH CC* ,,,5336.64,5336.64,2 TRIS-DRG,594,SKIN ULCERS WITHOUT CC/MCC* ,,,5616.26,5616.26,2 TRIS-DRG,595,MAJOR SKIN DISORDERS WITH MCC ,,,8599.81,8599.81,2 TRIS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC ,,,2465.18,2465.18,2 TRIS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC* ,,,7892.89,7892.89,2 TRIS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC* ,,,5202.38,5202.38,2 TRIS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC* ,,,4985.23,4985.23,2 TRIS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC ,,,2633.88,2633.88,2 TRIS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC ,,,2127.77,2127.77,2 TRIS-DRG,602,CELLULITIS WITH MCC ,,,6479.04,6479.04,2 TRIS-DRG,603,CELLULITIS WITHOUT MCC ,,,3466.89,3466.89,2 TRIS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC ",,,9538.48,9538.48,2 TRIS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC ",,,4340.18,4340.18,2 TRIS-DRG,606,MINOR SKIN DISORDERS WITH MCC ,,,6476.71,6476.71,2 TRIS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC ,,,2494.36,2494.36,2 TRIS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC ,,,13707.62,13707.62,2 TRIS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC ,,,8826.89,8826.89,2 TRIS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,20470.95,20470.95,2 TRIS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,9059.22,9059.22,2 TRIS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH ",,,9189.98,9189.98,2 TRIS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC ,,,25246.61,25246.61,2 TRIS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC ,,,11517.97,11517.97,2 TRIS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC ,,,10950.57,10950.57,2 TRIS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,29511.49,29511.49,2 TRIS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,8373.9,8373.9,2 TRIS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR ",,,8111.79,8111.79,2 TRIS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC ",,,19569.06,19569.06,2 TRIS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC ",,,9268.2,9268.2,2 TRIS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC ",,,8794.2,8794.2,2 TRIS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC ",,,15868.67,15868.67,2 TRIS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC ",,,11287.98,11287.98,2 TRIS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC ",,,9310.23,9310.23,2 TRIS-DRG,637,DIABETES WITH MCC ,,,6456.28,6456.28,2 TRIS-DRG,638,DIABETES WITH CC ,,,3597.07,3597.07,2 TRIS-DRG,639,DIABETES WITHOUT CC/MCC ,,,2615.2,2615.2,2 TRIS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M ",,,6768.0,6768.0,2 TRIS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU ",,,3484.41,3484.41,2 TRIS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM ,,,6627.9,6627.9,2 TRIS-DRG,643,ENDOCRINE DISORDERS WITH MCC ,,,7791.9,7791.9,2 TRIS-DRG,644,ENDOCRINE DISORDERS WITH CC ,,,4737.72,4737.72,2 TRIS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC ,,,3076.36,3076.36,2 TRIS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC ,,,12986.69,12986.69,2 TRIS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC ,,,96604.23,96604.23,2 TRIS-DRG,652,KIDNEY TRANSPLANT ,,,21300.46,21300.46,2 TRIS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC ,,,23754.54,23754.54,2 TRIS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC ,,,16424.39,16424.39,2 TRIS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC ,,,10853.08,10853.08,2 TRIS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC ,,,25822.19,25822.19,2 TRIS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC ,,,13992.49,13992.49,2 TRIS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC ,,,10877.6,10877.6,2 TRIS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC ,,,10359.81,10359.81,2 TRIS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC ,,,7170.2,7170.2,2 TRIS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC ,,,6882.41,6882.41,2 TRIS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC ,,,19837.58,19837.58,2 TRIS-DRG,663,MINOR BLADDER PROCEDURES WITH CC ,,,9850.2,9850.2,2 TRIS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC ,,,5679.89,5679.89,2 TRIS-DRG,665,PROSTATECTOMY WITH MCC ,,,20224.03,20224.03,2 TRIS-DRG,666,PROSTATECTOMY WITH CC ,,,11334.68,11334.68,2 TRIS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC ,,,7167.87,7167.87,2 TRIS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC ,,,18920.51,18920.51,2 TRIS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC ,,,10056.26,10056.26,2 TRIS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC ,,,6332.52,6332.52,2 TRIS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC ,,,11630.64,11630.64,2 TRIS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC ,,,6994.49,6994.49,2 TRIS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC ,,,23294.55,23294.55,2 TRIS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC ,,,13157.15,13157.15,2 TRIS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC ,,,9885.81,9885.81,2 TRIS-DRG,682,RENAL FAILURE WITH MCC* ,,,6874.24,6874.24,2 TRIS-DRG,683,RENAL FAILURE WITH CC* ,,,3970.67,3970.67,2 TRIS-DRG,684,RENAL FAILURE WITHOUT CC/MCC* ,,,2562.08,2562.08,2 TRIS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC ,,,14930.58,14930.58,2 TRIS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC ,,,6306.84,6306.84,2 TRIS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC ,,,5120.66,5120.66,2 TRIS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC ,,,6233.28,6233.28,2 TRIS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC ,,,3472.73,3472.73,2 TRIS-DRG,693,URINARY STONES WITH MCC ,,,8711.89,8711.89,2 TRIS-DRG,694,URINARY STONES WITHOUT MCC ,,,3442.96,3442.96,2 TRIS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC ,,,7411.29,7411.29,2 TRIS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC ,,,2778.65,2778.65,2 TRIS-DRG,697,URETHRAL STRICTURE ,,,6983.99,6983.99,2 TRIS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC ,,,7953.01,7953.01,2 TRIS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC ,,,5716.08,5716.08,2 TRIS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC ,,,4009.2,4009.2,2 TRIS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC ,,,16719.19,16719.19,2 TRIS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC ,,,12430.38,12430.38,2 TRIS-DRG,709,PENIS PROCEDURES WITH CC/MCC ,,,15078.85,15078.85,2 TRIS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC ,,,8675.11,8675.11,2 TRIS-DRG,711,TESTES PROCEDURES WITH CC/MCC ,,,13502.14,13502.14,2 TRIS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC ,,,6461.53,6461.53,2 TRIS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC ,,,9023.03,9023.03,2 TRIS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC ,,,6490.13,6490.13,2 TRIS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC ,,,14496.85,14496.85,2 TRIS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC ,,,9531.47,9531.47,2 TRIS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC ,,,12250.0,12250.0,2 TRIS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC ,,,5137.59,5137.59,2 TRIS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC ",,,11726.37,11726.37,2 TRIS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC ",,,7404.29,7404.29,2 TRIS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ",,,4248.53,4248.53,2 TRIS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC ,,,7582.33,7582.33,2 TRIS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC ,,,3740.67,3740.67,2 TRIS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC ,,,9608.53,9608.53,2 TRIS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC ,,,3212.96,3212.96,2 TRIS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC ,,,6860.23,6860.23,2 TRIS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC ,,,4354.19,4354.19,2 TRIS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC ",,,13801.61,13801.61,2 TRIS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC ",,,8718.31,8718.31,2 TRIS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC ,,,20932.7,20932.7,2 TRIS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC ,,,12551.8,12551.8,2 TRIS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC ,,,9489.44,9489.44,2 TRIS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC ,,,16629.29,16629.29,2 TRIS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC ,,,12290.86,12290.86,2 TRIS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT ,,,11593.86,11593.86,2 TRIS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC ,,,10006.06,10006.06,2 TRIS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC ,,,8434.61,8434.61,2 TRIS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC ",,,8335.37,8335.37,2 TRIS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC ",,,7061.63,7061.63,2 TRIS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC ",,,11427.49,11427.49,2 TRIS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC ",,,4781.5,4781.5,2 TRIS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES ,,,12353.91,12353.91,2 TRIS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC ,,,9681.5,9681.5,2 TRIS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC ,,,7848.52,7848.52,2 TRIS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC ",,,10036.42,10036.42,2 TRIS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC ",,,5399.1,5399.1,2 TRIS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC ",,,6223.94,6223.94,2 TRIS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC* ",,,7976.36,7976.36,2 TRIS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC* ",,,3510.67,3510.67,2 TRIS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC* ",,,3451.72,3451.72,2 TRIS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC ,,,3722.57,3722.57,2 TRIS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC ,,,2477.44,2477.44,2 TRIS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C ,,,3485.57,3485.57,2 TRIS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES ,,,7922.07,7922.07,2 TRIS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY ",,,5228.65,5228.65,2 TRIS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES ,,,2138.86,2138.86,2 TRIS-DRG,779,ABORTION WITHOUT D&C ,,,2326.83,2326.83,2 TRIS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC ,,,8293.92,8293.92,2 TRIS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC ,,,5472.07,5472.07,2 TRIS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC ,,,4554.42,4554.42,2 TRIS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC ,,,6713.13,6713.13,2 TRIS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC ,,,6855.56,6855.56,2 TRIS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY ",,,14436.73,14436.73,2 TRIS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE ",,,4374.04,4374.04,2 TRIS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS ,,,1797.37,1797.37,2 TRIS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS ,,,1293.01,1293.01,2 TRIS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS ,,,27017.71,27017.71,2 TRIS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS ,,,18061.81,18061.81,2 TRIS-DRG,795,NORMAL NEWBORN ,,,791.57,791.57,2 TRIS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC ,,,7561.9,7561.9,2 TRIS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC ,,,6481.96,6481.96,2 TRIS-DRG,799,SPLENIC PROCEDURES WITH MCC ,,,29345.71,29345.71,2 TRIS-DRG,800,SPLENIC PROCEDURES WITH CC ,,,14462.41,14462.41,2 TRIS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC ,,,12369.08,12369.08,2 TRIS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC ,,,63812.07,63812.07,2 TRIS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC ,,,13467.12,13467.12,2 TRIS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC ,,,8891.1,8891.1,2 TRIS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC ,,,3391.01,3391.01,2 TRIS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC ,,,2814.26,2814.26,2 TRIS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC ,,,2519.47,2519.47,2 TRIS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,14925.91,14925.91,2 TRIS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,5097.89,5097.89,2 TRIS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO ,,,3506.0,3506.0,2 TRIS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC ,,,7108.33,7108.33,2 TRIS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC ,,,3799.63,3799.63,2 TRIS-DRG,813,COAGULATION DISORDERS ,,,6695.03,6695.03,2 TRIS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC ,,,9506.37,9506.37,2 TRIS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC ,,,4885.4,4885.4,2 TRIS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC ,,,3113.72,3113.72,2 TRIS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC ,,,9223.84,9223.84,2 TRIS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC ,,,6870.74,6870.74,2 TRIS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,5295.2,5295.2,2 TRIS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC ,,,22688.04,22688.04,2 TRIS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC ,,,12238.32,12238.32,2 TRIS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC ,,,7951.85,7951.85,2 TRIS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC ,,,30588.51,30588.51,2 TRIS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC ,,,13381.31,13381.31,2 TRIS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC ,,,6871.32,6871.32,2 TRIS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,28771.88,28771.88,2 TRIS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,14319.39,14319.39,2 TRIS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. ,,,9187.06,9187.06,2 TRIS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE ,,,14362.01,14362.01,2 TRIS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE ,,,12491.09,12491.09,2 TRIS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC ,,,3778.61,3778.61,2 TRIS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC ,,,2608.78,2608.78,2 TRIS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC ,,,1777.52,1777.52,2 TRIS-DRG,834,ACUTE LEUKEMIA WITH MCC ,,,40394.34,40394.34,2 TRIS-DRG,835,ACUTE LEUKEMIA WITH CC ,,,14015.26,14015.26,2 TRIS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC ,,,14265.69,14265.69,2 TRIS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT ,,,18678.84,18678.84,2 TRIS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE ,,,8056.92,8056.92,2 TRIS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC ,,,7544.39,7544.39,2 TRIS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC* ,,,23415.97,23415.97,2 TRIS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC* ,,,10240.73,10240.73,2 TRIS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC* ,,,9455.0,9455.0,2 TRIS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,7278.2,7278.2,2 TRIS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,6166.74,6166.74,2 TRIS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES ,,,5518.19,5518.19,2 TRIS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC ,,,13668.51,13668.51,2 TRIS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC ,,,5962.42,5962.42,2 TRIS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC ,,,3284.18,3284.18,2 TRIS-DRG,849,RADIOTHERAPY ,,,17556.29,17556.29,2 TRIS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES ,,,51175.04,51175.04,2 TRIS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC ,,,25227.35,25227.35,2 TRIS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC ,,,9097.75,9097.75,2 TRIS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC ,,,5408.44,5408.44,2 TRIS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC* ,,,19612.84,19612.84,2 TRIS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC* ,,,9877.05,9877.05,2 TRIS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC* ,,,8245.47,8245.47,2 TRIS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC ,,,6860.82,6860.82,2 TRIS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC ,,,4190.74,4190.74,2 TRIS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS ,,,4345.44,4345.44,2 TRIS-DRG,865,VIRAL ILLNESS WITH MCC ,,,9606.78,9606.78,2 TRIS-DRG,866,VIRAL ILLNESS WITHOUT MCC ,,,3910.54,3910.54,2 TRIS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC ,,,11739.22,11739.22,2 TRIS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC ,,,5876.03,5876.03,2 TRIS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC ,,,3024.41,3024.41,2 TRIS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS ,,,46157.71,46157.71,2 TRIS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC ,,,8942.47,8942.47,2 TRIS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC ,,,4514.72,4514.72,2 TRIS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS ,,,25053.39,25053.39,2 TRIS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION ,,,3932.72,3932.72,2 TRIS-DRG,881,DEPRESSIVE NEUROSES ,,,2312.82,2312.82,2 TRIS-DRG,882,NEUROSES EXCEPT DEPRESSIVE ,,,3510.67,3510.67,2 TRIS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL ,,,6501.81,6501.81,2 TRIS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY ,,,11134.45,11134.45,2 TRIS-DRG,885,PSYCHOSES ,,,3497.25,3497.25,2 TRIS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS ,,,8268.24,8268.24,2 TRIS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES ,,,5775.04,5775.04,2 TRIS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA ",,,3235.14,3235.14,2 TRIS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY ",,,3637.35,3637.35,2 TRIS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC ",,,6432.93,6432.93,2 TRIS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC ,,,27192.25,27192.25,2 TRIS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC ,,,12102.31,12102.31,2 TRIS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC ,,,5236.82,5236.82,2 TRIS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC ,,,18388.71,18388.71,2 TRIS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC ,,,9612.03,9612.03,2 TRIS-DRG,906,HAND PROCEDURES FOR INJURIES ,,,8828.64,8828.64,2 TRIS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC* ,,,22045.91,22045.91,2 TRIS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC* ,,,9991.47,9991.47,2 TRIS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC* ,,,7083.23,7083.23,2 TRIS-DRG,913,TRAUMATIC INJURY WITH MCC ,,,10591.56,10591.56,2 TRIS-DRG,914,TRAUMATIC INJURY WITHOUT MCC ,,,4816.52,4816.52,2 TRIS-DRG,915,ALLERGIC REACTIONS WITH MCC ,,,9854.29,9854.29,2 TRIS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC ,,,2955.53,2955.53,2 TRIS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC* ,,,7669.31,7669.31,2 TRIS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC* ,,,3473.9,3473.9,2 TRIS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC* ,,,8487.73,8487.73,2 TRIS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC* ,,,4655.41,4655.41,2 TRIS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC* ,,,2658.98,2658.98,2 TRIS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC ",,,7776.72,7776.72,2 TRIS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC ",,,2879.64,2879.64,2 TRIS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT ,,,138343.5,138343.5,2 TRIS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC ,,,23619.12,23619.12,2 TRIS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC ,,,13290.24,13290.24,2 TRIS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT ,,,25233.19,25233.19,2 TRIS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY ,,,3986.43,3986.43,2 TRIS-DRG,935,NON-EXTENSIVE BURNS ,,,9472.51,9472.51,2 TRIS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC ,,,23511.12,23511.12,2 TRIS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC ,,,10237.23,10237.23,2 TRIS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ ,,,14680.15,14680.15,2 TRIS-DRG,945,REHABILITATION WITH CC/MCC ,,,10034.08,10034.08,2 TRIS-DRG,946,REHABILITATION WITHOUT CC/MCC ,,,7430.56,7430.56,2 TRIS-DRG,947,SIGNS AND SYMPTOMS WITH MCC ,,,5240.32,5240.32,2 TRIS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC ,,,4926.85,4926.85,2 TRIS-DRG,949,AFTERCARE WITH CC/MCC ,,,11782.41,11782.41,2 TRIS-DRG,950,AFTERCARE WITHOUT CC/MCC ,,,14970.27,14970.27,2 TRIS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS ,,,3328.54,3328.54,2 TRIS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA ,,,39345.34,39345.34,2 TRIS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA ",,,45166.5,45166.5,2 TRIS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC ,,,49477.5,49477.5,2 TRIS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC ,,,25607.37,25607.37,2 TRIS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC ,,,13993.08,13993.08,2 TRIS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC* ,,,16772.89,16772.89,2 TRIS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC* ,,,7960.02,7960.02,2 TRIS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC* ,,,6023.72,6023.72,2 TRIS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC ,,,39663.49,39663.49,2 TRIS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC ,,,17089.29,17089.29,2 TRIS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC ,,,11139.7,11139.7,2 TRIS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC ,,,5842.17,5842.17,2 TRIS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC ,,,5849.18,5849.18,2 TRIS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION ,,,8408.34,8408.34,2 TRIS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC ,,,28565.81,28565.81,2 TRIS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ,,,11290.9,11290.9,2 TRIS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,9653.48,9653.48,2 TRIS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC ,,,21832.84,21832.84,2 TRIS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC ,,,9021.86,9021.86,2 TRIS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC ,,,6200.01,6200.01,2